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Watanabe N, Watari T, Otsuka Y, Hosokawa N, Yamagata K, Fujioka M. Clinical and microbiological characteristics of Ruminococcus gnavus bacteremia and intra-abdominal infection. Anaerobe 2024; 85:102818. [PMID: 38211774 DOI: 10.1016/j.anaerobe.2024.102818] [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: 11/01/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/13/2024]
Abstract
OBJECTIVES Ruminococcus gnavus is a rare human pathogen, and clinical data on R. gnavus infection are insufficient. This retrospective study aimed to investigate the clinical characteristics of R. gnavus infections. METHODS This study included 13 cases of bacteremia and three cases of non-bacteremia infections caused by R. gnavus. We evaluated the patient data, infection source, clinical outcomes, and antimicrobial susceptibility of R. gnavus isolates for these cases. RESULTS The median age of patients was 75 years (range 47-95), and eight patients were female. Twelve cases were presumed to have an intra-abdominal infection source, and the remaining four cases had an unknown infection source. The most common underlying conditions were immunosuppression (seven cases), solid tumors (seven cases), and history of gastrointestinal surgery (five cases). Thirteen patients exhibited gastrointestinal problems (dysfunction, bleeding, intra-abdominal infection, or inflammation). Multiple pathogens were observed in six cases, and fatal outcomes were recorded in three cases. Antimicrobial susceptibility data were available for eight isolates, all of which exhibited low minimum inhibitory concentrations to penicillin (≤0.03 μg/mL), ampicillin-sulbactam (≤0.5 μg/mL), piperacillin-tazobactam (≤4 μg/mL), and metronidazole (≤0.5-1 μg/mL). CONCLUSION Ruminococcus gnavus is frequently associated with an intra-abdominal infection source, and treatment strategies should consider the possibility of multiple pathogens.
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Affiliation(s)
- Naoki Watanabe
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba, Japan; Graduate School of Health Sciences, Hirosaki University, Hon-cho 66-1, Hirosaki, Aomori, Japan.
| | - Tomohisa Watari
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba, Japan.
| | - Yoshihito Otsuka
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba, Japan.
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, Higashi-cho 929, Kamogawa, Chiba, Japan.
| | - Kazufumi Yamagata
- Graduate School of Health Sciences, Hirosaki University, Hon-cho 66-1, Hirosaki, Aomori, Japan.
| | - Miyuki Fujioka
- Graduate School of Health Sciences, Hirosaki University, Hon-cho 66-1, Hirosaki, Aomori, Japan.
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Tachita T, Takahata T, Yamashita S, Ebina T, Kamata K, Yamagata K, Tamai Y, Sakuraba H. Newly diagnosed extranodal NK/T-cell lymphoma, nasal type, at the injected left arm after BNT162b2 mRNA COVID-19 vaccination. Int J Hematol 2023; 118:503-507. [PMID: 37093551 PMCID: PMC10124685 DOI: 10.1007/s12185-023-03607-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/15/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/25/2023]
Abstract
Anti-SARS-CoV-2 vaccines were developed in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the BNT162b2 mRNA vaccine is effective, adverse effects have been reported. Here, we report a case of extranodal NK/T-cell lymphoma, nasal type (ENKL), of the left arm following BNT162b2 mRNA vaccination. A 73-year-old male presented with a lump in the left arm, which was the site where he received the BNT162b2 mRNA vaccine 3 months prior. He was treated with topical corticosteroids and debridement, but the tumor progressed. Additionally, fever, night sweats, and general fatigue were observed. Laboratory findings included thrombocytopenia, elevated lactate dehydrogenase, and soluble interleukin-2 receptor levels. Skin biopsy led to a diagnosis of ENKL. The patient was treated with a 50% dose of SMILE therapy and radiotherapy, resulting in regression of the tumor. It seems that latent Epstein-Barr virus (EBV)-infected NK/T cells were reactivated by vaccination and contributed to the onset of ENKL. This is the first report of ENKL after BNT162b2 mRNA vaccination. The present case highlights the possible risk of development of malignant lymphoma, including ENKL at the injection site, after BNT162b2 COVID-19 vaccination.
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Affiliation(s)
- Takuto Tachita
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan.
| | - Takenori Takahata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan
| | - Satoru Yamashita
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan
| | - Toru Ebina
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan
| | - Kosuke Kamata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan
| | - Kazufumi Yamagata
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Yoshiko Tamai
- Department of Transfusion and Cell Therapy Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho, Hirosaki, , Aomori, 036-8562, Japan
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Takahata T, Tachita T, Yamashita S, Ebina T, Kamata K, Chen Y, Saito K, Sato A, Yamagata K, Tamai Y, Fukuda S. P65-1 Clinicopathological feature of T-cell lymphoma in our institute. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.328] [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: 11/01/2022] Open
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Nozaka H, Oda M, Sasaki A, Harako H, Miyazaki M, Kaga S, Sakaiya N, Kudo K, Kimura S, Nakano M, Fujioka M, Yamagata K. The Effect of Data Augmentation in Deep Learning Approach for Peripheral Blood Leukocyte Recognition. Stud Health Technol Inform 2022; 290:273-277. [PMID: 35673016 DOI: 10.3233/shti220077] [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] [Indexed: 06/15/2023]
Abstract
Data augmentation is reported as a useful technique to generate a large amount of image datasets from a small image dataset. The aim of this study is to clarify the effect of data augmentation for leukocyte recognition with deep learning. We performed three different data augmentation methods (rotation, scaling, and distortion) as pretreatment on the original images. The subjects of clinical assessment were 51 healthy persons. The thin-layer blood smears were prepared from peripheral blood and stained with MG. The effect of data augmentation with rotation was the only significant effective technique in AI model generation for leukocyte recognition. On contrast, the effect of data augmentation with image distortion or image scaling was poor, and accuracy improvement was limited to specific leukocyte categories. Although data augmentation is one effective method for high accuracy in AI training, we consider that a highly effective method should be selected.
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Affiliation(s)
- Hiroyuki Nozaka
- Hirosaki university Graduate school of health sciences, Japan
| | - Miku Oda
- Hirosaki university School of health sciences, Japan
| | - Ami Sasaki
- Hirosaki university School of health sciences, Japan
| | - Honoka Harako
- Hirosaki university School of health sciences, Japan
| | - Mae Miyazaki
- Hirosaki university School of health sciences, Japan
| | - Suzuka Kaga
- Hirosaki university School of health sciences, Japan
| | - Niina Sakaiya
- Hirosaki university School of health sciences, Japan
| | - Kyouka Kudo
- Hirosaki university School of health sciences, Japan
| | - Shou Kimura
- Hirosaki university School of health sciences, Japan
| | - Manabu Nakano
- Hirosaki university Graduate school of health sciences, Japan
| | - Miyuki Fujioka
- Hirosaki university Graduate school of health sciences, Japan
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Watanabe N, Watari T, Otsuka Y, Yamagata K, Fujioka M. Clinical characteristics and antimicrobial susceptibility of Klebsiella pneumoniae, Klebsiella variicola and Klebsiella quasipneumoniae isolated from human urine in Japan. J Med Microbiol 2022; 71. [PMID: 35699119 DOI: 10.1099/jmm.0.001546] [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] [Indexed: 11/18/2022] Open
Abstract
Introduction. The three Klebsiella species K. pneumoniae, K. variicola and K. quasipneumoniae are difficult to distinguish, owing to their similar biochemical properties, and are often confused in medical practice.Gap statement. There is a scarcity of data comparing the clinical characteristics and antimicrobial susceptibility of K. pneumoniae, K. variicola and K. quasipneumoniae. We believe that knowledge of the characteristics of each species will help in their better identification. Further, knowing the antimicrobial susceptibility of the species will help physicians in prescribing an effective treatment course for Klebsiella infections.Aim. This study aimed to determine the clinical characteristics and antimicrobial resistance of K. pneumoniae, K. variicola and K. quasipneumoniae isolated from human urine samples.Methodology. This study included 125 K. pneumoniae strains isolated from human urine samples. Multiplex polymerase chain reaction was performed to identify K. pneumoniae, K. variicola and K. quasipneumoniae. We retrospectively investigated the patient background, complications of bacteraemia, antimicrobial susceptibility and extended-spectrum β-lactamase (ESBL).Results. We identified 84 (67.2 %), 31 (24.8 %) and 10 strains (8 .0%) of K. pneumoniae, K. variicola and K. quasipneumoniae, respectively. There was no difference in patient background and frequency of bacteraemia complications among these species. K. pneumoniae was significantly less susceptible than K. variicola to ampicillin/sulbactam (P=0.03) and piperacillin (P<0.01). Furthermore, K. pneumoniae (79.8 %) was less susceptible to trimethoprim/sulfamethoxazole than K. variicola (96.8 %) and K. quasipneumoniae (100 %). There were nine ESBL-producing strains (7.2 %), all of which were K. pneumoniae.Conclusion. There was no difference in patient background and frequency of bacteraemia complications between K. pneumoniae, K. variicola and K. quasipneumoniae isolated from urine. The three Klebsiella species showed a varying extent of antimicrobial susceptibility and ESBL production, and accurate identification is needed to understand the epidemiology of these species.
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Affiliation(s)
- Naoki Watanabe
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa-shi, Chiba, 296-8602, Japan.,Hirosaki University, Graduate School of Health Sciences, Hon-cho 66-1, Hirosaki-shi, Aomori, 036-8564, Japan
| | - Tomohisa Watari
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa-shi, Chiba, 296-8602, Japan
| | - Yoshihito Otsuka
- Department of Clinical Laboratory, Kameda Medical Center, Higashi-cho 929, Kamogawa-shi, Chiba, 296-8602, Japan
| | - Kazufumi Yamagata
- Hirosaki University, Graduate School of Health Sciences, Hon-cho 66-1, Hirosaki-shi, Aomori, 036-8564, Japan
| | - Miyuki Fujioka
- Hirosaki University, Graduate School of Health Sciences, Hon-cho 66-1, Hirosaki-shi, Aomori, 036-8564, Japan
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Yamagata K, Yamagata LM, Abela M. Cardiac screening in police and armed forces: a pilot project. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.274] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Most international bodies now recommend cardiac screening for all individuals undertaking high intensity physical activity. The sensitivity and specificity of the ECG in cardiac screening is undisputed.
Study Objective
Two major national institutions (Police Force and the Armed Forces) have now recognized the importance of having a cardiac screening program. As of 2020, the department of Cardiology has been offering remote ECG interpretation for all new recruits. The aim of the study was to retrospectively review this service, specifically looking at the diagnostic yield.
Methodology
All reported ECGs were retrospectively evaluated. ECG changes were labelled as training related, borderline or pathological ECG patterns as depicted in the 2017 International Recommendations for ECG interpretation in athletes. Demographic, symptom and ECG data were tabulated. The clinical outcomes of those referred were also recorded. Categorical data was presented as percentages. Statistical analysis was performed using SPSS v23.
Results
318 recruits were screened, mean age 31.42 ± 13.2 years. The majority (n=196, 61.6%) were younger than 35 years. It was a predominant male population (n=262, 82.4%), all being Caucasian. Armed forces and police force recruits were equally represented (n=154, 48.4% vs n=164, 51.6%). No one reported symptoms (0.0%). The commonest training related changes included early repolarisation (22.3%), left ventricular hypertrophy (15.4%), sinus bradycardia (14.2%) and partial right bundle branch block (7.5%). Some had pathological ECG patterns (Anterior T Wave Inversion n=6 [1.9%], ST segment depression n=6 [1.9%], pathological Q waves n=5 [1.6%], ventricular ectopics n=3 [0.9%], pre-excitation n=2 [0.6%], inferior T Wave inversion n=1 [0.3%], Short QT n=1 [0.3%]).
Most were cleared at the initial assessment (n=292, 91.5%). 26 (8.2%) were referred for further evaluation. 14 (4.4%) needed a repeat ECG. Most (n=6, 23.1%) were cleared after secondary evaluation. Another 4 (15.4%) needed surveillance. 6 (23.1%) had a clinical diagnosis, equating to 1 in 53 individuals screened (1.9% of initial cohort). Two patients were already under the care of a cardiologist (n=1 sinus venosus defect with PAPVD, n=1 ischaemic cardiomyopathy). 4 were newly diagnosed cardiac patients (n=1 HCM, n=2 WPW, n=1 Aortopathy). Age did not have any significant impact on the diagnostic yield (<35 [50%] vs ≥35 [50%] years, p=0.244).
Conclusion
8.2% were referred for further evaluation (1 in 12). 1.9% (1 in 53) had a clinical diagnosis. This highlights the importance of an ECG based screening algorithm in close liaison with experts in cardiac screening. A clinical diagnosis in law enforcement and army personnel may have important lifelong career implications.
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Affiliation(s)
- K Yamagata
- Mater Dei Hospital of Malta, Department of cardiology, Msida, Malta
| | - LM Yamagata
- Mater Dei Hospital of Malta, Department of cardiology, Msida, Malta
| | - M Abela
- Mater Dei Hospital of Malta, Department of cardiology, Msida, Malta
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Komeyama S, Watanabe T, Yamagata K, Iwasaki Y, Hada T, Shimojima M, Mochizuki H, Tadokoro N, Kainuma S, Tsukamoto Y, Seguchi O, Fukushima S, Kusano K, Fujita T, Fukushima N. Successful Recovery from Refractory Hypoxia Due to Right-to-Left Shunting Associated with Iatrogenic Atrial Septal Defect After Catheter Ablation in a Patient with a Left Ventricular Assist Device. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1731] [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: 12/01/2022] Open
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Aiuchi N, Nakagawa J, Sakuraba H, Takahata T, Kamata K, Saito N, Ueno K, Ishiyama M, Yamagata K, Kayaba H, Niioka T. Impact of polymorphisms of pharmacokinetics-related genes and the inflammatory response on the metabolism of voriconazole. Pharmacol Res Perspect 2022; 10:e00935. [PMID: 35199485 PMCID: PMC8866912 DOI: 10.1002/prp2.935] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
The effects of inflammatory responses and polymorphisms of the genes encoding cytochrome P450 (CYP) (CYP2C19 and CYP3A5), flavin-containing monooxygenase 3 (FMO3), pregnane X receptor (NR1I2), constitutive androstane receptor (NR1I3), and CYP oxidoreductase (POR) on the ratio of voriconazole (VRCZ) N-oxide to VRCZ (VNO/VRCZ) and steady-state trough concentrations (C0h ) of VRCZ were investigated. A total of 56 blood samples were collected from 36 Japanese patients. Results of multiple linear regression analyses demonstrated that the presence of the extensive metabolizer CYP2C19 genotype, the dose per administration, and the presence of the NR1I2 rs3814057 C/C genotype were independent factors influencing the VNO/VRCZ ratio in patients with CRP levels of less than 40 mg/L (standardized regression coefficients (SRC) = 0.448, -0.301, and 0.390, respectively; all p < .05). With regard to the concentration of VRCZ itself, in addition to the above factors, the presence of the NR1I2 rs7643645 G/G and rs3814055 T/T genotypes were found to be independent factors influencing the VRCZ C0h in these patients (SRC = -0.430, 0.424, -0.326, 0.406 and -0.455, respectively; all p < .05). On the contrary, in patients with CRP levels of at least 40 mg/L, no independent factors were found to affect VNO/VRCZ and VRCZ C0h . Inflammatory responses, and CYP2C19 and NR1I2 polymorphisms may be useful information for the individualization of VRCZ dosages.
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Affiliation(s)
- Naoya Aiuchi
- Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Junichi Nakagawa
- Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Takenori Takahata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kosuke Kamata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Norihiro Saito
- Department of Clinical Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kayo Ueno
- Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Masahiro Ishiyama
- Department of Clinical Laboratory, Hirosaki University Hospital, Hirosaki, Aomori, Japan
| | - Kazufumi Yamagata
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Hiroyuki Kayaba
- Department of Clinical Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Takenori Niioka
- Department of Pharmacy, Hirosaki University Hospital, Hirosaki, Aomori, Japan.,Department of Pharmaceutical Science, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
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Miki Y, Kamata K, Goto S, Sakuraba H, Mori F, Yamagata K, Kijima H, Fukuda S, Wakabayashi K. The clinical and neuropathological picture of adult neuronal intranuclear inclusion disease with no radiological abnormality. Neuropathology 2022; 42:204-211. [PMID: 35274390 DOI: 10.1111/neup.12792] [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] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/29/2021] [Accepted: 11/02/2021] [Indexed: 11/30/2022]
Abstract
In typical adult neuronal intranuclear inclusion disease (NIID) with predilection for the basal ganglia or cerebral cortex, not only neurons but also glial cells harbor intranuclear inclusions. In addition, these inclusions are present in the peripheral autonomic nervous system, visceral organs and skin. In NIID cases with an expansion of GGC repeats in the 5'-untranslated region (5'-UTR) of the Notch 2 N-terminal like C (NOTCH2NLC) gene, these repeats are located in an upstream open reading frame (uN2C) and result in the production of a polyglycine-containing protein called uN2CpolyG. Typically, patients with adult NIID show high-intensity signals at the corticomedullary junction on diffusion-weighted brain magnetic resonance imaging. We report a case of adult NIID in a 78-year-old Japanese male, who suffered from mild, non-progressive tremor during life but showed no radiographic abnormalities suggestive of adult NIID. Pathologically, ubiquitin-, p62- and uN2CpolyG-positive neuronal intranuclear inclusions were particularly frequent in the hippocampal formation, but were also seen in the enteric plexuses, kidney and cardiac muscles. By contrast, glial intranuclear inclusions were barely evident in the affected regions. The present case also had an immunohistochemical profile differing from that of typical adult NIID. The findings in this case suggest that adult NIID can show clinical, radiographic and pathological heterogeneity.
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Affiliation(s)
- Yasuo Miki
- Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kosuke Kamata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shintaro Goto
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Fumiaki Mori
- Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazufumi Yamagata
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koichi Wakabayashi
- Department of Neuropathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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12
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Watanabe N, Otsuka Y, Watari T, Hosokawa N, Yamagata K, Fujioka M. Time to positivity of Corynebacterium in blood culture: Characteristics and diagnostic performance. PLoS One 2022; 17:e0278595. [PMID: 36512568 PMCID: PMC9747040 DOI: 10.1371/journal.pone.0278595] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
The presence of Corynebacterium in blood samples can indicate true bacteremia or contamination, thus complicating the diagnosis of true bacteremia. We aimed to evaluate the usefulness of time to positivity (TTP) in diagnosing true bacteremia and contamination in cases where Corynebacterium was isolated from blood samples. We compared the TTP of the true-bacteremia group (n = 77) with that of the contamination group (n = 88). For the true-bacteremia cases that had only one set of positive blood cultures (n = 14), considering clinical and bacteriological data, additional cultures were performed on blood or other specimens. The same Corynebacterium spp. as in blood were isolated from these specimens. Receiver operating characteristic curves were generated, and the sensitivity and specificity of TTP were calculated for diagnosing true bacteremia. The median TTP of the true-bacteremia group (26.8 h) was shorter than that of the contamination group (43.3 h) (P < 0.0001). When considering TTP ≤ 25.0 h as true bacteremia, the sensitivity and specificity were 44.2% and 95.5%, respectively. Moreover, when considering TTP ≤ 69.4 h as true bacteremia, the sensitivity and specificity were 96.1% and 20.5%, respectively. Among the true-bacteremia groups with one set of positive blood cultures (n = 14), no case exhibited a TTP > 69.4 h. Only three cases showed TTP ≤ 25.0 h in the true-bacteremia group with one set of positive blood cultures. TTP > 69.4 h is likely to indicate contamination and may be useful to exclude true bacteremia in cases with one set of positive blood cultures. Meanwhile, diagnosing true bacteremia using the threshold of TTP 25.0 h would be difficult. Therefore, the clinical and bacteriological data are important for diagnosing bacteremia, especially in cases with TTP ≤ 69.4 h.
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Affiliation(s)
- Naoki Watanabe
- Department of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan
- Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
- * E-mail:
| | - Yoshihito Otsuka
- Department of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomohisa Watari
- Department of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Kazufumi Yamagata
- Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - Miyuki Fujioka
- Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
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13
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Abela M, Debattista J, Yamagata K, Felice T, Burg M, Sammut MA, Xuereb RG, Grech V, Monserrat L, Papadakis M. Yield from family screening in a national adolescent cardiac screening program. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2704] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Cascade family screening in patients with confirmed or suspected inherited cardiac disorders is now well established. This may refute or confirm a familial clinical diagnosis and is particularly relevant in young adolescent individuals as it may be too early to manifest a distinct phenotype.
Objectives
A large cohort of 2708 adolescents aged 14–16 years gave consent to participate in a national cardiac screening program (BEAT-IT). Individuals with suspected inherited cardiac disorders were extensively evaluated. Their relatives were also invited to undergo screening. This study reports the yield of this family cardiac screening program.
Methodology
Family members of probands with suspected or confirmed inherited cardiac conditions were offered cardiac screening. A standard clinical screening protocol for all first-degree family members included a resting 12-lead ECG and echocardiogram. Those with a channelopathy suspicion also underwent postural ECGs and exercise testing. Screening second-degree relatives was also performed in a cascade fashion when clinically indicated. Relatives with a normal baseline screen were offered surveillance if younger than 25 years or a proband clinical diagnosis. Those with an abnormal ECG and/or echocardiogram were referred for further evaluation.
Results
17 probands (63% females) were suspected of harbouring inherited heart disease. Another 2 were diagnosed with a clinical phenotype. The mean age was 15.3±0.58 years. All were Caucasian.
77 family members underwent cardiac screening, with a mean age of 42.5±16.43 at first evaluation. The majority were female (n=44, 57.1%). 12 (15.6%) had an abnormal ECG. 6 (7.8%) had an abnormal echocardiogram, with 2 (2.6%) consistent with cardiomyopathy. 8 (10.4%) were diagnosed with an inherited cardiac condition (n=2 HCM, n=1 DCM, n=5 LQTS). Another 7 (9.1%) are under surveillance because of a pathological ECG in the absence of a clinical phenotype.
The highest clinical yield was in the Long QT group (n=5, 55.6%). Family members (n=25) referred because of proband lateral TWI were the second most likely to require clinical follow-up because of a pathological ECG or a clinical diagnosis (n=7, 28.0%). Relatives referred because of isolated anterior TWI on the proband's ECG had the lowest diagnostic yield (n=17, 0%). After excluding families of probands with isolated anterior TWI (n=18), the overall clinical yield increased to 13.6%. Another 11.9% are under surveillance because of a pathological ECG.
Conclusion
The yield of family screening as part of a national cardiac screening program was 10.4%. This increases to 13.6% when excluding probands with anterior TWI, with 11.9% under surveillance because of a pathological ECG. To our knowledge, this is the first such study of its kind.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Beating Hearts MaltaResearch, Innovation and Development Trust (University of Malta)
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Affiliation(s)
- M Abela
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - J Debattista
- Mater Dei Hospital of Malta, Genetics laboratory, pathology department, Msida, Malta
| | - K Yamagata
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - T Felice
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - M Burg
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - M A Sammut
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - R G Xuereb
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - V Grech
- Mater Dei Hospital of Malta, Paediatrics, Msida, Malta
| | - L Monserrat
- University Hospital A Coruna, Cardiology département, Health in Code, A Coruna, Spain
| | - M Papadakis
- St George's University of London, Cardiovascular Clinical Academic Group, London, United Kingdom
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14
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Yamagata K, Fukuzawa S, Uchida F, Okubo-Sato M, Ishibashi-Kanno N, Bukawa H. Is the addition of extranodal extension and lymph node yield of pN0 to the lymph node ratio useful as a prognostic parameter for patients with oral squamous cell carcinoma? Br J Oral Maxillofac Surg 2021; 59:941-946. [PMID: 34456079 DOI: 10.1016/j.bjoms.2020.12.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
We investigated the value of the weighted lymph node ratio (WLNR), a new marker in pN0 patients that incorporates the number of metastatic lymph nodes with extranodal extension and the lymph node yield, for the prognosis and postsurgical management of oral squamous cell carcinoma (OSCC). We designed a retrospective study and enrolled patients with OSCC who were treated by neck dissection (ND). The predictor variable was WLNR, and the outcome variable was overall survival (OS). The Cox proportional-hazards model was used to identify independent prognostic factors. In 133 patients with OSCC, the WLNR cut-off value for predicting OS was 0.0363 (area under the curve 0.723, p<0.001). When stratified according to WLNR, there was a significant difference in OS (88.4% for low WLNR and 63.0% for high WLNR, p<0.001). Univariate analyses showed close associations between OS and age, dissection area, postoperative management, extranodal extension, number of positive lymph nodes, pN stage, WLNR, and nodal disease area. Cox multivariate analysis identified the WLNR as an independent predictive factor for OS (HR 3.273, 95% CI 1.227 to 8.731, p=0.018). As a predictive factor, a high WLNR (≥0.0363) in patients with pN0 disease, which included the addition of extranodal extension and lymph node yield to the LNR, was associated with diminished survival.
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Affiliation(s)
- K Yamagata
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba.
| | - S Fukuzawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - F Uchida
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - M Okubo-Sato
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - N Ishibashi-Kanno
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba
| | - H Bukawa
- Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba
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15
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Abela M, Grech N, Degiorgio S, Xuereb R, Xuereb S, Yamagata K, Bonello J, Fleri Soler J, Buttigieg L, Camilleri W, Burg M, Sammut MA, Felice T, Grech V, Papadakis M. The prevalence of short PR interval in adolescent athletes and non-athletes. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.374] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Malta Heart Foundation and Beating Hearts
Background
Little is known about the prevalence and clinical relevance of an isolated short PR interval in young individuals.
Objectives
To explore the PR interval in adolescent athletes and non-athletes and determine possible association with sex, age, ethnicity, athletic ability and sporting discipline.
Methods
Between 2017-2018, school children aged 14-17 years were invited to participate in a National cardiac screening programme comprised of a health questionnaire and a resting 12-lead ECG. An athlete was defined as an individual participating in >4 hours/week of organised sports. Sport disciplines were categorised as skill, power, mixed and endurance. A short PR interval was defined as <120ms.
Results
A total of 1619 (61.0%) non-athletes and 1036 (39.0%) athletes (median age 15 years, 50.5% females, 93.0% Caucasian) participated in the screening program. Most athletes participated in mixed sports (62.2%).
The mean PR interval was shorter in non-athletes compared to athletes (136.65 ± 19.00ms vs 139.93 ± 19.86ms p < 0.001) and in females compared to males (135.98 ± 18.39ms vs 139.93 ± 20.20ms, p < 0.001). An isolated short PR interval was present in 405 (15.3%) individuals. Associated pre-excitation was present in an additional 5 cases (0.2%). A short PR interval was commoner in females (18.7% vs 11.7%, p < 0.001) and in non-athletes (16.6% vs 13.2%, p = 0.020). Age (p = 0.657) and ethnicity (p = 0.115) did not influence the presence of a short PR interval.
The presence of a short PR interval in adolescent athletes was independent of the sporting discipline category (p = 0.071), in both males (p = 0.400) and females (p = 0.233). The absolute PR interval did not differ significantly between sporting categories (p = 0.065), in both genders (males, p = 0.202, females, p = 0.279).
Symptoms that were suggestive of arrhythmias were present in similar proportions of individuals with short and normal PR intervals (18.8% vs 17.1%, p = 0.393).
Conclusion
An isolated short PR interval was a frequent finding in this cohort, with a predilection for females and non-athletes. The high frequency of short PR in young individuals suggests that in the absence of pre-excitation or symptoms, further evaluation is not warranted. Long-term follow-up studies may further elucidate the clinical relevance of this phenomenon.
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Affiliation(s)
- M Abela
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - N Grech
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - S Degiorgio
- Mater Dei Hospital of Malta, Paediatrics, Msida, Malta
| | - R Xuereb
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - S Xuereb
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - K Yamagata
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - J Bonello
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - J Fleri Soler
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - L Buttigieg
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - W Camilleri
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - M Burg
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - MA Sammut
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - T Felice
- Mater Dei Hospital of Malta, Cardiology, Msida, Malta
| | - V Grech
- Mater Dei Hospital of Malta, Paediatrics, Msida, Malta
| | - M Papadakis
- St George"s University of London, Cardiovascular Clinical Academic Group, London, United Kingdom of Great Britain & Northern Ireland
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16
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Miki Y, Kamata K, Akemoto Y, Tsushima F, Sakuraba H, Yamagata K, Kurose A, Fukuda S, Wakabayashi K. Leptomeningeal and intraventricular myelomatosis manifesting an aggressive form of communicating hydrocephalus. Neuropathology 2021; 41:243-249. [PMID: 33973283 DOI: 10.1111/neup.12728] [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: 11/24/2020] [Revised: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 11/29/2022]
Abstract
Leptomeningeal myelomatosis (LMM) is a fatal complication that occurs in < 1% of patients with multiple myeloma. Many patients with LMM present with neurologic symptoms referable to cranial neuropathies, while the manifestation of communicating hydrocephalus has been underrecognized. A Japanese man with Bence Jones protein-κ multiple myeloma developed fever and headache at age 54 years. He then became somnolent and went into a coma. Neuroimaging analyses identified rapidly progressive communicating hydrocephalus due to meningitis. He died 83 days after the onset of headache without any response to treatment at age 55 years. No symptoms or signs associated with cranial nerves were found during the course of illness. Postmortem examination revealed hydrocephalus and diffuse infiltration of myeloma cells into the subarachnoid space of the cerebrum, cerebellum, and brainstem. In addition, the interstitial tissue of the choroid plexuses was filled with myeloma cells. These myeloma cells were positive for CD156 and light chain κ. The Ki-67 labeling index in myeloma cells of the central nervous system (CNS) was 30-40%. Histopathological examination further revealed many myeloma cells on the surface of the lateral, third and fourth ventricles and at the area postrema of the medulla oblongata. Patients with LMM can develop an aggressive form of communicating hydrocephalus. Given that cerebrospinal fluid, produced by epithelial cells in the choroid plexuses of the ventricles, passes into the subarachnoid space through the third and fourth ventricles, myeloma cells may invade the CNS through the choroid plexuses.
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Affiliation(s)
- Yasuo Miki
- Department of Neuropathology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kosuke Kamata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yui Akemoto
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Fumiyasu Tsushima
- Department of Radiation, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kazufumi Yamagata
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koichi Wakabayashi
- Department of Neuropathology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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17
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Wada M, Yamagata K, Ishibashi K, Inoue Y, Noda T, Nagase S, Ota M, Aiba T, Nakajima T, Fukuda T, Kusano K. Ventricular tachycardia in cardiac sarcoidosis -prognosis, characterization of ventricular substrates and outcomes of treatment-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2141] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prognosis, the underlying substrate and clinical outcomes of treatment are unclear in patients with cardiac sarcoidosis (CS)-related ventricular tachycardia (VT).
Objective
This study investigated the prognosis and the relationship between electroanatomical mapping (EAM) and imaging findings in patients with CS-related VT.
Methods
A total of 203 CS patients (Age 68.1±11.6 years, 87 males) were enrolled at two tertiary care medical centers between 2000 and 2018. All met the 2016 Japanese Circulation Society guidelines for diagnosis of CS. They were followed for a composite of major adverse cardiac events (MACE) including cardiac death, heart transplantation, unscheduled hospitalization for heart failure, and life-threatening ventricular arrhythmias. Distribution of late gadolinium enhancement (LGE) on cardiac MRI (CMR) and/or an abnormal myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography at diagnosis were examined. The relationship between EAM and the image findings were also analyzed in patients with radiofrequency ablation (RFA) for VT.
Results
During a median follow-up of 53 months, 87 of the 203 patients (43%) experienced a MACE. Baseline factors associated with MACE were presence of sustained VT (HR, 2.43, 95% CI 1.54–3.85, P<0.001), left ventricular ejection fraction below 50% (HR, 1.95 95% CI 1.07–3.56, P=0.029), and abnormal myocardial FDG uptake (HR, 2.42 95% CI 1.04–5.61, P=0.039). Overall, 69 of the 203 patients (34%) experienced sustained VT. Abnormal myocardial FDG uptake was significantly more prevalent in patients with VT than in those without (92.7% vs. 78.5%, P=0.02). A total of 25 patients (9.9%) required RFA for CS-related VT (Age 64.0±8.7 years, 12 males, 1.32±0.56 RFAs per patient). Abnormal electrocardiograms (EGM) were observed in 22 of the 25 patients (88%). LGE was more frequent than abnormal FDG uptake in areas with an abnormal EGM (77% vs. 41%; P=0.002). Over a mean follow-up period of 67-months, 13 of the 25 patients with RFA (52%) remained free of VT episodes (Figure). VT recurred in nine of the 12 patients with RFA and in 17 of the 47 patients without RFA, but was suppressed by intensive pharmacologic therapy such as the combined use of amiodarone and sotalol. In patients with CS-related VT, survival without experiencing a MACE did not differ in participants with or without RFA.
Conclusions
In our 203 CS patients, sustained VT and abnormal FDG uptake were associated with worse cardiac outcomes. The prevalence of abnormal FDG uptake was significantly higher in patients with CS-related VT, LGE on CMR was more frequent within localized areas of an abnormal EGM, suggesting that both scar itself and the associated inflammation were involved in the pathogenesis of CS-related VT. Successful RFA of CS-related VT is still challenging, and recurrence is common. Preprocedural CMR can be useful in detecting abnormal EGMs that are potential targets for substrate ablation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Ota
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Nakajima
- Saitama Cardiovascular and Respiratory Center, Department of Cardiology, Kumagaya, Japan
| | - T Fukuda
- National Cerebral & Cardiovascular Center, Department of Radiology, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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18
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Cardiac function at diagnosis is important prognostic factor in patients with cardiac sarcoidosis -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2130] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic non-caseating granulomatous disease of unknown etiology. Cardiac involvement (cardiac sarcoidosis, CS) has been reported to be an important prognostic factor in this disease because of heart failure and/or ventricular arrhythmia, and corticosteroid therapy is usually prescribed to prevent cardiac events. However, little is known about the relationship of cardiac function and concomitant corticosteroid therapy on later cardiac events in CS.
Objective
We evaluated the relationship between prognosis and left ventricular ejection fraction (LVEF) at the time of diagnosis in CS patients from the Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, mean age 60±13 years old, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The relationship of adverse events (all-cause death, cardiovascular death, and appropriate ICD [Implantable Cardioverter Defibrillator] discharge) and LVEF (with corticosteroid 84%) (low LVEF: LVEF≤35% n=98 [with corticosteroid in 78%], moderate LVEF: LVEF 35–50% n=104 [with corticosteroid in 93%], normal LVEF: 50≤LVEF n=218 [with corticosteroid in 83%]) were evaluated respectively.
Results
89 CS patients developed all-cause death (n=50), cardiovascular death (n=30) or appropriate ICD discharge (n=48). The frequency of corticosteroid therapy was not different in the each LVEF group, but Kaplan-Meier analysis revealed that all-cause death, cardiovascular death, and all cardiovascular adverse events were more observed in lower LVEF group (log-rank p<0.0001). Furthermore, multivariate Cox hazard analysis revealed that LVEF was a most important independent prognostic factor in CS.
Conclusion
This Japanese nationwide questionnaire survey data showed that initial LVEF was an independent and strong prognostic predictor in CS, therefore primary prevention would be needed even after starting corticosteroid in patients with decreased cardiac function.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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19
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long time clinical course of cardiac sarcoidosis with corticosteroid therapy -from Japanese nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2109] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement has been reported to be an important prognostic factor in this disease. An autopsy study has reported that the frequency of this cardiac involvement (cardiac sarcoidosis: CS) varies in the different countries and races and very frequent in Japanese patients. We therefore performed the nationwide questionnaire survey and try to clarify the clinical characteristics and corticosteroid effect in CS, especially focused on arrhythmic events in this disease.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The clinical outcome and corticosteroid effect were evaluated.
Results
Clinical characteristics at diagnosis was as follows: female dominant (68%), mean age of 60±13 years old, mean left ventricular ejection fraction was 49±16%. Arrhythmic events were very frequently observed as an initial cardiac manifestation in 263 patients (62%) of CS, of which atrioventricular block (AVB) in 174 (41%), ventricular tachycardia (VT) in 73 (17%) and AVB with VT in 17 (4%) (Figure 1A). Pacemaker was implanted in 166 patients (40%) and defibrillators was 137 patients (33%). Corticosteroid was prescribed in 144 (83%) of 174 patients with AVB and in 62 (85%) of 73 patients with VT. Initial dose was mean 47.9 mg and maintenance dose of mean 7.3 mg. Corticosteroid improved VT as good as AVB (27% vs. 29%). However, corticosteroid sometimes worsened VT events compared with AVB (10% vs. 2%) (Figure 1B). During the course of follow-up, 32 patients were needed to increase corticosteroid in 23 of AVB and 10 of VT cases. However, there were no difference in mortality between the groups, whether or not to increase corticosteroid. All survival rate was 92% (5-year mortality), 83% (10-year mortality) and free from all cause death and defibrillator charge was 81% (5 year), 71% (10 year).
Conclusion
Fatal arrhythmia is commonly observed in CS as a primary symptom. Corticosteroid sometimes worsen ventricular arrhythmia and appropriate defibrillator discharge was common. Thus, careful attention for activating ventricular arrhythmia would be needed during the follow-up period even after corticosteroid therapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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20
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Kamada H, Ishibashi K, Nakajima K, Ueda N, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Isobe M, Terasaki F, Kusano K. Long-term follow up ventricular tachycardia patients with preserved cardiac function -from Japanese cardiac sarcoidosis nationwide questionnaire survey-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2128] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Prior ventricular tachycardia (VT) and low left ventricular ejection fraction (LVEF) are the most important prognostic factors in cardiac sarcoidosis (CS). Recently diagnosis of CS was renewed according to Japanese new guidelines. Patients with preserved cardiac function often have VT events, thus new guidelines recommends to assess the implantable cardioverter defibrillator (ICD) implantation for CS patients with preserved LVEF (35%≤LVEF<50%). However, the long-term prognosis of CS patients with preserved LVEF is unclear.
Objective
In CS patients with preserved LVEF, we evaluated the prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis from Japanese nationwide questionnaire survey.
Methods
Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, who had LVEF≤35%, LVEF>50%, or who underwent cardiac transplantations were excluded. 104 patients with LVEF 35–50% (67 females, mean age 60±15 years old, median follow-up periods 2134 days [interquartile range: 758–2935 days]) were analyzed. The prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis were evaluated.
Results
30 patients had VT manifestation at CS diagnosis and 24 patients (80%) received ICDs. 74 patients had no VT manifestation at CS diagnosis and 19 patients (44%) received ICDs during follow up period. All-cause mortality was not different between two groups (Figure). Appropriate ICD therapy of non-VT manifestation group was significantly lower compared with that of VT manifestation group (log-rank p=0.001), however considerable number (n=7, 15%) of non-VT manifestation group had appropriate ICD therapy event during follow-up period. Cox hazard analysis revealed that concomitant non-sustained VT (NSVT) with atrioventricular block (AVB) was a predictor of appropriate ICD therapy in non-VT manifestation group.
Conclusion
This nationwide survey showed that considerable number of CS patients with preserved LVEF had VT events, independent of VT manifestation. Concomitant NSVT with AVB was a predictor of VT events, and ICD implantation should be assessed.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Kamada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Isobe
- Tokyo Medical and Dental University, Tokyo, Japan
| | | | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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21
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Tonegawa R, Miyamoto K, Ueda N, Nakajima K, Kamakura T, Yamagata K, Wada M, Ishibashi K, Inoue Y, Noda T, Nagase S, Aiba T, Kusano K. Micro-embolic risks during radiofrequency and cryoballoon-ablation of atrial fibrillation -analysis from real-time carotid artery doppler monitoring-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0486] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Catheter ablation of atrial fibrillation (AF) is associated with risks of silent cerebral events. However, the timing of intraprocedural micro-embolic events or differences between open-irrigated radiofrequency (RF) and cryoballoon (Cryo) ablation are unclear. Newly developed real-time carotid artery Doppler is a simple non-invasive method to detect micro-embolic signals (MESs) during ablation.
Objective
We investigated the timing of detecting MESs during RF and Cryo ablation of AF.
Methods
During the first pulmonary vein isolation (PVI) session of AF, MESs were monitored by real-time carotid artery Doppler monitoring throughout the procedure. The MES counts were collected and evaluated separately during the different steps of the procedure (Figure).
Results
Thirty-three AF patients (RF/Cryo: 22/11 cases, 9 females, 69.5±11.6 y.o) were included. PVI was successfully accomplished in all patients with no major complications. The MES count was significantly greater in the RF group than Cryo group (table). In both groups, left atrial (LA) access (interatrial puncture) and sheaths insertion to the LA generated a significant number of MESs (RF: 1690 of 9116 MESs [18.5% of the total MESs], Cryo: 793 of 2285 MESs [34.7%]). In the RF group, MESs were observed incessantly during PVI (Figure). The LA dwell time was significantly longer in the RF group than Cryo group (table). In the RF group, the MES count was significantly greater in the longer LA dwell time group (LA dwell time >130min) than the shorter group (464.2±179.7 vs 302.6±138.2: P=0.049). During the cryo-applications in the Cryo group, the MESs were greatest during the first cryoballoon application (625 of 2285 MESs [27.4%]).
Conclusions
There were more MESs during RF ablation than cryoablation. MESs were recorded during a variety of steps throughout the procedure. In the RF group, most of MESs were recorded incessantly during radiofrequency ablation and greater number of MESs were recorded in patients with longer LA dwell time. In the Cryo group, most of MESs occurred during phases with a high probability of gaseous emboli.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Tonegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Division of arrhythmia, Department of Cardiovascular Medicine, Suita, Japan
| | - K.F Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Kumamoto University, Department of Advanced Cardiovascular Medicine, Kumamoto, Japan
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22
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Yokoyama Y, Miyamoto K, Nakai M, Sumita Y, Ueda N, Nakajima K, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Nagase S, Noda T, Aiba T, Kusano K. The safety of catheter ablation of atrial fibrillation in elderly patients -analysis of the nationwide database in Japan, JROAD-DPC-. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0613] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
“Age” is one of the major concerns and determinants of the indications for catheter ablation (CA) of atrial fibrillation (AF). There are little safety data on CA of AF according to the age. This study aimed to assess the safety of CA in elderly patients undergoing CA of AF.
Methods and results
We investigated the complication rate of CA of AF for the different age groups (<60 years, 60–65, 65–70, 70–75, 75–80, 80–85, and ≥85) by a nationwide database (Japanese Registry Of All cardiac and vascular Diseases [JROAD]-DPC). The JROAD-DPC included 73,296 patients (65±11 years, 52,883 men) who underwent CA of AF from 516 hospitals in Japan. Aged patients had more comorbidities and a significantly increased CHADS2 score and higher rate of female according to a higher age. The overall complication rate was 2.6% and in-hospital mortality was 0.05%. By comparing each age group, complications occurred more frequently in higher aged groups. A multivariate adjusted hazard ratio revealed an increased age was independently and significantly associated with the overall complications (odds ratio was 1.25, 1.35, 1.72, 1.86, 2.76 and 3.13 respectively; reference <60 years).
Conclusions
The frequency of complications was significantly higher according to a higher age. We should take note of the indications and procedure for CA of AF in aged patients.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Intramural Research Fund 17 (Kusano) for Cardiovascular Diseases of the National Cerebral and Cardiovascular Center
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Affiliation(s)
- Y Yokoyama
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center Hospital, Center for Cerebral and Cardiovascular Disease Information, Osaka, Japan
| | - N Ueda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Kamakura
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Kusano
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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23
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Ishibashi-Kanno N, Takaoka S, Nagai H, Okubo-Sato M, Fukuzawa S, Uchida F, Yamagata K, Yanagawa T, Bukawa H. Postoperative delirium after reconstructive surgery for oral tumor: a retrospective clinical study. Int J Oral Maxillofac Surg 2020; 49:1143-1148. [DOI: 10.1016/j.ijom.2020.01.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/12/2019] [Accepted: 01/24/2020] [Indexed: 10/24/2022]
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24
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Fukui S, Ichinose K, Sada KE, Miyamoto J, Harigai M, Amano K, Atsumi T, Takasaki Y, Dobashi H, Arimura Y, Hasegawa H, Yuzawa Y, Yamagata K, Tsuboi N, Maruyama S, Matsuo S, Makino H, Maeda T, Kawakami A. Complement profile in microscopic polyangiitis and granulomatosis with polyangiitis: analysis using sera from a nationwide prospective cohort study. Scand J Rheumatol 2020; 49:301-311. [PMID: 32286129 DOI: 10.1080/03009742.2019.1695927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The complement cascade, especially the alternative pathway of complement, has been shown in basic research to be associated with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). We aimed to elucidate relationships between serum complement components and clinical characteristics in AAV. METHOD In a nationwide prospective cohort study (RemIT-JAV-RPGN), we measured the serum levels of C1q, C2, C3, C3b/iC3b, C4, C4b, C5, C5a, C9, factor B, factor D, factor H, factor I, mannose-binding lectin, and properdin in 52 patients with microscopic polyangiitis (MPA) and 39 patients with granulomatosis with polyangiitis (GPA). RESULTS The properdin level of MPA and GPA was significantly lower than that of healthy donors. The properdin level was negatively correlated with the Birmingham Vasculitis Activity Score (BVAS) (ρ = -0.2148, p = 0.0409). The factor D level at 6 months was significantly positively correlated with the Vasculitis Damage Index (VDI) at 6, 12, and 24 months (ρ = 0.4207, 0.4132, and 0.3115, respectively). Patients with a higher ratio of C5a to C5 had higher neutrophil percentage and serum immunoglobulin G levels, and significantly lower creatinine levels. Cluster analysis divided the MPA and GPA patients into three subgroups. A principal component (PC) analysis aggregated 15 types of complements into alternative pathway-related PC 1 and complement classical pathway and common pathway-related PC 2. CONCLUSIONS The serum levels of properdin and factor D were correlated with the BVAS and the VDI in MPA and GPA, respectively. Our analyses suggested the pathological heterogeneity of MPA and GPA from the aspect of complement components.
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Affiliation(s)
- S Fukui
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan.,Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan
| | - K-E Sada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama, Japan
| | - J Miyamoto
- Nagasaki University Hospital Clinical Research Center , Nagasaki, Japan
| | - M Harigai
- Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, Department of Rheumatology, School of Medicine, Tokyo Women's Medical University , Tokyo, Japan
| | - K Amano
- Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University , Kawagoe, Japan
| | - T Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo, Japan
| | - Y Takasaki
- Department of Rheumatology, Graduate School of Medicine, Juntendo University , Tokyo, Japan
| | - H Dobashi
- Division of Endocrinology and Metabolism, Haematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University , Miki-cho, Japan
| | - Y Arimura
- Nephrology and Rheumatology, First Department of Internal Medicine, Kyorin University School of Medicine , Tokyo, Japan
| | - H Hasegawa
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine , Toon, Japan
| | - Y Yuzawa
- Department of Nephrology, Fujita Health University School of Medicine , Toyoake, Japan
| | - K Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba , Tsukuba, Japan
| | - N Tsuboi
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - S Maruyama
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - S Matsuo
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine , Nagoya, Japan
| | - H Makino
- Okayama University , Okayama, Japan
| | - T Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan.,Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki, Japan
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25
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Tachita T, Kinoshita S, Ri M, Aoki S, Asano A, Kanamori T, Yoshida T, Totani H, Ito A, Kusumoto S, Komatsu H, Yamagata K, Kubo K, Tohkin M, Fukuda S, Iida S. Expression, mutation, and methylation of cereblon-pathway genes at pre- and post-lenalidomide treatment in multiple myeloma. Cancer Sci 2020; 111:1333-1343. [PMID: 32061138 PMCID: PMC7156787 DOI: 10.1111/cas.14352] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/03/2020] [Accepted: 02/04/2020] [Indexed: 12/11/2022] Open
Abstract
Cereblon (CRBN) is a target for immunomodulatory drugs. This study investigated the prognostic value of the expression of CRBN‐pathway genes on the clinical relevance of lenalidomide (Len) treatment and evaluated the levels of CRBN‐binding proteins and mutations in these genes after Len treatment. Forty‐eight primary multiple myeloma cells were collected prior to treatment with Len and dexamethasone (Ld) and 25 paired samples were obtained post‐Ld therapy. These tumor cells were used to determine the expression and mutated forms of the CRBN‐pathway genes. Following normalization with CRBN levels, there was a significantly reduced IKZF1/CRBN ratio in samples that responded poorly to Ld therapy. Moreover, patients with low ratios of IKZF1/CRBN showed a significantly shorter progression‐free survival (PFS) and overall survival (OS) than those with higher ratios. However, patients with high ratios of KPNA2/CRBN showed a significantly shorter PFS and OS than patients with lower ratios. Of the 25 paired samples analyzed, most samples showed a reduction in the expression of CRBN and an increase in IKZF1 gene expression. No mutations were observed in CRBN, IKZF1, or CUL4A genes in the post‐Ld samples. In conclusion, a decreased expression of IKZF1 and increased expression of KPNA2 compared to that of CRBN mRNA predicts poor outcomes of Ld therapy.
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Affiliation(s)
- Takuto Tachita
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shiori Kinoshita
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Blood Transfusion and Cell Therapy, Nagoya City University Hospital, Nagoya, Japan
| | - Sho Aoki
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Arisa Asano
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takashi Kanamori
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takashi Yoshida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Clinical Oncology, Nagoya Memorial Hospital, Nagoya, Japan
| | - Haruhito Totani
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Asahi Ito
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazufumi Yamagata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kohmei Kubo
- Department of Hematology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Masahiro Tohkin
- Department of Regulatory Science, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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26
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Buttigieg LL, Yamagata K, Cassar J, Pace Bardon M, Balzan M, Borg A. P1691 A case of congenital pulmonary stenosis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1054] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
We present an unusual case of sequential right ventricular outflow tract obstruction (RVOTO) caused by pulmonary and subpulmonary stenosis, with formation of aortopulmonary collaterals.
Case presentation
We report a case of a 47 year old Senegalese man who presented with a three year history of shortness of breath on exertion which worsened over the past week. Cardiovascular examination revealed a parasternal heave, a systolic murmur loudest in the pulmonary area and no evidence of fluid overload.
A transthoracic echocardiogram revealed leftward septal deviation during systole due to right ventricular pressure overload, severe right ventricular hypertrophy (RV free wall end-diastolic thickness of 8mm) and normal systolic function (FAC 47%), a dilated right atrium and moderate tricuspid regurgitation with estimated maximum pressures of 112mmHg. On continuous-wave doppler of the right ventricular outflow tract (RVOT), there was a late peaking systolic flow with maximum velocity of 3.8m/s.
A cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) was performed which showed sequential stenoses of the RVOT; one at subvalvular level by an infundibular muscular ridge with an area of 0.7 cm2 in mid-systole and one at the level of a dome-shaped pulmonary valve with planimetered valve area of 0.5cm2, severe RV hypertrophy and normal RV ejection fraction. Aortopulmonary collaterals from proximal thoracic descending aorta were seen. The main pulmonary artery was shown to be dilated with no evidence of pulmonary artery branch stenosis. See image: In-plane phase contrast velocity flow mapping of the RVOT using a VENC of 80cm/s, showing aliasing at the level of the pulmonary valve (red arrow) and at the level of the infundibulum (white arrow).
Conclusion
Congenital pulmonary stenosis (PS) occurs in 8% of congenital heart defects. 80% of pulmonary valve stenosis is typically dome-shaped with commissural fusion whilst the remainder is of the dysplastic type. Congenital PS can be associated with RVOTO at the infundibular level secondary to reactive muscular hypertrophy. In our case, there is a discrete, circumferential muscular ridge at the level of the infundibulum resulting in sequential outflow tract obstruction.
PS with intact ventricular septum occurs in conjunction with varying degrees of right ventricular hypertrophy and elevated right ventricular systolic pressures. A dilated pulmonary artery is common in dome-shaped subtype of PS.
Survival into adulthood of severe PS is primarily dependent on the adequacy of pulmonary blood flow from systemic-to-pulmonary collateral arteries, which serve as an additive, or the only source of blood supply to the pulmonary arterial vasculature. These collaterals are usually seen in association with cyanotic congenital heart disease such as pulmonary atresia and tetralogy of fallot.
Abstract P1691 Figure. Sequential RVOTO
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Affiliation(s)
| | - K Yamagata
- Mater Dei Hospital of Malta, Msida, Malta
| | - J Cassar
- Mater Dei Hospital of Malta, Msida, Malta
| | | | - M Balzan
- Mater Dei Hospital of Malta, Msida, Malta
| | - A Borg
- Mater Dei Hospital of Malta, Msida, Malta
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27
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Tanaka N, Sakuraba H, Hiraga H, Mayama K, Kikuchi H, Kishida D, Akemoto Y, Hasui K, Ota S, Watanabe R, Murai Y, Maeda T, Kamata K, Tatsuta T, Sawaya M, Chinda D, Mikami T, Yamagata K, Ishiguro Y, Tanaka M, Fukuda S. Long-term maintenance of the mucosal healing induced by azacitidine therapy in a patient with intestinal Behçet's-like disease accompanied with myelodysplastic syndrome involving trisomy 8. Immunol Med 2019; 42:135-141. [PMID: 31707933 DOI: 10.1080/25785826.2019.1687251] [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: 12/26/2022] Open
Abstract
Myelodysplastic syndromes (MDSs) are a group of myeloid neoplasms characterized by blood cell deformation and dysfunction, and MDS with trisomy 8 is closely linked with intestinal Behçet's-like diseases. Intestinal Behçet's-like disease is refractory to conventional therapies, including prednisolone, immunomodulators, and anti-tumor necrosis factor α agents. Here, we describe a 56-year-old woman with intestinal Behçet's-like disease ascribed to MDS with trisomy 8 who had multiple intractable intestinal ulcers. She presented with periodic fever and abdominal pain. The genetic analysis showed a heterozygous E148Q mutation in the Mediterranean fever gene. The patient did not tolerate treatment with colchicine because of diarrhea; therefore, azacitidine therapy was initiated. One cycle of azacitidine therapy improved the multiple intestinal ulcers, and the periodic fever and abdominal pain gradually disappeared. After eight cycles of azacitidine therapy, ileocolonoscopy, histological assessment and capsule endoscopy revealed mucosal healing. Azacitidine therapy was continued, and mucosal healing was maintained for more than 2 years. This case suggests that azacitidine therapy which has immunoregulatory effects and epigenetic modulations, might control intestinal Behçet's-like disease associated with MDS involving trisomy 8.
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Affiliation(s)
- Nahoko Tanaka
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroto Hiraga
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Community Healthcare Development in Odate and North Akita, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ko Mayama
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hidezumi Kikuchi
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Dai Kishida
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
| | - Yui Akemoto
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Keisuke Hasui
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shinji Ota
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Rina Watanabe
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhisa Murai
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takato Maeda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kosuke Kamata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Manabu Sawaya
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Daisuke Chinda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Community Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tatsuya Mikami
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan
| | - Kazufumi Yamagata
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yoh Ishiguro
- Division of Clinical Research, Hirosaki National Hospital, National Hospital Organization, Hirosaki, Japan
| | - Masanori Tanaka
- Department of Pathology and Laboratory Medicine, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Shinsaku Fukuda
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan.,Division of Clinical Research, Hirosaki National Hospital, National Hospital Organization, Hirosaki, Japan
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28
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Kamakura T, Nakajima K, Kataoka N, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Yasuda S, Kusano K. P5655Efficacy of new-generation atrial antitachycardia pacing for atrial tachyarrhythmias in patients with left ventricular dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0598] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The progression to persistent atrial fibrillation (AF) is associated with a worse clinical outcome in patients with previous atrial tachyarrhythmias. New-generation atrial antitachycardia pacing (ATP) (Reactive ATP) reduced the progression to persistent AF in patients with pacemaker and preserved left ventricular (LV) function. However, little is known about the efficacy of Reactive ATP in patients with cardiac implantable electronic devices (CIED) and LV dysfunction.
Purpose
We aimed to investigate the efficacy of Reactive ATP for atrial tachyarrhythmias in patients with LV dysfunction (LV ejection fraction [LVEF] <40%).
Methods
This study included 423 patients with CIED and previous atrial tachyarrthythmias. Reactive ATP was programmed in 284 patients (ATP group) and 139 were implanted with a dual-chamber device without ATP function (control group). The differences in the success rate of ATP and incidence of progression to persistent AF (≥7 days) between the ATP and control groups were evaluated in 108 patients with LVEF <40% (reduced LVEF) and 315 with LVEF ≥40% (preserved LVEF). Patients with persistent AF were excluded from this study.
Results
During 710±337 days of follow-up period, 16 patients (15%) with reduced LVEF and 51 (16%) with preserved LVEF progressed to persistent AF (p=0.88). The mean ATP success rate was lower in patients with reduced LVEF than in those with preserved LVEF, although not statistically significant (reduced LVEF: 27.2±19.4% and preserved LVEF: 35.1±29.2%, p=0.12). The incidence of progression to persistent AF was significantly lower in the ATP group than in the control group both in patients with reduced and preserved LVEF (log-rank, reduced LVEF: p=0.0070 and preserved LVEF: p<0.0001) (Figure). Multivariate analysis showed that use of Reactive ATP and smaller left atrium were associated with lower incidences of persistent AF, while LVEF was not predictive of progression to persistent AF (Reactive ATP: hazard ratio [HR] 0.28, 95% confidence interval [CI] 0.17–0.46, p<0.0001, left atrium diameter: HR 1.03, 95% CI 1.00–1.07, p=0.030).
Figure 1
Conclusions
Reactive ATP was effective in preventing AF progression in patients with LV dysfunction.
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Affiliation(s)
- T Kamakura
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Nakajima
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - N Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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29
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Matsunaga H, Machida Y, Nakagawa M, Yamaguchi M, Ogawara Y, Shima Y, Yamagata K, Katsumoto T, Hattori A, Itoh M, Seki T, Nishiya Y, Nakamura K, Suzuki K, Imaoka T, Suzuki M, Sampetrean O, Saya H, Ichimura K, Kitabayashi I. Characterization of a novel BBB-permeable mutant IDH1 inhibitor, DS-1001b. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz243.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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30
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YAMAMOTO H, Tsuruya K, Hase H, Nishi S, Yamagata K, Nangaku M, Wada T, Hayashi T, Uemura Y, Ohashi Y, Hirakata H. SUN-291 PREDICTIVE FACTORS OF ESA HYPORESPONSIVENESS IN PRE-DIALYSIS CKD PATIENTS: SECONDARY ANALYSIS OF THE RADIANCE-CKD STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.796] [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: 11/28/2022] Open
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31
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Suzuki R, Nakamiya Y, Watanabe M, Ando E, Tanichi M, Koga M, Kohno K, Usui J, Yamagata K, Ohkohchi N, Toda H, Saito T, Yoshino A, Takahara S, Yamauchi K, Yuzawa K. Relationship Between Stress Coping Mechanisms and Depression in Kidney Transplant Recipients. Transplant Proc 2019; 51:761-767. [PMID: 30979461 DOI: 10.1016/j.transproceed.2018.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND It has been reported that transplant recipients are exposed to physical and psychosocial stresses even after transplant surgery and exhibit psychological disorders such as depression. PURPOSE In this study, we extracted trends concerning how recipients of kidney transplants cope with stress, and we also examined how they cope with depression and its countermeasures. METHOD We administered questionnaire surveys to 109 kidney transplant recipients. These included items on personal attributes, medical information, depression, and stress-coping type scales. Statistical analysis was performed using factor analysis and multiple regression analysis. RESULTS Fifteen out of 109 (13.8%) were found to be high-risk patients for depression based on responses to the questionnaire using the depression scale. We extracted 2 factors of stress-coping type, namely Factor 1, "Directly coping with the problem," of patients who try to directly resolve the problem in a positive manner and Factor 2, "Stress-release while avoiding the problem," for those who relieve their feelings in response to the stress without resolving the problem itself. When multiple regression analysis was conducted with the depression scale as the dependent variable and the stress-coping factor as the independent variable, Factor 1 tended to be associated with reduced depression and Factor 2 with increased depression. CONCLUSIONS Results showed that to improve the mental health of those who receive kidney transplants, it is necessary to examine the depression and stress-coping types of such patients at an early stage and carry out education on stress-coping, focusing on resolving the actual problem.
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Affiliation(s)
- R Suzuki
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan; Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan; Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan; Department of Advanced Technology for Transplantation, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Y Nakamiya
- Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan
| | - M Watanabe
- Kanto Gakuin University College of Nursing, Yokohama, Kanagawa, Japan
| | - E Ando
- Department of Social and Environmental Health, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University Suita, Osaka, Japan
| | - M Tanichi
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - M Koga
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - K Kohno
- Hitachino Family Clinic, Ushiku, Ibaraki, Japan
| | - J Usui
- Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - K Yamagata
- Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - N Ohkohchi
- Mito Chuo Hospital, Mito, Ibaraki, Japan
| | - H Toda
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - T Saito
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - A Yoshino
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - S Takahara
- Department of Advanced Technology for Transplantation, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - K Yamauchi
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - K Yuzawa
- Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan
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32
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Wada M, Kamakura T, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Kusano K. P3217Relationship between conductor externalization and electrical malfunction in recalled and non-recalled implantable defibrillator leads. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3217] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Wada
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Osaka, Japan
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33
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Korai K, Ishibashi K, Kamakura T, Wada M, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Noguchi T, Yasuda S, Kusano K. P5777Clinical outcomes of patient with single-coil vs. dual-coil implantable cardioverter defibrillation lead for secondary prevention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5777] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Korai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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34
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Ueda N, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P5740Efficacy and safety of new-generation atrial antitachycardia pacing for atrial tachyarrhythmias in patients implanted with a cardiac resynchronization therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5740] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Ueda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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35
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Otuki S, Kamakura T, Wada M, Ishibashi K, Yamagata K, Inoue Y, Miyamoto K, Nagase S, Noda T, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P1904Comparison of the efficacy of new-generation atrial antitachycardia pacing between patients with sick sinus syndrome and atrioventricular block. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1904] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Otuki
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
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36
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Ueda N, Noda T, Kamakura T, Wada M, Yamagata K, Ishibashi K, Inoue Y, Miyamoto K, Nagase S, Aiba T, Izumi C, Noguchi T, Yasuda S, Kusano K. P1948The efficacy of a new device-based continuous optimization algorithm for mildly wide QRS and non-CLBBB patients with cardiac resynchronization therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1948] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- N Ueda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Kamakura
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Wada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Yamagata
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Ishibashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Inoue
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Miyamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Nagase
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Aiba
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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37
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Tanoue H, Morinaga J, Yoshizawa T, Yugami M, Itoh H, Nakamura T, Uehara Y, Masuda T, Odagiri H, Sugizaki T, Kadomatsu T, Miyata K, Endo M, Terada K, Ochi H, Takeda S, Yamagata K, Fukuda T, Mizuta H, Oike Y. Angiopoietin-like protein 2 promotes chondrogenic differentiation during bone growth as a cartilage matrix factor. Osteoarthritis Cartilage 2018; 26:108-117. [PMID: 29074299 DOI: 10.1016/j.joca.2017.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 02/21/2017] [Revised: 08/30/2017] [Accepted: 10/10/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Chondrocyte differentiation is crucial for long bone growth. Many cartilage extracellular matrix (ECM) proteins reportedly contribute to chondrocyte differentiation, indicating that mechanisms underlying chondrocyte differentiation are likely more complex than previously appreciated. Angiopoietin-like protein 2 (ANGPTL2) is a secreted factor normally abundantly produced in mesenchymal lineage cells such as adipocytes and fibroblasts, but its loss contributes to the pathogenesis of lifestyle- or aging-related diseases. However, the function of ANGPTL2 in chondrocytes, which are also differentiated from mesenchymal stem cells, remains unclear. Here, we investigate whether ANGPTL2 is expressed in or functions in chondrocytes. METHODS First, we evaluated Angptl2 expression during chondrocyte differentiation using chondrogenic ATDC5 cells and wild-type epiphyseal cartilage of newborn mice. We next assessed ANGPTL2 function in chondrogenic differentiation and associated signaling using Angptl2 knockdown ATDC5 cells and Angptl2 knockout mice. RESULTS ANGPTL2 is expressed in chondrocytes, particularly those located in resting and proliferative zones, and accumulates in ECM surrounding chondrocytes. Interestingly, long bone growth was retarded in Angptl2 knockout mice from neonatal to adult stages via attenuation of chondrocyte differentiation. Both in vivo and in vitro experiments show that changes in ANGPTL2 expression can also alter p38 mitogen-activated protein kinase (MAPK) activity mediated by integrin α5β1. CONCLUSION ANGPTL2 contributes to chondrocyte differentiation and subsequent endochondral ossification through α5β1 integrin and p38 MAPK signaling during bone growth. Our findings provide insight into molecular mechanisms governing communication between chondrocytes and surrounding ECM components in bone growth activities.
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Affiliation(s)
- H Tanoue
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - J Morinaga
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Yoshizawa
- Department of Medical Biochemistry, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - M Yugami
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - H Itoh
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Nakamura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - Y Uehara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Masuda
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - H Odagiri
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Sugizaki
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Kadomatsu
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - K Miyata
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - M Endo
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - K Terada
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - H Ochi
- Department of Physiology and Cell Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - S Takeda
- Endocrine Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 05-8470, Japan
| | - K Yamagata
- Department of Medical Biochemistry, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - T Fukuda
- Department of Anatomy and Neurobiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - H Mizuta
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan
| | - Y Oike
- Department of Molecular Genetics, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo,Chuo-ku, Kumamoto 860-8556, Japan; Core Research for Evolutional Science and Technology (CREST), Japan Agency for Medical Research and Development (AMED), Tokyo, Japan.
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Peichl P, Krebsova A, Wichterle D, Kubanek M, Cihak R, Yamagata K, Aldhoon B, Piherova L, Norambuena P, Stranecky V, Kmoch S, Macek M, Kautzner J. 1222Characteristics of an arrhythmogenic substrate and results of catheter ablation of ventricular arrhythmias in patients with desmoplakin mutation associated arrhythmogenic cardiomyopathy. Europace 2017. [DOI: 10.1093/ehjci/eux154.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Peichl P, Wichterle D, Cihak R, Yamagata K, Aldhoon B, Kautzner J. P1419Effect of pulmonary vein isolation on drivers of persistent atrial fibrillation: a prospective study using non-invasive panoramic mapping. Europace 2017. [DOI: 10.1093/ehjci/eux158.047] [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: 11/13/2022] Open
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Miyagawa I, Nakayamada S, Nakano K, Yamagata K, Sakata K, Yamaoka K, Tanaka Y. THU0027 Induction of Regulatory T Cells and Its Regulation with Insulin-like Growth Factor/Insulin-like Growth Factor Binding Protein-4 by Human Mesenchymal Stem Cells. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2843] [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: 11/04/2022]
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Takahata T, Sato A, Saito K, Yamagata K. [Microtubule polymerization inhibitors]. Nihon Rinsho 2015; 73 Suppl 2:162-166. [PMID: 25831744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Zuffada F, Airoldi F, Pappalettera M, Salerno-Uriarte JA, Cameli M, Casini S, Fineschi M, Lunghetti S, Geyer A, D'ascenzi F, Pierli C, Mondillo S, Lee CH, Son JW, Park KH, Choi YJ, Lee SH, Kim U, Park JS, Shin DG, Kim YJ, Kim HJ, Abreu G, Azevedo P, Braga C, Arantes C, Martins J, Vieira C, Salgado A, Correia A, Nabais S, Dingli P, Reichmuth L, Yamagata K, Felice H, Prisecaru R, Riahi L, Bolatti M, Van Den Heuvel P, De Greef Y, Stockman D, Schwagten B. Case-based session Club 35: Friday 5 December 2014, 10:00-11:00 * Location: Agora. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu259] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Dostalova G, Hlubocka Z, Ravlykova K, Rohn V, Zeman J, Palecek T, Linhart A, Bochard Villanueva B, Fabregat-Andres O, De La Espriella-Juan R, Cubillos-Arango A, Ferrando-Beltran M, Chacon-Hernandez N, Estornell-Erill J, Perez-Bosca J, Morell-Cabedo S, Paya-Serrano R, Mediratta A, Retzer E, Decara J, Weinert L, Shah A, Lang RM, Altun I, Guz G, Akin F, Kose N, Ilknur Altun I, Felice T, Mercieca Balbi M, Yamagata K, Felice H. Case-based session: unusual cases in clinical practice: Wednesday 3 December 2014, 09:00-10:30 * Location: Agora. Eur Heart J Cardiovasc Imaging 2014; 15 Suppl 2:ii1-ii265. [DOI: 10.1093/ehjci/jeu232] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hasegawa S, Uchida F, Baba O, Ito T, Yamatoji M, Kanno N, Yamagata K, Yanagawa T, Bukawa H. miR-205-5p Targets Interferon Regulatory Factor 1 and Suppresses Metastasis in Oral Cancer Cells. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.294] [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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Baba O, Ito T, Uchida F, Yamatoji M, Kanno N, Yamagata K, Hasegawa S, Yanagawa T, Bukawa H. Utility of saliva in the evaluation of microRNA functions as a tumor suppressor in oral squamous cell carcinoma. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.274] [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: 11/25/2022]
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Nakaoka Y, Hashimoto S, Amo A, Yamagata K, Takaya C, Iwahata H, Himeno T, Inoue T, Ito K, Morimoto Y. Confocal live cell images with fluorescent proteins reveal multinucleation of morphologically good day 3 embryos impairs subsequent development. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2014.07.080] [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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Humalda JK, Assa S, Navis GJ, Franssen CFM, De Borst MH, Ogawa H, Ota Y, Watanabe T, Watanabe Y, Nishii H, Sato A, Waniewski J, Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W, Guastoni CM, Turri C, Toma L, Rombola G, Frattini G, Romei Longhena G, Teatini U, Siriopol DC, Stuard S, Ciolan A, Mircescu G, Raluca D, Nistor I, Covic A, De Roij Van Zuijdewijn CL, Chapdelaine I, Nube MJ, Blankestijn PJ, Bots ML, Konings SJ, Van Den Dorpel MA, Van Der Weerd NC, Ter Wee PM, Grooteman MP, Djuric PS, Jankovic A, Tosic J, Bajcetic S, Damjanovic T, Popovic J, Dimkovic N, Dimkovic N, Marinkovic J, Djuric Z, Knezevic V, Lazarevic T, Ljubenovic S, Markovic R, Rabrenovic V, Djukanovic L, Djuric PS, Popovic J, Jankovic A, Tosic J, Radovic Maslarevic V, Dimkovic N, Mathrani V, Drew P, Chess JI, Williams AI, Robertson S, Jibani M, Aithal VI, Kumwenda M, Roberts G, Mikhail AI, Grzegorzewska AE, Ostromecki G, Mostowska A, Sowi ska A, Jagodzi ski PP, Wu HY, Chen HY, Hsu SP, Pai MF, Yang JY, Peng YS, Hirose M, Hasegawa T, Kaneshima N, Sasai F, Komukai D, Takahashi K, Koiwa F, Shishido K, Yoshimura A, Selim G, Stojceva-Taneva O, Tozija L, Dzekova-Vidimliski P, Trajceska L, Petronievic Z, Gelev S, Amitov V, Sikole A, Moon SJ, Yoon SY, Shin DH, Lee JE, Kim HJ, Park HC, Hadjiyannakos D, Filiopoulos V, Loukas G, Pagonis S, Andriopoulos C, Drakou A, Vlassopoulos D, Catarino C, Cunha P, Ribeiro S, Rocha-Pereira P, Reis F, Sameiro-Faria M, Miranda V, Bronze-Rocha E, Belo L, Costa E, Santos-Silva A, De Mauri A, Brambilla M, Chiarinotti D, Lizio D, Matheoud R, Conti N, Conte MM, Carriero A, De Leo M, Karpetas AV, Sarafidis PA, Georgianos PI, Koutroumpas G, Divanis D, Vakianis P, Tzanis G, Raptopoulou K, Protogerou A, Stamatiadis D, Syrganis C, Liakopoulos V, Efstratiadis G, Lasaridis AN, Georgianos PI, Sarafidis PA, Karpetas AV, Koutroumpas G, Divanis D, Tersi M, Tzanis G, Raptopoulou K, Protogerou A, Syrganis C, Stamatiadis DN, Liakopoulos V, Efstratiadis G, Lasaridis AN, Kuczera P, Adamczak M, Wiecek A, Bove S, Giacon B, Corradini R, Prati E, Brognoli M, Tommasi A, Sereni L, Palladino G, Moriya H, Mochida Y, Ishioka K, Oka M, Maesato K, Hidaka S, Ohtake T, Kobayashi S, Moura A, Madureira J, Alija P, Fernandes JC, Oliveira JG, Lopez M, Filgueiras M, Amado L, Miranda V, Sameiro-Faria M, Vieira M, Santos-Silva A, Costa E, Lee JE, Seok JH, Choi HY, Ha SK, Park HC, Bossola M, Laudisio A, Antocicco M, Tazza L, Colloca G, Tosato M, Zuccala G, Ettema EM, Kuipers J, Assa S, Groen H, Gansevoort RT, Stade K, Bakker SJL, Gaillard CAJM, Westerhuis R, Franssen CFM, Bacchetta J, Couchoud K, Semlali S, Sellier-Leclerc AL, Bertholet-Thomas A, Cartier R, Cochat P, Ranchin B, Kim JC, Park K, Van Ende C, Wilmes D, Lecouvet FE, Labriola L, Cuvelier R, Van Ingelgem G, Jadoul M, De Mauri A, Doriana C, Brambilla M, Matheoud R, David P, Capurro F, Brustia M, Ruva CE, De Leo M, Bossola M, Giungi S, Di Stasio E, Tazza L, Lemesch S, Leber B, Horvath A, Ribitsch W, Schilcher G, Zettel G, Tawdrous M, Rosenkranz AR, Stadlbauer-Kollner V, Matsushima H, Oyama A, Bosch Benitez-Parodi E, Baamonde Laborda E, Batista Garcia F, Perez Suarez G, Anton Perez G, Garcia Canton C, Toledo Gonzalez A, Lago Alonso MM, Checa Andres MD, Cobo G, Di Gioia C, Camacho R, Garcia Lacalle C, Ortega O, Rodriguez I, Herrero J, Oliet A, Ortiz M, Mon C, Vigil A, Gallar P, Bossola M, Pellu V, Di Stasio E, Giungi S, Nebiolo PE, Sasaki K, Yamguchi S, Hesaka A, Iwahashi E, Sakai S, Fujimoto T, Minami S, Fujita Y, Yokoyama K, Shutov E, Ryabinskya G, Lashutin S, Gorelova E, Volodicheva E, Podesta MA, Cancarini G, Cucchiari D, Montanelli A, Badalamenti S, Graziani G, Bossola M, Distasio E, Tazza L, Pchelin I, Shishkin A, Fedorova Y, Kao CC, Chu TS, Tsai TJ, Wu KD, Wu MS, Kim JC, Park K, Raikou V, Kaisidis P, Tsamparlis E, Kanellopoulos P, Boletis J, Ueda A, Hirayama A, Owada S, Nagai K, Saito C, Yamagata K. DIALYSIS. PATHOPHYSIOLOGY AND CLINICAL STUDIES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu177] [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: 11/13/2022] Open
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Morito N, Yoh K, Yamagata K, Allard L, Demoncheaux N, Machuca-Gayet I, Georgess D, Mazzorana M, Jurdic P, Bacchetta J, Jankowski V, Schuchardt M, Van Der Giet M, Zidek W, Jankowski J, Egidi MF, Mangione E, Poletti R, Passino C, Caprioli R, Lippi A, Del Torto A, Emdin M, Lin MC, Chan CK, Wu VC, O. Neill J, Healy V, Johns EJ, Lin MC, Wu VC, Beilhack GF, Kotzmann H, Heinze G, Kohl M, Luger A, Schmidt A, Gohel K, Saurin D, Hegde U, Gang S, Rajapurkar M, Cho H, Kim SB, Sonikian M, Giakoumis M, Pani I, Karaitianou A, Trovas G, Hiramitsu T, Yamamoto T, Tominaga Y. HORMONES. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu163] [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: 11/14/2022] Open
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Vlahu CA, De Graaff M, Struijk DG, Krediet RT, Shin HS, Ryu ES, Choi HS, Ryu DR, Choi KB, Kang DH, Sanchez-Alvarez E, Rodriguez-Suarez C, Galvan-.Hernandez JA, Kim YL, Kee YK, Lee MJ, Oh HJ, Park JT, Han SH, Yoo TH, Kang SW, Zhu F, Abbas SR, Bologa R, Lanto B, Kotanko P, Parikova A, Smit W, Struijk DG, Krediet RT, Rroji ( Molla) M, Seferi S, Cafka M, Thereska N, Huang CC, Wang IK, Shiao YT, Teixeira L, Sousa I, Rodrigues A, Mendonca D, Ueda A, Iwase M, Usui T, Hirayama A, Nagai K, Saito C, Yamagata K, La Milia V, Pontoriero G, Locatelli F, Kim SM, Kim TY, Lee JE, Teta D, Guillodo MP, Kolko-Labadens A, Lasseur C, Levannier M, Panaye M, Fouque D, HAMADA C, Hara K, Kang SH, Cho KH, Park JW, Yoon KW, Do JY, Dogan I, Biro Dr B, Zakar Dr G, Foldine Z, Staudt S, Martins AR, Vizinho R, Branco PQ, Gaspar MA, Barata JD, Sikorska D, Klysz P, Posnik B, Baum E, Hoppe K, Schwermer K, Wanic-Kossowska M, Frankiewicz D, Pawlaczyk K, Lindholm B, Oko A, Busuioc M, Trolliet P, Guerraoui A, Caillette-Beaudoin A, Hallonet P, Yang JO, Gursu M, Topcuoglu D, Koc LK, Yucel L, Sumnu A, Cebeci E, Doner B, Ozkan O, Behlul A, Koc L, Ozturk S, Kazancioglu R, Casas Parra AII, Gonzalez MTT, Sandoval DA, Carlota GC, Grinyo JMM, Tseng CH, Chao CT, Yen CJ, Chiang CK, Hung KY, Huang JW, Al Wakeel JS, Al Ghonaim M, Al Suwaida A, Al Harbi A, Makoshi Z, Abdullah S, Matsushita Y, Basic-Jukic N, Coen-Herak D, Martinovic Z, Radi -Antoli M, Kes P, Wu TJ, Chen JS, Lin SH, Shiang JC, Wu CC, Munteanu D, Gemene M, Mircescu G, Opatrna S, Popperlova A, Tesar V, Rychlik I, Viklicky O, Jin K, Park BS, Jeong HJ, Kim YW, Hogas S, Voroneanu L, Onofriescu M, Nistor I, Apetrii M, Siriopol D, Cujba M, Hogas M, Covic A. PERITONEAL DIALYSIS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu174] [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: 11/12/2022] Open
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El Minshawy O, Ghabrah T, Hamza A, Fadl A, Adam M, El Bassuoni E, Saran R, Tilea A, Sands R, Kiser M, Han SW, Stack A, Finkelstein F, Eisele G, Kotanko P, Levin N, Gillespie B, Krane V, Bhuvanakrishna T, Burnapp L, Hilton R, Sibley-Allen C, Blake G, Goldsmith D, Taylor-Stokes G, Ozbay AB, Sayers J, Marx SE, Yanai M, Okada K, Takeuchi K, Matsuyama K, Nitta K, Takahashi S, Delanaye P, Cavalier E, Moranne O, Lutteri L, Bruyere O, Krzesinski JM, Silverwood RJ, Richards M, Pierce M, Hardy R, Sattar N, Ferro C, Savage C, Kuh D, Nitsch D, Shin JH, Kim SH, Yu SH, Oberdhan D, Krasa HB, Cheng R, Hays RD, Chapman A, Perrone R, Cole JC, Tilea A, Hedgeman E, Steffick D, Rein-Weston A, Banerjee T, Powe N, Rios-Burrows N, Williams D, Saran R, Nagasawa Y, Yamamoto R, Shinzawa M, Hasuike Y, Kuragano T, Rakugi H, Isaka Y, Nakanishi T, Iseki K, Yamagata K, Tsuruya K, Yoshida H, Fujimoto S, Asahi K, Watanabe T, Moriyama T, Warren S, Rutherford P, Van Den Bosch J, Kusztal M, Trafidlo E, Madziarska K, Augustyniak-Bartosik H, Golebiowski T, Krajewska M, Rymaszewska J, Weyde W, Klinger M, Sato Y, Fujimoto S, Konta T, Iseki K, Moriyama T, Yamagata K, Tsuruya K, Yoshida H, Asahi K, Kurahashi I, Ohashi Y, Watanabe T, Elsayed I, Khwaja A, Siddall S, Mortimer F, Ando M, Hara M, Tsuchiya K, Nitta K, Hiwatashi A, Hagiwara M, Tsuruoka S, Usui J, Nagai K, Kai H, Morito N, Saito C, Yoh K, Hosojima M, Saito A, Yamagata K, Stack AG, Chernenko T, Abdalla AA, Saran R, Nguyen HT, Hedgeman E, Hannigan A, Casserly LF, Abd ElHafeez S, Gad Z, Sallam S, Tripepi G, Zoccali C, ElWakil H, Awad N, Sestigiani E, Tedesco D, Mandreoli M, Ubaldi G, Olmeda F, Monti M, Rucci P, Gibertoni D, Santoro A, Zaza G, Bernich P, Lupo A, Rogacev KS, Seiler S, Zawada AM, Fliser D, Heine GH, Douros A, Schaeffner E, Jakob O, Kreutz R, Ebert N, Gerasimovska Kitanovska B, Bogdanovska S, Severova Andreevska G, Gerasimovska V, Sikole A, Rakov V, Schiepe F, Rutkowski B, Zdrojewski T, Bandosz P, Zdrojewski L, Rutkowski M, Gaciong Z, Solnica B, Jedrzejczyk T, Krol E, Wyrzykowski B, Nacak H, van Diepen M, de Goeij MCM, Dekker FW, Suzuki K, Konta T, Kamei K, Sato H, Kudo K, Nagasawa A, Ichikawa K, Kubota I, Clavero R, Vasquez N, Tapia B, Aldunate T, Heleniak Z, Cieplinska M, Pryczkowska M, Szychlinski T, Bartosinska E, Wiatr H, Kotlowska H, Tylicki L, Rutkowski B, So B, Methven S, Hair MD, Jardine AG, MacGregor MS, Jankowski V, Schulz A, Zidek W, Jankowski J, Holmar J, Fridolin I, Uhlin F, Luman M, Fernstrom A, Rodriguez I, Ortega O, Hinostroza J, Cobo G, Gallar P, Mon C, Herrero JC, Ortiz M, Di Giogia C, Oliet A, Vigil A, Premuzic V, Vrdoljak A, Fucek M, Karanovic S, Vukovic-Lela I, Kos J, Fistrek M, Dika Z, Cvitkovic A, Juric D, Laganovic M, Rogic D, Katalinic L, Jelakovic B, Vrdoljak A, Fucek M, Premuzic V, Karanovic S, Vukovic Lela I, Kos J, Fistrek M, Cvitkovic A, Jelakovic B, Deger SM, Onec K, Derici UB, Guz G, Ozturk MA, Sindel S, Arinsoy T, Hojs N, Bevc S, Hojs R, Ekart R, Koycheva R, Cholakov V, Penev M, Andreev J, Iliev R, Macia M, Jarque A, del Castillo N, Mendez ML, Martin JA, Tevar E, Bermudez C, NasrAllah MM, Osman N, Osanlou O, Greer AB, Morgan H, Archer T, Ryan N, Khalil A, Ahmed S, Melemadathil S, Ashok AV, El-Wakil HS, Asaad SH, Nawar MM, Adam AG, Abdel-Gawad MM. Epidemiology - renal outcomes. Nephrol Dial Transplant 2013; 28:i140-i154. [DOI: 10.1093/ndt/gft109] [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: 09/02/2023] Open
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