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Hayashi M, Shiraishi K, Yoshida S, Yatsuzuka K, Kohri N, Kuroo Y, Horie K, Muto J, Murakami M, Fujisawa Y. Cutaneous arteritis combined with antiphospholipid syndrome associated with the use of immune checkpoint inhibitors in a patient with a metastatic lung adenocarcinoma. J Dermatol 2024; 51:e166-e167. [PMID: 38063285 DOI: 10.1111/1346-8138.17063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/01/2023] [Accepted: 11/16/2023] [Indexed: 05/03/2024]
Affiliation(s)
- Maiko Hayashi
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ken Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Satoshi Yoshida
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kazuki Yatsuzuka
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Nobushige Kohri
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuta Kuroo
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kenta Horie
- Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Toon, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yasuhiro Fujisawa
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
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Asamoto S, Sawada H, Muto J, Arai T, Kawamata T. Green Hospital as A New Standard in Japan: How far can Neurosurgery go in Japan? World Neurosurg 2024:S1878-8750(24)00659-4. [PMID: 38649025 DOI: 10.1016/j.wneu.2024.04.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Climate change is a significant challenge that the medical community must address. Hospitals are large facilities with high water and energy consumption, as well as high levels of waste generation, which makes it important to pursue green hospital initiatives. Neurosurgery requires substantial energy for surgeries and tests. METHODS Based on the keywords "Climate change," "green hospital," "neurosurgery," "energy consumption," "environmental impact" listed in this paper, we extracted representative manuscripts, and the practices employed in the authors' hospital were assessed. RESULTS The "Guidelines for Environmental Consideration in Hospitals" and "Guidelines for the Sustainability of Hospital Environments" have been developed; however, they are not implemented in most hospitals in Japan. Inhalational anaesthetics were found to contribute significantly to greenhouse gas emissions. Educating patients and staff and employing the "8 Rs" (rethink, refuse, reduce, reuse, recycle, research, renovation and revolution) showed promise in achieving green hospital standards. CONCLUSION The advent of 'green hospitals' in Japan is imminent. The active participation of neurosurgeons can play a crucial role in diminishing the environmental footprint of health care while simultaneously enhancing medical standards. Given the pressing challenges posed by climate change, there is a critical need for an overhaul of medical practices. It is imperative for neurosurgeons to pioneer the adoption of new, sustainable medical methodologies.
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Affiliation(s)
| | - Haruki Sawada
- Executive Director, Green Sports Alliance, Tokyo, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Medical University Hospital, Toyoake City, Japan
| | - Takashi Arai
- Department of Neurosurgery, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women's Medical University Hospital, Tokyo, Japan
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Kitahama Y, Shizuka H, Nakano Y, Ohara Y, Muto J, Tsuchida S, Motoyama D, Miyake H, Sakai K. Advancements and Challenges in Robot-Assisted Bone Processing in Neurosurgical Procedures. Neurospine 2024; 21:97-103. [PMID: 38569635 PMCID: PMC10992635 DOI: 10.14245/ns.2347164.582] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/05/2024] [Accepted: 02/18/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE Practical applications of nerve decompression using neurosurgical robots remain unexplored. Our ongoing research and development initiatives, utilizing industrial robots, aim to establish a secure and efficient neurosurgical robotic system. The principal objective of this study was to automate bone grinding, which is a pivotal component of neurosurgical procedures. METHODS To achieve this goal, we integrated an endoscope system into a manipulator and conducted precision bone machining using a neurosurgical drill, recording the grinding resistance values across 3 axes. Our study encompassed 2 core tasks: linear grinding, such as laminectomy, and cylindrical grinding, such as foraminotomy, with each task yielding unique measurement data. RESULTS In linear grinding, we observed a proportional increase in grinding resistance values in the machining direction with acceleration. This observation suggests that 3-axis resistance measurements are a valuable tool for gauging and predicting deep cortical penetration. However, problems occurred in cylindrical grinding, and a significant error of 10% was detected. The analysis revealed that multiple factors, including the tool tip efficiency, machining speed, teaching methods, and deflection in the robot arm and jig joints, contributed to this error. CONCLUSION We successfully measured the resistance exerted on the tool tip during bone machining with a robotic arm across 3 axes. The resistance ranged from 3 to 8 Nm, with the measurement conducted at a processing speed approximately twice that of manual surgery performed by a surgeon. During the simulation of foraminotomy under endoscopic grinding conditions, we encountered a -10% error margin.
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Affiliation(s)
- Yoshihiro Kitahama
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Mechanical Engineering, Shizuoka University, Hamamatsu, Japan
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Hiroo Shizuka
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Yuto Nakano
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Yukoh Ohara
- Department of Mechanical Engineering, Shizuoka University, Hamamatsu, Japan
| | - Jun Muto
- Spine Center, Fuji Toranomon Orthopedic Surgery Hospital, Gotenba, Japan
| | - Shuntaro Tsuchida
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
| | - Daisuke Motoyama
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideaki Miyake
- Departments by Donation Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Katsuhiko Sakai
- Department of Neurosurgery, Fujita Medical University, Toyoake, Japan
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Muto J, Tateya I, Nakatomi H, Uyama I, Hirose Y. Transoral Robotic-Assisted Neurosurgery for Skull Base and Upper Spine Lesions. Neurospine 2024; 21:106-115. [PMID: 38569637 PMCID: PMC10992650 DOI: 10.14245/ns.2448062.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The application of the da Vinci Surgical System in neurosurgery is limited due to technical difficulties requiring precise maneuvers and small instruments. This study details the advantages and disadvantages of robotics in neurosurgery and the reachable range of the transoral approach to lesions of the skull base and upper cervical spine. METHODS In a cadaver study, the da Vinci Xi robot, lacking haptic feedback, was utilized for sagittal and coronal approaches on 5 heads, facilitating dura suturing in 3, with a 30°-angled drill for bone removal. RESULTS Perfect exposure of all the nasopharyngeal sites, clivus, sellar, and choana, including the bilateral eustachian tubes, was achieved without any external incisions using this palatal split approach of transoral robotic surgery. The time required to perform a single stitch, knot, and complete single suture in robotic suturing of deep-seated were significantly less compared to manual suturing via the endonasal approach. CONCLUSION This is the first report to show the feasibility of suturing the dural defect in deep-seated lesions transorally and revealed that the limit of reach in the coronal plane via a transoral approach with incision of the soft palate is the foramen ovale. This preclinical investigation also showed that the transoral robotic approach is feasible for lesions extending from the sellar to the C2 in the sagittal plane. Refinement of robotic instruments for specific anatomic sites and future neurosurgical studies are needed to further demonstrate the feasibility and effectiveness of this system in treating benign and malignant skull base lesions.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - Ichiro Tateya
- Department of Otolaryngology-Head and Neck Surgery, Fujita Health University, Aichi, Japan
| | | | - Ichiro Uyama
- Department of General Surgery, Fujita Health University, Aichi, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
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Inoue T, Endo T, Muto J, Umebayashi D, Mitsuhara T, Shigekawa S, Kanematsu R, Iwasaki M, Takami T, Hida K, Mizuno M. Shorter survival time of adolescents and young adult patients than older adults with spinal cord glioblastoma: a multicenter study. J Neurosurg Spine 2024; 40:196-205. [PMID: 37976504 DOI: 10.3171/2023.9.spine23642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Cancers in adolescents and young adults (AYAs) (age 15-39 years) often present with unique characteristics and poor outcomes. To date, spinal cord glioblastoma, a rare tumor, remains poorly understood across all age groups, including AYAs. This comparative study aimed to investigate the clinical characteristics and outcomes of spinal cord glioblastoma in AYAs and older adults (age 40-74 years), given the limited availability of studies focusing on AYAs. METHODS Data from the Neurospinal Society of Japan's retrospective intramedullary tumor registry (2009-2020) were analyzed. Patients were dichotomized on the basis of age into AYAs and older adults. Univariate and multivariate Cox proportional hazards regression models were utilized to explore risk factors for overall survival (OS). RESULTS A total of 32 patients were included in the study, with a median (range) age of 43 (15-74) years. Of these, 14 (43.8%) were AYAs and 18 (56.2%) were older adults. The median OS was 11.0 months in AYAs and 32.0 months in older adults, and the 1-year OS rates were 42.9% and 66.7%, respectively, with AYAs having a significantly worse prognosis (p = 0.017). AYAs had worse preoperative Karnofsky Performance Status (KPS) than older patients (p = 0.037). Furthermore, AYAs had larger intramedullary tumors on admission (p = 0.027) and a significantly higher frequency of intracranial dissemination during the clinical course (p = 0.048). However, there were no significant differences in the degrees of surgical removal or postoperative radiochemotherapy between groups. The Cox proportional hazards regression model showed that AYAs (HR 3.53, 95% CI 1.17-10.64), intracranial dissemination (HR 4.30, 95% CI 1.29-14.36), and no radiation therapy (HR 57.34, 95% CI 6.73-488.39) were risk factors for mortality for patients of all ages. Worse preoperative KPS did not predict mortality in AYAs but did in older adults. The high incidence of intracranial dissemination may play an important role in the poor prognosis of AYAs, but further studies are needed. CONCLUSIONS The clinical characteristics of AYAs with spinal cord glioblastoma differ from those of older adults. The prognosis of AYAs was clearly worse than that of older adults. The devastating clinical course of spinal glioblastoma in AYAs was in line with those of other cancers in this age group.
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Affiliation(s)
- Tomoo Inoue
- 1Department of Neurosurgery, Saitama Red Cross Hospital, Saitama, Saitama, Japan
| | - Toshiki Endo
- 2Department of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Jun Muto
- 3Department of Neurosurgery, Fujita Health University, Nagoya, Aichi, Japan
| | - Daisuke Umebayashi
- 4Department of Neurosurgery, Kyoto Prefectural Hospital of Medicine, Kyoto, Kyoto, Japan
| | - Takafumi Mitsuhara
- 5Department of Neurosurgery, Hiroshima University Graduate School of Medicine, Hiroshima, Hiroshima, Japan
| | - Seiji Shigekawa
- 6Department of Neurosurgery, Ehime University, Ehime, Ehime, Japan
| | - Ryo Kanematsu
- 7Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan
| | - Motoyuki Iwasaki
- 8Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Toshihiro Takami
- 9Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Osaka, Osaka, Japan
| | - Kazutoshi Hida
- 10Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan; and
| | - Masaki Mizuno
- 11Department of Minimum Invasive Neurospinal Surgery, Mie University, Mie, Mie, Japan
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Planet M, Roux A, Elia A, Moiraghi A, Leclerc A, Aboubakr O, Bedioui A, Antonia Simboli G, Benzakoun J, Parraga E, Dezamis E, Muto J, Chrétien F, Oppenheim C, Turc G, Zanello M, Pallud J. Presentation and Management of Cerebral Venous Sinus Thrombosis After Supratentorial Craniotomy. Neurosurgery 2024:00006123-990000000-01018. [PMID: 38206001 DOI: 10.1227/neu.0000000000002825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 11/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cerebral venous sinus thrombosis (CVST) after supratentorial craniotomy is a poorly studied complication, for which there are no management guidelines. This study assessed the incidence, associated risk factors, and management of postoperative CVST after awake craniotomy. METHODS This is an observational, retrospective, monocentric analysis of patients who underwent a supratentorial awake craniotomy. Postoperative CVST was defined as a flow defect on the postoperative contrast-enhanced 3D T1-weighted sequence and/or as a T2* hypointensity within the sinus. RESULTS In 401 supratentorial awake craniotomies (87.3% of diffuse glioma), the incidence of postoperative CVST was 4.0% (95% CI 2.5-6.4): 14/16 thromboses located in the superior sagittal sinus and 12/16 located in the transverse sinus. A venous sinus was exposed during craniotomy in 45.4% of cases, and no intraoperative injury to a cerebral venous sinus was reported. All thromboses were asymptomatic, and only two cases were diagnosed at the time of the first postoperative imaging (0.5%). Postoperative complications, early postoperative Karnofsky Performance Status score, and duration of hospital stay did not significantly differ between patients with and without postoperative CVST. Adjusted independent risk factors of postoperative CVST were female sex (adjusted Odds Ratio 4.00, 95% CI 1.24-12.91, P = .021) and a lesion ≤1 cm to a venous sinus (adjusted Odds Ratio 10.58, 95% CI 2.93-38.20, P < .001). All patients received standard prophylactic-dose anticoagulant therapy, and none received treatment-dose anticoagulant therapy. No thrombosis-related adverse event was reported. All thromboses presented spontaneous sinus recanalization radiologically at a mean of 89 ± 41 days (range, 7-171). CONCLUSION CVST after supratentorial awake craniotomy is a rare event with satisfactory clinical outcomes and spontaneous sinus recanalization under conservative management without treatment-dose anticoagulant therapy. These findings are comforting to neurosurgeons confronted with postoperative MRI reports suggesting CVST.
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Affiliation(s)
- Martin Planet
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Alexandre Roux
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Angela Elia
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Alessandro Moiraghi
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Arthur Leclerc
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
- Department of Neurosurgery, Caen University Hospital, Caen, France
- Normandy University, Unicaen, ISTCT/CERVOxy Group, UMR6030, GIP CYCERON, Caen, France
| | - Oumaima Aboubakr
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Aziz Bedioui
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Giorgia Antonia Simboli
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Joseph Benzakoun
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
- Department of Neuroradiology, GHU Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, France
| | - Eduardo Parraga
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Edouard Dezamis
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - Fabrice Chrétien
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
- Department of Neuropathology, GHU Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, France
| | - Catherine Oppenheim
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
- Department of Neuroradiology, GHU Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, France
| | - Guillaume Turc
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
- Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Site Sainte Anne, Paris, France
- FHU Neurovasc, Paris, France
| | - Marc Zanello
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
| | - Johan Pallud
- Department of Neurosurgery, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris, France
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Yatsuzuka K, Kawakami R, Niko Y, Tsuda T, Kameda K, Kohri N, Yoshida S, Shiraishi K, Muto J, Mori H, Fujisawa Y, Imamura T, Murakami M. A fluorescence imaging technique suggests that sweat leakage in the epidermis contributes to the pathomechanism of palmoplantar pustulosis. Sci Rep 2024; 14:378. [PMID: 38172327 PMCID: PMC10764317 DOI: 10.1038/s41598-023-50875-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
Sweat is an essential protection system for the body, but its failure can result in pathologic conditions, including several skin diseases, such as palmoplantar pustulosis (PPP). As reduced intraepidermal E-cadherin expression in skin lesions was confirmed in PPP skin lesions, a role for interleukin (IL)-1-rich sweat in PPP has been proposed, and IL-1 has been implicated in the altered E-cadherin expression observed in both cultured keratinocytes and mice epidermis. For further investigation, live imaging of sweat perspiration on a mouse toe-pad under two-photon excitation microscopy was performed using a novel fluorescent dye cocktail (which we named JSAC). Finally, intraepidermal vesicle formation which is the main cause of PPP pathogenesis was successfully induced using our "LASER-snipe" technique with JSAC. "LASER-snipe" is a type of laser ablation technique that uses two-photon absorption of fluorescent material to destroy a few acrosyringium cells at a pinpoint location in three-dimensional space of living tissue to cause eccrine sweat leakage. These observatory techniques and this mouse model may be useful not only in live imaging for physiological phenomena in vivo such as PPP pathomechanism investigation, but also for the field of functional physiological morphology.
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Affiliation(s)
- Kazuki Yatsuzuka
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ryosuke Kawakami
- Department of Molecular Medicine for Pathogenesis, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yosuke Niko
- Research and Education Faculty, Multidisciplinary Science Cluster, Interdisciplinary Science Unit, Kochi University, Kochi, Japan
| | - Teruko Tsuda
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Kenji Kameda
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Nobushige Kohri
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Satoshi Yoshida
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ken Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hideki Mori
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yasuhiro Fujisawa
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Takeshi Imamura
- Department of Molecular Medicine for Pathogenesis, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan.
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Fujisawa H, Takeuchi T, Ishii A, Muto J, Kamasaki H, Suzuki A, Sugimura Y. Absence of anti-rabphilin-3A antibodies in children and young adults with idiopathic central diabetes insipidus: a potential clue to elucidating a tumor etiology. Hormones (Athens) 2023; 22:747-758. [PMID: 37697216 PMCID: PMC10651553 DOI: 10.1007/s42000-023-00484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 08/31/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Central diabetes insipidus (CDI) is a rare condition caused by various underlying diseases, including neoplasms, autoimmune diseases, and infiltrative diseases. Differentiating between CDI etiologies is difficult. What has initially been classified as "idiopathic" central diabetes insipidus might in fact underlie various pathogenic mechanisms that are less understood to date and/or are not obvious at initial presentation. Therefore, even if idiopathic CDI is diagnosed at the time of onset, it is common for tumors such as germinoma to develop during surveillance. Crucially, a delayed diagnosis of germinoma may be associated with a worse prognosis. Recently, the presence of anti-rabphilin-3A antibodies has been found to be a highly sensitive and specific marker of lymphocytic infundibuloneurohypophysitis, an autoimmune-mediated CDI. CASE PRESENTATION We herein present two cases, namely, a 13-year-old boy (patient 1) and a 19-year-old young man (patient 2) who were diagnosed with idiopathic CDI. In both patients, panhypopituitarism developed. Magnetic resonance imaging revealed pituitary stalk thickening and pituitary swelling approximately 1 1/2 years after the onset of CDI. Western blotting did not reveal the presence of anti-rabphilin-3A antibodies in serum in either patient, suggesting that autoimmune mechanisms might not be involved. Both patients were subsequently diagnosed with germinoma on pathological examination. They received chemotherapy, followed by radiation therapy. Notably, testosterone and insulin-like growth factor-1 levels normalized, and libido and beard growth recovered after chemoradiotherapy in patient 2. CONCLUSION Our data suggest that the absence of anti-rabphilin-3A antibodies in young patients clinically diagnosed with idiopathic CDI may increase the probability of the development of non-lymphocytic lesions, including germinoma. We thus recommend a more attentive approach at the onset of these diseases.
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Affiliation(s)
- Haruki Fujisawa
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Takako Takeuchi
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Akira Ishii
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake, Aichi, 470-1192, Japan
| | - Hotaka Kamasaki
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Atsushi Suzuki
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan
| | - Yoshihisa Sugimura
- Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
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Shiiya H, Kaga K, Ujiie H, Fujiwara-Kuroda A, Muto J, Nomura S, Honda S, Kato T. Tumor-to-thoracic height ratio as an easy method to predict the feasibility of reduced-port video-assisted thoracic surgery for mediastinal lesions in children: a single-center experience. J Thorac Dis 2023; 15:5020-5028. [PMID: 37868880 PMCID: PMC10586945 DOI: 10.21037/jtd-23-515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/11/2023] [Indexed: 10/24/2023]
Abstract
In the last few decades, reduced-port video-assisted thoracic surgery (RP-VATS) has been developed to minimize surgical invasiveness. Nevertheless, VATS in children can occasionally be difficult because the lesion occupies a small thoracic cavity, limiting the working space. This study aimed to assess the feasibility of RP-VATS for the resection of mediastinal lesions in children in association with the tumor-to-thoracic height ratio (TTH ratio). We reviewed all patients aged ≤10 years who underwent resection for mediastinal lesions in our institute between January 2008 and August 2022. Patients who underwent diagnostic procedures were excluded from this study. The TTH ratio was calculated as tumor height divided by thoracic height. Seven patients in the RP-VATS group and six in the conventional procedures (multi-portal VATS or open surgery) group were included in this study. The TTH ratio was significantly lower in the RP-VATS group than in the conventional procedures group (median, 26.3% vs. 50.8%; P=0.007). The operating time (P=0.01) and duration of drainage (P=0.003) were significantly shorter and the blood loss (P=0.001) was significantly lower in the RP-VATS group than in the conventional procedures group. After adjusting for age, a lower TTH ratio was significantly associated with the completion of RP-VATS (odds ratio: 0.776; 95% confidence interval: 0.529-0.926; P=0.048). In conclusion, RP-VATS can be performed appropriately in carefully selected cases of pediatric mediastinal lesions. A low TTH ratio may predict the feasibility of RP-VATS. Further studies are warranted to determine the criteria for the indications of RP-VATS in children, so that more children can benefit from RP-VATS.
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Affiliation(s)
- Haruhiko Shiiya
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kichizo Kaga
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideki Ujiie
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Aki Fujiwara-Kuroda
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Jun Muto
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shunsuke Nomura
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shohei Honda
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tatsuya Kato
- Department of Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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10
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Kanematsu R, Mizuno M, Inoue T, Takahashi T, Endo T, Shigekawa S, Muto J, Umebayashi D, Mitsuhara T, Hida K, Hanakita J. The Impact of Adjuvant Radiotherapy on Clinical Performance Status in Patients With Grade II Spinal Cord Astrocytoma - A Nationwide Analysis by the Neurospinal Society of Japan. Neurospine 2023; 20:766-773. [PMID: 37798968 PMCID: PMC10562227 DOI: 10.14245/ns.2346386.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The impact of adjuvant radiotherapy on overall survival (OS) and progression-free survival (PFS) of patients with grade II spinal cord astrocytomas remains controversial. Additionally, the relationship between progression and clinical deterioration after radiotherapy has not been well investigated. METHODS This study included 53 patients with grade II intramedullary spinal cord astrocytomas treated by either subtotal, partial resection or open biopsy. Their clinical performance status was assessed immediately before operation and 1, 6, 12, 24, and 60 months after surgery by Karnofsky Performance Scale (KPS). Patients with and without adjuvant radiotherapy were compared. RESULTS The groups with and without radiation comprised 23 and 30 patients with a mean age of 50.3 ± 22.6 years (range, 2-88 years). The mean overall disease progression rate was 47.1% during a mean follow-up period of 48.4 ± 39.8 months (range, 2.5-144.5 months). In the radiation group, 11 patients (47.8%) presented with progressive disease, whereas 14 patients (46.7%) presented with progressive disease in the group without radiation. There were no significant differences in OS or PFS among patients with or without adjuvant radiotherapy. KPS in both groups, especially radiation group, gradually decreased after operation and deteriorated before the confirmation of disease progression. CONCLUSION Adjuvant radiotherapy did not show effectiveness regarding PFS or OS in patients with grade II spinal cord astrocytoma according to classical classification based on pathohistological findings.
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Affiliation(s)
| | - Masaki Mizuno
- Department of Minimum-Invasive Neurospinal Surgery, Mie University, Tsu city, Japan
| | - Tomoo Inoue
- Department of Neurosurgery, Saitama Red Cross Hospital, Saitama, Japan
| | | | - Toshiki Endo
- Division of Neurosurgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | - Daisuke Umebayashi
- Division of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Kazutoshi Hida
- Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Japan
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11
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Muto J, Murata H, Shigekawa S, Mitsuhara T, Umebayashi D, Kanematsu R, Joko M, Inoue T, Inoue T, Endo T, Hirose Y. Clinical Characteristics and Long-term Outcomes of Spinal Pilocytic Astrocytomas: A Multicenter Retrospective Study by the Neurospinal Society of Japan. Neurospine 2023; 20:774-782. [PMID: 37798969 PMCID: PMC10562249 DOI: 10.14245/ns.2346450.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The characteristics, imaging features, long-term surgical outcomes, and recurrence rates of primary spinal pilocytic astrocytomas (PAs) have not been clarified owing to their rarity and limited reports. Thus, this study aimed to analyze the clinical presentation, radiological features, pathological findings, and long-term outcomes of spinal PAs. METHODS Eighteen patients with spinal PAs who were surgically treated between 2009 and 2020 at 58 institutions were included in this retrospective multicenter study. Patient data, including demographics, radiographic features, treatment modalities, and long-term outcomes, were evaluated. RESULTS Among the 18 consecutive patients identified, 11 were women and 7 were men; the mean age at presentation was 31 years (3-73 years). Most PAs were located eccentrically, were solid or heterogeneous in appearance (cystic and solid), and had unclear margins. Gross total resection (GTR), subtotal resection (STR), partial resection (PR), and biopsy were performed in 28%, 33%, 33%, and 5% of cases, respectively. During a follow-up period of 65 ± 49 months, 4 patients developed a recurrence; however, the recurrence-free survival did not differ significantly between the GTR and non-GTR (STR, PR, and biopsy) groups. CONCLUSION Primary spinal PAs are rare and present as eccentric and intermixed cystic and solid intramedullary cervical tumors. The imaging features of spinal PAs are nonspecific, and a definitive diagnosis requires pathological support. Surgical resection with prevention of neurological deterioration can serve as the first-line treatment; however, the resection rate does not affect recurrence-free survival. Investigation of relevant molecular biomarkers is required to elucidate the regrowth risk and prognostic factors.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - Hidetoshi Murata
- Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama, Japan
| | | | | | - Daisuke Umebayashi
- Department of Neurosurgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Kanematsu
- Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
| | - Masahiro Joko
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - Tatsushi Inoue
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - Tomoo Inoue
- Department of Neurosurgery, Saitama Red Cross Hospital, Saitama, Japan
| | - Toshiki Endo
- Department of Neurosurgery, Tohoku Medical and Phamaceutical University, Sendai, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | - for the Investigators of Intramedullary Spinal Cord Tumors in the Neurospinal Society of Japan
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
- Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama, Japan
- Department of Neurosurgery, Ehime University, Ehime, Japan
- Department of Neurosurgery, Hiroshima University, Hiroshima, Japan
- Department of Neurosurgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Shizuoka, Japan
- Department of Neurosurgery, Saitama Red Cross Hospital, Saitama, Japan
- Department of Neurosurgery, Tohoku Medical and Phamaceutical University, Sendai, Japan
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Jayawickrama EG, Sekiguchi T, Muto J, Sawa S, Nagahama H, Kono Y, Bae KO, Shin HS. A split Hopkinson pressure bar for experimental investigation of dynamic pulverization under very high strain rates. Rev Sci Instrum 2023; 94:095110. [PMID: 37724930 DOI: 10.1063/5.0151448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/28/2023] [Indexed: 09/21/2023]
Abstract
Off-fault damage or pulverized rocks found in large-scale strike-slip faults are of great interest in earthquake research. In order to experimentally investigate rock pulverization, we developed a split Hopkinson pressure bar with compact dimensions and high-speed imaging. The developed experimental setup is capable of generating very high strain rates up to 1320 s-1 with the satisfaction of stress equilibrium, which are essential to reproduce the dynamic pulverization observed in nature and obtain dynamic stress-strain responses accurately. High-speed imaging revealed that cracks initiate and propagate along the grain boundaries at very high speeds, while the dynamic stress-strain response suggested that energy dissipated into the fracture increases with stronger impacts. In addition, we show that the apparatus is capable of producing particle size distributions partly similar to those in naturally pulverized rocks of large-scale strike-slip faults. Thus, our developed system with compact dimensions opens new ways to understand the dynamics of the rock pulverization in off-fault regions of large-scale strike-slip faults.
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Affiliation(s)
- Eranga Gayanath Jayawickrama
- Department of Earth Science, Graduate School of Science, Tohoku University, 6-3, Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8578, Japan
- Earth and Planetary Systems Science Program, Graduate School of Advanced Science and Engineering, Hiroshima University, 1-3-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8526, Japan
| | - Takuma Sekiguchi
- Department of Earth Science, Graduate School of Science, Tohoku University, 6-3, Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8578, Japan
| | - Jun Muto
- Department of Earth Science, Graduate School of Science, Tohoku University, 6-3, Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8578, Japan
| | - Sando Sawa
- Department of Earth Science, Graduate School of Science, Tohoku University, 6-3, Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8578, Japan
| | - Hiroyuki Nagahama
- Department of Earth Science, Graduate School of Science, Tohoku University, 6-3, Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8578, Japan
| | - Yoshio Kono
- Geodynamics Research Center, Ehime University, 2-5 Bunkyo-cho, Matsuyama, Ehime 790-8577, Japan
| | - Kyung-Oh Bae
- Korea Research Institute of Standards and Science (KRISS), 267 Gajeong-Ro, Yuseong-Gu, Daejeon 34113, Republic of Korea
- PRETECH CO., LTD. 403-2 Sannoucho, Inage-ku, Chiba, 263-0002, Japan
| | - Hyung-Seop Shin
- Department of Mechanical and Robotics Engineering, Andong National University, 1375, Gyeongdong-ro (SongCheon-dong), Andong, Gyeongsangbuk-do 36729, Republic of Korea
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13
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Muto J, Hirose Y. [Transoral Robot-Assisted Surgery for Pituitary Gland]. No Shinkei Geka 2023; 51:734-742. [PMID: 37491071 DOI: 10.11477/mf.1436204807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Robotic surgery has been introduced into various surgical fields and is expected to be useful in neurosurgery. Robotic surgery is a technology used to safely and reliably perform minimally invasive surgeries. There are three main types of robotic surgery in neurosurgery: 1)Aids to improve the performance and efficiency of stereotactic surgery; 2)Leader-follower types, such as Da Vinci and hinotori, which enable operations under endoscopy, surgical maneuvers in deep-seated lesions, and operations in areas that are difficult to reach with tools; and 3)Aids to assist the surgeon. Many neurosurgical procedures have shifted from microscopy to endoscopy. One such case is pituitary lesions, where transsphenoidal sinus surgery is currently performed. Originally, Hardy's surgery using microscopy was performed, whereas now endoscopic surgery is mainstream, with the possibility of robotic surgery being used in the near future. This report describes the history of the development of robots, including neurosurgery, the advantages and disadvantages of robotic surgery, and the DaVinci Xi approach to the pituitary gland.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University
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14
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Dai X, Shiraishi K, Muto J, Mori H, Murakami M, Sayama K. Nuclear IL-33 Plays an Important Role in EGFR-Mediated Keratinocyte Migration by Regulating the Activation of Signal Transducer and Activator of Transcription 3 and NF-κB. JID Innov 2023; 3:100205. [PMID: 37441125 PMCID: PMC10333683 DOI: 10.1016/j.xjidi.2023.100205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 07/15/2023] Open
Abstract
Nuclear IL-33 levels are high at the epidermal edges of skin wounds and facilitate wound healing. However, IL-33-mediated regulation of keratinocyte (KC) biology during wound healing remains poorly understood. During skin-wound healing, KC migration and re-epithelialization are mediated predominantly by EGFR signaling activation and depend on the function of signal transducer and activator of transcription 3 (STAT3). We found that migrating KCs at the leading edges of mouse skin wounds exhibited concomitant induction and nuclear colocalization of IL-33 and phosphorylated STAT3. In cultured human KCs, activation of EGFR signaling caused rapid elevation of nuclear IL-33, which directly interacts with phosphorylated STAT3, promoting STAT3 activation. In vitro KC migration and wound-healing assays revealed that high nuclear IL-33 levels were required for KC migration and wound closure. KC mobility associated with a lack of suprabasal epidermal keratins and extracellular matrix degradation mediated by matrix metalloproteinases (MMPs) control cell migration at the intracellular and extracellular levels, respectively. In EGFR-activated KCs, nuclear IL-33 mediated keratin 1 and 10 downregulation and MMP9 upregulation by promoting STAT3 activation and limited MMP1, MMP3, and MMP10 induction by suppressing NF-κB transactivation. Thus, epidermal nuclear IL-33 is involved in KC migration and wound closure by regulating the STAT3 and NF-κB pathways.
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Affiliation(s)
- Xiuju Dai
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ken Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hideki Mori
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Koji Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
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15
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Yokota M, Morikawa A, Matsuoka H, Muto J, Hashida K, Nagahisa Y, Masui T, Okabe M, Kitagawa H, Kawamoto K. Is frequent measurement of tumor markers beneficial for postoperative surveillance of colorectal cancer? Int J Colorectal Dis 2023; 38:75. [PMID: 36947196 DOI: 10.1007/s00384-023-04356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE To determine whether frequent measurement of tumor markers triggers early detection of colorectal cancer recurrence. METHODS Of 1,651 consecutive patients undergoing colorectal cancer surgery between 2010 and 2016, 1,050 were included. CEA and CA 19-9 were considered to be postoperative tumor markers and were measured every 3 months for 3 years, and then every 6 months for 2 years. Sensitivity analysis of elevated CEA and CA19-9 levels and multivariate analysis of factors associated with elevated CEA and CA19-9 levels were performed. The proportion of triggers for detecting recurrence was determined. RESULTS The median follow-up period was 5.3 years. After applying the exclusion criteria, 1,050 patients were analyzed, 176 (16.8%) of whom were found to have recurrence. After excluding patients with persistently elevated CEA and CA19-9 levels before and after surgery from the 176 patients, 71 (43.6%) of 163 patients had elevated CEA levels and 35 (20.2%) of 173 patients had elevated CA19-9 levels. Sensitivity/positive predictive values for elevated CEA and CA19-9 levels at recurrence were 43.6%/32.3% and 20.2%/32.4%, respectively. Lymph node metastasis was a factor associated with both elevated CEA and CA19-9 levels at recurrence. Of the 176 patients, computed tomography triggered the detection of recurrence in 137 (78%) and elevated tumor marker levels in 13 (7%); the diagnostic lead interval in the latter 13 patients was 1.7 months. CONCLUSION Tumor marker measurements in surveillance after radical colorectal cancer resection contribute little to early detection, and frequent measurements are unnecessary for stage I patients with low risk of recurrence.
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Affiliation(s)
- Mitsuru Yokota
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan.
| | - Akitaka Morikawa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Hiroya Matsuoka
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Jun Muto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Kazuki Hashida
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Yoshio Nagahisa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Toshihiko Masui
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Michio Okabe
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Hirohisa Kitagawa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
| | - Kazuyuki Kawamoto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710-8602, Japan
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16
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Muto J, Mine Y, Nishiyama Y, Murayama K, Hayakawa M, Hasegawa M, Lee JKY, Hirose Y. Intraoperative real-time near-infrared image-guided endoscopic endonasal surgery for pituitary tumors. World Neurosurg 2023:S1878-8750(23)00377-7. [PMID: 36924890 DOI: 10.1016/j.wneu.2023.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND For endoscopic endonasal surgery of pituitary tumors, tissue identification, and intraoperative judgment depend largely on the surgeons' expertise. OBJECTIVE This study aims to assess whether the delayed-window indocyanine green (ICG) (DWIG) technique can identify pituitary gland tumors in real-time during the surgery and analyze the mechanism of ICG fluorescence in pituitary gland and tumor. METHODS Twenty-five patients with pituitary adenoma were administered 12.5 mg ICG intravenously during the surgery. Thereafter, the near-infrared (NIR) visualization was performed from 0 to 180 min. Only eight patients underwent dynamic contrast enhanced (DCE) perfusion magnetic resonance imaging (MRI) due to the limitations of the insurance system. Consequently, we analyzed these eight patients extensively. RESULTS The pituitary gland and pituitary adenoma were visualized in all 25 patients with NIR fluorescence. The relative ratio of the fluorescence emission of the normal gland to that of the tumor (signal-to-background ratio [SBR] normal gland/tumor) increased after 15 min, peaking (5.8) at 90 min, demonstrating that the pituitary gland was distinctly visualized during that period. The tumor/blood (SBR tumor) and normal gland/ blood (SBR gland) NIR fluorescence was significantly positively correlated with each Ktrans on dynamic contrast-enhanced MRI, indicating vascular permeability. CONCLUSIONS This study exhibits the utility of DWIG in distinguishing the normal pituitary gland from a tumor during the endoscopic endonasal surgery from 15 to 90 min following the ICG administration. Permeability can contribute to gadolinium enhancement on MRI as well as ICG retention and NIR fluorescence in a normal pituitary gland and tumor.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Aichi, Japan.
| | - Yutaka Mine
- Department of Neurosurgery, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan; Department of Neurosurgery, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Yuya Nishiyama
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
| | | | | | | | - John K Y Lee
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, USA
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Aichi, Japan
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17
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Moriya Y, Oshino T, Hosoda M, Shikishima K, Miura S, Muto J, Kato T, Takahashi M. A Case of Pneumothorax Required Surgical Treatment as a Complication of Paclitaxel with Bevacizumab Treatment. Case Rep Oncol 2023; 16:797-802. [PMID: 37900807 PMCID: PMC10601756 DOI: 10.1159/000533440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/03/2023] [Indexed: 10/31/2023] Open
Abstract
A 63-year-old woman had a history of neoadjuvant chemotherapy, mastectomy, and adjuvant endocrine therapy for 5 years before being diagnosed with recurrent lesions involving the right anterior chest wall, multiple lymph nodes, and pulmonary metastases. The patient was subsequently initiated on a paclitaxel and bevacizumab regimen. During this treatment, the patient complained of palpitations and malaise. Chest radiography revealed a left pneumothorax. Despite attempts at conservative treatment, the pneumothorax did not improve and a thoracoscopic approach was required. One of the metastatic tumors in the left lower lobe appeared to rupture, and this area was estimated to be the cause of air leak. The tumor was covered with a tissue seal sheet, and the patient's condition improved with no recurrence of pneumothorax. This case highlights the importance of early conversion to surgical treatment when conservative treatment for pneumothorax is unresponsive due to the potential side effects of bevacizumab. The findings of this case report may be of interest to oncologists, pulmonologists, and other healthcare professionals involved in the care of patients with breast cancer and pulmonary metastases who are undergoing bevacizumab chemotherapy.
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Affiliation(s)
- Yumi Moriya
- Department of Breast Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Tomohiro Oshino
- Department of Breast Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Mitsuchika Hosoda
- Department of Breast Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Karin Shikishima
- Department of Breast Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Shun Miura
- Department of Respiratory Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Jun Muto
- Department of Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Tatsuya Kato
- Department of Thoracic Surgery, Hokkaido University Hospital, Sapporo, Japan
| | - Masato Takahashi
- Department of Breast Surgery, Hokkaido University Hospital, Sapporo, Japan
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Horio K, Harada K, Muto J, Nakatomi H, Saito N, Morita A, Watanabe E, Mitsuishi M. Real-Time Suture Thread Detection with an Image Classifier. J Robot Mechatron 2022. [DOI: 10.20965/jrm.2022.p1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Micro-anastomosis is considered to be a difficult task even for skilled surgeons. Our group has developed a surgical robotic system to assist surgeons. Going further, the detection of surgically relevant objects in the microscopic view is indispensable for the automation or semi-automation of the system. This paper proposes a novel surgical thread detector inspired by an automatic crack detection method. The proposed method achieved a Dice score of 76.30% and an intersection over union (IOU) of 66.08% at 34.50 fps.
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Muto J, Mine Y, Joko M, Oba S, Hirose Y. MET-11 NEAR-INFRATED OPTICAL CONTRAST OF INDOCYANINE GREEN CAN LOCALIZE METASTATIC BRAIN TUMORS. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Abstract
Introduction
The utility of intraoperative real-time fluorescent navigation of indocyanine green (ICG) for cerebrospinal tumors has been demonstrated in gliomas, schwannomas, and meningiomas. We reported the usefulness of the existing Second window ICG (SWIG) for metastatic brain tumors, in which 5 mg/kg is administered 24 hours before the day before surgery. Subsequently, we developed a Delayed window ICG (DWIG) administered 1 hour before observation intraoperatively and report our experience.
Methods
The subjects were 28 patients from August 2019 to March 2022, with an average age of 67 years, diagnosed with metastatic brain tumors. Eighteen patients were in the SWIG group and 10 in the DWIG group. Iridium (Visionsense) and KINEVO (Carl Zeiss) were used for near-infrared irradiation and observation.
Results
Near-infrared light was irradiated during surgery, and in all cases, fluorescence from the tumor was confirmed. Fluorescence emission could be confirmed as far as 10 mm from the brain surface. The Signal Background Ratio (SBR) of tumor to brain parenchyma was 3.4 in SWIG and 4.2 in DWIG. There is no significant difference between them.(P=0.15) All patients had contrast areas on preoperative contrast MRI, and the ratio of contrast area to brain parenchyma (T1BR) was 2.5. After intraoperative resection, all resected patients showed no contrast lesions on immediate postoperative MRI. No perioperative complications due to I CG administration were noted.
Conclusions
Metastatic tumors may be difficult to distinguish from the normal brain visually due to the inaccuracy of the navigation system caused by intraoperative brainshift and blurring of the boundaries under an optical microscope. Intraoperative fluorescence angiography is useful in such cases because it allows tumor localization and removal in real time. DWIG is useful for metastatic brain tumors because it is simple and easy to use, with no significant difference compared to existing SWIG.
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Affiliation(s)
- Jun Muto
- Fujita Health University, Department of Neurosurgery
| | - Yutaka Mine
- National Hospital Organization Tokyo Medical Center
| | - Masahiro Joko
- Fujita Health University, Department of Neurosurgery
| | - Shigeo Oba
- Fujita Health University, Department of Neurosurgery
| | - Yuichi Hirose
- Fujita Health University, Department of Neurosurgery
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20
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Mori H, Murakami M, Muto J, Yatsuzuka K, Shiraishi K, Kameda K, Fujisawa Y. 624 HMGB1 Bbox induces wound healing in keratinocyte. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Matsumura K, Muto J, Tanaka M, Joko M, Yoshikawa T, Hirose Y. Usefulness of three-dimensional computed tomography venography differentiating calvarium subperiosteal hematoma crossing the suture lines due to hair pulling from subgaleal hematoma: case report and review of the literature. Childs Nerv Syst 2022; 38:2017-2020. [PMID: 35380260 DOI: 10.1007/s00381-022-05517-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
This case showed a 13-year-old boy presented with calvarium subperiosteal hematoma crossing the suture lines caused by hair pulling, and 3D-CTV can differentiate calvarium subperiosteal hematoma crossing the suture lines from subgaleal hematoma. He was treated successfully.
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Affiliation(s)
- Kazuyasu Matsumura
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan.
| | - Makito Tanaka
- Department of Pediatrics, Fujita Health University, Aichi, Japan
| | - Masahiro Joko
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
| | | | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Toyoake City, 1-98 Dengakugakubo, Kutsukake, Aichi, Japan
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22
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Ono H, Oshita A, Inaba S, Kawamata M, Nakao Y, Uetani T, Muto J, Joko T, Kawakami H. Pseudoxanthoma elasticum resulting in acute coronary syndrome. J Cardiol Cases 2022; 26:308-310. [DOI: 10.1016/j.jccase.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 10/15/2022] Open
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23
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Yoshida S, Yatsuzuka K, Kuroo Y, Utsunomiya R, Ando R, Muto J, Sayama K. Involvement of the spinal trigeminal nucleus secondary to herpes zoster in a patient with hemifacial redness and swelling. J Cutaneous Imm & Allergy 2022. [DOI: 10.1002/cia2.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Satoshi Yoshida
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Kazuki Yatsuzuka
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Yuta Kuroo
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Ryo Utsunomiya
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Rina Ando
- Department of Neurology and Clinical Pharmacology Ehime University Graduate School of Medicine Toon Japan
| | - Jun Muto
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Koji Sayama
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
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24
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Hu L, Nomura S, Sato Y, Takagi K, Ishii T, Honma Y, Watanabe K, Mizukami Y, Muto J. Anti-inflammatory effects of differential molecular weight Hyaluronic acids on UVB-induced calprotectin-mediated keratinocyte inflammation. J Dermatol Sci 2022; 107:24-31. [PMID: 35717315 DOI: 10.1016/j.jdermsci.2022.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/09/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The biological functions of Hyaluronic acid are related to its molecular weight and binding to its receptor, Toll-like receptor4 (TLR4) or CD44. Recent studies have shown that low-molecular-weight Hyaluronic acid (LMW-HA) exhibits proinflammatory effects, while high-molecular-weight Hyaluronic acid (HMW-HA) functions as an anti-inflammatory factor. UVB-induced epidermal inflammation is mainly mediated by endogenous molecules, such as damage-associated molecular patterns (DAMPs), that cause severe skin damage by activating TLR signaling pathways. OBJECTIVE Since both LMW- and HMW-HA have inhibitory functions on TLR-mediated macrophage inflammation, HA is assumed to suppress UVB-induced DAMP-mediated inflammation in the skin. In this study, both Ultra- low-molecular-weight Hyaluronic acid (uLMW-HA) and HMW-HA were found to inhibit UVB-induced keratinocyte inflammation. METHODS HaCaT cells were treated with medium containing Hyaluronic acid at the appropriate concentration after 15 mJ/cm2 irradiation. Secreted protein levels were determined with ELISA kits. Expression levels of proteins downstream of TLR4 were detected by Simple Western system. RESULTS By competitively binding to TLR4, uLMW-HA downregulated Calprotectin-induced TRAF6 expression, which might be the direct process by which uLMW-HA decreased UVB-induced IL-6 secretion. Reduced CD44 variant (CD44v) expression in keratinocytes attenuated the inhibitory effect of both uLMW-HA and HMW-HA on UVB-induced inflammation, which indicated the involvement of CD44v in HA-regulated anti-inflammatory activity. CONCLUSION Overall, this research indicates that Hyaluronic acid is more than a moisturizer; it is also a biologically effective material that can prevent the excessive skin inflammation caused in daily life, especially in the late stages after sunburn.
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Affiliation(s)
- Liuying Hu
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan.
| | - Satoshi Nomura
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan
| | - Yasunari Sato
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan
| | - Kyoko Takagi
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan
| | - Tsuyoshi Ishii
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan
| | - Yoichi Honma
- Basic Research Development Division, ROHTO Pharmaceutical Co., Ltd., Kunimidai, Kizugawa, Kyoto, Japan
| | - Kenji Watanabe
- Institute of Gene Research, Yamaguchi University Science Research Center, Yamaguchi, Japan
| | - Yoichi Mizukami
- Institute of Gene Research, Yamaguchi University Science Research Center, Yamaguchi, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Shitsukawa, Touon-shi, Ehime, Japan
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25
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Muto J, Mine Y, Nishiyama Y, Murayama K, Yamada S, Kojima D, Hayakawa M, Adachi K, Hasegawa M, Lee JYK, Hirose Y. Intraoperative Real-Time Near-Infrared Image-Guided Surgery to Identify Intracranial Meningiomas via Microscope. Front Neurosci 2022; 16:837349. [PMID: 35600609 PMCID: PMC9114498 DOI: 10.3389/fnins.2022.837349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/08/2022] [Indexed: 11/24/2022] Open
Abstract
Meningiomas are a common pathology in the central nervous system requiring complete surgical resection. However, in cases of recurrence and post-irradiation, accurate identification of tumor remnants and a dural tail under bright light remains challenging. We aimed to perform real-time intraoperative visualization of the meningioma and dural tail using a delayed-window indocyanine green (ICG) technique with microscopy. Fifteen patients with intracranial meningioma received 0.5 mg/kg ICG a few hours before observation during the surgery. We used near-infrared (NIR) fluorescence to identify the tumor location. NIR fluorescence could visualize meningiomas in 12 out of 15 cases. Near-infrared visualization during the surgery ranged from 1 to 4 h after the administration of ICG. The mean signal-to-background ratio (SBR) of the intracranial meningioma in delayed-window ICG (DWIG) was 3.3 ± 2.6. The ratio of gadolinium-enhanced T1 tumor signal to the brain (T1BR) (2.5 ± 0.9) was significantly correlated with the tumor SBR (p = 0.016). Ktrans, indicating blood–brain barrier permeability, was significantly correlated with tumor SBR (p < 0.0001) and T1BR (p = 0.013) on dynamic contrast-enhanced magnetic resonance imaging (MRI). DWIG demonstrated a sensitivity of 94%, specificity of 38%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 75% for meningiomas. This is the first pilot study in which DWIG fluorescence-guided surgery was used to visualize meningioma and dural tail intraoperatively with microscopy. DWIG is comparable with second-window ICG in terms of mean SBR. Gadolinium-enhanced T1 tumor signal may predict NIR fluorescence of the intracranial meningioma. Blood–brain barrier permeability as shown by Ktrans on dynamic contrast-enhanced MRI can contribute to gadolinium enhancement on MRI and to ICG retention and tumor fluorescence by NIR.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
- *Correspondence: Jun Muto,
| | - Yutaka Mine
- Department of Neurosurgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Yuya Nishiyama
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | | | - Seiji Yamada
- Department of Pathology, Fujita Health University, Toyoake, Japan
| | - Daijiro Kojima
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | - Motoharu Hayakawa
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | - Kazuhide Adachi
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | | | - John Y. K. Lee
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
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26
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Dai X, Murakami M, Shiraishi K, Muto J, Tohyama M, Mori H, Utsunomiya R, Sayama K. EGFR ligands synergistically increase IL-17A-induced expression of psoriasis signature genes in human keratinocytes via IκBζ and Bcl3. Eur J Immunol 2022; 52:994-1005. [PMID: 35411943 DOI: 10.1002/eji.202149706] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 11/07/2022]
Abstract
Various epidermal growth factor receptor (EGFR) ligands are highly expressed in the epidermis of psoriasis lesions, and abnormal EGFR activation appears to be involved in the pathogenesis of psoriasis. However, how EGFR signaling contributes to the development of psoriasis is unclear. Interleukin (IL)-17A, a critical effector of the IL-23/IL-17A pathway, increases the expression of psoriasis signature genes in keratinocytes and plays an essential role in the pathogenesis of psoriasis by inducing IκBζ, a critical transcriptional regulator in psoriasis. In this study, we stimulated primary human keratinocytes with IL-17A and various EGFR ligands to investigate whether EGFR ligands regulate the expression of psoriasis signature genes. In cultured normal human keratinocytes and a living skin equivalent, EGFR ligands did not induce psoriasis-related gene expression, but significantly enhanced the IL-17A-mediated induction of various psoriasis signature genes, including antimicrobial peptides, cytokines, and chemokines. This was dependent on an EGFR activation-mediated synergistic increase in IL-17A-induced IκBζ expression and was partially mediated by the EGFR-dependent upregulation of Bcl3. Therefore, EGFR ligands can act as synergistic agents of IL-17A signaling by stimulating the epidermal production of psoriasis signature genes in psoriasis lesions. This study reveals a potential mechanism by which EGFR signaling contributes to the pathogenesis of psoriasis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xiuju Dai
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ken Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Mikiko Tohyama
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan.,Department of Dermatology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Hideki Mori
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ryo Utsunomiya
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Koji Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Ehime, Japan
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27
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Okazaki R, Poudel S, Hane Y, Saito T, Muto J, Syoji Y, Hase R, Senmaru N, Hirano S. Laparoscopic approach as a safe and effective option for incarcerated femoral hernias. Asian J Endosc Surg 2022; 15:328-334. [PMID: 34749433 DOI: 10.1111/ases.13010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The laparoscopic approach for elective femoral herniorrhaphy is well established. However, femoral hernias often present as incarcerations and require emergency repair surgery, mainly using the open approach. This study aimed to retrospectively analyze the efficacy of the laparoscopic approach for incarcerated femoral hernias. METHODS Data of patients who underwent emergency surgery for incarcerated femoral hernia between April 2016 and August 2021 were retrospectively analyzed. Laparoscopy was performed whenever possible; however, conversion to an open approach remained a fallback option for when laparoscopic repair was not possible. In laparoscopic repair, incarcerated femoral hernias reduced using traction, water pressure, and preperitoneal methods. Data of patients who underwent open repair and laparoscopy were then compared. RESULTS During the observation period, 20 patients underwent emergency surgery for incarcerated femoral hernia. Eleven patients subsequently underwent repair using a laparoscopic approach, and eight underwent repair using an open approach. Only one patient underwent intestinal resection without hernia repair due to perforated bowel. Operative time for laparoscopic repair was longer. Mesh repair was performed in 18 patients. Four patients each in the laparoscopic repair and open group required intestinal resection. CONCLUSION Incarcerated femoral hernias can be safely repaired using the laparoscopic approach.
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Affiliation(s)
- Ryo Okazaki
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan.,Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan.,Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Yuma Hane
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Takahiro Saito
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Jun Muto
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Yasuhito Syoji
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Ryunosuke Hase
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Naoto Senmaru
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
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28
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Yatsuzuka K, Murakami M, Kuroo Y, Fukui M, Yoshida S, Muto J, Shiraishi K, Sayama K. Flare-up of generalized pustular psoriasis combined with systemic capillary leak syndrome after coronavirus disease 2019 mRNA vaccination. J Dermatol 2022; 49:454-458. [PMID: 34862669 DOI: 10.1111/1346-8138.16271] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/31/2021] [Accepted: 11/25/2021] [Indexed: 01/14/2023]
Abstract
Generalized pustular psoriasis (GPP) is characterized by acute flare-ups induced by various factors, but few reports have described GPP onset or flare-up induced by vaccination. To our knowledge, only three such cases following coronavirus disease 2019 (COVID-19) vaccination have been reported. We herein report a case of GPP flare-up after COVID-19 mRNA vaccination. A 65-year-old man with GPP controlled by infliximab presented with widespread pustular erythema, fever, and malaise following his second COVID-19 mRNA vaccination. A skin eruption was apparent at the injection site. He also exhibited systemic capillary leak syndrome (SCLS), which responded rapidly to secukinumab and systemic corticosteroids. Two biopsies, one of which was of the injection site, revealed not only findings typical of GPP, but also a dermal mixed-cell infiltration with eosinophils, and microthrombi in the small dermal vessels. The latter findings have been observed in cutaneous lesions induced by both COVID-19 infection and vaccination. This is the first case of a GPP flare-up accompanied by SCLS induced by a COVID-19 mRNA vaccine. Also, this is the first flare-up induced by the second vaccine dose, and the first such report including detailed histological data, including for the injection site.
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Affiliation(s)
- Kazuki Yatsuzuka
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Masamoto Murakami
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Yuta Kuroo
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Maiko Fukui
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Satoshi Yoshida
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Ken Shiraishi
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koji Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
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29
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Muto J, Mine Y, Nagai S, Shizu N, Takeda H, Ikeda D, Saito A, Joko M, Hasegawa M, Kaneko S, Inoue T, Lee JYK, Hirose Y. Utility of intraoperative real-time near-infrared fluorescence surgery for spinal schwannoma. Neurosurgical Focus: Video 2022; 6:V12. [PMID: 36284589 PMCID: PMC9557329 DOI: 10.3171/2021.10.focvid21158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
The authors report the first cases of fluorescence-guided spinal surgery of schwannomas using near-infrared fluorescence imaging with the delayed window indocyanine (ICG) green (DWIG) technique for accurate real-time intraoperative tumor visualization. Patients with intradural spinal schwannomas received 0.5 mg/kg ICG at the beginning of surgery. After 1 hour, using the DWIG technique, near-infrared spectroscopy (NIRS) detected the spinal schwannomas, showing the exact tumor location and boundaries. DWIG with NIRS microscopy confirmed the exact location of spinal schwannomas before and after opening of the dura mater, thereby facilitating successful tumor dissection from the surrounding tissues, tumor resection, and confirmation of tumor removal. The video can be found here: https://stream.cadmore.media/r10.3171/2021.10.FOCVID21158
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake
| | - Yutaka Mine
- Department of Neurosurgery, Brain Nerve Center, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan; and
| | - Sota Nagai
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake
| | - Naoyuki Shizu
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake
| | - Hiroki Takeda
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake
| | - Daiki Ikeda
- Department of Orthopaedic Surgery, Fujita Health University, Toyoake
| | - Akifumi Saito
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake
| | - Masahiro Joko
- Department of Neurosurgery, Fujita Health University, Toyoake
| | | | - Shinjiro Kaneko
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake
| | - Tatsushi Inoue
- Department of Neurosurgery, Fujita Health University, Toyoake
| | - John Y. K. Lee
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Toyoake
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30
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Inoue T, Joko M, Saito F, Muto J, Takeda H, Kaneko S, Hirose Y. Bone wax technique for full-endoscopic lumbar laminotomy. J Spine Surg 2022; 9:98-101. [PMID: 37038418 PMCID: PMC10082434 DOI: 10.21037/jss-22-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
Hemostatic procedures in endoscopic spine surgery have not yet been established, especially in full-endoscopic spine surgery (FESS) performed under continuous irrigation, which has been a major concern for surgeons. Chu et al. had previously reported a technique to convey bone wax during full-endoscopic cervical spine surgery via intracorporeal route by using ball tip of the drill in 2018. However, to the best of our knowledge, there has been no report by surgeons to adopt bone wax as a hemostatic material in full-endoscopic lumbar surgery to date, probably because of difficulty in handling bone wax under continuous irrigation and through a narrow and long working channel in endoscope. We have renewed the bone wax technique (BWT) for hemostasis in FESS, improving its handling by introducing a nozzle applicator, without which the bone wax would stick to the working channel of the endoscope on the way to the bleeding target. This would result in significant loss of bone wax and repeated bone-wax contact would cause dirt build-up on the endoscope lens, which would then be pushed out from the wall of the working channel, thereby disturbing the laminectomy procedure and obfuscating the visual field. Technical details using nozzle-loaded bone wax have been demonstrated.
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Affiliation(s)
- Tatsushi Inoue
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Masahiro Joko
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | - Fumiaki Saito
- Section of Fujita Nurse Practitioner, Fujita Health University, Toyoake, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
| | - Hiroki Takeda
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Shinjiro Kaneko
- Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University, Toyoake, Japan
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31
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Dai X, Muto J, Shiraishi K, Utsunomiya R, Mori H, Murakami M, Sayama K. TSLP impairs epidermal barrier integrity by stimulating the formation of nuclear IL-33/phosphorylated STAT3 complex in human keratinocytes. J Invest Dermatol 2022; 142:2100-2108.e5. [DOI: 10.1016/j.jid.2022.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 12/20/2022]
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32
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Yokota M, Muto J, Hashida K, Nagahisa Y, Okabe M, Kitagawa H, Kawamoto K. The necessity of intensive surveillance colonoscopy for patients with a remaining right colon after resection of colorectal cancer: a retrospective cohort study. Surg Today 2021; 52:502-509. [PMID: 34499260 DOI: 10.1007/s00595-021-02372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To clarify how often postoperative surveillance colonoscopy should be undertaken based on the risk factors for the development of metachronous cancer (MC) and advanced adenoma (AA) after surgery for colorectal cancer. METHODS We collected data of consecutive patients who underwent curative resection for primary colorectal cancer between 2005 and 2012, with preoperative colonoscopy and surveillance colonoscopy at 1 year after surgery (406 patients, mean age: 69 years, 59% male). The detection rates of AA (with villous features, > 10 mm or high-grade dysplasia) and MC by surveillance colonoscopy were the primary outcomes. RESULTS At 5 years, colonoscopy was performed as postoperative surveillance an average of 3.2 times. AA and MC were detected in 57 (14.0%) and 18 patients (4.4%), respectively. Both lesions were more common in the right colon (n = 43) than in the left colon (n = 28). The detection rate did not differ to a statistically significant extent according to the number of colonoscopies performed for surveillance (p = 0.21). However, after left-sided colectomy, both types of lesions were more commonly detected in those who received ≥ 3 colonoscopies than in those with one or two colonoscopies (p = 0.04). CONCLUSION A remaining right colon after left-sided colectomy was associated with a higher risk of developing AA and MC. Physicians should consider performing surveillance colonoscopy more frequently if the right colon remains after surgery.
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Affiliation(s)
- Mitsuru Yokota
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.
| | - Jun Muto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Kazuki Hashida
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Yoshio Nagahisa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Michio Okabe
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Hirohisa Kitagawa
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Kazuyuki Kawamoto
- Department of General Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
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Doi C, Muto J, Yatsuzuka K, Iwata H, Sayama K. A case of aplasia cutis congenita type VII with tibial dysplasia. Clin Exp Dermatol 2021; 47:412-413. [PMID: 34407227 DOI: 10.1111/ced.14900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- C Doi
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - J Muto
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - K Yatsuzuka
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - H Iwata
- Department of, Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - K Sayama
- Departments of, Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Yamada S, Muto J, Iba S, Shiogama K, Tsuyuki Y, Satou A, Ohba S, Murayama K, Sugita Y, Nakamura S, Yokoo H, Tomita A, Hirose Y, Tsukamoto T, Abe M. Primary central nervous system lymphomas with massive intratumoral hemorrhage: Clinical, radiological, pathological, and molecular features of six cases. Neuropathology 2021; 41:335-348. [PMID: 34254378 DOI: 10.1111/neup.12739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/08/2021] [Accepted: 02/22/2021] [Indexed: 02/01/2023]
Abstract
Primary central nervous system lymphomas (PCNSLs) rarely exhibit intratumoral hemorrhage. The differential diagnosis of hemorrhagic neoplasms of the central nervous system (CNS) currently includes metastatic carcinomas, melanomas, choriocarcinomas, oligodendrogliomas, and glioblastomas. Here we present the clinical, radiological, pathological, and molecular genetic features of six cases of PCNSL associated with intratumoral hemorrhage. The median age of patients was 75 years, with male predominance. While conventional PCNSLs were associated with low cerebral blood volume (CBV), perfusion magnetic resonance imaging (MRI) revealed elevated CBV in three cases, consistent with vascular proliferation. All six cases were diagnosed pathologically as having diffuse large B-cell lymphoma (DLBCL) with a non-germinal center B-cell-like (non-GCB) phenotype; marked histiocytic infiltrates and abundant non-neoplastic T-cells were observed in most cases. Expression of vascular endothelial growth factor and CD105 in the lymphoma cells and the small vessels, respectively, suggested angiogenesis within the neoplasms. Neoplastic cells were immunohistochemically negative for programmed cell death ligand 1 (PD-L1), while immune cells in the microenvironment were positive for PD-L1. Mutations in the MYD88 gene (MYD88) (L265P) and the CD79B gene (CD79B) were detected in five and one case, respectively. As therapeutic modalities used for PCNSLs differ from those that target conventional hemorrhagic neoplasms, full tissue diagnoses of all hemorrhagic CNS tumors are clearly warranted.
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Affiliation(s)
- Seiji Yamada
- Department of Diagnostic Pathology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Sachiko Iba
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuya Shiogama
- Division of Morphology and Cell Function, Faculty of Medical Technology, Fujita Health University School of Health Sciences, Toyoake, Japan
| | - Yuta Tsuyuki
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Akira Satou
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Shigeo Ohba
- Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kazuhiro Murayama
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yasuo Sugita
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihiro Tomita
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Tetsuya Tsukamoto
- Department of Diagnostic Pathology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masato Abe
- Department of Pathology, School of Health Sciences, Fujita Health University, Toyoake, Japan
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Kojima K, Ishikawa M, Endo T, Muto J, Fukui Y, Asamoto S. Lateral mass intra-pedicular screw fixation for subaxial cervical spines - An alternative surgical technique. J Craniovertebr Junction Spine 2021; 12:165-169. [PMID: 34194163 PMCID: PMC8214242 DOI: 10.4103/jcvjs.jcvjs_17_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 03/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Lateral mass screw (LMS) and transpedicular screw (TPS) techniques are the two major options for performing posterior cervical fusion of the subaxial cervical spine. Although these two techniques can cover the vast majority of patients who require posterior fixation of the cervical spine, they are not without their limitations. Objective: The objective of this study is to introduce a novel technique, lateral mass intrapedicular screw (LMIS) fixation, for posterior subaxial cervical spine (C3–C6) fixation. Materials and Methods: The starting point of the screw is defined as the midpoint of the lateral mass. In the axial plane, the screw is angled at 20–25 with respect to the midline of the spinous process. In the sagittal plane, the screw is directed toward the rostral quarter (zone 1) of the vertebral body and placed within the pedicle. A preliminary, proof-of-concept experiment was performed using a bone model created with synthetic bone and computed tomography images before performing the operation on a patient. Results: During the preliminary experiment, insignificant breaching of the inner cortex of the pedicle was observed with one of the screws. However, no other screws breached the inner cortex in the same manner during the preliminary experiment or during the operation, and the intraoperative fixation was strong. Conclusion: LMIS is a relatively simple and safe technique that can be performed for the fixation of subaxial cervical spines with screws that are longer than those used in LMS. We believe that this technique may join the two existing techniques to become a common alternative technique, particularly for patients with poor bone quality.
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Affiliation(s)
- Kota Kojima
- Spine and Spinal Cord Center, Makita General Hospital, Tokyo, Japan
| | | | - Takahiro Endo
- Spine and Spinal Cord Center, Makita General Hospital, Tokyo, Japan.,Department of Neurosurgery, Makita General Hospital, Tokyo, Japan
| | - Jun Muto
- Department of Neurosurgery, Fujita Health University, Nagoya, Japan
| | - Yasuyuki Fukui
- Spine and Spinal Cord Center, Makita General Hospital, Tokyo, Japan
| | - Shunji Asamoto
- Spine and Spinal Cord Center, Makita General Hospital, Tokyo, Japan.,Department of Neurosurgery, Makita General Hospital, Tokyo, Japan
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Yamashiro K, Muto J, Wakako A, Murayama K, Kojima D, Omi T, Adachi K, Hasegawa M, Hirose Y. Diploic veins as collateral venous pathways in patients with dural venous sinus invasion by meningiomas. Acta Neurochir (Wien) 2021; 163:1687-1696. [PMID: 33629122 DOI: 10.1007/s00701-021-04777-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although it is known that diploic veins frequently communicate with the dural venous sinuses, the role of diploic veins in patients with venous sinus invasion from meningiomas remains unknown. METHODS We retrospectively examined the medical records of 159 patients who underwent their first craniotomies for intracranial meningiomas. Contrast-enhanced magnetic resonance imaging was used to evaluate diploic vein routes, and digital subtraction angiography (DSA) was used to evaluate diploic vein blood flow. When high blood flow was visualized concurrently with the venous sinuses, the veins were classified as of the "early type." Diploic vein routes were classified into five routes. RESULTS DSA was performed in 110 patients, with 14 showing superior sagittal sinus (SSS) invasion (SSS group) and 23 showing non-SSS venous sinus invasion (non-SSS group). The proportion of early type diploic veins was significantly higher in the SSS group (27.1%) than in other patients (patients without venous sinus invasion, 2.1%; non-SSS, 4.3%) (p < 0.01). In patients not in the SSS group, diploic veins were sacrificed during craniotomy in 76 patients, including four patients with veins of the early type. No patients demonstrated new neurological deficits postoperatively. In the SSS group, diploic veins were sacrificed in all patients, and early type diploic veins were cut in five patients. Two of these five patients showed postoperative neurological deficits. CONCLUSIONS In the SSS group, diploic veins may function as collateral venous pathways, and attention is recommended for their interruption. In patients without SSS invasion, diploic veins, even of the early type, can be sacrificed.
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Yoshida S, Muto J, Utsunomiya R, Kitazawa R, Matsumoto T, Sayama K. Cutaneous arteritis with compartment syndrome: Case report and review of published works. J Cutan Immunol Allergy 2021. [DOI: 10.1002/cia2.12165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Satoshi Yoshida
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Jun Muto
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Ryo Utsunomiya
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
| | - Riko Kitazawa
- Department of Molecular Pathology Ehime University Graduate School of Medicine Toon Japan
| | - Takuya Matsumoto
- Department of Hematology, Clinical Immunology and Infectious Diseases Ehime University Graduate School of Medicine Toon Japan
| | - Koji Sayama
- Department of Dermatology Ehime University Graduate School of Medicine Toon Japan
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Muto J, Yasuoka Y, Miura N, Iwata D, Nagahama H, Hirano M, Ohmomo Y, Mukai T. Preseismic atmospheric radon anomaly associated with 2018 Northern Osaka earthquake. Sci Rep 2021; 11:7451. [PMID: 33811241 PMCID: PMC8018951 DOI: 10.1038/s41598-021-86777-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/19/2021] [Indexed: 11/09/2022] Open
Abstract
Despite the challenges in identifying earthquake precursors in intraplate (inland) earthquakes, various hydrological and geochemical measurements have been conducted to establish a possible link to seismic activities. Anomalous increases in radon (222Rn) concentration in soil, groundwater, and atmosphere have been reported prior to large earthquakes. Although the radon concentration in the atmosphere is lower than that in groundwater and soils, a recent statistical analysis has suggested that the average atmospheric concentration over a relatively wide area reflects crustal deformation. However, no study has sought to determine the underlying physico-chemical relationships between crustal deformation and anomalous atmospheric radon concentrations. Here, we show a significant decrease in the atmospheric radon concentration temporally linked to the seismic quiescence before the 2018 Northern Osaka earthquake occurring at a hidden fault with complex rupture dynamics. During seismic quiescence, deep-seated sedimentary layers in Osaka Basin, which might be the main sources of radon, become less damaged and fractured. The reduction in damage leads to a decrease in radon exhalation to the atmosphere near the fault, causing the preseismic radon decrease in the atmosphere. Herein, we highlight the necessity of continuous monitoring of the atmospheric radon concentration, combined with statistical anomaly detection method, to evaluate future seismic risks.
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Affiliation(s)
- Jun Muto
- Department of Earth Sciences, Graduate School of Science, Tohoku University, 6-3 Aramaki-Aza-Aoba, Aoba-ku, Sendai, 980-8578, Japan.
| | - Yumi Yasuoka
- Radioisotope Research Center, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan
| | - Nao Miura
- Radioisotope Research Center, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan
| | - Daichi Iwata
- Department of Earth Sciences, Graduate School of Science, Tohoku University, 6-3 Aramaki-Aza-Aoba, Aoba-ku, Sendai, 980-8578, Japan
| | - Hiroyuki Nagahama
- Department of Earth Sciences, Graduate School of Science, Tohoku University, 6-3 Aramaki-Aza-Aoba, Aoba-ku, Sendai, 980-8578, Japan
| | - Mitsuhiro Hirano
- Department of Earth Sciences, Graduate School of Science, Tohoku University, 6-3 Aramaki-Aza-Aoba, Aoba-ku, Sendai, 980-8578, Japan
| | - Yoshiro Ohmomo
- Osaka Medical and Pharmaceutical University, 4-20-1 Nasahara Takatuki-shi, Osaka, 569-1094, Japan
| | - Takahiro Mukai
- Radioisotope Research Center, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan.,Laboratory of Biophysical Chemistry, Kobe Pharmaceutical University, 4-19-1 Motoyamakita-machi, Higashinada-ku, Kobe, 658-8558, Japan
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Abstract
The presence of anomalous geochemical changes related to earthquakes has been controversial despite widespread, long time challenges for earthquake prediction. Establishing a quantitative relationship among geochemical changes and geodetical and seismological changes can clarify their hidden connection. Here we determined the response of atmospheric radon (222Rn) to diurnal tidal (K1 constituent) loading in the reported 11-year-long variation in the atmospheric radon concentration, including its anomalous evolution for 2 months before the devastating 1995 Kobe earthquake in Japan. The response to the tidal loading had been identified for 5 years before the occurrence of the earthquake. Comparison between these radon responses relative to crustal strain revealed that the response efficiency for the diurnal K1 tide was larger than that for the earthquake by a factor of 21–33, implying the involvement of crustal fluid movement. The radon responses occurred when compressional crustal stress decreased or changed to extension. These findings suggest that changes in radon exhaled from the ground were induced by ascent flow of soil gas acting as a radon carrier and degassed from mantle-derived crustal fluid upwelling due to modulation of the crustal stress regime.
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Affiliation(s)
- Yasutaka Omori
- Department of Radiation Physics and Chemistry, Fukushima Medical University, Fukushima, 960-1295, Japan.
| | - Hiroyuki Nagahama
- Department of Earth Science, Graduate School of Science, Tohoku University, Sendai, 980-8578, Japan
| | - Yumi Yasuoka
- Institute of Radioisotope Research, Kobe Pharmaceutical University, Kobe, 658-8558, Japan
| | - Jun Muto
- Department of Earth Science, Graduate School of Science, Tohoku University, Sendai, 980-8578, Japan
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Muto J, Murakawa K, Yamamoto H, Poudel S, Sato S, Kato K, Senmaru N, Ono K. A new technique to avoid unintentional adhesion while deploying ProGrip mesh and its utility in the laparoscopic repair of obturator hernia. J Minim Access Surg 2021; 17:116-119. [PMID: 33353897 PMCID: PMC7945631 DOI: 10.4103/jmas.jmas_285_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The ProGrip™ laparoscopic self-fixating mesh provides advantages such as low cost and reduced pain following tack-free fixation in laparoscopic hernia repair through a transabdominal preperitoneal approach. Obturator hernia repair needs adequate fixation around the hernial orifice without the use of tacking, and ProGrip™ mesh provides options for secure fixation. However, it is often difficult to adequately adjust the mesh placement to cover the obturator hernia orifice with a ProGrip™ mesh, due to adhesion of the grips to the surrounding tissues. We introduce our technique to avoid unintentional adhesion during ProGrip mesh repair and discuss its utility in the treatment of obturator hernias. We repaired seven obturator hernia lesions in five patients using this technique without any complications. The biggest advantage of our technique is that the position of the mesh can be adjusted after it is expanded, unless the sheet is completely removed, allowing the surgeons to fix the mesh without any unintended adhesion to surrounding tissue.
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Affiliation(s)
- Jun Muto
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido; Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan
| | | | - Hiroyuki Yamamoto
- Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Saseem Poudel
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Shoki Sato
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Kohei Kato
- Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan
| | - Naoto Senmaru
- Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Koichi Ono
- Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan
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Muto J, Mine Y, Nakagawa Y, Joko M, Kagami H, Inaba M, Hasegawa M, Lee JYK, Hirose Y. Intraoperative real-time near-infrared optical imaging for the identification of metastatic brain tumors via microscope and exoscope. Neurosurg Focus 2021; 50:E11. [PMID: 33386024 DOI: 10.3171/2020.10.focus20767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE As chemotherapy and radiotherapy have developed, the role of a neurosurgeon in the treatment of metastatic brain tumors is gradually changing. Real-time intraoperative visualization of brain tumors by near-infrared spectroscopy (NIRS) is feasible. The authors aimed to perform real-time intraoperative visualization of the metastatic tumor in brain surgery using second-window indocyanine green (SWIG) with microscope and exoscope systems. METHODS Ten patients with intraparenchymal brain metastatic tumors were administered 5 mg/kg indocyanine green (ICG) 1 day before the surgery. In some patients, a microscope was used to help identify the metastases, whereas in the others, an exoscope was used. RESULTS NIRS with the exoscope and microscope revealed the tumor location from the brain surface and the tumor itself in all 10 patients. The NIR signal could be detected though the normal brain parenchyma up to 20 mm. While the mean signal-to-background ratio (SBR) from the brain surface was 1.82 ± 1.30, it was 3.35 ± 1.76 from the tumor. The SBR of the tumor (p = 0.030) and the ratio of Gd-enhanced T1 tumor signal to normal brain (T1BR) (p = 0.0040) were significantly correlated with the tumor diameter. The SBR of the tumor was also correlated with the T1BR (p = 0.0020). The tumor was completely removed in 9 of the 10 patients, as confirmed by postoperative Gd-enhanced MRI. This was concomitant with the absence of NIR fluorescence at the end of surgery. CONCLUSIONS SWIG reveals the metastatic tumor location from the brain surface with both the microscope and exoscope systems. The Gd-enhanced T1 tumor signal may predict the NIR signal of the metastatic tumor, thus facilitating tumor resection.
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Affiliation(s)
- Jun Muto
- 1Department of Neurosurgery, Fujita Health University, Aichi
| | - Yutaka Mine
- 2Department of Neurosurgery, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan; and
| | - Yu Nakagawa
- 2Department of Neurosurgery, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan; and
| | - Masahiro Joko
- 1Department of Neurosurgery, Fujita Health University, Aichi
| | - Hiroshi Kagami
- 2Department of Neurosurgery, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan; and
| | - Makoto Inaba
- 2Department of Neurosurgery, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan; and
| | | | - John Y K Lee
- 3Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Yuichi Hirose
- 1Department of Neurosurgery, Fujita Health University, Aichi
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Kuwahara K, Ohba S, Matsumura K, Higashiguchi S, Kojima D, Muto J, Nakae S, Nishiyama Y, Yamada S, Adachi K, Abe M, Hasegawa M, Hirose Y. ML-23 The outcome of malignant lymphoma of the central nervous system in a single institution. Neurooncol Adv 2020. [PMCID: PMC7699112 DOI: 10.1093/noajnl/vdaa143.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Although high dose-methotrexate therapy has been performed for primary central nervous system malignant lymphoma (PCNSL), R-MPV (rituximab, methotrexate (MTX), procarbazine and vincristine) therapy is currently the first line therapy for (PCNSL) in our hospital. This study examines the results of R-MPV therapy comparing with past treatment. Method/Subjects: Thirty-seven patients treated at our hospital from 2009 to 2020 were included. Overall survival time, progression free survival time, and toxicities were evaluated. Results: The average age of patients was 65.7 years. Patients included 21 males and 16 females. Thirty-six patients were diagnosed DLBCL by resected brain tumor tissues, and one was diagnosed DLBCL by vitreous biopsy. As initial treatment, rituximab±HD-MTX therapy (R±MTX group) was performed in 20 cases, HD-MTX therapy plus radiation (R±MTX+RT group) was performed in 12 cases, and RMPV therapy was performed in 5 cases (R-MPV group). Median OS of all cases was 69 months and median PFS was 38 months. Median OS was 69 months in R±MTX group and could not be calculated in R±MTX+RT, and R-MPV groups. Median PFS was 16 months and 56 months in R±MTX group and R±MTX+RT, respectively, and could not be calculated in the R-MPV group. Although the R-MPV group had a short follow-up period, the results were considered to be comparable to those of the R±MTX+RT group. On the other hand, grade 3/4 adverse events occurred in 50%, 25%, and 100%, respectively. Conclusion: R-MPV therapy may delay the timing of radiation and reduce the amount of radiation. On the other hand, the frequency of adverse events is high, and more strict management of treatment is required.
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Affiliation(s)
- Kiyonori Kuwahara
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shigeo Ohba
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kazuyasu Matsumura
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Saeko Higashiguchi
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Daijiro Kojima
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Jun Muto
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Shunsuke Nakae
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yuya Nishiyama
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Seiji Yamada
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kazuhide Adachi
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Masato Abe
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Mitsuhiro Hasegawa
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, School of Medicine, Fujita Health University, Toyoake, Japan
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Adachi K, Murayama K, Hayakawa M, Hasegawa M, Muto J, Nishiyama Y, Ohba S, Hirose Y. Objective and quantitative evaluation of angiographic vascularity in meningioma: parameters of dynamic susceptibility contrast-perfusion-weighted imaging as clinical indicators of preoperative embolization. Neurosurg Rev 2020; 44:2629-2638. [DOI: 10.1007/s10143-020-01431-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/01/2020] [Accepted: 10/30/2020] [Indexed: 10/22/2022]
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Muto J, Yoshida S, Doi C, Habu M, Sayama K. Dupilumab treatment of atopic dermatitis leading to successful treatment of alopecia universalis: A Japanese case report. J Dermatol 2020; 48:e72-e73. [PMID: 33029817 DOI: 10.1111/1346-8138.15631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Jun Muto
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Satoshi Yoshida
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Chiaki Doi
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Minako Habu
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
| | - Koji Sayama
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Japan
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Hu L, Sato Y, Takagi K, Ishii T, Honma Y, Muto J. LB926 Hyaluronic acids (HAs) molecular size-dependent biological functions on UVB-induced DAMPs-mediated keratinocyte inflammation. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Muto J, Fukuda S, Shirakata Y, Tsuda T, Tan E, Dai X, Shiraishi K, Mori H, Murakami M, Higashiyama S, Sayama K. 796 Effect of novel disaccharide for construction of living skin equivalents. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ishida H, Seyama Y, Ome Y, Matsumura M, Nemoto S, Doi M, Muto J, Hayakawa S, Karasawa K, Horio H, Horiguchi S, Honda G. [A Case of Pulmonary Metastasis from Hilar Cholangiocarcinoma Treated by Stereotactic Body Radiotherapy]. Gan To Kagaku Ryoho 2020; 47:340-342. [PMID: 32381982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We report a case of pulmonary metastasis from hilar cholangiocarcinoma successfully treated by stereotactic body radiotherapy. The patient was a 70-year-old woman who underwent extended left hemi-hepatectomy with bile duct reconstruction for hilar cholangiocarcinoma at the age of 67. Pathological diagnosis indicated a well-differentiated adenocarcinoma. We followed up the patient without adjuvant chemotherapy. Nineteen months after the initial resection, a solitary pulmonary metastasis was detected in the right upper lobe. The patient received gemcitabine plus cisplatin(GC)therapy. After 4 courses of GC therapy, the size of the pulmonary metastasis was unchanged. Therefore, we performed a thoracoscopic wedge resection. Pathological diagnosis indicated that the pulmonary metastasis originated from the cholangiocarcinoma. Fifteen months after the pulmonary resection, another solitary pulmonary metastasis was detected in the left lower lobe. As the patient refused further chemotherapy, we performed stereotactic body radiotherapy(SBRT)(50 Gy/4 Fr). An adverse event of Grade 1 radiation pneumonitis was observed. The metastasis disappeared after SBRT. Twenty-eight months after SBRT and 70 months after the initial surgery, the patient is alive without recurrence.
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Affiliation(s)
- Hiroyuki Ishida
- Dept. of Hepatobiliary and Pancreatic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
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Muto J, Matsutani T, Matsuda R, Kinoshita M, Oikawa M, Johan P, Adachi K, Hirose Y, Sasaki H. ACT-18 SHOULD THE DOSE OF TEMOZOLOMIDE BE DECREASED FOR PATIENTS WITH HIGH-GRADE GLIOMAS WHO ARE ON HEMODIALYSIS? Neurooncol Adv 2019. [PMCID: PMC7213182 DOI: 10.1093/noajnl/vdz039.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
BACKGROUND
The pharmacokinetics of temozolomide in patients with severe renal impairments (creatinine clearance less than 36 mL/min/m2) or in hemodialysis patients has not been investigated. Temozolomide and its metabolic products are mainly excreted in urine, as retention of these in the body may result in increased adverse events in hemodialysis patients harboring a high-grade glioma.
METHODS
Eight hemodialysis patients with high-grade gliomas from seven institutions were included in the study. Patient characteristics, treatment schedule, clinical course, pathological/molecular findings, and adverse events were evaluated.
RESULTS
The histopathological diagnoses were Isocitrate dehydrogenase (IDH) wild-type glioblastoma in four cases, Not other specified (NOS) glioblastoma in two cases and IDH-mutant anaplastic astrocytoma in one case. Five of the seven patients completed radiotherapy (48–60 Gy) with concomitant temozolomide (75 mg/m2) followed by adjuvant 5-day temozolomide (150 mg/m2) every 28 days. During the entire course of treatment with temozolomide, severe (Common Terminology Criteria for Adverse Events (CTCAE) more than grade 3) lymphocytopenia occurred in 57%(41.7–61%: non hemodialysis patients data, the same as below), neutropenia in 0%(1–15.4%) and thrombocytopenia in 14%(0–16.7%) of the patients. Generally, the frequency and degree of myelosuppression do not increase in hemodialysis patients with high-grade gliomas. Two of the seven (28.5%) patients died of infectious disease despite having no direct correlation to myelosuppression that is similar rate of 21.9% of the death results from infection in hemodialysis patients in Japan.
CONCLUSIONS
The high-grade glioma patients under study on hemodialysis did not require decreasing doses of Temozolomide during concomitant radiochemotherapy and maintenance therapy. However, careful clinical and hematological observation is required to avoid critical hematotoxicity and infection.
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Affiliation(s)
- Jun Muto
- Fujtia Health University,School of Medicine
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Muto J, Matsutani T, Matsuda R, Kinoshita M, Oikawa M, Pallud J, Sasaki H. Temozolomide radiochemotherapy for high-grade glioma patients with hemodialysis: a case series of 7 patients. Neurooncol Pract 2019; 7:111-117. [PMID: 32025326 DOI: 10.1093/nop/npz034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The pharmacokinetics of temozolomide (TMZ) in patients with severe renal impairments (creatinine clearance, <36 mL/min/m2) or in hemodialysis (HD) patients has not been investigated. TMZ and its metabolic products are mainly excreted in urine, as retention of these in the body may result in increased adverse events in HD patients. Methods Seven HD patients with high-grade gliomas from 6 institutions were included in the study. Patient characteristics, treatment schedule, clinical course, pathological/molecular findings, and adverse events were evaluated. Results The histopathological diagnoses were isocitrate dehydrogenase (IDH) wild-type glioblastoma in 4 cases, not other specified (NOS) glioblastoma in 2 cases, and IDH-mutant anaplastic astrocytoma in 1 case. Five of the 7 patients completed radiotherapy (48-60 Gy) with concomitant TMZ (75 mg/m2) followed by adjuvant 5-day TMZ (150 mg/m2) every 28 days. During the entire course of treatment with TMZ, severe (Common Terminology Criteria for Adverse Events [CTCAE] ≥ Grade 3) lymphocytopenia occurred in 57%, neutropenia in 0%, and thrombocytopenia in 14% of the patients. Generally, the frequency and degree of myelosuppression do not increase in HD patients with high-grade gliomas. Two of the 7 (28.5%) patients died of infectious disease despite having no direct correlation to myelosuppression; that is similar to the death rate of 21.9% resulting from infection in HD patients in Japan. Conclusions Decreasing the dose of TMZ might not be required in HD patients with high-grade gliomas during concomitant radiochemotherapy and maintenance therapy. However, careful clinical and hematological observation is required to avoid critical hematotoxicity and infection.
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Affiliation(s)
- Jun Muto
- Department of Neurosurgery, Fujita Health University, Japan.,Department of Neurosurgery, Keio University School of Medicine, Japan.,Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Japan
| | | | | | | | | | - Johan Pallud
- Department of Neurosurgery, Sainte-Anne Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, France.,Inserm, U894, IMA-Brain, Centre de Psychiatrie et Neurosciences, Paris, France
| | - Hikaru Sasaki
- Department of Neurosurgery, Keio University School of Medicine, Japan
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Doi M, Seyama Y, Nakanishi Y, Ome Y, Muto J, Imamura J, Horiguchi S, Koga F. [A Case of Bladder Urothelial Carcinoma with Hepatic Metastasis Achieving Histologically Complete Response by Multimodal Treatment Including Pembrolizumab]. Gan To Kagaku Ryoho 2019; 46:2321-2323. [PMID: 32156918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 70s man underwent transurethral resection of the bladder tumor(TURBT)at a previous hospital. The pathological diagnosis was urothelial carcinoma pT1. Nine months later, recurrence appeared in the bladder and he underwent repeated TURBT. The pathological diagnosis was also pT1 and he was administered 8 courses of intravesical BCG therapy. Fourteen months after the first operation, computed tomography scans showed new lesions in the liver. Therefore, he was referred to our hospital. Because biopsy from the hepatic lesion confirmed the diagnosis of metastatic urothelial carcinoma, he received 10 courses of gemcitabine plus cisplatin(GC)and radiofrequency ablation. However, daughter nodule and enlargement of the main tumor were revealed on MRI 33 months after the initial TURBT. After 5 courses of pembrolizumab that limited the potential for hepatic metastases, he had no evidence of other metastatic sites and underwent laparoscopic right hepatectomy. There was no viable carcinoma in the pathological specimens of the hepatic lesions. Six months after hepatectomy, the patient has a high quality of life without any recurrence.
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Affiliation(s)
- Manami Doi
- Dept. of Hepato-Biliary-Pancreatic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
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