1
|
Murali A, Alapatt D, Mascagni P, Vardazaryan A, Garcia A, Okamoto N, Mutter D, Padoy N. Latent Graph Representations for Critical View of Safety Assessment. IEEE Trans Med Imaging 2024; 43:1247-1258. [PMID: 37971921 DOI: 10.1109/tmi.2023.3333034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Assessing the critical view of safety in laparoscopic cholecystectomy requires accurate identification and localization of key anatomical structures, reasoning about their geometric relationships to one another, and determining the quality of their exposure. Prior works have approached this task by including semantic segmentation as an intermediate step, using predicted segmentation masks to then predict the CVS. While these methods are effective, they rely on extremely expensive ground-truth segmentation annotations and tend to fail when the predicted segmentation is incorrect, limiting generalization. In this work, we propose a method for CVS prediction wherein we first represent a surgical image using a disentangled latent scene graph, then process this representation using a graph neural network. Our graph representations explicitly encode semantic information - object location, class information, geometric relations - to improve anatomy-driven reasoning, as well as visual features to retain differentiability and thereby provide robustness to semantic errors. Finally, to address annotation cost, we propose to train our method using only bounding box annotations, incorporating an auxiliary image reconstruction objective to learn fine-grained object boundaries. We show that our method not only outperforms several baseline methods when trained with bounding box annotations, but also scales effectively when trained with segmentation masks, maintaining state-of-the-art performance.
Collapse
|
2
|
Okamoto N, Mineta S, Mishima K, Fujiyama Y, Wakabayashi T, Fujita S, Sakamoto J, Wakabayashi G. Comparison of short-term outcomes of robotic and laparoscopic transabdominal peritoneal repair for unilateral inguinal hernia: a propensity-score matched analysis. Hernia 2023; 27:1131-1138. [PMID: 36595086 DOI: 10.1007/s10029-022-02730-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/19/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE This study aimed to compare perioperative outcomes of robotic and laparoscopic transabdominal peritoneal repair (TAPP) for unilateral inguinal hernia. METHODS This single institutional retrospective cohort study used de-identified data of patients who underwent robotic TAPP (R-TAPP) or laparoscopic TAPP (L-TAPP) for unilateral inguinal hernia between January 1, 2016 and October 31, 2021. Two cohorts were propensity matched, and data were analyzed. The learning curve was evaluated in the R-TAPP group. RESULTS Among 938 patients analyzed, 704 were included. After propensity-score matching, 80 patients were included in each group. The difference in operative time between R-TAPP and L-TAPP groups was 10 min (99.5 and 89.5 min, p = 0.087); however, console/laparoscopic time was similar (67 and 66 min, p = 0.71). The dissection time for medial-type hernia in the R-TAPP group was marginally shorter than that in the L-TAPP group (17 and 27 min, p = 0.056); however, there was no difference for lateral-type hernia (38.5 and 40 min p = 0.37). Perioperative variables, including estimated blood loss, postoperative hospital stay, and postoperative pain, had no significant difference, and chronic pain, which needed medication or intervention, was not observed in each group. The number of cases needed to achieve plateau performance was 7-10 in the R-TAPP group. CONCLUSION This study suggests that R-TAPP was safely introduced, and its perioperative outcomes were not inferior to those of L-TAPP. A shorter dissection time for medial-type hernia might be due to the robot's advantages, and a fast-learning curve could help with the early standardization of the procedure.
Collapse
Affiliation(s)
- N Okamoto
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan.
| | - S Mineta
- Department of Surgery, Chiba Tokusyukai Hospital, Funabashi, Japan
| | - K Mishima
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - Y Fujiyama
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - T Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - S Fujita
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - J Sakamoto
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| | - G Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
| |
Collapse
|
3
|
Heuvelings DJI, Al-Difaie Z, Scheepers MHMC, Okamoto N, Diana M, Stassen LPS, Bouvy ND, Al-Taher M. Simultaneous fluorescence imaging of bowel perfusion and ureter delineation using methylene blue: a demonstration in a porcine model. Surg Endosc 2023; 37:6779-6790. [PMID: 37253870 PMCID: PMC10462514 DOI: 10.1007/s00464-023-10142-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Intraoperative near-infrared fluorescence imaging (NIRF) with preoperative optical dye administration is a promising technique for quick and easy intraoperative visualization of the ureter and for an improved, real-time assessment of intestinal perfusion. During colorectal surgery, there is a need for simultaneous non-invasive ureteral imaging and bowel perfusion assessment, using one single camera system. The purpose of this study is to investigate the feasibility of simultaneous intestinal perfusion and ureteral imaging using a single commercially available NIRF imaging system. METHODS Six Landrace pigs underwent laparotomy under general anesthesia in this experiment. An intravenous (IV) dose of 0.2 mg/kg indocyanine green (ICG) was given to assess bowel perfusion. Two pairs received a methylene blue (MB) iv injection of 0.75, 0.50 or 0.25 mg/kg respectively to investigate ureteral visualization. Quest Spectrum Fluorescence Camera (Quest Medical Imaging, Middenmeer, The Netherlands) was used for NIRF imaging. RESULTS Ureter visualization and bowel perfusion under NIRF imaging was achieved in all animals. All ureters were visible after five to ten minutes and remained clearly visible until the end of every experiment (120-420 min). A mixed model analysis did not show any significant differences neither between the three groups nor over time. Importantly, we demonstrated that bowel perfusion could be visualized with methylene blue (MB) as well. We observed no interference between ICG and MB and a faster washout of MB. CONCLUSION We successfully demonstrated simultaneous fluorescence angiography with ICG and ureteral imaging with MB in the same surgical procedure, with the same commercially available NIRF imaging equipment. More importantly, we showed that the use MB is adequate for bowel perfusion assessment and ureter visualization with this NIRF imaging system. Besides, MB showed an earlier washout time, which can be clinical beneficial as a repeated dye injection may be necessary during a surgical procedure.
Collapse
Affiliation(s)
- Danique J I Heuvelings
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | - Zaid Al-Difaie
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Max H M C Scheepers
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Nariaki Okamoto
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| | - Michele Diana
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France
- Department of Digestive and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France
| | - Laurents P S Stassen
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicole D Bouvy
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mahdi Al-Taher
- IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| |
Collapse
|
4
|
Famularo S, Bannone E, Collins T, Reitano E, Okamoto N, Mishima K, Riva P, Tsai YC, Nkusi R, Hostettler A, Marescaux J, Felli E, Diana M. Partial Hepatic Vein Occlusion and Venous Congestion in Liver Exploration Using a Hyperspectral Camera: A Proposal for Monitoring Intraoperative Liver Perfusion. Cancers (Basel) 2023; 15:cancers15082397. [PMID: 37190325 DOI: 10.3390/cancers15082397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/14/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION The changes occurring in the liver in cases of outflow deprivation have rarely been investigated, and no measurements of this phenomenon are available. This investigation explored outflow occlusion in a pig model using a hyperspectral camera. METHODS Six pigs were enrolled. The right hepatic vein was clamped for 30 min. The oxygen saturation (StO2%), deoxygenated hemoglobin level (de-Hb), near-infrared perfusion (NIR), and total hemoglobin index (THI) were investigated at different time points in four perfused lobes using a hyperspectral camera measuring light absorbance between 500 nm and 995 nm. Differences among lobes at different time points were estimated by mixed-effect linear regression. RESULTS StO2% decreased over time in the right lateral lobe (RLL, totally occluded) when compared to the left lateral (LLL, outflow preserved) and the right medial (RML, partially occluded) lobes (p < 0.05). De-Hb significantly increased after clamping in RLL when compared to RML and LLL (p < 0.05). RML was further analyzed considering the right portion (totally occluded) and the left portion of the lobe (with an autonomous draining vein). StO2% decreased and de-Hb increased more smoothly when compared to the totally occluded RLL (p < 0.05). CONCLUSIONS The variations of StO2% and deoxy-Hb could be considered good markers of venous liver congestion.
Collapse
Affiliation(s)
- Simone Famularo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20133 Milan, Italy
- Department of Hepatobiliary and General Surgery, IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Elisa Bannone
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of General Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy
| | - Toby Collins
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Elisa Reitano
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Nariaki Okamoto
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Photonics Instrumentation for Health, iCube Laboratory, University of Strasbourg, 67000 Strasbourg, France
| | - Kohei Mishima
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Pietro Riva
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Yu-Chieh Tsai
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Richard Nkusi
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | | | - Jacques Marescaux
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
| | - Eric Felli
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - Michele Diana
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Photonics Instrumentation for Health, iCube Laboratory, University of Strasbourg, 67000 Strasbourg, France
- Department of General, Digestive and Endocrine Surgery, University Hospital of Strasbourg, 67000 Strasbourg, France
| |
Collapse
|
5
|
Okamoto N, Al-Difaie Z, Scheepers MHMC, Heuvelings DJI, Rodríguez-Luna MR, Marescaux J, Diana M, Stassen LPS, Bouvy ND, Al-Taher M. Simultaneous, Multi-Channel, Near-Infrared Fluorescence Visualization of Mesenteric Lymph Nodes Using Indocyanine Green and Methylene Blue: A Demonstration in a Porcine Model. Diagnostics (Basel) 2023; 13:diagnostics13081469. [PMID: 37189570 DOI: 10.3390/diagnostics13081469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023] Open
Abstract
Near-infrared fluorescence (NIRF) image-guided surgery is a useful tool that can help reduce perioperative complications and improve tissue recognition. Indocyanine green (ICG) dye is the most frequently used in clinical studies. ICG NIRF imaging has been used for lymph node identification. However, there are still many challenges in lymph node identification by ICG. There is increasing evidence that methylene blue (MB), another clinically applicable fluorescent dye, can also be useful in the intraoperative fluorescence-guided identification of structures and tissues. We hypothesized that MB NIRF imaging could be used for lymph node identification. The aim of this study was to evaluate the feasibility of intraoperative lymph node fluorescence detection using intravenously (IV) administered MB and compare it to ICG via a camera that has two dedicated near-infrared (NIR) channels. Three pigs were used in this study. ICG (0.2 mg/kg) was administered via a peripheral venous catheter followed by immediate administration of MB (0.25 mg/kg). NIRF images were acquired as video recordings at different time points (every 10 min) over an hour using the QUEST SPECTRUM® 3 system (Quest Medical Imaging, Middenmeer, The Netherlands), which has two dedicated NIR channels for simultaneous intraoperative fluorescence guidance. The 800 nm channel was used to capture ICG fluorescence and the 700 nm channel was used for MB. The target (lymph nodes and small bowel) and the background (vessels-free field of the mesentery) were highlighted as the regions of interest (ROIs), and corresponding fluorescence intensities (FI) from these ROIs were measured. The target-to-background ratio (TBR) was then computed as the mean FI of the target minus the mean FI of the background divided by the mean FI of the background. In all included animals, a clear identification of lymph nodes was achieved at all time points. The mean TBR of ICG in lymph nodes and small bowel was 4.57 ± 1.00 and 4.37 ± 1.70, respectively for the overall experimental time. Regarding MB, the mean TBR in lymph nodes and small bowel was 4.60 ± 0.92 and 3.27 ± 0.62, respectively. The Mann-Whitney U test of the lymph node TBR/small bowel TBR showed that the TBR ratio of MB was statistically significantly higher than ICG. The fluorescence optical imaging technology used allows for double-wavelength assessment. This feasibility study proves that lymph nodes can be discriminated using two different fluorophores (MB and ICG) with different wavelengths. The results suggest that MB has a promising potential to be used to detect lymphatic tissue during image-guided surgery. Further preclinical trials are needed before clinical translation.
Collapse
Affiliation(s)
- Nariaki Okamoto
- IRCAD, Research Institute against Digestive Cancer, 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Zaid Al-Difaie
- GROW School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Max H M C Scheepers
- GROW School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Danique J I Heuvelings
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - María Rita Rodríguez-Luna
- IRCAD, Research Institute against Digestive Cancer, 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Jacques Marescaux
- IRCAD, Research Institute against Digestive Cancer, 67091 Strasbourg, France
| | - Michele Diana
- IRCAD, Research Institute against Digestive Cancer, 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Laurents P S Stassen
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 HX Maastricht, The Netherlands
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Mahdi Al-Taher
- IRCAD, Research Institute against Digestive Cancer, 67091 Strasbourg, France
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| |
Collapse
|
6
|
Rodríguez-Luna MR, Okamoto N, Cinelli L, Baratelli L, Ségaud S, Rodríguez-Gómez A, Keller DS, Zonoobi E, Bannone E, Marescaux J, Diana M, Gioux S. Quantification of bowel ischaemia using real-time multispectral Single Snapshot Imaging of Optical Properties (SSOP). Surg Endosc 2023; 37:2395-2403. [PMID: 36443562 PMCID: PMC10017661 DOI: 10.1007/s00464-022-09764-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Single snapshot imaging of optical properties (SSOP) is a relatively new non-invasive, real-time, contrast-free optical imaging technology, which allows for the real-time quantitative assessment of physiological properties, including tissue oxygenation (StO2). This study evaluates the accuracy of multispectral SSOP in quantifying bowel ischaemia in a preclinical experimental model. METHODS In six pigs, an ischaemic bowel segment was created by dividing the arcade branches. Five regions of interest (ROIs) were identified on the bowel loop, as follows: ROI 1: central ischaemic; ROI 2: left marginal; ROI 3: left vascularised; ROI 4: right marginal; and ROI 5: right vascularised. The Trident imaging system, specifically developed for real-time tissue oxygenation imaging using SSOP, was used to image before (T0) and after ischaemia induction. Capillary and systemic lactates were measured at each time point (T0, T15, T30, T45, T60), as well as StO2 values acquired by means of SSOP (SSOP-StO2). RESULTS The mean value of SSOP-StO2 in ROI 1 was 30.08 ± 6.963 and was significantly lower when compared to marginal ROIs (ROI 2 + ROI 4: 45.67 ± 10.02 p = < 0.0001), and to vascularised ROIs (ROI 3 + ROI 5: 48.08 ± 7.083 p = < 0.0001). SSOP-StO2 was significantly correlated with normalised lactates r = - 0.5892 p < 0.0001 and with histology r =- 0.6251 p = 0.0002. CONCLUSION Multispectral SSOP allows for a contrast-free accurate assessment of small bowel perfusion identifying physiological tissue oxygenation as confirmed with perfusion biomarkers.
Collapse
Affiliation(s)
- María Rita Rodríguez-Luna
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France.
- University of Strasbourg, ICube Laboratory, Strasbourg, France.
| | - Nariaki Okamoto
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France
- University of Strasbourg, ICube Laboratory, Strasbourg, France
| | - Lorenzo Cinelli
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, Milan, Italy
| | | | - Silvère Ségaud
- University of Strasbourg, ICube Laboratory, Strasbourg, France
| | | | - Deborah S Keller
- Marks Colorectal Surgical Associates, Lankenau Medical Center, Main Line Health, Wynnewood, PA, USA
| | - Elham Zonoobi
- Edinburgh Molecular Imaging Ltd. (EMI), Edinburgh, EH16 4UX, UK
- Department of Surgery, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - Elisa Bannone
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France
- Department of General and Pancreatic surgery - The Pancreas Institute, University of Verona, Verona, Italy
| | - Jacques Marescaux
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France
| | - Michele Diana
- Research Institute Against Digestive Cancer (IRCAD), 1, place de l'Hôpital, 67000, Strasbourg Cedex, France
- University of Strasbourg, ICube Laboratory, Strasbourg, France
| | - Sylvain Gioux
- University of Strasbourg, ICube Laboratory, Strasbourg, France
- Intuitive Surgical Sàrl, Aubonne, Switzerland
| |
Collapse
|
7
|
Okamoto N, Sujishi K, Tsugawa S, Jin L, Suzuki T, Waseda M. Needlescopic appendectomy versus conventional laparoscopic appendectomy in young patients. Asian J Endosc Surg 2022; 16:241-247. [PMID: 36426403 DOI: 10.1111/ases.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Several studies have reported that needlescopic appendectomy (NA) is a safe and effective procedure for appendicitis because of reduced trocar wounds and tissue trauma. The aim of this study was to evaluate the efficacy of NA in young patients under 40 years of age whose cosmesis matters with appendicitis by comparing it to conventional laparoscopic appendectomy (CLA). METHODS We retrospectively reviewed our database looking for patients under 40 years of age diagnosed with appendicitis who underwent NA or CLA from January 2013 to April 2017. Patients were divided into two groups: the NA group, and the CLA group. Data collected from each group included age, gender, body mass index, preoperative C-reactive protein, emergency or non-emergency settings, operative time, postoperative length of stay, postoperative complications, and pathological diagnosis. RESULTS Fifty-four patients underwent NA and 53 patients underwent CLA. The groups were similar in terms of demographic features. Pathological diagnoses were divided into the following categories: catarrhalis (n = 35), phlegmonous (n = 37), and gangrenous (n = 35). No significant difference was noted regarding the distribution of the three groups (P = .4). NA resulted in significantly shorter operative times (P = .0005), and reduced lengths of hospital stay (P = .03) as compared to CLA. There was no significant difference in the number of complications between the two groups. CONCLUSION NA might be an effective surgical technique when performing a laparoscopic appendectomy in young patients with appendicitis.
Collapse
Affiliation(s)
- Nariaki Okamoto
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| | - Ken Sujishi
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| | - Sou Tsugawa
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| | - Longxue Jin
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| | - Tetsutaro Suzuki
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| | - Masahiro Waseda
- Department of Surgery, Yokohama Asahi Chuo General Hospital, Kanagawa, Japan
| |
Collapse
|
8
|
Felli E, Cinelli L, Bannone E, Giannone F, Muttillo EM, Barberio M, Keller DS, Rodríguez-Luna MR, Okamoto N, Collins T, Hostettler A, Schuster C, Mutter D, Pessaux P, Marescaux J, Gioux S, Felli E, Diana M. Hyperspectral Imaging in Major Hepatectomies: Preliminary Results from the Ex-Machyna Trial. Cancers (Basel) 2022; 14:cancers14225591. [PMID: 36428685 PMCID: PMC9688371 DOI: 10.3390/cancers14225591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/07/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
Ischemia-reperfusion injury during major hepatic resections is associated with high rates of post-operative complications and liver failure. Real-time intra-operative detection of liver dysfunction could provide great insight into clinical outcomes. In the present study, we demonstrate the intra-operative application of a novel optical technology, hyperspectral imaging (HSI), to predict short-term post-operative outcomes after major hepatectomy. We considered fifteen consecutive patients undergoing major hepatic resection for malignant liver lesions from January 2020 to June 2021. HSI measures included tissue water index (TWI), organ hemoglobin index (OHI), tissue oxygenation (StO2%), and near infrared (NIR). Pre-operative, intra-operative, and post-operative serum and clinical outcomes were collected. NIR values were higher in unhealthy liver tissue (p = 0.003). StO2% negatively correlated with post-operative serum ALT values (r = -0.602), while ΔStO2% positively correlated with ALP (r = 0.594). TWI significantly correlated with post-operative reintervention and OHI with post-operative sepsis and liver failure. In conclusion, the HSI imaging system is accurate and precise in translating from pre-clinical to human studies in this first clinical trial. HSI indices are related to serum and outcome metrics. Further experimental and clinical studies are necessary to determine clinical value of this technology.
Collapse
Affiliation(s)
- Emanuele Felli
- Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000 Strasbourg, France
- University Hospital Institute (IHU), Institut de Chirurgie Guidée par l’image, University of Strasbourg, 67000 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Institut of Viral and Liver Disease, Inserm U1110, University of Strasbourg, 67000 Strasbourg, France
| | - Lorenzo Cinelli
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy
| | - Elisa Bannone
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Department of Surgery, Istituto Fondazione Poliambulanza, 25124 Brescia, Italy
- Department of Pancreatic Surgery, Verona University, 37134 Verona, Italy
| | - Fabio Giannone
- Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000 Strasbourg, France
- University Hospital Institute (IHU), Institut de Chirurgie Guidée par l’image, University of Strasbourg, 67000 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Institut of Viral and Liver Disease, Inserm U1110, University of Strasbourg, 67000 Strasbourg, France
| | - Edoardo Maria Muttillo
- Dipartimento di Scienze Medico Chirurgiche e Medicina Traslazionale, Sapienza Università di Roma, 00189 Roma, Italy
| | - Manuel Barberio
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Ospedale Cardinale G. Panico, General Surgery Department, 73039 Tricase, Italy
| | | | - María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67400 Strasbourg, France
| | - Nariaki Okamoto
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
| | - Toby Collins
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
| | | | - Catherine Schuster
- Institut of Viral and Liver Disease, Inserm U1110, University of Strasbourg, 67000 Strasbourg, France
| | - Didier Mutter
- Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000 Strasbourg, France
- University Hospital Institute (IHU), Institut de Chirurgie Guidée par l’image, University of Strasbourg, 67000 Strasbourg, France
| | - Patrick Pessaux
- Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- Institut of Viral and Liver Disease, Inserm U1110, University of Strasbourg, 67000 Strasbourg, France
| | - Jacques Marescaux
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
| | - Sylvain Gioux
- ICube Laboratory, Photonics Instrumentation for Health, 67400 Strasbourg, France
| | - Eric Felli
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
- Department for BioMedical Research, Hepatology, University of Bern, 3012 Bern, Switzerland
| | - Michele Diana
- Digestive and Endocrine Surgery, Nouvel Hopital Civil, University of Strasbourg, 67000 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67400 Strasbourg, France
- Correspondence:
| |
Collapse
|
9
|
Okamoto N, Rodríguez-Luna MR, Bencteux V, Al-Taher M, Cinelli L, Felli E, Urade T, Nkusi R, Mutter D, Marescaux J, Hostettler A, Collins T, Diana M. Computer-Assisted Differentiation between Colon-Mesocolon and Retroperitoneum Using Hyperspectral Imaging (HSI) Technology. Diagnostics (Basel) 2022; 12:diagnostics12092225. [PMID: 36140626 PMCID: PMC9497769 DOI: 10.3390/diagnostics12092225] [Citation(s) in RCA: 4] [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: 08/31/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 12/01/2022] Open
Abstract
Complete mesocolic excision (CME), which involves the adequate resection of the tumor-bearing colonic segment with “en bloc” removal of its mesocolon along embryological fascial planes is associated with superior oncological outcomes. However, CME presents a higher complication rate compared to non-CME resections due to a higher risk of vascular injury. Hyperspectral imaging (HSI) is a contrast-free optical imaging technology, which facilitates the quantitative imaging of physiological tissue parameters and the visualization of anatomical structures. This study evaluates the accuracy of HSI combined with deep learning (DL) to differentiate the colon and its mesenteric tissue from retroperitoneal tissue. In an animal study including 20 pig models, intraoperative hyperspectral images of the sigmoid colon, sigmoid mesentery, and retroperitoneum were recorded. A convolutional neural network (CNN) was trained to distinguish the two tissue classes using HSI data, validated with a leave-one-out cross-validation process. The overall recognition sensitivity of the tissues to be preserved (retroperitoneum) and the tissues to be resected (colon and mesentery) was 79.0 ± 21.0% and 86.0 ± 16.0%, respectively. Automatic classification based on HSI and CNNs is a promising tool to automatically, non-invasively, and objectively differentiate the colon and its mesentery from retroperitoneal tissue.
Collapse
Affiliation(s)
- Nariaki Okamoto
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
- Correspondence:
| | - María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Valentin Bencteux
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Mahdi Al-Taher
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of Surgery, Maastricht University Medical Center, 6229 ER Maastricht, The Netherlands
| | - Lorenzo Cinelli
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy
| | - Eric Felli
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Takeshi Urade
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe 6500017, Japan
| | - Richard Nkusi
- Research Institute against Digestive Cancer (IRCAD), Kigali, Rwanda
| | - Didier Mutter
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Department of Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, 67091 Strasbourg, France
- IHU-Strasbourg—Institut de Chirurgie Guidée par L’image, 67091 Strasbourg, France
| | - Jacques Marescaux
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
| | - Alexandre Hostettler
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), Kigali, Rwanda
| | - Toby Collins
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- Research Institute against Digestive Cancer (IRCAD), Kigali, Rwanda
| | - Michele Diana
- Research Institute against Digestive Cancer (IRCAD), 67091 Strasbourg, France
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| |
Collapse
|
10
|
Rodríguez-Luna MR, Okamoto N, Al-Taher M, Keller DS, Cinelli L, Hoskere Ashoka A, Klymchenko AS, Marescaux J, Diana M. In Vivo Imaging Evaluation of Fluorescence Intensity at Tail Emission of Near-Infrared-I (NIR-I) Fluorophores in a Porcine Model. Life (Basel) 2022; 12:life12081123. [PMID: 35892925 PMCID: PMC9332805 DOI: 10.3390/life12081123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Over the last decade fluorescence-guided surgery has been primarily focused on the NIR-I window. However, the NIR-I window has constraints, such as limited penetration and scattering. Consequently, exploring the performance of NIR-I dyes at longer wavelengths (i.e., the NIR-II window) is crucial to expanding its application. Two fluorophores were used in three pigs to identify the mean fluorescence intensity (MFI) using two commercially available NIR-I and NIR-II cameras. The near-infrared coating of equipment (NICE) was used to identify endoluminal surgical catheters and indocyanine green (ICG) for common bile duct (CBD) characterization. The NIR-II window evaluation showed an MFI of 0.4 arbitrary units (a.u.) ± 0.106 a.u. in small bowel NICE-coated catheters and an MFI of 0.09 a.u. ± 0.039 a.u. in gastric ones. In CBD characterization, the ICG MFI was 0.12 a.u. ± 0.027 a.u., 0.18 a.u. ± 0.100 a.u., and 0.22 a.u. ± 0.041 a.u. at 5, 35, and 65 min, respectively. This in vivo imaging evaluation of NIR-I dyes confirms its application in the NIR-II domain. To the best of our knowledge, this is the first study assessing the MIF of NICE in the NIR-II window using a commercially available system. Further comparative trials are necessary to determine the superiority of NIR-II imaging systems.
Collapse
Affiliation(s)
- María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France; (N.O.); (M.A.-T.); (J.M.); (M.D.)
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
- Correspondence:
| | - Nariaki Okamoto
- Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France; (N.O.); (M.A.-T.); (J.M.); (M.D.)
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| | - Mahdi Al-Taher
- Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France; (N.O.); (M.A.-T.); (J.M.); (M.D.)
- Maastricht University Medical Center, 6229 Maastricht, The Netherlands
| | - Deborah S. Keller
- Marks Colorectal Surgical Associates, Lankenau Medical Center, Main Line Health, Wynnewood, PA 19096, USA;
| | - Lorenzo Cinelli
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy;
| | - Anila Hoskere Ashoka
- Laboratoire de Bioimagerie et Pathologies, UMR 7021 CNRS, Université de Strasbourg, 74 Route du Rhin, 67401 Illkirch, France; (A.H.A.); (A.S.K.)
| | - Andrey S. Klymchenko
- Laboratoire de Bioimagerie et Pathologies, UMR 7021 CNRS, Université de Strasbourg, 74 Route du Rhin, 67401 Illkirch, France; (A.H.A.); (A.S.K.)
| | - Jacques Marescaux
- Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France; (N.O.); (M.A.-T.); (J.M.); (M.D.)
| | - Michele Diana
- Research Institute against Digestive Cancer (IRCAD), 1 Place de l’Hôpital, 67000 Strasbourg, France; (N.O.); (M.A.-T.); (J.M.); (M.D.)
- ICube Laboratory, Photonics Instrumentation for Health, 67081 Strasbourg, France
| |
Collapse
|
11
|
Ramanan A, Quartier P, Okamoto N, Meszaros G, Araujo J, Wang Z, Liao R, Crowe B, Zhang X, Decker R, Keller S, Brunner H, Ruperto N. LB0002 BARICITINIB IN JUVENILE IDIOPATHIC ARTHRITIS: A PHASE 3, DOUBLE-BLIND, PLACEBO-CONTROLLED, WITHDRAWAL, EFFICACY AND SAFETY STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5091a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundBaricitinib is a JAK1/2 selective inhibitor approved for the treatment of rheumatoid arthritis. Juvenile idiopathic arthritis (JIA) is a group of diseases characterized by immune mediated chronic arthritis which often requires treatment with conventional synthetic or biologic disease-modifying antirheumatic drugs (cs or b-DMARDs).ObjectivesTo investigate baricitinib efficacy and safety in pediatric patients with JIA and an inadequate response to cs or b-DMARDs.MethodsThis Phase 3 multicenter, double-blind, withdrawal, efficacy, and safety study, enrolled patients (pts) age 2 to <18 years with extended oligo- or poly-articular JIA, ERA, or JPsA, per ILAR criteria, and an inadequate response to ≥1 cs and/or b-DMARDs (NCT03773978). There were 3 periods: a 2-week (wk) pharmacokinetic/safety assessment (PKS), a 12-wk open-label lead-in (OLLI), and an up-to 32-wk double-blind withdrawal (DBW). Dosage and safety were confirmed in the PKS and then pts, including those from the PKS, enrolled in the OLLI, receiving age-based, oral, once daily doses of baricitinib. Pts with a JIA-ACR30 response at wk12, end of OLLI, entered the DBW to be randomized 1:1 to continued baricitinib or newly started placebo (PBO) and remained until flare or up to wk32. Primary endpoint was time to flare during the DBW. Secondary endpoints included JIA-ACR30/50/70/90 response rates at wk12, and proportion of pts with a flare during the DBW. Survival curves were estimated using the Kaplan-Meier method.ResultsOf 220 pts enrolled, 29 participated in the PKS, 219 entered the OLLI, and 163 entered the DBW. The JIA-ACR30/50/70/90 response at wk12 was 76.3%/63.5%/46.1%/20.1%, respectively. During the DBW, time of flare was significantly shorter with PBO vs baricitinib (hazard ratio 0.24 [95% CI 0.13,0.45], p<0.001; Figure 1). The proportion of pts with a flare during the DBW was significantly lower for baricitinib vs PBO (14 (17.1%) vs. 41 (50.6%), p<0.001). In the PKS and OLLI periods, 126 (57.3%) pts reported ≥1 treatment emergent adverse event (TEAE), while 6 (2.7%) reported ≥1 serious adverse event (SAE); Table 1. In the DBW, 38 (46.9%) and 54 (65.9%) pts reported ≥1 TEAE for PBO and baricitinib, respectively, whereas those with ≥1 SAE were 3 (3.7%) and 4 (4.9%). The mean wks of exposure was higher in the baricitinib vs PBO group during DBW (26.34 vs 18.91) due to study design. There were no deaths, cardiovascular events or uveitis and 1 case of herpes zoster.
Table 1.Safety dataEvents, N (%)PKS and OLLI (N=220)Events, N (%)DBW Placebo (N=81)DBW Baricitinib (N=82)Discontinuations due to AEs2 (0.9)2 (2.5)1 (1.2)TEAEs126 (57.3)38 (46.9)54 (65.9)most common TEAEsNasopharyngitis19 (8.6)URTI1 (1.2)9 (11.0)Headache14 (6.4)Headache3 (3.7)9 (11.0)Arthralgia12 (5.5)Nasopharyngitis3 (3.7)6 (7.3)URTI11 (5.0)Arthralgia3 (3.7)6 (7.3)Nausea11 (5.0)Oropharyngeal pain1 (1.2)5 (6.1)SAEs6 (2.7)3 (3.7)4 (4.9)All reported SAEsArthralgia1 (0.5)COVID-1901 (1.2)Joint Destruction1 (0.5)Gastroenteritis01 (1.2)Joint Effusion1 (0.5)Headache01 (1.2)JIA1 (0.5)Pulmonary Embolism01 (1.2)Musculoskeletal Chest Pain1 (0.5)Bronchospasm1 (1.2)0Decreased Appetite1 (0.5)JIA1 (1.2)0Suicide Attempt1 (1.2)0Potential opportunistic infections2 (0.9)1 (1.2)1 (1.2)Herpes virus1 (0.5)Herpes virus1 (1.2)0Herpes zoster1 (0.5)Candida01 (1.2)URTI= Upper Respiratory Tract InfectionConclusionBaricitinib significantly reduced time to and frequency of JIA flares in pts with JIA versus PBO, and improved JIA-ACR scores in the majority of pts within 12wks. Safety findings were consistent with the known safety profile in adult rheumatoid arthritis indications. These findings support baricitinib as a treatment for signs and symptoms of JIA with an inadequate response to cs or b-DMARDs.References[1]Giannini EH, et. al. Preliminary definition of improvement in juvenile arthritis. Arthritis Rheum 1997; 40: 1202-1209.[2]Brunner HI, et. al. Preliminary definition of disease flare in juvenile rheumatoid arthritis. J Rheumatol 2002; 29(5):1058-64.Disclosure of InterestsAthimalaipet Ramanan Consultant of: Eli Lilly and Company, Abbvie, Roche, UCB, Novartis, Pfizer, and Sobi, Grant/research support from: Eli Lilly and Company, Pierre Quartier Consultant of: Eli Lilly and Company, Abbvie, Amgen, BMS, Novartis, Novimmune, Pfizer, Swedish Orphan Biovitrum, SANOFI, Speakers bureau: Abbvie, Novartis, Pfizer, Swedish Orphan Biovitrum, Nami Okamoto Consultant of: Swedish Orphan Biovitrum, Eli Lilly and Company, Speakers bureau: AbbVie, Eli Lilly and Company, Sanofi, Asahi Kasei Medical, Mitsubishi Tanabe Pharma, Bristol Myers Squibb, Pfizer Japan, Ayumi Pharma, Eisai, Torii Pharma, GlaxoSmithKline, Kyorin Pharma, Novartis, Chugai Pharmaceutical, Teijin Pharma, Gabriella Meszaros Employee of: Eli Lilly and Company, Joana Araujo Employee of: Eli Lilly and Company, Zhongkai Wang Employee of: Eli Lilly and Company, Ran Liao Employee of: Eli Lilly and Company, Brenda Crowe Employee of: Eli Lilly and Company, Xin Zhang Employee of: Eli Lilly and Company, Rodney Decker Employee of: Eli Lilly and Company, Stuart Keller Employee of: Eli Lilly and Company, Hermine Brunner Consultant of: AbbVie, Astra Zeneca-Medimmune, Biogen, Boehringer, Bristol-Myers Squibb, Celgene, Eli Lilly, EMD Serono, Idorsia, Cerocor, Janssen, GlaxoSmithKline, F. Hoffmann-La Roche, Merck, Novartis, R-Pharm, Sanofi, Speakers bureau: Novartis, Pfizer, GlaxoSmithKline, Nicolino Ruperto Consultant of: Eli Lilly and Company, Ablynx, Amgen, Astrazeneca-Medimmune, Aurinia, Bayer, Bristol Myers and Squibb, Cambridge Healthcare Research (CHR), Celgene, Domain therapeutic, Eli-Lilly, EMD Serono, Glaxo Smith and Kline, Idorsia, Janssen, Novartis, Pfizer, Sobi, UCB, Speakers bureau: Eli Lilly and Company, Glaxo Smith and Kline, Pfizer, Sobi, UCB
Collapse
|
12
|
Al-Taher M, Okamoto N, Mutter D, Stassen LPS, Marescaux J, Diana M, Dallemagne B. International survey among surgeons on laparoscopic right hemicolectomy: the gap between guidelines and reality. Surg Endosc 2022; 36:5840-5853. [PMID: 35064320 PMCID: PMC8782220 DOI: 10.1007/s00464-022-09044-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/08/2022] [Indexed: 12/14/2022]
Abstract
Introduction To assess the current approaches and perioperative treatments of laparoscopic right hemicolectomy (LRHC) and to highlight similarities and differences with international guidelines and scientific evidence, we conducted a survey for surgeons across the globe. Methods All digestive and colorectal surgeons registered with the database of the Research Institute against Digestive Cancer (IRCAD) were invited to take part in the survey via email and through the social media networks of IRCAD. Results There were a total of 440 respondents from 78 countries. Most surgeons worked in the European region (38.6%) followed by the Americas (34.1%), the Eastern Mediterranean region (13.0%), the South-East Asian region (5.9%), the Western Pacific region (4.8%), and Africa (3.2%) respectively. Over half of the respondents performed less than 25% of right hemicolectomies laparoscopically where 4 ports are usually used by 68% of the surgeons. The medial-to-lateral, vessel-first approach is the approach most commonly used (74.1%). The most common extraction site was through a midline incision (53%) and an abdominal drain tube is routinely used by 52% of the surgeons after surgery. A total of 68.6% of the responding surgeons perform the majority of the anastomoses extracorporeally. Finally, we found that the majority of responders (60.7%) routinely used mechanical bowel preparations prior to LRHC. Conclusion Regarding several topics related to LRHC care, a discrepancy was observed between the current medical practice and the recommendations from RCTs and international guidelines and significant regional differences were observed. Supplementary Information The online version contains supplementary material available at 10.1007/s00464-022-09044-w.
Collapse
|
13
|
Cinelli L, Felli E, Baratelli L, Ségaud S, Baiocchini A, Okamoto N, Rodríguez-Luna MR, Elmore U, Rosati R, Partelli S, Marescaux J, Gioux S, Diana M. Single Snapshot Imaging of Optical Properties (SSOP) for Perfusion Assessment during Gastric Conduit Creation for Esophagectomy: An Experimental Study on Pigs. Cancers (Basel) 2021; 13:cancers13236079. [PMID: 34885189 PMCID: PMC8656795 DOI: 10.3390/cancers13236079] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 01/03/2023] Open
Abstract
Simple Summary Anastomotic leak is the most dangerous complication occurring after esophagectomy and its relationship with inadequate visceral perfusion is widely recognized. Currently, the adequate perfusion of the gastric conduit is intraoperatively assessed by surgeons using subjective indicators (e.g., serosal color or pulsatile flow of vessels). During the last decades, several innovative optical techniques based on the interaction of light with tissue have been developed to monitor perfusion in esophagogastric surgery. However, these innovative approaches are characterized by a lack of video rate and reproducibility. They also provide operator-dependent results and lengthen the surgical workflow. Single Snapshot imaging of Optical Properties (SSOP) is an optical technique, which can overcome such limitations, providing quantitative information on the optical properties of biological tissues over a large field of view. It is the first study to demonstrate the accuracy of SSOP in the quantification of serosal StO2% in a porcine gastric conduit model. Abstract Anastomotic leakage (AL) is a serious complication occurring after esophagectomy. The current knowledge suggests that inadequate intraoperative perfusion in the anastomotic site contributes to an increase in the AL rate. Presently, clinical estimation undertaken by surgeons is not accurate and new technology is necessary to improve the intraoperative assessment of tissue oxygenation. In the present study, we demonstrate the application of a novel optical technology, namely Single Snapshot imaging of Optical Properties (SSOP), used to quantify StO2% in an open surgery experimental gastric conduit (GC) model. After the creation of a gastric conduit, local StO2% was measured with a preclinical SSOP system for 60 min in the antrum (ROI-A), corpus (ROI-C), and fundus (ROI-F). The removed region (ROI-R) acted as ischemic control. ROI-R had statistically significant lower StO2% when compared to all other ROIs at T15, T30, T45, and T60 (p < 0.0001). Local capillary lactates (LCLs) and StO2% correlation was statistically significant (R = −0.8439, 95% CI −0.9367 to −0.6407, p < 0.0001). Finally, SSOP could discriminate resected from perfused regions and ROI-A from ROI-F (the future anastomotic site). In conclusion, SSOP could well be a suitable technology to assess intraoperative perfusion of GC, providing consistent StO2% quantification and ROIs discrimination.
Collapse
Affiliation(s)
- Lorenzo Cinelli
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy; (U.E.); (R.R.)
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France; (N.O.); (M.R.R.-L.); (J.M.); (M.D.)
- Correspondence: ; Tel.: +39-02-2643-2270
| | - Eric Felli
- Department of Visceral Surgery and Medicine, Inselspital, University of Bern, 3010 Bern, Switzerland;
- Department of BioMedical Research, Visceral Surgery and Medicine, University of Bern, 3010 Bern, Switzerland
| | - Luca Baratelli
- ICube Laboratory, University of Strasbourg, 67400 Strasbourg, France; (L.B.); (S.S.); (S.G.)
| | - Silvère Ségaud
- ICube Laboratory, University of Strasbourg, 67400 Strasbourg, France; (L.B.); (S.S.); (S.G.)
| | - Andrea Baiocchini
- Department of Surgical Pathology, San Camillo Hospital, 00152 Rome, Italy;
| | - Nariaki Okamoto
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France; (N.O.); (M.R.R.-L.); (J.M.); (M.D.)
| | - María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France; (N.O.); (M.R.R.-L.); (J.M.); (M.D.)
| | - Ugo Elmore
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy; (U.E.); (R.R.)
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Riccardo Rosati
- Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy; (U.E.); (R.R.)
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
| | - Stefano Partelli
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
- Pancreas Translational & Clinical Research Center, Pancreatic Surgery Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Jacques Marescaux
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France; (N.O.); (M.R.R.-L.); (J.M.); (M.D.)
| | - Sylvain Gioux
- ICube Laboratory, University of Strasbourg, 67400 Strasbourg, France; (L.B.); (S.S.); (S.G.)
| | - Michele Diana
- Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France; (N.O.); (M.R.R.-L.); (J.M.); (M.D.)
- ICube Laboratory, University of Strasbourg, 67400 Strasbourg, France; (L.B.); (S.S.); (S.G.)
- Department of General, Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, 67000 Strasbourg, France
| |
Collapse
|
14
|
Okamoto N, Al-Taher M, Mascagni P, Vazquez AG, Takeuchi M, Marescaux J, Diana M, Dallemagne B. Robotic endoscopic cooperative surgery for colorectal tumors: a feasibility study (with video). Surg Endosc 2021; 36:826-832. [PMID: 34741202 DOI: 10.1007/s00464-021-08786-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Laparoscopic endoscopic cooperative colorectal surgery (LECS-CR) is a promising technique to achieve full-thickness resection of colorectal tumors. This approach has shown good rates of complete resection and low local recurrence, especially for large laterally spreading tumors, which are difficult to remove via endoscopy alone. However, it is often difficult to prevent peritoneal leakage of intestinal content, causing infections and risks of cancer spreading. It was hypothesized that a robotic assistance could make the procedure easier and decrease intestinal fluid leakage. This preclinical trial aims to assess the feasibility of robotic and endoscopic cooperative colorectal surgery (RECS-CR). METHODS LECS-CR was performed in five female pigs and RECS-CR was also performed in five female pigs. With the animal under general anesthesia, pseudotumors were created on the colonic mucosa at a distance comprised between 20 and 25 cm from the anal verge. Desired resection margins were marked endoscopically and two stay sutures were placed either robotically or laparoscopically. A mucosa-to-submucosa dissection was performed endoscopically along the markings. Complete full-thickness dissection was performed cooperatively. The specimen was withdrawn endoscopically. The colon was closed using a self-fixating running suture. Abdominal contaminations, operating times, complications, and complete resections were evaluated and compared between LECS-CR and RECS-CR. RESULTS The mean number of colonies of Escherichia coli in the RECS group was significantly lower than in the LECS group (36.7 ± 30.2 vs. 142.2 ± 78.4, respectively, p < 0.05). Operating time was comparable (118 ± 11.2 vs. 98.6 ± 25.7, respectively, p = 0.22). Two stenoses occurred in the LECS group. R0 resection was achieved in all cases. CONCLUSION This study suggests that RECS-CR is feasible and has the potential to reduce intestinal content leakage, potentially preventing postoperative infections.
Collapse
Affiliation(s)
- Nariaki Okamoto
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France.
| | - Mahdi Al-Taher
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France.,Department of Surgery, Maastricht University Medical Center, Maastricht, Netherlands
| | - Pietro Mascagni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
| | | | - Masashi Takeuchi
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France.,Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Jacques Marescaux
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France
| | - Michele Diana
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France.,Department of Digestive and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France
| | - Bernard Dallemagne
- IRCAD, Research Institute Against Digestive Cancer, 1, place de l'Hôpital, 67091, Strasbourg, France.,Department of Digestive and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France
| |
Collapse
|
15
|
Johnson M, Doi T, Piha-Paul S, Sen S, Shimizu T, Cheng B, Yoshizuka N, Okamoto N, Okuda Y, Qian X, Serbest G, Hammett T, Brady W, Patel M, Bendell J. 513O A phase I/II multicenter, first-in-human study of DS-7300 (B7-H3 DXd-ADC) in patients (pts) with advanced solid tumors. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1035] [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: 10/20/2022] Open
|
16
|
Fujii T, Atsumi T, Okamoto N, Takahashi N, Tamura N, Nakajima A, Nakajima A, Matsuno H, Tsujimoto N, Nishikawa A, Ishii T, Takeuchi T, Kuwana M, Takagi M. AB0249 SAFETY OF BARICITINIB IN JAPANESE PATIENTS WITH RHEUMATOID ARTHRITIS (RA): THE 2020 INTERIM REPORT FROM ALL-CASE POST MARKETING SURVEILLANCE IN CLINICAL PRACTICE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:An all-case post marketing surveillance (PMS) of baricitinib (Bari), that started in Sep 2017, collects safety and effectiveness for the first 24 wks of treatment and continues to collect serious adverse events (SAEs) for 3 yrs.Objectives:To evaluate Bari safety in RA patients (pt) in clinical practice.Methods:We report pt baseline demographics and adverse events (AEs) up to 24 wks for pts whose case report files for 24-wk data were completed as of Jun 2020.Results:Data from 3445 pts were analyzed (females=80%, mean age=64yr, mean RA duration 12yr). Bari dose regimen was as follows: 4mg, 60%, 2mg, 27%, 4mg→2mg, 5%, 2mg→4mg, 5%, and others, 2%. Concomitant use of MTX and glucocorticoid was 65% and 48%, respectively. 74% continued treatment for 24 wks. AE and SAE were recognized in 887 (26%) and 122 pts (4%), respectively. 6 pts died of pneumonia, aspiration pneumonia, bacterial pneumonia, cerebral infarction/ILD/aspiration pneumonia, adenocarcinoma, and colorectal cancer. Major AEs were as follows: herpes zoster=3%, liver dysfunction=3%, serious infection=1%, anemia=1%, hyperlipidemia=1%, malignancy=0.3%, interstitial pneumonia=0.2%, MACE=0.1%, and VTE=0.1%.Conclusion:Data do not show new safety concerns and encourage guideline-compliant use of Bari.Disclosure of Interests:Takao Fujii Speakers bureau: Chugai Pharmaceutical Co. Ltd.; Eisai Co. Ltd; Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K.; Ono Pharmaceutical Co. Ltd., Consultant of: Asahikasei Pharma Corp, Grant/research support from: Asahikasei Pharma Corp; AbbVie Japan GK; Chugai Pharmaceutical Co. Ltd., Eisai Co. Ltd; Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Co.; Ono Pharmaceutical Co., Ltd., Tatsuya Atsumi Speakers bureau: AbbVie Japan GK; Astellas Pharma Inc.; Bristol-Myers Squibb Co. Ltd; Chugai Pharmaceutical Co. Ltd.; Daiichi Sankyo Co. Ltd.; Eisai Co. Ltd.; Eli Lilly Japan K.K.; Mitsubishi Tanabe Pharma Co.; Pfizer Japan Inc.; Takeda Pharmaceutical Co. Ltd., UCB Japan Co. Ltd., Consultant of: AbbVie Japan GK; AstraZeneca plc.; Boehringer Ingelheim Co. Ltd.; Medical & Biological Laboratories Co. Ltd.; Novartis Pharma K.K.; Ono Pharmaceutical Co. Ltd.; Pfizer Japan Inc., Grant/research support from: Astellas Pharma Inc., Alexion Inc.; Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co., Ltd.Pfizer Japan Inc.; Takeda Pharmaceutical Co. Ltd., Nami Okamoto Speakers bureau: AbbVie Japan GK; Asahikasei Pharma Co.; AYUMI Pharmaceutical Co.Eisai Co. Ltd; Bristol-Myers Squibb Co. Ltd.; Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Co.; Pfizer Japan Inc.Sanofi K.K.; Chugai Pharmaceutical Co. Ltd.; Novartis Pharma Co.; Teijin Pharma Ltd.; Torii Pharmaceutical Co., Ltd., Nobunori Takahashi Speakers bureau: AbbVie Japan GK; Eisai Co. Ltd.; Mitsubishi Tanabe Pharma Co.; Pfizer Japan Inc.; Chugai Pharmaceutical Co., Ltd.; Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K.; UCB Japan Co. Ltd.; Astellas Pharma Inc.; Bristol Myers Squibb Co. Ltd., Grant/research support from: Bristol Myers Squibb Co. Ltd., Naoto Tamura Speakers bureau: AbbVie Japan GK; Bristol Myers Squibb Co. Ltd.; Chugai Pharmaceutical Co. Ltd.; Eisai Co. Ltd.; Eli Lilly Japan K.K.; Glaxo Smith Kline K.K.; Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Co.; Novartis Pharma Co., Atsuo Nakajima: None declared, Ayako Nakajima Speakers bureau: AbbVie Japan GK; Actelion Pharmaceuticals Japan Ltd., Asahi Kasei Pharma Co., Astellas Pharma Inc., Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd.,Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Glaxo Smith Kline K.K., Hisamitsu Pharmaceutical Co. Inc., Kyorin Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co. Ltd., Pfizer Japan Inc., Teijin Pharma Ltd., Grant/research support from: Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Hiroaki Matsuno Speakers bureau: Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan K.K., Consultant of: Mochida Pharmaceutical Co., Ltd., Grant/research support from: Astellas Pharma Inc., Eli Lilly Japan K.K.; Janssen Pharmaceutical K.K, Naoto Tsujimoto Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Atsushi Nishikawa Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Taeko Ishii Shareholder of: Eli Lilly, Employee of: Eli Lilly Japan K.K., Tsutomu Takeuchi Speakers bureau: AbbVie Japan GK, Ayumi Pharmaceutical Co., Bristol Myers Squibb Co., Ltd., Chugai Pharmaceutical Co, Ltd. Daiichi Sankyo Co., Ltd. Eisai Co., Ltd. Eli Lilly Japan K.K.; Gilead Sciences, Inc. Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Co.; Novartis Pharma Co.; Pfizer Japan Inc.; Sanofi K.K.; UCB Japan Co., Ltd., Consultant of: AbbVie Japan GK, Astellas Pharma, Inc.; Chugai Pharmaceutical Co, Ltd.; Eli Lilly Japan K.K.; Eisai Co., Ltd.; Gilead Sciences, Inc.; Janssen Pharmaceutical K.K.; Mitsubishi-Tanabe Pharma Corp., Pfizer Japan Inc., Grant/research support from: AbbVie Japan GK, Asahikasei Pharma Corp., Chugai Pharmaceutical Co, Ltd., DNA Chip Research Inc.; Eisai Co., Ltd., Eli Lilly Japan K.K.; Mitsubishi-Tanabe Pharma Corp., UCB Japan Co., Ltd., Masataka Kuwana Speakers bureau: AbbVie Japan GK, Astellas Pharma Inc., Asahi Kasei Pharma Co., Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Janssen Pharmaceutical K.K., Medical &Biological Laboratories Co., Ltd.; Mitsubishi Tanabe Pharma Co.; Mochida Pharmaceutical Co., Ltd., Nippon Shinyaku Co., Ltd.; Ono Pharmaceutical Co., Ltd.; Pfizer Japan Inc., Consultant of: Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Corbus Pharmaceuticals Holdings, Inc.; Medical &Biological Laboratories Co., Ltd.; Mochida Pharmaceutical Co., Ltd., Grant/research support from: Boehringer-Ingelheim, Chugai Pharmaceutical Co., Ltd., Eisai Co., Ltd., Medical &Biological Laboratories Co., Ltd; Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., Ltd., Michiaki Takagi Speakers bureau: Yes, but sponsored lectures without COI in the academic meetings, only.
Collapse
|
17
|
Al-Taher M, Pruimboom T, Schols RM, Okamoto N, Bouvy ND, Stassen LPS, van der Hulst RRWJ, Kugler M, Hostettler A, Noll E, Marescaux J, Diemunsch S, Diana M. Influence of intraoperative vasopressor use on indocyanine green fluorescence angiography: first evaluation in an experimental model. Sci Rep 2021; 11:9650. [PMID: 33958693 PMCID: PMC8102475 DOI: 10.1038/s41598-021-89223-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/22/2021] [Indexed: 12/13/2022] Open
Abstract
Intraoperative indocyanine green (ICG) fluorescence angiography has gained popularity and acceptance in many surgical fields for the real-time assessment of tissue perfusion. Although vasopressors have the potential to preclude an accurate assessment of tissue perfusion, there is a lack of literature with regards to its effect on ICG fluorescence angiography. An experimental porcine model was used to expose the small bowel for quantitative tissue perfusion assessment. Three increasing doses of norepinephrine infusion (0.1, 0.5, and 1.0 µg/kg/min) were administered intravenously over a 25-min interval. Time-to-peak fluorescence intensity (TTP) was the primary outcome. Secondary outcomes included absolute fluorescence intensity and local capillary lactate (LCL) levels. Five large pigs (mean weight: 40.3 ± 4.24 kg) were included. There was no significant difference in mean TTP (in seconds) at baseline (4.23) as compared to the second (3.90), third (4.41), fourth (4.60), and fifth ICG assessment (5.99). As a result of ICG accumulation, the mean and the maximum absolute fluorescence intensity were significantly different as compared to the baseline assessment. There was no significant difference in LCL levels (in mmol/L) at baseline (0.74) as compared to the second (0.82), third (0.64), fourth (0.60), and fifth assessment (0.62). Increasing doses of norepinephrine infusion have no significant influence on bowel perfusion using ICG fluorescence angiography.
Collapse
Affiliation(s)
- Mahdi Al-Taher
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France. .,Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Tim Pruimboom
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - Rutger M Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - Nariaki Okamoto
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - Nicole D Bouvy
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Laurents P S Stassen
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - René R W J van der Hulst
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
| | - Michael Kugler
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - Alexandre Hostettler
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - Eric Noll
- Department of Anesthesiology, Critical Care and Prehospital Emergency Medicine, University Hospital of Strasbourg, Strasbourg, France
| | - Jacques Marescaux
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France
| | - Sophie Diemunsch
- Department of Anesthesiology, Critical Care and Prehospital Emergency Medicine, University Hospital of Strasbourg, Strasbourg, France
| | - Michele Diana
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67000, Strasbourg, France.,Department of General, Digestive, and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France.,ICube Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| |
Collapse
|
18
|
Shutta R, Nishino M, Kawamura A, Ukita K, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga Y, Yano M, Egami Y, Tanouchi J. Negative impact of ultra-thin strut on neointimal coverage condition within one year after implantation as compared to thin sturt in biogradable-polymer sirorimus eluting stents. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
BIOSCIENCE randomized trial which compared biodegradable-polymer sirolimus-eluting stents with ultra-thin (60μm) strut (ultra-thin BP-SES) and durable-polymer everolimus-eluting stents with thin (81μm) strut (thin DP-EES) have reported that definite stent thrombosis within 1 year had more frequently occurred in ultra-thin BP-SES (0.9%) than in thin DP-EES group (0.4%) although it was not statistically significant. It suggests that neointimal coverage after stent implantation within 1 year might be different between ultra-thin BP-SES and thin DP-EES. Recently, two types of biogradable-polymer sirorimus eluting stents, thin (80μm) strut type (thin BP-SES) and ultra-thin (60μm) strut type (ultra-thin BP-SES), can be available in clinical settings.
Purpose
We compared neointimal coverage conditions between ultra-thin BP-SES and thin BP-SES by optical coherence tomography (OCT).
Methods
Consecutive Forty-six patients who underwent 21 ultra-thin BP-SESs or 25 thin BP-SESs implantation were enrolled. We compared incidences of acute coronary syndrome, type B2/C lesion, atherectomy device use, stent size, stent length, maximum inflation pressure, and 8-month follow-up OCT parameters including proportions of uncovered struts (%Uncovered), malapposed struts, (%Mallaposed) and mean neointimal hyperplasia thickness (mean NHT) between the two groups.
Results
%Uncovered and %malapposed were significantly higher and mean NHT was significantly lower in ultra-thin BP-SES than in thin BP-SES (Table). The other parameters were similar between the two groups.
Conclusion
Ultra-thin BP-SES showed worse neointimal coverage as compared to thin BP-SES within 1 year after stent implantation, which may increase stent thrombosis.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- R Shutta
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - M Nishino
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - A Kawamura
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - K Ukita
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Sakai, Osaka, Japan
| |
Collapse
|
19
|
Okamoto N, Shutta R, Yanagawa K, Matsuhiro Y, Nakamura H, Yasumoto K, Tsuda M, Tanaka A, Matsunaga Y, Yano M, Yamato M, Egami Y, Tanouchi J, Nishino M. Real-world clinical impact of external elastic lamina-based stent sizing criteria using optical coherence tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
ILUMIEN III trial has reported that non-inferiority of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) to intravascular ultrasound-guided PCI for postprocedural minimum stent area. In the trial, external elastic lamina (EEL)-based stent sizing criteria was introduced, however OCT has limitations including incomplete visualization of EEL in severale lesions.
Purpose
The aim of the study is to investigate real-world clinical impact of EEL-based stent sizing criteria.
Methods
The study included consecutive patients who underwent OCT-guided percutaneous coronary intervention (PCI) for de novo lesions in our institution between September 2016 and April 2018. EEL visibility, mean EEL diameter, mean lumen diameter and plaque morphology were assessed at proximal and distal references. The plaque morphology at references was categorized according to its most prevalent component as follows: normal, fibrous plaque, lipid plaque, and calcified plaque. Both references were divided into 3 groups according to visibility of EEL.
Results
Among 205 lesions, 31 lesions had artifacts at references (16 proximal and 17 distal references). EEL visibility was summarized in a table. Out of 174 lesions with both analyzable references, 111 lesions (63.8%) had >180-degree EEL visibility at both references. Proportion of plaque morphology were significantly different among 3 groups at proximal and distal references as shown in a figure.
Conclusions
EEL-based stent sizing criteria was usable for 63.8% of all the lesions. Vessel size and plaque morphology were significantly associated with EEL visibility.
Proportion of plaque morphology
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- N Okamoto
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsunaga
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Yano
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Yamato
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| |
Collapse
|
20
|
Yano M, Nishino M, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yamato M, Egami Y, Shutta R, Tanouchi J. Difference of myocardial injury, inflammation and early recurrence after pulmonary vein isolation among laser balloon ablation, radiofrequency catheter ablation and cryoballoon ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) has become well-established as the main therapy for patients with drug-refractory paroxysmal atrial fibrillation (PAF) and various isolation methods including radiofrequency ablation (RFA), cryoballoon ablation (CBA) and laser balloon ablation (LBA) were available. Pathological findings in each ablation methods such as myocardial injury and inflammation are thought to be different. High sensitive cardiac troponin I (hs-TnI), subunit of cardiac troponin complex, is a sensitive and specific marker of myocardium injury. High-sensitive C-reactive protein (hs-CRP) is a biomarker of inflammation and is elevated following cardiomyocyte necrosis. Relationship between myocardial injury and inflammation after ablation using RFA, CBA and LBA and early recurrence of atrial fibrillation (ERAF) remains unclear.
Methods
We enrolled consecutive PAF patients from Osaka Rosai Atrial Fibrillation (ORAF) registry who underwent PVI from January 2019 to October 2019. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters including left ventricular dimensions, left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between RFA, CBA and LBA groups. We investigated the difference of relationship between myocardial injury marker (hs-TnI), inflammation markers (white blood cell change (DWBC) from post to pre PVI, neutrophil-to-lymphocyte ratio change (DNLR) from after to before PVI and hs-CRP) at 36–48 hours after PVI and ERAF (<3 months after PVI) between each group.
Results
We enrolled 187 consecutive PAF patients who underwent PVI. RFA, CBA and LBA groups comprised 108, 57 and 22 patients, respectively. There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters between each group. Serum hs-TnI in RFA group and LBA group were significantly lower than in CBA group (2.643 ng/ml vs 5.240ng/ml, 1.344 ng/ml vs 5.240 ng/ml, p<0.001, p=0.002, respectively, Figure). DWBC was significantly higher in LBA group than CBA group (1157.3/μl vs 418.4/μl, p=0.045). DNLR did not differ between each group. Hs-CRP in RFA group and LBA group were significantly higher than in CBA group (1.881 mg/dl vs 1.186 mg/dl, 2.173 mg/dl vs 1.186 mg/dl, p=0.010, p=0.003, respectively, Figure). Incidence of ERAF was significantly higher in LBA group than RFA group (36.4% vs 16.7%, p=0.035). Incidence of ERAF tended to be higher in LBA group than CBA group (36.4% vs 19.3%, p=0.112).
Conclusion
LBA may cause less myocardial injury than RFA and CBA, on the contrary LBA may cause more inflammation than CBA. Incidence of ERAF in LBA was highest between each procedure.
Inflammation markers and ERAF
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M Yano
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | | | - M Yamato
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| |
Collapse
|
21
|
Ukita K, Kawamura A, Nakamura H, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga Y, Yano M, Egami Y, Shutta R, Nishino M, Tanouchi J. Outcome of contact force-guided radiofrequency catheter ablation or second generation cryoballoon ablation for paroxysmal atrial fibrillation: propensity score matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Little has been reported on the outcome of contact force (CF)-guided radiofrequency catheter ablation (RFCA) and second generation cryoballoon ablation (CBA).
Purpose
The purpose of this study was to compare the outcome of CF-guided RFCA and second generation CBA for paroxysmal atrial fibrillation (PAF).
Methods
We enrolled the consecutive 364 patients with PAF who underwent initial ablation between September 2014 and July 2018 in our hospital. We compared the late recurrence of atrial tachyarrhythmia more than three months after ablation between RFCA group and CBA group. All RFCA procedures were performed using CF-sensing catheter and all CBA procedures were performed using second generation CB.
Results
There were significant differences in background characteristics: chronic kidney disease, serum brain natriuretic peptide level, and left ventricular ejection fraction. After propensity score matched analysis (Table), atrial tachyarrhythmia free survival was significantly higher in CBA group than in RFCA group (Figure).
Conclusions
Second generation CBA showed a significantly lower late recurrence rate compared to CF-guided RFCA.
Kaplan-Meier Curve
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Ukita
- Osaka Rosai Hospital, Sakai, Japan
| | | | | | | | - M Tsuda
- Osaka Rosai Hospital, Sakai, Japan
| | | | - A Tanaka
- Osaka Rosai Hospital, Sakai, Japan
| | | | - M Yano
- Osaka Rosai Hospital, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Sakai, Japan
| | | | | |
Collapse
|
22
|
Kini A, Okamoto N, Barman N, Vengrenyuk Y, Yasumura K, Bhatheja S, Kapur V, Hasan C, Sweeny J, Baber U, Mehran R, Stone G, Sharma S. Side branch FFR after provisional stenting: simplified approach based on OCT frame count. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Treatment of bifurcation coronary artery lesions remains a major challenge in interventional cardiology. Side branch (SB) stenoses are frequently observed after stent implantation in bifurcation lesions, although angiographically narrowed SBs may not be functionally significant. Fractional flow reserve (FFR), a pressure-derived index of the hemodynamic significance of a coronary artery stenosis, may be useful in determining whether additional intervention is required in jailed SBs. Angiography and intravascular ultrasound (IVUS) derived parameters have showed poor diagnostic accuracy in predicting the functional significance of jailed SBs.
Purpose
The aim of the present study was to use high resolution optical coherence tomography (OCT) imaging to predict functionally significant SB stenoses after provisional stenting defined as SB FFR ≤0.80.
Methods
Seventy-one patients with 71 calcified bifurcation lesions with angiographically intermediate SB stenoses undergoing provisional stenting were enrolled in the prospective study. OCT pullbacks were performed before and after stent placement, and SB FFR was measured after main vessel stenting. SB ostium area (SBOA) was assessed using three-dimensional OCT cut-plane analysis off-line. In addition, we developed a simplified approach to SB ostium assessment based on SB ostium frame count using two-dimensional OCT pullback not requiring off-line 3D reconstruction. For the analysis, consecutive frames were counted between the most distal and most proximal take-off of the SB frames.
Results
Similar to previous studies, quantitative coronary angiography findings were not associated with the functional significance of SBs after main vessel stenting. In contrast, SBOA assessed by 3D-OCT after provisional stenting strongly correlated with post-procedure SB FFR. The optimal cut-off value for the SBOA area to predict a SB FFR ≤0.80 was 0.76 mm2 (sensitivity 82%, specificity 89% and area under the curve of 0.92 (95% CI: 0.84–0.99). A simplified approach to SB ostium assessment using OCT frame count yielded a sensitivity of 82%, specificity 89% and area under the curve 0.92 (95% CI: 0.84 to 0.99) with a cut-off of 4.5 frames allowing detection of functionally significant SB stenoses during the procedure in real time. Figure 1 shows a receiver-operating characteristic curve for SB FFR ≤0.8 and a representative case with SB FFR = 0.66 after provisional stenting and SB ostium frame count equal 3 (Frame 1 to 3)
Conclusion(s)
Assessment of SB using either 3D OCT off-line reconstruction or a simplified approach based on OCT frame count can detect SB branches with FFR ≤0.80 with high sensitivity and specificity. The developed approaches may represent a useful tool to assess provisional stent outcomes.
Figure 1
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific; St. Jude Medical
Collapse
Affiliation(s)
- A Kini
- Mount Sinai Medical Center, New York, United States of America
| | - N Okamoto
- Mount Sinai Medical Center, New York, United States of America
| | - N Barman
- Mount Sinai Medical Center, New York, United States of America
| | - Y Vengrenyuk
- Mount Sinai Medical Center, New York, United States of America
| | - K Yasumura
- Mount Sinai Medical Center, New York, United States of America
| | - S Bhatheja
- Mount Sinai Medical Center, New York, United States of America
| | - V Kapur
- Mount Sinai Medical Center, New York, United States of America
| | - C Hasan
- Mount Sinai Medical Center, New York, United States of America
| | - J Sweeny
- Mount Sinai Medical Center, New York, United States of America
| | - U Baber
- Mount Sinai Medical Center, New York, United States of America
| | - R Mehran
- Mount Sinai Medical Center, New York, United States of America
| | - G Stone
- Mount Sinai Medical Center, New York, United States of America
| | - S Sharma
- Mount Sinai Medical Center, New York, United States of America
| |
Collapse
|
23
|
Yano M, Nishino M, Yanagawa K, Nakamura H, Matsuhiro Y, Yasumoto K, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yamato M, Egami Y, Shutta R, Tanouchi J. Clinical characteristics and outcomes after pulmonary vein isolation in atrial fibrillation patients with complete right bundle branch block. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Complete right bundle branch block (CRBBB) is one of the most frequent alterations of the electrocardiogram (ECG). Several studies have shown that CRBBB was a risk factor for cardiovascular diseases and the appearance of CRBBB in patients hospitalized for exacerbated heart failure (HF) was associated with a worse prognosis. Various alternations of ECG such as early repolarization pattern and intraventricular conduction disturbance were associated with high recurrence ratio of atrial fibrillation (AF) after pulmonary vein isolation (PVI). However clinical outcome after PVI in patients with CRBBB remains unclear.
Methods
We enrolled consecutive AF patients who underwent PVI from September 2014 to November 2018 rom Osaka Rosai Atrial Fibrillation (ORAF) registry. We excluded patients with other wide QRS (left bundle branch block, ventricular pacing and unclassified intraventricular conduction disturbance) and divided into 2 groups; CRBBB (QRS duration ≥120msec) group and no-CRBBB (QRS duration <120) group. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, paroxysmal AF (PAF), renal function, plasma brain natriuretic peptide (BNP) level and echocardiographic parameters including left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between the 2 groups. We also compared the incidence of late recurrence of AF/atrial tachycardia (AT) between the 2 groups. We investigated whether CRBBB was an independent predictor of late recurrence of AF/AT after PVI by multivariate Cox analysis.
Results
We enrolled 736 consecutive AF patients who underwent PVI. CRBBB patients comprised 55 patients (7.5%). There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, history of stroke, CHADS2Vasc score, PAF, renal function, plasma BNP level and echocardiographic parameters (LVDd, LVDs, LVEF and LAD) between the 2 groups. Incidence of AF/AT recurrence after PVI was significantly higher in CRBBB group than no-CRBBB group (Figure). CRBBB was an independently and significantly associated with late recurrence of AF/AT after PVI by multivariate Cox analysis (hazard ratio: 1.923, 95% CI: 1.190–2.961, p=0.009) in addition to female (p<0.001), no-PAF (p=0.005) and left atrial diameter (p=0.042).
Conclusion
CRBBB may be a strong predictor of AF/AT late recurrence after PVI.
AF/Ar recurrence after PVI
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M Yano
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - K Yasumoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | | | - M Yamato
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Division of cardiology, Sakai, Japan
| |
Collapse
|
24
|
Yasumoto K, Egami Y, Ukita K, Yanagawa K, Nakamura H, Matsuhiro Y, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yano M, Yamato M, Shutta R, Nishino M, Tanouchi J. Ablation index guide pulmonary vein isolation can reduce early recurrence of atrial fibrillation: a propensity score-matched analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ablation index (AI) is a novel marker of ablation lesion quality for radiofrequency ablation (RFA). It has been reported that AI guided pulmonary vein isolation (PVI) reduced pulmonary vein reconnection and late recurrence of atrial fibrillation (AF). However, little is known about the impact of AI guided PVI on early recurrence of AF (ERAF).
Purpose
The aim of this study is to clarify whether AI guided PVI can reduce ERAF.
Methods
From September 2014 to August 2019, consecutive AF patients who underwent 1st session PVI were enrolled. We compared prevalence of ERAF between AI guided PVI group (AI group) and conventional contact force guided PVI group (CF group) using propensity score-matched analysis, which adjusted patient backgrounds (age, sex, and body mass index (BMI)), type of AF, the history of heart failure, hypertension, diabetes and stroke, laboratory findings including estimated glomerular filtration rate (eGFR) and b-type natriuretic peptide (BNP), and echocardiographic parameters including left ventricular ejection fraction (LVEF) and left atrial diameter.
Results
Total 711 patients were enrolled. AI group comprised 233 patients and CF group comprised 233 patients. Prevalence of ERAF were significantly lower in AI group than in CF group significantly (21.5% vs 36.1%, p=0.001, Table).
Conclusions
AI guided PVI can reduce ERAF as compared to conventional method.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Yasumoto
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Egami
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - K Ukita
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - K Yanagawa
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - H Nakamura
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Matsuhiro
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Tsuda
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - N Okamoto
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - A Tanaka
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - Y Matsunaga-Lee
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Yano
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Yamato
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - R Shutta
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - M Nishino
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| | - J Tanouchi
- Osaka Rosai Hospital, Department of Cardiology, Sakai, Japan
| |
Collapse
|
25
|
Al-Taher M, Okamoto N, Felli E, Agnus V, Barberio M, Gioux S, Bouvy N, Stassen L, Marescaux J, Diana M. Noninvasive Near-Infrared Fluorescence Imaging of the Ureter During Robotic Surgery: A Demonstration in a Porcine Model. J Laparoendosc Adv Surg Tech A 2020; 30:962-966. [DOI: 10.1089/lap.2020.0399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Mahdi Al-Taher
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nariaki Okamoto
- Research Institute against Digestive Cancer, IRCAD, Strasbourg, France
| | - Eric Felli
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
| | - Vincent Agnus
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
| | - Manuel Barberio
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
| | - Sylvain Gioux
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
- ICUBE Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| | - Nicole Bouvy
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Laurents Stassen
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jacques Marescaux
- Research Institute against Digestive Cancer, IRCAD, Strasbourg, France
| | - Michele Diana
- Institute of Image-Guided Surgery, IHU Strasbourg, Strasbourg, France
- Research Institute against Digestive Cancer, IRCAD, Strasbourg, France
- ICUBE Laboratory, Photonics Instrumentation for Health, Strasbourg, France
| |
Collapse
|
26
|
Ikeda T, Ohashi K, Sekine A, Ohe Y, Tsuda T, Kataoka Y, Hara S, Okamoto N, Kodani M, Matsumoto S, Goto K. Tumor mutation burden (TMB) estimation using small-sized targeted next-generation sequencing (NGS) to predict efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.032] [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
|
27
|
Kawagoe Y, Sato Y, Okamoto N, Ishizuka B, Kawamura K. Maternal STAT3 regulates oocyte maturation and development of early embryos through autophagy. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.982] [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: 10/28/2022]
|
28
|
Abstract
AbstractThe outline of the Nagoya Program, the most representative software package for computerized electrocardiography in Japan, is described. First, the history and current status of research and its transfer to commercial products for computerized interpretation of electrocardiograms is briefly reviewed. Second, development and testing of the Nagoya Program is depicted, referring to a gold standard for evaluation and the database being used for this purpose, and to its participation in the CSE study. Third, a description of signal acquisition and wave identification is given, followed by the detection of rhythm disturbances. Next, algorithms for contour classification, which consist of decision-tree logic established through trial and error and making use of the database of ECGs, are described. Finally, special features and future plans of the Nagoya Program are mentioned.
Collapse
|
29
|
Taniguchi-Ikeda M, Morisada N, Inagaki H, Ouchi Y, Takami Y, Tachikawa M, Satake W, Kobayashi K, Tsuneishi S, Takada S, Yamaguchi H, Nagase H, Nozu K, Okamoto N, Nishio H, Toda T, Morioka I, Wada H, Kurahashi H, Iijima K. Two patients with PNKP mutations presenting with microcephaly, seizure, and oculomotor apraxia. Clin Genet 2017; 93:931-933. [PMID: 29243230 DOI: 10.1111/cge.13106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/22/2017] [Accepted: 07/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- M Taniguchi-Ikeda
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Genetic Counseling, Kobe University Hospital, Kobe, Japan
| | - N Morisada
- Department of Clinical Genetics, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan
| | - H Inagaki
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan
| | - Y Ouchi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan
| | - Y Takami
- Department of Pediatrics, Himeji Red Cross Hospital, Himeji, Japan
| | - M Tachikawa
- Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - W Satake
- Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Kobayashi
- Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Tsuneishi
- Medical and Welfare Center Kizuna, Kasai, Japan
| | - S Takada
- Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - H Yamaguchi
- Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, Kobe, Japan
| | - H Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - H Nishio
- Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - T Toda
- Division of Genetic Counseling, Kobe University Hospital, Kobe, Japan.,Division of Neurology/Molecular Brain Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - I Morioka
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Wada
- Medical and Welfare Center Sakura, Sanda, Japan
| | - H Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan
| | - K Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
30
|
Okamoto N, Hosono A, Shibata K, Tsujimura S, Oka K, Fujita H, Kamiya M, Kondo F, Wakabayashi R, Yamada T, Suzuki S. Accuracy of self-reported height, weight and waist circumference in a Japanese sample. Obes Sci Pract 2017; 3:417-424. [PMID: 29259800 PMCID: PMC5729501 DOI: 10.1002/osp4.122] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/28/2017] [Accepted: 07/10/2017] [Indexed: 11/15/2022] Open
Abstract
Objective Inconsistent results have been found in prior studies investigating the accuracy of self‐reported waist circumference, and no study has investigated the validity of self‐reported waist circumference among Japanese individuals. This study used the diagnostic standard of metabolic syndrome to assess the accuracy of individual's self‐reported height, weight and waist circumference in a Japanese sample. Methods Study participants included 7,443 Japanese men and women aged 35–79 years. They participated in a cohort study's baseline survey between 2007 and 2011. Participants' height, weight and waist circumference were measured, and their body mass index was calculated. Self‐reported values were collected through a questionnaire before the examination. Results Strong correlations between measured and self‐reported values for height, weight and body mass index were detected. The correlation was lowest for waist circumference (men, 0.87; women, 0.73). Men significantly overestimated their waist circumference (mean difference, 0.8 cm), whereas women significantly underestimated theirs (mean difference, 5.1 cm). The sensitivity of self‐reported waist circumference using the cut‐off value of metabolic syndrome was 0.83 for men and 0.57 for women. Conclusions Due to systematic and random errors, the accuracy of self‐reported waist circumference was low. Therefore, waist circumference should be measured without relying on self‐reported values, particularly in the case of women.
Collapse
Affiliation(s)
- N Okamoto
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - A Hosono
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - K Shibata
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan.,Aichi Gakusen University Okazaki Japan
| | - S Tsujimura
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - K Oka
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - H Fujita
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - M Kamiya
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - F Kondo
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - R Wakabayashi
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - T Yamada
- Okazaki City Medical Association, Public Health Center Okazaki Japan
| | - S Suzuki
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| |
Collapse
|
31
|
Tanaka A, Tamiya A, Tamiya M, Morita S, Shiroyama T, Saijo N, Minomo S, Tsuji T, Takeuchi N, Omachi N, Morishita N, Suzuki H, Okamoto N, Okishio K, Hirashima T, Atagi S. Final analysis of phase II trial of carboplatin, S-1, and gefitinib as first-line triplet chemotherapy for advanced non-small cell lung cancer patients with activating epidermal growth factor receptor mutations. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.032] [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
|
32
|
Naito M, Naoki Y, Takata S, Ishii S, Taniguchi Y, Saijo N, Tamiya A, Omachi N, Okishio K, Morita S, Tanaka A, Shiroyama T, Morishita N, Suzuki H, Okamoto N, Hirashima T, Atagi S. The efficacy of dose reduced crizotinib for advanced ALK-positive non-small cell lung cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.025] [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
|
33
|
Matsuhiro Y, Syutta R, Nakamura H, Yasumura K, Yasumoto K, Okamoto N, Tanaka H, Mori N, Nakamura D, Yano M, Makino N, Egami Y, Nisino M, Tanouti J. P5597Effect of number of connectors on vessel healing at proximal edge part after everolimus -eluting stent implantation using optical coherence tomography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5597] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
34
|
Iki M, Fujita Y, Tamaki J, Kouda K, Yura A, Sato Y, Moon JS, Harano A, Hazaki K, Kajita E, Hamada M, Arai K, Tomioka K, Okamoto N, Kurumatani N. Incident fracture associated with increased risk of mortality even after adjusting for frailty status in elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study. Osteoporos Int 2017; 28:871-880. [PMID: 27752744 DOI: 10.1007/s00198-016-3797-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
Abstract
UNLABELLED Frail elderly individuals have elevated risks of both fracture and mortality. We found that incident fractures were associated with an increased risk of death even after adjusting for pre-fracture frailty status as represented by physical performance tests and laboratory tests for common geriatric diseases in community-dwelling elderly Japanese men. INTRODUCTION While fractures reportedly increase the risk of mortality, frailty may complicate this association, generating a false-positive result. We evaluated this association after adjusting for pre-fracture levels of frailty. METHODS We examined 1998 community-dwelling ambulatory men aged ≥65 years at baseline in the Fujiwara-kyo Osteoporosis Risk in Men Study for frailty status as represented by activities of daily living (ADL), physical performance tests (grip strength, one-foot standing balance with eyes open, timed 10-m walk), and laboratory sera tests. Participants were then followed for 5 years for incident clinical fractures and death. Effects of incident fracture on death were determined by Cox proportional hazards model with the first fracture during follow-up as a time-dependent predictor and with frailty status indices as covariates. RESULTS We identified 111 fractures in 99 men and 138 deaths during the follow-up period (median follow-up, 4.5 years). Participants with incident fractures did not have significantly worse frailty statuses, but did show a significantly higher cumulative mortality rate than those without fractures (p = 0.0047). Age-adjusted hazard ratio (HR) of death for incident fracture was 3.57 (95 % confidence interval: 2.05, 6.24). When adjusted for physical performance, this decreased to 2.77 (1.51, 5.06), but remained significant. The HR showed no significant change when adjusted for laboratory test results (3.96 (2.26, 6.94)). Exclusion of deaths within the first 24 months of follow-up did not alter these results. CONCLUSION Incident clinical fracture was associated with an elevated risk of death independently of pre-fracture levels of frailty in community-dwelling elderly men.
Collapse
Affiliation(s)
- M Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Y Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - J Tamaki
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - K Kouda
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - A Yura
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Y Sato
- Department of Health and Nutrition, Faculty of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui, 915-8586, Japan
| | - J S Moon
- Department of Nursing, Faculty of Health Science, Kio University, 4-2-2 Umami-naka, Kita-Katsuragi-gun, Koryo-cho, Nara, 635-0832, Japan
| | - A Harano
- Department of Orthopedics, Yamato-Takada Municipal Hospital, 1-1 Isonokitamachi, Yamato-Takada, Nara, 635-8501, Japan
| | - K Hazaki
- Department of Physical Therapy, Faculty of Biomedical Engineering, Osaka Electro-Communication University, 18-8 Hatsucho, Neyagawa, Osaka, 572-8530, Japan
| | - E Kajita
- Department of Public Health and Home Nursing, Graduate School of Medical Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan
| | - M Hamada
- Department of Public Health and Home Nursing, Graduate School of Medical Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan
| | - K Arai
- Department of Public Health and Home Nursing, Graduate School of Medical Sciences, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan
| | - K Tomioka
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| | - N Okamoto
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| | - N Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| |
Collapse
|
35
|
Tamiya A, Tamiya M, Nishihara T, Shiroyama T, Nakao K, Tsuji T, Takeuchi N, Isa SI, Omachi N, Okamoto N, Suzuki H, Okishio K, Iwazaki A, Imai K, Hirashima T, Atagi S. Afatinib efficacy and cerebrospinal fluid concentration in NSCLC patients with EGFR mutation developing leptomeningeal carcinomatosis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
36
|
Suzuki T, Miyake N, Tsurusaki Y, Okamoto N, Alkindy A, Inaba A, Sato M, Ito S, Muramatsu K, Kimura S, Ieda D, Saitoh S, Hiyane M, Suzumura H, Yagyu K, Shiraishi H, Nakajima M, Fueki N, Habata Y, Ueda Y, Komatsu Y, Yan K, Shimoda K, Shitara Y, Mizuno S, Ichinomiya K, Sameshima K, Tsuyusaki Y, Kurosawa K, Sakai Y, Haginoya K, Kobayashi Y, Yoshizawa C, Hisano M, Nakashima M, Saitsu H, Takeda S, Matsumoto N. Molecular genetic analysis of 30 families with Joubert syndrome. Clin Genet 2016; 90:526-535. [PMID: 27434533 DOI: 10.1111/cge.12836] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [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: 05/13/2016] [Revised: 06/27/2016] [Accepted: 07/14/2016] [Indexed: 02/02/2023]
Abstract
Joubert syndrome (JS) is rare recessive disorders characterized by the combination of hypoplasia/aplasia of the cerebellar vermis, thickened and elongated superior cerebellar peduncles, and a deep interpeduncular fossa which is defined by neuroimaging and is termed the 'molar tooth sign'. JS is genetically highly heterogeneous, with at least 29 disease genes being involved. To further understand the genetic causes of JS, we performed whole-exome sequencing in 24 newly recruited JS families. Together with six previously reported families, we identified causative mutations in 25 out of 30 (24 + 6) families (83.3%). We identified eight mutated genes in 27 (21 + 6) Japanese families, TMEM67 (7/27, 25.9%) and CEP290 (6/27, 22.2%) were the most commonly mutated. Interestingly, 9 of 12 CEP290 disease alleles were c.6012-12T>A (75.0%), an allele that has not been reported in non-Japanese populations. Therefore c.6012-12T>A is a common allele in the Japanese population. Importantly, one Japanese and one Omani families carried compound biallelic mutations in two distinct genes (TMEM67/RPGRIP1L and TMEM138/BBS1, respectively). BBS1 is the causative gene in Bardet-Biedl syndrome. These concomitant mutations led to severe and/or complex clinical features in the patients, suggesting combined effects of different mutant genes.
Collapse
Affiliation(s)
- T Suzuki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Y Tsurusaki
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - A Alkindy
- Department of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
| | - A Inaba
- Yokohama City University Medical Center, Children's Medical Center, Yokohama, Japan
| | - M Sato
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - S Ito
- Department of Pediatrics, Graduate school of Medicine, Yokohama City University, Yokohama, Japan
| | - K Muramatsu
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan
| | - S Kimura
- Kumamoto City Child Development Support Center, Kumamoto, Japan
| | - D Ieda
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - S Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - M Hiyane
- Division of Child Neurology, Okinawa Prefectural Southern Medical Center & Children's Medical Center, Okinawa, Japan
| | - H Suzumura
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - K Yagyu
- Department of Child and Adolescent Psychiatry, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - H Shiraishi
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - M Nakajima
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - N Fueki
- Division of Rehabilitation, Nagano Children's Hospital, Nagano, Japan
| | - Y Habata
- Department of Pediatric Rehabilitation, Hokkaido Medical Center for Child Health and Rehabilitation, Hokkaido, Japan
| | - Y Ueda
- Nire-no-kai Children's Clinic, Hokkaido, Japan
| | - Y Komatsu
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | - K Yan
- Department of Pediatrics, Kyorin University School of Medicine, Tokyo, Japan
| | - K Shimoda
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Shitara
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - S Mizuno
- Department of Pediatrics, Central Hospital, Aichi Human Service Center, Aichi, Japan
| | - K Ichinomiya
- Department of Neonatology, Gunma Children's Medical Center, Gunma, Japan
| | - K Sameshima
- Division of Medical Genetics, Gunma Children's Medical Center, Gunma, Japan
| | - Y Tsuyusaki
- Division of Neurology, Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Kurosawa
- Division of Medical Genetics, Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Y Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Haginoya
- Department of Pediatric Neurology, Miyagi Children's Hospital, Sendai, Japan
| | - Y Kobayashi
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan.,Academic Renal Unit, School of Clinical Science, University of Bristol, Bristol, UK
| | - C Yoshizawa
- Department of Pediatrics, Gunma University Graduate School of Medicine, Gunma, Japan
| | - M Hisano
- Department of Nephrology, Chiba Children's Hospital, Chiba, Japan
| | - M Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - H Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - S Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - N Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| |
Collapse
|
37
|
Takae S, Tsukada K, Okamoto N, Sato Y, Kawahara T, Suzuki N. Verification of accuracy & safety for ovarian reserve assessment with optical coherence tomography using mouse ovary. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.014] [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: 10/21/2022]
|
38
|
Nishioka H, Nakamura E, Hirose J, Okamoto N, Yamabe S, Mizuta H. MRI T1ρ and T2 mapping for the assessment of articular cartilage changes in patients with medial knee osteoarthritis after hemicallotasis osteotomy. Bone Joint Res 2016; 5:294-300. [PMID: 27421285 PMCID: PMC4969631 DOI: 10.1302/2046-3758.57.bjr-2016-0057.r1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 06/09/2016] [Indexed: 02/05/2023] Open
Abstract
Objectives The purpose of this study was to clarify the appearance of the reparative tissue on the articular surface and to analyse the properties of the reparative tissue after hemicallotasis osteotomy (HCO) using MRI T1ρ and T2 mapping. Methods Coronal T1ρ and T2 mapping and three-dimensional gradient-echo images were obtained from 20 subjects with medial knee osteoarthritis. We set the regions of interest (ROIs) on the full-thickness cartilage of the medial femoral condyle (MFC) and medial tibial plateau (MTP) of the knee and measured the cartilage thickness (mm) and T1ρ and T2 relaxation times (ms). Statistical analysis of time-dependent changes in the cartilage thickness and the T1ρ and T2 relaxation times was performed using one-way analysis of variance, and Scheffe’s test was employed for post hoc multiple comparison. Results The cartilage-like repair tissue appeared on the cartilage surface of the medial compartment post-operatively, and the cartilage thickness showed a significant increase between the pre-operative and one-year post-operative time points (MFC; p = 0.003, MTP; p < 0.001). The T1ρ values of the cartilage-like repair tissue showed no difference over time, however, the T2 values showed a significant decrease between the pre-operative and one-year post-operative time points (MFC; p = 0.004, MTP; p = 0.040). Conclusion This study clarified that the fibrocartilage-like repair tissue appeared on the articular surface of the medial compartment after HCO as evidenced by MRI T1ρ and T2 mapping. Cite this article: H. Nishioka, E. Nakamura, J. Hirose, N. Okamoto, S. Yamabe, H. Mizuta. MRI T1ρ and T2 mapping for the assessment of articular cartilage changes in patients with medial knee osteoarthritis after hemicallotasis osteotomy. Bone Joint Res 2016;5:294–300. DOI: 10.1302/2046-3758.57.BJR-2016-0057.R1.
Collapse
Affiliation(s)
- H Nishioka
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - E Nakamura
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - J Hirose
- Department of Medical Information Science and Administration Planning, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - N Okamoto
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - S Yamabe
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - H Mizuta
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| |
Collapse
|
39
|
Okamoto N, Miya F, Tsunoda T, Kato M, Saitoh S, Yamasaki M, Shimizu A, Torii C, Kanemura Y, Kosaki K. Targeted next-generation sequencing in the diagnosis of neurodevelopmental disorders. Clin Genet 2015; 88:288-92. [PMID: 25156961 DOI: 10.1111/cge.12492] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 04/26/2014] [Revised: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 02/04/2023]
Abstract
We developed a next-generation sequencing (NGS) based mutation screening strategy for neurodevelopmental diseases. Using this system, we screened 284 genes in 40 patients. Several novel mutations were discovered. Patient 1 had a novel mutation in ACTB. Her dysmorphic feature was mild for Baraitser-Winter syndrome. Patient 2 had a truncating mutation of DYRK1A. She lacked microcephaly, which was previously assumed to be a constant feature of DYRK1A loss of function. Patient 3 had a novel mutation in GABRD gene. She showed Rett syndrome like features. Patient 4 was diagnosed with Noonan syndrome with PTPN11 mutation. He showed complete agenesis of corpus callosum. We have discussed these novel findings.
Collapse
Affiliation(s)
- N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - F Miya
- Laboratory for Medical Science Mathematics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - T Tsunoda
- Laboratory for Medical Science Mathematics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - M Kato
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - S Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - M Yamasaki
- Department of Pediatric Neurosurgery, Takatsuki General Hospital, Osaka, Japan
| | - A Shimizu
- Division of Biomedical Information Analysis, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Iwate, Japan
| | - C Torii
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Y Kanemura
- Division of Regenerative Medicine, Institute for Clinical Research, Osaka National Hospital, National Hospital Organization, Osaka, Japan
- Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - K Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
40
|
Iki M, Fujita Y, Tamaki J, Kouda K, Yura A, Sato Y, Moon JS, Winzenrieth R, Okamoto N, Kurumatani N. Trabecular bone score may improve FRAX® prediction accuracy for major osteoporotic fractures in elderly Japanese men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Cohort Study. Osteoporos Int 2015; 26:1841-8. [PMID: 25752623 DOI: 10.1007/s00198-015-3092-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 02/25/2015] [Indexed: 01/28/2023]
Abstract
UNLABELLED FRAX® is widely used to evaluate fracture risk of individuals in clinical settings. However, FRAX® prediction accuracy is not sufficient, and improvement is desired. Trabecular bone score, a bone microarchitecture index, may improve FRAX® prediction accuracy for major osteoporotic fractures in community-dwelling elderly Japanese men. INTRODUCTION To improve fracture risk assessment in clinical settings, we evaluated whether the combination of FRAX® and Trabecular Bone Score (TBS) improves the prediction accuracy of major osteoporotic fractures (MOFs) in elderly Japanese men compared to FRAX® alone. METHODS Two thousand and twelve community-dwelling men aged ≥65 years completed the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Baseline Study comprising lumbar spine (LS) and femoral neck areal bone mineral density (aBMD) measurements, and interviews regarding clinical risk factors required to estimate 10-year risk of MOF (hip, spine, distal forearm, and proximal humerus) using the Japanese version of FRAX® (v.3.8). TBS was calculated for the same vertebrae used for LS-aBMD with TBS iNsight software (v.2.1). MOFs that occurred during the follow-up period were identified by interviews or mail and telephone surveys. Prediction accuracy of a logistic model combining FRAX® score and TBS compared to FRAX® alone was evaluated by area under receiver-operating characteristic curves (AUCs), as well as category-free integrated discrimination improvement (IDI) and net reclassification improvement (NRI). RESULTS We identified 22 men with MOFs during 8140 person-years (PY) of follow-up among 1872 men; 67 men who suffered from fractures other than MOFs were excluded. Participants with MOFs had significantly lower TBS (p = 0.0015) and higher FRAX® scores (p = 0.0089) than those without. IDI and NRI showed significant improvements in reclassification accuracy using FRAX® plus TBS compared to FRAX® alone (IDI 0.006 (p = 0.0362), NRI 0.452 (p = 0.0351)), although no difference was observed in AUCs between the two. CONCLUSIONS TBS may improve MOF prediction accuracy of FRAX® for community-dwelling elderly Japanese men.
Collapse
Affiliation(s)
- M Iki
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Y Fujita
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - J Tamaki
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - K Kouda
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - A Yura
- Department of Public Health, Kinki University Faculty of Medicine, 377-2 Oono-higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Y Sato
- Department of Health and Nutrition, Faculty of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui, 915-8586, Japan
| | - J-S Moon
- Department of Nursing and Medical Care, Faculty of Health Science, Kio University, 4-2-2 Umami-naka, Koryo-cho, Kita-Katsuragi-gun, Nara, 635-0832, Japan
| | - R Winzenrieth
- Med-Imaps, Hôpital Xavier Arnozan, Avenue du Haut Lévèque, Pessac, 33600, France
| | - N Okamoto
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| | - N Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijocho, Kashihara, Nara, 634-8521, Japan
| |
Collapse
|
41
|
Sato Y, Iki M, Fujita Y, Tamaki J, Kouda K, Yura A, Moon JS, Winzenrieth R, Iwaki H, Ishizuka R, Amano N, Tomioka K, Okamoto N, Kurumatani N. Greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in a population of elderly Japanese men with relatively low dietary calcium intake: Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) Study. Osteoporos Int 2015; 26:1585-94. [PMID: 25627112 DOI: 10.1007/s00198-015-3032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 01/06/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED The effects of milk intake on bone health are not clear in elderly Asian men with low dietary calcium intake. This study showed that greater milk intake is associated with lower bone turnover, higher bone density, and higher bone microarchitecture index in community-dwelling elderly Japanese men. INTRODUCTION The consumption of milk or dairy products is widely recommended for maintaining bone health regardless of gender or age. However, little evidence exists on the beneficial effects of milk intake on bone health in elderly Japanese men characterized with relatively low dietary calcium intake. Here we examined whether or not greater milk intake was associated with lower bone turnover, higher bone density, and stronger bone microarchitecture in community-dwelling elderly Japanese men. METHODS Interviews were conducted to obtain information on medical history and lifestyle, including the amount of habitual milk intake, nutrient intake calculations based on a 1-week food diary, and measurements of areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy x-ray absorptiometry (DXA), trabecular bone score (TBS) using DXA images at LS, and biochemical markers of bone turnover in sera. Participants with a history of diseases or medications that affect bone metabolism, or with missing data, were excluded from the analysis. RESULTS The median intake of milk in the 1479 participants (mean age, 73.0 ± 5.1 years) was one glass of milk per day. Bone turnover markers showed a decreasing trend (p < 0.05) and aBMD at TH (p = 0.0019) and FN (p = 0.0057) and TBS (p = 0.0017) showed increasing trends with greater milk intake after adjusting for demographic and behavioral confounding factors. This association was attenuated after further adjusting for nutrient intake, in particular, calcium intake. CONCLUSIONS Greater milk intake was associated with lower bone turnover, higher aBMD, and higher TBS in community-dwelling elderly Japanese men.
Collapse
Affiliation(s)
- Y Sato
- Department of Health and Nutrition, Faculty of Human Life, Jin-ai University, 3-1-1 Ohdecho, Echizen, Fukui, 915-8586, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Miyake N, Tsurusaki Y, Koshimizu E, Okamoto N, Kosho T, Brown NJ, Tan TY, Yap PJJ, Suzumura H, Tanaka T, Nagai T, Nakashima M, Saitsu H, Niikawa N, Matsumoto N. Delineation of clinical features in Wiedemann-Steiner syndrome caused by KMT2A mutations. Clin Genet 2015; 89:115-9. [PMID: 25810209 DOI: 10.1111/cge.12586] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [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: 12/09/2014] [Accepted: 03/06/2015] [Indexed: 01/24/2023]
Abstract
Wiedemann-Steiner syndrome (WSS) is an autosomal dominant congenital anomaly syndrome characterized by hairy elbows, dysmorphic facial appearances (hypertelorism, thick eyebrows, downslanted and vertically narrow palpebral fissures), pre- and post-natal growth deficiency, and psychomotor delay. WSS is caused by heterozygous mutations in KMT2A (also known as MLL), a gene encoding a histone methyltransferase. Here, we identify six novel KMT2A mutations in six WSS patients, with four mutations occurring de novo. Interestingly, some of the patients were initially diagnosed with atypical Kabuki syndrome, which is caused by mutations in KMT2D or KDM6A, genes also involved in histone methylation. KMT2A mutations and clinical features are summarized in our six patients together with eight previously reported patients. Furthermore, clinical comparison of the two syndromes is discussed in detail.
Collapse
Affiliation(s)
- N Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Y Tsurusaki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - E Koshimizu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - T Kosho
- Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan
| | - N J Brown
- Department of Clinical Genetics, Austin Health, Heidelberg, Australia.,Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia
| | - T Y Tan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - P J J Yap
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, Australia
| | - H Suzumura
- Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan
| | - T Tanaka
- Department of Pediatrics and Clinical research, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - T Nagai
- Department of Pediatrics, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - M Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - H Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - N Niikawa
- Health Science University of Hokkaido, Hokkaido, Japan
| | - N Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| |
Collapse
|
43
|
Hasegawa T, Tateishi C, Asai M, Imai Y, Okamoto N, Shioyasono A, Kimoto A, Akashi M, Suzuki H, Furudoi S, Komori T. Retrospective study of changes in the sensitivity of the oral mucosa: sagittal split ramus osteotomy (SSRO) versus intraoral vertical ramus osteotomy (IVRO). Int J Oral Maxillofac Surg 2014; 44:349-55. [PMID: 25468631 DOI: 10.1016/j.ijom.2014.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 10/22/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022]
Abstract
We investigated changes in the sensitivity of cutaneous points and the oral mucosa after sagittal split ramus osteotomy (SSRO) and assessed the differences between SSRO and intraoral vertical ramus osteotomy (IVRO). The subjects included in this study were 46 patients with mandibular prognathism who underwent IVRO (88 rami) and 30 patients who underwent SSRO (59 rami). An objective evaluation of the neurosensory status of each patient was completed preoperatively and at 1, 4, 8, 12, and 24 weeks postoperatively. Other variables studied for each patient included sex, age, magnitude of mandibular setback, and amount of blood loss during surgery. We found that a neurosensory recovery occurred earlier in the oral mucosa than at cutaneous points. The number of oral mucosa points showing reduced neurosensory function and neurosensory disturbance after SSRO was significantly higher than after IVRO at 1, 4, and 8 weeks (P<0.05). The nerve recovery observed after SSRO was delayed for a longer period than that noted in our previous study of IVRO. In conclusion, we found changes in sensitivity at cutaneous points and the oral mucosa after SSRO and assessed the differences between SSRO and IVRO.
Collapse
Affiliation(s)
- T Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - C Tateishi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Asai
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Imai
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Okamoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - A Shioyasono
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - A Kimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Suzuki
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Furudoi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - T Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
44
|
Okamoto N, Kurebayashi H, Trypiniotis T, Farrer I, Ritchie DA, Saitoh E, Sinova J, Mašek J, Jungwirth T, Barnes CHW. Electric control of the spin Hall effect by intervalley transitions. Nat Mater 2014; 13:932-937. [PMID: 25108612 DOI: 10.1038/nmat4059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 07/09/2014] [Indexed: 06/03/2023]
Abstract
Controlling spin-related material properties by electronic means is a key step towards future spintronic technologies. The spin Hall effect (SHE) has become increasingly important for generating, detecting and using spin currents, but its strength--quantified in terms of the SHE angle--is ultimately fixed by the magnitude of the spin-orbit coupling (SOC) present for any given material system. However, if the electrons generating the SHE can be controlled by populating different areas (valleys) of the electronic structure with different SOC characteristic the SHE angle can be tuned directly within a single sample. Here we report the manipulation of the SHE in bulk GaAs at room temperature by means of an electrical intervalley transition induced in the conduction band. The spin Hall angle was determined by measuring an electromotive force driven by photoexcited spin-polarized electrons drifting through GaAs Hall bars. By controlling electron populations in different (Γ and L) valleys, we manipulated the angle from 0.0005 to 0.02. This change by a factor of 40 is unprecedented in GaAs and the highest value achieved is comparable to that of the heavy metal Pt.
Collapse
Affiliation(s)
- N Okamoto
- Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - H Kurebayashi
- 1] Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK [2] London Centre for Nanotechnology, UCL, 17-19 Gordon Street, WC1H 0AH, UK [3] PRESTO, Japan Science and Technology Agency, Kawaguchi 332-0012, Japan
| | - T Trypiniotis
- 1] Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK [2] Department of Physics, University of Cyprus, 1678 Nicosia, Cyprus
| | - I Farrer
- Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - D A Ritchie
- Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - E Saitoh
- 1] Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan [2] The Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan [3] CREST, Japan Science and Technology Agency, Sanbancho, Tokyo 102-0075, Japan
| | - J Sinova
- 1] Institut fur Physik, Johannes Gutenberg-Universitat Mainz, 55128 Mainz, Germany [2] Institute of Physics ASCR v.v.i., Cukrovarnická 10, 162 53 Praha 6, Czech Republic
| | - J Mašek
- Institute of Physics ASCR v.v.i., Na Slovance 2, 182 21 Praha 8, Czech Republic
| | - T Jungwirth
- 1] Institute of Physics ASCR v.v.i., Cukrovarnická 10, 162 53 Praha 6, Czech Republic [2] School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - C H W Barnes
- Cavendish Laboratory, University of Cambridge, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| |
Collapse
|
45
|
Ohtsuka Y, Higashimoto K, Sasaki K, Jozaki K, Yoshinaga H, Okamoto N, Takama Y, Kubota A, Nakayama M, Yatsuki H, Nishioka K, Joh K, Mukai T, Yoshiura KI, Soejima H. Autosomal recessive cystinuria caused by genome-wide paternal uniparental isodisomy in a patient with Beckwith-Wiedemann syndrome. Clin Genet 2014; 88:261-6. [PMID: 25171146 DOI: 10.1111/cge.12496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 01/08/2023]
Abstract
Approximately 20% of Beckwith-Wiedemann syndrome (BWS) cases are caused by mosaic paternal uniparental disomy of chromosome 11 (pUPD11). Although pUPD11 is usually limited to the short arm of chromosome 11, a small minority of BWS cases show genome-wide mosaic pUPD (GWpUPD). These patients show variable clinical features depending on mosaic ratio, imprinting status of other chromosomes, and paternally inherited recessive mutations. To date, there have been no reports of a mosaic GWpUPD patient with an autosomal recessive disease caused by a paternally inherited recessive mutation. Here, we describe a patient concurrently showing the clinical features of BWS and autosomal recessive cystinuria. Genetic analyses revealed that the patient has mosaic GWpUPD and an inherited paternal homozygous mutation in SLC7A9. This is the first report indicating that a paternally inherited recessive mutation can cause an autosomal recessive disease in cases of GWpUPD mosaicism. Investigation into recessive mutations and the dysregulation of imprinting domains is critical in understanding precise clinical conditions of patients with mosaic GWpUPD.
Collapse
Affiliation(s)
- Y Ohtsuka
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Higashimoto
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Sasaki
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Jozaki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - H Yoshinaga
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Y Takama
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - A Kubota
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - M Nakayama
- Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - H Yatsuki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Nishioka
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Joh
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - T Mukai
- Nishikyushu University, Saga, Japan
| | - K-i Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Soejima
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| |
Collapse
|
46
|
Uehara Y, Hirose J, Yamabe S, Okamoto N, Okada T, Oyadomari S, Mizuta H. Endoplasmic reticulum stress-induced apoptosis contributes to articular cartilage degeneration via C/EBP homologous protein. Osteoarthritis Cartilage 2014; 22:1007-17. [PMID: 24795271 DOI: 10.1016/j.joca.2014.04.025] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/18/2014] [Accepted: 04/23/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE When endoplasmic reticulum (ER) stress, i.e., the excessive accumulation of unfolded proteins in ER, endangers homeostasis, apoptosis is induced by C/EBP homologous protein (Chop). In osteoarthritis (OA) cartilage, Chop expression and apoptosis increase as degeneration progresses. We investigated the role of Chop in murine chondrocyte apoptosis and in the progression of cartilage degeneration. METHOD We induced experimental OA in Chop-knockout (Chop(-/-)) mice by medial collateral ligament transection and meniscectomy and compared cartilage degeneration, apoptosis, and ER stress in Chop(-/-)- and wild-type (Chop(+/+)) mice. In our in vitro experiments we treated murine Chop(-/-) chondrocytes with the ER stress inducer tunicamycin (TM) and evaluated apoptosis, ER stress, and chondrocyte function. RESULTS In vivo, the degree of ER stress was similar in Chop(-/-)- and Chop(+/+) mice. However, in Chop(-/-) mice apoptosis and cartilage degeneration were lower by 26.4% and 42.4% at 4 weeks, by 26.8% and 44.9% at 8 weeks, and by 26.9% and 32.3% at 12 weeks after surgery than Chop(+/+) mice, respectively. In vitro, the degree of ER stress induction by TM was similar in Chop(-/-)- and Chop(+/+) chondrocytes. On the other hand, apoptosis was 55.3% lower and the suppression of collagen type II and aggrecan mRNA was 21.0% and 23.3% less, and the increase of matrix metalloproteinase-13 mRNA was 20.0% less in Chop(-/-)- than Chop(+/+) chondrocytes. CONCLUSION Our results indicate that Chop plays a direct role in chondrocyte apoptosis and that Chop-mediated apoptosis contributes to the progression of cartilage degeneration in mice.
Collapse
Affiliation(s)
- Y Uehara
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - J Hirose
- Department of Orthopaedic Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - S Yamabe
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - N Okamoto
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - T Okada
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| | - S Oyadomari
- Division of Molecular Biology, Institute for Genome Research, The University of Tokushima, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.
| | - H Mizuta
- Department of Orthopaedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.
| |
Collapse
|
47
|
Sciancalepore AG, Sallustio F, Girardo S, Passione LG, Camposeo A, Mele E, Di Lorenzo M, Costantino V, Schena FP, Pisignano D, Casino FG, Mostacci SD, Di Carlo M, Sabato A, Procida C, Creput C, Vanholder R, Stolear JC, Lefrancois G, Hanoy M, Nortier J, Potier J, Sereni L, Ferraresi M, Pereno A, Nazha M, Barbero S, Piccoli GB, Ficheux A, Gayrard N, Duranton F, Guzman C, Szwarc I, Bismuth -Mondolfo J, Brunet P, Servel MF, Argiles A, Bernardo A, Demers J, Hutchcraft A, Marbury TC, Minkus M, Muller M, Stallard R, Culleton B, Krieter DH, Korner T, Devine E, Ruth M, Jankowski J, Wanner C, Lemke HD, Surace A, Rovatti P, Steckiph D, Mancini E, Santoro A, Leypoldt JK, Agar BU, Bernardo A, Culleton BF, Vankova S, Havlin J, Klomp DJ, Van Beijnum F, Day JPR, Wieringa FP, Kooman JP, Gremmels H, Hazenbrink DH, Simonis F, Otten ML, Wester M, Boer WH, Joles JA, Gerritsen KG, Umimoto K, Shimamoto Y, Mastushima K, Miyata M, Muller M, Naik A, Pokropinski S, Bairstow S, Svatek J, Young S, Johnson R, Bernardo A, Rikker C, Juhasz E, Gaspar R, Rosivall L, Rusu E, Zilisteanu D, Balanica S, Achim C, Atasie T, Carstea F, Voiculescu M, Monzon Vazquez T, Saiz Garcia S, Mathani V, Escamilla Cabrera B, Cornelis T, Van Der Sande FM, Eloot S, Cardinaels E, Bekers O, Damoiseaux J, Leunissen KM, Kooman J, Baamonde Laborda E, Bosch Benitez-Parodi E, Perez Suarez G, Anton Perez G, Batista Garcia F, Lago Alonso M, Garcia Canton C, Hashimoto S, Seki M, Tomochika M, Yamamoto R, Okamoto N, Nishikawa A, Koike T, Ravagli E, Maldini L, Badiali F, Perazzini C, Lanciotti G, Steckiph D, Surace A, Rovatti P, Severi S, Rigotti A, McFarlane P, Marticorena R, Dacouris N, Pauly R, Nikitin S, Amdahl M, Bernardo A, Culleton B, Calabrese G, Mancuso D, Mazzotta A, Vagelli G, Balenzano C, Steckiph D, Bertucci A, Della Volpe M, Gonella M, Uchida T, Ando K, Kofuji M, Higuchi T, Momose N, Ito K, Ueda Y, Miyazawa H, Kaku Y, Nabata A, Hoshino T, Mori H, Yoshida I, Ookawara S, Tabei K, Umimoto K, Suyama M, Shimamoto Y, Miyata M, Kamada A, Sakai R, Minakawa A, Fukudome K, Hisanaga S, Ishihara T, Yamada K, Fukunaga S, Inagaki H, Tanaka C, Sato Y, Fujimoto S, Potier J, Bouet J, Queffeulou G, Bell R, Nolin L, Pichette V, Provencher H, Lamarche C, Nadeau-Fredette AC, Ouellet G, Leblanc M, Bezzaoucha S, Kouidmir Y, Kassis J, Alonso ML, Lafrance JP, Vallee M, Fils J, Mailley P, Cantaluppi V, Medica D, Quercia AD, Dellepiane S, Ferrario S, Gai M, Leonardi G, Guarena C, Caiazzo M, Biancone L, Enos M, Culleton B, Wiebenson D, Potier J, Hanoy M, Duquennoy S, Tingli W, Ling Z, Yunying S, Ping F, Dolley-Hitze T, Hamel D, Lombart ML, Leypoldt JK, Bernardo A, Hutchcraft AM, Vanholder R, Culleton BF, Movilli E, Camerini C, Gaggia P, Zubani R, Feller P, Pola A, Carli O, Salviani C, Manenti C, Cancarini G, Bozzoli L, Colombini E, Ricchiuti G, Pisanu G, Gargani L, Donadio C, Sidoti A, Lusini ML, Biagioli M, Ghezzi PM, Sereni L, Caiazzo M, Palladino G, Tomo T, Ishida K, Nakata T, Hamel D, Dolley-Hitze T. HAEMODIALYSIS TECHNIQUES AND ADEQUACY 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu153] [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
|
48
|
Nakajima J, Okamoto N, Tohyama J, Kato M, Arai H, Funahashi O, Tsurusaki Y, Nakashima M, Kawashima H, Saitsu H, Matsumoto N, Miyake N. De novo EEF1A2 mutations in patients with characteristic facial features, intellectual disability, autistic behaviors and epilepsy. Clin Genet 2014; 87:356-61. [PMID: 24697219 DOI: 10.1111/cge.12394] [Citation(s) in RCA: 60] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 03/24/2014] [Accepted: 04/01/2014] [Indexed: 01/07/2023]
Abstract
Eukaryotic elongation factor 1, alpha-2 (eEF1A2) protein is involved in protein synthesis, suppression of apoptosis, and regulation of actin function and cytoskeletal structure. EEF1A2 gene is highly expressed in the central nervous system and Eef1a2 knockout mice show the neuronal degeneration. Until now, only one missense mutation (c.208G > A, p.Gly70Ser) in EEF1A2 has been reported in two independent patients with neurological disease. In this report, we described two patients with de novo mutations (c.754G > C, p.Asp252His and c.364G > A, p.Glu122Lys) in EEF1A2 found by whole-exome sequencing. Common clinical features are shared by all four individuals: severe intellectual disability, autistic behavior, absent speech, neonatal hypotonia, epilepsy and progressive microcephaly. Furthermore, the two patients share the similar characteristic facial features including a depressed nasal bridge, tented upper lip, everted lower lip and downturned corners of the mouth. These data strongly indicate that a new recognizable disorder is caused by EEF1A2 mutations.
Collapse
Affiliation(s)
- J Nakajima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan; Department of Pediatrics, Tokyo Medical University, Shinjuku, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Nakamura E, Okamoto N, Nishioka H, Karasugi T, Hirose J, Mizuta H. The long-term outcome of open-wedge osteotomy of the proximal tibia with hemicallotasis. Bone Joint J 2014; 96-B:467-72. [PMID: 24692612 DOI: 10.1302/0301-620x.96b4.31345] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report the long-term outcome of 33 patients (37 knees) who underwent proximal tibial open-wedge osteotomy with hemicallotasis (HCO) for medial osteoarthritis of the knee between 1995 and 2000. Among these, 29 patients with unilateral HCO were enrolled and 19 were available for review at a mean of 14.2 years (10 to 15.7) post-operatively. For these 19 patients, the mean Hospital for Special Surgery knee score was 60 (57 to 62) pre-operatively and 85 (82 to 87) at final follow-up (p < 0.001; paired t-test). The femorotibial angle and tibial inclination angle (IA) were measured at short-term follow-up, one to four years post-operatively, and showed no significant subsequent changes. The clinical scores and radiological measurements showed little change over time. One patient required conversion to total knee replacement during this time. These results suggest that the coronal angle achieved at operation is maintained at long-term follow up after HCO without alteration of the IA, providing a good long-term clinical outcome. Cite this article: Bone Joint J 2014;96-B:467–72.
Collapse
Affiliation(s)
- E. Nakamura
- Kumamoto University, Department
of Orthopaedic Surgery, Faculty of Life Sciences, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| | - N. Okamoto
- Kumamoto University, Department
of Orthopaedic Surgery, Faculty of Life Sciences, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| | - H. Nishioka
- Kumamoto University, Department
of Orthopaedic Surgery, Faculty of Life Sciences, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| | - T. Karasugi
- Kumamoto University, Department
of Orthopaedic Surgery, Faculty of Life Sciences, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| | - J. Hirose
- Kumamoto University, Department
of Medical Information Science and Administration Planning, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| | - H. Mizuta
- Kumamoto University, Department
of Orthopaedic Surgery, Faculty of Life Sciences, 1-1-1
Honjo, Chuo-ku, Kumamoto-City, Kumamoto, 860-8556, Japan
| |
Collapse
|
50
|
Okamoto N, Suzuki H, Shiroyama T, Tamiya M, Kitani M, Kurata K, Otsuka T, Yamadori T, Kawahara K, Hirashima T. The Bronchoscopy-Guided Re-Biopsy of Non-Small Cell Lung Cancer in Patients Who Relapse After Gefitinib Therapy. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.149] [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
|