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Ayano M, Tsubouchi K, Suzuki K, Kimoto Y, Arinobu Y, Akashi K, Horiuchi T, Okamoto I, Niiro H. Comparing the safety and efficacy of nintedanib starting dose in patients with connective tissue disease-associated interstitial lung diseases. Scand J Rheumatol 2024:1-8. [PMID: 38563202 DOI: 10.1080/03009742.2024.2327159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to analyse whether initiating nintedanib treatment at a reduced dose could improve the treatment continuation rate while maintaining efficacy in patients with connective tissue disease (CTD)-associated interstitial lung disease. METHOD In total, 51 patients (age 61.6 ± 13.2 years; 38 women, 13 men) were retrospectively analysed. The primary endpoint was the cumulative discontinuation rate due to adverse events. Secondary endpoints included changes in drug dosage, efficacy evaluated based on annual changes in forced vital capacity (FVC), and safety assessed based on the frequency of adverse events. RESULTS Eighteen patients who started treatment at the standard dose of 300 mg (standard dosage group) were compared with 33 patients who started treatment at a reduced dose (reduced dosage group). Systemic sclerosis was the most common CTD (n = 32), followed by idiopathic inflammatory myopathies and, rarely, rheumatoid arthritis. Both groups exhibited comparable cumulative discontinuation rates due to adverse events and similar frequencies of adverse events. No significant differences were observed in maintenance doses between the two groups; however, patients in the reduced dosage group had a lower cumulative dose for up to 52 weeks than those in the standard dosage group. No significant differences were observed in changes in FVC between the two groups. CONCLUSION There was no evidence for a difference between the two groups in terms of discontinuation rates, efficacy, and safety. To provide further evidence, future studies using more precise dose-escalation protocols are warranted.
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Affiliation(s)
- M Ayano
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Tsubouchi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Suzuki
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Kimoto
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Arinobu
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - I Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Niiro
- Department of Medical Education, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Mahajan AB, Bari M, Collar N, Chakravorty S, Duong DK, Suzuki K, Patel PP, Weyant MJ, Hogarth DK. Safety of Home Discharge With a Chest Tube After Bronchoscopic Lung Volume Reduction Complicated by Persistent Airleak. J Bronchology Interv Pulmonol 2024; 31:126-131. [PMID: 37702527 DOI: 10.1097/lbr.0000000000000945] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND The incidence of pneumothorax after bronchoscopic lung volume reduction (BLVR) using Zephyr (Pulmonx Corporation) endobronchial valves is ~26%. Many patients who develop a postprocedural pneumothorax require chest tube placement. If a persistent airleak is present, patients tolerating waterseal can be discharged home with a mini-atrium with a low risk of empyema. METHODS Data were collected on patients from the Epic (Epic System Corporation) electronic medical record between July 2019 and November 2022. Our retrospective study reviewed a total of 102 BLVR procedures. Twenty-six of these procedures were complicated by a pneumothorax post-BLVR (25%). After 24 procedures, patients were discharged home with a chest tube after a persistent airleak. The primary endpoint of the study was the incidence of intrapleural infection in this population. The secondary endpoint was the average length of time the chest tube was in place until outpatient removal. RESULTS Out of the 24 discharge events, 2 events (8.3%) were complicated by an intrapleural infection before chest tube removal. The average number of days requiring a chest tube until outpatient removal was 16.9 days, which is similar to the duration observed in patients discharged home with a chest tube after lung volume reduction surgery. CONCLUSION Discharging patients home with a chest tube after BLVR therapy is safe and may reduce hospital length of stay. Our study shows the incidence of intrapleural infection after home discharge with a chest tube after BLVR is low.
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Affiliation(s)
- Amit Bobby Mahajan
- Department of Surgery, Interventional Pulmonology, Inova Schar Cancer Institute
| | - Mahwish Bari
- Clinical Research Coordinator Lung/Interventional Pulmonology, Inova Schar Cancer Institute
| | | | | | - Duy K Duong
- Department of Interventional Pulmonology, Inova Schar Cancer Institute
| | - Kei Suzuki
- Department of Thoracic Surgery, Inova Schar Cancer Institute
| | - Priya P Patel
- Department of Interventional Pulmonology, Inova Schar Cancer Institute
| | - Michael J Weyant
- Department of Thoracic Surgery, Moran Family Endowed Chair in Thoracic Oncology, Inova Schar Cancer Institute, Inova Fairfax Hospital
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3
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Kouzu K, Tsujimoto H, Ishinuki T, Shinji S, Shinkawa H, Tamura K, Uchino M, Ohge H, Shimizu J, Haji S, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Hanai Y, Nobuhara H, Imaoka H, Yoshida M, Mizuguchi T, Mayumi T, Kitagawa Y. The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. J Hosp Infect 2024; 146:174-182. [PMID: 37734678 DOI: 10.1016/j.jhin.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
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Affiliation(s)
- K Kouzu
- Department of Surgery, National Defense Medical College, Japan
| | - H Tsujimoto
- Department of Surgery, National Defense Medical College, Japan.
| | - T Ishinuki
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - S Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Japan
| | - H Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - K Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - M Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Japan
| | - H Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - J Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Japan
| | - S Haji
- Department of Surgery, Soseikai General Hospital, Japan
| | - Y Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Japan
| | - C Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Japan
| | - Y Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Japan
| | - K Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Japan
| | - M Kobayashi
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Japan
| | - Y Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Japan
| | - H Nobuhara
- Department of Dentistry, Hiroshima Prefectural Hospital, Japan
| | - H Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Japan
| | - M Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Japan
| | - T Mizuguchi
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - T Mayumi
- Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Japan
| | - Y Kitagawa
- Keio University, School of Medicine, Japan
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Park JA, Pham D, Yalamanchili S, Twardus S, Suzuki K. Developing technologies and areas of interest in lung cancer screening adjuncts. J Thorac Dis 2024; 16:1552-1564. [PMID: 38505010 PMCID: PMC10944753 DOI: 10.21037/jtd-23-1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/22/2023] [Indexed: 03/21/2024]
Abstract
Lung cancer remains the leading cause of cancer mortality. Screening guidelines have been implemented in the past decade to aid in earlier detection of at-risk groups. Nevertheless, computed tomography (CT) scans, the principal screening modality in use today, are still low yield, with 3.6% of lung cancer confirmed amongst 39.1% of lesions detected over a 3-year period. They also carry relatively high false positive rates, between 9% and 27%, which can bear unnecessary financial and emotional costs to patients. As such, research efforts have been dedicated to the development of lung cancer screening adjuncts to improve detection reliability. We herein review several emerging technologies in this specific arena and their efficacy. These include plasma markers (microDNA, DNA methylation, and tumor-associated antibodies), breath/sputum biomarkers [volatile organic compounds (VOCs) and exhaled breath condensate (EBC)], proteomics, metabolomics, and machine learning, such as radiomics technology. We find that, across the board, they offer promising results in terms of non-invasive diagnostics, genetic sequencing for higher-risk individuals, and accessibility for a diverse cohort of patients. While these screening adjuncts are unlikely to completely replace the current standard of care at the moment, continued research into these technologies is crucial to improve and personalize the identification, treatment, and outcome of lung cancer patients in the near future.
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Affiliation(s)
- Ju Ae Park
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Duy Pham
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sriya Yalamanchili
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Shaina Twardus
- University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Kei Suzuki
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
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Liu A, Siddiqi N, Tapan U, Mak KS, Steiling KA, Suzuki K. Black Race Remains Associated with Lower Eligibility for Screening Using 2021 US Preventive Services Task Force Recommendations Among Lung Cancer Patients at an Urban Safety Net Hospital. J Racial Ethn Health Disparities 2023; 10:2836-2843. [PMID: 36441493 DOI: 10.1007/s40615-022-01460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate whether the revised US Preventive Services Task Force (USPSTF) criteria reduced inequities in lung cancer screening (LCS) eligibility among a racially diverse sample of patients with lung cancer. METHODS This is a retrospective analysis of adults diagnosed with primary lung malignancies at an urban safety net hospital. For all patients and exclusively ever-smokers, χ2 tests were used to evaluate differences in LCS eligibility among socio-demographic variables using the 2013 and 2021 USPSTF criteria. Patients who were ineligible for LCS were categorized by reason for exclusion. RESULTS Among 678 lung cancer patients (46% female, mean age 66 ± 10 years), 51% were White, and 39% were Black. Using the 2013 guidelines, White patients (57%) would have been more likely to be eligible than Black (37%) and other-race patients (35%) (P < 0.0001) at time of cancer diagnosis. Under the 2021 guidelines, White patients (68%) remained more likely to be eligible for LCS than Black (54%) and other-race patients (48%) (P = 0.0002). Among exclusively ever-smoking patients, we did not observe a significant difference in eligibility by race under the 2021 USPSTF guidelines (White [73%], Black [65%], and other-race [65%]; [P = 0.48]). Sex, ethnicity, education level, and insurance type were not associated with differential screening eligibility under either the 2013 or 2021 guidelines. CONCLUSION The revised 2021 USPSTF LCS guidelines may not be sufficient to eliminate racial inequities in LCS eligibility among patients who go on to be diagnosed with primary lung cancer. Differential rates of lung cancer among never-smokers may contribute to this inequity.
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Affiliation(s)
- Anqi Liu
- Boston University School of Medicine, Boston, MA, USA
| | - Noreen Siddiqi
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Umit Tapan
- Section of Hematology & Medical Oncology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Kimberley S Mak
- Department of Radiation Oncology, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Katrina A Steiling
- Section of Pulmonary, Allergy, Sleep and Critical Care Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Kei Suzuki
- Division of Thoracic Surgery, Department of Surgery, INOVA, Schar Cancer Institute, Falls Church, VA, USA.
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Hirata K, Yamamoto Y, Hatanaka K, Kinoshita K, Abiko S, Suzuki K, Tanaka T, Ishibe E, Nakajima K, Naruse H, Umehara M, Tsuruga Y, Nakanishi K, Munakata S, Shimoyama N. Hepatobiliary and pancreatic: Tiny pigmented intra-hepatic ducts stones as the cause of jaundice and liver failure. J Gastroenterol Hepatol 2023; 38:2052. [PMID: 37680105 DOI: 10.1111/jgh.16350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/26/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023]
Affiliation(s)
- K Hirata
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Kinoshita
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Abiko
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Suzuki
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - T Tanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - E Ishibe
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakajima
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Munakata
- Department of Cancer Pathology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Shimoyama
- Department of Cancer Pathology, Hakodate Municipal Hospital, Hakodate, Japan
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7
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Ma L, Sullivan TB, Rieger-Christ KM, Yambayev I, Zhao Q, Higgins SE, Yilmaz OH, Sultan L, Servais EL, Suzuki K, Burks EJ. Vascular invasion predicts the subgroup of lung adenocarcinomas ≤2.0 cm at risk of poor outcome treated by wedge resection compared to lobectomy. JTCVS Open 2023; 16:938-947. [PMID: 38204657 PMCID: PMC10775162 DOI: 10.1016/j.xjon.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/10/2023] [Accepted: 11/06/2023] [Indexed: 01/12/2024]
Abstract
Background Recent randomized control trials (JCOG0802 and CALGB140503) have shown sublobar resection to be noninferior to lobectomy for non-small cell lung cancer (NSCLC) ≤2.0 cm. We have previously proposed histologic criteria stratifying lung adenocarcinoma into indolent low malignant potential (LMP) and aggressive angioinvasive adenocarcinomas, resulting in better prognostication than provided by World Health Organization grade. Here we determine whether pathologic classification is reproducible and whether subsets of adenocarcinomas predict worse outcomes when treated by wedge resection compared to lobectomy. Methods A retrospective cohort of 108 recipients of wedge resection and 187 recipients of lobectomy for stage I/0 lung adenocarcinomas ≤2.0 cm was assembled from 2 institutions. All tumors were classified by a single pathologist, and interobserver reproducibility was assessed in a subset (n = 92) by 5 pathologists. Results Angioinvasive adenocarcinoma (21%-27% of cases) was associated with worse outcomes when treated with wedge resection compared to lobectomy (5-year recurrence-free survival, 57% vs 85% [P = .007]; 5-year disease-free survival [DSS], 70% vs 90% [P = .043]; 7-year overall survival, 37% vs 58% [P = .143]). Adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and LMP exhibited 100% 5-year DSS regardless of the surgical approach. Multivariable analysis showed that angioinvasion, tumor size, margin status, and extent of nodal sampling were significantly associated with recurrence but not with surgical procedure. There was substantial interobserver reproducibility among the pathologists for the diagnosis of angioinvasive adenocarcinoma (κ = 0.71) and the combined indolent AIS/MIA/LMP group (κ = 0.74). Conclusions The majority (∼75%) of lung adenocarcinomas ≤2 cm are adequately managed with wedge resection; however, angioinvasive adenocarcinomas (∼25%) treated by wedge resection with suboptimal nodal sampling exhibit poor outcomes, with a 40% to 45% rate of recurrence within 5 years and 60% to 65% overall mortality at 7 years.
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Affiliation(s)
- Lina Ma
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Travis B. Sullivan
- Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, Mass
| | - Kimberly M. Rieger-Christ
- Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, Mass
| | - Ilyas Yambayev
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Qing Zhao
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Sara E. Higgins
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Osman H. Yilmaz
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Lila Sultan
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
| | - Elliot L. Servais
- Department of Surgery, Lahey Hospital & Medical Center, Burlington, Mass
| | - Kei Suzuki
- Division of Thoracic Surgery, Department of Surgery, INOVA, Falls Church, Va
| | - Eric J. Burks
- Department of Pathology & Laboratory Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Mass
- Department of Translational Research, Ian C. Summerhayes Cell and Molecular Biology Laboratory, Lahey Hospital & Medical Center, Burlington, Mass
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8
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Suzuki K, Ceppa DP. Lung Cancer Screening: Where Are We, and How Can We Improve? Thorac Surg Clin 2023; 33:xiii-xiv. [PMID: 37806746 DOI: 10.1016/j.thorsurg.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
- Kei Suzuki
- Director of Thoracic Surgery Research, Schar Cancer Institute, Inova Health Systems, Assistant Professor, University of Virginia School of Medicine, 8081 Innovation Park Drive, Fairfax, VA 22031, USA.
| | - DuyKhanh P Ceppa
- Associate Professor of Surgery, Indiana University School of Medicine, Program Director, Cardiothoracic Surgery Residency, Deputy Chief of Surgery, Roudebush VA Medical Center, 545 Barnhill Drive, Indianapolis, IN 46202, USA.
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Yamaguchi T, Hayashi R, Hanaki R, Takahashi Y, Suzuki K, Hirayama M, Tanabe M. A Pediatric Case of Septic Pulmonary Embolism Caused by Tsukamurella paurometabola. Intern Med 2023; 62:3069-3073. [PMID: 36889705 PMCID: PMC10641193 DOI: 10.2169/internalmedicine.1444-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023] Open
Abstract
We herein report a three-year-old boy with septic pulmonary embolism caused by Tsukamurella paurometabola bacteremia during chemotherapy for rhabdomyosarcoma. During the interval of chemotherapy, the patient was temporarily discharged with a peripherally inserted central venous catheter but was re-admitted to the hospital with a fever on the same day. A blood culture taken at the time of re-admission showed T. paurometabola. The patient had a persistent fever, and computed tomography performed on the ninth day showed septic pulmonary embolism. We stress the importance of being aware of the possibility of septic pulmonary embolism in patients with Tsukamurella bacteremia.
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Affiliation(s)
- Takanori Yamaguchi
- Department of Infection Control and Prevention, Mie University Hospital, Japan
- Department of Infectious Disease, Mie University Hospital, Japan
| | | | - Ryo Hanaki
- Department of Pediatrics, Mie University Hospital, Japan
| | - Yoshinori Takahashi
- Department of Infection Control and Prevention, Mie University Hospital, Japan
| | - Kei Suzuki
- Department of Infectious Disease, Mie University Hospital, Japan
| | | | - Masaki Tanabe
- Department of Infection Control and Prevention, Mie University Hospital, Japan
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10
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Higuchi M, Suzuki K, Kaminishi Y. Acute limb ischemia due to arterial dissection caused by mechanical compression of vascular tissue by the robotic arm during robot-assisted surgery: a case report. QJM 2023; 116:789-791. [PMID: 37225399 DOI: 10.1093/qjmed/hcad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- M Higuchi
- Department of Cardiology, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki Prefecture 311-4145, Japan
| | - K Suzuki
- Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito Ibaraki Prefecture 311-4145, Japan
| | - Y Kaminishi
- Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito Ibaraki Prefecture 311-4145, Japan
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11
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Qureshi MM, Lin Y, Moeller AR, Yan SX, Dyer MA, Suzuki K, Everett P, Litle V, Truong MT, Mak KS. Change in stage after neoadjuvant chemoradiation is associated with survival in patients with esophageal cancer. J Surg Oncol 2023; 128:781-789. [PMID: 37288789 DOI: 10.1002/jso.27367] [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: 12/12/2022] [Revised: 05/17/2023] [Accepted: 05/27/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of this study was to determine if change in stage after neoadjuvant chemoradiation (CRT) was associated with improved survival in esophageal cancer using a national database. METHODS Using the National Cancer Database, patients with non-metastatic, resectable esophageal cancer who received neoadjuvant CRT and surgery were identified. Comparing clinical to the pathologic stage, change in stage was classified as pathologic complete response (pCR), downstaged, same-staged, or upstaged. Univariable and multivariable Cox regression models were used to identify factors associated with survival. RESULTS A total of 7745 patients were identified. The median overall survival (OS) was 34.9 months. Median OS was 60.3 months if pCR, 39.1 months if downstaged, 28.3 months if same-staged, and 23.4 months if upstaged (p < 0.0001). On multivariable analysis, pCR was associated with improved OS compared to the other groups (downstaged: hazard ratio [HR]: 1.32 [95% confidence interval [CI]: 1.18-1.46]; same-staged: HR: 1.89 [95% CI: 1.68-2.13]; upstaged: HR: 2.54 [95% CI: 2.25-2.86]; all p < 0.0001). CONCLUSIONS In this large database study, change in stage after neoadjuvant CRT was strongly associated with survival for patients with non-metastatic, resectable esophageal cancer. There was a significant stepwise decline in survival, in descending order of pCR, downstaged tumor, same-staged tumor, and upstaged tumor.
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Affiliation(s)
- Muhammad M Qureshi
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Yue Lin
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Alexander R Moeller
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Sherry X Yan
- Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Michael A Dyer
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kei Suzuki
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Peter Everett
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Virginia Litle
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Surgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Minh-Tam Truong
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts, USA
| | - Kimberley S Mak
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Department of Radiation Oncology, Boston Medical Center, Boston, Massachusetts, USA
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12
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Matsumoto T, Wada H, Shiraki K, Suzuki K, Yamashita Y, Tawara I, Shimpo H, Shimaoka M. The Evaluation of Clot Waveform Analyses for Assessing Hypercoagulability in Patients Treated with Factor VIII Concentrate. J Clin Med 2023; 12:6320. [PMID: 37834964 PMCID: PMC10573981 DOI: 10.3390/jcm12196320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Regular prophylactic therapy has become an increasingly common treatment for severe hemophilia. Therefore, hypercoagulability-a potential risk factor of thrombosis-is a cause for concern in hemophilic patients treated with a high dose of FVIII concentrate. In clot waveform analysis (CWA)-thrombin time (TT), a small amount of thrombin activates clotting factor VIII (FVIII) instead of fibrinogen, resulting in FVIII measurements using CWA-TT with a small amount of thrombin. METHODS The coagulation ability of patients treated with FVIII concentrate or emicizumab was evaluated using activated partial thromboplastin time (APTT), TT and a small amount of tissue factor-induced FIX activation assay (sTF/FIXa) using CWA. RESULTS The FVIII activity based on CWA-TT was significantly greater than that based on the CWA-APTT or chromogenic assay. FVIII or FVIII-like activities based on the three assays in plasma without emicizumab were closely correlated; those in plasma with emicizumab based on CWA-TT and chromogenic assays were also closely correlated. CWA-APTT and CWA-TT showed different patterns in patients treated with FVIII concentrates compared to those treated with emicizumab. In particular, CWA-TT in patients treated with FVIII concentrate showed markedly higher peaks in platelet-rich plasma than in platelet-poor plasma. CWA-APTT showed lower coagulability in hemophilic patients treated with FVIII concentrate than in healthy volunteers, whereas CWA-sTF/FIXa did not. In contrast, CWA-TT showed hypercoagulability in hemophilic patients treated with FVIII concentrate. CONCLUSIONS CWA-TT can be used to evaluate the thrombin bursts that cause hypercoagulability in patients treated with emicizumab. Although routine APTT evaluations demonstrated low coagulation ability in patients treated with FVIII concentrate, CWA-TT showed hypercoagulability in these patients, suggesting that the evaluation of coagulation ability may be useful when using multiple assays.
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Affiliation(s)
- Takeshi Matsumoto
- Department of Transfusion Medicine and Cell Therapy, Mie University Hospital, Tsu 514-8507, Japan;
| | - Hideo Wada
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
| | - Katsuya Shiraki
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
| | - Kei Suzuki
- The Emergency and Critical Care Center, Mie University Hospital, Tsu 514-8507, Japan;
| | - Yoshiki Yamashita
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (Y.Y.); (I.T.)
| | - Isao Tawara
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (Y.Y.); (I.T.)
| | - Hideto Shimpo
- Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
| | - Motomu Shimaoka
- Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan;
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13
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Vazirani A, Rodriguez A, Pavesi F, McDermott S, Cabral H, Billatos E, Suzuki K. Black race and lower age at surgery are associated with smoking relapse in a safety-net setting after surgery for stage I non-small cell lung cancer. J Thorac Dis 2023; 15:4757-4764. [PMID: 37868906 PMCID: PMC10586932 DOI: 10.21037/jtd-23-392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/21/2023] [Indexed: 10/24/2023]
Abstract
Background Smoking relapse after surgical resection for lung cancer (LC) remains a health concern. This study aims to determine various factors associated with postoperative smoking relapse in patients undergoing surgical resection for stage I non-small cell lung cancer (NSCLC) at an urban safety net hospital. Methods We analyzed the demographic and clinical variables of all patients who underwent surgical resection for stage I NSCLC from 2002 to 2016 at our institution. Based on the post-operative smoking history, we segregated the cohort into two groups: relapse and abstinent. Chi-squared and analysis of variance tests were used to identify the variables that registered a significant difference between the two groups. Further, we used univariable and multivariable logistic regression to determine association between variables and smoking relapse. Results We analyzed data from 168 patients, excluding those with inadequate smoking history and never smokers. In total, 64 (38.1%) patients experienced smoking relapse, and 104 (61.9%) remained abstinent. The age, annual income, and race showed significant differences between the two groups. Multivariable logistic regression reflected that black patients had higher odds of relapse than white patients [odds ratio (OR) =3.26, confidence interval (CI): 1.54-6.89, P=0.002] and the chances of relapse decreased as the age increased (5-year age gap, OR =0.70, CI: 0.58-0.85, P<0.001). Conclusions Black race and younger age at the time of surgery are associated with smoking relapse after surgery for stage I NSCLC. Targeted smoking cessation programs catered towards these patient groups may help reduce the prevalence of post-operative smoking.
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Affiliation(s)
- Aniket Vazirani
- Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | | | - Flaminio Pavesi
- Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Shannon McDermott
- Department of Computational Biomedicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Howard Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Ehab Billatos
- Department of Pulmonary Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Kei Suzuki
- Department of Surgery, Thoracic Surgery, Inova, Fairfax, VA, USA
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14
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Tanaka H, Mizuma K, Nakamura Y, Hirata A, Miyazaki J, Suzuki K, Seta H, Watanabe H, Suzuki T, Watanabe R, Murayama N, Okamura T, Nakamura S. Predicting habitual water intake from lifestyle questions. Eur Rev Med Pharmacol Sci 2023; 27:8829-8841. [PMID: 37782192 DOI: 10.26355/eurrev_202309_33803] [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] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Previous studies have used selective recall and descriptive dietary record methods, requiring considerable effort for assessing food and water intake. This study created a simplified lifestyle questionnaire to predict habitual water intake (SQW), accurately and quickly assessing the habitual water intake. We also evaluated the validity using descriptive dietary records as a cross-sectional study. SUBJECTS AND METHODS First, we used crowdsourcing and machine learning to collect data, predict water intake records, and create questionnaires. We collected 305 lifestyle-related questions as predictor variables and selective recall methods for assessing water intake as an outcome variable. Random forests were used for the machine learning models because of their interpretability and accurate estimation. Random forest and single regression correlation analysis were augmented by the synthetic minority oversampling that trained the model. We separated the data by sex and evaluated our model using unseen hold-out testing data, predicting the individual and overall habitual water intake from various sources, including non-alcoholic beverages, alcohol, and food. RESULTS We found a 0.60 Spearman's correlation coefficient for total water intake between the predicted and the selective recall method values, reflecting the target value to be achieved. This question set was then used for feasibility tests. The descriptive dietary record method helped to obtain a ground-truth value. We categorized the data by gender, season, and source: non-alcoholic beverages, alcohol, food, and total water intake, and the correlation was confirmed. Consequently, our results showed a Pearson's correlation coefficient of 0.50 for total water intake between the predicted and the selective recall method values. CONCLUSIONS We hypothesize that dissemination of SQW can lead to better health management by easily determining the habitual water intake.
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Affiliation(s)
- H Tanaka
- Division of Information Science, Nara Institute of Science and Technology, Ikoma, Nara, Japan.
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15
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Okuno F, Ito-Masui A, Hane A, Maeyama K, Ikejiri K, Ishikura K, Yanagisawa M, Dohi K, Suzuki K. Severe hypocalcemia after denosumab treatment leading to refractory ventricular tachycardia and veno-arterial extracorporeal membrane oxygenation support: a case report. Int J Emerg Med 2023; 16:52. [PMID: 37635211 PMCID: PMC10463425 DOI: 10.1186/s12245-023-00529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/20/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Severe hypocalcemia may lead to life-threatening arrhythmias. Denosumab is an effective treatment for osteoporosis that allows long intervals between doses. However, there is a risk of hypocalcemia in some patients. Due to the long half-life of denosumab, emergency physicians caring for patients presenting with symptoms of hypocalcemia may not be aware of the medication, and adverse effects may last longer. CASE PRESENTATION A 55-year-old woman with a history of systemic lupus erythematosus (SLE) and anxiety disorder called for an ambulance for symptoms of hyperventilation and muscle cramps. After evaluation at the local hospital, she developed pulseless ventricular tachycardia and was resuscitated by defibrillation by the hospital staff. After conversion to sinus rhythm, she was transported to a tertiary center. Upon arrival, pulseless ventricular tachycardia occurred again, and veno-arterial extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pumping (IABP) were implemented. Laboratory results showed severe hypocalcemia (corrected calcium level of 5.3 mg/dL) whereupon intravenous calcium supplementation was started. She had received the first dose of denosumab (60 mg) by subcutaneous injection 24 days prior to hospitalization. She was eventually weaned from ECMO and IABP support. CONCLUSION Cardiac arrest due to hypocalcemia is relatively rare but can be fatal. In the present case, hyperventilation may have acutely exacerbated pre-existing hypocalcemia, leading to ventricular tachycardia. The patient had a slightly decreased serum calcium level prior to denosumab. Close monitoring may be preferable after the primary dose of denosumab in selected patients. Emergency physicians caring for patients who may be suffering from symptoms/signs of hypocalcemia must be mindful of medications that have long half-lives and affect electrolyte balance when treating fatal arrhythmia due to hypocalcemia.
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Affiliation(s)
- Fumito Okuno
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Asami Ito-Masui
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan.
| | - Atsuya Hane
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Keiko Maeyama
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Kaoru Ikejiri
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Ken Ishikura
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Masashi Yanagisawa
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
| | - Kei Suzuki
- Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan
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16
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Amadutsumi T, Urashima Y, Urashima K, Suzuki K, Kurachi K, Nishihara M, Neo M, Myotoku M, Kobori T, Obata T. Semisolid Enteral Nutrients Alter the Pharmacokinetics of Orally Administered Levetiracetam in Rats. Pharmazie 2023; 78:117-121. [PMID: 37592422 DOI: 10.1691/ph.2023.3575] [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] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Enteral nutrients (ENs) affect the plasma drug concentration of orally co-administered drugs, particularly those of antiepileptic drugs, such as phenytoin and carbamazepine. However, few studies have reported the interactions of levetiracetam (LEV), an upcoming antiepileptic drug, with ENs. In this study we aimed to investigate the pharmacokinetics of LEV in 55 rats after oral co-administration of LEV with liquid or semisolid ENs. Compared with the control group, co-administration with Terumeal ® Soft significantly decreased the plasma LEV concentration at 0.5, 1, and 2 h and area under the plasma concentration-time curve from 0 to 3 h (AUC0→3h) (P < 0.01). However, the AUC0→3h of LEV remained unchanged following the administration of Terumeal ® Soft 2 h after the initial LEV administration. Moreover, co-administration with semisolid Racol® NF delayed the absorption of LEV without decreasing the AUC0→3h, whereas liquid Racol ® NF did not alter LEV pharmacokinetics. Thus, co-administration of LEV with Terumeal® Soft reduced the absorption of LEV from the gastrointestinal tract, which was prevented by administering Terumeal ® Soft 2 h after LEV administration. Semisolid Racol ® NF altered LEV pharmacokinetics without decreasing its gastrointestinal absorption. Our findings suggested that careful monitoring of the plasma LEV levels is necessary when co-administering LEV with Terumeal ® Soft, semisolid Racol ® NF, or any other semisolid ENs, to prevent the inadvertent effects of the interaction between LEV and ENs.
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Affiliation(s)
| | - Y Urashima
- Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan Tokio Obata, Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan ,
| | | | | | | | | | | | | | | | - T Obata
- Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan
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17
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Park JA, Suzuki K. Novel Screening Tools for Lung Cancer. Thorac Surg Clin 2023; 33:215-226. [PMID: 37414477 DOI: 10.1016/j.thorsurg.2023.04.011] [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: 07/08/2023]
Abstract
Screening with low-dose computed tomography has been shown to decrease lung cancer mortality. However, the issues of low detection rates and false positive results remain, highlighting the need for adjunctive tools in lung cancer screening. To this end, researchers have investigated easily applicable, minimally invasive tests with high validity. We herein review some of the more promising novel markers utilizing plasma, sputum, and airway samples.
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Affiliation(s)
- Ju Ae Park
- Department of General Surgery, Inova Fairfax Medical Campus, 3300 Gallows Road, Falls Church, VA 22042, USA
| | - Kei Suzuki
- Inova Thoracic Surgery, Schar Cancer Institute, 8081 Innovation Park Drive, Fairfax, VA 22031, USA.
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18
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Yamamoto T, Sugimoto K, Ichikawa S, Suzuki K, Wakabayashi H, Dohi K, Yamamoto N. Impact of body composition on patient prognosis after SARS-Cov-2 infection. PLoS One 2023; 18:e0289206. [PMID: 37506083 PMCID: PMC10381082 DOI: 10.1371/journal.pone.0289206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Since the first outbreak of coronavirus disease 2019 (COVID-19), it has been reported that several factors, including hypertension, type 2 diabetes mellitus, and obesity, have close relationships with a severe clinical course. However, the relationship between body composition and the prognosis of COVID-19 has not yet been fully studied. METHODS The present study enrolled 76 consecutive COVID-19 patients with computed tomography (CT) scans from the chest to the pelvis at admission. The patients who needed intubation and mechanical ventilation were defined as severe cases. Patients were categorized into four groups according to their body mass index (BMI). The degree of hepatic steatosis was estimated by the liver/spleen (L/S) ratio of the CT values. Visceral fat area (VFA), psoas muscle area (PMA), psoas muscle mass index (PMI), and intra-muscular adipose tissue content (IMAC) were measured by CT scan tracing. These parameters were compared between non-severe and severe cases. RESULTS Severe patients had significantly higher body weight, higher BMI, and greater VFA than non-severe patients. However, these parameters did not have an effect on disease mortality. Furthermore, severe cases had higher IMAC than non-severe cases in the non-obese group. CONCLUSIONS Our data suggest high IMAC can be a useful predictor for severe disease courses of COVID-19 in non-obese Japanese patients, however, it does not predict either disease severity in obese patients or mortality in any obesity grade.
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Affiliation(s)
| | - Kazushi Sugimoto
- Department of Clinical Laboratory, Mie University Hospital, Tsu, Japan
| | - Syuhei Ichikawa
- Department of General Medicine, Mie University Hospital, Tsu, Japan
| | - Kei Suzuki
- Department of Infectious Disease, Mie University Hospital, Tsu, Japan
| | | | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Hospital, Tsu, Japan
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19
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Qureshi MM, Kam A, Suzuki K, Litle V, Tapan U, Balasubramaniyan R, Dyer MA, Truong MT, Mak KS. Association between hospital safety-net burden and receipt of trimodality therapy and survival for patients with esophageal cancer. Surgery 2023; 173:1153-1161. [PMID: 36774317 DOI: 10.1016/j.surg.2022.12.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 12/12/2022] [Accepted: 12/22/2022] [Indexed: 02/12/2023]
Abstract
BACKGROUND To examine the relationship between hospital safety-net burden and (1) receipt of surgery after chemoradiation (trimodality therapy) and (2) survival in esophageal cancer patients. METHODS The National Cancer Database was queried to identify 22,842 clinical stage II to IVa esophageal cancer patients diagnosed in 2004 to 2015. The treatment facilities were categorized by proportion of uninsured/Medicaid-insured patients into percentiles. No safety-net burden hospitals (0-37th percentile) treated no uninsured/Medicaid-insured patients, whereas low (38-75th percentile) and high (76-100th percentile) safety-net burden hospitals treated a median (range) of 8.8% (0.87%-16.7%) and 23.6% (16.8%-100%), respectively. Adjusted odds ratios and hazard ratios with 95% confidence intervals were computed, adjusting for patient, tumor, and treatment characteristics. RESULTS Compared to no safety-net burden hospital patients, high safety-net burden hospital patients were significantly more likely to be young, Black, and low-income. Age, female sex, Black race, Hispanic ethnicity, nonprivate insurance, lower income, higher comorbidity score, upper esophageal location, squamous cell histology, higher stage, time to treatment, and treatment at a community program or a low-volume facility were associated with lower odds of receiving trimodality therapy. Adjusting for these factors, high safety-net burden hospital patients were less likely to receive surgery after chemoradiation versus no safety-net burden hospital patients (adjusted odds ratio 0.77 [95% confidence interval 0.68-0.86], P < .0001); no difference was detected comparing low safety-net burden hospitals versus no safety-net burden hospitals (adjusted odds ratio 1.01 [0.92-1.11], P = .874). No significant survival difference was noted by safety-net burden (low safety-net burden hospitals versus no safety-net burden hospitals: adjusted hazard ratio 1.01 [0.96-1.06], P = .704; high safety-net burden hospital versus no safety-net burden hospitals: adjusted hazard ratio 0.99 [0.93-1.06], P = .859). CONCLUSION Adjusting for patient, tumor, and treatment factors, high safety-net burden hospital patients were less likely to undergo surgery after chemoradiation but without significant survival differences.
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Affiliation(s)
- Muhammad M Qureshi
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Ariana Kam
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Kei Suzuki
- Department of Thoracic Surgery, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Virginia Litle
- Department of Thoracic Surgery, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Umit Tapan
- Section of Hematology & Medical Oncology, Department of Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Ramkumar Balasubramaniyan
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Michael A Dyer
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Minh Tam Truong
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - Kimberley S Mak
- Department of Radiation Oncology, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA.
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20
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Xi Z, Koga Y, McDermott S, Beane J, Mazzilli SA, Suzuki K, Campbell JD. Abstract 4651: Comparison of the tumor and lymph node immune microenvironment in early non-small cell lung cancer through multimodal single cell sequencing. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-4651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background/Purpose: Previous studies have analyzed the tumor and local immune microenvironments in lung cancers and suggest immune modulation is associated with worse clinical outcome. However, the tumor-immune microenvironment in early stage lung tumors and lymph nodes (LNs) have not been fully described. We aim to compare cell states in the immune microenvironments between lung tumors and LNs through multi-modal profiling of the transcriptome and surface proteins.
Methods: Needle biopsy samples were taken from 10 treatment-naive early stage lung cancer patients undergoing lung cancer resections. Tissues were obtained from normal lung, lung tumor, and multiple mediastinal LNs, and processed for scRNA-seq including labeling with Total-Seq C CITE-seq panel to quantify the levels of 130 cell surface proteins. In total, 76,721 cells (4,462 normal lung; 39,019 tumor; 33,240 LN) were identified with a median of 1,673 genes and 92 protein features detected per cell. Protein expression was decontaminated through the decontX algorithm. Weighted-Nearest Neighbor analysis from the Seurat R package was applied to integrate the CITE-seq and RNA-seq level data for clustering cells into subpopulations.
Results: Six broad cell populations were identified including T/NK, myeloid (CD14+), B (CD19+), mast (TPSAB1+), pDC (IRF8+), and epithelial (EPCAM+) cells. Among 8 CD4+ T lymphocyte subpopulations and 11 CD8+ T lymphocyte subpopulations observed through clustering, a naïve CD4+ and a CD8+ T subpopulation (LEF1+, TCF7+) was observed respectively. These naïve T lymphocyte populations displayed increased proportions in LNs in comparison to tumors. In addition, 5 of the 8 observed CD4+ T lymphocyte populations were enriched in LNs. Immune populations enriched in LNs were largely shared and uniform across different patients. In contrast, a single CD4+ and CD8+ T lymphocyte subpopulation displayed expression of T lymphocyte exhaustion markers (TIGIT+, LAG3+, PD-1+) and were enriched in tumors. 6 of the 11 observed CD8+ T lymphocyte populations were enriched in tumor samples in comparison to LNs. Two alveolar macrophage populations (MARCO+) were enriched in normal lung tissue, in which one showed a heightened stress response.
Conclusion: Single-cell profiling reveals diversity in immune cell populations between LNs, tumor, and adjacent normal tissue in early-stage LUAD. The results suggest the composition of immune cell type is fairly consistent across LNs but more heterogeneous in the tumor and adjacent normal tissue in early-stage patients. In the future, we aim to determine if these immune subpopulations are associated with survival, recurrence, aggressiveness, and predict responses for neoadjuvant treatments, which could improve prognosis and patient quality of life.
Citation Format: Zhanhao Xi, Yusuke Koga, Shannon McDermott, Jennifer Beane, Sarah A. Mazzilli, Kei Suzuki, Joshua D. Campbell. Comparison of the tumor and lymph node immune microenvironment in early non-small cell lung cancer through multimodal single cell sequencing. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4651.
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Nakata K, Suzuki K. Magnonic Casimir Effect in Ferrimagnets. Phys Rev Lett 2023; 130:096702. [PMID: 36930906 DOI: 10.1103/physrevlett.130.096702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/20/2022] [Accepted: 12/21/2022] [Indexed: 06/18/2023]
Abstract
Quantum fluctuations are the key concepts of quantum mechanics. Quantum fluctuations of quantum fields induce a zero-point energy shift under spatial boundary conditions. This quantum phenomenon, called the Casimir effect, has been attracting much attention beyond the hierarchy of energy scales, ranging from elementary particle physics to condensed matter physics together with photonics. However, the application of the Casimir effect to spintronics has not yet been investigated enough, particularly to ferrimagnetic thin films, although yttrium iron garnet (YIG) is one of the best platforms for spintronics. Here we fill this gap. Using the lattice field theory, we investigate the Casimir effect induced by quantum fields for magnons in insulating magnets and find that the magnonic Casimir effect can arise not only in antiferromagnets but also in ferrimagnets including YIG thin films. Our result suggests that YIG, the key ingredient of magnon-based spintronics, can serve also as a promising platform for manipulating and utilizing Casimir effects, called Casimir engineering. Microfabrication technology can control the thickness of thin films and realize the manipulation of the magnonic Casimir effect. Thus, we pave the way for magnonic Casimir engineering.
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Affiliation(s)
- Kouki Nakata
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - Kei Suzuki
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
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22
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Asokan S, Pavesi F, Bains A, Qureshi MM, Shetty S, Singh S, Mak KS, Litle VR, Suzuki K. Frailty Index is Associated with Treatment Decisions for Stage I Non-Small Cell Lung Cancer at a High-Burden Safety-Net Hospital. Clin Lung Cancer 2023; 24:153-164. [PMID: 36641324 DOI: 10.1016/j.cllc.2022.12.002] [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: 05/30/2022] [Revised: 10/20/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Lobectomy remains the cornerstone of care for stage I NSCLC while sublobar resection and stereotactic body radiation therapy (SBRT) are reserved for patients with smaller tumors and/or poor operative risk. Herein, we investigate the effect of patient frailty on treatment modality for stage I NSCLC at a safety-net hospital. PATIENTS AND METHODS A retrospective chart review was performed of stage I NSCLC patients between 2006 and 2015. Demographics, patient characteristics, and treatment rates were compared to a National Cancer Database cohort of stage 1 NSCLC patients. Patient frailty was assessed using the MSK-FI. RESULTS In our cohort of 304 patients, significantly fewer patient were treated via lobectomy compared to national rates (P < .001). Advanced age (P = .02), lower FEV1 (P < .001) and DLCO (P < .001), not socioeconomic factors, were associated with higher utilization of non-lobectomy (sublobar resection or SBRT). Patients with lower MSK-FI were more likely to receive any surgical treatment (P = .01) and lobectomy (P = .03). Lower MSK-FI was an independent predictor for use of lobectomy over other modalities (OR 0.75, P = .04). MSK-FI (OR 0.64, P = .02), and FEV1 (OR 1.03, P < .001) were independently associated with use of SBRT over any surgery. CONCLUSION Our safety-net hospital performed fewer lobectomies and lung resections compared to national rates. Patient frailty and clinical factors were associated with use of SBRT or sublobar resection suggesting that the increased illness burden of a safety-net population may drive the lower use of lobectomy. The MSK-FI may help physicians stratify patient risk to guide stage I NSCLC management.
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Affiliation(s)
- Sainath Asokan
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Flaminio Pavesi
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Ashank Bains
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Muhammad M Qureshi
- Department of Surgery, Division of Thoracic Surgery, Intermountain Healthcare and Invoma Medical Group, Murray, UT
| | - Syona Shetty
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Sarah Singh
- Department of Surgery, Boston University School of Medicine, Boston, MA
| | - Kimberley S Mak
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Virginia R Litle
- Department of Surgery, Division of Thoracic Surgery, Intermountain Healthcare and Invoma Medical Group, Murray, UT
| | - Kei Suzuki
- Department of Surgery, Division of Thoracic Surgery, Intermountain Healthcare and Invoma Medical Group, Falls Church, VA
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Kawai T, Shimohira M, Nakayama K, Sato T, Ohta K, Suzuki K, Sawada Y, Wei Ng K, Huei Leong S, Hiwatashi A. Abstract No. 230 Robot-Assisted CT-Guided Biopsy with an Artificial Intelligence-Based Needle-Path Generator: A Phantom Study. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.291] [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: 02/26/2023] Open
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Shimohira M, Kawai T, Ohta K, Suzuki K, Nakayama K, Hiwatashi A. Abstract No. 162 Pulmonary Arteriovenous Malformations: Which Factors Are Associated with Symptomatic Neurologic Complications in Solitary Lesions? J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.217] [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: 02/26/2023] Open
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25
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Siddiqi N, Pan G, Liu A, Lin Y, Jenkins K, Zhao J, Mak K, Tapan U, Suzuki K. Timeliness of Lung Cancer Care From the Point of Suspicious Image at an Urban Safety Net Hospital. Clin Lung Cancer 2023; 24:e87-e93. [PMID: 36642641 DOI: 10.1016/j.cllc.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/03/2022] [Accepted: 12/08/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Timeliness of care is an important metric for lung cancer patients, and care delays in the safety-net setting have been described. Timeliness from the point of the suspicious image is not well-studied. Herein, we evaluate time intervals in the workup of lung cancer at an urban, safety net hospital and assess for disparities by demographic and clinical factors. PATIENTS AND METHODS We performed a retrospective analysis of lung cancer patients receiving some portion of their care at Boston Medical Center between 2015 and 2020. A total of 687 patients were included in the final analysis. Median times from suspicious image to first treatment (SIT), suspicious image to diagnosis (SID), and diagnosis to treatment (DT) were calculated. Nonparametric tests were applied to assess for intergroup differences in time intervals. RESULTS SIT, SID, and DT for the entire cohort was 78, 34, and 32 days, respectively. SIT intervals were 87 days for females and 72 days for males (p < .01). SIT intervals were 106, 110, 81, and 41 days for stages I, II, III, and IV, respectively (p < .01). SID intervals differed between black (40.5) and Hispanic (45) patients compared to white (28) and Asian (23) patients (p < .05). CONCLUSION Advanced stage at presentation and male gender were associated with more timely treatment from the point of suspicious imaging while white and Asian were associated with more timely lung cancer diagnosis. Future analyses should seek to elucidate drivers of timeliness differences and assess for the impact of timeliness disparities on patient outcomes in the safety net setting.
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Affiliation(s)
- Noreen Siddiqi
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Gilbert Pan
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Anqi Liu
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Yue Lin
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Kendall Jenkins
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Jenny Zhao
- Department of Surgery, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Kimberley Mak
- Department of Radiation Oncology, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Umit Tapan
- Department of Hematology/Oncology, Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Kei Suzuki
- Department of Surgery, Inova Fairfax Hospital, Fairfax, VA
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Wada H, Kawasugi K, Honda G, Kawano N, Uchiyama T, Madoiwa S, Takezako N, Suzuki K, Seki Y, Ikezoe T, Iba T, Okamoto K. Sepsis-Associated DIC with Decreased Levels of Antithrombin and Fibrinogen is the Target for Combination Therapy with Thrombomodulin Alfa and Antithrombin. TH Open 2023; 7:e65-e75. [PMID: 36846833 PMCID: PMC9946787 DOI: 10.1055/a-2009-9073] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
Background Disseminated intravascular coagulation (DIC) is not a homogeneous condition, but rather includes heterogeneous conditions, and its pathophysiology and outcome vary considerably depending on the background. Although anticoagulant therapy is expected to be of benefit in the treatment of DIC, previous studies have suggested that the benefits are limited only to a specific subtype. Objects The purpose of this study was to identify the group that would benefit from combination therapy using thrombomodulin/antithrombin. Methods The data from 2,839 patients registered in the postmarketing surveillance of thrombomodulin were evaluated. The patients were divided into four groups depending on antithrombin and fibrinogen levels, and the additive effects of antithrombin on thrombomodulin were examined in the groups. Results The DIC score, Sequential Organ Failure Assessment score, and mortality were significantly higher in the DIC group with low-antithrombin/low-fibrinogen than in the DIC groups without either low antithrombin or low fibrinogen. The survival curve was significantly higher in DIC patients with combination therapy than in patients treated with thrombomodulin monotherapy, but this effect was seen only in patients with infection-based DIC. Conclusion DIC patients with low-antithrombin/low-fibrinogen risk poor outcomes, but they can be the target of combination therapy with antithrombin and thrombomodulin as long as the DIC is due to infection.
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Affiliation(s)
- Hideo Wada
- Department of General Medicine, Mie Prefectural General Medical Center, Mie, Japan,Address for correspondence Hideo Wada, MD, PhD Department of General Medicine, Mie Prefectural General Medical CenterMieJapan
| | - Kazuo Kawasugi
- Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Goichi Honda
- Department of Medical Affairs, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Noriaki Kawano
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Toshimasa Uchiyama
- Department of Laboratory Medicine, National Hospital Organization Takasaki General Medical Center, Gunma, Japan
| | - Seiji Madoiwa
- Department of Clinical Laboratory Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Naoki Takezako
- Department of Hematology, Nerima Hikarigaoka Hospital, Tokyo, Japan
| | - Kei Suzuki
- Emergency and Critical Care Center, Mie University Hospital, Mie, Japan
| | - Yoshinobu Seki
- Department of Hematology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University, Fukushima, Japan
| | - Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kohji Okamoto
- Department of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata Hospital, Fukuoka, Japan
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Yokoyama K, Kaneko T, Ieki Y, Ito A, Kawamoto E, Suzuki K, Ishikura K, Imai H. Continuous High Positive-End Expiratory Pressure May Worsen Renal Function in Patients With Acute Respiratory Distress Syndrome: Retrospective Analyses of a Nationwide, Multicenter Observational Study in Japan. Cureus 2023; 15:e35233. [PMID: 36968897 PMCID: PMC10038686 DOI: 10.7759/cureus.35233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Positive end-expiratory pressure (PEEP), especially continuous high PEEP, is thought to be a risk factor for worsening renal function (WRF) due to impaired venous return and the development of renal interstitial edema. In this study, we investigated whether PEEP is a risk factor for WRF in patients with acute respiratory distress syndrome (ARDS), a representative pathology that requires continuous high PEEP for respiratory management. METHODS We performed retrospective sub-analyses of the Japanese Association for Acute Medicine, a nationwide prospective observational registry of ARDS (FORECAST ARDS registry) prospective multicenter cohort study. WRF was defined on the basis of a worsening renal Sequential Organ Failure Assessment (SOFA) score. We performed univariate and multivariable analyses to identify possible risk factors for WRF, and propensity score analyses to compare the frequency of WRF according to cutoff values for the difference in PEEP between day 1 and day 4. RESULTS We analyzed 151 cases. Multivariable analysis showed that the difference in PEEP (odds ratio (OR) 1.123 (95% confidence interval (CI) 1.017-1.240), P = 0.022) and male sex (OR 3.287 (95% CI 1.029-10.502), P = 0.045) were risk factors for WRF. Propensity score analysis showed trends towards an increased risk for WRF in each cutoff value for the difference in PEEP: -5 cmH2O (OR 0.389 (95% CI 0.084-1.799), P = 0.229), 0 cmH2O (OR 2.222 (95% CI 0.755-6.540), P = 0.150), and 5 cmH2O (OR 3.277 (95% CI 0.940-11.425), P = 0.065). CONCLUSIONS This study revealed that the difference in PEEP between days 1 and 4 was positively associated with WRF. However, a significant cutoff value for the difference in PEEP was not determined.
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Xi Z, Koga Y, McDermott S, Beane JE, Mazzilli SA, Suzuki K, Campbell JD. Abstract P075: Comparison of the tumor and lymph node immune microenvironment in early non-small cell lung cancer through multimodal single cell sequencing. Cancer Prev Res (Phila) 2023. [DOI: 10.1158/1940-6215.precprev22-p075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Background/Purpose: Previous studies have analyzed the tumor and local immune microenvironments in lung cancers and suggest immune modulation is associated with worse clinical outcome. However, the tumor-immune microenvironment in early-stage lung tumors and lymph nodes (LNs) have not been fully described. We aim to compare cell states in the immune microenvironments between lung tumors and LNs through multi-modal profiling of the transcriptome and surface proteins. Methods: Needle biopsy samples were taken from 10 treatment-naive early-stage lung cancer patients undergoing lung cancer resections. Tissues were obtained from normal lung, lung tumor, and multiple mediastinal LNs, and processed with scRNA-seq along with the Total-Seq C panel to quantify the levels of 130 cell surface proteins. In total, 98,337 cells (4,661 normal lung; 52,119 tumor; 42,117 LN) were identified with a median of 1,401 genes and 23 protein features detected per cell. Weighted-Nearest Neighbor analysis from the Seurat R package was applied to integrate the CITE-seq and RNA-seq level data for clustering cells into subpopulations. Results: Six broad cell populations were identified including T/NK, myeloid (CD14+), B (CD19+), mast (TPSAB1+), pDC (IRF8+), and epithelial (EPCAM+) cells. Protein expression measured with CITE-seq revealed additional T cell populations not captured by scRNA-seq. Preliminary results have identified cell populations enriched in LNs, which include naive CD4+ (CD4, FHIT, LEF1, CCR7) and CD8+ T cells (CD8A, TCF7, LEF1, CD27, CCR7). Additionally, we have identified numerous other CD8+ T-cell subpopulations enriched in tumors, including resident memory CD8+ T cells (KLRC1, ITGAE, ITGA1, VIM, JUN). Furthermore, immune populations enriched in LNs were similarly shared across different patients, while those enriched in tumors displayed patient-level specificity. Conclusion: Single-cell profiling reveals diversity in immune cell populations between LNs, tumor, and adjacent normal tissue in early-stage LUAD. The results suggest the composition of immune cell type is consistent across LNs but more heterogeneous in the tumor and adjacent normal tissue. In the future, we aim to determine if these markers for various immune subpopulations are associated with survival, recurrence, aggressiveness, and predict responses for neoadjuvant treatments, which could improve prognosis and patient quality of life.
Citation Format: Zhan Xi, Yusuke Koga, Shannon McDermott, Jennifer E. Beane, Sarah A. Mazzilli, Kei Suzuki, Joshua D. Campbell. Comparison of the tumor and lymph node immune microenvironment in early non-small cell lung cancer through multimodal single cell sequencing. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P075.
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Affiliation(s)
- Zhan Xi
- 1Boston University School of Medicine, Boston, MA,
| | - Yusuke Koga
- 1Boston University School of Medicine, Boston, MA,
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Hidaka R, Masuda Y, Ogawa K, Tanaka T, Kanazawa M, Suzuki K, Stading M, Iijima K, Matsuo K. Impact of the Comprehensive Awareness Modification of Mouth, Chewing and Meal (CAMCAM) Program on the Attitude and Behavior Towards Oral Health and Eating Habits as Well as the Condition of Oral Frailty: A Pilot Study. J Nutr Health Aging 2023; 27:340-347. [PMID: 37248757 DOI: 10.1007/s12603-023-1913-1] [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: 02/19/2023] [Accepted: 03/29/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Preserving sufficient oral function and maintaining aadequate nutrition are essential for preventing physical frailty and the following long-term care. We recently developed the 6-month Comprehensive Awareness Modification of Mouth, Chewing And Meal (CAMCAM) program, in which participants gather monthly to learn about oral health and nutrition while eating a textured lunch together. This study examined whether the CAMCAM program could improve attitude and behavior towards oral health, mastication, and diet as well as ameliorate oral frailty in community-dwelling older adults. DESIGN Single-arm pre-post comparison study. SETTING AND PARTICIPANTS A total of 271 community-dwelling adults (72.3 ± 5.7 years of age; 159 women [58.7%]) in 4 Japanese municipalities were recruited, of which 249 participants (92%) were assessed at the final evaluation. INTERVENTION Participants gathered once a month at community centers to learn about oral health and nutrition while eating a "munchy" textured lunch containing proper nutrition. MEASUREMENTS Oral frailty, frailty, and eating behavior were evaluated with the Oral Frailty Index-8 (OFI-8), Kihon checklist (KCL), and CAMCAM checklist, respectively. Participants were divided into Oral frailty (OF) and Robust groups according to OFI-8 scores. The differences in KCL and CAMCAM checklist results between the OF and Robust groups were statistically tested along with changes in scores after the program. RESULTS KCL and CAMCAM checklist scores were significantly lower in the OF group at the initial assessment. OFI-8 and KCL findings were significantly improved in the OF group after completing the program (all P <0.05). Regarding the CAMCAM checklist, awareness of chewing improved significantly in the Robust group (P=0.009), with a similar tendency in the OF group (P=0.080). CONCLUSION The findings of this pilot study suggest that the CAMCAM program may improve both oral and systemic frailty in addition to attitudes towards chewing, oral health, and meals, especially in individuals with oral frailty. The CAMCAM program merits expansion as a community-based frailty prevention program.
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Affiliation(s)
- R Hidaka
- Koichiro Matsuo, Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan, Phone: +81-3-5803-4545, E-mail:
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Hattori K, Suenaga D, Suzuki K, Yasui S. Phase diagram of the QCD Kondo effect and inactivation of the magnetic catalysis. EPJ Web Conf 2023. [DOI: 10.1051/epjconf/202327601015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
We investigate the QCD phase diagram in strong magnetic fields with heavy-quark impurities and determine the ground state within the mean-field analysis. The ground state is characterized by magnitudes of the pairing not only between the light quark and antiquark, i.e., chiral condensate, but also between the light quark and heavy-quark impurity, dubbed the Kondo condensate. We propose signatures of the interplay and/or competition between those two pairing phenomena reflected in the magnitude of the chiral condensate that is saturated with respect to the magnetic-field strength and anomalously increases with increasing temperature.
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Nishi Y, Murakami Y, Teshima S, Tsukano K, Otsuka M, Hirata H, Tsuchiya M, Suzuki K. Endotoxin activity and leukocytic STAT3 mRNA alterations differ according to age in lipopolysaccharide-challenged calves. Res Vet Sci 2022; 152:300-306. [DOI: 10.1016/j.rvsc.2022.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 11/27/2022]
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Suzuki K, Nishio N, Kimura H, Tokura T, Kishi S, Ozaki N, Fujimoto Y, Sone M. Comparison of quality of life and psychological distress in patients with tongue cancer undergoing a total/subtotal glossectomy or extended hemiglossectomy and free flap transfer: a prospective evaluation. Int J Oral Maxillofac Surg 2022; 52:621-629. [PMID: 36470693 DOI: 10.1016/j.ijom.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
The aim of this study was to assess changes in the quality of life and psychological distress of patients with tongue cancer undergoing total/subtotal glossectomy (TG) or extended hemiglossectomy (HG) and free flap transfer. Differences between the two groups were compared using the Short Form 8-Item Health Survey (SF-8) and Hospital Anxiety and Depression Scale (HADS). Of the 43 patients with tongue cancer, 24 (56%) underwent TG and 19 (44%) underwent HG. The general health and social functioning scores in the SF-8 and depression in the HADS were significantly worse in the TG group than in the HG group at 12 months after surgery, indicating that patients in the TG group may experience social isolation and psychological distress, and have difficulty in employability even 12 months after surgery. In contrast, all items of the SF-8 in the HG group were nearly equal to those in the general population. Due to the extensive psychological impact on patients with tongue cancer who are planned for an extended resection, curative surgery with free flap transfer and multidisciplinary psychiatric support are essential to improve quality of life and manage psychological distress.
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Ikejiri K, Goto H, Usui M, Nakayama Y, Sugioka K, Ito A, Suzuki K, Hirokawa Y, Yamanaka K, Imai H. Septic pulmonary embolism and subsequent bilateral pneumothorax in patients undergoing chemoradiotherapy for head angiosarcoma: An autopsy case report and literature review. Medicine (Baltimore) 2022; 101:e31755. [PMID: 36397415 PMCID: PMC9666164 DOI: 10.1097/md.0000000000031755] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
RATIONALE Septic pulmonary embolism (SPE) and subsequent pneumothorax are rare but serious conditions. We report a case of SPE and pneumothorax caused by central venous port (CV port) infection. PATIENT CONCERNS A 73-year-old woman, who underwent chemoradiotherapy for a head angiosarcoma and a CV port placement, presented with general malaise and myalgia. DIAGNOSIS A laboratory examination showed high levels of inflammatory markers. Chest computed tomography showed fluid collection around the CV port and multiple ground-glass opacities and nodular shadows in the bilateral lung field. She was admitted with a diagnosis of SPE due to CV port infection. The port was removed, and antibiotic administration was initiated; however, she was intubated because of refractory septic shock. Methicillin-susceptible Staphylococcus aureus was detected in the blood and pus around the port site. INTERVENTIONS Her respiratory status did not improve despite recovering from septic shock, and radiologic findings showed a left pneumothorax and exacerbation of SPE on day 9. Her condition was judged ineligible for surgery for pneumothorax, and chest tube thoracostomy was continued. OUTCOMES Air leaks persisted after chest tube thoracostomy, and her respiratory status did not improve despite ventilator management and recruitment maneuvers. Moreover, a right pneumothorax developed on day 19. Her respiratory status gradually worsened, and she died on day 21. Autopsy showed multiple cavitary lesions in the bilateral lungs and emboli containing organization and inflammatory cells that obstructed the pulmonary arterioles. LESSONS This case indicates that CV port-related infections are infrequent and difficult to diagnose; understanding the clinical features of SPE is important because of its high mortality rate; and pneumothorax secondary to SPE is a rare but serious condition and is difficult to treat during ventilator management.
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Affiliation(s)
- Kaoru Ikejiri
- Emergency and Critical Care Center, Mie University Hospital, Tsu City, Japan
- * Correspondence: Kaoru Ikejiri, Emergency and Critical Care Center, Mie University Hospital, 2-174 Edobashi, Tsu City, Mie 514-8507, Japan (e-mail: )
| | - Hiroyuki Goto
- Department of Dermatology, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Miki Usui
- Department of Diagnostic Pathology, Mie University Hospital, Tsu City, Japan
| | - Yuichi Nakayama
- Department of Dermatology, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Kyoko Sugioka
- Department of Dermatology, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Asami Ito
- Emergency and Critical Care Center, Mie University Hospital, Tsu City, Japan
| | - Kei Suzuki
- Emergency and Critical Care Center, Mie University Hospital, Tsu City, Japan
- Department of Infectious Diseases, Mie University Hospital, Tsu City, Japan
| | - Yoshifumi Hirokawa
- Department of Diagnostic Pathology, Mie University Hospital, Tsu City, Japan
| | - Keiichi Yamanaka
- Department of Dermatology, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Hiroshi Imai
- Emergency and Critical Care Center, Mie University Hospital, Tsu City, Japan
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Wada H, Shiraki K, Matsumoto T, Suzuki K, Yamashita Y, Tawara I, Shimpo H, Shimaoka M. A Clot Waveform Analysis of Thrombin Time Using a Small Amount of Thrombin Is Useful for Evaluating the Clotting Activity of Plasma Independent of the Presence of Emicizumab. J Clin Med 2022; 11:jcm11206142. [PMID: 36294464 PMCID: PMC9605059 DOI: 10.3390/jcm11206142] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: Although emicizumab is a bispecific, monoclonal antibody that has led to a significant improvement of treatment for hemophilia A patients with inhibitors, the routine monitoring of patients treated with emicizumab is difficult. Thrombin time (TT) reflects thrombin burst, which mainly depends on activation of factor V (FV) and FVIII. Methods: We, therefore, developed a method for evaluating clotting activity independent of the presence of emicizumab. Normal plasma (NP) or FVIII-deficient plasma (FVIIIDP) with and without emicizumab was measured using clot waveform analysis (CWA)-activated partial thromboplastin time (APTT) and TT. Results: Emicizumab caused clot formation in FVIIIDP using the CWA-APTT; however, the coagulation peaks of plasma with and without emicizumab measured by the CWA-TT did not differ to a statistically significant extent. Regarding the mixing tests with NP and FVIIIDP, CWA-APTT showed large differences between each mixing test in plasma with and without emicizumab, whereas the CWA-TT showed similar patterns in mixing plasma with and without emicizumab. Regarding the standard curve of FVIII activity, the CWA-APTT showed an FVIII-concentration-dependent increase; however, the values with each concentration of FVIII differed between samples with and without emicizumab, whereas CWA-TT showed FVIII-concentration-dependent fluctuations independent of the presence of emicizumab, and the values with each concentration of FVIII were similar in samples with and without emicizumab. Conclusions: As CWA-TT using a small amount of thrombin (0.5 IU/mL) can reflect thrombin burst and be useful for evaluating FVIII activity, independent of the presence of emicizumab, it is useful for monitoring clotting activity in patients with an anti-FVIII inhibitor treated with emicizumab.
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Affiliation(s)
- Hideo Wada
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan
- Correspondence: ; Tel.: +81-59-345-2321
| | - Katsuya Shiraki
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan
| | - Takeshi Matsumoto
- Department of Transfusion Medicine and Cell Therapy, Mie University Hospital, Tsu 514-8507, Japan
| | - Kei Suzuki
- Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Yoshiki Yamashita
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Isao Tawara
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
| | - Hideto Shimpo
- Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan
| | - Motomu Shimaoka
- Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
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Hirata K, Naruse H, Yamamoto Y, Hatanaka K, Kinoshita K, Abiko S, Suzuki K, Nakajima K, Katagiri M, Takano M, Ozasa M, Umemura M, Nakajima S, Aoyama K, Sasaki T, Kuwatani M, Sakamoto N, Tanikawa S, Okazaki N, Tanaka S. Gastrointestinal: Rare malignant biliary stricture with rapid progression. J Gastroenterol Hepatol 2022; 37:1839. [PMID: 35307882 DOI: 10.1111/jgh.15802] [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] [Received: 09/14/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 12/09/2022]
Affiliation(s)
- K Hirata
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Kinoshita
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Abiko
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Suzuki
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakajima
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Katagiri
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Takano
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Ozasa
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Umemura
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - S Nakajima
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - K Aoyama
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - T Sasaki
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Kuwatani
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Tanikawa
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - N Okazaki
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - S Tanaka
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Yambayev I, Sullivan TB, Rieger-Christ KM, Servais EL, Stock CT, Quadri SM, Sands JM, Suzuki K, Burks EJ. Vascular invasion identifies the most aggressive histologic subset of stage I lung adenocarcinoma: Implications for adjuvant therapy. Lung Cancer 2022; 171:82-89. [DOI: 10.1016/j.lungcan.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 11/15/2022]
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Suzuki K, Yoshida H, Esumi R, Ieki Y, Yamamoto A, Ohi M, Kaneko T, Imai H. Esophageal Perforation Accompanying Mediastinitis in Blunt Trauma in a Patient with Thoracic Osteophytes. Intern Med 2022; 61:2601-2605. [PMID: 35135923 PMCID: PMC9492484 DOI: 10.2169/internalmedicine.8930-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We herein report a 61-year-old man who sustained injury after a 2-m fall and developed mediastinitis. He presented to another hospital two days after the fall and was transferred to our hospital four days after the fall with a fever and dysphagia. Computed tomography revealed osteophytes on the second and third thoracic vertebrae and free air in the mediastinum, indicating esophageal perforation. Emergent surgery was performed. Intraoperatively, a longitudinal esophageal tear was identified. We stress the importance of being aware of the possibility of osteophyte-related esophageal perforation in patients with a history of a fall. A delayed diagnosis affects the prognosis.
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Affiliation(s)
- Kei Suzuki
- Emergency and Critical Care Center, Mie University Hospital, Japan
- Department of Infectious Diseases, Mie University Hospital, Japan
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Japan
| | - Haruna Yoshida
- Emergency and Critical Care Center, Mie University Hospital, Japan
| | - Ryo Esumi
- Emergency and Critical Care Center, Mie University Hospital, Japan
| | - Yohei Ieki
- Emergency and Critical Care Center, Mie University Hospital, Japan
| | - Akira Yamamoto
- Department of Gastrointestinal and Pediatric Surgery, Mie University Hospital, Japan
| | - Masaki Ohi
- Department of Gastrointestinal and Pediatric Surgery, Mie University Hospital, Japan
| | - Tadashi Kaneko
- Emergency and Critical Care Center, Mie University Hospital, Japan
| | - Hiroshi Imai
- Emergency and Critical Care Center, Mie University Hospital, Japan
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Uchida S, Hattori A, Fukui M, Matsunaga T, Takamochi K, Suzuki K. EP02.03-025 Long-Term Oncological Outcomes and Risk Factors of Recurrence After Segmentectomy for Primary Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.381] [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: 11/17/2022]
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Broadley D, van Lessen M, Takeoka A, Arai R, Suzuki K, Abe A, Nagahama T, Takaoka A, Funk W, Erdmann H, Bíró T, Bertolini M. 640 Exploring the synergic effects of a plant and a peptide on hair follicle pigmentation. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.651] [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]
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Lee MH, Qureshi MM, Suzuki K, Everett P, Tapan U, Mak KS. Small cell lung cancer in young patients: trends in sociodemographic factors, diagnosis, treatment, and survival. J Thorac Dis 2022; 14:2880-2893. [PMID: 36071763 PMCID: PMC9442513 DOI: 10.21037/jtd-22-210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Background Small cell lung cancer (SCLC) in patients <50 years old has unique socioeconomic and clinical implications. We aimed to examine the demographics, treatment patterns, and survival of young patients with SCLC and compared them to older adults. Methods The National Cancer Database (NCDB) was queried to identify SCLC cases diagnosed from 2004 to 2016. Patients were divided into three age groups: ≥18–<50, ≥50–<70, and ≥70 years. Patient characteristics were evaluated for survival within each age group. Kaplan-Meier and Cox regression analyses were used to assess survival. Results Of the 172,453 evaluated SCLC patients (median age 66 years), 8,792 were ≥18–<50 years old. Compared to the older groups, patients under 50 were more likely to be Black, uninsured or on Medicaid, have household income <$30,000, and present with stage III or IV disease (P<0.0001 for all). While young patients were more likely to receive guideline-concordant care (GCC), the hazard of death increased to 1.96 (95% CI: 1.80–2.14; P<0.0001) with receipt of nonstandard therapy. Private insurance, female gender, non-White race, Hispanic ethnicity, and higher income were associated with better survival. The youngest cohort had significantly better survival overall when compared to the older patients (P<0.0001), but the survival advantage was reduced with the advancing stage. Conclusions SCLC patients under 50 years old represent a socioeconomically disadvantaged group with advanced disease at presentation. Despite having fewer comorbidities and being offered guideline-concordant treatment, younger patients with SCLC have only marginally better survival than older patients in advanced stages.
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Affiliation(s)
- Michelle H. Lee
- Hematology and Oncology Section, Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Muhammad Mustafa Qureshi
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kei Suzuki
- Division of Thoracic Surgery, Department of Surgery, Inova Fairfax Hospital, Falls Church, VA, USA
| | - Peter Everett
- Hematology and Oncology Section, Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Umit Tapan
- Hematology and Oncology Section, Department of Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kimberley S. Mak
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Murata O, Suzuki K, Takeuchi T. AB0545 THYMUS VARIANTS ON IMAGING IN PATIENTS WITH PRIMARY SJÖGREN’S SYNDROME AND POLYMYOSITIS/DERMATOMYOSITIS PATIENTS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe thymus, a primary lymphoid organ, plays a crucial role in immune system homeostasis [1,2]. Although several studies of an association between radiographic thymus variants and serological features in systemic autoimmune diseases such as systemic scleroderma, have been reported [3-6], information in patients with other systemic autoimmune disease, especially in primary Sjögren’s syndrome (pSS) or polymyositis/dermatomyositis (PM/DM) patients, is quite limited.ObjectivesWe investigated the association between radiographic thymus variants and clinical and immunological features in patients with pSS and PM/DM, and clarified its significance.MethodsPatients with pSS and PM/DM were randomly selected from all patients who had visited our department and underwent chest CT scan between April 2009 and March 2019. Patients with thymoma or thymic cyst and those aged less than 30 years were excluded. Thymic enlargement and thymus attenuation score in axial images of CT scans were quantitatively interpreted. We defined thymic enlargement as a thickness of more than 13 mm and graded the score by a four-point scale (score 0-3) according to previous studies [7, 8]. Association with radiographic thymus variants and clinical and immunological features was statistically analyzed.Results72 pSS and 47 PM/DM patients were enrolled. 90% and 63.8% were women and mean age was 62.7 ± 12.2 and 56.2 ± 13.7 years in pSS and PM/DM patients, respectively. Thymic enlargement was found in 16 (22.2%) and 14 (29.8%) patients with pSS and PM/DM, respectively. Thymus attenuation (score ≥ 2) was found in 11 (15.3%) and 9 (19.1%) patients with pSS and PM/DM, respectively. These findings were more frequent than in non-connective tissue diseases patients (9.1% and 9.1%, respectively). In pSS patients, radiographic thymus variants, both thymic enlargement and the thymus attenuation score, were significantly positively associated with body weight (P < 0.0073 and 0.037, respectively). Although there was no significant difference between immunological features such as titres of serum RF, the ratio of RF-positivity, SS-A antibody-positivity or SS-B antibody-positivity, and radiographic thymus variants, titres of serum RF tended to be positively associated with thymic enlargement (P = 0.057). In PM/DM patients, thymic enlargement was significantly positively associated with titres of serum RF (P = 0.046), and the thymus attenuation score was significantly positively associated with titres of serum IgG (P = 0.042) and significantly negatively associated with age (P = 0.033). There was no significant difference between the ratio of myositis specific antibody-positivity and radiographic thymus variants.ConclusionRadiographic thymus variants were frequently observed in pSS and PM/DM patients, and particularly, in case of PM/DM, may reflect an abnormal immune response involved in the pathogenesis.References[1]Gorozny JJ, et al. Trends Immunol 2001;22:251-255,[2]Seddon B, et al. Immunol Today 2000;21:94-99,[3]Truffault F, et al. Clin Rev Allergy Immunol 2017; 52:108-124,[4]Berrih-Aknin S, et al. J Autoimmun 2014;52:90-110,[5]Colaci M, et al. Rheumatology 2014;53:732-36,[6]Murata O, et al. Rheumatology 2021;60:5595-5600,[7]Ackman JB, et al. Radiology 2013;268:245-53,[8]Naidich DP, et al. Philadelphia: Lippincott-Raven 1999:57-73.AcknowledgementsI have no acknowledgements to declare.Disclosure of InterestsNone declared
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Ichimura T, Ogawa C, Murata H, Miyahara K, Yuge S, Tsukioka R, Kado K, Yoshimura T, Suzuki K, Nomura H, Shimizu H. Community pharmacists' measurement of health-related quality of life in outpatients taking high-risk drugs. Pharmazie 2022; 77:202-206. [PMID: 35751159 DOI: 10.1691/ph.2022.1914] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Patients experiencing severe side effects when taking high-risk drugs may have a significantly reduced health-related quality of life (QOL); therefore, it is important to identify changes in the health-related QOL in these patients. This study aimed to determine the health-related QOL in community pharmacy outpatients taking high-risk drugs. This prospective observational study was conducted in 29 community pharmacies with 71 pharmacists in 12 regions and cities in Japan from October to December 2020 and 760 patients were enrolled. Using descriptive questionnaires of EuroQOL-5-dimensions-5-levels (EQ-5D-5L), community pharmacists obtained health-related QOL data from outpatients taking high-risk drugs. The mean health-related QOL of all outpatients was 0.869. The health-related QOL decreased with increasing age. The outpatient health-related QOL was 0.700, 0.763, 0.785, and 0.817 when taking antiepileptic, antidepressant, digitalis, and antiarrhythmic drugs, respectively, which was lower than the average health-related QOL of all outpatients. Mobility and pain/ discomfort accounted for a large proportion of the decline in the health-related QOL with increasing age. There were no significant differences in personal care with increasing age; however, the number of outpatients with mobility, normal activity, and pain challenges decreased with age. In contrast, outpatients aged <65 years with anxiety/depression showed a lower than overall average health-related QOL. To the best of our knowledge, this is the first study in Japan to report an investigation by community pharmacists regarding health-related QOL assessment in outpatients taking high-risk drugs.
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Affiliation(s)
- T Ichimura
- Study group for Comprehensive Cost-Effectiveness Analysis of Pharmacotherapy, Koto-ku, Tokyo; Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Shinagawa-ku, Tokyo
| | - C Ogawa
- Study group for Comprehensive Cost-Effectiveness Analysis of Pharmacotherapy, Koto-ku, Tokyo; Department of Pharmacy, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo
| | - H Murata
- Study group for Comprehensive Cost-Effectiveness Analysis of Pharmacotherapy, Koto-ku, Tokyo; QOL Co., Ltd., Minato-ku, Tokyo
| | | | - S Yuge
- Nihon Chouzai Co., Ltd., Chiyoda-ku, Tokyo
| | - R Tsukioka
- AIN PHARMACIEZ INC., Sapporo city, Hokkaido
| | - K Kado
- KRAFT Inc., Chiyoda-ku, Tokyo
| | | | - K Suzuki
- Division of Applied Pharmaceutical Education and Research, Hoshi University, Shinagawa-ku, Tokyo
| | - H Nomura
- Department of Date Science / Pharmacy, National Cancer Center Hospital East, Kashiwa city, Chiba
| | - H Shimizu
- Study group for Comprehensive Cost-Effectiveness Analysis of Pharmacotherapy, Koto-ku, Tokyo; Department of Pharmacy, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo; Department of Nursing, School of Nursing and Rehabilitation Sciences, Showa University, Shinagawa-ku, Tokyo, Japan;,
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Kajio N, Suzuki K, Matsumoto K, Iijima H, Nakamura S, Ishizawa Y, Inamo J, Takeshita M, Yoshimoto K, Kaneko Y, Takeuchi T. POS0530 MOLECULAR SIGNATURE IN SUSTAINED CLINICAL REMISSION INDUCED BY TOCILIZUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundClinical remission is a clinical goal in the treatment of rheumatoid arthritis (RA). Sustained, biologics-free and true remission is an unachieved goal of the “treat-to-target” approach in most patients, and the determinants for achievement are still unclear. In our recent prospective study using multiomics analysis, we proposed that a molecular signature in peripheral whole blood can be a predictor for subsequent disease activity or activities of daily living.1 We also showed that tocilizumab (TCZ) induced deep clinical remission associated with gene expression in peripheral CD4+ T cells.2ObjectivesTo consolidate and expand our hypothesis, we investigated the significance of molecular signatures in sustained remission in a larger scale cohort.MethodsTo build and validate the diagnostic model, we collected 73 peripheral blood samples from 30 patients with active RA, 30 patients in clinical remission induced by TCZ and 13 healthy controls. We then collected another 23 samples at a point before TCZ was halted due to sustained clinical remission. In total, 96 samples were analyzed by a multiomics platform, which included RNA sequencing and comprehensive proteomics.ResultsWe first developed an optimized partial least-squares regression (PLSR) model using data from 5,436 genes and 255 proteins extracted in our previous model.1 The odds ratio in the model clearly reflected the clinical state with high fidelity (Figure 1). In that study, TCZ induced nearly half of the patients with clinical remission into molecular remission, with an odds ratio of less than zero. To clarify the characteristics of the molecular signature at sustained clinical remission under TCZ continuation, 23 samples were applied to the model. The odds ratio was largely the same as that for clinical remission. Next, we investigated the association with disease flare after cessation of TCZ. At some points before cessation, the median odds ratio in patients who experienced disease flare after stopping TCZ tended to be higher than that in patients with sustained remission after stopping TCZ in the transcriptomics model but not in the proteomics model. Thirty-five differentially expressed genes were identified between the two groups under the conditions of a >1.5-fold change and P-value<0.05.Figure 1.Odds ratio in the partial least-squares regression model using transcriptomics (A) and proteomics (B) data from rheumatoid arthritis and healthy control groupsConclusionOur larger scale study validated the idea in our previous study that TCZ induces molecular remission. A certain substantial gap associated with prognosis after quitting TCZ may exist as a molecular signature of sustained clinical remission induced by TCZ. These multiomics data sets enable us to understand sustained clinical remission at a molecular level.References[1]Nat Commun. 9(1):2775, 2018, 2) Sci Rep.11(1):16691, 2021Graphs:AcknowledgementsWe acknowledge funding by Chugai Pharmaceutical Co., Ltd.Disclosure of InterestsNobuhiko Kajio: None declared, Katsuya Suzuki Speakers bureau: AbbVie, AsahiKasei, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Gilead, Janssen, Mitsubishi Tanabe, Pfizer, Sanofi, Viatris, Consultant of: AbbVie, Asahi Kasei, Janssen, Pfizer, Grant/research support from: Chugai, Daiichi-Sankyo, Eli Lilly, Mitsubishi Tanabe, Ono, Takeda, Kotaro Matsumoto: None declared, Hiroshi Iijima: None declared, Seiji Nakamura: None declared, Yohei Ishizawa: None declared, Jun Inamo: None declared, Masaru Takeshita: None declared, Keiko Yoshimoto: None declared, Yuko Kaneko Speakers bureau: Chugai, Consultant of: Chugai, Grant/research support from: Chugai, Tsutomu Takeuchi Speakers bureau: Chugai, Consultant of: Chugai, Grant/research support from: Chugai.
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Hiramoto K, Saito S, Hanaoka H, Suzuki K, Kikuchi J, Fukui H, Takano R, Miyoshi F, Seki N, Sugahara K, Kaneko Y, Takeuchi T. POS0459 APTAMER-BASED PROTEOMIC SCREENING IN IDENTIFICATION OF PATHOGENIC SIGNAL PATHWAY AND URINARY BIOMARKERS ASSOCIATED WITH HISTOLOGICAL FINDINGS IN LUPUS NEPHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe current gold standard for the diagnosis and classification, assessment of the severity of lupus nephritis (LN) is a renal biopsy. On the other hand, since the procedure is highly invasive, there is a pressing need to identify biomarkers for predicting the presence and its histological severity of LN. In addition, the background pathogenesis of each histological findings is not clearly understood.ObjectivesThe purpose of this study was to elucidate the urine biomarkers for predicting the presence and the severity of histological findings of LN, and to search the pathogenic signal pathway.MethodsUrine samples from 24 biopsy-proven active LN patients were initially screened for the levels of 1305 distinct human proteins using an aptamer-based-targeted proteomic assay. We developed histological scoring system based on ISN/RPS lesion definitions and classification, NIH activity and chronicity score. Two experienced evaluators assessed the histological scores. Cluster analysis and pathway analysis were performed.ResultsA total of 24 LN patients were included: 20 (83%) had a proliferative histological class (III or IV +/-V), 4 (17%) pure membranous (V). Through cluster analysis, several histological subgroups were extracted according to correlation with each histological finding, and proteins which corelated with each histological scores were analyzed. We focused on two subgroups: one in which including active glomerular histological findings (endocapillary hypercellularity, karyorrhexis, neutrophil infiltration, subendothelial deposits) and the other in which including interstitial histological findings (interstitial inflammation, interstitial fibrosis, tubular atrophy). Histological scores in the former group showed strong positive correlation with protein group which contained 59 proteins (Group A), including CCL21, CXCL10, VCAM1. Histological scores in the latter group corelated with another protein group which contained 85 proteins (Group B), including MCP-1, CCL11. Ingenuity Pathway Analysis showed 16 pathways (PDGF Signaling, Granulocyte Adhesion and Diapedesis, etc) were upregulated in Group A and 11 pathways (IL-17 signaling, Fibrosis signaling pathway, etc) upregulated in Group B. Among group A and group B urine proteins, those showed strong correlation between respective histological findings were validated with ELISA assays.ConclusionAn aptamer-based-targeted proteomic assay screening by combining with renal histological scoring system suggested several urine proteins can predict the severity and the presence of major renal histological findings, and suggested to be related with the pathogenesis in patients with LN.Disclosure of InterestsKazuoto Hiramoto: None declared, Shuntaro Saito: None declared, Hironari Hanaoka: None declared, Katsuya Suzuki: None declared, Jun Kikuchi: None declared, Hiroyuki Fukui: None declared, Ryo Takano Employee of: Mitsubishi Tanabe Pharma Corporation Sohyaku, Fumihiko Miyoshi Employee of: Mitsubishi Tanabe Pharma Corporation Sohyaku, Noriyasu Seki Employee of: Mitsubishi Tanabe Pharma Corporation Sohyaku, Kunio Sugahara Employee of: Mitsubishi Tanabe Pharma Corporation Sohyaku, Yuko Kaneko: None declared, Tsutomu Takeuchi: None declared.
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Kondo Y, Takeshita M, Uwamino Y, Namkoong H, Saito S, Kikuchi J, Hanaoka H, Suzuki K, Hasegawa N, Murata M, Kaneko Y. POS0257 COMPARISON OF SARS-CoV-2 VACCINE RESPONSE IN PATIENTS WITH INFLAMMATORY RHEUMATIC DISEASE; mRNA-1273 VACCINE INDUCES HIGHER HUMORAL IMMUNOGENICITY THAN BNT162b2. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe SARS-CoV-2 messenger RNA (mRNA) vaccines BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) have benefitted all countries amid the coronavirus disease 2019 (COVID-19) crisis. Whereas both of them have shown efficacy in preventing COVID-19 illness in healthy participants, there is paucity of data about immunogenicity and safety of mRNA COVID-19 vaccines in patients with autoimmune, inflammatory rheumatic disease. Recent observational studies evaluated mainly BNT162b2, suggesting that glucocorticoids, immunosuppressive agents impair SARS-CoV-2 vaccine responses. However, difference in immune reactions and safety between BNT162b2 and mRNA-1273 have not been clarified in patients with inflammatory rheumatic diseases.ObjectivesTo assess humoral and T cell immune responses and safety profiles after two doses of different mRNA vaccine against SARS-CoV-2; BNT162b2 and mRNA-1273.MethodsWe enrolled consecutive, previously uninfected patients with inflammatory rheumatic diseases receiving mRNA vaccine including BNT162b2 and mRNA-1273. Healthy participants receiving BNT162b2 were also recruited as control. Blood samples were obtained 3weeks, 2 months, 3 months, 4 months, and 6 months after second dose of vaccines. We measured titres of neutralizing antibodies against SARS-CoV-2 and calculated seroconversion rates to evaluate humoral responses. We also assessed T-cell immunity responses by using interferon releasing assay against SARS-CoV-2 in a part of the patients. Answers to questionnaires about adverse reactions were obtained from participants.ResultsA total of 974 patients with inflammatory rheumatic diseases and healthy 630 control participants were enrolled. Among them, 796 patients received BNT162b2, 178 patients received mRNA-1273, and all control participants received BNT162b2. Seroconversion rates and neutralizing antibody titres 3 weeks after vaccination were significantly higher in patients with mRNA-1273 and healthy participants with BNT162b2 compared with patients with BNT162b2; seroconversion rates, 97.2% vs 99.5% vs 83.3%, p<0.001; titers of neutralizing antibodies, 29.4±33.9 IU/mL vs 23.9±14.2 IU/mL vs 10.8±16.5 IU/mL, p<0.001, respectively. On another front, T cell reaction against SARS-CoV-2 was similar in both patients with mRNA-1273 and BNT162b2; interferon gamma levels for antigen 1, 1.2±2.1 IU/mL vs 0.8±2.5 IU/mL, p=0.23; and for antigen 2, 1.4±1.9 IU/mL vs 1.0±2.1 IU/mL, p=0.11, respectively. Regarding adverse reaction of each mRNA vaccine, the frequency of systemic adverse reactions including fever and general fatigue are also significantly higher in patients with mRNA-1273 and healthy controls than patients with BNT162b2; fever, 48.0% vs 44.9% vs 10.2%, p<0.001; general fatigue, 70.4% vs 61.8% vs 31.2%, p<0.001, respectively). In longitudinal measurement, neutralizing antibody titres in patients with BNT162b2 were decreased more rapidly than those in healthy controls; 3.3±3.2 IU/mL in patients with BNT162b2 at 4 months and 3.2±4.7 IU/mL in healthy controls with BNT162b2 at 6 months. We identified age, glucocorticoid dose (prednisolone > 7.5mg), use of immunosuppressants including methotrexate, mycophenolate, cyclophosphamide, and tacrolimus are associated with rapid attenuation of humoral responses in patients with BNT162b2.ConclusionOur results demonstrated a significant higher humoral immunogenicity and frequency of systemic adverse reaction of the SARS-CoV-2 mRNA-1273 (Moderna) compared with the BNT162b2 (Pfizer-BioNTech) in inflammatory rheumatic disease patients. Glucocorticoid and immunosuppressive agents impaired induction and sustention of neutralizing antibody, and earlier third booster vaccination may be required within 4 months, especially for those receiving BNT162b2.References[1]Steensels D, Pierlet N, Penders J et al. JAMA. 2021;326(15):1533–1535.[2]Friedman MA, Curtis JR and Winthrop KL. Ann Rheum Dis 2021;80:1255–1265.Disclosure of InterestsNone declared
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Tanaka A, Nakano H, Yoneto K, Yoneto C, Furubayashi T, Suzuki K, Okae A, Ueno T, Sakane T. Topical Xerostomia Treatment with Hyaluronate Sheets Containing Pilocarpine. Biol Pharm Bull 2022; 45:403-408. [DOI: 10.1248/bpb.b21-00763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Akiko Tanaka
- Department of Pharmaceutical Technology, Kobe Pharmaceutical University
| | - Hiroyuki Nakano
- Department of Oral Surgery, Osaka Medical and Pharmaceutical University
| | | | | | | | - Kei Suzuki
- Department of Oral Surgery, Osaka Medical and Pharmaceutical University
| | - Azusa Okae
- Department of Oral Surgery, Osaka Medical and Pharmaceutical University
| | - Takaaki Ueno
- Department of Oral Surgery, Osaka Medical and Pharmaceutical University
| | - Toshiyasu Sakane
- Department of Pharmaceutical Technology, Kobe Pharmaceutical University
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Hashimoto T, Aikawa S, Akaishi T, Asano H, Bazzi M, Bennett DA, Berger M, Bosnar D, Butt AD, Curceanu C, Doriese WB, Durkin MS, Ezoe Y, Fowler JW, Fujioka H, Gard JD, Guaraldo C, Gustafsson FP, Han C, Hayakawa R, Hayano RS, Hayashi T, Hays-Wehle JP, Hilton GC, Hiraiwa T, Hiromoto M, Ichinohe Y, Iio M, Iizawa Y, Iliescu M, Ishimoto S, Ishisaki Y, Itahashi K, Iwasaki M, Ma Y, Murakami T, Nagatomi R, Nishi T, Noda H, Noumi H, Nunomura K, O'Neil GC, Ohashi T, Ohnishi H, Okada S, Outa H, Piscicchia K, Reintsema CD, Sada Y, Sakuma F, Sato M, Schmidt DR, Scordo A, Sekimoto M, Shi H, Shirotori K, Sirghi D, Sirghi F, Suzuki K, Swetz DS, Takamine A, Tanida K, Tatsuno H, Trippl C, Uhlig J, Ullom JN, Yamada S, Yamaga T, Yamazaki T, Zmeskal J. Measurements of Strong-Interaction Effects in Kaonic-Helium Isotopes at Sub-eV Precision with X-Ray Microcalorimeters. Phys Rev Lett 2022; 128:112503. [PMID: 35363014 DOI: 10.1103/physrevlett.128.112503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
We have measured the 3d→2p transition x rays of kaonic ^{3}He and ^{4}He atoms using superconducting transition-edge-sensor microcalorimeters with an energy resolution better than 6 eV (FWHM). We determined the energies to be 6224.5±0.4(stat)±0.2(syst) eV and 6463.7±0.3(stat)±0.1(syst) eV, and widths to be 2.5±1.0(stat)±0.4(syst) eV and 1.0±0.6(stat)±0.3(stat) eV, for kaonic ^{3}He and ^{4}He, respectively. These values are nearly 10 times more precise than in previous measurements. Our results exclude the large strong-interaction shifts and widths that are suggested by a coupled-channel approach and agree with calculations based on optical-potential models.
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Affiliation(s)
- T Hashimoto
- Advanced Science Research Center, Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - S Aikawa
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - T Akaishi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - H Asano
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Bazzi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - D A Bennett
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M Berger
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - D Bosnar
- Department of Physics, Faculty of Science, University of Zagreb, Zagreb 10000, Croatia
| | - A D Butt
- Politecnico di Milano, Dipartimento di Elettronica, Milano 20133, Italy
| | - C Curceanu
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - W B Doriese
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M S Durkin
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Ezoe
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - J W Fowler
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - H Fujioka
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - J D Gard
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - C Guaraldo
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - F P Gustafsson
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - C Han
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - R Hayakawa
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - R S Hayano
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Hayashi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara 252-5210, Japan
| | - J P Hays-Wehle
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - G C Hilton
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Hiraiwa
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - M Hiromoto
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - Y Ichinohe
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - M Iio
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - Y Iizawa
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Iliescu
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - S Ishimoto
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - Y Ishisaki
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - K Itahashi
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Iwasaki
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - Y Ma
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - T Murakami
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Nagatomi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Nishi
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako 351-0198, Japan
| | - H Noda
- Department of Earth and Space Science, Osaka University, Toyonaka 560-0043, Japan
| | - H Noumi
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - K Nunomura
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - G C O'Neil
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Ohashi
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - H Ohnishi
- Research Center for Electron Photon Science (ELPH), Tohoku University, Sendai 982-0826, Japan
| | - S Okada
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
- Engineering Science Laboratory, Chubu University, Kasugai 487-8501, Japan
| | - H Outa
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - K Piscicchia
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - C D Reintsema
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Sada
- Research Center for Electron Photon Science (ELPH), Tohoku University, Sendai 982-0826, Japan
| | - F Sakuma
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Sato
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - D R Schmidt
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - A Scordo
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - M Sekimoto
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - H Shi
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - K Shirotori
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - D Sirghi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - F Sirghi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - K Suzuki
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - D S Swetz
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - A Takamine
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
| | - H Tatsuno
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - C Trippl
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - J Uhlig
- Chemical Physics, Lund University, Lund 22100, Sweden
| | - J N Ullom
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - T Yamaga
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - T Yamazaki
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - J Zmeskal
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
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Singh S, Pavesi F, Steiling K, Asokan S, Espinosa C, Cabral HJ, Burks EJ, Meister A, Akpoviroro O, Buck A, Drozdowicz K, Litle VR, Suzuki K. Risk Factors for Lung Cancer in an Underrepresented Safety-Net Screening Cohort. Clin Lung Cancer 2022; 23:e165-e170. [PMID: 34393063 PMCID: PMC8766584 DOI: 10.1016/j.cllc.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION/BACKGROUND The USPSTF (United States Preventive Services Task Force) guidelines suggest criteria centering on smoking status and age to select patients for lung cancer screening. Despite the significant advances in screening with low-dose computed tomography (LDCT), cancer detection rate is low (1.1%), highlighting the need to investigate possible ways to refine the current lung cancer screening strategy. Our aim was to determine clinical risk factors predictive of lung cancer in an urban safety-net hospital. MATERIALS AND METHODS We performed a retrospective chart review of 2847 patients who received LDCT screening for lung cancer between 3/1/2015 and 12/31/2019. Patient demographics and medical history were collected. A bivariate logistic regression was used to evaluate predictors of lung cancer. RESULTS Compared to the National Lung Cancer Screening Trial (NLST) population, our screening cohort had significantly more African Americans (38.2% vs. 4.5%, P < .0001), more obesity (32.7% vs. 28.3%, P < .0001), and higher rates of chronic obstructive pulmonary disease (COPD) (45.9% vs. 5.0%, P < .0001). The strongest predictors of lung cancer were COPD (odds ratio [OR] = 2.14, P < .0001) and a family history of lung cancer (OR = 2.77, P < .0001). Age (OR = 1.04, P< .001) and pack years (OR = 1.01, P< .001) were less predictive. CONCLUSION A diagnosis of COPD and family history of lung cancer were most predictive of lung cancer in a screening cohort at our urban safety-net hospital. Future studies should focus on whether inclusion of these additional risk-factors improves proportion of lung cancer detected via screening.
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Affiliation(s)
- Sarah Singh
- Boston University School of Medicine, Boston, MA, United States
| | - Flaminio Pavesi
- Boston University School of Medicine, Boston, MA, United States
| | - Katrina Steiling
- Division of Pulmonary Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Sainath Asokan
- Boston University School of Medicine, Boston, MA, United States
| | - Cisco Espinosa
- Boston University School of Medicine, Boston, MA, United States
| | - Howard J. Cabral
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Eric J. Burks
- Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Amanda Meister
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, United States
| | - Ogheneyoma Akpoviroro
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, United States
| | - Anne Buck
- Boston University School of Medicine, Boston, MA, United States
| | | | - Virginia R. Litle
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA, United States
| | - Kei Suzuki
- Division of Thoracic Surgery, Department of Surgery, Boston University School of Medicine, Boston, MA.
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Wada H, Yamamoto A, Tomida M, Ichikawa Y, Ezaki M, Masuda J, Yoshida M, Fukui S, Moritani I, Inoue H, Shiraki K, Suzuki K, Imai H, Shimaoka M, Shimpo H. Proposal of Quick Diagnostic Criteria for Disseminated Intravascular Coagulation. J Clin Med 2022; 11:jcm11041028. [PMID: 35207302 PMCID: PMC8878374 DOI: 10.3390/jcm11041028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/08/2022] [Accepted: 02/14/2022] [Indexed: 12/10/2022] Open
Abstract
BACKGROUND The diagnostic criteria for disseminated intravascular coagulation (DIC) vary and are complicated and the cut-off values are different. Simple and quick diagnostic criteria for DIC are required in physicians for critical care. MATERIAL AND METHODS Platelet counts, prothrombin time-international normalized ratio (PT-INR) and D-dimer levels were examined in 1293 critical ill patients. Adequate cut-off values of these parameters were determined and a quick DIC score using these biomarkers was proposed. The quick DIC score was evaluated using a receiver operating characteristic (ROC) analysis. RESULTS Using the Japanese Ministry of Health, Labor and Welfare diagnostic criteria, 70 and 109 patients were diagnosed with DIC and pre-DIC, respectively. The ROC analysis of factors difference between DIC and non-DIC, revealed the following cut-off values: PT-INR, 1.20; platelet count, 12.0 × 1010/L and D-dimer, 10.0 μg/mL. Based on the above results, the quick DIC score system was proposed. All patients with DIC had a quick DIC score of 3, 4 or 5, and 85.3% of the patients with pre-DIC had a quick DIC score of ≥3 points. All patients with pre-DIC had a score of ≥2 points. In the ROC analysis, the area under the curve was 0.997 for DIC vs. non-DIC, and 0.984 for pre-DIC + DIC vs. non-DIC, and the cut-off value was 3 points for DIC and 2 points for DIC + pre-DIC. The quick DIC scores of non-survivors were significantly higher than those of survivors. CONCLUSIONS The Quick DIC score system is a simple and useful tool that can be used for the diagnosis of DIC and pre-DIC. Further evaluation of the quick DIC score system in a large-scale study is required.
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Affiliation(s)
- Hideo Wada
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan
- Correspondence:
| | - Akitaka Yamamoto
- Department of Emergency and Critical Care Center, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (A.Y.); (M.T.)
| | - Masaki Tomida
- Department of Emergency and Critical Care Center, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (A.Y.); (M.T.)
| | - Yuhuko Ichikawa
- Department of Central Laboratory, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (Y.I.); (M.E.)
| | - Minoru Ezaki
- Department of Central Laboratory, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (Y.I.); (M.E.)
| | - Jun Masuda
- Department of Cardiovascular Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
| | - Masamichi Yoshida
- Department of Respiratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
| | - Shunsuke Fukui
- Department of Gastroenterology, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (S.F.); (I.M.); (H.I.); (K.S.)
| | - Isao Moritani
- Department of Gastroenterology, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (S.F.); (I.M.); (H.I.); (K.S.)
| | - Hidekazu Inoue
- Department of Gastroenterology, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (S.F.); (I.M.); (H.I.); (K.S.)
| | - Katsuya Shiraki
- Department of Gastroenterology, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan; (S.F.); (I.M.); (H.I.); (K.S.)
| | - Kei Suzuki
- Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (K.S.); (H.I.)
| | - Hiroshi Imai
- Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu 514-8507, Japan; (K.S.); (H.I.)
| | - Motomu Shimaoka
- Department of Molecular Pathobiology and Cell Adhesion Biology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan;
| | - Hideto Shimpo
- Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan;
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Omori A, Katayama K, Saiki R, Masui S, Suzuki K, Kanii Y, Tsujimoto K, Nakamori S, Kurita T, Murata T, Inoue T, Dohi K. Disruption of the glomerular basement membrane associated with nutcracker syndrome and double inferior vena cava in Noonan syndrome: a case report. BMC Nephrol 2022; 23:65. [PMID: 35151252 PMCID: PMC8841073 DOI: 10.1186/s12882-022-02671-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background Nutcracker syndrome (NCS) is characterized by compression of the left renal vein (LRV) between the aorta and the superior mesenteric artery. While rare, NCS was reported to be accompanied by double inferior vena cava (IVC). We herein report a case of Noonan syndrome (NS) with double IVC who presented with macrohematuria and proteinuria. Case presentation The patient was a 23-year-old man, who had been diagnosed with NS due to RIT1 mutation, after showing foamy macrohematuria 3 weeks previously. A physical examination revealed low-set ears and a webbed neck. A urinalysis showed hematuria and proteinuria, and urinary sediments showed more than 100 isomorphic red blood cells per high-power field. His proteinuria and albuminuria concentrations were 7.1 and 4.5 g/g⋅Cr, respectively. Three-dimensional contrast-enhanced computed tomography (CT) showed double IVC and narrowing of the LRV after interflow of the left IVC. The aortomesenteric angle on a sagittal reconstruction of the CT image was 14.7°. Cystoscopy revealed a flow of macrohematuria from the left ureteral opening. On Doppler ultrasonography, there was scant evidence to raise the suspicion of the nutcracker phenomenon. Since severe albuminuria continued, a left kidney biopsy was performed. Light microscopy showed red blood cells in Bowman’s space and the tubular lumen. Electron microscopy revealed disruption of the glomerular basement membrane (GBM). Vulnerability of the GBM was suspected and a genetic analysis revealed a heterozygous mutation at c.4793 T > G (p.L1598R) in the COL4A3 gene. Screening for coagulation disorders revealed the factor VIII and von Willebrand factor (vWF) values were low, at 47.6 and 23%, respectively. A multimer analysis of vWF showed a normal multimer pattern and he was diagnosed with von Willebrand disease type 1. As the bleeding tendency was mild, replacement of factor VIII was not performed. His macrohematuria and proteinuria improved gradually without treatment, and his urinalysis results have been normal for more than 6 months. Conclusions The present case showed macrohematuria and proteinuria due to NCS in NS with double IVC and von Willebrand disease type 1. The macrohematuria and proteinuria originated from glomerular hemorrhage because of vulnerability of the GBM due to COL4A3 mutation. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02671-4.
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