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Yindeedej V, Uda T, Nishijima S, Inoue T, Kuki I, Fukuoka M, Nukui M, Okazaki S, Kunihiro N, Umaba R, Goto T. Changes in interhemispheric coherence after total corpus callosotomy: a scalp EEG study in children with non-lesional generalized epilepsy. Childs Nerv Syst 2024:10.1007/s00381-024-06435-3. [PMID: 38687362 DOI: 10.1007/s00381-024-06435-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/27/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE Coherence analysis in electroencephalography (EEG) allows measurement of the degree of consistency of amplitude between pairs of electrodes. Theoretically, disconnective epilepsy surgery should decrease coherence between corresponding areas. The study aimed to evaluate postoperative changes in interhemispheric coherence values after corpus callosotomy (CC). METHODS Non-lesional, drug-resistant, generalized epilepsy patients who underwent total CC were retrospectively collected. To evaluate coherence, we divided the scalp interictal EEG into "baseline" and "discharge" states after excluding periods with artifacts. Interhemispheric coherence values were obtained between eight pairs of symmetrically opposite scalp electrodes in six different frequency bands. We analyzed both pre- and postoperative EEG sessions and calculated the percentage of difference (POD) in coherence values. RESULTS We collected 13 patients and analyzed 2496 interhemispheric coherence values. Preoperative coherence values differed significantly between baseline and discharge states (p = 0.0003), but postoperative values did not (p = 0.11). For baseline state, coherence values were decreased after CC and median POD was - 22.3% (p < 0.0001). Delta frequency showed the most decreased POD (-44.3%, p = 0.0009). Median POD was lowest in the Fp1-Fp2 pair of electrodes. For discharge state, coherence values were decreased after CC and median POD was - 24.7% (p < 0.0001). Delta frequency again showed the most decreased POD (-55.9%, p = 0.0016). Median POD was lowest in the F7-F8 pair. CONCLUSION After total CC, interhemispheric coherence decreased significantly in both baseline and discharge states. The most decreased frequency band was the delta band, which may be used as a representative frequency band in future studies.
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Affiliation(s)
- Vich Yindeedej
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
- Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Takehiro Uda
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan.
| | - Shugo Nishijima
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Ryoko Umaba
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takeo Goto
- Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan
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Kuki I, Inoue T, Fukuoka M, Nukui M, Okuno H, Amo K, Otsuka Y, Ishikawa J, Rinka H, Ujiro A, Togawa M, Shiomi M, Okazaki S. Efficacy and safety of ketamine for pediatric and adolescent super-refractory status epilepticus and the effect of cerebral inflammatory conditions. J Neurol Sci 2024; 459:122950. [PMID: 38461760 DOI: 10.1016/j.jns.2024.122950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To investigate the short-term benefits and adverse effects of ketamine in the treatment of pediatric and adolescent super-refractory status epilepticus (SRSE), with a focus on the inflammatory etiology. METHODS This retrospective observational cohort study included a consecutive series of 18 pediatric to adolescent patients with SRSE admitted between 2008 and 2023 and treated with ketamine. Seizure frequency per hour before and after ketamine administration and response rate were calculated. Neurological decline, catecholamine administration, and adverse effects were also assessed. The patients were divided into inflammatory and non-inflammatory etiology groups. RESULTS The median age at SRSE onset was 1 year 5 months (range: 11 days-24 years), and 78% of the patients were male individuals. The median duration of treatment was 7.5 days (interquartile range: 2.8-15.5 days). Fifteen (83%) patients achieved >50% seizure reduction. The median seizure frequency before and after ketamine treatment was 5.9 and 0.9, respectively, showing a significant reduction in seizure frequency (p < 0.0001). Ten patients had inflammatory etiologies including bacterial meningitis (n = 2), viral encephalitis (n = 3), and febrile infection related epilepsy syndrome (n = 5). The inflammatory etiology group required a longer treatment duration (p = 0.0453) and showed lower seizure reduction (p = 0.0264), lower response rate (p = 0.0044), and higher neurological decline (p = 0.0003) than the non-inflammatory etiology group. Three (17%) patients experienced transient adverse events requiring intervention within 24 h of initiating ketamine administration. CONCLUSIONS Ketamine administration was associated with fewer serious adverse events and a reduced seizure frequency. Additionally, inflammatory conditions may weaken the efficacy of ketamine in patients with SRSE.
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Affiliation(s)
- Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hideo Okuno
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Yasunori Otsuka
- Department of Intensive Care Medicine, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan; Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Atushi Ujiro
- Department of Pediatrics, Medical Corporation ISEIKAI, ISEIKAI International General Hospital
| | - Masao Togawa
- Department of Pediatrics, Medical Corporation ISEIKAI, ISEIKAI International General Hospital
| | - Masashi Shiomi
- Department of Pediatrics, Aizenbashi Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
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Matsubara K, Kuki I, Ishioka R, Yamada N, Fukuoka M, Inoue T, Nukui M, Okamoto N, Mizuguchi T, Matsumoto N, Okazaki S. Abnormal axonal development and severe epileptic phenotype in Dynamin-1 (DNM1) encephalopathy. Epileptic Disord 2024; 26:139-143. [PMID: 38009673 DOI: 10.1002/epd2.20181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Abstract
Dynamin-1 (DNM1) is involved in synaptic vesicle recycling, and DNM1 mutations can lead to developmental and epileptic encephalopathy. The neuroimaging of DNM1 encephalopathy has not been reported in detail. We describe a severe phenotype of DNM1 encephalopathy showing characteristic neuroradiological features. In addition, we reviewed previously reported cases who have DNM1 pathogenic variants with white matter abnormalities. Our case presented drug-resistant seizures from 1 month of age and epileptic spasms at 2 years of age. Brain MRI showed no progression of myelination, progression of diffuse cerebral atrophy, and a thin corpus callosum. Proton magnetic resonance spectroscopy showed a decreased N-acetylaspartate peak and diffusion tensor imaging presented with less pyramidal decussation. Whole-exome sequencing revealed a recurrent de novo heterozygous variant of DNM1. So far, more than 50 cases of DNM1 encephalopathy have been reported. Among these patients, delayed myelination occurred in two cases of GTPase-domain DNM1 encephalopathy and in six cases of middle-domain DNM1 encephalopathy. The neuroimaging findings in this case suggest inadequate axonal development. DNM1 is involved in the release of synaptic vesicles with the inhibitory transmitter GABA, suggesting that GABAergic neuron dysfunction is the mechanism of refractory epilepsy in DNM1 encephalopathy. GABA-mediated signaling mechanisms play important roles in axonal development and GABAergic neuron dysfunction may be cause of white matter abnormalities in DNM1 encephalopathy.
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Affiliation(s)
- Kohei Matsubara
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Risako Ishioka
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Naoki Yamada
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Nobuhiko Okamoto
- Division of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takeshi Mizuguchi
- Division of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Division of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shin Okazaki
- Division of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
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Polak S, Beever L, Wade A, Fukuoka M, Worth AJ. Biomechanical comparison of titanium alloy additively manufactured and conventionally manufactured plate-screw constructs. N Z Vet J 2024; 72:17-27. [PMID: 37772312 DOI: 10.1080/00480169.2023.2264805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/21/2023] [Indexed: 09/30/2023]
Abstract
AIM To biomechanically compare the bending stiffness, strength, and cyclic fatigue of titanium additively manufactured (AM) and conventionally manufactured (CM) limited contact plates (LCP) of equivalent dimensions using plate-screw constructs. METHODS Twenty-four 1.5/2.0-mm plate constructs (CM: n = 12; AM: n = 12) were placed under 4-point bending conditions. Data were collected during quasi-static single cycle to failure and cyclic fatigue testing until implants plastically deformed or failed. Bending stiffness, bending structural stiffness, and bending strength were determined from load-displacement curves. Fatigue life was determined as number of cycles to failure. Median test variables for each method were compared using the Wilcoxon rank sum test within each group. Fatigue data was also analysed by the Kaplan-Meier estimator of survival function. RESULTS There was no evidence for a difference in bending stiffness and bending structural stiffness between AM and CM constructs. However, AM constructs exhibited greater bending strength (median 3.07 (min 3.0, max 3.4) Nm) under quasi-static 4-point bending than the CM constructs (median 2.57 (min 2.5, max 2.6) Nm, p = 0.006). Number of cycles to failure under dynamic 4-point bending was higher for the CM constructs (median 164,272 (min 73,557, max 250,000) cycles) than the AM constructs (median 18,704 (min 14,427, max 33,228) cycles; p = 0.02). Survival analysis showed that 50% of AM plates failed by 18,842 cycles, while 50% CM plates failed by 78,543 cycles. CONCLUSION AND CLINICAL RELEVANCE Additively manufactured titanium implants, printed to replicate a conventional titanium orthopaedic plate, were more prone to failure in a shorter fatigue period despite being stronger in single cycle to failure. Patient-specific implants made using this process may be brittle and therefore not comparable to CM orthopaedic implants. Careful selection of their use on a case/patient-specific basis is recommended.
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Affiliation(s)
- S Polak
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - L Beever
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A Wade
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - M Fukuoka
- Mechatronics, Electronics and Computer Engineering, School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A J Worth
- Tāwharau Ora - School of Veterinary Science, Massey University, Palmerston North, New Zealand
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Usui N, Kondo A, Matsuda K, Ogawa H, Nishida T, Tokumoto K, Kawaguchi N, Matsudaira T, Araki Y, Fukuoka M, Omatsu H, Otani H, Yamaguchi T, Imai K, Takahashi Y. Localized focal cortical dysplasia type II: seizure freedom with lesionectomy guided by MRI and FDG-PET. J Neurosurg 2023:1-9. [PMID: 37948689 DOI: 10.3171/2023.8.jns231282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/29/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE The authors perform thorough, noninvasive presurgical evaluations for intractable epilepsy at their center and avoid unnecessary intracranial EEG when possible. The purpose of this study was to clarify the appropriateness of their lesion-oriented surgical strategy for localized focal cortical dysplasia (FCD) type II. METHODS Fifty-one patients with pathologically proven localized FCD type II who were followed for at least 1 year after surgery were included. Patients with FCD type II with lobar or multilobar distribution were excluded. The results of presurgical evaluations, including thin-slice 3-T MRI, FDG-PET, and ictal SPECT, as well as surgical procedures and postoperative seizure and functional outcomes, were examined retrospectively. RESULTS MRI was positive in 46 (90%) of 51 patients, and FDG-PET revealed localized hypo- or hypermetabolism in 47 (92%) of 51 patients. Ictal SPECT revealed concordant hyperperfusion in 37 of 42 patients examined. Intracranial EEG was used in only 13 patients (25%), including 5 with negative MRI results and 4 with subtle MRI findings. Of the 15 patients with FCD in the vicinity of eloquent (sensorimotor and language) areas, intracranial EEG was used in 4. Lesionectomy was performed in all 51 patients. Intraoperative electrocorticography (ECoG) was performed in 8 patients, but the findings were not used to tailor the extent of resection. Postoperative seizure outcomes were Engel class I in 47 patients (92%) and Ia in 45 (88%). In the 15 patients with FCD in the vicinity of eloquent areas, 13 (87%) achieved a class I outcome. Predictive factors for favorable seizure outcome were complete resection of the MRI lesion (p = 0.006) and frontal lobe surgery (p = 0.012). Postoperative neurological deficits were noted in only 4 (27%) of 15 patients with FCD in the vicinity of eloquent areas. All 5 MRI-negative patients achieved an Engel class I outcome. CONCLUSIONS In most of the patients with localized FCD type II, MRI and/or FDG-PET detected the localized abnormality. Lesionectomy without intracranial EEG led to seizure freedom in most cases. Even when lesions were in the vicinity of eloquent areas, seizure and functional outcomes were favorable. Intraoperative ECoG may thus be unnecessary. Complete resection of the lesion is essential for favorable seizure outcome in MRI-positive patients. In MRI-negative patients, surgery with intracranial EEG guided by FDG-PET provided seizure-free outcomes.
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Affiliation(s)
- Naotaka Usui
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Akihiko Kondo
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Kazumi Matsuda
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Hiroshi Ogawa
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Takuji Nishida
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Kentaro Tokumoto
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Norihiko Kawaguchi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Takashi Matsudaira
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Yasukiyo Araki
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Masataka Fukuoka
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Hirowo Omatsu
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Hideyuki Otani
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Tokito Yamaguchi
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | - Katsumi Imai
- National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
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Fukuoka M, Kuki I, Hattori Y, Tsuji H, Horino A, Nukui M, Inoue T, Okazaki S, Kawawaki H, Kunihiro N, Uda T, Inoue T, Takahashi Y. A case of focal cortical dysplasia type IIa with pathologically suspected bilateral Rasmussen syndrome. Brain Dev 2022; 44:401-404. [PMID: 35241305 DOI: 10.1016/j.braindev.2022.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/31/2022] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Rasmussen syndrome (RS) is a rare neurological disorder characterized by unilateral chronic inflammation, drug-resistant epilepsy, and progressive neurological and cognitive deterioration. There has been no detailed pathological evaluation or finding, including focal cortical dysplasia, for bilateral RS. CASE REPORT A 13-year-old boy presented with status epilepticus with focal to bilateral tonic clonic seizure starting from the left upper limb. At the age of 15, epilepsia partialis continua of the right face and upper extremities appeared, and MRI showed hemispheric abnormal signal intensities with left frontal lobe predominance. Three months later, MRI showed extensive abnormal signal intensities in the right occipitoparietal and left temporal lobes. Tacrolimus was useful in preventing recurrence. Because the seizures were intractable, a corpus callosotomy was performed at 16 years along with a concurrent brain biopsy from the bilateral lateral frontal cortices. We detected dysmorphic neurons in addition to inflammatory changes suspicious for RS, leading to a diagnosis of focal cortical dysplasia (FCD) type Ⅱa and suspected bilateral RS. Total callosotomy and vagus nerve stimulation were not sufficiently effective. CONCLUSIONS In bilateral RS, FCD may be present in both cerebral hemispheres. In the current case, an autoimmune response to dysmorphic neurons may have contributed to the pathogenesis of intense inflammation.
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Affiliation(s)
- Masataka Fukuoka
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan; National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan.
| | - Ichiro Kuki
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Yuka Hattori
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Hitomi Tsuji
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Asako Horino
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Megumi Nukui
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Takeshi Inoue
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Shin Okazaki
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Hisashi Kawawaki
- Division of Pediatric Neurology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Noritsugu Kunihiro
- Division of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Takehiro Uda
- Division of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan; Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka City, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Yukitoshi Takahashi
- National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ku, Shizuoka 420-8688, Japan
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Tsukuda H, Tsuya A, Hasegawa Y, Ota T, Fukuoka M. Migratory bone lesions in lymphoma. QJM 2022; 115:177-178. [PMID: 35094089 DOI: 10.1093/qjmed/hcac031] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Tsukuda
- Department of Medical Oncology, Izumi City General Hospital, 4-10-10 Fuchu-Cho, Izumi, Osaka 594-0073, Japan
| | - A Tsuya
- Department of Medical Oncology, Izumi City General Hospital, 4-10-10 Fuchu-Cho, Izumi, Osaka 594-0073, Japan
| | - Y Hasegawa
- Department of Medical Oncology, Izumi City General Hospital, 4-10-10 Fuchu-Cho, Izumi, Osaka 594-0073, Japan
| | - T Ota
- Department of Medical Oncology, Izumi City General Hospital, 4-10-10 Fuchu-Cho, Izumi, Osaka 594-0073, Japan
| | - M Fukuoka
- Department of Medical Oncology, Izumi City General Hospital, 4-10-10 Fuchu-Cho, Izumi, Osaka 594-0073, Japan
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Fukuoka M, Okazaki S, Kim K, Nukui M, Inoue T, Kuki I, Kawawaki H, Nakashima M, Matsumoto N. Preliminary report for Epilepsia Open A case of West syndrome with severe global developmental delay and confirmed KIF5A gene variant. Epilepsia Open 2021; 6:230-234. [PMID: 33681666 PMCID: PMC7918309 DOI: 10.1002/epi4.12431] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 12/02/2022] Open
Abstract
Objective Kinesin family member 5A (KIF5A) is a molecular motor protein responsible for intracellular transport, specifically in neurons. While abnormalities in the KIF5A gene have been reported in the onset of various neurological diseases, there are no studies demonstrating an association between this gene and West syndrome. Methods In the case presented here, epileptic spasms appeared at 7 months; electroencephalogram (EEG) investigation confirmed hypsarrhythmia, resulting in a diagnosis of West syndrome. The patient exhibited peculiar facies, hypotonia, failure to thrive, and severe global developmental delay. Results Cranial magnetic resonance imaging (MRI) revealed severe delayed myelination. 123I-iomazenil SPECT image at 7 months demonstrated decreased accumulation in bilateral areas, including the primary somatosensory and motor cortices, and the primary and association visual areas compared to an age-matched control. Whole exome sequencing analysis demonstrated a novel de novo heterozygous missense variant in KIF5A, (NM_004984.4:c.710A>T: p. Glu237Val). Significance It was concluded that the KIF5A variant impaired the transport of GABAA receptors to the cell membrane surface, thus leading to an imbalance of these receptors between regions of the cerebrum and resulting in the onset of epilepsy.
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Affiliation(s)
- Masataka Fukuoka
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Shin Okazaki
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Kiyohiro Kim
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Megumi Nukui
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Takeshi Inoue
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Ichiro Kuki
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Hisashi Kawawaki
- Department of Pediatric NeurologyOsaka City General HospitalOsakaJapan
| | - Mitsuko Nakashima
- Department of BiochemistryHamamatsu University School of MedicineHamamatsuJapan
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Naomichi Matsumoto
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
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Miyatake S, Kato M, Kumamoto T, Hirose T, Koshimizu E, Matsui T, Takeuchi H, Doi H, Hamada K, Nakashima M, Sasaki K, Yamashita A, Takata A, Hamanaka K, Satoh M, Miyama T, Sonoda Y, Sasazuki M, Torisu H, Hara T, Sakai Y, Noguchi Y, Miura M, Nishimura Y, Nakamura K, Asai H, Hinokuma N, Miya F, Tsunoda T, Togawa M, Ikeda Y, Kimura N, Amemiya K, Horino A, Fukuoka M, Ikeda H, Merhav G, Ekhilevitch N, Miura M, Mizuguchi T, Miyake N, Suzuki A, Ohga S, Saitsu H, Takahashi H, Tanaka F, Ogata K, Ohtaka-Maruyama C, Matsumoto N. De novo ATP1A3 variants cause polymicrogyria. Sci Adv 2021; 7:7/13/eabd2368. [PMID: 33762331 PMCID: PMC7990330 DOI: 10.1126/sciadv.abd2368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
Polymicrogyria is a common malformation of cortical development whose etiology remains elusive. We conducted whole-exome sequencing for 124 patients with polymicrogyria and identified de novo ATP1A3 variants in eight patients. Mutated ATP1A3 causes functional brain diseases, including alternating hemiplegia of childhood (AHC), rapid-onset dystonia parkinsonism (RDP), and cerebellar ataxia, areflexia, pes cavus, optic nerve atrophy, and sensorineural deafness (CAPOS). However, our patients showed no clinical features of AHC, RDP, or CAPOS and had a completely different phenotype: a severe form of polymicrogyria with epilepsy and developmental delay. Detected variants had different locations in ATP1A3 and different functional properties compared with AHC-, RDP-, or CAPOS-associated variants. In the developing cerebral cortex of mice, radial neuronal migration was impaired in neurons overexpressing the ATP1A3 variant of the most severe patients, suggesting that this variant is involved in cortical malformation pathogenesis. We propose a previously unidentified category of polymicrogyria associated with ATP1A3 abnormalities.
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Affiliation(s)
- Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Clinical Genetics Department, Yokohama City University Hospital, Yokohama, Kanagawa 236-0004, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Takuma Kumamoto
- Developmental Neuroscience Project, Department of Brain & Neurosciences, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Tomonori Hirose
- Department of Molecular Biology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Eriko Koshimizu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takaaki Matsui
- Gene Regulation Research, Nara Institute of Science and Technology, Ikoma, Nara 630-0101, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Keisuke Hamada
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
| | - Kazunori Sasaki
- Department of Molecular Biology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Akio Yamashita
- Department of Molecular Biology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Atsushi Takata
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Laboratory for Molecular Pathology of Psychiatric Disorders, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Kohei Hamanaka
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Mai Satoh
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takabumi Miyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Yuri Sonoda
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
| | - Momoko Sasazuki
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
| | - Hiroyuki Torisu
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
- Section of Pediatrics, Department of Medicine, Fukuoka Dental College, Fukuoka 814-0193, Japan
| | - Toshiro Hara
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
- Fukuoka Children's Hospital, Fukuoka 813-0017, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
| | - Yushi Noguchi
- Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Mazumi Miura
- Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Yoko Nishimura
- Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Kazuyuki Nakamura
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata 990-9585, Japan
| | - Hideyuki Asai
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Nodoka Hinokuma
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8666, Japan
| | - Fuyuki Miya
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
- Laboratory for Medical Science Mathematics, Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Tatsuhiko Tsunoda
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- Laboratory for Medical Science Mathematics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
- Laboratory for Medical Science Mathematics, Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Masami Togawa
- Department of Pediatrics, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Yukihiro Ikeda
- Department of Neonatology, Japanese Red Cross Otsu Hospital, Otsu, Shiga 520-8511, Japan
| | - Nobusuke Kimura
- Department of Pediatrics, Naniwa Ikuno Hospital, Osaka, Shiga 556-0014, Japan
| | - Kaoru Amemiya
- Department of Pediatrics, Saiwai Kodomo Clinic, Tachikawa 190-0002, Japan
| | - Asako Horino
- Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka 420-8688, Japan
| | - Masataka Fukuoka
- Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka 420-8688, Japan
| | - Hiroko Ikeda
- Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka 420-8688, Japan
| | - Goni Merhav
- Radiology Department, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Nina Ekhilevitch
- The Genetics Institute, Rambam Health Care Campus, Haifa 3109601, Israel
| | - Masaki Miura
- Department of Pediatrics, Nagaoka Red Cross Hospital, Nagaoka, Niigata 940-2085, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Atsushi Suzuki
- Molecular Cellular Biology Laboratory, Yokohama City University Graduate School of Medical Life Science, Yokohama, Kanagawa 236-0004, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Kyushu University, Fukuoka 812-8582, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka 431-3192, Japan
| | - Hidehisa Takahashi
- Department of Molecular Biology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Kazuhiro Ogata
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Chiaki Ohtaka-Maruyama
- Developmental Neuroscience Project, Department of Brain & Neurosciences, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan.
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10
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Takahashi Y, Nishimura S, Takao E, Kasai R, Enokida K, Ida K, Fukuoka M, Koike T, Omatsu H, Yamaguchi T, Takano S, Yoshida T, Mori H. Characteristics of internalization of NMDA-type GluRs with antibodies to GluN1 and GluN2B. J Neuroimmunol 2020; 349:577427. [PMID: 33091764 DOI: 10.1016/j.jneuroim.2020.577427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/15/2022]
Abstract
To characterize internalization of NMDA-type glutamate receptors (GluRs) by antibodies to NMDA-type GluRs, we produced rabbit antibodies to N-terminals of human GluN1 and GluN2B, and examined internalization of NMDA-type GluRs in HEK293T cells using confocal microscopy. Internalization of NMDA-type GluRs occurred from at least 10 min after incubation with antibodies to GluN1 and or GluN2B and was temperature-dependent. These findings confirm that antibodies to N-terminals of GluN1 and GluN2B present in the cerebrospinal fluid of patients with NMDAR encephalitis can mediate prompt internalization of NMDA-type GluR complexes.
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Affiliation(s)
- Yukitoshi Takahashi
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan; Department of Pediatrics, Gifu University School of Medicine, Yanagido, Gifu, Japan; School of Pharmaceutical Sciences, University of Shizuoka, Japan.
| | - Shigeko Nishimura
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Emiko Takao
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Risa Kasai
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Kaoru Enokida
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Kuniko Ida
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Masataka Fukuoka
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Takayoshi Koike
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Hiroo Omatsu
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Tokito Yamaguchi
- National Epilepsy Center, NHO, Shizuoka Institute of Epilepsy and Neurological Disorders, 886 Urushiyama, Aoi-ward, Shizuoka, Japan.
| | - Shiho Takano
- Department of Molecular Neuroscience, Graduate Schools of Innovative Life Science and Medicine, University of Toyama, Toyama, Japan
| | - Tomoyuki Yoshida
- Department of Molecular Neuroscience, Graduate Schools of Innovative Life Science and Medicine, University of Toyama, Toyama, Japan.
| | - Hisashi Mori
- Department of Molecular Neuroscience, Graduate Schools of Innovative Life Science and Medicine, University of Toyama, Toyama, Japan.
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11
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Yamamoto N, Seto T, Nishio M, Goto K, Yamamoto N, Okamoto I, Yamanaka T, Tanaka M, Takahashi K, Fukuoka M. Erlotinib plus bevacizumab vs erlotinib monotherapy as first-line treatment for advanced EGFR mutation-positive non-squamous non-small-cell lung cancer: Survival follow-up results of the randomized JO25567 study. Lung Cancer 2020; 151:20-24. [PMID: 33279874 DOI: 10.1016/j.lungcan.2020.11.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The JO25567 randomized Phase II study demonstrated a statistically significant progression-free survival (PFS) benefit with erlotinib plus bevacizumab compared with erlotinib monotherapy in chemotherapy-naïve Japanese patients with epidermal growth factor receptor mutation-positive (EGFR+) non-small-cell lung cancer (NSCLC). Here we present updated PFS and final overall survival (OS) data after a median follow-up of 34.7 months. MATERIALS AND METHODS Patients with stage IIIB/IV or postoperative recurrent NSCLC were randomized to receive oral erlotinib 150 mg once daily (n = 77) or erlotinib in combination with intravenous bevacizumab 15 mg/kg every 21 days (n = 75) until disease progression or unacceptable toxicity. OS was analyzed using an unstratified Cox proportional hazards model. RESULTS Consistent with the primary analysis, addition of bevacizumab to erlotinib was associated with a significant improvement in PFS (hazard ratio [HR] 0.52; 95 % confidence interval [CI]: 0.35-0.76; log-rank two-sided P = 0.0005; median 16.4 months vs 9.8 months, respectively). In contrast, a significant improvement in OS was not seen (HR 0.81; 95 % CI, 0.53-1.23; P = 0.3267; median 47.0 months vs 47.4 months, respectively). Post-study therapy was similar between the treatment arms and EGFR mutation type did not affect OS outcomes. The 5-year OS rate was numerically higher with erlotinib plus bevacizumab vs erlotinib monotherapy (41 % vs 35 %). Updated safety analyses confirmed the previously reported manageable tolerability profile, with no new safety issues. CONCLUSION Addition of bevacizumab to first-line erlotinib did not show significant improvement in OS in Japanese patients with stage IIIB/IV or postoperative recurrent EGFR+ NSCLC. Both treatment arms showed a similar median OS benefit (as long as 4 years), irrespective of individual patient characteristics. Results from ongoing studies evaluating the combination of EGFR and VEGF signaling inhibitors are eagerly awaited. TRIAL REGISTRATION JapicCTI-111390 and JapicCTI-142569.
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Affiliation(s)
- N Yamamoto
- Wakayama Medical University, Wakayama, Japan.
| | - T Seto
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
| | - M Nishio
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - K Goto
- National Cancer Center Hospital East, Kashiwa, Japan.
| | - N Yamamoto
- National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan.
| | - I Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - T Yamanaka
- Faculty of Medicine, Yokohama City University, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan.
| | - M Tanaka
- Chugai Pharmaceutical Co. Ltd., Tokyo, Japan.
| | - K Takahashi
- Chugai Pharmaceutical Co. Ltd., Tokyo, Japan.
| | - M Fukuoka
- Izumi City General Hospital, Izumi-City, Osaka, Japan.
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12
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Azuma M, Kato S, Kodama S, Hayakawa K, Kagimoto M, Iguchi K, Fukuoka M, Fukui K, Iwasawa T, Utsunomiya D, Kimura K, Tamura K. Relationship between cardiac magnetic resonance derived extracellular volume fraction and myocardial strain in patients with non-ischemic dilated cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0239] [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
The feature tracking (FT) technique has been proposed as a robust method to evaluate the myocardial strain using conventional cine magnetic resonance imaging (MRI) of the left ventricle. Data is limited regarding the relationship between FT-derived myocardial strain and diffuse myocardial fibrosis evaluated by T1 mapping in patients with non-ischemic dilated cardiomyopathy (NIDCM).
Purpose
The aim of this study was to evaluate the correlation between extracellular volume (ECV) by T1 mapping and myocardial strain by FT in patients with NIDCM.
Methods
A total of sixty-four patients with NIDCM (62±12 years) and 15 controls (62±11 years) were studied. Using a 1.5T MR scanner, pre- and post- T1 mapping images of LV wall at mid-ventricular level was acquired to calculate ECV by modified Look-Locker inversion recovery (MOLLI) sequence. Radial strain (RS), circumferential strain (CS) and longitudinal strain (LS) was assessed by FT technique. ECV and myocardial strain were compared using a 6-segment model at mid-ventricular level.
Results
Compared to the controls, the NIDCM patients had a significantly higher ECV (0.30±0.02 vs. 0.24±0.01, p<0.001) and impaired myocardial strain (RS, 24.2±3.0 vs. 52.2±6.2, p<0.001; CS, −7.5±2.1 vs. −15.3±2.2, p<0.001; LS −10.4±3.5 vs. −20.2±4.7, p<0.001, respectively). Similar results were obtained when comparing all 6 myocardial segments (segment 7–12) (all p values <0.001). In a segment-based analysis, a significant positive correlation was found between the ECV and CS (r=0.26 to 0.41; all p values <0.05), a negative correlation was found between the ECV and RS (r=−0.31 to −0.41; all p values <0.05). In a patient-based analysis, there were significant positive correlations between the ECV and CS (r=0.45, p<0.001), ECV and LS from 2-chamber view (r=0.30, p=0.006), ECV and LS from 4-chamber view (r=0.37, p<0.001). There was a significant negative correlation between the ECV and RS (r=−0.43, p<0.001) (FIGURE)
Conclusions
In NIDCM patients, severity of myocardial fibrosis evaluated by T1 mapping is associated with impaired myocardial strain by FT technique.
Correlation between the ECV and strain
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Azuma
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - S Kato
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - S Kodama
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Hayakawa
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - M Kagimoto
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Iguchi
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - M Fukuoka
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Fukui
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - T Iwasawa
- Kanagawa Cardiovascular and Respiratory Center, Radiology, Yokohama, Japan
| | - D Utsunomiya
- Yokohama City University Hospital, Diagnostic Radiology, Yokohama, Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiology, Yokohama, Japan
| | - K Tamura
- Yokohama City University Hospital, Medical Science and Cardiorenal Medicine, Yokohama, Japan
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Azuma M, Kato S, Kodama S, Hayakawa K, Kagimoto M, Iguchi K, Fukuoka M, Fukui K, Iwasawa T, Utsunomiya D, Kimura K, Tamura K. Extracellular volume fraction by T1 mapping predicts omprovement of left ventricular ejection fraction after catheter ablation in patients with non-ischemic cardiomyopathy and atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0261] [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
The Catheter Ablation versus Standard Conventional Therapy in Patients with Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF) trial has shown that the catheter ablation (CA) for atrial fibrillation (AF) significantly reduced the risk of death and hospitalization for heart failure in patients with non-ischemic dilated cardiomyopathy (NIDCM) and AF (N Engl J Med 2018; 378:417–27). In addition, the Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction (CAMERA-MRI) study demonstrated that the absence of myocardial fibrosis on late gadolinium enhanced (LGE) magnetic resonance imaging (MRI) is associated with improvement of left ventricular systolic function after CA in NIDCM patients with AF (J Am Coll Cardiol 2017; 70:1949–61). Extracellular volume fraction (ECV) by T1 mapping has emerges as a non-invasive mean to quantify diffuse myocardial fibrosis.
Purpose
The aim of this study was to compare the predictive value of LGE-MRI and ECV by T1 mapping for the prediction of improvement of LVEF after CA in NIDCM patients.
Methods
A total of twenty-eight patients with NIDCM and AF (age: 67±10 years; 25 (89%) male; LVEF: 34.1±8.8%) were studied. Using a 1.5T MR scanner and 32 channel cardiac coils, cine MRI, LGE-MRI, pre- and post- T1 mapping images of LV wall at mid-ventricular level (modified Look-Locker inversion recovery sequence) were acquired. Myocardial fibrosis on LGE was defined as area with >5SD signal intensity of normal myocardium. ECV from six segments of mid ventricular level were averaged for each patient. All patients underwent CA for AF, and the improvement of LVEF before and after CA were evaluated by echocardiography.
Results
All patients restored sinus rhythm after CA at the time of echocardiography. The mean LVEF was 34.1±8.8% before CA and 49.1±12.0% after CA (p<0.001), resulting an improvement of 15.0±11.8%. Significant correlation was found between improvements in LVEF and amount of fibrosis on LGE-MRI (r=−0.40, p=0.034), improvement of LVEF and ECV (r=−0.55, p=0.008). In the ROC analysis, ECV had a higher discriminative ability for the improvement of LVEF after CA compared with amount of fibrosis on LGE-MRI (AUC 0.885 vs 0.650) (Figure).
Conclusions
In NIDCM patients with AF, ECV by T1 mapping had better predictive ability for improvement of LVEF after CA in comparison to LGE-MRI.
ROC curves of ECV and LGE-MRI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Azuma
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - S Kato
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - S Kodama
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Hayakawa
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - M Kagimoto
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Iguchi
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - M Fukuoka
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - K Fukui
- Kanagawa Cardiovascular and Respiratory Center, Cardiology, Yokohama, Japan
| | - T Iwasawa
- Kanagawa Cardiovascular and Respiratory Center, Radiology, Yokohama, Japan
| | - D Utsunomiya
- Yokohama City University Hospital, Diagnostic Radiology, Yokohama, Japan
| | - K Kimura
- Yokohama City University Medical Center, Cardiology, Yokohama, Japan
| | - K Tamura
- Yokohama City University Hospital, Medical Science and Cardiorenal Medicine, Yokohama, Japan
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14
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Hinokuma N, Nakashima M, Asai H, Nakamura K, Akaboshi S, Fukuoka M, Togawa M, Oana S, Ohno K, Kasai M, Ogawa C, Yamamoto K, Okumiya K, Chong PF, Kira R, Uchino S, Fukuyama T, Shinagawa T, Miyata Y, Abe Y, Hojo A, Kobayashi K, Maegaki Y, Ishikawa N, Ikeda H, Amamoto M, Mizuguchi T, Iwama K, Itai T, Miyatake S, Saitsu H, Matsumoto N, Kato M. Clinical and genetic characteristics of patients with Doose syndrome. Epilepsia Open 2020; 5:442-450. [PMID: 32913952 PMCID: PMC7469791 DOI: 10.1002/epi4.12417] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To elucidate the genetic background and genotype-phenotype correlations for epilepsy with myoclonic-atonic seizures, also known as myoclonic-astatic epilepsy (MAE) or Doose syndrome. METHODS We collected clinical information and blood samples from 29 patients with MAE. We performed whole-exome sequencing for all except one MAE case in whom custom capture sequencing identified a variant. RESULTS We newly identified four variants: SLC6A1 and HNRNPU missense variants and microdeletions at 2q24.2 involving SCN1A and Xp22.31 involving STS. Febrile seizures preceded epileptic or afebrile seizures in four patients, of which two patients had gene variants. Myoclonic-atonic seizures occurred at onset in four patients, of which two had variants, and during the course of disease in three patients. Variants were more commonly identified in patients with a developmental delay or intellectual disability (DD/ID), but genetic status was not associated with the severity of DD/ID. Attention-deficit/hyperactivity disorder and autistic spectrum disorder were less frequently observed in patients with variants than in those with unknown etiology. SIGNIFICANCE MAE patients had genetic heterogeneity, and HNRNPU and STS emerged as possible candidate causative genes. Febrile seizures prior to epileptic seizures and myoclonic-atonic seizure at onset indicate a genetic predisposition to MAE. Comorbid conditions were not related to genetic predisposition to MAE.
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Affiliation(s)
- Nodoka Hinokuma
- Department of PediatricsShowa University School of MedicineTokyoJapan
| | - Mitsuko Nakashima
- Department of BiochemistryHamamatsu University School of MedicineHamamatsuJapan
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hideyuki Asai
- Department of PediatricsShowa University School of MedicineTokyoJapan
| | - Kazuyuki Nakamura
- Department of PediatricsYamagata University Faculty of MedicineYamagataJapan
| | | | - Masataka Fukuoka
- Shizuoka Institute of Epilepsy and Neurological DisordersShizuokaJapan
| | - Masami Togawa
- Department of PediatricsTottori Prefectural Central HospitalTottoriJapan
| | - Shingo Oana
- Department of PediatricsTokyo Medical UniversityTokyoJapan
| | - Koyo Ohno
- Division of Child NeurologyInstitute of Neurological SciencesFaculty of MedicineTottori UniversityYonagoJapan
| | - Mariko Kasai
- Department of Developmental Medical Sciences Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Chikako Ogawa
- Department of PediatricsNagoya University Graduate School of MedicineAichiJapan
| | - Kazuna Yamamoto
- Department of PediatricsTeikyo University School of MedicineTokyoJapan
| | - Kiyohito Okumiya
- Department of Pediatrics and Child HealthKurume University School of MedicineFukuokaJapan
| | - Pin Fee Chong
- Department of Pediatric NeurologyFukuoka Children's HospitalFukuokaJapan
| | - Ryutaro Kira
- Department of Pediatric NeurologyFukuoka Children's HospitalFukuokaJapan
| | - Shumpei Uchino
- Department of NeuropediatricsTokyo Metropolitan Neurological HospitalTokyoJapan
- Department of PediatricsThe University of TokyoTokyoJapan
| | - Tetsuhiro Fukuyama
- Department of PediatricsShinshu University School of MedicineMatsumotoJapan
| | | | - Yohane Miyata
- Department of PediatricsKyorin University Faculty of MedicineTokyoJapan
| | - Yuichi Abe
- Department of PediatricsSaitama Medical UniversityMoroyamaJapan
- Division of NeurologyNational Center for Child Health and DevelopmentTokyoJapan
| | - Akira Hojo
- Department of PediatricsShowa University School of MedicineTokyoJapan
| | - Kozue Kobayashi
- Department of PediatricsShowa University School of MedicineTokyoJapan
| | - Yoshihiro Maegaki
- Division of Child NeurologyInstitute of Neurological SciencesFaculty of MedicineTottori UniversityYonagoJapan
| | | | - Hiroko Ikeda
- Shizuoka Institute of Epilepsy and Neurological DisordersShizuokaJapan
| | - Masano Amamoto
- Kitakyushu City Yahata Hospital Pediatric Emergency/Children’s Medical CenterFukuokaJapan
| | - Takeshi Mizuguchi
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kazuhiro Iwama
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Toshiyuki Itai
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Satoko Miyatake
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Hirotomo Saitsu
- Department of BiochemistryHamamatsu University School of MedicineHamamatsuJapan
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Naomichi Matsumoto
- Department of Human GeneticsYokohama City University Graduate School of MedicineYokohamaJapan
| | - Mitsuhiro Kato
- Department of PediatricsShowa University School of MedicineTokyoJapan
- Department of PediatricsYamagata University Faculty of MedicineYamagataJapan
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15
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Fullard L, Godfrey A, Manaf M, Davies C, Cliff A, Fukuoka M. Mixing experiments in 3D-printed silos; the role of wall friction and flow correcting inserts. ADV POWDER TECHNOL 2020. [DOI: 10.1016/j.apt.2020.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Ota T, Fukui T, Nakahara Y, Takeda T, Uchino J, Mouri T, Kudo K, Nakajima S, Suzumura T, Okabe T, Hayashi H, Miyatake N, Nakano Y, Terashima M, Hasegawa Y, Tsukuda H, Matsui K, Masuda N, Fukuoka M. P1.04-40 Serum Perforin Levels During the First Cycle of Anti-PD-1 Antibody Therapies in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Hashimoto A, Kuki I, Fukuoka M, Kim K, Inoue T, Nukui M, Okazaki S, Kawawaki H, Nakamura Y, Saitoh S. Chronological dynamic changes in cortico-subcortical imbalance of cerebral blood flow in a boy with CAPOS syndrome. Brain Dev 2019; 41:625-629. [PMID: 30904181 DOI: 10.1016/j.braindev.2019.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 02/28/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy and Sensorineural hearing loss (CAPOS) syndrome is a known ATP1A3-related disorder, but little has been elucidated regarding its pathophysiology. We now report two new patients, a Japanese boy and his mother with a pathogenic mutation (c.2452G>A) in ATP1A3, who were diagnosed with CAPOS syndrome. METHODS After febrile illnesses at 7 months of age, and again at 22 months of age, the boy had a reduced level of consciousness, truncal ataxia and eye movement-disorders. The patient's 32-year-old mother may have experienced an episode of acute encephalopathy in her childhood and sustained sensorineural hearing loss. In the present study, we demonstrated chronological dynamic changes in cerebral blood flow (CBF) in the son, using serial single-photon emission computed tomography (SPECT). RESULTS The serial CBF-SPECT findings using statistical methods showed progressive hyperperfusion in the frontal lobes, basal ganglia and thalamus, and hypoperfusion in the occipital and temporal lobes during the acute and subacute phases. Thereafter, the dynamic changes of CBF improved in the chronic but hypoperfusion in thalamus appeared to the chronic phase. CONCLUSION The abnormal cortico-subcortical CBF may contribute to an acute encephalopathy-like condition in the acute stage of CAPOS syndrome. CAPOS syndrome is not often reported, and is possibly an under-recognized syndrome in clinically mild cases.
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Affiliation(s)
- Aya Hashimoto
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yuji Nakamura
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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18
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Iwai K, Amo K, Kuki I, Fukuoka M, Kim K, Yamairi C, Togawa M. An unusual manifestation of Sjögren syndrome encephalitis. Brain Dev 2019; 41:217-220. [PMID: 30170935 DOI: 10.1016/j.braindev.2018.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022]
Abstract
Sjögren syndrome (SS) is a systemic inflammatory and autoimmune disease characterized by systemic disorders of the exocrine glands, predominantly the salivary and lacrimal glands. Here, we report a 4-year-old boy who presented with the repetition of generalized tonic-clonic seizures for 1-2 min. Initially, he was diagnosed with idiopathic autoimmune encephalitis and was treated with steroids. He was eventually diagnosed with SS based on the examination results, such as inflammatory cell infiltration into the minor salivary glands and positive serum anti-SSA/Ro antibody. Although central nervous system complications are rare in pediatric SS, this condition should be considered in the differential diagnosis when a patient presents with idiopathic autoimmune encephalitis of unknown cause. Furthermore, SS can occur in relatively young children and can present without imaging abnormalities.
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Affiliation(s)
- Kenji Iwai
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan.
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Chiharu Yamairi
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Masao Togawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
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19
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Fullard LA, Breard ECP, Davies CE, Godfrey AJR, Fukuoka M, Wade A, Dufek J, Lube G. The dynamics of granular flow from a silo with two symmetric openings. Proc Math Phys Eng Sci 2019; 475:20180462. [PMID: 30760953 DOI: 10.1098/rspa.2018.0462] [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] [Received: 07/12/2018] [Accepted: 11/29/2018] [Indexed: 12/30/2022] Open
Abstract
The dynamics of granular flow in a rectangular silo with two symmetrically placed exit openings is investigated using particle image velocimetry (PIV), flow rate measurements and discrete element modelling (DEM). The flow of mustard seeds in a Perspex silo is recorded using a high-speed camera and the resulting image frames are analysed using PIV to obtain velocity, velocity divergence and shear rate plots. A change in flow structure is observed as the distance L between the two openings is varied. The mass flow rate is shown to be at a maximum at zero opening separation, decreasing as L is increased; it then reaches a minimum before rising to an equilibrium rate close to two times that of an isolated (non-interacting) opening. The flow rate experiment is repeated using amaranth and screened sand and similar behaviour is observed. Although this result is in contrast with some recent DEM and physical experiments in silo systems, this effect has been reported in an analogous system: the evacuation of pedestrians from a room through two doors. Our experimental results are replicated using DEM and we show that inter-particle friction controls the flow rate behaviour and explains the discrepancies in the literature results.
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Affiliation(s)
- L A Fullard
- Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
| | - E C P Breard
- Department of Earth Sciences, University of Oregon, Eugene, OR, USA
| | - C E Davies
- School of Engineering and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A J R Godfrey
- Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand
| | - M Fukuoka
- School of Engineering and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - A Wade
- School of Engineering and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - J Dufek
- Department of Earth Sciences, University of Oregon, Eugene, OR, USA
| | - G Lube
- Volcanic Risk Solutions, Massey University, Palmerston North, New Zealand
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20
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Uda T, Kunihiro N, Nakajo K, Kuki I, Fukuoka M, Ohata K. Seizure freedom from temporal lobe epilepsy with mesial temporal lobe tumor by tumor removal alone without hippocampectomy despite remaining abnormal discharges on intraoperative electrocorticography: Report of two pediatric cases and reconsideration of the surgical strategy. Surg Neurol Int 2018; 9:181. [PMID: 30283714 PMCID: PMC6157038 DOI: 10.4103/sni.sni_61_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 08/09/2018] [Indexed: 11/24/2022] Open
Abstract
Background: In the surgical treatment of temporal lobe epilepsy with mesial temporal lobe tumor, whether to remove the hippocampus aiming for a better seizure outcome in addition to removing the tumor is a dilemma. Two pediatric cases treated successfully with tumor removal alone are presented. Case Description: The first case was an 11-year-old girl with a ganglioglioma in the left uncus, and the second case was a 9-year-old girl with a pleomorphic xanthoastrocytoma in the left parahippocampal gyrus. In both cases, the hippocampus was not invaded, merely compressed by the tumor. Tumor removal was performed under intraoperative electrocorticography (ECoG) monitoring. After tumor removal, abnormal discharges remained at the hippocampus and adjacent temporal cortices, but further surgical interventions were not performed. The seizures disappeared completely in both cases. Conclusions: When we must decide whether to remove the hippocampus, the side of the lesion, the severity and chronicity of the seizures, and the presence of invasion to the hippocampus are the factors that should be considered. Abnormal discharges on ECoG at the hippocampus or adjacent cortices are one of the factors related to epileptogenicity, but it is simply a result of interictal irritation, and it is not an absolute indication for additional surgical intervention.
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Affiliation(s)
- Takehiro Uda
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Kosuke Nakajo
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kenji Ohata
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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21
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Ota T, Takeda T, Fukui T, Nakahara Y, Kudo K, Okabe T, Hayashi H, Otani S, Hiyoshi Y, Yonesaka K, Sugiura T, Suzumura T, Terashima M, Nakano Y, Hasegawa Y, Tsukuda H, Matsui K, Masuda N, Fukuoka M. Serum biomarkers during the first cycle of anti-PD-1 antibody therapies in non-small cell lung cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.073] [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: 11/15/2022] Open
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22
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Yoshioka H, Katakami N, Okamoto H, Iwamoto Y, Seto T, Takahashi T, Sunaga N, Kudoh S, Chikamori K, Harada M, Tanaka H, Saito H, Saka H, Takeda K, Nogami N, Masuda N, Harada T, Kitagawa H, Horio H, Yamanaka T, Fukuoka M, Yamamoto N, Nakagawa K. A randomized, open-label, phase III trial comparing amrubicin versus docetaxel in patients with previously treated non-small-cell lung cancer. Ann Oncol 2017; 28:285-291. [PMID: 28426104 DOI: 10.1093/annonc/mdw621] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Amrubicin is approved for treating non-small-cell lung cancer (NSCLC) and small-cell lung cancer. However, no direct comparisons between amrubicin and docetaxel, a standard treatment for NSCLC, have been reported. Patients and methods We conducted a randomized phase III trial of Japanese NSCLC patients after one or two chemotherapy regimens. Patients were randomized to amrubicin (35 mg/m2 on days 1-3 every 3 weeks) or docetaxel (60 mg/m2 on day 1 every 3 weeks). Outcomes included progression-free survival, overall survival, tumor responses, and safety. Results Between October 2010 and June 2012, 202 patients were enrolled across 32 institutions. Median progression-free survival (3.6 versus 3.0 months; P = 0.54) and overall survival (14.6 versus 13.5 months; P = 0.86) were comparable in the amrubicin and docetaxel groups, respectively. The overall response rate was 14.4% (14/97) and 19.6% (19/97) in the amrubicin and docetaxel groups, respectively (P = 0.45). The disease control rate was 55.7% in both groups. Adverse events occurred in all patients, and included grade ≥3 neutropenia occurred in 82.7% and 78.8% of patients in the amrubicin and docetaxel groups, respectively, grade ≥3 leukopenia occurred in 63.3% and 70.7%, and grade ≥3 febrile neutropenia occurred in 13.3% and 18.2% of patients in the amrubicin and docetaxel groups, respectively. Of eight cardiac-related events in the amrubicin group, three were considered related to amrubicin and resolved without treatment discontinuation. Conclusions This was the first phase III study to compare amrubicin and docetaxel in patients with pretreated NSCLC. Amrubicin did not significantly improve the primary endpoint of PFS compared with docetaxel. Clinical trial registration NCT01207011 (ClinicalTrials.gov).
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Affiliation(s)
- H Yoshioka
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama
| | - N Katakami
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Hyogo
| | - H Okamoto
- Department of Respiratory Medicine and Medical Oncology, Yokohama Municipal Citizen's Hospital, Kanagawa
| | - Y Iwamoto
- Department of Medical Oncology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima
| | - T Seto
- Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka
| | - T Takahashi
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka
| | - N Sunaga
- Department of Medicine and Molecular Science, Gunma University School of Medicine, Gunma
| | - S Kudoh
- Department of Respiratory Medicine, Osaka City University Hospital, Osaka
| | - K Chikamori
- Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Yamaguchi
| | - M Harada
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Sapporo
| | - H Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata
| | - H Saito
- Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Aichi
| | - H Saka
- Respiratory Medicine and Medical Oncology, National Hospital Organization Nagoya Medical Center, Aichi
| | - K Takeda
- Department of Medical Oncology, Osaka City General Hospital, Osaka
| | - N Nogami
- Department of Respiratory Medicine, National Hospital Organization Shikoku Cancer Center, Ehime
| | - N Masuda
- Department of Respiratory Medicine, Kitasato University Hospital, Kanagawa
| | - T Harada
- Center of Respiratory Disease, Japan Community Health Care Organization Hokkaido Hospital, Sapporo
| | - H Kitagawa
- Drug Development Division, Sumitomo Dainippon Pharma. Co, Ltd, Tokyo
| | - H Horio
- Drug Development Division, Sumitomo Dainippon Pharma. Co, Ltd, Tokyo
| | - T Yamanaka
- Department of Biostatistics and Epidemiology, Graduate School of Medicine, Yokohama City University, Kanagawa
| | - M Fukuoka
- Medical Oncology, Izumi Municipal Hospital, Osaka
| | - N Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University Hospital, Wakayama
| | - K Nakagawa
- Department of Medical Oncology, Faculty of Medicine, Kinki University Hospital, Osaka, Japan
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23
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Inoue T, Kawawaki H, Fukuoka M, Kim K, Nukui M, Kuki I, Okazaki S, Koh S, Kunihiro N, Uda T, Matsusaka Y, Matsuhashi M, Iimura Y, Otsubo H. Intraoperative cortico-cortical evoked potentials show disconnection of the motor cortex from the epileptogenic network during subtotal hemispherotomy. Clin Neurophysiol 2017; 129:455-457. [PMID: 29306848 DOI: 10.1016/j.clinph.2017.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan.
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Saya Koh
- Department of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Takehiro Uda
- Department of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan; Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-5-7, Asahimachi, Abeno-ku, Osaka 545-8586, Japan
| | - Yasuhiro Matsusaka
- Department of Pediatric Neurosurgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka 534-0021, Japan
| | - Masao Matsuhashi
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yasushi Iimura
- Divison of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X3, Canada
| | - Hiroshi Otsubo
- Divison of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X3, Canada
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24
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Kimura K, Hohjoh H, Fukuoka M, Sato W, Takahashi R, Yamamura T. Suppression of regulatory T cells by exosomes via LET-7I-IGF1R/TGFBR1 axis in multiple sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3475] [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: 11/30/2022]
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25
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Fukuoka M, Kuki I, Horino A, Kim K, Hattori Y, Tsuji H, Nukui M, Okazaki S, Kawawaki H, Yoshida Y, Ishikawa J, Rinka H. A child with acute transverse myelitis requiring permanent pacemaker implantation. Brain Dev 2017; 39:811-814. [PMID: 28551037 DOI: 10.1016/j.braindev.2017.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/30/2017] [Accepted: 05/05/2017] [Indexed: 11/18/2022]
Abstract
We diagnosed a 3-year-old girl with acute transverse myelitis (ATM). She presented with weakness of the limbs and developed urination difficulty and respiratory disturbance. Magnetic resonance imaging revealed a symmetric area of high signal intensity on T2-weighted images involving the lower end of the medulla oblongata to the level of the fourth thoracic vertebra. Anti-aquaporin-4 antibody was negative. She was treated with intravenous methylprednisolone pulse therapy, immunoglobulin therapy, and plasmapheresis; however, her clinical symptoms did not change. At 10 and 20days after symptom onset, cardiac arrest occurred on postural change, requiring cardiopulmonary resuscitation. A permanent pacemaker was implanted 23days after onset. In the presence of sympathetic nerve hypofunction, relative hyperactivity of the parasympathetic nerves may have led to severe bradycardia and cardiac arrest in the presence of an inducer, such as a postural change. This is the first reported case of pacemaker implantation for management of ATM.
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Affiliation(s)
- Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Asako Horino
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yuka Hattori
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hitomi Tsuji
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yoko Yoshida
- Department of Pediatric Electrophysiology, Osaka City General Hospital, Osaka, Japan
| | - Jyunichi Ishikawa
- Department of Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Department of Emergency Medicine, Osaka City General Hospital, Osaka, Japan
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26
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Fukuoka M, Kuki I, Kawawaki H, Kim K, Hattori Y, Tsuji H, Horino A, Nukui M, Okazaki S. Reply to the remarks about "A pediatric patient of hemorrhagic acute transverse myelitis". Brain Dev 2017; 39:456. [PMID: 28089122 DOI: 10.1016/j.braindev.2016.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 12/27/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yuka Hattori
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hitomi Tsuji
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Asako Horino
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
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Fukuoka M, Kuki I, Kawawaki H, Kim K, Hattori Y, Tsuji H, Horino A, Nukui M, Okazaki S. A pediatric patient of hemorrhagic acute transverse myelitis. Brain Dev 2017; 39:252-255. [PMID: 27686688 DOI: 10.1016/j.braindev.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 04/21/2016] [Revised: 09/12/2016] [Accepted: 09/12/2016] [Indexed: 01/27/2023]
Abstract
An 11-year-old boy presented with progressive leg hypesthesia but no history of trauma. Dysuria and constipation appeared subsequent to gait difficulty. He was admitted 8days after onset. Spinal magnetic resonance imaging (MRI) revealed longitudinal hyperintensity with cord swelling and hypointensity on T2-weighted images, suggesting severe inflammation and microbleeding change, respectively. Gadolinium contrast-enhanced MRI demonstrated mild enhancement in the lesions. Platelet count and coagulation findings were normal, and cerebrospinal fluid analysis showed no pleocytosis. He was diagnosed with idiopathic acute transverse myelitis (ATM), and intravenous methylprednisolone pulse therapy and plasmapheresis were initiated. On day 14, motor dysfunction aggravated suddenly, accompanied by expanding hemorrhagic lesions. Thereafter, administration of intravenous immunoglobulin, repeated intravenous methylprednisolone pulse therapy and prednisolone for one month resulted in complete recovery four months later. Both anti-aquaporin-4 and anti-myelin oligodendrocyte glycoprotein antibodies were negative. We presented the first pediatric case showing hemorrhagic spinal lesions in the clinical course of ATM. This severe complication should be recognized in the management of ATM.
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Affiliation(s)
- Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yuka Hattori
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hitomi Tsuji
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Asako Horino
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
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28
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Fukuoka M, Kuki I, Kawawaki H, Okazaki S, Kim K, Hattori Y, Tsuji H, Nukui M, Inoue T, Yoshida Y, Uda T, Kimura S, Mogami Y, Suzuki Y, Okamoto N, Saitsu H, Matsumoto N. Quinidine therapy for West syndrome with KCNTI mutation: A case report. Brain Dev 2017; 39:80-83. [PMID: 27578169 DOI: 10.1016/j.braindev.2016.08.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [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: 05/26/2016] [Revised: 08/01/2016] [Accepted: 08/07/2016] [Indexed: 11/26/2022]
Abstract
The KCNT1 gene encodes the sodium-dependent potassium channel, with quinidine being a partial antagonist of the KCNT1 channel. Gain-of-function KCNT1 mutations cause early onset epileptic encephalopathies including migrating partial seizures of infancy (MPSI). At 5months of age, our patient presented with epileptic spasms and hypsarrhythmia by electroencephalogram. Psychomotor retardation was observed from early infancy. The patient was diagnosed with West syndrome. Consequently, various anti-epileptic drugs, adrenocorticotropic hormone therapy (twice), and ketogenic diet therapy were tried. However, the epileptic spasms were intractable. Whole exome sequencing identified a KCNT1 mutation (c.1955G>T; p.G652V). At 2years and 6months, the patient had daily epileptic spasms despite valproate and lamotrigine treatment, and was therefore admitted for quinidine therapy. With quinidine therapy, decreased epileptic spasms and decreased epileptiform paroxysmal activity were observed by interictal EEG. Regarding development, babbling, responsiveness, oral feeding and muscle tone were ameliorated. Only transient diarrhea was observed as an adverse effect. Thus, quinidine therapy should be attempted in patients with West syndrome caused by KCNT1 mutations, as reported for MPSI.
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Affiliation(s)
- Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyohiro Kim
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yuka Hattori
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hitomi Tsuji
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Yoko Yoshida
- Department of Pediatric Electrophysiology, Osaka City General Hospital, Osaka, Japan
| | - Takehiro Uda
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Sadami Kimura
- Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yukiko Mogami
- Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yasuhiro Suzuki
- Department of Pediatric Neurology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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29
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Horino A, Kawawaki H, Fukuoka M, Tsuji H, Hattori Y, Inoue T, Nukui M, Kuki I, Okazaki S, Tomiwa K, Hirose S. A case of succinic semialdehyde dehydrogenase deficiency with status epilepticus and rapid regression. Brain Dev 2016; 38:866-70. [PMID: 27117035 DOI: 10.1016/j.braindev.2016.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 08/30/2015] [Revised: 03/26/2016] [Accepted: 03/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clinical phenotypic expression of SSADH deficiency is highly heterogeneous, and some infants may develop refractory secondary generalized seizures. PATIENT A 9-month-old boy manifested partial seizures, developing severe status epilepticus, and conventional antiepileptic drugs were ineffective. Use of ketamine contributed to the control of status epilepticus, achieving a reduction in frequency of partial seizures, and improving EEG findings without apparent complications. Diffusion-weighted images showed hyperintensities in the bilateral basal ganglia and fornix, and multiple T2 hyperintensity lesions were detected. (123)I-iomazenil (IMZ) SPECT revealed a decrease in binding of (123)I-iomazenil predominantly in the left temporal region by the 18th day of hospitalization. However, repeated IMZ-SPECT on the 46th day of hospitalization demonstrated almost no accumulation across a broad region, sparing the left temporal region. The patient showed rapid regression, refractory myoclonus, and severe progressive brain atrophy. CONCLUSION IMZ-SPECT findings demonstrated reduced benzodiazepine receptor binding and its dynamic changes in an SSADH-deficient patient. Considering the down regulation of the GABAA receptor, ketamine should be included in pharmacotherapeutic strategies for treatment of refractory status epilepticus in SSADH-deficient patients.
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Affiliation(s)
- Asako Horino
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan.
| | - Hisashi Kawawaki
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Hitomi Tsuji
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Yuka Hattori
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Ichiro Kuki
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Kiyotaka Tomiwa
- Departments of Pediatric Neurology, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Shinichi Hirose
- Department of Pediatric, Fukuoka University, School of Medicine, Japan
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Abstract
Purpose: To report an important complication related to carotid stenting. Methods and Results: A 71-year-old man with symptomatic subtotal occlusion of the left internal carotid artery had a 30-mm lesion treated percutaneously with implantation of 2 stents. Although the procedure was completed satisfactorily, left intraventricular hemorrhage occurred 4 hours later, possibly related to hyperperfusion injury. The patient expired 30 days after the stent procedure. Preoperative single-photon emission computed tomography revealed severely reduced vasoreactivity in the affected territory after acetazolamide challenge. Conclusions: The risk of hyperperfusion injury must be considered and minimized in patients with significant restriction of regional vasoreactivity. We recommend that cerebral hemodynamic status be determined prior to carotid stenting.
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Affiliation(s)
- T Mori
- Department of Neurosurgery, Kochi Medical School Hospital, Okoutyo, Nankoku City, Japan.
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31
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Mori T, Kazita K, Fukuoka M, Mori K. Carotid and Vertebral Stenting: Preliminary Report. Interv Neuroradiol 2016; 3 Suppl 2:59-61. [DOI: 10.1177/15910199970030s210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/1997] [Accepted: 09/18/1997] [Indexed: 11/15/2022] Open
Abstract
We report our initial experience of carotid and vertebral stenting. Three haemodynamically significant extra-cranial lesions (% diameter stenosis >70) in 3 clinically symptomatic patients were treated by stenting between March 1996 and September 1996. Two lesions of the internal carotid arteries were ostial and in one case a subtotal stenosis and ostial lesion of the vertebral artery were observed. All lesions looked more widely and smoothly dilated by stenting than by ordinary standard balloon angioplasty.
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Affiliation(s)
- T. Mori
- Department of Neurosurgery, Kochi Medical School; Kochi
| | - K. Kazita
- Department of Neurosurgery, Kochi Medical School; Kochi
| | - M. Fukuoka
- Department of Neurosurgery, Kochi Medical School; Kochi
| | - K. Mori
- Department of Neurosurgery, Kochi Medical School; Kochi
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32
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Kazita K, Mori T, Fukuoka M, Mori K. Follow-up Study after Percutaneous Transluminal Cerebral Angioplasty. Interv Neuroradiol 2016; 4 Suppl 1:49-52. [DOI: 10.1177/15910199980040s108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/1998] [Accepted: 08/25/1998] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to assess the safety and efficacy of percutaneous transluminal cerebral balloon angioplasty (PTCBA) of extra- and intra-cranial arteries by investigating procedural outcome. Eighty haemodynamically significant extra- and intra-cranial lesions (% diameter stenosis >70) in 74 clinically symptomatic patients were treated by elective and initial PTCBA between March 1991 and February 1996 and followed thereafter. Death, stroke including transient ischemia, surgery, or repeated angioplasty of restenosis or new lesions were regarded as cerebral events after the initial PTCBA. Crescendo ischaemic symptoms disappeared completely after clinically successful dilatation. The clinical success rate was 81% (65/80). Angiographic restenosis rate at 3 months was 22% (14/65). By life-table method, the death/stroke risk was 16% and death/stroke/surgery/repeated PTCBA risk was 49 % at 2 years following PTCBA, respectively. In conclusion, PTCBA successfully, decreased recurrent neurological symptoms and produced a favourable short-term outcome, whereas restenosis limited long-term benefit.
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Affiliation(s)
| | | | | | - K. Mori
- Department of Neurosurgery, Kochi Medical School; Kochi, Japan
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33
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Mok T, Saijo N, Thongprasert S, Yang JH, Wu YL, Young H, Haddad V, Jiang H, Fukuoka M. 426PD Efficacy by blind independent central review (BICR): Post hoc analyses of the phase III, multicentre, randomised IPASS study of 1st-line gefitinib (G) vs carboplatin/paclitaxel (C/P) in Asian patients (pts) with EGFR mutation-positive advanced NSCLC. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv532.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Emoto-Yamamoto Y, Iida S, Kawanishi T, Fukuoka M. Population pharmacokinetics of erlotinib in Japanese patients with advanced non-small cell lung cancer. J Clin Pharm Ther 2014; 40:232-9. [DOI: 10.1111/jcpt.12232] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 10/20/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Y. Emoto-Yamamoto
- Clinical Research Planning Department; Chugai Pharmaceutical Co. Ltd.; Tokyo Japan
| | - S. Iida
- Clinical Research Planning Department; Chugai Pharmaceutical Co. Ltd.; Tokyo Japan
| | - T. Kawanishi
- Clinical Research Planning Department; Chugai Pharmaceutical Co. Ltd.; Tokyo Japan
| | - M. Fukuoka
- Cancer Center; Izumi Municipal Hospital; Osaka Japan
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35
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Yano W, Kazuno H, Yokogawa T, Sakamoto K, Yoshisue K, Wakasa T, Fukuoka M, Matsuo K, Noguchi K, Utsugi T. 29 TAS-114 is a novel dUTPase/DPD inhibitor, its DPD inhibition reduces capecitabine dosage but does not diminish therapeutic window in human tumor xenografts. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70155-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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36
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Murakami H, Nokihara H, Shimizu T, Seto T, Keating A, Krivoshik A, Uegaki K, Morita S, Nakagawa K, Fukuoka M. 9LBA Antitumor activity of ASP8273, an irreversible mutant selective EGFR-TKI, in NSCLC patients with tumors harboring EGFR activating mutations and T790M resistance mutation. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70730-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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Urakami T, Hamada Y, Magarihuchi H, Yamaguchi H, Fukuoka M, Aoki Y. P32 A proposal for therapeutic drug monitoring (TDM)-guided therapy with beta-lactams. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70277-2] [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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38
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Soria JC, Mauguen A, Reck M, Sandler A, Saijo N, Johnson D, Burcoveanu D, Fukuoka M, Besse B, Pignon JP. Systematic review and meta-analysis of randomised, phase II/III trials adding bevacizumab to platinum-based chemotherapy as first-line treatment in patients with advanced non-small-cell lung cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mds590] [Citation(s) in RCA: 256] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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39
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Yokogawa T, Wakasa T, Yano W, Yoshisue K, Fujioka A, Eshima K, Fukuoka M, Matsuo K, Noguchi K, Utsugi T. 65 TAS-114 Enhances S-1 Activity in Vivo When Used in Combination. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71863-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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40
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Ohno A, Hirashima T, Kubo A, Masuda N, Takada M, Fujiwara H, Yasumitsu T, Kikui M, Fukuoka M, Nakagawa K. p53 status and prognosis in stage I-IIIa non-small cell lung cancer. Int J Oncol 2012; 10:521-8. [PMID: 21533407 DOI: 10.3892/ijo.10.3.521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
To investigate the role of p53 abnormalities in predicting the survival of patients with non-small cell lung cancer (NSCLC), polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and immunohistochemical analyses were performed on 74 and 67 tumor samples, respectively, from patients with pathological stage I-IIIa NSCLC. An abnormally migrating SSCP band was observed in 21 of 74 (28%) tumor specimens. DNA sequence analysis revealed 23 intragenic mutations including 3 small deletions and 20 point mutations. Immunohistochemical analysis using the DO-7 monoclonal antibody showed abnormal expression of p53 in 27 of 67 (40%) patients. The concordance rate between immunohistochemical and PCRSSCP analyses was 73% (49/67) in this study. Univariate and multivariate analyses demonstrated that abnormal expression of p53 may be associated with prolonged survival (p=0.0997 and 0.0099, respectively). In contrast, no relationship was observed between p53 mutation and overall survival (0.6968). These results suggest that p53 status and the survival outcome changes between immunohistochemical and mutational analyses in stage I-IIIa NSCLC.
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Affiliation(s)
- A Ohno
- KINKI UNIV,SCH MED,DEPT INTERNAL MED 4,OSAKA,OSAKA 589,JAPAN. GIFU UNIV,SCH MED,DEPT INTERNAL MED 2,GIFU 500,JAPAN. OSAKA PREFECTURE HABIKINO HOSP,DEPT INTERNAL MED,HABIKINO,OSAKA 583,JAPAN. OSAKA PREFECTURE HABIKINO HOSP,DEPT SURG,HABIKINO,OSAKA 583,JAPAN. OSAKA PREFECTURE HABIKINO HOSP,DEPT PATHOL,HABIKINO,OSAKA 583,JAPAN
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41
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Tsukuda H, Yonesaka K, Ikeda M, Otsuka M, Ozaki T, Sugiura T, Hasegawa Y, Makimura C, Matsuyama S, Fukushima M, Fukuoka M. Care Cycle on Advanced Cancer: Reforming a Value-Based System. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32227-4] [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] Open
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42
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Okada H, Murakami H, Yamanaka T, Seto T, Sugio K, Okamoto I, Sawa T, Hirashima T, Nakamura S, Fukuoka M, Nakanishi Y, Nakagawa K, Yamamoto N. Randomized Phase II Trial of Zoledronic Acid in Combination with Docetaxel in Previously Treated Non-Small-Cell Lung Cancer (NSCLC) Patients with Bone Metastases: WJTOG3806. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32040-8] [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: 11/30/2022] Open
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43
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Kiyohara Y, Yamazaki N, Seki A, Fukuoka M. Analysis of Erlotinib-Related Skin Toxicities from Japanese Post-Marketing Surveillance (Polarstar) in 9,909 Non-Small-Cell Lung Cancer (NSCLC) Patients (PTS). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33896-5] [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] Open
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44
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Katakami N, Atagi S, Yoshioka H, Fukuoka M, Ogiwara A, Imai M, Ueda M, Matsui S. Nested Case Control Study of Proteomic Biomarkers for Interstitial Lung Disease in Japanese Patients With Non-Small Cell Lung Cancer Treated With Erlotinib. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32800-3] [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] Open
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45
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Niho S, Ohe Y, Ishikura S, Atagi S, Yokoyama A, Ichinose Y, Okamoto H, Takeda K, Shibata T, Tamura T, Saijo N, Fukuoka M. Induction chemotherapy followed by gefitinib and concurrent thoracic radiotherapy for unresectable locally advanced adenocarcinoma of the lung: a multicenter feasibility study (JCOG 0402). Ann Oncol 2012; 23:2253-2258. [PMID: 22357446 DOI: 10.1093/annonc/mds012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND We conducted a feasibility study of induction chemotherapy followed by gefitinib and thoracic radiotherapy (TRT) for unresectable locally advanced adenocarcinoma of the lung. PATIENTS AND METHODS Patients received induction chemotherapy with cisplatin (80 mg/m(2), days 1 and 22) and vinorelbine (25 mg/m(2), days 1, 8, 22, and 29) followed by gefitinib (250 mg daily, beginning on day 43, for 1 year) and TRT (60 Gy/30 fractions, days 57-98). The primary end point was feasibility, which was defined as the proportion of patients who completed 60 Gy of TRT and received >75% of the planned dose of gefitinib without developing grade 2 or worse pneumonitis. RESULTS Of the 38 enrolled patients, 23 patients [60.5% ; 80% confidence interval (CI) 48.8-71.3] completed treatment without experiencing grade 2 or worse pneumonitis. During the chemoradiation phase, grade 3-4 alanine aminotransferase elevations were observed in 37.1% of the patients. The overall response rate was 73.0% . The median survival time was 28.5 months (95% CI 22.5-38.2), and the 2-year survival rate was 65.4% . CONCLUSIONS Although the results did not meet our criterion for feasibility, the toxicity was acceptable. This treatment warrants further evaluation among patients with locally advanced non-small-cell lung cancer harboring epidermal growth factor receptor mutations.
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Affiliation(s)
- S Niho
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa.
| | - Y Ohe
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa
| | - S Ishikura
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - S Atagi
- Department of Thoracic Oncology, Division of Internal Medicine, NHO Kinki-Chuo Chest Medical Center, Sakai
| | - A Yokoyama
- Department of Internal Medicine, Niigata Cancer Center, Niigata
| | - Y Ichinose
- Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka
| | - H Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama
| | - K Takeda
- Department of Clinical Oncology, Osaka City General Hospital, Osaka
| | - T Shibata
- Japan Clinical Oncology Group Data Center, Multi-institutional Clinical Trial Support Center, National Cancer Center, Tokyo
| | - T Tamura
- Division of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - N Saijo
- Department of Medical Oncology, Kinki University School of Medicine, Osaka, Japan
| | - M Fukuoka
- Department of Medical Oncology, Kinki University School of Medicine, Osaka, Japan
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46
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Ohe Y, Fukuoka M, Kudoh S, Nakagawa K, Johkoh T, Ando M, Yamazaki N, Takemoto S, Seki A. 9129 POSTER Safety Profile and Efficacy of Erlotinib in a Japanese Post-marketing Surveillance Study of 10,708 Non-small-cell Lung Cancer (NSCLC) Patients (pts) – Interim Analyses From the First 3,488 Pts. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72441-8] [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: 10/17/2022]
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47
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Yang J, Wu Y, Saijo N, Thongprasert S, Chu D, Chen Y, Duffield E, Rukazenkov Y, Mok T, Fukuoka M. 9132 POSTER Efficacy Outcomes in First-line Treatment of Advanced NSCLC With Gefitinib (G) vs Carboplatin/paclitaxel (C/P) by Epidermal Growth Factor Receptor (EGFR) Gene-copy Number Score and by Most Common EGFR Mutation Subtypes – Exploratory Data From IPASS. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72444-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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48
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Tsuva A, Kurata T, Tamiya A, Okamoto I, Sugimoto N, Matsumoto K, Goto I, Yamamoto N, Fukuoka M, Nakagawa K. 1259 POSTER A Phase II Study of Cisplatin Plus S-1 in Patients With Carcinomas of Unknown Primary Site. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70871-1] [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: 10/17/2022]
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49
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Wu Y, Fukuoka M, Mok T, Saijo N, Thongprasert S, Yang J, Chu D, Yang J, Rukazenkov Y. 9134 POSTER Tumour Response, Skin Rash and Health-related Quality of Life (HRQoL) – Post-hoc Data From the IPASS Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72446-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Hirai F, Murakami H, Yamamoto N, Yamanaka T, Okamoto I, Sawa T, Hirashima T, Takeda K, Fukuoka M, Nakagawa K. 9117 POSTER Randomized Phase II Trial of Zoledronic Acid in Combination With Docetaxel in Previously Treated Non-small Cell Lung Cancer (NSCLC) Patients With Bone Metastases – Result of a West Japan Oncology Group Study. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72429-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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