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Kodama H, Kawamura N, Ohya J, Onishi Y, Horii C, Nishizawa M, Sekimizu M, Ishino Y, Kunogi J. Two-year results of single-level fixation with lateral mass screws for cervical degenerative spondylolisthesis: patient series. J Neurosurg Case Lessons 2023; 6:CASE23343. [PMID: 37910011 PMCID: PMC10566526 DOI: 10.3171/case23343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND In surgery for cervical spondylotic myelopathy (CSM) with spondylolisthesis, there is no consensus on the correction and fixation for spondylolisthesis. The authors retrospectively studied whether the correction of single-level fixation with lateral mass screws (LMSs) could be maintained. OBSERVATIONS The records of patients with CSM with spondylolisthesis who had been treated with posterior decompression and single-level fusion with LMSs from 2017 to 2021 were retrospectively reviewed. Radiographic measurements included cervical parameters such as C2-7 lordosis, T1 slope, and the degree of spondylolisthesis (percent slippage) before surgery, immediately after surgery, and at the final observation. Ten cases (mean age 72.8 ± 7.8 years) were included in the final analysis, and four cases (40%) were on hemodialysis. The median observation period was 26.5 months (interquartile range, 12-35.75). The mean percent slippage was 16.8% ± 4.7% before surgery, 5.3% ± 4.0% immediately after surgery, and 6.5% ± 4.7% at the final observation. Spearman's rank correlation showed a moderate correlation between preoperative slippage magnitude and correction loss (r = 0.659; p = 0.038). Other parameters showed no correlation with correction loss. LESSONS For CSM with spondylolisthesis, single-level fixation with LMSs achieved and maintained successful correction in the 2-year observation.
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Kudo Y, Okano I, Toyone T, Kanzaki K, Segami K, Kawamura N, Sekimizu M, Maruyama H, Yamamura R, Hayakawa C, Tsuchiya K, Tani S, Ishikawa K, Inagaki K. Distal junctional failure after corrective surgery without pelvic fixation for thoracolumbar junctional kyphosis due to osteoporotic vertebral fracture. J Orthop Sci 2023:S0949-2658(23)00073-8. [PMID: 36931977 DOI: 10.1016/j.jos.2023.03.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Thoracolumbar junctional kyphosis (TLJK) due to osteoporotic vertebral fracture (OVF) negatively impacts patients' quality of life. The necessity of pelvic fixation in corrective surgery for TLJK due to OVF remains controversial. This study aimed to: 1) evaluate the surgical outcomes of major corrective surgery for thoracolumbar junctional kyphosis due to osteoporotic vertebral fracture, and 2) identify the risk factors for distal junctional failure to identify potential candidates for pelvic fixation. METHODS Patients who underwent surgical correction (fixed TLJK>40°, OVF located at T11-L2, the lowermost instrumented vertebra at or above L5) were included. Sagittal vertical axis, pelvic tilt, pelvic incidence, thoracic kyphosis, lumbar lordosis (L1-S1), local kyphosis, and lower lumbar lordosis (L4-S1) were assessed. Proximal and distal junctional kyphosis (P/DJK) and failures (P/DJF) were evaluated. Pre/postoperative spinopelvic parameters were compared between DJF and non-DJF patients. RESULTS Thirty-one patients (mean age: 72.3 ± 7.9 years) were included. PJK was observed in five patients (16.1%), while DJK in 11 (35.5%). Twelve cases (38.7%) were categorized as failure. Among the patients with PJK, there was only one patient (20%) categorized as PJF and required an additional surgery. Contrary, all of eleven patients with DJK were categorized as DJF, among whom six (54.5%) required additional surgery for pelvic fixation. In comparisons between DJF and non-DJF patients, there was no significant difference in pre/postoperative LK (pre/post, p = 0.725, p = 0.950). However, statistically significant differences were observed in the following preoperative alignment parameters: SVA (p = 0.014), LL (p = 0.001), LLL (p = 0.006), PT (p = 0.003), and PI-LL (p < 0.001). CONCLUSIONS Spinopelvic parameters, which represent the compensatory function of lumbar hyperlordosis and pelvic retroversion, have notable impacts on surgical outcomes in correction surgery for TLJK due to OVF. Surgeons should consider each patient's compensatory function when choosing a surgical approach.
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Affiliation(s)
- Yoshifumi Kudo
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan.
| | - Ichiro Okano
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Tomoaki Toyone
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Koji Kanzaki
- Department of Orthopedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama City, Kanagawa 227-8501, Japan
| | - Kazuyuki Segami
- Department of Orthopedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama City, Kanagawa 227-8501, Japan
| | - Naohiro Kawamura
- Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Tokyo, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Masaya Sekimizu
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan; Department of Spine and Orthopedic Surgery, Japanese Red Cross Medical Center, Tokyo, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Hiroshi Maruyama
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Ryo Yamamura
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Chikara Hayakawa
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Koki Tsuchiya
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Soji Tani
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Koji Ishikawa
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
| | - Katsunori Inagaki
- Department of Orthopedic Surgery, Showa University, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142-8666, Japan
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Matsumura T, Hashimoto H, Sekimizu M, Saito A, Asakura M, Kimura K, Iwata Y. VP.59 A single-arm, open-label, multicenter study of tranilast for advanced heart failure in patients with muscular dystrophy. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.253] [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: 11/07/2022]
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Hori D, Kobayashi R, Nakazawa A, Iwafuchi H, Klapper W, Osumi T, Fujita N, Mitsui T, Koga Y, Mori T, Fukano R, Ohki K, Kamei M, Mori T, Tanaka M, Tsuchimochi T, Moriya K, Tao K, Kada A, Sekimizu M. NON-GERMINAL CENTER B-CELL SUBTYPE OF PEDIATRIC DISFFUSE LARGE B-CELL LYMPHOMA IN JAPAN: A MULTI-CASE ANALYSIS. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00195-3] [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: 11/07/2022]
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Tani S, Ishikawa K, Kudo Y, Tsuchiya K, Matsuoka A, Maruyama H, Emori H, Yamamura R, Hayakawa C, Sekimizu M, Oshita Y, Ozawa T, Shirahata T, Nagai T, Toyone T, Inagaki K. The effect of denosumab on pedicle screw fixation: a prospective 2-year longitudinal study using finite element analysis. J Orthop Surg Res 2021; 16:219. [PMID: 33771178 PMCID: PMC7995779 DOI: 10.1186/s13018-021-02360-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pedicle screw loosening is a major complication following spinal fixation associated with osteoporosis in elderly. However, denosumab is a promising treatment in patients with osteoporosis. The effect of denosumab on pedicle screw fixation is unknown. Therefore, we investigated whether denosumab treatment improves pedicle screw fixation in elderly patients with osteoporosis. METHODS This was a 2-year prospective open-label study. From February 2015 to January 2016, we included 21 patients with postmenopausal osteoporosis who received initial denosumab treatment. At baseline, 12 months, and 24 months, we measured volumetric bone mineral density (BMD) using quantitative computed tomography (QCT) and performed CT-based finite element analysis (FEA). Finite element models of L4 vertebrae were created to analyze the bone strength and screw fixation. RESULTS BMD increased with denosumab treatment. FEA revealed that both pullout strength of pedicle screws and compression force of the vertebra increased significantly at 12 and 24 months following denosumab treatment. Notably, pullout strength showed a stronger correlation with three-dimensional volumetric BMD around pedicle screw placement assessed by QCT (r = 0.83, at 24 months) than with two-dimensional areal BMD assessed by dual energy X-ray absorptiometry (r = 0.35, at 24 months). CONCLUSION To our knowledge, this is the first study to reveal that denosumab treatment achieved strong pedicle screw fixation with an increase in BMD around the screw assessed by QCT and FEA; therefore, denosumab could be useful for osteoporosis treatment during spinal surgery in elderly patients with osteoporosis.
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Affiliation(s)
- Soji Tani
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Koji Ishikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan.
| | - Yoshifumi Kudo
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Koki Tsuchiya
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
- Department of Orthopaedic Surgery, Yamanashi Red Cross Hospital, 6663-1 Funatsu Fujikawaguchiko-machi, Minamitsuru-gun, Yamanashi, 401-0301, Japan
| | - Akira Matsuoka
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Hiroshi Maruyama
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Haruka Emori
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
- Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo Tsuzuki-ku, Yokohama, Kanagawa, Japan
| | - Ryo Yamamura
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Chikara Hayakawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Masaya Sekimizu
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Yusuke Oshita
- Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo Tsuzuki-ku, Yokohama, Kanagawa, Japan
| | - Tomoyuki Ozawa
- Department of Orthopaedic Surgery, Tokyo Kyosai Hospital, 2-3-8, Nakameguro, Meguro, Tokyo, 153-0061, Japan
| | - Toshiyuki Shirahata
- Department of Orthopaedic Surgery, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan
| | - Takashi Nagai
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Tomoaki Toyone
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8666, Japan
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Kudo Y, Okano I, Toyone T, Matsuoka A, Maruyama H, Yamamura R, Ishikawa K, Hayakawa C, Tani S, Sekimizu M, Hoshino Y, Ozawa T, Shirahata T, Fujita M, Oshita Y, Emori H, Omata H, Inagaki K. Lateral lumbar interbody fusion in revision surgery for restenosis after posterior decompression. Neurosurg Focus 2020; 49:E11. [PMID: 32871574 DOI: 10.3171/2020.6.focus20361] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/10/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the clinical results of revision interbody fusion surgery between lateral lumbar interbody fusion (LLIF) and posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF) with propensity score (PS) adjustments and to investigate the efficacy of indirect decompression with LLIF in previously decompressed segments on the basis of radiological assessment. METHODS A retrospective study of patients who underwent revision surgery for recurrence of neurological symptoms after posterior decompression surgery was performed. Postoperative complications and operative factors were evaluated and compared between LLIF and PLIF/TLIF. Moreover, postoperative improvement in cross-sectional areas (CSAs) in the spinal canal and intervertebral foramen was evaluated in LLIF cases. RESULTS A total of 56 patients (21 and 35 cases of LLIF and PLIF/TLIF, respectively) were included. In the univariate analysis, the LLIF group had significantly more endplate injuries (p = 0.03) and neurological deficits (p = 0.042), whereas the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), surgical site infections (SSIs) (p = 0.02), and estimated blood loss (EBL) (p < 0.001). After PS adjustments, the LLIF group still showed significantly more endplate injuries (p = 0.03), and the PLIF/TLIF group demonstrated significantly more dural tears (p < 0.001), EBL (p < 0.001), and operating time (p = 0.04). The PLIF/TLIF group showed a trend toward a higher incidence of SSI (p = 0.10). There was no statistically significant difference regarding improvement in the Japanese Orthopaedic Association scores between the 2 surgical procedures (p = 0.77). The CSAs in the spinal canal and foramen were both significantly improved (p < 0.001). CONCLUSIONS LLIF is a safe, effective, and less invasive procedure with acceptable complication rates for revision surgery for previously decompressed segments. Therefore, LLIF can be an alternative to PLIF/TLIF for restenosis after posterior decompression surgery.
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Affiliation(s)
- Yoshifumi Kudo
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Ichiro Okano
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Tomoaki Toyone
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Akira Matsuoka
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | | | - Ryo Yamamura
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Koji Ishikawa
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | | | - Soji Tani
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | | | - Yushi Hoshino
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Tomoyuki Ozawa
- 1Department of Orthopedic Surgery, Showa University, Tokyo
| | - Toshiyuki Shirahata
- 2Department of Orthopedic Surgery, Showa University Koto Toyosu Hospital, Tokyo; and
| | - Masayori Fujita
- 2Department of Orthopedic Surgery, Showa University Koto Toyosu Hospital, Tokyo; and
| | - Yusuke Oshita
- 3Department of Orthopedic Surgery, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Haruka Emori
- 3Department of Orthopedic Surgery, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Hiroaki Omata
- 3Department of Orthopedic Surgery, Showa University Northern Yokohama Hospital, Kanagawa, Japan
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Watanabe S, Shimomura A, Kubo T, Sekimizu M, Seo T, Watanabe SI, Kawai A, Yamamoto N, Tamura K, Kohno T, Ichikawa H, Yoshida A. BRAF V600E mutation is a potential therapeutic target for a small subset of synovial sarcoma. Mod Pathol 2020; 33:1660-1668. [PMID: 32238877 DOI: 10.1038/s41379-020-0530-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022]
Abstract
Synovial sarcoma (SS) is an aggressive tumor that most often affects the deep soft tissues in young adults. Intrathoracic SS is rare and is associated with poor outcome, highlighting the urgent need for a novel therapeutic strategy. In the process of clinical sequencing, we identified two patients with intrathoracic SS harboring the BRAF V600E mutation. The patients were women aged 32 and 23 years, and both presented with SS18-SSX2-positive monophasic SS in the thoracic cavity. BRAF V600E mutations were detected by next generation sequencing, and validated immunohistochemically by diffuse intense positivity to BRAF V600E mutation-specific antibodies. The phosphorylated ERK (pERK) immunohistochemistry result was also positive. One patient received a combination therapy of dabrafenib and trametinib, which led to tumor shrinkage. However, the tumor growth progressed 7.5 months later with an additional NRAS Q61K mutation. Immunohistochemical screening of 67 archival SS tumor samples failed to identify additional samples with BRAF V600E mutation. However, 32% of BRAF V600E-negative cases was positive for pERK, and one of the six tumors showing the highest pERK expression harbored an FGFR2-activating mutation. This is the first report of targetable BRAF mutation in a small subset of SS. Our study suggests involvement of the mitogen-activated protein kinase pathway and the potential clinical implication of BRAF mutation screening in SS.
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Affiliation(s)
- Sho Watanabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.,Division of Cancer Immunology, Research Institute/Exploratory Oncology Research & Clinical Trial Center, National Cancer Center East, Chiba, Japan
| | - Akihiko Shimomura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Kubo
- Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan.,Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Masaya Sekimizu
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan.,Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Takuji Seo
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Kohno
- Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan.,Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Hitoshi Ichikawa
- Division of Translational Genomics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan.,Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan. .,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
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Sekimizu M, Ogura K, Yasunaga H, Matsui H, Tanaka S, Inagaki K, Kawai A. Development of nomograms for prognostication of patients with primary soft tissue sarcomas of the trunk and extremity: report from the Bone and Soft Tissue Tumor Registry in Japan. BMC Cancer 2019; 19:657. [PMID: 31272407 PMCID: PMC6610844 DOI: 10.1186/s12885-019-5875-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/17/2018] [Accepted: 06/24/2019] [Indexed: 11/27/2022] Open
Abstract
Background The use of nomograms for prognostication of individual cancer patients has been recommended in order to facilitate precision medicine. However, models for patients with soft tissue sarcomas (STSs) are limited because of the rarity and heterogeneity of such cancers. In addition, no model has been developed on the basis of an Asian cohort. Here, we attempted to develop and internally validate nomograms for patients with localized STSs of the trunk and extremity. Methods This study retrospectively extracted 2827 patients with primary trunk and extremity STSs after definitive surgery using the Bone and Soft Tissue Tumor Registry, which is a nationwide sarcoma database in Japan. We developed three nomograms predicting the probability of local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and disease-specific survival (DSS) at 2 years after surgery, using the Cox multivariate model. The nomograms were internally validated for discrimination and calibration using bootstrap resampling and assessed for their clinical applicability by decision curve analysis (DCA). Results Local recurrence, distant metastasis and disease-specific death occurred in 241 patients (8.5%), 554 patients (19.6%) and 230 patients (8.1%), respectively. Histological diagnosis, grade and tumor size strongly influenced all three endpoints. The nomograms predicted accurately the probability of LRFS, DMFS and DSS (concordance index: 0.73, 0.70 and 0.75, respectively). DCA demonstrated that our nomograms had clinical applicability. Conclusion We have developed the first nomograms for STSs based on an Asian cohort. These nomograms allowed accurate prediction of LRFS, DMFS and DSS at 2 years after definitive surgery, and can be used as a guide by clinicians for appropriate follow-up and counseling of patients. Electronic supplementary material The online version of this article (10.1186/s12885-019-5875-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masaya Sekimizu
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Department of Orthopaedic Surgery, Showa University, Tokyo, Japan
| | - Koichi Ogura
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. .,Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan.
| | - Hideo Yasunaga
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Health Economics and Epidemiology Research, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | | | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Makise N, Sekimizu M, Konishi E, Motoi T, Kubo T, Ikoma H, Watanabe SI, Okuma T, Hiraoka N, Fukayama M, Kawai A, Ichikawa H, Yoshida A. H3K27me3 deficiency defines a subset of dedifferentiated chondrosarcomas with characteristic clinicopathological features. Mod Pathol 2019; 32:435-445. [PMID: 30291346 DOI: 10.1038/s41379-018-0140-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 12/13/2022]
Abstract
Dedifferentiated chondrosarcoma is a rare bone sarcoma, whose genetic background remains incompletely understood. Mutations in SUZ12 or EED, which encode polycomb repressive complex 2 (PRC2) components, and resulting deficiency in H3K27me3 are characteristic features of the majority of malignant peripheral nerve sheath tumors. Here, we investigated H3K27me3 and PRC2 status in dedifferentiated chondrosarcoma. Among 19 evaluable dedifferentiated chondrosarcoma cases, six (32%) showed immunohistochemical loss of H3K27me3 only in the dedifferentiated component, whereas the well-differentiated component retained H3K27me3. H3K27me3-deficient dedifferentiated chondrosarcoma occurred in two men and four women with a median age of 66. All of these tumors affected bones of the upper half of the body, with the ribs being preferentially involved, which represented a significantly different distribution compared to that in the 13 H3K27me3-intact dedifferentiated chondrosarcomas. H3K27me3-deficient dedifferentiated chondrosarcomas were histologically different from H3K27me3-intact dedifferentiated chondrosarcomas, as the former invariably demonstrated dedifferentiated histology with a striking similarity to classic malignant peripheral nerve sheath tumor, comprising sweeping to swirling fascicles of relatively uniform spindle cells. Heterologous rhabdomyoblastic differentiation, the focal presence of grade 3 chondrosarcoma histology, and a cartilaginous component in the metastatic sites were exclusively seen in some cases of H3K27me3-deficient dedifferentiated chondrosarcoma. In all three H3K27me3-deficient dedifferentiated chondrosarcomas that contained focal grade 3 histology, dedifferentiated components did not juxtapose to the grade 3 areas but transitioned abruptly from the grade 1-2 components. Targeted next generation sequencing, which was successfully performed on four H3K27me3-deficient dedifferentiated chondrosarcomas, identified an IDH2 mutation in one case and COL2A1 truncations in three cases. The dedifferentiated areas of three cases harbored SUZ12 or EED alterations, which were absent in the well-differentiated component, suggesting a role for PRC2 aberrations in dedifferentiation. H3K27me3 deficiency defines a novel subset of dedifferentiated chondrosarcoma that requires recognition because of its diagnostic and potential clinical implications.
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Affiliation(s)
- Naohiro Makise
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.,Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Masaya Sekimizu
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Eiichi Konishi
- Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takashi Kubo
- Division of Translational Genomics, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tomotake Okuma
- Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | | | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan.,Division of Translational Genomics, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan. .,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
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10
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Sekimizu M, Yoshida A, Mitani S, Asano N, Hirata M, Kubo T, Yamazaki F, Sakamoto H, Kato M, Makise N, Mori T, Yamazaki N, Sekine S, Oda I, Watanabe S, Hiraga H, Yonemoto T, Kawamoto T, Naka N, Funauchi Y, Nishida Y, Honoki K, Kawano H, Tsuchiya H, Kunisada T, Matsuda K, Inagaki K, Kawai A, Ichikawa H. Frequent mutations of genes encoding vacuolar H
+
‐ATPase components in granular cell tumors. Genes Chromosomes Cancer 2019; 58:373-380. [DOI: 10.1002/gcc.22727] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/25/2018] [Accepted: 12/27/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Masaya Sekimizu
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
- Department of Musculoskeletal OncologyNational Cancer Center Hospital Tokyo Japan
- Department of Orthopaedic SurgeryShowa University School of Medicine Tokyo Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical LaboratoriesNational Cancer Center Hospital Tokyo Japan
| | - Sachiyo Mitani
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
| | - Naofumi Asano
- Department of Orthopaedic SurgeryKeio University School of Medicine Tokyo Japan
| | - Makoto Hirata
- Laboratory of Genome TechnologyInstitute of Medical Science, University of Tokyo Tokyo Japan
| | - Takashi Kubo
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
- Division of Translational GenomicsNational Cancer Center‐Exploratory Oncology Research & Clinical Trial Center Tokyo Japan
| | - Fumito Yamazaki
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
- Department of PediatricsKeio University School of Medicine Tokyo Japan
| | - Hiromi Sakamoto
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
| | - Mamoru Kato
- Department of BioinformaticsNational Cancer Center Research Institute Tokyo Japan
| | - Naohiro Makise
- Department of Pathology and Clinical LaboratoriesNational Cancer Center Hospital Tokyo Japan
| | - Taisuke Mori
- Department of Pathology and Clinical LaboratoriesNational Cancer Center Hospital Tokyo Japan
| | - Naoya Yamazaki
- Department of Dermatologic OncologyNational Cancer Center Hospital Tokyo Japan
| | - Shigeki Sekine
- Department of Pathology and Clinical LaboratoriesNational Cancer Center Hospital Tokyo Japan
| | - Ichiro Oda
- Endoscopy DivisionNational Cancer Center Hospital Tokyo Japan
| | - Shun‐ichi Watanabe
- Department of Thoracic SurgeryNational Cancer Center Hospital Tokyo Japan
| | - Hiroaki Hiraga
- Department of Orthopaedic SurgeryHokkaido Cancer Center Sapporo Japan
| | | | - Teruya Kawamoto
- Department of Orthopaedic SurgeryKobe University Graduate School of Medicine Kobe Japan
| | - Norifumi Naka
- Musculoskeletal Oncology ServiceOsaka International Cancer Institute Osaka Japan
| | - Yuki Funauchi
- Department of Orthopaedic SurgeryThe Cancer Institute, Japanese Foundation for Cancer Research Tokyo Japan
| | | | - Kanya Honoki
- Department of Orthopedic SurgeryNara Medical University Kashihara Nara Japan
| | - Hirotaka Kawano
- Department of Orthopaedic SurgeryTeikyo University School of Medicine Tokyo Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic SurgeryKanazawa University Graduate School of Medical Sciences Kanazawa Japan
| | - Toshiyuki Kunisada
- Department of Orthopaedic SurgeryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Koichi Matsuda
- Laboratory of Clinical Genome SequencingGraduate School of Frontier Sciences, University of Tokyo Tokyo Japan
| | - Katsunori Inagaki
- Department of Orthopaedic SurgeryShowa University School of Medicine Tokyo Japan
| | - Akira Kawai
- Department of Musculoskeletal OncologyNational Cancer Center Hospital Tokyo Japan
| | - Hitoshi Ichikawa
- Department of Clinical GenomicsNational Cancer Center Research Institute Tokyo Japan
- Division of Translational GenomicsNational Cancer Center‐Exploratory Oncology Research & Clinical Trial Center Tokyo Japan
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11
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Toki S, Wakai S, Sekimizu M, Mori T, Ichikawa H, Kawai A, Yoshida A. PAX7 immunohistochemical evaluation of Ewing sarcoma and other small round cell tumours. Histopathology 2018; 73:645-652. [PMID: 29920735 DOI: 10.1111/his.13689] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 06/16/2018] [Indexed: 12/15/2022]
Abstract
AIMS Ewing sarcoma is a small round cell tumour that affects bone and soft tissues. Although the detection of the specific fusion gene is a robust method of its diagnosis, immunohistochemistry may serve as a practical surrogate. Recent tissue microarray studies suggested that PAX7 is a novel marker, because it was expressed consistently in Ewing sarcoma, in addition to rhabdomyosarcoma and synovial sarcoma. Here, we evaluated the utility of PAX7 immunohistochemistry in whole-tissue sections of an expanded array of round cell malignancies with adequate molecular characterisation. METHODS AND RESULTS We stained 30 molecularly confirmed Ewing sarcomas, one EWSR1-NFATC2 sarcoma and 141 non-Ewing round cell tumours by a monoclonal antibody against PAX7. Staining was considered positive if at least 5% of tumour cells were stained. PAX7 was expressed in 27 of 30 Ewing sarcomas (90%), mainly in a diffuse and strong manner. Although NKX2-2 showed similar sensitivity, PAX7 showed more extensive and strong reactivity. One EWSR1-NFATC2 sarcoma co-expressed PAX7 and NKX2-2. PAX7 was also expressed in 24 of 141 non-Ewing tumours, including alveolar rhabdomyosarcomas (seven of 10), poorly differentiated synovial sarcomas (seven of 10), BCOR-CCNB3 sarcomas (eight of 10), small-cell osteosarcoma (one of five) and desmoplastic small round cell tumour (one of 10), one-third of which showed diffuse strong reactivity. CONCLUSIONS Although we confirmed that PAX7 is a sensitive marker for Ewing sarcoma, anti-PAX7 antibody also stained several Ewing sarcoma mimics, whose spectrum was distinct from NKX2-2-positive non-Ewing entities. Further studies are required to determine how PAX7 could be integrated into practice to classify small round cell tumours efficiently.
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Affiliation(s)
- Shunichi Toki
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.,Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Susumu Wakai
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Masaya Sekimizu
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Taisuke Mori
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Hitoshi Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan.,Division of Translational Genomics, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan
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12
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Makise N, Sekimizu M, Kubo T, Wakai S, Watanabe SI, Kato T, Kinoshita T, Hiraoka N, Fukayama M, Kawai A, Ichikawa H, Yoshida A. Extraskeletal osteosarcoma: MDM2 and H3K27me3 analysis of 19 cases suggest disease heterogeneity. Histopathology 2018; 73:147-156. [DOI: 10.1111/his.13506] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/24/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Naohiro Makise
- Department of Pathology and Clinical Laboratories; National Cancer Center Hospital; Tokyo Japan
- Department of Pathology; The University of Tokyo; Tokyo Japan
| | - Masaya Sekimizu
- Department of Clinical Genomics; National Cancer Center Research Institute; Tokyo Japan
| | - Takashi Kubo
- Division of Translational Genomics; Exploratory Oncology Research & Clinical Trial Center; National Cancer Center; Tokyo Japan
| | - Susumu Wakai
- Department of Pathology and Clinical Laboratories; National Cancer Center Hospital; Tokyo Japan
| | - Shun-ichi Watanabe
- Division of Thoracic Surgery; National Cancer Center Hospital; Tokyo Japan
| | - Tomoyasu Kato
- Division of Gynecology; National Cancer Center Hospital; Tokyo Japan
| | - Takayuki Kinoshita
- Division of Breast Surgery; National Cancer Center Hospital; Tokyo Japan
| | - Nobuyoshi Hiraoka
- Department of Pathology and Clinical Laboratories; National Cancer Center Hospital; Tokyo Japan
| | | | - Akira Kawai
- Department of Musculoskeleltal Oncology; National Cancer Center Hospital; Tokyo Japan
- Rare Cancer Center; National Cancer Center Hospital; Tokyo Japan
| | - Hitoshi Ichikawa
- Department of Clinical Genomics; National Cancer Center Research Institute; Tokyo Japan
- Division of Translational Genomics; Exploratory Oncology Research & Clinical Trial Center; National Cancer Center; Tokyo Japan
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories; National Cancer Center Hospital; Tokyo Japan
- Rare Cancer Center; National Cancer Center Hospital; Tokyo Japan
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13
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Koga Y, Ueyama J, Sekimizu M, Mitsui T, Mori T, Fukano R, Gunma K, Osumi T, Mori T, Kikuchi A, Sunami S, Kobayashi R. Pediatric Hodgkin's Lymphoma in Japan. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Affiliation(s)
- T Kushihashi
- Showa University, School of Medicine, Tokyo, Japan
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15
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Abstract
A 32-year-old female presented with a history of intermittent, severe lower back pain, exacerbated by pregnancy and persisting for several years. Magnetic resonance (MR) imaging showed a sacral mass as a low signal intensity area on the T1-weighted image and a high signal intensity area on the T2-weighted image, consistent with a cystic structure containing cerebrospinal fluid. A tethered cord attached to the thecal sac was also confirmed. Sacral laminectomy revealed thinned sacral vertebral laminae, but no neuronal elements existed within the cyst. The cyst was attached to the distal thecal sac by a small fistula. The thecal sac was explored, revealing a thick filum terminale, which was transected. The severe pain resolved postoperatively. This type of meningeal cyst, often called "occult intrasacral meningocele," is best diagnosed by MR imaging. Surgery to obliterate the fistulous tract is the optimum treatment. Total removal of the cyst is unnecessary, but evaluation of other associated congenial abnormalities is important.
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Affiliation(s)
- H Doi
- Department of Neurosurgery, Showa University School of Medicine, Tokyo
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16
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Suzuki K, Kobayashi J, Sekimizu M. Simple micromethod for determination of erythrocyte electrolyte concentration. Clin Chem 1985; 31:156-7. [PMID: 3965196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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17
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Suzuki K, Kadowaki T, Sekimizu M, Shishiba Y. Erythrocyte ouabain binding capacity as a possible cellular index of hyperthyroid status. Endocrinol Jpn 1983; 30:609-14. [PMID: 6323155 DOI: 10.1507/endocrj1954.30.609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The maximum ouabain binding capacity in erythrocytes from 8 normal subjects and 14 patients with hyperthyroidism was assessed by measuring [3H]-ouabain binding. The mean value for maximum ouabain binding capacity was significantly lower in the patients than in normals (0.422 +/- 0.084 vs 0.671 +/- 0.095 pmol per 10(9) cells, p less than 0.001). Furthermore, a close inverse correlation was found between the ouabain binding capacity and serum T3 (r = 0.766; p less than 0.01) or T4 (r = -0.870; p less than 0.001) levels. These results suggest that the maximum ouabain binding capacity in erythrocytes may provide a useful index of the peripheral effect of thyroid hormone.
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