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Takamasu E, Yokogawa N, Shimada K. Digital ischemia with Bywaters' lesions in rheumatoid vasculitis. QJM 2024; 117:133-134. [PMID: 37738589 DOI: 10.1093/qjmed/hcad212] [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: 09/11/2023] [Indexed: 09/24/2023] Open
Affiliation(s)
- E Takamasu
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan
| | - N Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan
| | - K Shimada
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan
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Onishi Y, Ohno T, Shimizu H, Shimada K, Isoda H, Ishii T, Takai A, Nakamoto Y. Natural History of Hepatic Hemangiomas Larger Than 10 cm: Imaging Findings and Clinical Course of 22 Cases. Cureus 2023; 15:e50563. [PMID: 38226088 PMCID: PMC10788688 DOI: 10.7759/cureus.50563] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION The natural history of a large hepatic hemangioma is important in determining the treatment strategy. Although several studies have assessed the natural history of hepatic hemangiomas, no study has focused on hepatic hemangiomas measuring >10 cm. The aim of this study was to assess the natural history of hepatic hemangiomas measuring >10 cm by evaluating imaging findings and clinical course. METHODS Computed tomography (CT) and magnetic resonance imaging (MRI) reports at Kyoto University Hospital, Kyoto, Japan, between January 2001 and March 2023 were retrospectively searched to find adult patients with hepatic hemangiomas >10 cm. Patients who were followed up without treatment for over six months were included. The maximum diameter of the hepatic hemangioma was compared between the baseline and the final CT or MRI. The clinical course of the patients was evaluated. RESULTS Twenty-two patients (17 women, five men; median age, 51 years) were identified. The median diameter of hepatic hemangiomas in the baseline study was 114 mm. Two patients had abdominal distention at the time of the baseline imaging, whereas the others were asymptomatic. After follow-up without treatment (the median; 95.5 months), enlargement, no change, shrinkage of hepatic hemangioma was observed in six, 11, and five patients, respectively. The median growth rate of hepatic hemangiomas was 2.5 mm/year. Two patients underwent liver resection for hepatic hemangioma, while the others were followed up without treatment. In four patients, symptoms appeared or worsened. Two patients died: one patient died from prostate cancer progression; the cause of death for the other was not confirmed. CONCLUSION Hepatic hemangiomas show a slow growth rate during follow-up, and shrinkage is occasionally observed. Some patients experience new symptoms or aggravation of symptoms; however, deaths associated with hepatic hemangiomas are uncommon.
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Affiliation(s)
- Yasuyuki Onishi
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Tsuyoshi Ohno
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Hironori Shimizu
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Kotaro Shimada
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | - Hiroyoshi Isoda
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
| | | | - Atsushi Takai
- Gastroenterology and Hepatology, Kyoto University, Kyoto, JPN
| | - Yuji Nakamoto
- Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, JPN
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Sakaki K, Murakami T, Fujimoto H, Shimizu Y, Miyake KK, Otani D, Kiyobayashi S, Okada T, Fujimoto M, Hakata T, Yamauchi I, Shimada K, Shimizu H, Nagai K, Nakamoto Y, Inagaki N. 18F-labeled PEGylated exendin-4 imaging noninvasively differentiates insulinoma from an accessory spleen: the first case report of [18F]FB(ePEG12)12-exendin-4 positron emission tomography/computed tomography for insulinoma. Front Endocrinol (Lausanne) 2023; 14:1245573. [PMID: 37720533 PMCID: PMC10501723 DOI: 10.3389/fendo.2023.1245573] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Background Insulinomas are the most common functioning pancreatic neuroendocrine neoplasms, and these tumors induce hypoglycemia due to hyperinsulinemia. Hypoglycemia caused by insulinomas can cause seizures, coma or death due to the delayed diagnosis. The only curative treatment is surgical resection. To perform curative surgical resection of insulinomas, preoperative localization is crucial. However, localization of insulinomas is often challenging using conventional imaging methods such as computed tomography (CT) and magnetic resonance imaging. Although endoscopic ultrasound (EUS) fine-needle aspiration and selective arterial calcium stimulation test, which can reflect the endocrine character of the tumor, are performed in such cases, these modalities are invasive and require operator-dependent techniques. Additionally, somatostatin receptor (SSTR)-targeted imaging has a relatively low sensitivity for detecting insulinomas due to its low SSTR type 2 expression. Thus, there is an urgent need for developing a noninvasive diagnostic technique which is specific for detecting insulinomas. Consequently, glucagon-like peptide-1 receptor-targeted imaging has recently emerged and gained a wide interest. Recently, we have developed a novel 18F-labeled exendin-4-based probe conjugated with polyethylene glycol, [18F]FB(ePEG12)12-exendin-4 (18F-exendin-4), for positron emission tomography (PET) imaging. Here we report a case of insulinoma in which 18F-exendin-4 PET/CT noninvasively provided critical information for localization. Case description This is a case of a 58-year-old male with symptomatic hypoglycemia for 10 years; however, a preoperative diagnosis of insulinoma was not established due to the difficulty in differentiating it from an accessory spleen using conventional imaging. Moreover, the patient requested to avoid invasive diagnostic procedures including EUS. 18F-exendin-4 PET/CT revealed significant uptakes in the pancreatic tail whereas no apparent uptakes were observed in the spleen; thus, curative laparoscopic enucleation of the pancreatic tail was performed. The diagnosis of insulinoma was confirmed via histopathological examination. This is the first case report of insulinoma diagnosed using 18F-exendin-4 PET/CT. Conclusion In this case, PET information led to curative resection through enucleation of the pancreas. 18F-exendin-4 PET/CT may serve as a useful noninvasive clinical tool for insulinoma localization.
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Affiliation(s)
- Kentaro Sakaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takaaki Murakami
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Fujimoto
- Radioisotope Research Center, Agency for Health, Safety and Environment, Kyoto University, Kyoto, Japan
| | - Yoichi Shimizu
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kanae Kawai Miyake
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Daisuke Otani
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sakura Kiyobayashi
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuya Okada
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masakazu Fujimoto
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuro Hakata
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ichiro Yamauchi
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kotaro Shimada
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironori Shimizu
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuyuki Nagai
- Division of Hepatobiliary Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuya Inagaki
- Medical Research Institute Kitano HospitalPIIF Tazuke-kofukai, Osaka, Japan
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Andou M, Yanai S, Hada T, Kanno K, Sakate S, Sawada M, Kato K, Shimada K, Yoshino Y. Management for Ureteral Injury during Laparoscopic or Robotic Hysterectomy: Minimally Invasive Strategies. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.244] [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: 11/26/2022]
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Honma O, Watanabe C, Fukuchimoto H, Kashiwazaki J, Tateba M, Wagatsuma S, Ogata K, Maki K, Sonou H, Shiga K, Otsuka E, Hiruta M, Hirasawa Y, Hosonuma M, Murayama M, Narikawa Y, Toyoda H, Tsurui T, Kuramasu A, Kin M, Kubota Y, Sambe T, Horiike A, Ishida H, Shimada K, Umeda M, Tsunoda T, Yoshimura K. Verification of the Usefulness of an Assessment and Risk Control Sheet that Promotes Management of Cancer Drug Therapy. Front Pharmacol 2022; 13:744916. [PMID: 35222016 PMCID: PMC8864067 DOI: 10.3389/fphar.2022.744916] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/20/2022] [Indexed: 12/22/2022] Open
Abstract
Background: Proper management of adverse events is crucial for the safe and effective implementation of anticancer drug treatment. Showa University Hospital uses our interview sheet (assessment and risk control [ARC] sheet) for the accurate evaluation of adverse events. On the day of anticancer drug treatment, a nurse conducts a face-to-face interview. As a feature of the ARC sheet, by separately describing the symptoms the day before treatment and the day of treatment and sharing the information on the medical record, it is possible to clearly determine the status of adverse events. In this study, we hypothesized that the usefulness and points for improvement of the ARC sheet would be clarified by using and evaluating a patient questionnaire. Methods: This study included 174 patients (144 at Showa University Hospital (Hatanodai Hospital) and 30 at Showa University Koto Toyosu Hospital (Toyosu Hospital) who underwent pre-examination interviews by nurses and received cancer chemotherapy at the outpatient center of Hatanodai and Toyosu Hospital. In the questionnaire survey, the ARC sheet’s content and quality, respondents’ satisfaction, structural strengths, and points for improvement were evaluated on a five-point scale. Results: The patient questionnaire received responses from 160 participants, including the ARC sheet use group (132 people) and the non-use group (28 people). Unlike the ARC sheet non-use group, the ARC sheet use group recognized that the sheet was useful to understand the adverse events of aphthous ulcers (p = 0.017) and dysgeusia (p = 0.006). In the satisfaction survey questionnaire, there was a high sense of security in the pre-examination interviews by nurses using the ARC sheet. Conclusions: The ARC sheet is considered an effective tool for comprehensively evaluating adverse events. Pre-examination interviews by nurses using ARC sheets accurately determined the adverse events experienced by patients with anxiety and tension due to confrontation with physicians.
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Affiliation(s)
- O Honma
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - C Watanabe
- Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - H Fukuchimoto
- Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan.,Department of Nursing, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - J Kashiwazaki
- Faculty of Nursing, Kyoritsu Women's University, Tokyo, Japan
| | - M Tateba
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - S Wagatsuma
- Department of Nursing, Showa University Hospital, Tokyo, Japan.,Department of Nursing, Showa University School of Nursing and Rehabilitation Sciences, Kanagawa, Japan
| | - K Ogata
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - K Maki
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - H Sonou
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - K Shiga
- Department of Nursing, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - E Otsuka
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - M Hiruta
- Department of Nursing, Showa University Hospital, Tokyo, Japan
| | - Y Hirasawa
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - M Hosonuma
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - M Murayama
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - Y Narikawa
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - H Toyoda
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - T Tsurui
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - A Kuramasu
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
| | - M Kin
- Department of Pharmacy, Showa University Hospital, Tokyo, Japan
| | - Y Kubota
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - T Sambe
- Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Shinagawa-ku, Japan
| | - A Horiike
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - H Ishida
- Division of Medical Oncology, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - K Shimada
- Division of Medical Oncology, Internal Medicine Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - M Umeda
- Family Hospice Co., Ltd., Tokyo, Japan
| | - T Tsunoda
- Department of Medical Oncology, Showa University, Tokyo, Japan
| | - K Yoshimura
- Department of Clinical Immunology and Oncology, Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan
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El-Husseiny HM, Mady EA, Shimada K, Hamabe L, Yoshida T, Ma D, Mandour AS, Hendawy H, Sasaki K, Fukuzumi S, Watanabe M, Hirose M, Mizuki H, Takahashi K, Tanaka R. Intraventricular pressure gradient: a promising tool to predict the post-infarction chronic congestive heart failure in rats. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.390] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: Congestive heart failure (CHF), the main reason for morbidity and mortality, is considered a serious consequence of myocardial infarction (MI). The use of left ventricular end-diastolic pressure (LVEDP) as a chief indicator of CHF becomes limited because of the possible impairment of cardiac function and induced aortic valve damage during its recording. Echocardiography is the gold standard approach to diagnose structural myocardial dysfunction. However, its ability to predict chronic CHF following MI is still limited. Recently, intraventricular pressure gradient (IVPG) was presented as a non-invasive, highly sensitive preload-independent diastolic function parameter to assess cardiac function, especially during cardiomyopathy. However, there have not been any investigations demonstrating the feasibility of IVPG in the evaluation of post-infarction chronic CHF.
Purpose
This study aimed to investigate the utility of IVPG to assess the heart function in a rat model with chronic CHF following MI with evaluating its capacity to predict these changes.
Methods
Fifty male rats were included. MI was induced via ligation of the left anterior descending artery (LAD) at the level of the atrioventricular junction (MI animals, n = 35). Sham animals were subjected to the same left thoracotomy procedure without LAD ligation (Sham animals, n = 15). Transthoracic conventional echocardiography and colour M-mode echocardiography (CMME) for IVPG were performed in all animals 6 months post-surgery. The next day, animals were anesthetized, ventilated, and euthanized after the recording of hemodynamics. The heart weight, and lung and liver wet-to-dry weight ratios were recorded. J-tree cluster-analysis was performed based on ten echocardiographic variables indicative of CHF.
Results
Based on the cluster analysis, animals were joined into two clusters; CHF+ (n = 22) and named MI/HF+, and CHF- (n = 28) that was joined from sham (n = 15), and MI/HF- (n = 13). MI/HF+ presented the most severe anatomical and echocardiographic changes indicative of CHF with significant reduction of all IVPG indices and impairment of the hemodynamics. The IVPG indices were significantly (P< 0.0001) correlated with the anatomical and echocardiographic findings, LVDP, LVEDP, HR, -dP/dtmin, and Tau. Meanwhile, LVSP was only significantly correlated with apical IVPG (R = 0.677, P = 0.022). dP/dtmax was significantly correlated with total IVPG, basal IVPG, and apical IVPG (R = 0.797, P = 0.017, R = 0.724, P = 0.003, and R = 0.652, P = 0.026 ; respectively). Moreover, total, basal, mid-to-apical, mid-, and apical IVPG were significant (P< 0.0001) predictors of chronic CHF following MI.
Conclusion
Compared to the structural, and functional indices of conventional echocardiography, IVPG derived from CMME could provide a substantial non-invasive tool to diagnose and predict CHF after long-term MI.
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Affiliation(s)
- HM El-Husseiny
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - EA Mady
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - K Shimada
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - L Hamabe
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - T Yoshida
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - D Ma
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - AS Mandour
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - H Hendawy
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - K Sasaki
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - S Fukuzumi
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - M Watanabe
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - M Hirose
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - H Mizuki
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
| | - K Takahashi
- Juntendo University Graduate School of Medicine, Department of Pediatrics and Adolescent Medicine, Tokyo, Japan
| | - R Tanaka
- Tokyo university of agriculture and technology, Fuchu, Tokyo, Japan
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Onishi Y, Isoda H, Ohno T, Shimizu H, Shimada K, Taura K, Hatano E, Nakamoto Y. Future liver remnant hypertrophy rate in portal vein embolization before left trisectionectomy: a retrospective cohort study. Abdom Radiol (NY) 2022; 47:878-884. [PMID: 34958405 DOI: 10.1007/s00261-021-03387-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Reports on the future liver remnant (FLR) hypertrophy rate in patients undergoing portal vein embolization (PVE) before left trisectionectomy are sparse. This study aimed to assess the FLR hypertrophy rate in patients undergoing PVE before left trisectionectomy. METHODS Between January 2010 and June 2021, 30 patients (22 men and eight women; mean age, 65.7 years) underwent PVE, mainly using gelatin sponge, before left trisectionectomy. The preoperative diagnosis was cholangiocarcinoma in 28 patients and colorectal liver metastases in two patients. The FLR hypertrophy rate, increase in the FLR volume (FLRV) ratio (the ratio of the FLRV to the total liver volume), and complications were evaluated. The patients were further divided into two groups: one group of patients with left portal vein stenosis or occlusion before PVE (n = 12) and another without left portal vein stenosis or occlusion before PVE (n = 18). The FLR hypertrophy rate and increase in the FLRV ratio were compared between the two groups. RESULTS The FLR hypertrophy rate and increase in the FLRV ratio were 31.3% and 6.9%, respectively. One major complication, cholangitis, developed; however, its association with PVE was unclear. The difference in the FLR hypertrophy rate and the increase in the FLRV ratio between the two groups of patients was statistically insignificant. CONCLUSION PVE before left trisectionectomy is effective in achieving FLR hypertrophy. PVE before left trisectionectomy was equally effective in patients with left portal vein stenosis or occlusion as compared to those without. The complication rates were acceptable.
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Feichtinger I, Adnet S, Cuny G, Guinot G, Kriwet J, Neubauer TA, Pollerspöck J, Shimada K, Straube N, Underwood C, Vullo R, Harzhauser M. Comment on "An early Miocene extinction in pelagic sharks". Science 2021; 374:eabk0632. [PMID: 34882475 DOI: 10.1126/science.abk0632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- I Feichtinger
- Geological-Palaeontological Department, Natural History Museum Vienna, 1010 Vienna, Austria
| | - S Adnet
- Institut des Sciences de l'Evolution de Montpellier, CNRS, IRD, EPHE, Université de Montpellier, 34095 Montpellier, France
| | - G Cuny
- Univ Lyon, Université Claude Bernard Lyon 1, CNRS, ENTPE, UMR 5023 LEHNA, 69622 Villeurbanne, France
| | - G Guinot
- Institut des Sciences de l'Evolution de Montpellier, CNRS, IRD, EPHE, Université de Montpellier, 34095 Montpellier, France
| | - J Kriwet
- Department of Paleontology, University of Vienna, Geozentrum, 1090 Vienna, Austria
| | - T A Neubauer
- Department of Animal Ecology and Systematics, Justus Liebig University, 35392 Giessen, Germany.,Naturalis Biodiversity Center, 2333 CR Leiden, Netherlands
| | - J Pollerspöck
- Bavarian State Collection of Zoology, 81247 Munich, Germany
| | - K Shimada
- Department of Environmental Science and Studies and Department of Biological Sciences, DePaul University, Chicago, IL 60614, USA.,Sternberg Museum of Natural History, Fort Hays State University, Hays, KS 67601, USA
| | - N Straube
- University Museum Bergen, University of Bergen, Bergen, Norway
| | - C Underwood
- Department of Earth and Planetary Sciences, Birkbeck College, London, UK
| | - R Vullo
- Univ Rennes, CNRS, Géosciences Rennes, UMR 6118, Rennes, France
| | - M Harzhauser
- Geological-Palaeontological Department, Natural History Museum Vienna, 1010 Vienna, Austria
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Shimada K. A 6-Step Technique for Smooth Transvaginal Extraction of a Fibroid in Laparoscopic Myomectomy. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.035] [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: 11/29/2022]
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Nunokawa T, Kakutani T, Chinen N, Shimada K, Kimura M, Tateishi M, Chen F, Setoguchi K, Sugihara M. AB0180 A MULTICENTER SELF-CONTROLLED CASE SERIES STUDY INVESTIGATING THE PREVENTIVE EFFECT OF SULFASALAZINE AGAINST PNEUMOCYSTIS PNEUMONIA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3734] [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
Background:An animal study revealed that sulfasalazine (SSZ) enhances Pneumocystis clearance from the lung by accelerating macrophage activity.[1] Although the preventive effect of SSZ on Pneumocystis pneumonia (PCP) in patients with rheumatoid arthritis (RA) is reported in case-control studies, some important confounders might remain unmeasured and distort the results. [2-3]. The self-controlled case series (SCCS) method involves only cases and controls fixed confounders automatically.[4]Objectives:To evaluate the prophylactic effect of SSZ against PCP in patients with RA, controlling unmeasurable confounders by the SCCS method.Methods:A retrospective study was conducted at five hospitals. Patients with RA who developed PCP between 2003 and 2019 were included. PCP was defined by the following criteria: (1) detection of Pneumocystis jirovecii in respiratory specimens by polymerase chain reaction; (2) clinical manifestations (pyrexia, dry cough, dyspnea, or hypoxia); (3) diffuse interstitial infiltrate on chest imaging; (4) absence of prophylaxis for PCP. Incidence rate ratio (IRR) for Pneumocystis pneumonia associated with sulfasalazine use was calculated by conditional Poisson regression.Results:We identified 48 episodes of PCP in 47 cases. Of these, 15 (31.9%) died. Thirty received SSZ in certain periods of their observations (Table 1). While 46 episodes of PCP developed in the period of 168.9 person-years without SSZ use, only one episode of PCP developed in the period of 103.7 person-years with SSZ use. SSZ use had a decreased risk of PJP (adjusted IRR 0.007, 95% CI <0.001-0.067) after adjusted for age group, the use of glucocorticoid, methotrexate, and tacrolimus, and the use of biologic agent or janus kinase inhibitor (Table 2).Table 1.Characteristic of the 47 patients enrolled in the study.Male/female, n (%)14 (29.8)/33 (70.2)Observational period (years), median (IQR)72.0 (66.3-79.1)Lung disease, n (%)4.7 (1.4-9.5)Use of sulfasalazine, n (%)23 (48.9)Outcome of PCP, death, n (%)30 (63.8)Age at the onset of PCP (years), median (IQR)15 (31.9)PCP, Pneumocystis pneumonia; IQR, interquartile range.Table 2.Unadjusted and adjusted incidence rate ratio for Pneumocystis pneumonia associated with sulfasalazine use.Observation length (years)Episodes of PCP, n (%)Unadjusted IRR95% CI)Adjusted IRRa(% CI)Use of SSZ103.71 (2.1)0.010 (0.001-0.092)0.007 (<0.001-0.067)No use of SSZ168.947 (97.9)referencereferenceIRR, incidence rate ratio; PCP, Pneumocystis pneumonia; SSZ, sulfasalazine.Conclusion:Our study demonstrated the preventive effect of SSZ against PCP with confounders controlled by the SCCS.References:[1]Wang, J., et al. Immune modulation with sulfasalazine attenuates immunopathogenesis but enhances macrophage- mediated fungal clearance during pneumocystis pneumonia. PLoS Pathog. 2010;19;6(8):e1001058.[2]Nunokawa, T. et al. Prophylactic effect of sulfasalazine against Pneumocystis pneumonia in patients with rheumatoid arthritis: A nested case-control study. Semin. Arthritis Rheum. 2019;48(4):573-578.[3]Nunokawa, T., et al. Effect of Sulfasalazine Use on the Presence of Pneumocystis Organisms in the Lung among Patients with Rheumatoid Arthritis: A Test-Negative Design Case-Control Study with PCR Tests. Mod. Rheumatol. 2019;29(3):436-440.[4]Petersen, I., et al. Self controlled case series methods: an alternative to standard epidemiological study designs. BMJ. 2016;12;354:i4515.Disclosure of Interests:None declared
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Takeuchi A, Uemura A, Goya S, Shimada K, Yoshida T, Hara S, Sato K, Shiraishi K, Yairo A, Kto K, Matsuura K, Tanaka R. The utility of patent ductus arteriosus closure with hemostatic clip in dogs. Pol J Vet Sci 2021; 23:255-260. [PMID: 32627978 DOI: 10.24425/pjvs.2020.133640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study investigated the utility of patent ductus arteriosus (PDA) closure with hemostatic clip by comparing with traditional PDA closure. Medical records of 51 dogs with surgical closure of PDA were reviewed and retrospective study was conducted. 29 dogs were treated by procedure with hemostatic clip (Group HC), and 22 dogs were treated by surgical ligation (Group SL). Data pertaining to breed, sex, age and body weight at the time of surgery, echocardiographic minimal ductal diameter, duration of surgery, hemostatic clip size, echocardiographic findings, hemor-rhage, residual ductal flow and recanalization were collected from records. The results showed that procedure with hemostatic clip had been selected in lighter dogs than traditional PDA closure. Duration of surgery performed only hemostatic clip technique was significantly shorter than that in group SL. Preoperative LVIDd, E-wave and FS were significantly lower than postoperative ones. As regard all parameters, the differences between pre- and postoperative periods were not significantly different between group HC and group SL. Hemorrhage, residual ductal flow, and recanalization were not significantly different in both groups. The present study showed that procedure with hemostatic clip is beneficial in that it is available in smaller dogs and can make shorter operation duration than traditional PDA closure. Moreover, the procedure is effective for the resolution of volume overload of the left atrium and ventricle in short-term outcome. Complications including hemorrhage, residual ductal flow and recanaliza-tion were not significantly different with both techniques.
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Affiliation(s)
- A Takeuchi
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - A Uemura
- Graduate School of Life and Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8572, Japan
| | - S Goya
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - K Shimada
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - T Yoshida
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - S Hara
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - K Sato
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - K Shiraishi
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - A Yairo
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - K Kto
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - K Matsuura
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
| | - R Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai, Fuchu, Tokyo, 183-8509, Japan
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Vidal RC, Bentmann H, Facio JI, Heider T, Kagerer P, Fornari CI, Peixoto TRF, Figgemeier T, Jung S, Cacho C, Büchner B, van den Brink J, Schneider CM, Plucinski L, Schwier EF, Shimada K, Richter M, Isaeva A, Reinert F. Orbital Complexity in Intrinsic Magnetic Topological Insulators MnBi_{4}Te_{7} and MnBi_{6}Te_{10}. Phys Rev Lett 2021; 126:176403. [PMID: 33988442 DOI: 10.1103/physrevlett.126.176403] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/09/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
Using angle-resolved photoelectron spectroscopy (ARPES), we investigate the surface electronic structure of the magnetic van der Waals compounds MnBi_{4}Te_{7} and MnBi_{6}Te_{10}, the n=1 and 2 members of a modular (Bi_{2}Te_{3})_{n}(MnBi_{2}Te_{4}) series, which have attracted recent interest as intrinsic magnetic topological insulators. Combining circular dichroic, spin-resolved and photon-energy-dependent ARPES measurements with calculations based on density functional theory, we unveil complex momentum-dependent orbital and spin textures in the surface electronic structure and disentangle topological from trivial surface bands. We find that the Dirac-cone dispersion of the topologial surface state is strongly perturbed by hybridization with valence-band states for Bi_{2}Te_{3}-terminated surfaces but remains preserved for MnBi_{2}Te_{4}-terminated surfaces. Our results firmly establish the topologically nontrivial nature of these magnetic van der Waals materials and indicate that the possibility of realizing a quantized anomalous Hall conductivity depends on surface termination.
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Affiliation(s)
- R C Vidal
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - H Bentmann
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - J I Facio
- Leibniz Institute for Solid State and Materials Research (IFW) Dresden, Helmholtzstr. 20, D-01069 Dresden, Germany, EU
| | - T Heider
- Peter Grünberg Institut, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany, EU
| | - P Kagerer
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - C I Fornari
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - T R F Peixoto
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - T Figgemeier
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
| | - S Jung
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
- Department of Physics, Gyeongsang National University, Jinju 52828, Korea
| | - C Cacho
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - B Büchner
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
- Leibniz Institute for Solid State and Materials Research (IFW) Dresden, Helmholtzstr. 20, D-01069 Dresden, Germany, EU
- Institut für Festkörper- und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany, EU
| | - J van den Brink
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
- Leibniz Institute for Solid State and Materials Research (IFW) Dresden, Helmholtzstr. 20, D-01069 Dresden, Germany, EU
- Institut für Festkörper- und Materialphysik, Technische Universität Dresden, D-01062 Dresden, Germany, EU
| | - C M Schneider
- Peter Grünberg Institut, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany, EU
| | - L Plucinski
- Peter Grünberg Institut, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany, EU
| | - E F Schwier
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-0046, Japan
| | - K Shimada
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima 739-0046, Japan
| | - M Richter
- Leibniz Institute for Solid State and Materials Research (IFW) Dresden, Helmholtzstr. 20, D-01069 Dresden, Germany, EU
- Dresden Center for Computational Materials Science (DCMS), Technische Universität Dresden, D-01062 Dresden, Germany, EU
| | - A Isaeva
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
- Leibniz Institute for Solid State and Materials Research (IFW) Dresden, Helmholtzstr. 20, D-01069 Dresden, Germany, EU
- Department of Physics, Gyeongsang National University, Jinju 52828, Korea
- Van der Waals-Zeeman Institute, Institute of Physics, University of Amsterdam, 1098 XH Amsterdam, The Netherlands, EU
| | - F Reinert
- Experimentelle Physik VII, Universität Würzburg, Am Hubland, D-97074 Würzburg, Germany, EU
- Würzburg-Dresden Cluster of Excellence ct.qmat, Germany, EU
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13
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Honda N, Tagashira Y, Kawai S, Kobayashi T, Yamamoto M, Shimada K, Yokogawa N. Reduction of Pneumocystis jirovecii pneumonia and bloodstream infections by trimethoprim-sulfamethoxazole prophylaxis in patients with rheumatic diseases. Scand J Rheumatol 2021; 50:365-371. [PMID: 33749507 DOI: 10.1080/03009742.2020.1850854] [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: 10/21/2022]
Abstract
Objective: Trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis against Pneumocystis jirovecii pneumonia (PJP) is routinely administered to patients with rheumatic diseases in Japan. The present study aimed to evaluate the effect of TMP/SMX prophylaxis on PJP and non-central line-associated bloodstream infections (BSIs) in patients receiving high-dose glucocorticoids for the treatment of rheumatic diseases.Method: This study enrolled patients who were admitted between 1 October 2003 and 31 March 2018 and began high-dose glucocorticoid therapy for rheumatic diseases during hospitalization. The observation period was 4 months from the commencement of high-dose glucocorticoid therapy. The effect of TMP/SMX prophylaxis on PJP and non-central line-associated BSI was analysed.Results: Of the 437 patients included in the study, 376 received TMP/SMX prophylaxis and 61 patients did not. During the observation period, TMP/SMX prophylaxis was discontinued in 76 patients (20.2%). Three PJP cases (0.7%) occurred. Among the 399 patients included in our analysis of non-central line-associated BSI, eight experienced non-central line-associated BSI (2.0%). Among the covariates, TMP/SMX prophylaxis was associated with reduced PJP and non-central line-associated BSI incidence [odds ratio (OR) 0, 95% confidence interval (CI) 0.00-0.38, and OR 0.08, 95% CI 0.01-0.42, respectively].Conclusion: Routine TMP/SMX prophylaxis reduced the incidence of both PJP and BSI in patients with rheumatic diseases undergoing high-dose glucocorticoid therapy.
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Affiliation(s)
- N Honda
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Y Tagashira
- Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - S Kawai
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - T Kobayashi
- Department of Infection Prevention and Control, Tokyo Medical University Hospital, Tokyo, Japan
| | - M Yamamoto
- Department of Rheumatology and Nephrology, Chubu Rosai Hospital, Nagoya, Japan
| | - K Shimada
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - N Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
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Shiozawa T, Shimada K, Lee-Okada H, Kadoguchi T, Aikawa T, Hayashi H, Miyazaki T, Matsushita S, Suwa S, Yokomizo T, Amano A, Nakazato Y, Daida H. Levels of phospholipids and triacylglycerol-containing omega 3 fatty acids in myocardial tissue of patients with myocardial infarction: analyzed by a lipidomics profiling method. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
According to population-based studies, low omega 3 fatty acid (omega3FA) intake and high levels of serum triacylglycerol (TAG) are associated with cardiovascular diseases. Recent advances in mass spectrometry allow molecular lipid (lipidomics) profiling, which may enhance cardiovascular risk prediction. In this study, we assessed the levels of omega3FA-containing phospholipids (PL) and TAG in myocardial tissues of patients with and without myocardial infarction (MI) using a lipidomics profiling method.
Methods
We performed lipidomics profiling of human left atrial appendage (LAA) tissue of 29 consecutive patients receiving off-pump coronary bypass surgery with standard LAA resection. The patients were divided into the MI group (n=7) and an age- and gender-matched non-MI group (n=7).
Results
Lipidomics profiling revealed that the MI group tended to have low levels of phosphatidylcholines (PC), phosphatidylethanolamine (PE), lysophosphatidylethanolamine (LPE), and plasmalogen, and high levels of TAG species. Individual molecular species containing omega3FA, such as PC (18:0/20:5; 3,200±1,200 vs. 4,500±910 pmol/g tissue, p=0.04) and plasmalogen (18:1/20:5; 57,000±21,000 vs. 91,000±28,000 pmol/g tissue, p=0.02), were significantly lower in the MI group than in the non-MI group.
Conclusions
To our knowledge, this is the first study to determine the levels of omega3FA-containing PL and TAG in myocardial tissue using lipidomics profiling. We discovered that lower levels of omega3FA-containing PL and higher levels of TAG existed in myocardial tissues of patients with MI than in those of patients without MI. Accordingly, the lipidomics profiling method for human myocardial tissue may be useful for developing therapy targets for cardiovascular diseases.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): MEXT/JSPS KAKENHI Grant
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Affiliation(s)
- T Shiozawa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Shizuoka, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Lee-Okada
- Juntendo University School of Medicine, Department of Biochemistry, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Aikawa
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Hayashi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University Urayasu Hospital, Department of Cardiology, Chiba, Japan
| | - S Matsushita
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Shizuoka, Japan
| | - T Yokomizo
- Juntendo University School of Medicine, Department of Biochemistry, Tokyo, Japan
| | - A Amano
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - Y Nakazato
- Juntendo University Urayasu Hospital, Department of Cardiology, Chiba, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
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15
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Kunimoto M, Shimada K, Yokoyama M, Fujiwara K, Honzawa A, Yamada M, Matsubara T, Matsumori R, Abulimiti A, Asai T, Amano A, Morisawa T, Takahashi T, Daida H. Impact of body mass index on the clinical outcomes in heart failure patients undergoing cardiac rehabilitation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Increased body mass index (BMI) has recently shown to have a favorable effect on the prognosis in heart failure (HF) patients. However, the impact of BMI on clinical events and mortality in HF patients who underwent cardiac rehabilitation (CR) remains unclear.
Purpose
This study aimed to investigate whether the obesity paradox is present in HF patients who have undergone CR.
Methods
This study enrolled 238 consecutive HF patients who had undergone CR at our university hospital between November 2015 and October 2017. The clinical characteristics and anthropometric data of these patients, including BMI, were collected at the beginning of the CR. The major adverse cardiovascular event (MACE) was defined as a composite of all-cause mortality and unplanned hospitalization for HF. Follow-up data regarding the primary endpoints were collected until November 2018.
Results
Patients (mean age 68.7 years, male 61%) were divided into four groups as per BMI quartiles. More patients in the highest BMI group were women, were significantly younger, and had a higher prevalence of hypertension, dyslipidemia, and diabetes mellitus; however, no significant differences were observed in the prevalence of chronic kidney disease, left ventricular ejection fraction, and brain natriuretic peptide levels of the four groups. During a median follow-up duration of 583 days, 28 patients experienced all-cause mortality, and 42 were hospitalized for HF. Kaplan–Meier analysis showed that patients in the highest BMI quartiles had lower rates of MACE (Log-rank P<0.05) (Figure 1). After adjusting for confounding factors, Cox regression multivariate analysis revealed that BMI was negatively and independently associated with the incidence of MACE (hazard ratio: 0.89, 95% confidence interval: 0.83–0.96, P<0.05).
Conclusion
Increased BMI was associated with better clinical prognosis even in HF patients who have undergone CR Therefore, BMI assessment may be useful for risk stratification in HF patients who have undergone CR.
Figure 1. Kaplan-Meier survival curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Kunimoto
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Fujiwara
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Honzawa
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - M Yamada
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - T Matsubara
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - R Matsumori
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Abulimiti
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Asai
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - A Amano
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - T Morisawa
- Juntendo University School of Medicine, Faculty of Health Science, Tokyo, Japan
| | - T Takahashi
- Juntendo University School of Medicine, Faculty of Health Science, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Faculty of Health Science, Tokyo, Japan
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16
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Takahashi N, Dohi T, Funamizu T, Endo H, Wada H, Doi S, Kato Y, Ogita M, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Shimada K. Combined impact of residual inflammatory risk and chronic kidney disease on long-term clinical outcomes in patients undergoing percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inflammatory status pre-percutaneous coronary intervention (PCI) and post-PCI has been reported not only associated with poor prognosis, but also to impair renal function. Statins reduce cardiovascular events by lowering lipids and have anti-inflammatory impacts, but residual inflammatory risk (RIR) exists. It remains unclear that the synergistic effect of RIR and chronic kidney disease (CKD) on long-term clinical outcome in stable coronary artery disease (CAD) patients undergoing PCI in statin era.
Aim
The aim of this study was to investigate the long-term combined impact of RIR evaluating hs-CRP at follow-up and CKD among stable CAD patients undergoing PCI in statin era.
Methods
This is a single-center, observational, retrospective cohort study assessing consecutive 2,984 stable CAD patients who underwent first PCI from 2000 to 2016. We analyzed 2,087 patients for whom hs-CRP at follow-up (6–9 months later) was available. High residual inflammatory risk was defined as hs-CRP >0.6 mg/L according to the median value at follow up. Patients were assigned to four groups as Group1 (high RIR and CKD), Group2 (low RIR and CKD), Group3 (high RIR and non-CKD) or Group4 (low RIR and non-CKD). We evaluated all-cause death and major adverse cardiac events (MACE), defined as a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI) and non-fatal stroke.
Results
Of patients (83% men; mean age 67 years), there were 299 (14.3%) patients in group 1, 201 (9.6%) patients in group 2, 754 (36.1%) patients in group 3, and 833 (39.9%) patients in group 4. The median follow-up period was 5.2 years (IQR, 1.9–9.9 years). In total, 189 (frequency, 16.1%) cases of all-cause death and 128 (11.2%) MACE were identified during follow-up, including 53 (4.6%) CV deaths, 27 (2.4%) MIs and 52 (4.8%) strokes. The rate of all-cause death and MACE in group 1 was significantly higher than other groups (p<0.001, respectively). There was a stepwise increase in the incidence rates of all-cause death and MACE. After adjustment for important covariates, the presence of high RIR and/or CKD were independently associated with higher incidence of MACE and higher all-cause mortality. (shown on figure).
Conclusion
The presence of both high RIR and CKD conferred a synergistic adverse effect on the risk for long-term adverse cardiac events in patients undergoing PCI.
Kaplan-Meier curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Takahashi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Funamizu
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Wada
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - M Ogita
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
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17
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Niida T, Isoda K, Kitamura K, Okabayashi Y, Kadoguchi T, Ohtomo F, Shimada K. Blocking of interleukin-1 suppresses both angiotensin II-induced renal inflammation and hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Clinical hypertension is associated with renal inflammation and elevated circulating levels of proinflammatory cytokines. IL-1 receptor antagonist (IL-1Ra) is one of the most important anti-inflammatory cytokines and plays a crucial role in inflammation. Inhibition of IL-1 may contribute to modulation of the Angiotensin II (AngII)-induced hypertension response. This study aimed to elucidate the effects of IL-1Ra and anti-IL-1beta antibody (01BSUR) on AngII-induced hypertension and renal inflammation.
Methods and results
To determine the contribution of IL-1Ra to AngII-induced renal inflammation, male wild-type (WT) and IL-1Ra-deficient (IL-1Ra−/−) mice were infused with AngII (1000ng/kg/min) using subcutaneous osmotic pumps for 14 days. We checked blood pressure, histological change, and several mRNA expressions 14 days after infusion. Fourteen days after infusion, systolic blood pressure (197±5 vs 169±9 mmHg, p<0.05) in IL-1Ra−/− mice significantly increased compared with WT mice. Furthermore, on day 14 of AngII infusion, plasma IL-6 was 5.9-fold higher in IL-1Ra−/− versus WT mice (p<0.001); renal preproendothelin-1 mRNA expression was also significantly higher in IL-1Ra−/− mice (p<0.05). To examine renal function, we analyzed 24-hour urinary protein excretion and serum levels of blood urea nitrogen, creatinine, and uric acid in IL-1Ra−/− and WT mice. On day 14 of Ang II infusion, all levels increased significantly in IL-1Ra−/− mice compared with WT mice, suggesting that IL-1Ra deficiency reduced renal function following Ang II infusion. In addition, renal histology revealed that glomerular injury (Figure upper panels: PAS staining) and tubulointerstitial fibrosis (Figure lower panels: Elastica Masson staining) increased significantly in Ang II-infused IL-1Ra−/− versus Ang II-infused WT mice. Finally, we administrated 01BSUR to both IL-1Ra−/− and WT mice, and 01BSUR treatment decreased AngII-induced hypertension (162±17 vs 204±6 mmHg, p<0.05) and renal damage (glomerular injury and fibrosis of the tubulointerstitial area) in both IL-1Ra−/− and WT mice compared with IgG2a treatment. These findings suggest that 01BSUR suppresses Ang II-induced inflammation and renal injury.
Conclusions
Inhibition of interleukin-1 by both endogenous IL-1Ra and exogenous 01BSUR decreased AngII-induced hypertension and renal damage in mice, suggesting suppression of IL-1 may provide an additional strategy to protect against renal damage in hypertensive patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI
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Affiliation(s)
- T Niida
- Kashiwa Kousei General Hospital, Chiba, Japan, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Y Okabayashi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - F Ohtomo
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Tokyo, Japan
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Kitai M, Narita M, Shimada K, Suzuki K, Nakazawa H, Shibutani T, Yamamoto K, Jimi T, Yano H, Shiozaki T, Matsuoka K, Nagao S, Yamaguchi S. What is the best treatment for older patients with invasive cervical carcinoma? Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Singh P, Alam M, Kumar S, Anand K, Gangwar VK, Ghosh S, Sawada M, Shimada K, Singh RK, Ghosh AK, Chatterjee S. Roles of Re-entrant cluster glass state and spin-lattice coupling in magneto-dielectric behavior of giant dielectric double perovskite La 1.8Pr 0.2CoFeO 6. J Phys Condens Matter 2020; 32:445801. [PMID: 32688353 DOI: 10.1088/1361-648x/aba778] [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] [Indexed: 06/11/2023]
Abstract
La based Co-Fe combined double perovskite (La1.8Pr0.2CoFeO6) was synthesized and the dielectric (zero-field and in-field), magnetic, x-ray absorption and Raman spectroscopy measurements have been investigated for La1.8Pr0.2CoFeO6 double perovskite. The existence of re-entrant cluster glass state is observed. The magneto-dielectric (MD) is found in two temperature regions (25-80 K and 125-275 K). It has been demonstrated that the observed MD at low and high temperatures are respectively due to the spin freezing and the spin-lattice coupling. Furthermore, the very large dielectric constant and the low loss suggest that La1.8Pr0.2CoFeO6 is very important from the application point of view.
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Affiliation(s)
- Prajyoti Singh
- Department of Physics, Indian Institute of Technology (BHU), Varanasi-221005, India
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Mori T, Yokogawa N, Shimada K. AB1118 OPEN MUSCLE BIOPSY AS A SAFE AND USEFUL MEANS OF DIAGNOSING VASCULITIS: A SINGLE-CENTER EXPERIENCE OF 210 BIOPSY CASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1797] [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
Background:We previously reported the utility of open muscle biopsies in diagnosing vasculitis [1]. The number of open muscle biopsies performed at our department has increased to over 200. The purpose of the present study was to evaluate the diagnostic utility of vasculitis and the safety of the open muscle biopsies.Objectives:To clarify the diagnostic utility of vasculitis and the safety profile of the open muscle biopsy.Methods:We retrospectively examined all cases of open muscle biopsy performed between May 2012 and June 2018 in our department. The biopsy results, the presence or absence of adverse events, and blood test data at the time of the biopsy were extracted from the patients’ electronic medical records.Results:Between May 2012 and June 2018, 210 open muscle biopsies were performed, 120 of which were done for vasculitis diagnosis. Diagnostic histopathological findings were obtained in 42 of the 120 cases (35%). The definitive diagnosis in these cases was microscopic polyangiitis (30 cases), eosinophilic granulomatosis with polyangiitis (seven cases), granulomatosis with polyangiitis (one case), polyarteritis nodosa (three cases), and other vasculitis (one case). In 57 cases with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) ≥ 10 U/ml, 31 cases (54.3%) showed histopathology of vasculitis. In six cases with protainase-3-ANCA (PR3-ANCA) ≥ 10 U/ml, histopathology of vasculitis was found in one case (16.7%).In all 210 open muscle biopsy cases, complications included minor wound dehiscence (11 cases) and small subcutaneous hematoma (six cases), which were able to be managed by local treatment. Albumin was significantly lower in the patients with wound dehiscence (mean 3.2 vs 2.7, p = 0.049)Serious complications included anaphylaxis due to local anesthesia (one case), compartment syndrome due to hematoma (one case), hematoma requiring surgical removal (one case), and arterial hemorrhage requiring surgical intervention (one case). The patients in the latter three hemorrhagic cases were receiving antiplatelet drugs.Conclusion:An open muscle biopsy is useful for diagnosing vasculitis, especially for MPO-ANCA-positive anca-associated vasculitis. Its safety profile is acceptable. Serious adverse events are rare, but the procedure should be performed carefully when patients are receiving antiplatelet drugs.References:[1]Nunokawa T. et al. The use of muscle biopsy in the diagnosis of systemic vasculitis affecting small to medium-sized vessels: A prospective evaluation in Japan. Scand. J. Rheumatol. 2016;45:210–214Disclosure of Interests:None declared
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Kise T, Takamasu E, Miyoshi Y, Yokogawa N, Shimada K. THU0309 UNILATERAL TEMPORAL ARTERY BIOPSY IS SUFFICIENT FOR DIAGNOSING GIANT CELL ARTERITIS IF THE SERUM C-REACTIVE PROTEIN LEVEL IS 10 MG/DL OR HIGHER. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.458] [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
Background:Temporal artery biopsy (TAB) is the gold standard for diagnosing giant cell arteritis (GCA). However, previous studies have reported that the discordance rate of TAB is 3-45%,i.e., in unliteral TAB, GCA may be overlooked in one in five patients, approximately. Evidence as to whether bilateral TAB should be performed initially or one-sided TAB is sufficient for diagnosing GCA is lacking.Objectives:To investigate the predictors of patients with GCA in whom one-sided TAB is sufficient.Methods:The present study was a cross-sectional, single center study conducted from April 1, 2011 to July 31, 2019 at Tokyo Metropolitan Tama Medical Center. Of all consecutive GCA cases for which bilateral TAB was performed, bilaterally positive cases and unilaterally positive cases were extracted as bilateral positive group (BPG) and unilateral positive group (UPG), respectively. GCA was defined in accordance with the classification criteria of the 1990 American College of Rheumatology, and GCA was diagnosed if no other etiology was found within six months after beginning of high-dose glucocorticoid treatment. Demographic, clinical and laboratory data were obtained from the medical records, and the BPG and the UPG were compared statistically in each variable. Statistical significance was defined asp< 0.05.Results:During study, 264 biopsies were performed for 145 cases, who suspected GCA and underwent TAB. The pathological positivity rate was 26.1% (68 / 264 biopsies). Of these, 53 cases had final diagnosis of GCA, in which 43 cases were biopsy proven GCA. Thirty-seven biopsy proven GCA with bilateral TAB were enrolled; 64.9% women; mean (SD) age 75 (8.9) years; median [IQR] TAB length 17.5 [13.0,20.0] mm; headache 54.1%; jaw claudication 45.9%; scalp tenderness 16.2%; temporal artery (TA) tenderness 32.4%; TA engorgement 32.4%; TA pulse abnormality 5.4%; visual symptoms 2.7%; a fever of 38.5°C or higher 40.5%; shoulder girdle pain 48.6%; imaging of aortitis or arteritis 40.5%; median [IQR] white blood cell 9,100 [7200, 12050] /μl; median [IQR] platelet cell 37.5 [27.0, 46.3] ×104/μl; median [IQR] C-reactive protein (CRP) 10.1 [3.9, 16.5] mg/dL; erythrocyte sedimentation rate [IQR] 105 [66, 129] mm/h. Thirty-one in 37 cases were positive bilaterally while 6 in 37 cases were positive unilaterally; and the discordance rate was 16.2%. The median sample length after formalin fixation was 19.0 mm for the BPG and 14.5 mm for the UPG (p= 0.171). The parameters above were compared between UPG and BPG. Of these, only the serum CRP value (mg/dL) differed statistically between groups, and the median value of the two groups was 10.6 and 6.5, respectively (median test:p= 0.031). To predict BPG, in whom unilateral TAB is sufficient for diagnosing GCA, the cut-off value of serum CRP with a specificity of 100% and a sensitivity of 61.3% was set at 9.3 mg/dL (ROC analysis: AUC 0.726).Conclusion:When the serum CRP level is 10 mg/dL or higher in GCA suspected patients, an unilateral TAB alone was sufficient for an accurate diagnosis.References:[1]Hellmich, B, et al.Ann Rheum Dis2020;79(1):19-30.[2]Breuer, GS, et al.J Rheumatol. 2009;36(4):794-796.[3]Czyz CN, et al.Vascular2019;27(4):347-351.[4]Durling B, et al.Can J Ophthalmol2014;49(2):157-161.Figure.Comparison of median CRP levels between unilaterally positive group and bilaterally positive group.Disclosure of Interests:None declared
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Goto M, Yokogawa N, Miyoshi Y, Shimada K. SAT0208 INCIDENCES OF ADVERSE EFFECTS AND DISEASE FLARE DUE TO PNEUMOCYSTIS PNEUMONIA PROPHYLAXIS WITH TRIMETHOPRIM/SULFAMETHOXAZOLE IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:Methods of preventing pneumocystis pneumonia (PCP) in systemic lupus erythematosus (SLE) are controversial. Previous studies have verified the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) in patients with rheumatic diseases1. However, as for SLE, some clinicians advise against prescribing TMP-SMX because sulfa allergy is reportedly more common in SLE than in other rheumatic diseases2, 3. Anecdotally, sulfonamides may also worsen SLE itself, but few data are available on lupus flares related to sulfonamides3.Objectives:This study aimed to assess the incidences of adverse effects and disease flare due to PCP prophylaxis with TMP-SMX in SLE patients.Methods:SLE patients seen at our hospital between September 2010 and April 2018 who received TMP-SMX as a PCP prophylaxis were enrolled. The clinical manifestations, treatment course, adverse drug reactions, and occurrence of lupus flares were retrospectively assessed from the medical records. The Naranjo adverse drug reaction probability scale4 was used to determine whether the reactions were induced by SMX-TMP. According to the British Isles Lupus Assessment Group (BILAG) 2004 index, a severe flare of lupus was defined as a development of a new grade A manifestation, and a moderate flare as a development of grade B manifestation following grade C, D or E. Two board-certificated rheumatologists reviewed the medical records in a blinded fashion to determine the reason for the flare, with disagreement resolved by consensus.Results:In total, 188 SLE patients were enrolled; of these, 117 (62.2%) had no adverse events and were able to continue taking SMX-TMP as needed. Seventy-one patients (37.8%) stopped SMX-TMP due to suspected adverse drug reactions, including fever, rash, liver function disorder, and cytopenia. The Naranjo scale indicated “definite” in 4, “probable” in 39, and “possible” in 28. Eighteen-patients restarted the SMX-TMP and 9 patients could continue the prophylaxis without adverse effects. Five patients were hospitalized to treat the adverse events: 3 with drug rash (concomitant use of hydroxychloroquine in 2), 1 with hypersensitivity (concomitant use of azathioprine) and 1 with hyponatremia, respectively.Lupus flares occurred in 10 patients (5.3%) within one month after the start of the the SMX-TMP prophylaxis. Macrophage activation syndrome (MAS) or neuropsychiatric SLE occurred in 9 of them. Of 188 cases, 2 patients (1.1%) developed a new onset of MAS during the stable clinical course as the flare, which was considered due to SMX-TMP. Confounding factors, including high disease activity and the reduction of glucocorticoids, were identified in other 8 flares.Conclusion:PCP prophylaxis with SMX-TMP was tolerable in most SLE patients. However, a small number of SLE patients developed severe adverse effects or disease flares due to the SMX-TMP.References:[1]Park JW, et al. Annals of the Rheumatic Diseases 2018;77:644-649.[2]Suyama Y, et al. Modern Rheumatology 2016;26:557-61[3]Petri M, et al. Journal of Rheumatology 1992;19:265-9[4]Naranjo CA, et al. Clinical Pharmacology and Therapeutics 1981;30:239-45Disclosure of Interests:None declared
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Sugihara M, Yokogawa N, Shimada K. AB0358 REDUCTION OF WHITE BLOOD CELL COUNT PREDICTS THE EFFICACY OF BARICITINIB, DOES NOT OF TOFACITINIB FOR RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1468] [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
Background:Pairing Janus kinase (JAK) 1/JAK3 signaling mediates lymphocyte proliferation and differentiation while pairing JAK2/JAK2 signaling is essential in myelopoiesis, erythropoiesis, and platelet production by facilitating signaling mediated by granulocyte-macrophage colony stimulating factor and erythropoietin. Tofacitinib (TOF) preferentially inhibits JAK1 and JAK3, while baricitinib (BAR) inhibits JAK1 and JAK2in vitro(1). However, the difference in the efficacy and the clinical courses between TOF and BAR in patients with rheumatoid arthritis (RA) remains unclear.Objectives:The objective of this study was to compare TOF and BAR in efficacy and changes in peripheral blood cell counts. We hypothesized that the efficiency of BAR was related to the decline in the blood cell counts, but that of TOF was not in patients with RA.Methods:We conducted a multicenter, 24 week-retrospective observational study. All RA patients received TOF (n = 43) or BAR (n = 26) treatment at Tama-Hokubu Medical Center and Tama Medical Center from December 2013 to March 2019 were included.Results:Baseline characteristics were similar between both groups; age 59.1 and 65.0 years old, disease duration 164.1 and 111.7 months, C-reactive protein 1.98 and 2.22 mg/ml, rheumatoid factor positive 76.7 % and 84.0 %, anti-citrullinated peptide antibody positive 78.9 % and 78.8 %, methotrexate combination 81.4 % and 69.2 %, the number of previous treatment of biologic or targeted disease-modifying antirheumatic drugs were 2.7 and 2.8, for TOF and BAR, respectively (mean).Simplified Disease Activity Index (SDAI) at baseline were similar between the groups (TOF 20.77, BAR 19.15). There was no significant difference in efficacy between the both groups at week 24 (SDAI remission: TOF 3 (7%), BAR 6 (23.1%), p = 0.054, SDAI low disease activity (LDA): TOF 21 (48.8%), BAR 17 (65.4%), p = 0.181).Among those who achieved SDAI LDA at week 24 in the BAR group, significant decrement of white blood cell (WBC) counts at week 12 and 24 and of neutrophil counts at week 4, 12 and 24 were observed (p < 0.05, Table). These decrements of cell count were not observed in patients who did not achieve LDA or in patients in the TOF group. Platelets and hemoglobin (data not shown) had no significant change in all groups.Conclusion:Clinical efficacy of TOF and BAR in RA was comparable in our cohort. A significant decrease of WBCs and neutrophils was associated with LDA achievement at week 24 in the BAR group. This could be explained by the inhibition of myelopoiesis through JAK2 signaling.References:[1]Winthrop, K.Nat Rev Rheumatol13,234–243 (2017)Table 1.Description of the three clusterstofacitinibbaricitinibweekLDApnot LDApLDApnot LDApWhite Blood Cells[/µl]06821 ± 24026041 ± 26127994 ± 43097886 ± 251346247 ± 1905.2546465 ± 2440.3446706 ± 2499.0597143 ± 1526.363126480 ± 1949.4975871 ± 2070.2176470 ± 2867.0317383 ± 2963.356246733 ± 2297.8586450 ± 3001.4286418 ± 2875.0246833 ± 1021.454Neutrophils[/µl]04888 ± 23993982 ± 23006221 ± 40856221 ± 408544243 ± 1655.2104298 ± 2100.4614548 ± 2578.0155923 ± 2716.294124261 ± 1843.3243617 ± 1869.2364542 ± 3062.0195429 ± 3055.311244487 ± 2243.6574547 ± 2847.1904225 ± 2900.0084474 ± 1396.207Lymphocytes[/µl]01419 ± 6511305 ± 4891370 ± 4161395 ± 48541515 ± 544.3571502 ± 514.0391730 ± 659.0131530 ± 652.484121537 ± 555.5231327 ± 664.9961569 ± 572.0111453 ± 401.832241511 ± 598.6971143 ± 378.0921792 ± 699.0111836 ± 710.109Platelets[104/µl]026.9 ± 9.123.7 ± 6.630.3 ± 11.226.9 ± 7.4425.5 ± 8.9.29123.8 ± 6.6.94030.5 ± 4.6.94027.3 ± 10.8.7981224.7 ± 7.4.26125.6 ± 7.5.20933.1 ± 8.3.20927.0 ± 9.3.9052426.3 ± 8.1.93023.3 ± 6.1.96133.4 ± 6.9.96133.0 ± 4.4.063Data are mean ± standard deviation. LDA: patients achieved SDAI LDA at week 24. not LDA: patients did not achieve SDAI LDA at week 24. Shownpvalues were calculated by t-test compared to week 0.Disclosure of Interests:None declared
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Singh A, Kumar S, Singh M, Singh P, Singh R, Gangwar VK, Lakhani A, Patil S, Schwier EF, Matsumura T, Shimada K, Ghosh AK, Chatterjee S. Anomalous Hall effect in Cu doped Bi 2Te 3 topological insulator. J Phys Condens Matter 2020; 32:305602. [PMID: 32235039 DOI: 10.1088/1361-648x/ab8521] [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] [Indexed: 06/11/2023]
Abstract
The angle resolved photo-emission spectroscopy (ARPES) study and magneto-transport properties of Bi2Cu x Te3-x have been investigated. ARPES study indicates the clear existence of surface states in the as-prepared samples. The estimated bandgap from ARPES is found to be ∼5 meV and 16 meV respectively for x = 0.03 and x = 0.15 samples. Presence of larger Cu concentration (x = 0.15) introduces magnetic ordering. Observed non-linearity in the Hall data is due to the existence of anomalous Hall effect which can be attributed to the 2D transport. The observed magneto-transport features might be related to the surface carriers which is confirmed by ARPES study.
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Affiliation(s)
- Abhishek Singh
- Department of Physics, Indian Institute of Technology, Banaras Hindu University, Varanasi 221-005, India
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Abe M, Rastelli DD, Gomez AC, Cingolani E, Lee Y, Soni PR, Fishbein MC, Lehman TJA, Shimada K, Crother TR, Chen S, Noval Rivas M, Arditi M. IL-1-dependent electrophysiological changes and cardiac neural remodeling in a mouse model of Kawasaki disease vasculitis. Clin Exp Immunol 2019; 199:303-313. [PMID: 31758701 DOI: 10.1111/cei.13401] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2019] [Indexed: 02/06/2023] Open
Abstract
Kawasaki disease (KD) is the leading cause of acquired heart disease in children. In addition to coronary artery abnormalities, aneurysms and myocarditis, acute KD is also associated with echocardiogram (ECG) abnormalities in 40-80% of patients. Here, we show that these ECG changes are recapitulated in the Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis mouse model. LCWE-injected mice developed elevated heart rate and decreased R wave amplitude, with significant differences in prolonged ventricular repolarization. LCWE-injected mice developed cardiac ganglion inflammation, that may affect the impulse-conducting system in the myocardium. Furthermore, serum nerve growth factor (NGF) was significantly elevated in LCWE-injected mice, similar to children with KD vasculitis, associated with increased neural remodeling of the myocardium. ECG abnormalities were prevented by blocking interleukin (IL)-1 signaling with anakinra, and the increase in serum NGF and cardiac neural remodeling were similarly blocked in Il1r1-/- mice and in wild-type mice treated with anakinra. Thus, similar to clinical KD, the LCWE-induced KD vasculitis mouse model also exhibits electrophysiological abnormalities and cardiac neuronal remodeling, and these changes can be prevented by blocking IL-1 signaling. These data support the acceleration of anti-IL-1 therapy trials to benefit KD patients.
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Affiliation(s)
- M Abe
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - D D Rastelli
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Division of Gastroenterology and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - A C Gomez
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - E Cingolani
- Cedars-Sinai Medical Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Y Lee
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - P R Soni
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - M C Fishbein
- Department of Pathology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - T J A Lehman
- Division of Rheumatology, Department of Pediatrics, Weill Cornell Medical School, New York, NY, USA
| | - K Shimada
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - T R Crother
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - S Chen
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - M Noval Rivas
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - M Arditi
- Divisions of Infectious Diseases and Immunology, Departments of Biomedical Sciences and Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Cedars-Sinai Medical Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA.,Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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Hu Y, Chen X, Peng ST, Lane C, Matzelle M, Sun ZL, Hashimoto M, Lu DH, Schwier EF, Arita M, Wu T, Markiewicz RS, Shimada K, Chen XH, Shen ZX, Bansil A, Wilson SD, He JF. Spectroscopic Evidence for Electron-Boson Coupling in Electron-Doped Sr_{2}IrO_{4}. Phys Rev Lett 2019; 123:216402. [PMID: 31809181 DOI: 10.1103/physrevlett.123.216402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Indexed: 06/10/2023]
Abstract
The pseudogap, d-wave superconductivity and electron-boson coupling are three intertwined key ingredients in the phase diagram of the cuprates. Sr_{2}IrO_{4} is a 5d-electron counterpart of the cuprates in which both the pseudogap and a d-wave instability have been observed. Here, we report spectroscopic evidence for the presence of the third key player in electron-doped Sr_{2}IrO_{4}: electron-boson coupling. A kink in nodal dispersion is observed with an energy scale of ∼50 meV. The strength of the kink changes with doping, but the energy scale remains the same. These results provide the first noncuprate platform for exploring the relationship between the pseudogap, d-wave instability, and electron-boson coupling in doped Mott insulators.
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Affiliation(s)
- Yong Hu
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Xiang Chen
- Materials Department, University of California, Santa Barbara, California 93106, USA
| | - S-T Peng
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C Lane
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
| | - M Matzelle
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
| | - Z-L Sun
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - M Hashimoto
- Stanford Synchrotron Radiation Lightsource and Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D-H Lu
- Stanford Synchrotron Radiation Lightsource and Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - E F Schwier
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima 739-0046, Japan
| | - M Arita
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima 739-0046, Japan
| | - T Wu
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - R S Markiewicz
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
| | - K Shimada
- Hiroshima Synchrotron Radiation Center, Hiroshima University, Hiroshima 739-0046, Japan
| | - X-H Chen
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Z-X Shen
- Stanford Synchrotron Radiation Lightsource and Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
- Geballe Laboratory for Advanced Materials, Departments of Physics and Applied Physics, Stanford University, Stanford, California 94305, USA
| | - A Bansil
- Department of Physics, Northeastern University, Boston, Massachusetts 02115, USA
| | - S D Wilson
- Materials Department, University of California, Santa Barbara, California 93106, USA
| | - J-F He
- Hefei National Laboratory for Physical Sciences at the Microscale, Department of Physics and CAS Key Laboratory of Strongly-coupled Quantum Matter Physics, University of Science and Technology of China, Hefei, Anhui 230026, China
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Okazaki T, Kusano M, Shimada K. P2.09-25 Tumor Spread Through Air Spaces (STAS) Was Correlated with Multiple Advanced Clinicopathological Factors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Takamasu E, Yokogawa N, Shimada K, Sugii S. Simple dose-escalation regimen for hydroxychloroquine-induced hypersensitivity reaction in patients with systemic lupus erythematosus enabled treatment resumption. Lupus 2019; 28:1473-1476. [PMID: 31575325 DOI: 10.1177/0961203319879987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to investigate the risk factors of hydroxychloroquine (HCQ)-induced hypersensitivity in patients with systemic lupus erythematosus (SLE) and to propose a simple dose-escalation regimen in cases of mild HCQ-induced hypersensitivity. METHODS We identified patients with SLE who started HCQ between 2009 and 2018 and cases of HCQ-induced hypersensitivity by reviewing the electronic medical charts. A simple dose-escalation regimen, starting at 40 mg/day with weekly increments of 40 mg/day to 200 mg/day, was used in patients with HCQ-induced hypersensitivity who did not require hospitalization or systemic steroid therapy. We then compared the clinical parameters of patients with and without HCQ-induced hypersensitivity and evaluated the success of our dose-escalation regimen. RESULTS We enrolled 302 patients with SLE and identified 25 cases of HCQ-induced eruption (8.3%). The mean Naranjo score of these patients was 5.1 ± 1.4 (min 3, max 8), and all 25 patients received a 'possible' (9) or 'probable' (16) score. A mild, generalized, maculopapular rash occurred in 24 patients, and urticaria occurred in one patient at 24 days (interquartile range 15-40 days) after the start of treatment. The proportion of cyclophosphamide use, glucocorticoid consisting of prednisolone 20 mg/day or more, and initiation of SMX-TMP within 28 days were higher in patients with skin eruptions. On multivariate analysis, only cyclophosphamide use was identified as a risk factor of HCQ-induced hypersensitivity (odds ratio = 12.3 (95% confidential interval 1.4-14.3)). Thirteen of the 14 patients on the dose-escalation regimen (92.9%) tolerated continued HCQ treatment. One patient re-experienced eruptions on day 10 day after starting HCQ. CONCLUSIONS Mild late reactions are common in HCQ-induced hypersensitivity. A simpler dose-escalation regimen enables safe and easier reintroduction of HCQ but should not be applied to patients with immediate reactions or moderate late reactions.
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Affiliation(s)
- E Takamasu
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, Japan
| | - N Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, Japan
| | - K Shimada
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, Japan
| | - S Sugii
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Centre, Tokyo, Japan
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Kadoguchi T, Shimada K, Hamad A, Aikawa T, Ouchi S, Kitamura K, Kunimoto M, Fukao K, Yokoyama M, Sugita Y, Shiozawa T, Matsushita S, Miyazaki T, Isoda K, Daida H. P629Voluntary exercise associated with myokine production ameliorates cardiac remodeling and inflammation in a myocardial infarction mouse model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) remodeling, through excessive inflammation, leads to heart failure. Exercise (Ex) training is associated with a risk reduction in heart failure through direct and indirect mechanisms by which Ex contributes an anti-inflammatory effect. During Ex, contracting muscle fibers release myokines, including interleukins (ILs), tumor necrosis factor α (TNF-α), follistatin-like protein 1 (FSTL-1), and fibroblast growth factor 21 (FGF-21), into the bloodstream. These myokines may have beneficial effects on other damaged organs, such as an infarcted myocardium, through anti-inflammatory effects. However, the exact mechanisms of the anti-inflammatory effects of voluntary Ex in myocardial infarction (MI) are poorly understood. Therefore, we investigated the effect of voluntary Ex on cardiac remodeling and inflammation, the relationship between cardiac remodeling and skeletal muscle (SKM) response, and circulating myokine levels in a mouse model of MI.
Methods
Twelve-week-old male C57BL/6J mice were used and divided into the following 4 groups: sham operation (Sham), MI, Sham+Ex, and MI+Ex. MI was induced by ligation of the left anterior descending coronary artery. Ex groups began voluntary wheel running for 4 weeks after the operation. An echocardiography was performed at baseline and 4 weeks after the operation. The mRNA levels in the LV infarcted area and SKM were measured with RT-PCR and western blot analysis. Plasma levels of myokines were also measured with immunoassays.
Results
Four weeks after MI induction, echocardiographic evaluation showed that the MI mice had a larger LV end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD) than the Sham mice. The MI mice also showed higher mRNA levels of TNF-α, IL-1β, IL-6, and IL-10 in the LV tissue when compared to the Sham mice. These changes were significantly ameliorated in the MI+Ex mice. Interestingly, in the MI+Ex mice, mRNA levels of IL-6, IL-1β, FSTL-1, and FGF-21 in the SKM were significantly higher than in the MI mice, while there were no significant differences in TNF-α and IL-10 levels in all groups. Similarly, protein expression levels of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, sirtuin-1, and mitochondrial transcriptional factor A of mitochondrial function markers in SKM were also significantly higher in the MI+Ex mice than in the MI mice. Furthermore, there were significant correlations between plasma levels of IL-1β, but not other myokines, and LVEDD, and LVESD. In addition, there was also a significant correlation between the SKM IL-1β level and LVESD in the Sham+Ex mice (all, P<0.05).
Conclusions
Amelioration of cardiac remodeling and inflammation by voluntary Ex is associated with increased myokines, especially IL-1β, in a MI mouse model. These results suggest that increased myokine levels, through voluntary exercise, may play an important role in the prevention of cardiac remodeling after MI.
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Affiliation(s)
- T Kadoguchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Hamad
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - T Aikawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Kunimoto
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Fukao
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Sugita
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Shiozawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Matsushita
- Juntendo University, Cardiovascular Surgery, Tokyo, Japan
| | - T Miyazaki
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
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Kunimoto M, Shimada K, Yokoyama M, Honzawa A, Yamada M, Matsubara T, Fukao K, Kadoguchi T, Fujiwara K, Miyazaki T, Yamamoto T, Takahashi T, Fujiwara T, Amano A, Daida H. P6209Relationship between skin autofluorescence levels and clinical outcomes in heart failure patients undergoing cardiac rehabilitation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Advanced glycation end-products, indicated by skin autofluorescence (SAF) levels, could be prognostic predictors of all-cause and cardiovascular mortality in patients with diabetes mellitus (DM) and renal disease. However, the clinical usefulness of SAF levels in patients with heart failure (HF) who underwent cardiac rehabilitation (CR) remains unclear.
Purpose
The purpose of this study was to investigate the prognostic value of SAF levels in patients with HF who underwent CR.
Methods
This study enrolled 204 consecutive patients with HF who had undergone CR at our university hospital between November 2015 and October 2017. Clinical characteristics and anthropometric data were collected at the beginning of CR. SAF levels were noninvasively measured with an autofluorescence reader. The major adverse cardiovascular event (MACE) was a composite of all-cause mortality and unplanned hospitalization for HF. Follow-up data concerning primary endpoints were collected until November 2018.
Results
Patients' mean age was 68.1 years, and 61% were males. Patients were divided into two groups according to the median SAF levels (high and low SAF groups). Patients in the high SAF group were significantly older, had a higher prevalence of chronic kidney disease, and histories of coronary artery bypass surgery; however, there were no significant between-group differences in sex, prevalence of DM, left ventricular ejection fraction, and physical function. During a median follow-up period of 623 days, 25 patients experienced all-cause mortality and 34 were hospitalized for HF. Kaplan–Meier analysis showed that patients in the high SAF group had a higher incidence of MACE (log-rank P<0.05), whereas when patients were divided into two groups according to the median hemoglobin A1c level, no significant between-group difference was observed for the incidence of MACE (Figure). After adjusting for confounding factors, Cox regression multivariate analysis revealed that SAF levels were independently associated with the incidence of MACE (hazard ratio: 1.74, 95% confidence interval: 1.12–2.65, P<0.05).
Figure 1
Conclusion
SAF levels were significantly associated with the incidence of MACE in patients with HF and may be useful for risk stratification in patients with HF who undergo CR.
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Affiliation(s)
- M Kunimoto
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Honzawa
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - M Yamada
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - T Matsubara
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Fukao
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University School of Medicine, Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Fujiwara
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Yamamoto
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Takahashi
- Juntendo University, Department of Physical Therapy, Faculty of Health Sciences, Tokyo, Japan
| | - T Fujiwara
- Juntendo University School of Medicine, Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Amano
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Kitamura K, Isoda K, Akita K, Miyosawa K, Kadoguchi T, Shimada K, Daida H. P4141Lack of IkBNS promotes cholate-containing high-fat diet-induced inflammation and atherogenesis in low-density lipoprotein (LDL) receptor-deficient mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
IκBNS is one of the nuclear IκB proteins and regulates a subset of Toll-like receptor (TLR) dependent genes. LPS acts as extremely strong stimulator of innate immunity. We tried to investigate whether stimulation of innate immunity could promote atherosclerosis in the IκBNS-deficient atherogenic mice. However all IκBNS-deficient mice died of LPS challenge at a dose of which almost all wild-type mice survived, because IκBNS-deficient mice are highly sensitive to LPS-induced endotoxin shock. Then, we decided to use a cholate-containing high fat diet (HFD(CA(+))), which has been widely used as an atherogenic diet in mice. Furthermore, HFD(CA(+)) has been shown to induce TLR4 mediated early inflammatory response. The present study aims to clarify the lack of IκBNS promotes atherogenesis in LDL receptor-deficient (LDLr−/−) mice fed HFD(CA(+)) compared with those fed a cholate-free HFD (HFD(CA(−)).
Methods and results
Mice that lacked IκBNS (IκBNS−/−) were crossed with LDLr−/− mice and formation of atherosclerotic lesions was analyzed after 6 weeks consumption of HFD(CA(+)) or HFD(CA(−)). The extent of atherosclerosis in the aorta (en face) was significantly increased in IκBNS−/−/LDLr−/−(CA(+)) mice compared with others after 6-week consumption of HFD (p<0.01) (Figure). Interestingly, HFD(CA(−)) did not induce significant atherosclerotic lesions in IκBNS−/−/LDLr−/− compared with LDLr−/− mice after 6-week consumption (Figure). Immunostaining of aortic root lesion revealed that HFD(CA(+)) significantly increased positive area of Mac-3 (macrophage) by 1.5-fold (p=0.01) and TLR4, interleukin-6 (IL-6) expression by 1.7-fold (P<0.05) and 1.5-fold (p<0.05) respectively in IκBNS−/−/LDLr−/− (CA(+)) compared to LDLr−/− (CA(+)) mice. Furthermore, active STAT3 (pSTAT3)-positive cells were significantly increased by 1.7-fold in the atherosclerotic lesions of IκBNS−/−/LDLr−/− (CA(+)) compared with LDLr−/− (CA(+)) mice (p<0.01). TLR4 positive areas, IL-6 positive areas, and pSTAT3 positive cells were overlapped with Mac-3, indicating that TLR4-IL-6-STAT3 axis was activated in macrophages in IκBNS−/−/LDLr−/− (CA(+)) mice. On the other hand, HFD(CA(−)) could not induce any difference in these immunoreactivities of arteriosclerotic lesions between IκBNS−/−/LDLr−/− (CA(−)) compared with LDLr−/− (CA(−)) mice. These findings suggest that IκBNS deficiency and HFD(CA(+)) promote atherogenesis in LDLr−/− mice via TLR4/IL-6/STAT3 pathway. Finally, we show the monocytes from peripheral blood of IκBNS−/−/LDLr−/− (CA(+)) mice were found to contain the most mounts of Ly6Chi among four groups, suggesting that lack of IκBNS enhances inflammation in the response HFD(CA(+)) feeding and thereby influence atherogenesis in IκBNS−/−/LDLr−/− mice.
Aortic root atherosclerotic lesions
Conclusions
The present study is the first to demonstrate that the activation of innate immune system using HFD(CA(+)) induced significant inflammation and atherogenesis in IκBNS−/−/LDLr−/− compared with LDLr−/− mice.
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Affiliation(s)
- K Kitamura
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - K Isoda
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - K Akita
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - K Miyosawa
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - K Shimada
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Cardiology, Tokyo, Japan
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Pal A, Ghosh S, Joshi AG, Kumar S, Patil S, Gupta PK, Singh P, Gangwar VK, Prakash P, Singh RK, Schwier EF, Sawada M, Shimada K, Ghosh AK, Das A, Chatterjee S. Investigation of multi-mode spin-phonon coupling and local B-site disorder in Pr 2CoFeO 6 by Raman spectroscopy and correlation with its electronic structure by XPS and XAS studies. J Phys Condens Matter 2019; 31:275802. [PMID: 30921773 DOI: 10.1088/1361-648x/ab144f] [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] [Indexed: 06/09/2023]
Abstract
Electronic structure of Pr2CoFeO6 (at 300 K) was investigated by x-ray photoemission spectroscopy (XPS) and x-ray absorption spectroscopy techniques. All three cations, i.e. Pr, Co and Fe were found to be trivalent in nature. XPS valance band analysis suggested the system to be insulating in nature. The analysis suggested that Co3+ ions exist in low spin state in the system. Moreover, Raman spectroscopy study indicated the random distribution of the B-site ions (Co/Fe) triggered by same charge states. In temperature-dependent Raman study, the relative heights of the two observed phonon modes exhibited anomalous behaviour near magnetic transition temperature T N ~ 270 K, thus indicating towards interplay between spin and phonon degrees of freedom in the system. Furthermore, clear anomalous softening was observed below T N which confirmed the existence of strong spin-phonon coupling occurring for at least two phonon modes of the system. The line width analysis of the phonon modes essentially ruled out the role of magnetostriction effect in the observed phonon anomaly. The investigation of the lattice parameter variation across T N (obtained from the temperature-dependent neutron diffraction measurements) further confirmed the existence of the spin-phonon coupling.
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Affiliation(s)
- Arkadeb Pal
- Department of Physics, Indian Institute of Technology (BHU), Varanasi 221005, India
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Hisamatsu A, Ikusue T, Toshima H, Kobayashi K, Shimada K. Retrospective study of TAS-102 plus bevacizumab for patients with metastatic colorectal cancer in salvage therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Moriyama S, Takeuchi W, Kaburaki T, Shimada K, Hirose T, Kinugasa S, Matsuki T, Oba-Yabana I, Muroya Y, Mori T. SUN-018 LOW-VACUUM ELECTRON MICROSCOPY ANALYSIS FOR FORMALIN-FIXED PARAFFIN-EMBEDDED RAT KIDNEY SECTIONS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.412] [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] Open
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35
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Sai E, Shimada K, Yokoyama T, Hiki M, Aikawa T, Ouchi S, Aoshima C, Kawaguchi Y, Miyazaki T, Fujimoto S, Tamura Y, Aoki S, Watada H, Kawamori R, Daida H. P192Associations between ectopic fat accumulations and cardio-metabolic factors in apparently healthy subjects: assessed by 1H-magnetic resonance spectroscopy in myocardium, liver, and skeletal muscles. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez117.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Sai
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Yokoyama
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Hiki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Aikawa
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - C Aoshima
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Kawaguchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Fujimoto
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Tamura
- Juntendo University Graduate School of Medicine, Department of Metabolism and Endocrinology, Tokyo, Japan
| | - S Aoki
- Juntendo University Graduate School of Medicine, Department of Radiology, Tokyo, Japan
| | - H Watada
- Juntendo University Graduate School of Medicine, Department of Metabolism and Endocrinology, Tokyo, Japan
| | - R Kawamori
- Juntendo University Graduate School of Medicine, Department of Metabolism and Endocrinology, Tokyo, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
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Yamaguchi M, Suzuki R, Oguchi M, Miyazaki K, Taguchi S, Amaki J, Maeda T, Kubota N, Maruyama D, Terui Y, Sekiguchi N, Takizawa J, Tsukamoto H, Murayama T, Ando T, Matsuoka H, Hasegawa M, Wada H, Sakai R, Kameoka Y, Tsukamoto N, Choi I, Masaki Y, Shimada K, Fukuhara N, Utsumi T, Uoshima N, Kagami Y, Asano N, Katayama N. CLINICAL OUTCOMES AND DIAGNOSIS-TO-TREATMENT INTERVAL IN PATIENTS WITH NK/T-CELL LYMPHOMA: 7-YEAR FOLLOW-UP OF THE NKEA STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.86_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M. Yamaguchi
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
| | - R. Suzuki
- Oncology and Hematology; Shimane University Hospital; Izumo Japan
| | - M. Oguchi
- Radiation Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - K. Miyazaki
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
| | - S. Taguchi
- Radiation Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - J. Amaki
- Hematology and Oncology; Tokai University School of Medicine; Kanagawa Japan
| | - T. Maeda
- Hematology; Kurashiki Central Hospital; Kurashiki Japan
| | - N. Kubota
- Hematology; Saitama Cancer Center; Ina Japan
| | - D. Maruyama
- Hematology; National Cancer Center Hospital; Tokyo Japan
| | - Y. Terui
- Hematology Oncology; Cancer Institute Hospital of Japanese Foundation for Cancer Research; Tokyo Japan
| | - N. Sekiguchi
- Comprehensive Cancer Therapy; Shinshu University School of Medicine; Matsumoto Japan
| | - J. Takizawa
- Hematology; Endocrinology and Metabolism, Niigata University Faculty of Medicine; Niigata Japan
| | - H. Tsukamoto
- Hematology; Showa University School of Medicine; Tokyo Japan
| | - T. Murayama
- Hematology; Hyogo Cancer Center; Akashi Japan
| | - T. Ando
- Hematology; Respiratory Medicine and Oncology, Saga University; Saga Japan
| | - H. Matsuoka
- Medical Oncology/Hematology; Kobe University; Kobe Japan
| | - M. Hasegawa
- Radiation Oncology; Nara Medical University; Kashihara Japan
| | - H. Wada
- Hematology; Kawasaki Medical School; Kurashiki Japan
| | - R. Sakai
- Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Y. Kameoka
- Hematology; Nephrology and Rheumatology, Akita University; Akita Japan
| | - N. Tsukamoto
- Oncology Center; Gunma University Hospital; Maebashi Japan
| | - I. Choi
- Hematology; National Hospital Organization Kyushu Cancer Center; Fukuoka Japan
| | - Y. Masaki
- Hematology and Immunology; Kanazawa Medical University; Kanazawa Japan
| | - K. Shimada
- Hematology and Oncology; Nagoya University School of Medicine; Nagoya Japan
| | - N. Fukuhara
- Hematology & Rheumatology; Tohoku University School of Medicine; Sendai Japan
| | - T. Utsumi
- Hematology; Shiga Medical Center for Adults; Moriyama Japan
| | - N. Uoshima
- Hematology; Japanese Red Cross Kyoto Daini Hospital; Kyoto Japan
| | - Y. Kagami
- Hematology; Toyota Kosei Hospital; Toyota Japan
| | - N. Asano
- Molecular Diagnostics; Shinshu Medical Center; Suzaka Japan
| | - N. Katayama
- Department of Hematology and Oncology; Mie University Graduate School of Medicine; Tsu Japan
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Ishikawa E, Kohno K, Shimada K, Yamamura T, Nakamura M, Fujishiro M, Nakamura S. PROGNOSTIC IMPACT OF PD-L1 EXPRESSION, DOUBLE EXPRESSOR LYMPHOMA, AND PROGRESSION OF DISEASE WITHIN 24 MONTHS IN PRIMARY GASTROINTESTINAL DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.129_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- E. Ishikawa
- Department of Gastroenterology and Hepatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - K. Kohno
- Department of Pathology and Laboratory Medicine; Nagoya University Hospital; Nagoya Japan
| | - K. Shimada
- Department of Hematology and Oncology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - T. Yamamura
- Endoscopy; Nagoya University Hospital; Nagoya Japan
| | - M. Nakamura
- Department of Gastroenterology and Hepatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - M. Fujishiro
- Department of Gastroenterology and Hepatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - S. Nakamura
- Department of Pathology and Laboratory Medicine; Nagoya University Hospital; Nagoya Japan
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Yamada Y, Denda T, Gamoh M, Iwanaga I, Yuki S, Shimodaira H, Nakamura M, Yamaguchi T, Ohori H, Kobayashi K, Tsuda M, Kobayashi Y, Miyamoto Y, Kotake M, Shimada K, Sato A, Morita S, Takahashi S, Komatsu Y, Ishioka C. S-1 and irinotecan plus bevacizumab versus mFOLFOX6 or CapeOX plus bevacizumab as first-line treatment in patients with metastatic colorectal cancer (TRICOLORE): a randomized, open-label, phase III, noninferiority trial. Ann Oncol 2019; 29:624-631. [PMID: 29293874 PMCID: PMC5889030 DOI: 10.1093/annonc/mdx816] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [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] [Indexed: 12/18/2022] Open
Abstract
Background Combination therapy with oral fluoropyrimidine and irinotecan has not yet been established as first-line treatment of metastatic colorectal cancer (mCRC). We carried out a randomized, open-label, phase III trial to determine whether S-1 and irinotecan plus bevacizumab is noninferior to mFOLFOX6 or CapeOX plus bevacizumab in terms of progression-free survival (PFS). Patients and methods Patients from 53 institutions who had previously untreated mCRC were randomly assigned (1 : 1) to receive either mFOLFOX6 or CapeOX plus bevacizumab (control group) or S-1 and irinotecan plus bevacizumab (experimental group; a 3-week regimen: intravenous infusions of irinotecan 150 mg/m2 and bevacizumab 7.5 mg/kg on day 1, oral S-1 80 mg/m2 twice daily for 2 weeks, followed by a 1-week rest; or a 4-week regimen: irinotecan 100 mg/m2 and bevacizumab 5 mg/kg on days 1 and 15, S-1 80 mg/m2 twice daily for 2 weeks, followed by a 2-week rest). The primary end point was PFS. The noninferiority margin was 1.25; noninferiority would be established if the upper limit of the 95% confidence interval (CI) for the hazard ratio (HR) of the control group versus the experimental group was less than this margin. Result Between June 2012 and September 2014, 487 patients underwent randomization. Two hundred and forty-three patients assigned to the control group and 241 assigned to the experimental group were included in the primary analysis. Median PFS was 10.8 months (95% CI 9.6-11.6) in the control group and 14.0 months (95% CI 12.4-15.5) in the experimental group (HR 0.84, 95% CI 0.70-1.02; P < 0.0001 for noninferiority, P = 0.0815 for superiority). One hundred and fifty-seven patients (64.9%) in the control group and 140 (58.6%) in the experimental group had adverse events of grade 3 or higher. Conclusion S-1 and irinotecan plus bevacizumab is noninferior to mFOLFOX6 or CapeOX plus bevacizumab with respect to PFS as first-line treatment of mCRC and could be a new standard treatment. Clinical trials number UMIN000007834.
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Affiliation(s)
- Y Yamada
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - M Gamoh
- Department of Medical Oncology, Osaki Citizen Hospital, Miyagi, Japan
| | - I Iwanaga
- Department of Medical Oncology, Japanese Red Cross Kitami Hospital, Hokkaido, Japan
| | - S Yuki
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Hokkaido, Japan
| | - H Shimodaira
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - M Nakamura
- Comprehensive Cancer Center, Aizawa Hospital, Nagano, Japan
| | - T Yamaguchi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - H Ohori
- Clinical Oncology, Japanese Red Cross Ishinomaki Hospital, Miyagi, Japan
| | - K Kobayashi
- Division of Medical Oncology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - M Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Y Kobayashi
- Department of Internal Medicine, Kushiro Rosai Hospital, Hokkaido, Japan
| | - Y Miyamoto
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto, Japan
| | - M Kotake
- Department of Surgery, Kouseiren Takaoka Hospital, Toyama, Japan
| | - K Shimada
- Department of Internal Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - S Takahashi
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
| | - Y Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Hokkaido, Japan.
| | - C Ishioka
- Department of Medical Oncology, Tohoku University Hospital, Miyagi, Japan
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Kishi Y, Nara S, Esaki M, Hiraoka N, Shimada K. Feasibility of resecting the portal vein only when necessary during pancreatoduodenectomy for pancreatic cancer. BJS Open 2019; 3:327-335. [PMID: 31183449 PMCID: PMC6551409 DOI: 10.1002/bjs5.50130] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 05/19/2018] [Accepted: 11/16/2018] [Indexed: 12/26/2022] Open
Abstract
Background Whether the portal/superior mesenteric vein (PV) should be resected during pancreatoduodenectomy for pancreatic ductal adenocarcinoma (PDAC) based on preoperative CT or intraoperative findings is controversial. Methods This was a retrospective study with data of patients who had undergone pancreatoduodenectomy for PDAC between 2002 and 2016 in a tertiary referral centre. Based on the extent of contact between the PV and tumour on CT, patients were categorized into: group 1, no contact; group 2, contact 180° or less; group 3, contact greater than 180°. Extent of pathological PV invasion (pPV) (no invasion, pv0; invasion to tunica adventitia, pv1; invasion to media, pv2; invasion to intima, pv3) was compared with patient survival. To assess the feasibility of performing PV resection (PVR) based on intraoperative findings, the prognosis of patients in groups 1 and 2 with pv0 and no PVR (PVR(−)pv0) was compared with that of patients who had PVR (PVR(+)pv0), selected using propensity score matching. Results Groups 1, 2 and 3 comprised 230, 232 and 38 patients respectively, and PVR was performed in 10·9, 73·3 and 95 per cent of them (P < 0·001). Extent of pPV differed significantly (P < 0·001). The positive predictive value of radiological tumour contact with PV in predicting positive pPV was 42·6 per cent. In 64 patients with PVR(−)pv0 and 64 matched patients with PVR(+)pv0, the R0 resection rate (66 versus 73 per cent respectively; P = 0·337) and survival (median 32·4 versus 32·1 months; P = 0·780) were not significantly different. Conclusion PVR is needed only when the tumour is in clear contact with the PV and cannot be detached during surgery.
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Affiliation(s)
- Y Kishi
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital Tokyo Japan
| | - S Nara
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital Tokyo Japan
| | - M Esaki
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital Tokyo Japan
| | - N Hiraoka
- Division of Molecular Pathology National Cancer Centre Research Institute Tokyo Japan
| | - K Shimada
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital Tokyo Japan
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Morita K, Fujii T, Shimada K, Itami H, Hatakeyama K, Miyake M, Fujimoto K, Ohbayashi C. NACC1 as a target of microRNA-331-3p regulates cell proliferation in urothelial carcinoma cells. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sunakawa Y, Stintzing S, Cao S, Luecke J, Thompson D, Moran M, Astrow S, Hsiang J, Stephens C, Zhang W, Tsuji A, Takahashi T, Denda T, Shimada K, Kochi M, Takeuchi M, Fujii M, Ichikawa W, Heinemann V, Lenz HJ. A biomarker study to validate predictors for clinical outcome of cetuximab based chemotherapy in first-line metastatic colorectal cancer (mCRC) patients: JACCRO CC-05/06AR and FIRE-3. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nakamura M, Takashima A, Denda T, Gamoh M, Iwanaga I, Komatsu Y, Takahashi M, Ohori H, Sekikawa T, Tsuda M, Kobayashi Y, Miyamoto Y, Kotake M, Ishioka C, Shimada K, Sato A, Yuki S, Morita S, Takahashi S, Yamaguchi T. Updated analysis and exploratory analysis of primary tumor location in the TRICOLORE trial: A randomized phase III trial of S-1 and irinotecan plus bevacizumab versus mFOLFOX6 or CapeOX plus bevacizumab as first-line treatment for metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nishikawa K, Koizumi W, Tsuburaya A, Yamanaka T, Morita S, Fujitani K, Akamaru Y, Shimada K, Hosaka H, Nakayama N, Miyashita Y, Tsujinaka T, Sakamoto J. Meta-analysis of biweekly irinotecan plus cisplatin versus irinotecan alone as second-line treatment for advanced gastric cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ito T, Matsui F, Fujimoto K, Matsuyama S, Yazawa K, Matsumoto F, Shimada K. Acquired undescended testis and possibly associated testicular torsion in children with cerebral palsy or neuromuscular disease. J Pediatr Urol 2018; 14:402-406. [PMID: 30219308 DOI: 10.1016/j.jpurol.2018.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/15/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Torsion of an undescended testis (UDT) associated with cerebral palsy (CP) and neuromuscular disease (NMD) is an uncommon condition that is not well recognized by primary care physicians or healthcare providers. OBJECTIVE The objective of this study was to highlight the clinical importance of torsion of a UDT in children with CP and NMD. MATERIALS AND METHODS Eleven children with testicular torsion of a UDT operated on at the study institute between 1991 and 2015 were identified. The records of seven children (63.6%) associated with CP or NMD were retrospectively reviewed. Clinical findings of testicular torsion were assessed along with the treatment outcome and testicular salvageability. RESULTS All seven children were not identified with a UDT by public health checkup for infant and young children. No children with CP or NMD had torsion of a descended testis during the present study period. Median age at surgery was 15 years (range, 1-20 years). The testis location was at the external inguinal ring in five patients, in the inguinal canal in one, and in the superficial inguinal pouch in one. Of the contralateral testes, four were a UDT, one was a retractile testis, and two were descended testes. Orchiectomy was performed in six patients (85.7%). In the remaining patients, the testis was preserved but became atrophic. DISCUSSION This study demonstrated that children with CP or NMD may be affected with torsion of a UDT with peak at around puberty with the poor salvage rate, even if the testes appear descended in infancy and young children. Shortcomings of this study were the retrospective design and a small series of children undergoing surgery for torsion of a UDT. CONCLUSION Pediatric urologists need to educate primary care physicians and healthcare providers in the recognition of acquired UDTs and possibly associated testicular torsion in children with CP and NMD. Genital examination should be continued regularly until adolescence in these children to detect acquired UDT. These children should be referred to pediatric urologists to promote surgery as soon as the diagnosis of acquired UDT is carried out. It is believed that it is perhaps the best approach to prevent loss of the testis in children with CP and NMD.
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Affiliation(s)
- T Ito
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - F Matsui
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan.
| | - K Fujimoto
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - S Matsuyama
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - K Yazawa
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - F Matsumoto
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - K Shimada
- Department of Urology, Osaka Women's and Children's Hospital, Osaka, Japan
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Kadoguchi T, Shimada K, Miyazaki T, Aikawa T, Ouchi S, Kitamura K, Kunimoto M, Sugita Y, Shiozawa T, Isoda K, Daida H. 3142Angiotensin II-dependent activation of NADPH oxidase 4 contributes to muscle wasting in mice via downregulation of NF-E2-related factor 2. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Kadoguchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Aikawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Kunimoto
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Sugita
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Shiozawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
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Kunimoto M, Shimada K, Yokoyama M, Aikawa T, Ouchi S, Shimizu M, Fukao K, Miyazaki T, Fujiwra K, Honzawa A, Yamada M, Shimada A, Yamamoto T, Amano A, Daida H. 222Association between tissue accumulation of advanced glycation end products and exercise tolerance in patients who have undergone cardiac rehabilitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Kunimoto
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Aikawa
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - M Shimizu
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Fukao
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Fujiwra
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Honzawa
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - M Yamada
- Juntendo University School of Medicine, Cardiovascular Rehabilitation and Fitness, Tokyo, Japan
| | - A Shimada
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Yamamoto
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Amano
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Sugita Y, Miyazaki T, Shimizu M, Kunimoto M, Aikawa T, Ouchi S, Kadoguchi T, Kawaguchi Y, Shiozawa T, Takahashi S, Hiki M, Yokoyama M, Iwata H, Shimada K, Daida H. P6275Malnutrition and low omega 6 PUFA levels on admission were associated with the development of delirium in patients with acute cardiovascular disease admitted to coronary care unit. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Sugita
- Juntendo University, Tokyo, Japan
| | | | | | | | - T Aikawa
- Juntendo University, Tokyo, Japan
| | - S Ouchi
- Juntendo University, Tokyo, Japan
| | | | | | | | | | - M Hiki
- Juntendo University, Tokyo, Japan
| | | | - H Iwata
- Juntendo University, Tokyo, Japan
| | | | - H Daida
- Juntendo University, Tokyo, Japan
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Ishii K, Isoda K, Kitamura K, Sato-Okabayashi Y, Akita K, Kadoguchi T, Ohtomo F, Shimada K, Daida H. P1843Deficiency of interleukin-1 receptor antagonist continues angiotensin II induced aortic inflammation and promotes aneurysm formation after the cessation of its infusion. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Ishii
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - Y Sato-Okabayashi
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Akita
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - F Ohtomo
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
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Aikawa T, Miyazaki T, Shimada K, Sugita Y, Kitamura K, Kunimoto M, Shimizu M, Ouchi S, Shiozawa T, Kadoguchi T, Hiki M, Takahashi S, Daida H. P5411Low serum vitamin D levels are associated with polyunsaturated fatty acids, inflammation and long-term mortality in patients with acute cardiovascular disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Aikawa
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - K Shimada
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - Y Sugita
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - M Kunimoto
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - M Shimizu
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - T Shiozawa
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - T Kadoguchi
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - M Hiki
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - S Takahashi
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
| | - H Daida
- Juntendo university graduate school of medicine, Cardiovascular medicine, Tokyo, Japan
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Kishi Y, Nara S, Esaki M, Hiraoka N, Shimada K. Extent of lymph node dissection in patients with gallbladder cancer. Br J Surg 2018; 105:1658-1664. [DOI: 10.1002/bjs.10913] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/06/2018] [Accepted: 05/17/2018] [Indexed: 11/11/2022]
Abstract
Abstract
Background
Definitions of regional lymph nodes for gallbladder cancer differ according to staging system. Hence, the appropriate extent of lymph node dissection has not yet been standardized.
Methods
Pathological stages and disease-specific survival (DSS) of patients who had undergone surgical resection of gallbladder cancer between 1990 and 2016 were reviewed. Patients with nodal metastases limited to the hepatoduodenal ligament or common hepatic artery, extending to the posterosuperior pancreatic head lymph nodes (PSPLNs), or in nodes along the coeliac axis or superior mesenteric vessels were grouped as having Na, Nb and Nc disease respectively. Metastases beyond these regions were defined as distant metastases (M1). Absence of distant metastasis was expressed as M0.
Results
A total of 259 patients were evaluated. There were 74, 31 and nine patients respectively in the Na, Nb and Nc groups. Twenty-five, nine and four patients in the respective groups had M1 disease (P = 0·682). The 5-year DSS rate was comparable between patients with Na M0 and those with Nb M0 disease (36 versus 34 per cent respectively; P = 0·950), whereas the rate in patients with Nc M0 status (0 per cent) was worse than that of patients with Nb M0 (P = 0·017) and comparable to that of patients with M1 disease (14 per cent; P = 0·590). Among 22 patients with Nb M0 disease, the 5-year DSS rate did not differ between those who had undergone pancreatoduodenectomy and those who had had dissection of PSPLNs without pancreatoduodenectomy (50 versus 30 per cent respectively; P = 0·499).
Conclusion
PSPLNs and nodes along the hepatoduodenal ligament and hepatic artery should be considered regional nodes for gallbladder cancer, and should be resected.
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Affiliation(s)
- Y Kishi
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan
| | - S Nara
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan
| | - M Esaki
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan
| | - N Hiraoka
- Division of Molecular Pathology, National Cancer Centre Research Institute, Tokyo, Japan
| | - K Shimada
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan
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