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Yamahara N, Yoshikura N, Takekoshi A, Kimura A, Harada N, Mori Y, Shimohata T. Anti-N-methyl-d-aspartate receptor encephalitis preceded by meningitis lasting up to 60 days. J Neuroimmunol 2023; 382:578173. [PMID: 37572435 DOI: 10.1016/j.jneuroim.2023.578173] [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: 06/04/2023] [Revised: 07/27/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023]
Abstract
Long-lasting meningitis complicated by N-methyl-d-aspartate receptor (NMDAR) encephalitis has not been discussed widely in the literature. Herein, we present two cases of anti-NMDAR encephalitis preceded by meningitis. The patients had 60- and 22-day periods of preceding meningitis, which improved with intravenous methylprednisolone and plasmapheresis. No tumors were detected in either of the patients. Although meningitis preceding anti-NMDAR encephalitis is not rare, our patients, especially those who had it for a duration of 60 days, had longer durations of meningitis. This manuscript foregrounds that anti-NMDAR encephalitis might be included in the differential diagnosis of long-lasting meningitis.
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Affiliation(s)
- Naoki Yamahara
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan
| | - Nobuaki Yoshikura
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan
| | - Akira Takekoshi
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan
| | - Akio Kimura
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan
| | - Naoko Harada
- Department of Neurology, Gifu Municipal Hospital, 7-1, Kashima-cho, Gifu City, Gifu Prefecture 500-8513, Japan
| | - Yu Mori
- Department of Neurology, Gifu Prefectural Tajimi Hospital, 5-161, Maebata-cho, Tajimi City, Gifu Prefecture 507-8522, Japan
| | - Takayoshi Shimohata
- Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City, Gifu Prefecture 501-1194, Japan.
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2
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Hashiguchi MH, Chubachi S, Yamasawa W, Otsuka K, Harada N, Miyao N, Nakamura H, Asano K, Yamaguchi K, Fukunaga K. Interaction of BMI and respiratory status in obstructive sleep apnea, a cross-sectional COPD study. NPJ Prim Care Respir Med 2023; 33:30. [PMID: 37582926 PMCID: PMC10427682 DOI: 10.1038/s41533-023-00351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/02/2023] [Indexed: 08/17/2023] Open
Abstract
This cross-sectional study of 136 patients with chronic obstructive pulmonary disease (COPD) investigated the mechanism underlying overlap syndrome, defined as coexisting COPD and obstructive sleep apnea (OSA). OSA was defined as a respiratory event index (REI) ≥ 5 events/h, determined using type-3 portable monitors. The mean REI was 12.8 events/h. Most participants (60.1%) had mild OSA (REI: 5-15 events/h). The REI was positively correlated with forced expiratory volume in one second (%FEV1) (r = 0.33, p < 0.001), body mass index (BMI) (r = 0.24, p = 0.005), and fat-free mass index (r = 0.31, p = 0.005), and negatively correlated with residual volume divided by total lung capacity (r = -0.27, p = 0.003). Receiver-operating characteristic curve analysis revealed an optimal BMI cutoff of 21.96 kg/m2 for predicting moderate/severe OSA. A BMI ≥ 21.96 kg/m2 was associated with OSA among participants with %FEV1 ≥ 50%, but not those with %FEV1 < 50%. This study revealed an interaction between airflow limitation and hyperinflation, nutritional status, and OSA.
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Affiliation(s)
- Mizuha Haraguchi Hashiguchi
- Internal Medicine, Keiyu Hospital, Yokohama-shi, Kanagawa, Japan
- Internal Medicine, Nippon Koukan Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjyuku-ku, Tokyo, Japan.
| | - Wakako Yamasawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjyuku-ku, Tokyo, Japan
- Department of Laboratory Medicine, Keio University School of Medicine, Shinjyuku-ku, Tokyo, Japan
| | - Kengo Otsuka
- Internal Medicine, Nippon Koukan Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Naoko Harada
- Internal Medicine, Nippon Koukan Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Naoki Miyao
- Internal Medicine, Nippon Koukan Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Hidetoshi Nakamura
- Department of Respiratory Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | - Kazuhiro Yamaguchi
- Department of Pulmonary Medicine, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjyuku-ku, Tokyo, Japan
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Ohtsuka K, Harada N, Horiuchi A, Umemoto S, Kurabatashi R, Yui A, Yamamura H, Shinka Y, Miyao N. Therapeutic Response to Single-Inhaler Triple Therapies in Moderate-to-Severe COPD. Respir Care 2023; 68:330-337. [PMID: 36828578 PMCID: PMC10027151 DOI: 10.4187/respcare.10188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND COPD is characterized by progressive and irreversible air flow limitations. Single-inhaler therapies (SITTs) incorporating an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting β2-agonist have been shown to effectively alleviate symptoms and improve lung function. Fluticasone-furoate/umeclidinium/vilanterol (F/U/V) and budesonide/glycopyrronium/formoterol (B/G/F) are available as SITT in Japan. However, the clinical differences between these 2 combinations and the predictors of their proper use have not been established. This study aimed to identify the subject characteristics that could predict the effectiveness of inhaler therapy. METHODS We assessed the pulmonary function test results of subjects with COPD before and one month after using F/U/V and B/G/F as SITT. Subjects with a difference of 100 mL or more in the FEV1 after treatment with pre-SITT were extracted and divided into the F/U/V effect and no-effect group and B/G/F effect and no-effect group to examine the factors associated with positive outcomes with each inhaler. RESULTS F/U/V and B/G/F significantly improved the inspiratory capacity (IC), %IC, FVC, and %FEV1 when compared to pre-intervention values (P < .001, P = .001, P = .007, P = .009, respectively, for F/U/V; and P = .006, P = .008, P = .038, P = .005, respectively, for B/G/F). Factors associated with FEV1 improvement in F/U/V included lower %IC (odds ratio 0.97 [95% CI 0.94-0.99], P = .03) and a higher modified Medical Research Council (mMRC) dyspnea score (2.36 [1.27-4.70], P < .01). In addition, a higher %IC (1.03 [1.00-1.06], P = .02) and lower mMRC dyspnea score (0.55 [0.28-0.99], P = .041) were predictors for the effectiveness of B/G/F. CONCLUSIONS Our results showed that SITT significantly improved the IC, %IC, FVC, and %FEV1 when compared to pre-intervention and that F/U/V was more effective in subjects with severe symptoms, whereas B/G/F was more effective in subjects with mild symptoms.
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Affiliation(s)
- Kengo Ohtsuka
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Naoko Harada
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Atsuo Horiuchi
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Shintaro Umemoto
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Ryo Kurabatashi
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Akie Yui
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Hiroyuki Yamamura
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Yoko Shinka
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan
| | - Naoki Miyao
- Department of Internal Medicine, Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan.
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Shimizu K, Iyoda T, Sanpei A, Nakazato H, Okada M, Ueda S, Kato-Murayama M, Murayama K, Shirouzu M, Harada N, Hidaka M, Fujii SI. Identification of TCR repertoires in functionally competent cytotoxic T cells cross-reactive to SARS-CoV-2. Commun Biol 2021; 4:1365. [PMID: 34857854 PMCID: PMC8640030 DOI: 10.1038/s42003-021-02885-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/12/2021] [Indexed: 12/30/2022] Open
Abstract
SARS-CoV-2-specific CD8+ T cells are scarce but detectable in unexposed healthy donors (UHDs). It remains unclear whether pre-existing human coronavirus (HCoV)-specific CD8+ T cells are converted to functionally competent T cells cross-reactive to SARS-CoV-2. Here, we identified the HLA-A24-high binding, immunodominant epitopes in SARS-CoV-2 spike region that can be recognized by seasonal coronavirus-specific CD8+ T cells from HLA-A24+ UHDs. Cross-reactive CD8+ T cells were clearly reduced in patients with hematological malignancy, who are usually immunosuppressed, compared to those in UHDs. Furthermore, we showed that CD8+ T cells in response to a selected dominant epitope display multifunctionality and cross-functionality across HCoVs in HLA-A24+ donors. Cross-reactivity of T-cell receptors isolated from them exhibited selective diversity at the single-cell level. Taken together, when stimulated well by immunodominant epitopes, selective pre-existing CD8+ T cells with high functional avidity may be cross-reactive against SARS-CoV-2.
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Affiliation(s)
- Kanako Shimizu
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - Tomonori Iyoda
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - An Sanpei
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - Hiroshi Nakazato
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - Masahiro Okada
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - Shogo Ueda
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan
| | - Miyuki Kato-Murayama
- grid.508743.dLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics Research, Yokohama, Japan
| | - Kazutaka Murayama
- grid.508743.dLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics Research, Yokohama, Japan ,grid.69566.3a0000 0001 2248 6943Division of Biomedical Measurements and Diagnostics, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Mikako Shirouzu
- grid.508743.dLaboratory for Protein Functional and Structural Biology, RIKEN Center for Biosystems Dynamics Research, Yokohama, Japan
| | - Naoko Harada
- grid.415538.eDepartment of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Michihiro Hidaka
- grid.415538.eDepartment of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Shin-ichiro Fujii
- grid.509459.40000 0004 0472 0267Laboratory for Immunotherapy, RIKEN Center for Integrative Medical Science (IMS), Yokohama, Japan ,grid.7597.c0000000094465255Program for Drug Discovery and Medical Technology Platforms (DMP), RIKEN, Yokohama, Japan
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5
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Kawakita T, Hirano T, Inoue Y, Irie Y, Sugitani H, Kubota A, Watanabe M, Ueno M, Mitsui N, Yamaguchi S, Inoue Y, Sakai T, Harada N, Matsuoka M, Hidaka M. Feasibility of an intensified myeloablative conditioning regimen consisting of busulfan, fludarabine, cytarabine, and total body irradiation before single cord blood transplantation in elderly patients. Int J Hematol 2021; 114:85-93. [PMID: 33740219 DOI: 10.1007/s12185-021-03131-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/30/2022]
Abstract
The optimal conditioning regimen for stem cell transplantation in elderly patients remains to be established. We developed a novel preparative regimen using fludarabine 180 mg/m2, intravenous busulfan 12.8 mg/m2, cytarabine 8 g/m2, and 4-Gy total body irradiation before cord blood transplantation (CBT) in patients older than 55 years with various hematological malignancies. All but one patient received graft-versus-host disease (GVHD) prophylaxis consisting of cyclosporine (CsA) and short-term methotrexate (sMTX). Thirty-three patients were included in this study, with a median age of 64 years (range 56-70). The disease risk index was high or very high in 67% of patients, and 73% had a disease status other than complete remission. The probabilities of overall survival and disease-free survival at 3 years were 60 and 57%, respectively. The cumulative incidences of relapse and non-relapse mortality at 3 years were 18 and 25%, respectively. Regimen-related toxicities were generally tolerable. Disease-free survivors (n = 20) stopped immunosuppressants at a median of 7.4 months (range 2.6-25.0), in all cases by the time of the last follow-up. In conclusion, this highly myeloablative conditioning regimen resulted in a high probability of disease-free, GVHD-free, immunosuppressant-free survival after single CBT.(190 words).
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Affiliation(s)
- Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan. .,Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto Univerity Graduate School of Medicine, Kumamoto, Japan.
| | - Taichi Hirano
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Yoshitaka Inoue
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto Univerity Graduate School of Medicine, Kumamoto, Japan
| | - Yumiko Irie
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Hironori Sugitani
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Akira Kubota
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Miho Watanabe
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan.,Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto Univerity Graduate School of Medicine, Kumamoto, Japan
| | - Mitsunori Ueno
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan.,Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto Univerity Graduate School of Medicine, Kumamoto, Japan
| | - Norikazu Mitsui
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Shunichiro Yamaguchi
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan.,Department of Hematology, Arao Municipal Hospital, Kumamoto, Japan
| | - Yoshiko Inoue
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Tatsunori Sakai
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Naoko Harada
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
| | - Masao Matsuoka
- Departments of Hematology, Rheumatology, and Infectious Disease, Kumamoto Univerity Graduate School of Medicine, Kumamoto, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan
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Toshima T, Yoshizumi T, Harada N, Ikegami T, Itoh S, Fujimori N, Oono T, Mori M. Hepatobiliary and Pancreatic: A new strategy of endoscopic ultrasonography-guided internal drainage for a refractory hepatic abscess after liver transplantation. J Gastroenterol Hepatol 2020; 35:1854. [PMID: 33029802 DOI: 10.1111/jgh.15216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/09/2022]
Affiliation(s)
- T Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Fujimori
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Oono
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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7
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Yamasaki S, Kada A, Choi I, Iida H, Sekiguchi N, Harada N, Sawamura M, Shimomura T, Komeno T, Yano T, Yoshida I, Yoshida S, Sunami K, Hishita T, Takatsuki H, Ohshima K, Takeshita M, Saito AM, Iwasaki H, Nagai H. Phase II study of dose‐adjusted gemcitabine, dexamethasone, cisplatin, and rituximab in elderly relapsed diffuse large B‐cell lymphoma patients. eJHaem 2020; 1:507-516. [PMID: 35844987 PMCID: PMC9176064 DOI: 10.1002/jha2.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
High‐dose chemotherapy and autologous stem cell transplantation (ASCT) are too toxic for elderly patients with relapsed or refractory diffuse large B‐cell lymphoma (DLBCL). Therefore, effective and tolerable regimens for elderly patients are urgently needed. The present phase II study assessed the efficacy and safety of dose‐adjusted therapy with gemcitabine, dexamethasone, cisplatin, and rituximab (GDP‐R) in this population. ASCT‐ineligible elderly patients with relapsed or refractory DLBCL received dose‐adjusted GDP‐R in each 28‐day cycle for up to six cycles. The primary endpoint was overall response rate (ORR), and secondary endpoints were complete response (CR) rate, progression‐free survival (PFS), and safety. Thirty‐three patients were enrolled and received dose‐adjusted GDP‐R. The median age was 75 years (range: 68‐87 years). The ORR was 82.8% (90% confidence interval [CI], 67.1‐93.0%), with a CR rate of 58.6% (90% CI, 41.7‐74.1%). At a median follow‐up of 20.9 months, the 2‐year PFS rate was 46.8% (90% CI, 30.7‐61.5%) and the 2‐year overall survival rate was 63.2% (90% CI, 45.8‐76.3%). The most frequently observed grade 4 adverse events were neutropenia (63.6%), thrombocytopenia (57.6%), and lymphocytopenia (39.4%). Dose‐adjusted GDP‐R is a promising salvage regimen for ASCT‐ineligible elderly patients with relapsed DLBCL after rituximab‐containing chemotherapy and warrants further investigation.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Akiko Kada
- Clinical Research Center National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Ilseung Choi
- Department of Hematology National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Hiroatsu Iida
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Naohiro Sekiguchi
- Department of Hematology National Hospital Organization Disaster Medical Center Tachikawa Japan
| | - Naoko Harada
- Department of Hematology National Hospital Organization Kumamoto Medical Center Kumamoto Japan
| | - Morio Sawamura
- Department of Hematology National Hospital Organization Shibukawa Medical Center Shibukawa Japan
| | - Takeshi Shimomura
- Department of Hematology National Hospital Organization Hiroshimanishi Medical Center Otake Japan
| | - Takuya Komeno
- Department of Hematology National Hospital Organization Mito Medical Center Ibaraki Japan
| | - Takahiro Yano
- Department of Hematology National Hospital Organization Tokyo Medical Center Tokyo Japan
| | - Isao Yoshida
- Department of Hematologic Oncology National Hospital Organization Shikoku Cancer Center Matsuyama Japan
| | - Shinichiro Yoshida
- Department of Hematology National Hospital Organization Nagasaki Medical Center Omura Japan
| | - Kazutaka Sunami
- Department of Hematology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Terutoshi Hishita
- Department of Hematology National Hospital Organization Himeji Medical Center Himeji Japan
| | - Hiroshi Takatsuki
- Department of Hematology National Hospital Organization Kokura Medical Center Kitakyushu Japan
| | - Koichi Ohshima
- Department of Pathology School of Medicine Kurume University Kurume Japan
| | - Morishige Takeshita
- Department of Pathology Faculty of Medicine Fukuoka University Fukuoka Japan
| | - Akiko M. Saito
- Clinical Research Center National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Hirokazu Nagai
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
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8
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Matsumoto T, Itoh S, Yoshizumi T, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Harada N, Ikegami T, Soejima Y, Baba H, Mori M. C-reactive protein : albumin ratio in patients with resectable intrahepatic cholangiocarcinoma. BJS Open 2020; 4:1146-1152. [PMID: 32959537 PMCID: PMC7709369 DOI: 10.1002/bjs5.50348] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The C-reactive protein : albumin ratio (CAR) has been reported as a novel prognostic marker in several cancers. The aim of this study was to investigate the prognostic value of CAR in patients with intrahepatic cholangiocarcinoma (ICC). METHODS This was a single-centre retrospective study of patients who underwent surgery for ICC in a university hospital in Japan between 1998 and 2018. CAR, Glasgow Prognostic Score (GPS) and modified GPS (mGPS) were calculated. Their correlation with recurrence-free survival (RFS) and overall survival (OS) was analysed with Cox proportional hazards models. RESULTS Seventy-two patients were included in the study. Patients were divided into two groups according to the optimal CAR cut-off value of 0·02. CAR above 0·02 was associated with higher carbohydrate antigen 19-9 levels (20·5 versus 66·1 units/ml for CAR of 0·02 or less; P = 0·002), larger tumour size (3·2 versus 4·4 cm respectively; P = 0·031) and a higher rate of microvascular invasion (9 of 28 versus 25 of 44; P = 0·041). RFS and OS were shorter in patients with CAR above 0·02: hazard ratio (HR) 4·31 (95 per cent c.i. 2·02 to 10·63) and HR 4·80 (1·85 to 16·40) respectively. In multivariable analysis CAR above 0·02 was an independent prognostic factor of RFS (HR 3·29 (1·33 to 8·12); P < 0·001), but not OS. CONCLUSIONS CAR was associated with prognosis in patients who had hepatic resection for ICC.
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Affiliation(s)
- T. Matsumoto
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
- Department of Gastroenterological SurgeryGraduate School of Life Sciences, Kumamoto UniversityKumamotoJapan
| | - S. Itoh
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - T. Yoshizumi
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - T. Kurihara
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - S. Yoshiya
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - Y. Mano
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - K. Takeishi
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - N. Harada
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - T. Ikegami
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - Y. Soejima
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - H. Baba
- Department of Gastroenterological SurgeryGraduate School of Life Sciences, Kumamoto UniversityKumamotoJapan
| | - M. Mori
- Department of Surgery and ScienceGraduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
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9
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Watanabe A, Yoshizumi T, Harimoto N, Kogure K, Ikegami T, Harada N, Itoh S, Takeishi K, Mano Y, Yoshiya S, Morinaga A, Araki K, Kubo N, Mori M, Shirabe K. Right hepatic venous system variation in living donors: a three-dimensional CT analysis. Br J Surg 2020; 107:1192-1198. [PMID: 32335898 DOI: 10.1002/bjs.11602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/16/2020] [Accepted: 02/27/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The right hepatic venous system consists of the right hepatic vein (RHV) and inferior RHVs (IRHVs). When the right posterior section is used as a graft for liver transplantation, understanding variations and relationships between the RHV and IRHVs is critical for graft venous return and hepatic vein reconstruction. This study aimed to evaluate variations in the hepatic veins and the relationships between them. METHODS The medical records and CT images of patients who underwent hepatectomy as liver donors were assessed retrospectively. The relationship between the veins was evaluated by three-dimensional CT. RESULTS The configuration of the posterior section was classified into one of eight types based on the RHV and IRHVs in 307 patients. Type 1a (103 of 307), type 1b (139 of 307) and type 2a (40 of 307) accounted for 91·9 per cent of the total. The diameter of the RHV extending towards the inferior vena cava had a significant inverse correlation with that of the IRHV (r2 = -0·615, P < 0·001). Type 1a, which had no IRHVs, had the RHV with the largest diameter; conversely, type 2a, which had a large IRHV, had the RHV with the smallest diameter. CONCLUSION The hepatic venous system of the right posterior section was classified into eight types, with an inverse relationship between RHV and IRHV sizes. This information is useful for segment VII resection or when the right liver is used as a transplant graft.
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Affiliation(s)
- A Watanabe
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Hepatobiliary and Pancreatic Surgery, Maebashi Gunma, Japan.,Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Hepatobiliary and Pancreatic Surgery, Maebashi Gunma, Japan.,Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
| | - K Kogure
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Mano
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Morinaga
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Araki
- Department of Hepatobiliary and Pancreatic Surgery, Maebashi Gunma, Japan.,Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
| | - N Kubo
- Department of Hepatobiliary and Pancreatic Surgery, Maebashi Gunma, Japan.,Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
| | - M Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Shirabe
- Department of Hepatobiliary and Pancreatic Surgery, Maebashi Gunma, Japan.,Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan
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10
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Nishida H, Hayashi Y, Ban Y, Kudo T, Harada N, Sakurai T. A Case of Crossed Logopenic Primary Progressive Aphasia in a Dextral Patient with Underlying Frontotemporal Dementia. Intern Med 2019. [PMID: 31391394 DOI: 10.2169/internalmedicine.2301-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 61-year-old dextral woman was admitted to the hospital with difficulty finding words. Neurological examinations confirmed that her speech was affected by frequent pauses and occasional phonological paraphasia without cognitive deficits. We detected atrophy, hypoperfusion, and hypometabolism in the right perisylvian and parietal regions, expanding to the right anterior temporal lobes and right inferior frontal gyrus (opercular region) by magnetic resonance imaging, single-photon emission computed tomography, and fluorodexyglucose-positron emission tomography (PET), respectively. Amyloid-PET did not identify the accumulation of amyloid beta (Aβ) in the bilateral cerebral cortices. We herein report a case of crossed aphasia with Aβ-negative logopenic primary progressive aphasia that was likely the result of frontotemporal lobar degeneration.
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Affiliation(s)
- Hiroshi Nishida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Yuichi Hayashi
- Departments of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Japan
| | - Yuichi Ban
- Department of Rehabilitation, Gifu Prefectural General Medical Center, Japan
| | - Takuya Kudo
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Naoko Harada
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Takeo Sakurai
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
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11
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Affiliation(s)
- Hiroshi Nishida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Yuichi Hayashi
- Departments of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Japan
| | - Naoko Harada
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Takeo Sakurai
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Kenji Wakida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
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12
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Kimura K, Kudo K, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Itoh S, Harada N, Ikegami T, Yoshizumi T, Ikeda T. Rendezvous Technique Using Double Balloon Endoscope for Removal of Multiple Intrahepatic Bile Duct Stones in Hepaticojejunostomy After Living Donor Liver Transplant: A Case Report. Transplant Proc 2018; 51:579-584. [PMID: 30879594 DOI: 10.1016/j.transproceed.2018.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/09/2018] [Indexed: 02/08/2023]
Abstract
Cholangitis is a major complication following transplantation. We report a living donor liver transplant (LDLT) patient with cholangitis due to multiple stones in the intrahepatic bile duct during hepaticojejunostomy anastomosis, who was successfully treated with the rendezvous technique using double balloon endoscope. A 64-year-old woman underwent LDLT with right lobe graft and hepaticojejunostomy for Wilson disease. There was bile leakage with biliary peritonitis, which was treated conservatively after transplant. Two years after surgery, she developed reiterated cholangitis due to stenosis of hepaticojejunostomy anastomosis and multiple stones in the intrahepatic bile ducts. Percutaneous transhepatic biliary drainage was performed. The size of the drainage tube was increased, and the anastomotic area was dilated in a stepwise manner using a balloon catheter. The stones were crushed and lithotomy was performed using electronic hydraulic lithotripsy through cholangioscopy. Finally, lithotomy was performed for the remaining stones through endoscopic retrograde cholangiography with the rendezvous technique using the double balloon endoscope. Rendezvous approach with percutaneous transhepatic biliary drainage and double balloon endoscopic retrograde cholangiography was an effective treatment for the multiple intrahepatic stones in hepaticojejunostomy following LDLT with right lobe graft.
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Affiliation(s)
- K Kimura
- Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka, Japan; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - K Kudo
- Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka, Japan; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Kurihara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Mano
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikeda
- Department of Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka, Japan; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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13
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Soejima Y, Yoshizumi T, Ikegami T, Harimoto N, Harada N, Itoh S, Toshima T, Motomura T, Mano Y, Ohira M, Bekki Y, Maehara Y. Real-Time Ultrasound-Guided Thrombectomy for Extensive Portal Vein Thrombosis in Living Donor Liver Transplantation. Transplant Proc 2018; 50:3549-3551. [DOI: 10.1016/j.transproceed.2018.08.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/24/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
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14
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Harada N, Tada H, Miyashita M, Hamanaka Y, Sato A, Ishida T. A joint metabolic profile of plasma and tissue samples or discovering novel biomarkers in breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Kasamatsu T, Ozaki S, Saitoh T, Konishi J, Sunami K, Itagaki M, Asaoku H, Cho T, Handa H, Hagiwara S, Wakayama T, Negoro A, Takezako N, Harada N, Kuroda Y, Nakaseko C, Miyake T, Inoue N, Hata H, Shimazaki C, Ohno T, Kuroda J, Murayama T, Kobayashi T, Abe M, Ishida T, Nagura E, Shimizu K. Unsuppressed serum albumin levels may jeopardize the clinical relevance of the international staging system to patients with light chain myeloma. Hematol Oncol 2018; 36:792-800. [PMID: 30176173 DOI: 10.1002/hon.2559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/24/2018] [Accepted: 08/30/2018] [Indexed: 01/06/2023]
Abstract
The international staging system (ISS) is the most commonly used risk-stratification system for patients with multiple myeloma (MM) and is determined by serum albumin and β2-microglobulin levels. In the two determinants, β2-microglobulin levels are frequently observed to be elevated in patients with myeloma, particularly in those with renal impairment. In comparison with patients with intact immunoglobulin myeloma, patients with LC myeloma do not necessarily show decreased levels of serum albumin. The clinical impact of ISS in patients with LCMM, in particular the distinction between ISS I and II, may be complicated due to non-decreased levels of serum albumin in both stages. Accordingly, we have attempted to assess clinical relevance of the ISS in patients with LC myeloma. The clinical data of 1899 patients with MM diagnosed between January 2001 and December 2012 were collected from 38 affiliated hospitals of the Japanese Society of Myeloma. Significant difference was not found between stage I (n = 72) and stage II (n = 92) in LC myeloma patients (n = 307). The mean serum albumin concentration of patients with LC myeloma was within the reference range but higher than that of patients with IgG + IgA myeloma (n = 1501), which complicates the distinction between ISS stage I and II myeloma. Patients with LC myeloma had low frequencies of t(4; 14) and high frequency of elevated lactate dehydrogenase, and despite a relevant amount of missing data in our registry (R-ISS stage I; n = 11, stage II; n = 32, and stage III: n = 18), the information included in the R-ISS scoring system seems to be more accurate than ISS to obtain a reliable risk stratification approach in non-ISS stage III LC myeloma patients.
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Affiliation(s)
- Tetsuhiro Kasamatsu
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Shuji Ozaki
- Department of Hematology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Takayuki Saitoh
- Department of Laboratory Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Japan
| | - Jun Konishi
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Mitsuhiro Itagaki
- Department of Hematology, Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Hideki Asaoku
- Department of Hematology, Hiroshima Red Cross Hospital, Hiroshima, Japan
| | - Takaaki Cho
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University, Maebashi, Japan
| | - Shotaro Hagiwara
- Division of Hematology, Department of Internal Medicine, National Medical Center for Global Health and Medicine, Tokyo, Japan
| | - Toshio Wakayama
- Department of Hematology, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Akiko Negoro
- Department of Hematology, Japan Labor Health and Welfare Organization Yokohama Rosai Hospital, Yokohama, Japan
| | - Naoki Takezako
- Department of Hematology, National Hospital Organization National Disaster Medical Center, Tokyo, Japan
| | - Naoko Harada
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yoshiaki Kuroda
- Department of Hematology, Hiroshima University Hospital, Hiroshima, Japan
| | - Chiaki Nakaseko
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Takaaki Miyake
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Nobumasa Inoue
- Department of Internal Medicine, National Hospital Organization Osaka Medical Center, Osaka, Japan
| | - Hiroyuki Hata
- Department of Immunology and Hematology, Faculty of Life Sciences, Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan
| | - Chihiro Shimazaki
- Department of Hematology, Japan Community Healthcare Organization Kyoto Kuramaguchi Medical Center, Kyoto, Japan
| | - Tatsuharu Ohno
- Division of Hematology and Immunology, Department of Internal Medicine, Ohtsu Red Cross Hospital, Ohtsu, Japan
| | - Junya Kuroda
- Department of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tohru Murayama
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Takahiro Kobayashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Hospital, Akita, Japan
| | - Masahiro Abe
- Department of Hematology, Tokushima University Hospital, Tokushima, Japan
| | - Tadao Ishida
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Eiich Nagura
- Department of Hematology, Chutoen General Medical Center, Kakegawa, Japan
| | - Kazuyuki Shimizu
- Department of Hematology/Oncology, Higashi Nagoya National Hospital, Nagoya, Japan
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16
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Motomura T, Yoshizumi T, Ohira M, Mano Y, Toshima T, Itoh S, Harada N, Harimoto N, Ikegami T, Soejima Y, Maehara Y. Successful Recombinant Thrombomodulin Treatment for Thrombotic Microangiopathy After Liver Transplantation: A Case Report. Transplant Proc 2018; 49:2409-2410. [PMID: 29198692 DOI: 10.1016/j.transproceed.2017.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/23/2017] [Indexed: 12/27/2022]
Abstract
Transplant-associated thrombotic microangiopathy (TA-TMA) is a rare but severe complication after liver transplantation. In contrast to other thrombotic microangiopathies, treatment for TA-TMA has yet to be clarified. A 52-year-old male patient with liver cirrhosis due to hepatitis C underwent split liver transplantation from a deceased donor. His clinical course was without complication until 4 days after transplantation, when he experienced impaired consciousness, hemolytic anemia with fragmented erythrocytes, and marked thrombocytopenia. TA-TMA was diagnosed, and recombinant thrombomodulin was administered for 4 days. The patient's clinical symptoms and laboratory data rapidly improved. He has been followed up for 6 months and has not shown any complications. The pathogenesis of TA-TMA is endothelial damage in the vasculature. Recombinant thrombomodulin, an endothelial cell-protecting agent, is a promising new therapeutic choice for TA-TMA after liver transplantation.
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Affiliation(s)
- T Motomura
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - T Yoshizumi
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Ohira
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Mano
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Toshima
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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17
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Yoshikura N, Kimura A, Fukata M, Fukata Y, Yokoi N, Harada N, Hayashi Y, Inuzuka T, Shimohata T. Long-term clinical follow-up of a patient with non-paraneoplastic cerebellar ataxia associated with anti-mGluR1 autoantibodies. J Neuroimmunol 2018; 319:63-67. [PMID: 29685291 DOI: 10.1016/j.jneuroim.2018.04.001] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/26/2018] [Accepted: 04/02/2018] [Indexed: 02/03/2023]
Abstract
The clinical features of cerebellar ataxia associated with anti-metabotropic glutamate receptor 1 (mGluR1) autoantibodies, a rare autoimmune-mediated cerebellar ataxia, remain to be elucidated. Here, we describe a patient with non-paraneoplastic cerebellar ataxia associated with anti-mGluR1 autoantibodies, who was followed up over 5 years. She presented with relapses and remissions of subacute progressive cerebellar ataxia that were responsive to immunotherapy. Although serum anti-mGluR1 autoantibodies were continuously detected and cerebellar atrophy gradually progressed, repeated intravenous immunoglobulin therapy and oral immunosuppressants ensured cerebellar ataxia remained at almost the same level during the observation period.
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Affiliation(s)
- Nobuaki Yoshikura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Kimura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan.
| | - Masaki Fukata
- Division of Membrane Physiology, Department of Molecular and Cellular Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Okazaki, Japan; Department of Physiological Sciences, School of Life Science, SOKENDAI, The Graduate University for Advanced Studies, Okazaki, Japan
| | - Yuko Fukata
- Division of Membrane Physiology, Department of Molecular and Cellular Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Okazaki, Japan; Department of Physiological Sciences, School of Life Science, SOKENDAI, The Graduate University for Advanced Studies, Okazaki, Japan
| | - Norihiko Yokoi
- Division of Membrane Physiology, Department of Molecular and Cellular Physiology, National Institute for Physiological Sciences, National Institutes of Natural Sciences, Okazaki, Japan; Department of Physiological Sciences, School of Life Science, SOKENDAI, The Graduate University for Advanced Studies, Okazaki, Japan
| | - Naoko Harada
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yuichi Hayashi
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takashi Inuzuka
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takayoshi Shimohata
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
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18
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Abstract
A 61-year-old woman was admitted to our hospital due to memory difficulties, visual hallucinations, and slowly progressing motor difficulties in the limbs. A clinical examination revealed bradykinesia, gait disturbance, left-side-dominant rigidity, ideomotor apraxia, dressing apraxia, left-sided spatial agnosia, impaired visuospatial ability, and executive dysfunction. Her symptoms were unresponsive to levodopa, and corticobasal syndrome (CBS) was diagnosed. One year later, amyloid positron emission tomography revealed amyloid beta accumulation in the bilateral cerebral cortices; at this point, CBS with underlying Alzheimer's disease pathology (CBS-AD) was diagnosed. Visual hallucinations may help differentiate CBS with corticobasal degeneration (CBS-CBD) from other pathologies, including CBS-AD.
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Affiliation(s)
- Hiroshi Nishida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Yuichi Hayashi
- Departments of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Japan
| | - Naoko Harada
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Takeo Sakurai
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
| | - Kenji Wakida
- Department of Neurology, Gifu Prefectural General Medical Center, Japan
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19
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Tada H, Miyashita M, Gonda K, Watanabe M, Suzuki A, Watanabe G, Harada N, Sato A, Hamanaka Y, Masuda N, Toi M, Ohno S, Bando H, Ishiguro H, Inoue K, Yamamoto N, Kuroi K, Ohuchi N, Ishida T. Abstract P2-09-28: New quantitative diagnostic method by fluorescence nanoparticle for HER2 positive breast cancer treated with neoadjuvant lapatinib and trastuzumab: The Neo LaTH study (JBCRG-16TR). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: HER2 (human epidermal growth factor receptor 2) testing performed by IHC (immunohistochemical) methods and FISH (fluorescence in situ hybridization) is semi-quantitative. Exact quantification of HER2 is needed to predict which patients are more or less likely to response to anti HER2 therapy. To improve the method for cancer patients' HER2 status, we developed a novel fluorescence IHC method using new fluorescence nanoparticle. The fluorescent intensity of this new nanoparticles, termed phosphor-integrated dot (PID), was approximately 100-fold brighter than that of Quantum dots. Because of its increased brightness and analyzing technology, this PID-based fluorescent IHC(IHC-PIC) has an ability of quantifying the biomarker protein in the cancer tissue sample at single particle level. In this study, the primary objective was to investigate if pathological complete response (pCR) rate in HER2- positive breast cancer treated by trastuzumab and lapatinib containing neoadjuvant systemic therapy would depend on the level of HER2, EGFR, HER3, Ki67, ER and PgR protein quantified by this new method.
Methods: The Neo-LaTH study is a randomized phase II multicenter trial evaluating the efficacy and safety of lapatinib and trastuzumab followed by lapatinib and trastuzumab plus weekly paclitaxel with or without prolongation of anti-HER2 therapy prior to chemotherapy (18 weeks vs. 6 weeks). The primary endpoint was the comprehensive pCR rate. We evaluated the HER2, EGFR, HER3, Ki67, ER and PgR amount by nano-patho method using PID in formalin-fixed paraffin-embedded core biopsy samples taken at diagnosis retrospective analysis. Univariate and multivariate analyses were performed to determine the association between pCR and variables, including HER2, EGFR, HER3, Ki67, ER and PgR nano-patho score and clinicopathological factors including histological grade, tumor status, nodal status and HER2 FISH ratio.
Results: A total of 96 tumor samples from patients were used for the present analysis.The pCR rate was 60.4%. We obtained the images of only PID signal by the image analyses, and calculated the number of PID particles in a cell and defined it as IHC-PID score that reflects the level of HER2, EGFR, HER3, Ki67, ER and PgR protein expression in cancer cells. Univariate analysis showed that HER2 IHC-PID score(p<0.0001), ER IHC-PID score(p=0.009) and PgR IHC-PID score(p=0.019) were associated with pCR and multivariate analysis showed that HER2 IHC-PID score was significantly associated with pCR (adjusted odds ratio, 0.990 [95% CI, 0.984–0.996]; P < .0001).
Conclusion: We successfully performed the quantitative IHC-PID for HER2, EGFR, HER3, Ki67, ER and PgR. And we propose using HER2 IHC-PID score as a predictive factor for trastuzumab and lapatinib containing neoadjuvant systemic therapy. This quantitative diagnostic method would be expected to contribute to the development of a molecular therapeutic strategy.
Citation Format: Tada H, Miyashita M, Gonda K, Watanabe M, Suzuki A, Watanabe G, Harada N, Sato A, Hamanaka Y, Masuda N, Toi M, Ohno S, Bando H, Ishiguro H, Inoue K, Yamamoto N, Kuroi K, Ohuchi N, Ishida T. New quantitative diagnostic method by fluorescence nanoparticle for HER2 positive breast cancer treated with neoadjuvant lapatinib and trastuzumab: The Neo LaTH study (JBCRG-16TR) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-28.
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Affiliation(s)
- H Tada
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Miyashita
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Gonda
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Watanabe
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - A Suzuki
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - G Watanabe
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Harada
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - A Sato
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Y Hamanaka
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Masuda
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - M Toi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - S Ohno
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - H Bando
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - H Ishiguro
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Inoue
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Yamamoto
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - K Kuroi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - N Ohuchi
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - T Ishida
- Tohoku University, 1-1, Seiryo-machi, Sendai, Miyagi, Japan; Graduate School of Medicine, Tohoku University; Tohoku University Hospital; NHO Osaka National Hospital, Osaka, Japan; Graduate School of Medicine Kyoto University, Kyoto, Japan; The Cancer Institute Hospital of JFCR, Koto-ku, Tokyo, Japan; Breast and Endocrine Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; International University of Health and Welfare, Narita, Chiba, Japan; Saitama Cancer Center, Kitaadachi-gun, Saitama, Japan; Chiba Cancer Center, Chiba, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
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20
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Harimoto N, Yugawa K, Ikegami T, Ohira M, Mano Y, Motomura T, Toshima T, Itoh S, Harada N, Soejima Y, Yoshizumi T, Maehara Y, Oda Y. Hepatobiliary and Pancreatic: Pregnancy induced hepatic veno-occlusive disease requiring liver transplantation. J Gastroenterol Hepatol 2018; 33:9. [PMID: 29284078 DOI: 10.1111/jgh.13975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- N Harimoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Yugawa
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Ohira
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Mano
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Motomura
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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21
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Ikegami T, Yoshizumi T, Ohira M, Harada N, Soejima Y, Maehara Y. Indication of living donor liver transplantation for septuagenarians from double equipoise theory. Am J Transplant 2018; 18:278-279. [PMID: 28742945 DOI: 10.1111/ajt.14446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Ohira
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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22
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Waza M, Hayashi Y, Sakurai T, Harada N, Nishida H, Isono M, Oku Y. Efficacy of interferential currents stimulation on post-stroke dysphagia: A case control study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2358] [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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23
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Motomura T, Yoshizumi T, Wang H, Nagatsu A, Itoh S, Harada N, Harimoto N, Ikegami T, Uchiyama H, Soejima Y, Maehara Y. Duct-to-duct Biliary Reconstruction in Living-donor Liver Transplantation for Primary Sclerosing Cholangitis: Report of a Case. Transplant Proc 2017; 49:1196-1198. [PMID: 28583556 DOI: 10.1016/j.transproceed.2017.03.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/18/2022]
Abstract
Although Roux-en Y hepaticojejunostomy was previously recommended for the biliary reconstruction in liver transplantation for primary sclerosing cholangitis (PSC), some recent reports showed no difference in the graft survival between Roux-en Y and duct-to-duct anastomosis in deceased-donor liver transplantation. On the other hand, considering the risk of recurrence and the short length of the bile duct of the graft, duct-to-duct biliary anastomosis has never been reported in a patient undergoing living-donor liver transplantation (LDLT) for PSC. A 45 year-old male underwent LDLT using a left-lobe graft donated from his brother. Cholangiography showed no lesion in his common bile duct and duct-to-duct anastomosis was chosen for him. Fifteen months later, he suffered cholangitis due to PSC recurrence and endoscopic retrograde cholangiography was performed. The stents were inserted into his B2 and B3, and he remains well. Because of the ability to easily manage biliary complication, duct-to-duct biliary reconstruction may become the first choice in LDLT for PSC without common bile duct lesions.
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Affiliation(s)
- T Motomura
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - H Wang
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Nagatsu
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Uchiyama
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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24
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Nagatsu A, Yoshizumi T, Ikegami T, Harimoto N, Harada N, Soejima Y, Taketomi A, Maehara Y. In Situ Posterior Graft Segmentectomy for Large-for-Size Syndrome in Deceased Donor Liver Transplantation in Adults: A Case Report. Transplant Proc 2017; 49:1199-1201. [PMID: 28583557 DOI: 10.1016/j.transproceed.2017.03.036] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Large-for-size syndrome (LFSS) is controversial in pediatric living donor liver transplantation patients and is associated with a poor graft outcome. Similar situations in deceased donor liver transplantation (DDLT) in adults have not been reported frequently, and there are no official guidelines worldwide. Deceased donation is extremely limited in Japan, and when a larger liver is allocated for a very sick small recipient in Japan, transplantation with a plan to address LFSS might be necessary. The patient is a 58-year-old female patient who had acute liver failure with coma. The graft-recipient weight ratio (GRWR) was 2.74%. Although the graft was enlarged by reperfusion, the intraoperative Doppler ultrasound, performed after reperfusion, showed sufficient graft in-flow and out-flow. However, when the liver graft was situated appropriately into the right phrenic space supported by the rib cage and diaphragm, the blood flow in the hepatic vein and portal vein was significantly reduced. Graft blood flow did not improve without removing it from the right subphrenic space. Therefore, we decided to perform an in situ graft posterior segmentectomy, so that the graft right lobe was properly accommodated in the patient's right subphrenic space. After the segmentectomy of the graft, an intraoperative Doppler sonogram showed significantly improved blood flow. LFSS could be a significant operative challenge in adult DDLT, especially in areas with limited chances of DDLT. In situ posterior segmentectomy in the demarcated area could be a solution for treating patients with LFSS.
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Affiliation(s)
- A Nagatsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Taketomi
- Department of General Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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Soejima Y, Yoshizumi T, Ikegami T, Harimoto N, Harada N, Ito S, Motomura T, Uchiyama H, Maehara Y. In Situ Procurement of a Recipient's Portal Vein for a Right Lobe Liver Graft With Multiple Venous Orifices: A Case Report. Transplant Proc 2017; 49:172-174. [PMID: 28104129 DOI: 10.1016/j.transproceed.2016.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/27/2016] [Accepted: 10/27/2016] [Indexed: 11/28/2022]
Abstract
Reconstruction of multiple venous orifices of a right lobe graft is a time-consuming and troublesome procedure in right lobe living-donor liver transplantation. In the current study, we present a new venous reconstruction technique for a right lobe graft with multiple and complex hepatic vein (HV) orifices, in which procurement of the recipient's left portal vein was performed in situ to keep the anhepatic period to a minimum. All of the HV orifices were reconstructed together at the back table, while maintaining patency of the recipient's systemic and splanchnic circulation. A homologous vein graft and veno-venous bypass were not necessary. All HVs were patent during the follow-up and the patient was free from complications. In conclusion, the present technique is readily available for reconstruction of complex and multiple HV tributaries, while avoiding a long anhepatic time and the use of veno-venous bypass.
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Affiliation(s)
- Y Soejima
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan.
| | - T Yoshizumi
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - T Ikegami
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - S Ito
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - T Motomura
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - H Uchiyama
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Kyushu University, Fukuoka, Japan
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26
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Kimura A, Takemura M, Saito K, Yoshikura N, Hayashi Y, Harada N, Nishida H, Nakajima H, Inuzuka T. Comparison of cerebrospinal fluid profiles in Alzheimer's disease with multiple cerebral microbleeds and cerebral amyloid angiopathy-related inflammation. J Neurol 2016; 264:373-381. [PMID: 28000005 DOI: 10.1007/s00415-016-8362-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 07/18/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 01/25/2023]
Abstract
Brain magnetic resonance imaging (MRI) of patients with Alzheimer's disease (AD) sometimes reveals multiple cerebral microbleeds (CMBs) and confluent white matter hyperintensities (WMHs) similar to those observed in cerebral amyloid angiopathy-related inflammation (CAA-I). To determine whether there might be common pathophysiological mechanisms underlying the MRI findings of multiple CMBs and confluent WMHs, we investigated the cerebrospinal fluid (CSF) profiles of 38 AD, five amnestic mild cognitive impairment (MCI), and six CAA-I patients. The AD and MCI patients were divided into groups of patients with (n = 10) or without (n = 33) multiple CMBs (n ≥ 2) on T2*-gradient echo sequences of brain MRI. We compared the CSF profiles of AD and MCI patients with or without multiple CMBs, and CAA-I patients. The brain MRIs of the patients with multiple CMBs revealed severe degrees of WMHs compared with the patients without multiple CMBs. The levels of CSF anti-amyloid β autoantibody and interleukin 8, and CSF/serum albumin ratios and immunoglobulin G indexes, were significantly higher in CAA-I patients than the other groups. However, there were no significant differences in the CSF profiles of patients with or without multiple CMBs. Our study provides evidence for different pathophysiological mechanisms underlying these differential MRI findings in AD and CAA-I.
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Affiliation(s)
- Akio Kimura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.
| | - Masao Takemura
- Department of Informative Clinical Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
- Advanced Diagnostic System Research Laboratory, Fujita Health University Graduate School of Health Sciences, Toyoake, Aichi, Japan
| | - Kuniaki Saito
- Department of Disease Control and Prevention, Fujita Health University Graduate School of Health Sciences, Toyoake, Aichi, Japan
| | - Nobuaki Yoshikura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Yuichi Hayashi
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
| | - Naoko Harada
- Neurology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Hiroshi Nishida
- Neurology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Hideto Nakajima
- Department of Internal Medicine I, Osaka Medical College, Takatsuki, Japan
| | - Takashi Inuzuka
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan
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Tanisho Y, Shigemura J, Kubota K, Tanigawa T, Bromet EJ, Takahashi S, Matsuoka Y, Nishi D, Nagamine M, Harada N, Tanichi M, Takahashi Y, Shimizu K, Nomura S, Yoshino A. The longitudinal mental health impact of Fukushima nuclear disaster exposures and public criticism among power plant workers: the Fukushima NEWS Project study. Psychol Med 2016; 46:3117-3125. [PMID: 27534897 PMCID: PMC5108304 DOI: 10.1017/s003329171600194x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Fukushima Daiichi and Daini Nuclear Power Plant workers experienced multiple stressors as both victims and onsite workers after the 2011 Great East Japan Earthquake and subsequent nuclear accidents. Previous studies found that disaster-related exposures, including discrimination/slurs, were associated with their mental health. Their long-term impact has yet to be investigated. METHOD A total of 968 plant workers (Daiichi, n = 571; Daini, n = 397) completed self-written questionnaires 2-3 months (time 1) and 14-15 months (time 2) after the disaster (response rate 55.0%). Sociodemographics, disaster-related experiences, and peritraumatic distress were assessed at time 1. At time 1 and time 2, general psychological distress (GPD) and post-traumatic stress response (PTSR) were measured, respectively, using the K6 scale and Impact of Event Scale Revised. We examined multivariate covariates of time 2 GPD and PTSR, adjusting for autocorrelations in the hierarchical multiple regression analyses. RESULTS Higher GPD at time 2 was predicted by higher GPD at time 1 (β = 0.491, p < 0.001) and discrimination/slurs experiences at time 1 (β = 0.065, p = 0.025, adjusted R 2 = 0.24). Higher PTSR at time 2 was predicted with higher PTSR at time 1 (β = 0.548, p < 0.001), higher age (β = 0.085, p = 0.005), and discrimination/slurs experiences at time 1 (β = 0.079, p = 0.003, adjusted R 2 = 0.36). CONCLUSIONS Higher GPD at time 2 was predicted by higher GPD and discrimination/slurs experience at time 1. Higher PTSR at time 2 was predicted by higher PTSR, higher age, and discrimination/slurs experience at time 1.
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Affiliation(s)
- Y. Tanisho
- Health and Global Policy Institute, Chiyoda-ku, Tokyo, Japan
| | - J. Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - K. Kubota
- Department of Biostatistics, School of Medicine, Yokohama City University, Kanazawa-ku, Yokohama, Japan
| | - T. Tanigawa
- Department of Public Health, School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - E. J. Bromet
- Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - S. Takahashi
- Department of Disaster Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Y. Matsuoka
- Department of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - D. Nishi
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - M. Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - N. Harada
- Nursing Science of Community Health Care System, Department of Nursing, Tohoku University School of Health Sciences, Sendai, Japan
| | - M. Tanichi
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Y. Takahashi
- Department of Disaster Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - K. Shimizu
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - S. Nomura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
- Rokubancho Mental Clinic, Japan Depression Center, Chiyoda-ku, Tokyo, Japan
| | - A. Yoshino
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
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Sasamoto T, Fujimoto K, Kanawa M, Kimura J, Takeuchi J, Harada N, Goto N, Kawamoto T, Noshiro M, Suardita K, Tanne K, Kato Y. DEC2 is a negative regulator for the proliferation and differentiation of chondrocyte lineage-committed mesenchymal stem cells. Int J Mol Med 2016; 38:876-84. [PMID: 27430159 DOI: 10.3892/ijmm.2016.2660] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/15/2016] [Indexed: 11/06/2022] Open
Abstract
Differentiated embryo chondrocyte 2 (DEC2) is a basic helix-loop-helix-Orange transcription factor that regulates cell differentiation in various mammalian tissues. DEC2 has been shown to suppress the differentiation of mesenchymal stem cells (MSCs) into myocytes and adipocytes. In the present study, we examined the role of DEC2 in the chondrogenic differentiation of human MSCs. The overexpression of DEC2 exerted minimal effects on the proliferation of MSCs in monolayer cultures with the growth medium under undifferentiating conditions, whereas it suppressed increases in DNA content, glycosaminoglycan content, and the expression of several chondrocyte-related genes, including aggrecan and type X collagen alpha 1, in MSC pellets in centrifuge tubes under chondrogenic conditions. In the pellets exposed to chondrogenesis induction medium, DEC2 overexpression downregulated the mRNA expression of fibroblast growth factor 18, which is involved in the proliferation and differentiation of chondrocytes, and upregulated the expression of p16INK4, which is a cell cycle inhibitor. These findings suggest that DEC2 is a negative regulator of the proliferation and differentiation of chondrocyte lineage-committed mesenchymal cells.
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Affiliation(s)
- Tomoko Sasamoto
- Department of Orthodontic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Katsumi Fujimoto
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masami Kanawa
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima 734-8553, Japan
| | - Junko Kimura
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Junpei Takeuchi
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Naoko Harada
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Noriko Goto
- Department of Pediatric Dentistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Takeshi Kawamoto
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Mitsuhide Noshiro
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Ketut Suardita
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Kazuo Tanne
- Department of Orthodontic Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Yukio Kato
- Department of Dental and Medical Biochemistry, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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Higuchi Y, Tokunaga K, Watanabe Y, Kawakita T, Harada N, Yamaguchi S, Nosaka K, Mitsuya H, Asou N. Lineage switch with t(6;11)(q27;q23) from T-cell lymphoblastic lymphoma to acute monoblastic leukemia at relapse. Cancer Genet 2016; 209:267-71. [PMID: 27268298 DOI: 10.1016/j.cancergen.2016.05.070] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/18/2016] [Accepted: 05/17/2016] [Indexed: 11/25/2022]
Abstract
We present a patient with T-cell lymphoblastic lymphoma (T-LBL) harboring t(6;11)(q27;q23) that converted to acute monoblastic leukemia at relapse. A 27-year-old man developed T-LBL with a mediastinal mass. He exhibited several recurrences in the central nervous system and marrow. A fifth relapse occurred in the marrow, with 42.8% blasts with CD4, CD5, CD7, CD10, CD33, CD34, HLA-DR and cytoplasmic (cy) CD3. While achieving complete remission with nelarabine, sixth relapse occurred in the marrow with 6.8% blasts, which had characteristics of monoblastic features, 2 months later. Marrow blasts were positive for myeloperoxidase, CD4, CD33, CD56, CD64, and HLA-DR, but were negative for cyCD3, CD5, CD7, CD10, and CD34. Marrow cells at both the 5th lymphoid and 6th myeloid relapses had t(6;11)(q27;q23) and the same MLL-MLLT4 fusion transcript. In addition, the MLL-MLLT4 fusion sequences documented in the initial mediastinal cells were the same as seen in peripheral blood cells at the 6th relapse. The patient continues 7th remission after one course of gemtuzumab ozogamicin therapy followed by cord blood transplantation for more than 3 years. Sequential phenotypic and cytogenetic studies may yield valuable insights into the mechanism of leukemic recurrence and possible implications for treatment selection.
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Affiliation(s)
- Yusuke Higuchi
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto
| | - Kenji Tokunaga
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto
| | - Yuko Watanabe
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto
| | - Toshiro Kawakita
- Department of Hematology, National Institute of Kumamoto Medical Center, Kumamoto
| | - Naoko Harada
- Department of Hematology, National Institute of Kumamoto Medical Center, Kumamoto
| | | | - Kisato Nosaka
- Cancer Center, Kumamoto University Hospital, Kumamoto
| | - Hiroaki Mitsuya
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto
| | - Norio Asou
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto; Department of Hematology, International Medical Center, Saitama Medical University, Saitama, Japan.
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Harada N, Hiragun M, Mizuno M, Kawaguchi T, Ishii K, Yanase Y, Hiragun T, Sugita Y, Hide M. A Case of Erythritol Allergy Studied by Basophil Histamine Release and CD203c Expression In Vitro in Addition to a Challenge Test In Vivo. J Investig Allergol Clin Immunol 2016; 26:135-6. [PMID: 27164638 DOI: 10.18176/jiaci.0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- N Harada
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Hiragun
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Mizuno
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Kawaguchi
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ishii
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Yanase
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Hiragun
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Sugita
- Sugita Skin and Allergy Clinic, Higashihiroshima, Japan
| | - M Hide
- Department of Dermatology, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Hayashi Y, Godai A, Yamada M, Yoshikura N, Harada N, Koumura A, Kimura A, Okayasu S, Matsuno Y, Kinosada Y, Itoh Y, Inuzuka T. Reduction in the numbers of drugs administered to elderly in-patients with polypharmacy by a multidisciplinary review of medication using electronic medical records. Geriatr Gerontol Int 2016; 17:653-658. [PMID: 27137480 DOI: 10.1111/ggi.12764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/08/2016] [Accepted: 01/29/2016] [Indexed: 01/05/2023]
Abstract
AIM Polypharmacy is a major problem for elderly patients in developed countries. We investigated whether a multidisciplinary medication review using electronic medical records could reduce the number of drugs administered to elderly patients receiving polypharmacy. METHODS The present study included 432 elderly patients (188 women, 244 men; 267 patients aged 65-74 years and 165 patients aged ≥75 years) who were admitted to and discharged from the Department of Neurology and Geriatrics, Gifu University Hospital, between 2004 and 2011; those who died at the hospital were excluded. The names, categories, and numbers of orally administered drugs at admission and discharge were examined retrospectively using electronic medical records. The histories of continuous oral immunotherapy use at the hospital, falls during the 2 years before hospital admission and the presence of fall risk factors were also evaluated. P-values <0.05 were considered statistically significant. RESULTS On average 1.14 ± 3.07 fewer types of drugs were given to patients at discharge than at admission in patients receiving polypharmacy (P < 0.001). However, the number of drugs given to patients undergoing continuous oral immunotherapy increased by 1.67 ± 3.47 (P < 0.001). The number of drugs was reduced in 33.1% of fallers, and 36.3% of non-fallers. In both fallers and non-fallers, there was a reduction in drug categories associated with falls. CONCLUSIONS Multidisciplinary medication review using electronic medical records could significantly reduce the numbers of drugs taken by elderly inpatients receiving polypharmacy, including drugs associated with falls, in both fallers and non-fallers Geriatr Gerontol Int 2017; 17: 653-658.
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Affiliation(s)
- Yuichi Hayashi
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Ayumi Godai
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Megumi Yamada
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Nobuaki Yoshikura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Naoko Harada
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akihiro Koumura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Akio Kimura
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shinji Okayasu
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Yasuko Matsuno
- Division of Nursing, Gifu University Hospital, Gifu, Japan
| | - Yasutomi Kinosada
- Department of Biomedical Informatics, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoshinori Itoh
- Department of Pharmacy, Gifu University Hospital, Gifu, Japan
| | - Takashi Inuzuka
- Department of Neurology and Geriatrics, Gifu University Graduate School of Medicine, Gifu, Japan
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Chiba R, Miyamoto Y, Harada N. Psychological Transformation by an Intervention to Facilitate Benefit Finding Among People With Chronic Mental Illness in Japan. Perspect Psychiatr Care 2016; 52:139-44. [PMID: 25772412 DOI: 10.1111/ppc.12110] [Citation(s) in RCA: 5] [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: 09/28/2014] [Revised: 01/13/2015] [Accepted: 02/11/2015] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to preliminarily explore the psychological transformation effected by a newly developed intervention program for facilitating benefit finding among individuals with chronic mental illness in Japan. DESIGN AND METHODS An intervention study with three weekly group sessions was implemented, and qualitative data on the participants' experience of benefit finding were obtained by a questionnaire survey and analyzed using content analysis technique. FINDINGS Of the 31 participants, 23 responded that they realized some sort of benefit finding through the intervention. PRACTICE IMPLICATIONS The program component in question may contribute to enhanced benefit finding for people with chronic mental illness while longitudinal studies involving more participants are desirable.
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Affiliation(s)
- Rie Chiba
- School of Nursing, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoko Harada
- Department of Nursing, Faculty of Human Sciences, Sophia University, Tokyo, Japan
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Takeishi K, Ikegami T, Yoshizumi T, Itoh S, Harimoto N, Harada N, Tsujita E, Kimura Y, Yamashita Y, Saeki K, Oki E, Shirabe K, Maehara Y. Thymoglobulin for steroid-resistant immune-mediated graft dysfunction during simeprevir-based antiviral treatment for post-transplantation hepatitis C: case report. Transplant Proc 2015; 47:794-5. [PMID: 25891734 DOI: 10.1016/j.transproceed.2014.11.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/09/2014] [Accepted: 11/18/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Immune-mediated graft dysfunction (IGD), a recently established disease entity with unfavourable outcome, is an antigraft immune reaction during interferon-based antiviral treatment for hepatitis C virus (HCV) infection after liver transplantation (LT). We report a case having steroid-resistant acute cellular rejection (ACR) type IGD, which was successfully treated using thymoglobulin. CASE REPORT A 56-year-old woman with recurrent HCV after LT was commenced on antiviral treatment including simeprevir, pegylated-interferon (IFN) 2a, and ribavirin. A negative serum HCV-RNA was confirmed after 4 weeks. After 12 weeks of therapy, severe liver dysfunction developed, despite a constantly negative HCV-RNA. Liver biopsy revealed portal and periportal inflammatory infiltrates including numerous eosinophils, lymphocytes, and bile duct damages, indicating ACR. IFN therapy was ceased, and she was treated with steroid pulse treatment, followed by high-level immunosuppression maintenance. However, ACR was irremediable. Thereafter she was treated with thymoglobulin (75 mg/d for 5 days). Her serum alanine aminotransaminase and total bilirubin levels decreased immediately, and her liver biopsy specimen showed no activity. During these periods of the treatment, the HCV-RNA became positive and the liver enzyme elevated, but other liver function tests still remained within normal range. CONCLUSION Thymoglobulin could be the best choice in steroid-resistant IGD during antiviral treatment for post-transplantation recurrent hepatitis C.
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Affiliation(s)
- K Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
| | - T Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - E Tsujita
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Y Kimura
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Y Yamashita
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - K Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - K Shirabe
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
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Ikegami T, Yoshizumi T, Soejima Y, Harimoto N, Itoh S, Takeishi K, Uchiyama H, Kawanaka H, Yamashita YI, Tsujita E, Harada N, Oki E, Saeki H, Kimura Y, Shirabe K, Maehara Y. Triple therapy using direct-acting agents for recurrent hepatitis C after liver transplantation: a single-center experience. Transplant Proc 2015; 47:730-2. [PMID: 25891720 DOI: 10.1016/j.transproceed.2014.10.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/05/2014] [Accepted: 10/28/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hepatitis C viral graft reinfection is almost a universal event after liver transplantation with consequent disease progression. METHODS We applied triple therapy (n = 21) with the use of telaprevir (TVR; n = 12) or simeprevir (SVR; n = 9). RESULTS TVR was given at the dose 1,500 mg daily (n = 11) with reduced dose of cyclosporine at 25% to 50%, and SVR was given at the dose 100 mg daily with unadjusted cyclosporine, followed by 12 weeks of dual therapy. The early viral response was achieved in 91.7% (n = 11), end of treatment response rate was 91.7% (n = 11), and sustained viral response rate was 83.3% (n = 10) in the TVR group, and respective rates were 88.9% (n = 8), 77.8% (n = 7), and 77.8% (n = 7) in the SVR group. Although granulocyte colony-stimulating factor was not given in the patients with triple therapy, blood transfusion was performed in 7 cases (58.3%) in the TVR group and 1 case (11.1%) in the SVR group. Interferon-mediated graft dysfunction was observed in 4 cases (33.3%) in the TVR group and 3 cases (33.3%) in the SVR group, respectively. The cumulative viral clearance rates in triple (n = 21) and dual (n = 105) therapy were 95.0% and 18.1% at 12 weeks, and 95.0% and 40.0%, respectively, at 24 weeks (P < .01). CONCLUSIONS Although careful monitoring for possible adverse events is required during treatment, triple therapy with the use of direct-acting agents are very effective in treating hepatitis C after liver transplantation.
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Affiliation(s)
- T Ikegami
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
| | - T Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Soejima
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - N Harimoto
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - S Itoh
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Takeishi
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Uchiyama
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Kawanaka
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y-I Yamashita
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Tsujita
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - N Harada
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - H Saeki
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Kimura
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - K Shirabe
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
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Adachi T, Kishihara Y, Okano H, Honzawa H, Hirayama M, Higashi H, Yasuda H, Minami Y, Hara S, Harada N, Katsumi A, Suzaki S. The utility of procalcitonin for the patients with infected pancreatic necrotic and pancreatic abscess. Intensive Care Med Exp 2015. [PMCID: PMC4796962 DOI: 10.1186/2197-425x-3-s1-a113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Furugaki K, Fukumura J, Iwai T, Yorozu K, Yanagisawa M, Moriya Y, Kurasawa M, Yamamoto K, Suda K, Mizuuchi H, Mitsudomi T, Harada N. 3046 Impact of bevacizumab in combination with erlotinib on EGFRmutatant non-small cell lung cancer xenograft models with T790M mutation or MET amplification. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31688-4] [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: 10/22/2022]
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Harada N, Okada S, Kunimune S, Nishimura T. Prefrontal activation during a consecutive calculation related strategies for postural control in human adults: a fNIRS study. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wakelam V, Loison JC, Herbst E, Pavone B, Bergeat A, Béroff K, Chabot M, Faure A, Galli D, Geppert WD, Gerlich D, Gratier P, Harada N, Hickson KM, Honvault P, Klippenstein SJ, Picard SDL, Nyman G, Ruaud M, Schlemmer S, Sims IR, Talbi D, Tennyson J, Wester R. THE 2014 KIDA NETWORK FOR INTERSTELLAR CHEMISTRY. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0067-0049/217/2/20] [Citation(s) in RCA: 238] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Oze T, Hiramatsu N, Yakushijin T, Yamada R, Harada N, Morishita N, Oshita M, Mita E, Ito T, Inui Y, Inada M, Tamura S, Yoshihara H, Imai Y, Kato M, Miyagi T, Yoshida Y, Tatsumi T, Kasahara A, Hayashi N, Takehara T. The real impact of telaprevir dosage on the antiviral and side effects of telaprevir, pegylated interferon and ribavirin therapy for chronic hepatitis C patients with HCV genotype 1. J Viral Hepat 2015; 22:254-62. [PMID: 25081140 DOI: 10.1111/jvh.12289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 05/14/2014] [Indexed: 01/28/2023]
Abstract
Triple therapy with telaprevir, pegylated interferon and ribavirin has been reported to improve antiviral efficacy but have potentially severe adverse effects in patients with chronic hepatitis C. To avoid the severe effects of telaprevir, lowering the dose has been suggested. However, impact of dosage changes on antiviral and adverse effects remains unclear. One hundred and sixty-six Japanese patients with HCV genotype 1 were treated with triple therapy. The drug exposure of each medication was calculated by averaging the dose actually taken. The overall SVR rate was 82%. The telaprevir discontinuation rate was 26%. The factors associated with discontinuation were an older age (≥65 y.o.) and a higher average dose during treatment. The telaprevir discontinuation rates were 42%, 25% and 14% in patients at ≥35, 25-35 and <25 mg/kg/day of telaprevir and 58% in older patients at ≥35 mg/kg/day of TVR. The factors associated with SVR were treatment-naïve, relapse to previous treatment, higher average telaprevir dose during treatment and completion of treatment. The SVR rate was higher, at 91%, in patients at 25-35 mg/kg/day of telaprevir than the 71% and 78% observed in those at <25 and ≥35 mg/kg/day of drug. In Japanese patients, a mean telaprevir dose of 25-35 mg/kg/day during treatment can augment its efficacy in triple therapy for patients with HCV genotype 1.
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Affiliation(s)
- T Oze
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Terasako-Saito K, Nakasone H, Tanaka Y, Yamazaki R, Sato M, Sakamoto K, Ishihara Y, Kawamura K, Akahoshi Y, Hayakawa J, Wada H, Harada N, Nakano H, Kameda K, Ugai T, Yamasaki R, Ashizawa M, Kimura SI, Kikuchi M, Tanihara A, Kanda J, Kako S, Nishida J, Kanda Y. Persistence of recipient-derived as well as donor-derived clones of cytomegalovirus pp65-specific cytotoxic T cells long after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2014; 16:930-40. [DOI: 10.1111/tid.12318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/14/2014] [Indexed: 11/27/2022]
Affiliation(s)
- K. Terasako-Saito
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - H. Nakasone
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - Y. Tanaka
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - R. Yamazaki
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - M. Sato
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - K. Sakamoto
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - Y. Ishihara
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - K. Kawamura
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - Y. Akahoshi
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - J. Hayakawa
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - H. Wada
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - N. Harada
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - H. Nakano
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - K. Kameda
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - T. Ugai
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - R. Yamasaki
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - M. Ashizawa
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - S.-I. Kimura
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - M. Kikuchi
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - A. Tanihara
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - J. Kanda
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - S. Kako
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - J. Nishida
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
| | - Y. Kanda
- Division of Hematology; Saitama Medical Center; Jichi Medical University; Saitama Japan
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Muta T, Iida S, Matsue K, Sunami K, Isoda J, Harada N, Kuroda J, Miyamoto T, Akashi K, Takamatsu Y. Characteristics and Risk for Progression of Smoldering Multiple Myeloma: Japanese Nationwide Retrospective Survey. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu435.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Harada N, Kurahashi M, Haga M. The Influence of Low Casein Diet on the Fatty Acid Composition of Rat Liver Mitochondrial Phosphatides. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/00021369.1969.10859301] [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: 10/21/2022]
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Furugaki K, Yamamoto K, Moriya Y, Suda K, Mizuuchi H, Mitsudomi T, Harada N. Antitumor Activity of Bevacizumab Combined with Erlotinib in T790M Resistance Mutation Positive Non-Small Cell Lung Cancer Xenograft Models. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Harada N, Hiramatsu N, Oze T, Morishita N, Yamada R, Hikita H, Miyazaki M, Yakushijin T, Miyagi T, Yoshida Y, Tatsumi T, Kanto T, Kasahara A, Oshita M, Mita E, Hagiwara H, Inui Y, Katayama K, Tamura S, Yoshihara H, Imai Y, Inoue A, Hayashi N, Takehara T. Risk factors for hepatocellular carcinoma in hepatitis C patients with normal alanine aminotransferase treated with pegylated interferon and ribavirin. J Viral Hepat 2014; 21:357-65. [PMID: 24716638 DOI: 10.1111/jvh.12151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 05/02/2013] [Accepted: 06/20/2013] [Indexed: 12/09/2022]
Abstract
Pegylated interferon (Peg-IFN) plus ribavirin combination therapy is effective in patients with hepatitis C virus (HCV) infection and normal alanine aminotransferase levels (NALT). However, it remains unclear whether the risk of hepatocellular carcinoma (HCC) incidence is actually reduced in virological responders. In this study, HCC incidence was examined for 809 patients with NALT (ALT ≤ 40 IU/mL) treated with Peg-IFN alpha-2b and ribavirin for a mean observation period of 36.2 ± 16.5 months. The risk factors for HCC incidence were analysed by Kaplan-Meier method and Cox proportional hazards model. On multivariate analysis among NALT patients, the risk of HCC incidence was significantly reduced in patients with sustained virological response (SVR) or relapse compared with those showing nonresponse (NR) (SVR vs NR, hazard ratio (HR): 0.16, P = 0.009, relapse vs NR, HR: 0.11, P = 0.037). Other risk factors were older age (≥65 years vs <60 years, HR: 6.0, P = 0.032, 60-64 vs <60 years, HR: 3.2, P = 0.212) and male gender (HR: 3.9, P = 0.031). Among 176 patients with PNALT (ALT ≤ 30 IU/mL), only one patient developed HCC and no significant risk factors associated with HCC development were found. In conclusion, antiviral therapy for NALT patients with HCV infection can lower the HCC incidence in responders, particularly for aged and male patients. The indication of antiviral therapy for PNALT (ALT ≤ 30 IU/mL) patients should be carefully determined.
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Affiliation(s)
- N Harada
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
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Abstract
OBJECTIVES The aim of this study was to analyse the position and relationship of juxta-apical radiolucency (JAR) to the mandibular canal and buccal and/or lingual cortical plates using cone beam CT (CBCT). METHODS A retrospective study was carried out to analyse the JAR on CBCT for 27 patients. These findings were compared with 27 age- and sex-matched patients without the presence of JAR, which acted as the control group. The CBCT images were analysed according to a checklist, to evaluate the position of the JAR and its relationship to the mandibular canal. Then, any thinning or perforation of either the buccal or lingual cortical plate due to JAR was noted, and a classification to quantify the thinning of cortical plates was proposed. The findings in the two groups were analysed using a paired comparison by McNemar test. RESULTS A statistical increased thinning of cortical plates was seen in the JAR group compared with the control group, and most of the cases were in the J3 group. None of the patients in either the JAR or the control group showed perforation of the buccal and/or lingual cortical plate on CBCT images. CONCLUSIONS A classification to quantify the thinning of cortical plates was proposed, which may be used for objective evaluation of the thinning of the cortical plates in future studies. The present study gives an insight into the relationship of the juxta-apical area with the mandibular canal and cortical plates in the mandible using CBCT.
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Affiliation(s)
- R Kapila
- 1 Division of Radiology, Department of Oral Diagnostic Sciences, Showa University School of Dentistry, Tokyo, Japan
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Hiroshige K, Mahbub MH, Harada N. Effects of whole-body vibration on postural balance and proprioception in healthy young and elderly subjects: a randomized cross-over study. J Sports Med Phys Fitness 2014; 54:216-224. [PMID: 24509994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this paper was to investigate the effects of the whole-body vibration (WBV) intervention on neuromuscular performances in both young and elderly healthy subjects, taking into consideration the recommendations of the international standard for such exposure. METHODS Two groups of healthy subjects (9 young and 18 elderly) received the intervention while standing on a side-alternating platform, during two exposure periods of 8 weeks each separated by a washout period of 8 weeks between those periods. The intervention (with or without exposure to vibration) was administered twice a week. Vibration was produced at 20 Hz with an unweighted acceleration of 11.2 m/s2 rms in the first 4 weeks, and 22.3 m/s2 rms, in the last 4 weeks. Blood pressure, heart rate, single leg stance time with closed eyes (SSCE), postural stability parameters and knee joint position sense were measured before and after intervention and were compared. RESULTS In the young group, the post-intervention measurement values did not differ from the corresponding pre-intervention values. In the elderly group, SSCE at the right side significantly increased (P<0.014) after vibration intervention. The lateral sway (X-axis locus length) of postural stability parameter after WBV intervention tended to decrease in the elderly group (P=0.078). However, in both groups, pre- and post-intervention values of knee joint position sense were not significantly different. CONCLUSION The used level of vibration showed some improvements in postural balance among the elderly. However, an effective level of vibration exposure should be decided for this purpose, considering the recommendations of the relevant standards.
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Affiliation(s)
- K Hiroshige
- Department of Hygiene Yamaguchi University Graduate School of Medicine Yamaguchi, Japan -
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Harada N, Muraoka D, Hayashi T, Momose F, Shiku H, Tahara Y, Sawada S, Akiyoshi K. P56. A novel cancer vaccine with nanogel-based antigen transporter and sequence-optimised long peptide antigen. J Immunother Cancer 2014. [PMCID: PMC4072102 DOI: 10.1186/2051-1426-2-s2-p30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Harada N, Varghese V, Tharayil IA, Kenny L. Abstract P3-01-07: Metformin has an additive effect to cisplatin in triple negative breast cancer cells with high lactate dehydrogenase B (LDHB) expression. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-01-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background;
Glycolysis is one of the major metabolic pathways in cancer cells. The conversion of glucose to lactate in the presence of oxygen is a critical aerobic pathway that allows cancer cells to proliferate rapidly and the amount of lactate produced is correlated with tumor aggressiveness. Moreover, the increase in glycolysis is partially mediated by hypoxia-inducible transcription factor (HIF-1) and a metabolic enzyme, lactate dehydrogenase B (LDHB). However, the mechanism behind this metabolic shift is not well understood. Metformin reduces the overall risk of cancer incidence by 31%, improves cancer-related mortality and enhances response to chemotherapy in diabetic patients pre-operatively. This study aimed to evaluate metabolism in triple negative breast cancer.
Methods;
Breast cancer cell lines (estrogen receptor positive MCF7 and triple negative MDA-MB 231 and MDA-MB468) were analysed for protein expression by western blotting and mRNA expression by qRT-PCR with or without cisplatin and metformin. To study the biological mechanism, we evaluated cell growth using proliferation assay in the presence of metformin and cisplatin. The contribution of LDHB to glycolysis was evaluated using MDA-MB-231 and MDA-MB468 cell lines.
Results;
We first examined the basal expression levels of LDHB and HIF1a in these cancer cell lines. LDHB expression was high in MDA-MB 231, and HIF1α was high in MDA-MB468. Both metformin and cisplatin treatment resulted in the down-regulation of LDHB and HIF1α in MDA-MB231, metformin led to downregulation of LDHB in MDA-MB 468, while MCF7 demonstrated no significant changes. Inhibition of cell proliferation was dose-dependent and significant at low concentrations of cisplatin and metformin in only MDA-MB468 but not in MCF7 and MDA-MB231. The combination of cisplatin in with metformin had an added inhibitory effect on cell proliferation in these MD-MB231 cells.
Conclusion;
These studies suggest that combination treatment of metformin and cisplatin have potent anticancer activity in LDHB highly expressed triple negative breast cancer cells. Identification of a new targeted therapeutic approach could contribute to the new therapy to the breast cancer patients.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-01-07.
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Affiliation(s)
- N Harada
- Imperial College London, London, United Kingdom
| | - V Varghese
- Imperial College London, London, United Kingdom
| | - IA Tharayil
- Imperial College London, London, United Kingdom
| | - L Kenny
- Imperial College London, London, United Kingdom
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Antony Tharayil I, Harada N, Patel N, Varghese V, Kenny L. Abstract P4-01-22: Measurement of tumour lesion glycolysis by FDG-PET in triple negative breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-01-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Triple negative breast cancer (TNBC) has been associated with a high glycolytic rate. As a surrogate measure, the SUV of FDG uptake is found to be higher both in the TNBC and her2 positive phenotypes. Tumour lesion glycolysis (TLG) is a product of the mean SUV value and tumour volume. We wished to evaluate the role of combined volume and metabolic measurements of glycolysis in patients with TNBC.
Methods: 300 FDG-PET scans were performed in patients with breast cancer, of whom 25 were found to have TNBC over a 4 year period, in 19 patients there were suitable lesions identified for analysis. Patients were scanned on the same Siemens PET/CT scanner in the local hospital, static images were acquired 60 minutes post-injection. SUV was corrected for injected activity and body weight, TLGMAX50 was also calculated considering SUV50 isocontour instead of SUV mean. ∑TLG was the sum of TLG for an individual patient.
Results: 117 lesions in total from 19 different patients were analyzed (mean = 6.15 lesions per patient). SUVMEAN, TLG mean, SUVMAX and TLGMAX were calculated for each lesion. SUVMEAN per patient varied from 2.69 to 15.48 while SUV50 varied from 5.45 to 48.23. ∑TLGMEAN and ∑TLGMAX ranged from 13.06 to 364.072 and 18.29 to 575.627, respectively. There was significant variation between patients and within different tumor lesions within patients. SUVPEAK for all lesions of patients ranged from 4.8 to 36.4.
Conclusions: TLG varies widely in patients with triple negative breast cancer, further studies are required to determine if this will be a useful prognostic/predictive measure in the future.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-01-22.
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Affiliation(s)
- I Antony Tharayil
- Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
| | - N Harada
- Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
| | - N Patel
- Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
| | - V Varghese
- Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
| | - L Kenny
- Imperial College London, London, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom
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