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Sumiya R, Yamada K, Hagiwara T, Nagasaka S, Miyazaki H, Igari T, Kawamura YI. Kallikrein-related peptidase 13 expression and clinicopathological features in lung squamous cell carcinoma. Mol Clin Oncol 2023; 19:64. [PMID: 37559880 PMCID: PMC10407464 DOI: 10.3892/mco.2023.2660] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/15/2023] [Indexed: 08/11/2023] Open
Abstract
Lung squamous cell carcinoma (LSCC) is associated with poor prognosis. Molecular targeting drugs have been demonstrated to be effective for lung adenocarcinoma; however, they are often not effective for LSCC. Kallikrein-related peptidase 13 (KLK13) expression enhances the malignancy of lung adenocarcinoma; however, its expression and crucial role in LSCC remain largely unknown. The present study examined the relationship between the KLK13 expression and clinicopathological features of LSCC. A total of 94 patients diagnosed with LSCC who underwent lobectomy, segmentectomy or wedge resection were selected. KLK13 expression was evaluated through immunostaining of formalin-fixed paraffin-embedded sections of surgical specimens. Of the 94 LSCC samples, 70 exhibited no KLK13 expression, while the remaining 24 exhibited ectopic expression. KLK13 expression in tumors was focal and restricted to the cytoplasm of keratinized cells. LSCC cases were classified into KLK13-negative and KLK13-positive groups, and KLK13 expression was positively associated with E-cadherin expression (P=0.0143). Associations between KLK13 expression and keratinization (P=0.0052) or absence of lymphatic vessel invasion (P=0.0603) were observed; however, these trends did not reach statistical significance. The present findings indicated that KLK13 expression in keratinized LSCC may have a protective role in lymphatic vessel invasion of LSCC, which suggests its significance for therapeutic applications against LSCC.
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Affiliation(s)
- Ryusuke Sumiya
- Communal Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Kazuhiko Yamada
- Department of Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Teruki Hagiwara
- Communal Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Toru Igari
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Yuki I. Kawamura
- Communal Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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2
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Hatano H, Sumiya R, Misumi K, Miyazaki H, Ikeda T, Nagasaka S. Multilocular thymic cyst detected during COVID‑19 treatment in an HIV‑positive adult man: A case report and literature review. Exp Ther Med 2023; 25:285. [PMID: 37206571 PMCID: PMC10189587 DOI: 10.3892/etm.2023.11984] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/06/2023] [Indexed: 05/21/2023] Open
Abstract
A multilocular thymic cyst (MTC) is a rare mediastinal tumor with multiloculated cyst-like structures in the anterior mediastinum. This tumfor is associated with inflammatory diseases, including human immunodeficiency virus (HIV) infection. The present study reports a case of MTC detected during coronavirus disease 2019 (COVID-19) treatment in an adult who was tested HIV positive. An anterior mediastinal tumor was incidentally detected on computed tomography in a 52-year-old man with a 20-year history of HIV infection on the 9th day of COVID-19. The patient was asymptomatic with no notable physical findings. Magnetic resonance imaging revealed a 28-mm bilocular cyst. Robot-assisted thoracoscopic tumor resection was performed. Pathological examination showed that the cyst was lined with squamous or cuboidal epithelium, and the cystic lesion wall was mainly composed of thymic tissue with follicular hyperplasia. Based on these findings, the patient was diagnosed with MTC. To date, only 15 MTC cases have been reported in patients with HIV, and the majority of cases showed HIV infection-related symptoms such as lymphoid interstitial pneumonia and parotid gland enlargement. The present case was atypical for an HIV-related MTC because it did not involve HIV infection-related symptoms, suggesting the possibility for an alternative etiology such as COVID-19. Further reports on MTC development in patients with COVID-19 are required to elucidate the relationship between MTC and COVID-19.
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Affiliation(s)
- Hiroto Hatano
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
- Correspondence to: Dr Ryusuke Sumiya, Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo 162-8655, Japan
| | - Kento Misumi
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
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Hatano H, Tsujimoto Y, Watanabe H, Tsukada A, Izumi S, Nagasaka S, Igari T, Suzuki M, Iikura M, Hojo M. A case of idiopathic multicentric Castleman disease with pulmonary hyalinizing granuloma-like multiple pulmonary nodules. Respir Investig 2023; 61:405-408. [PMID: 37099891 DOI: 10.1016/j.resinv.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 03/01/2023] [Accepted: 03/15/2023] [Indexed: 04/28/2023]
Abstract
A 41-year-old man presented with chronic cough and chest pain. Laboratory tests revealed anemia, inflammation, hypoalbuminemia, polyclonal hypergammaglobulinemia, and elevated interleukin-6 levels. Computed tomography revealed diffuse bilateral pulmonary nodules and multicentric lymphadenopathy. Histopathology of the pulmonary nodule resembled pulmonary hyalinizing granuloma (PHG), whereas lymph node histopathology was consistent with idiopathic multicentric Castleman disease (iMCD). The patient was diagnosed with iMCD involving PHG-like pulmonary nodules. Little is known about the association between these two diseases, and the present case provides insights regarding the relationship between PHG and iMCD.
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Affiliation(s)
- Hiroto Hatano
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Yoshie Tsujimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Hiromu Watanabe
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Akinari Tsukada
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Toru Igari
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Motoyasu Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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Koda H, Sumiya R, Miyazaki H, Nagasaka S. Pyopneumothorax induced by rupturing of pneumatocele after COVID-19: A case report. Asian J Surg 2023; 46:1058-1059. [PMID: 35965176 PMCID: PMC9371946 DOI: 10.1016/j.asjsur.2022.07.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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Sumiya R, Nagasaka S, Okamoto T, Ikeda T, Hojo M, Omagari N, Kokudo N. Clinical outcomes after tracheostomy in patients with coronavirus disease 2019: a single-center experience in Japan. Surg Today 2023; 53:130-134. [PMID: 35771302 PMCID: PMC9244426 DOI: 10.1007/s00595-022-02541-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/12/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Many patients with coronavirus disease 2019 require mechanical ventilation and tracheostomy. However, the timing and indications for tracheostomy are controversial. This study assessed 11 patients with coronavirus disease 2019 who underwent tracheostomy with clinical information and retrospective analyses. METHODS A single-center retrospective observational study was performed on patients with coronavirus disease 2019 who underwent tracheostomy between 2020 and 2021. RESULTS Failure to wean was the most common indication for tracheostomy, followed by extracorporeal membrane oxygenation decannulation and the need for secretion management. After tracheostomy, six patients (54.5%) were liberated from the ventilator. The time from intubation to tracheostomy (21.1 ± 9.14 days) was correlated with the duration of ventilator dependency (36.83 ± 20.45 days, r2 = 0.792, p = 0.018). The mean Acute Physiological and Chronic Health Evaluation II score was significantly lower in the ventilator-liberated group (23 ± 2.77) than in the non-ventilator-liberated group (31 ± 6.13, p = 0.0292). Furthermore, patients with Acute Physiological and Chronic Health Evaluation II scores of < 27 points achieved ventilator liberation and a long-term survival (p = 0.0006). CONCLUSIONS This study describes the outcomes of a cohort of patients who underwent tracheostomy after intubation for coronavirus disease 2019. The Acute Physiological and Chronic Health Evaluation II score predicted whether or not the patient could achieve ventilator liberation.
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Affiliation(s)
- Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Masaaki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Omagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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Yamada K, Hara T, Sato K, Koyama Y, Kato D, Nohara K, Enomoto N, Yagi S, Kitagawa D, Takemura N, Nagasaka S, Kiyomatsu T, Kokudo N. Infection control of COVID-19 in operating theaters in a designated hospital for specified infectious diseases in Japan. Glob Health Med 2022; 4:332-335. [PMID: 36589221 PMCID: PMC9773218 DOI: 10.35772/ghm.2022.01042] [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: 05/15/2022] [Revised: 11/14/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
At the beginning of the COVID-19 pandemic in 2020, many hospitals around the world recommended stopping elective surgery as a precaution to stop the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The number of elective surgeries was reduced in Japan due to several waves of the pandemic. This work describes the management of COVID-19 and actual polymerase chain reaction (PCR) screening in operating theaters at the National Center for Global Health and Medicine (NCGM), a designated hospital for specified infectious diseases in Japan. The following three steps for COVID-19 infection control were taken to maintain the operating theater: i) Do not bring COVID-19 into the operating theater, ii) Infection control for all medical staff, and iii) Surgical management of surgical patients with COVID-19. We introduced checklists for surgical patients, simulations of surgery on infected patients, screening PCR tests for all surgical patients, and use of a negative pressure room for infective or suspected cases. We determined the flow and timing of surgery for patients with COVID-19. However, many aspects of COVID-19 infection control measures in the operating theater are still unclear. Therefore, infection control measures require further advances in the future to manage new infections.
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Affiliation(s)
- Kazuhiko Yamada
- Division of Operating Theaters, National Center for Global Health and Medicine, Tokyo, Japan;,Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan;,Address correspondence to:Kazuhiko Yamada, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan. E-mail:
| | - Tetsuo Hara
- Division of Operating Theaters, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazue Sato
- Division of Operating Theaters, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Koyama
- Division of Operating Theaters, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daiki Kato
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kyoko Nohara
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoki Enomoto
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Syusuke Yagi
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Dai Kitagawa
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuyuki Takemura
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomomichi Kiyomatsu
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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7
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Ikeda T, Sumiya R, Sugimura A, Hirai H, Nagasaka S. Liver herniation mimicking a thoracic tumor with restoration of the liver surface structure on closure of the hernia orifice under thoracoscopic surgery. Asian J Endosc Surg 2022; 15:805-808. [PMID: 35445564 DOI: 10.1111/ases.13067] [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: 02/03/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
Non-congenital, non-traumatic spontaneous diaphragmatic liver hernia in adults is extremely rare and sometimes misdiagnosed as a thoracic tumor. Almost all previous reports with a definitive diagnosis reported preservation; thus, differential diagnosis is extremely important for planning optimal management of such clinical conditions. An abnormal shadow in the right lower lung field was detected on chest radiography in a 61-year-old woman. Further imaging study revealed a 33-mm diameter mass adjacent to the right diaphragm. Thoracoscopic surgery was performed as diagnostic treatment. We found a pale hemispherical herniated liver on the central tendon of the diaphragm. After repositioning the herniated liver, the orifice was closed with a non-absorbable suture, and the surface of the liver returned to being a perfectly smooth surface. With this result, we believe that repair of diaphragmatic liver hernia through a minimally invasive procedure has great benefits for patients.
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Affiliation(s)
- Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Aya Sugimura
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hoshie Hirai
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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8
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Ueki Y, Sumiya R, Miyazaki H, Ikeda T, Nagasaka S. Pulmonary leiomyoma with iceberg tumor growth pattern: A case report. Mol Clin Oncol 2022; 17:150. [PMID: 36189105 PMCID: PMC9523436 DOI: 10.3892/mco.2022.2583] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Pulmonary leiomyoma is a rare disease, accounting for ~2% of cases of benign lung tumors. Pulmonary leiomyomas can be classified as tracheobronchial or pulmonary parenchymal, or as having an iceberg growth pattern, wherein the tumor extends into both the bronchial and pulmonary cavities. In the present report, a 41-year-old man complaining of sputum and discomfort during swallowing was referred to the National Center for Global Health and Medicine, because of an abnormal shadow on chest radiography and computed tomography (CT). Since the follow-up CT showed that the tumor in the third right lung segment had increased and progressed along the intra-bronchus over time, thoracoscopic right upper lobectomy was performed and leiomyoma was pathologically diagnosed. After resection, the symptoms of airway irritation improved. Since respiratory symptoms and radiographical findings are nonspecific with tracheobronchial and pulmonary parenchymal types of pulmonary leiomyoma, the identification of symptoms and determination of the extent of the lesion are necessary for treatment. In cases of iceberg growth pattern, in which the tumor extends into both the bronchial and pulmonary cavities, surgical resection should be considered.
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Affiliation(s)
- Yuka Ueki
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162‑8655, Japan
| | - Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162‑8655, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo 162‑8655, Japan
| | - Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162‑8655, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo 162‑8655, Japan
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9
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Murase T, Nakano S, Sakane T, Domen H, Chiyo M, Nagasaka S, Tanaka M, Kawahara Y, Toishi M, Tanaka T, Nakamura S, Sawabata N, Okami J, Mukaida H, Tzankov A, Szolkowska M, Porubsky S, Marx A, Roden AC, Inagaki H. Thymic Mucoepidermoid Carcinoma: A Clinicopathologic and Molecular Study. Am J Surg Pathol 2022; 46:1160-1169. [PMID: 35319525 DOI: 10.1097/pas.0000000000001886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Thymic mucoepidermoid carcinoma (MEC) is a rare tumor, and its characteristics remain to be clarified. Here we investigated 20 cases of thymic MEC to systematically characterize its clinical, histopathologic, and molecular features. The median age of the patients was 56 years (range, 19 to 80 y), there was a slight male predilection (3:2), and 44% of the patients were asymptomatic at diagnosis. The median tumor size was 6.8 cm in diameter, 55% were pT1 tumors, and 50% were TNM stage I tumors. When 4 tumor grading systems for salivary MEC (Armed Forces Institutes of Pathology, Brandwein, modified Healey, and the Memorial Sloan-Kettering) were employed, low-grade, intermediate-grade, and high-grade tumors accounted for 35% to 70%, 5% to 25%, and 25% to 50%, respectively. Many histologic variants were noted, and 70% of the cases were classified as nonclassic variants. MAML2 rearrangement was detected in 56% of cases, and the fusion partner was CRTC1 in all cases. CRTC1-MAML2 fusion was associated with lower pT classification and lower TNM stage. The overall survival rate of all patients was 69% and 43% at 5 and 10 years, respectively. Worse overall survival was associated with higher pT stage, higher TNM stage, residual tumors, greater tumor size, high-grade tumor histology (Armed Forces Institutes of Pathology and Memorial Sloan-Kettering, but not the other 2), and with the absence of CRTC1-MAML2 fusion. Of note, none of the patients with CRTC1-MAML2 fusion-positive tumors died during the follow-up. In conclusion, the clinicopathologic and molecular findings of thymic MEC presented here are expected to contribute to the management of this rare tumor.
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Affiliation(s)
- Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University
| | - Satsuki Nakano
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University
| | - Tadashi Sakane
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University
| | - Hiromitsu Domen
- Depatment of Thoracic Surgery, NTT-East Sapporo Hospital, Sapporo
| | - Masako Chiyo
- Department of Thoracic Surgery, National Hospital Organization Chiba Medical Center, Chiba
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine
| | - Michio Tanaka
- Department of Pathology, Tokyo Metropolitan Hiroo General Hospital
| | | | - Masayuki Toishi
- Department of Chest Surgery, Nagano Municipal Hospital, Nagano
| | - Takuji Tanaka
- Department of Diagnostic Pathology, Gifu Municipal Hospital, Gifu
| | - Shota Nakamura
- Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Noriyoshi Sawabata
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara
| | - Jiro Okami
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka
| | - Hidenori Mukaida
- Department of General Thoracic Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Alexandar Tzankov
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University Hospital Basel, Basel, Switzerland
| | - Malgorzata Szolkowska
- Department of Pathology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Stefan Porubsky
- Department of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | - Alexander Marx
- Department of Pathology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics, Graduate School of Medical Sciences, Nagoya City University
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Sumiya R, Terayama M, Hagiwara T, Nakata K, Nagasaka S, Yamada K, Kokudo N, Suzuki H, Yuki KI. Abstract 3783: GSTO2, a novel tumor suppressor gene of lung squamous cell carcinoma, regulates mitochondria function via the p38/β-catenin signaling pathway. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Glutathione S-transferase omega 2 (GSTO2) is one of regulators of GSH/GSSG balance, and its polymorphism showed strong associations with lung functions as well as the risk of chronic obstructive pulmonary disease. Recently, we found that GSTO2 was exclusively expressed in airway basal cells, Clara cells and type II alveolar cells, which have self-renewal capacity in the lungs; however, its expression was lost in lung squamous cell carcinoma (LSCC). In the present study, we restored GSTO2 expression in LSCC cell lines (LK-2 and H520) to clarify the significance of GSTO2 loss in LSCC. In both LSCC cell lines used, GSTO2 overexpression significantly inhibited cell growth and colony formation in vitro. In a subcutaneous xenograft model, GSTO2-transfected LK-2 cells formed smaller tumors in nude mice than mock-transfected cells. Upon intravenous injection into nude mice, the incidence of liver metastasis was lower in mice injected with GSTO2-transfected LK-2 cells than in those injected with mock-transfected cells. Metabolomic analyses using the XF96 extracellular flux analyzer revealed that GSTO2 overexpression suppressed mitochondrial oxidative phosphorylation but did not affect glycolysis. Upon JC-1 dye staining, GSTO2-transfected cells showed decreased mitochondrial membrane potential compared with mock-transfected cells. Since β-catenin has been reported as a novel regulator of the OXPHOS in hepatocytes, we next examined the effect of GSTO2 expression on β-catenin expression in LSCC and found that GSTO2 overexpression suppressed the expression of β-catenin. Because p38 phosphorylation was accelerated in both GSTO2-transfected cells, we examined the involvement of the p38 signaling pathway in the GSTO2-mediated downregulation of β-catenin as well as mitochondrial membrane potential in LSCC.When GSTO2-transfected cells were treated with SB203580, a specific inhibitor of p38 MAPK, β-catenin expression and mitochondrial membrane potentialwere restored. Finally, we examine whether DNA methylation of the GSTO2 could explain the loss of GSTO2 expression in LSCC. When human LSCC cell lines were treated with 5-aza-2′-deoxycytidine, a DNA-methyltransferase inhibitor, GSTO2 transcription was induced. Bisulfite sequencing showed that the promoter region of the GSTO2 was frequently methylated in LSCC tissues than that of normal tissue. Our study indicated that the loss of GSTO2 via DNA hypermethylation contributes to the cell growth and progression of LSCC, probably by modulating oxidative phosphorylation in mitochondria via the p38/β-catenin signaling pathway.
Citation Format: Ryusuke Sumiya, Masayoshi Terayama, Teruki Hagiwara, Kazuaki Nakata, Satoshi Nagasaka, Kazuhiko Yamada, Norihiro Kokudo, Hiromu Suzuki, Kawamura I. Yuki. GSTO2, a novel tumor suppressor gene of lung squamous cell carcinoma, regulates mitochondria function via the p38/β-catenin signaling pathway [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3783.
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Affiliation(s)
- Ryusuke Sumiya
- 1National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Teruki Hagiwara
- 2National Center for Global Health and Medicine, Research Institute, Chiba, Japan
| | - Kazuaki Nakata
- 3National Center for Global Health and Medicine, Research Institute, Tokyo, Japan
| | | | - Kazuhiko Yamada
- 1National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- 1National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Kawamura I. Yuki
- 5National Center for Global Health and Medicine, Reserch Institute, Chiba, Japan
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11
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Sumiya R, Terayama M, Hagiwara T, Nakata K, Sekihara K, Nagasaka S, Miyazaki H, Igari T, Yamada K, Kawamura YI. Loss of GSTO2 contributes to cell growth and mitochondria function via the p38 signaling in lung squamous cell carcinoma. Cancer Sci 2022; 113:195-204. [PMID: 34726807 PMCID: PMC8748250 DOI: 10.1111/cas.15189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/28/2022] Open
Abstract
Glutathione S-transferase omega 2 (GSTO2) lacks any appreciable GST activity, but it exhibits thioltransferase activity. The significance of GSTO2 in lung function has been reported; however, the precise expression and molecular function of GSTO2 in the lungs remain unclear. In the present study, we found that GSTO2 is expressed in airway basal cells, non-ciliated, columnar Clara cells, and type II alveolar cells, which have self-renewal capacity in the lungs. Contrastingly, no GSTO2 expression was observed in 94 lung squamous cell carcinoma (LSCC) samples. When human LSCC cell lines were treated with 5-aza-2'-deoxycytidine, a DNA-methyltransferase inhibitor, GSTO2 transcription was induced, suggesting that aberrant GSTO2 hypermethylation in LSCC is the cause of its downregulation. Forced GSTO2 expression in LSCC cell lines inhibited cell growth and colony formation in vitro. In a subcutaneous xenograft model, GSTO2-transfected cells formed smaller tumors in nude mice than mock-transfected cells. Upon intravenous injection into nude mice, the incidence of liver metastasis was lower in mice injected with GSTO2-transfected cells than in those injected with mock-transfected cells. In addition, GSTO2 induction suppressed the expression of β-catenin and the oxygen consumption rate, but it did not affect the extracellular acidification rate. Furthermore, GSTO2-transfected cells displayed lower mitochondrial membrane potential than mock-transfected cells. When GSTO2-transfected cells were treated with a p38 inhibitor, β-catenin expression and mitochondrial membrane potential were recovered. Our study indicated that the loss of GSTO2 via DNA hypermethylation contributes to the growth and progression of LSCC, probably by modulating cancer metabolism via the p38/β-catenin signaling pathway.
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Affiliation(s)
- Ryusuke Sumiya
- Department of GastroenterologyThe Research Center for Hepatitis and Immunology, Research InstituteNational Center for Global Health and MedicineChibaJapan
- Department of Thoracic SurgeryNational Center for Global Health and MedicineTokyoJapan
- Course of Advanced and Specialized MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Masayoshi Terayama
- Department of GastroenterologyThe Research Center for Hepatitis and Immunology, Research InstituteNational Center for Global Health and MedicineChibaJapan
- Department of SurgeryNational Center for Global Health and MedicineTokyoJapan
- Present address:
Department of Gastroenterological SurgeryGastroenterological CenterCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Teruki Hagiwara
- Department of GastroenterologyThe Research Center for Hepatitis and Immunology, Research InstituteNational Center for Global Health and MedicineChibaJapan
| | - Kazuaki Nakata
- Department of GastroenterologyThe Research Center for Hepatitis and Immunology, Research InstituteNational Center for Global Health and MedicineChibaJapan
| | - Keigo Sekihara
- Department of Thoracic SurgeryNational Center for Global Health and MedicineTokyoJapan
| | - Satoshi Nagasaka
- Department of Thoracic SurgeryNational Center for Global Health and MedicineTokyoJapan
| | - Hideki Miyazaki
- Pathology Division of Clinical LaboratoryNational Center for Global Health and MedicineTokyoJapan
| | - Toru Igari
- Pathology Division of Clinical LaboratoryNational Center for Global Health and MedicineTokyoJapan
| | - Kazuhiko Yamada
- Course of Advanced and Specialized MedicineJuntendo University Graduate School of MedicineTokyoJapan
- Department of SurgeryNational Center for Global Health and MedicineTokyoJapan
| | - Yuki I. Kawamura
- Department of GastroenterologyThe Research Center for Hepatitis and Immunology, Research InstituteNational Center for Global Health and MedicineChibaJapan
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12
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Sumiya R, Nagasaka S, Ikeda T, Suyama Y, Miyazaki H. Complete thoracoscopic surgery for extensive emphysema in the right upper and middle lobes caused by right B5 bronchial atresia. J Surg Case Rep 2021; 2021:rjab484. [PMID: 34729173 PMCID: PMC8557331 DOI: 10.1093/jscr/rjab484] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022] Open
Abstract
Bronchial atresia is a rare congenital condition that may lead to infectious complications. Almost all patients with this condition are diagnosed early in life with normal lungs, making them particularly suitable candidates for thoracoscopic surgery. A 30-year-old man was referred to our hospital due to an abnormal shadow on chest radiography taken 7 years prior. Despite being diagnosed with B5 bronchial atresia, he refused to undergo surgical resection. Seven years later, he developed right chest pain. Computed tomography showed B5 bronchial occlusion, mucoid impaction and emphysematous changes. Treatment with thoracoscopic right middle lobectomy and S3 partial resection using four ports resulted in good lung expansion after discharge. This study highlights that thoracoscopic surgical resection should be considered in patients with bronchial atresia.
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Affiliation(s)
- Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuto Suyama
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
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13
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Sumiya R, Nagasaka S, Ikeda T, Miyazaki H. Solitary pleural tuberculoma diagnosed by thoracoscopic surgical resection. J Surg Case Rep 2021; 2021:rjab408. [PMID: 34567522 PMCID: PMC8460271 DOI: 10.1093/jscr/rjab408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/10/2021] [Accepted: 08/21/2021] [Indexed: 01/05/2023] Open
Abstract
Tuberculoma is a manifestation of pleural tuberculosis. Although the clinical manifestation of tuberculoma has been widely reported, the pathogenesis of this condition still remains unclear. An abnormal shadow was detected on the chest radiograph of a 44-year-old man with a history of pulmonary tuberculosis. Computed tomography revealed a well-defined, elliptical 44 mm nodule located in the right posterior thoracic cavity. Thoracoscopic surgery was performed to rule out malignant tumors. Although loose adhesions were observed throughout the thoracic cavity, a nodule was found between the visceral pleura and parietal pleura. En bloc resection was performed, and the patient was pathologically diagnosed with tuberculoma. An acid-fast bacterium culture was negative, and the patient’s recovery was uneventful without chemotherapy. Surgical resection should be considered to rule out malignancy, because tuberculomas are difficult to distinguish from malignant pleural tumors.
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Affiliation(s)
- Ryusuke Sumiya
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Ikeda
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
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14
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Momose N, Takahashi T, Sugimura A, Sekihara K, Nagasaka S. Video-assisted thoracoscopic right upper lobectomy in a patient with a displaced bronchus and vascular abnormalities. Asian J Endosc Surg 2021; 14:109-111. [PMID: 32495500 DOI: 10.1111/ases.12819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/18/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022]
Abstract
Bronchial abnormalities are rare, and they are infrequently associated with pulmonary vascular abnormalities. It is important to identify such abnormal anatomical structures before lobectomy of the lung under thoracoscopy. There have been only three reports on video-assisted thoracoscopic lobectomy in patients with anomalous bronchi and vascular abnormalities to date. Here, we present a report of video-assisted thoracoscopic right upper lobectomy performed in a patient with bronchial and vascular abnormalities. Both preoperative imaging and intraoperative findings revealed a displaced anomalous B2 bronchus arising from the bronchus intermedius, as well as abnormal distribution of the aberrant vein V2 draining into vein V6 . It is critical to understand the precise anatomical structures preoperatively to perform video-assisted thoracoscopic pulmonary lobectomy safely.
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Affiliation(s)
- Naoya Momose
- Department of Thoracic Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsuyoshi Takahashi
- Department of Thoracic Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Aya Sugimura
- Department of Thoracic Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Keigo Sekihara
- Department of Thoracic Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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15
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Sekihara K, Hirai H, Sumiya R, Momose N, Sugimura A, Nagasaka S. Thoracoscopic right middle lobectomy for Mycobacterium abscessus in a young patient suspected of having congenital immunodeficiency. Asian J Endosc Surg 2021; 14:112-115. [PMID: 32776415 DOI: 10.1111/ases.12828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/26/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Abstract
Mycobacterium abscessus (M. abscessus) infection is resistant to multi-antibacterial treatment, and surgical resection is often recommended. We report a case of M. abscessus infection in a young patient suspected of having a GATA2 mutation. A 19-year-old woman with a medical history of severe sinusitis and a family history of non-tuberculous mycobacteriosis presented at our hospital. M. abscessus was confirmed by sputum culture. The patient received multidrug therapy, including clarithromycin. CT scan demonstrated bronchodilation and capacity decrease due to non-obstructive atelectasis in the middle lobe. We performed thoracoscopic resection without complications. Congenital immunodeficiency was suspected given the patient's past medical and family history. The result of lymphocyte subset analysis revealed a GATA2 mutation, but no genetic mutation was detected by a next-generation sequencer. The patient followed a good clinical course. This paper reports the successful treatment of an M. abscessus infection and the importance of checking the genetic background of young patients.
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Affiliation(s)
- Keigo Sekihara
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hoshie Hirai
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryusuke Sumiya
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoya Momose
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Aya Sugimura
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Division of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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16
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Nagano N, Izumi S, Katsuno T, Iikura M, Miyazaki H, Igari T, Okafuji T, Sekihara K, Nagasaka S, Hojo M. A case of diffuse pulmonary lymphangiomatosis with a venous anomaly presenting with acute respiratory failure and hemoptysis. Respir Med Case Rep 2020; 31:101243. [PMID: 33088708 PMCID: PMC7567044 DOI: 10.1016/j.rmcr.2020.101243] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 09/26/2020] [Accepted: 09/26/2020] [Indexed: 12/02/2022] Open
Abstract
Diffuse pulmonary lymphangiomatosis (DPL) is a rare lymphatic disease that can cause diverse respiratory symptoms. A 22-year-old man, whose chest CT had shown an abnormality for years, presented with acute respiratory failure due to the abrupt onset of hemoptysis. The diagnosis of DPL was confirmed by surgical lung biopsy and lymphangiography. Histopathological investigation showed dilated vascular and lymphatic vessels. DPL can cause acute and life-threatening symptoms during its chronic clinical course. A coexisting anomaly in the venous system may be present in DPL patients with hemoptysis.
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Affiliation(s)
- Naoko Nagano
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
- Department of Respiratory Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Motoyasu Iikura
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Hideki Miyazaki
- Department of Pathology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Toru Igari
- Department of Pathology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Takashi Okafuji
- Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Keigo Sekihara
- Department of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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17
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Sumiya R, Sekihara K, Sugimura A, Miyazaki H, Igari T, Ikeda T, Nagasaka S. Ectopic intrapulmonary follicular adenoma diagnosed by surgical resection. Gen Thorac Cardiovasc Surg 2020; 69:564-567. [PMID: 32939627 DOI: 10.1007/s11748-020-01485-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
Ectopic intrapulmonary thyroid tissue is extremely rare and considerably difficult to diagnose without surgery. Ectopic thyroid tissue, described as a mediastinal tumor, and intrapulmonary lesions are infrequent. An abnormal shadow was detected upon chest X-ray in a 60-year old woman with a history of benign thyroid goiter. A computed tomography scan revealed a solitary nodule measuring 27 mm in diameter in the left lower lobe, the diameter of which had increased by 5 mm since initial observation eight years ago. A thoracoscopic wedge resection was performed and the lesion was determined to be a non-invasive, soft-tissue tumor. It was pathologically diagnosed as an ectopic thyroid follicular adenoma. The course of the tumor was uneventful. A diagnosis of ectopic intrapulmonary thyroid should be made cautiously and only after ruling out metastasis of a follicular adenoma or thyroid carcinoma. This diagnosis of ectopic thyroid tissue was made possible by the surgical approach.
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Affiliation(s)
- Ryusuke Sumiya
- Division of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Keigo Sekihara
- Division of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Aya Sugimura
- Division of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toru Igari
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takeshi Ikeda
- Division of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
| | - Satoshi Nagasaka
- Division of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan
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18
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Sumiya R, Terayama M, Hagiwara T, Sekihara K, Nagasaka S, Yamada K, Kokudo N, Kawamura YI. Abstract 4716: Glutathione S transferase omega 2 (GSTO2) is a novel tumor suppressor gene of human lung squamous cell carcinoma. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Lung cancer is one of the most common malignant diseases and the leading cause of cancer death globally. The clinical, pathologic, and genomic characteristics of lung cancer are very diverse. Non-small cell lung cancer (NSCLC) is the most frequent type of lung cancers and can be histologically classified into lung adenocarcinoma and squamous cell carcinoma (SCC). Lung adenocarcinoma is generally located in alveolar or endobronchial, whereas LSCC frequently arises in bronchi and bronchiole. Molecular-targeted drugs have been developed for lung adenocarcinoma; however, there is currently no definite clinical implication for lung SCC (LSCC). Therefore, to increase the cure and survival rates of lung cancers, developing type-specific diagnostic/prognostic markers and treatment methods might improve this situation. One of the major risk factors of LSCC is smoking, which causes aberrant DNA methylation, abnormal gene expression, and eventually malignant transformation. We previously identified glutathione S-transferase omega 2 (GSTO2) as one of DNA methylation target genes in esophageal SCC (Otsubo T, Oncotarget, 8, 84434-84448, 2017). We reported that GSTO2 was exclusively expressed in nethermost basal cells which are believed to function as stem cells in normal esophageal mucosa. Furthermore, GSTO2 overexpression in esophageal SCC cells significantly inhibited cell growth in vitro and in vivo. (Terayama M, Carcinogenesis, in press). In present study, we investigated the expression and function of GSTO2 in normal lung and LSCC. In normal bronchi and bronchiole containing a variety of epithelial cell populations such as ciliated cells, non-ciliated, columnar Clara cells, and basal cells, GSTO2 was expressed in cytokeratin 5/6-positive airway basal cells. In contrast, all 94 LSCC specimens examined in this study showed no GSTO2 expression. To clarify the significance of GSTO2 silencing LSCC, we restored GSTO2 expression in LK-2 LSCC cells. Overexpression of GSTO2 significantly inhibited cell growth compared with the mock-transfected LK-2 cells. In colony formation assay, GSTO2-transfected cells failed to form colonies, whereas mock-transfected cells formed colonies efficiently. When human LSCC cell lines (LK-2 and EBC-1) were treated with 5-aza-2'-deoxycytidine (5-aza-dC), a DNA-methyltransferase inhibitor, the GSTO2 transcription was induced, indicating that aberrant hypermethylation of the GSTO2 in LSCC was likely the cause of the downregulated expression. Considering its expression in basal cells which are proposed to be the precursor cells of LSCC, the silencing of GSTO2 by DNA hypermethylation may contribute malignant transformation of LSCC.
Citation Format: Ryusuke Sumiya, Masayoshi Terayama, Teruki Hagiwara, Keigo Sekihara, Satoshi Nagasaka, Kazuhiko Yamada, Norihiro Kokudo, Yuki I. Kawamura. Glutathione S transferase omega 2 (GSTO2) is a novel tumor suppressor gene of human lung squamous cell carcinoma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4716.
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Affiliation(s)
- Ryusuke Sumiya
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Teruki Hagiwara
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Keigo Sekihara
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Kazuhiko Yamada
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- National Center for Global Health and Medicine, Tokyo, Japan
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19
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Yamamoto K, Mawatari M, Fujiya Y, Kutsuna S, Takeshita N, Hayakawa K, Nakamura M, Takanabe Y, Maruoka Y, Inoue M, Hara T, Nagasaka S, Tayama N, Miyazaki Y, Umeyama T, Ohmagari N. Survival case of rhinocerebral and pulmonary mucormycosis due to Cunninghamella bertholletiae during chemotherapy for acute myeloid leukemia: a case report. Infection 2020; 49:165-170. [PMID: 32720129 DOI: 10.1007/s15010-020-01491-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 07/22/2020] [Indexed: 11/24/2022]
Abstract
A 42-year-old man diagnosed with acute myeloid leukemia complained of progressive swelling of the right side of his face with pain 11 days after the third cycle of consolidation therapy with high-dose arabinosylcytosine-cytarabine. Head and neck magnetic resonance imaging showed a mass lesion in his right maxillary sinus with parapharyngeal involvement, which included the right masseter muscle, intraorbital involvement, and an abscess in his brain. Chest computed tomography revealed peribronchial small nodules in his right upper lobe and a necrotic tumor in his right lower lobe. Molds identified as Cunninghamella bertholletiae were isolated from the necrotic ulcer. According to these results, chemotherapy for leukemia was discontinued. High-dose liposomal amphotericin (10 mg/kg/day) was initiated. Because renal dysfunction occurred, the dosage was decreased to 6 mg/kg and combined with 150 mg/day micafungin. Debridement of necrotic tissue in the right maxillary sinus and establishment of the fenestration between the sinus and oral cavity were performed. Subsequently, brain and lung lesions were surgically removed. Rhinocerebral mucormycosis was successfully treated without relapse over 3 years by a 112-day course of intravenous anti-fungal therapy and 223-day course of terbinafine and partial surgical removal, respectively, to maintain masticatory and ocular functions. To our knowledge, there has been no other report of a long-term survival case of rhinocerebral mucormycosis due to C. bertholletiae.
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Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan.
| | - Momoko Mawatari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yoshihiro Fujiya
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Miki Nakamura
- Department of Hematology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yusuke Takanabe
- Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yutaka Maruoka
- Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Masato Inoue
- Department of Neurosurgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Tetsuo Hara
- Department of Neurosurgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Niro Tayama
- Department of Otolaryngology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Takashi Umeyama
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan
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20
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Sugimura A, Takahashi T, Sekihara K, Nagasaka S. Case of Rapid Formation of Intraoperative Pulmonary Pneumatocele After Lobectomy. Ann Thorac Surg 2020; 110:e331-e332. [PMID: 32302662 DOI: 10.1016/j.athoracsur.2020.03.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/27/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
Pulmonary pneumatocele that forms immediately after pulmonary resection is extremely rare. This report describes a case of pneumatocele that formed rapidly in the left lower lobe immediately after left upper lobectomy in a patient with lung cancer and emphysema. Massive and persistent air leakage through a chest tube was noted immediately after chest closure. Therefore, the chest was reopened, and the cyst wall was incised. The air leakage point was cauterized and covered with a polyglycolic acid sheet and fibrin glue. Herein, we report a rare case of newly developed pneumatocele immediately after lobectomy.
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Affiliation(s)
- Aya Sugimura
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsuyoshi Takahashi
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Keigo Sekihara
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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21
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Uchida T, Matsubara H, Nagasaka S, Kina S, Ichihara T, Matsuoka H, Nakajima H. Video-assisted thoracoscopic surgery can help enable the complete resection of a mediastinal tumor caused by immunoglobulin G4-related disease and avoid the need for postoperative medication: A case report. Asian J Endosc Surg 2018; 11:248-251. [PMID: 29297990 DOI: 10.1111/ases.12450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/31/2017] [Accepted: 11/05/2017] [Indexed: 11/30/2022]
Abstract
Immunoglobulin (Ig) G4-related disease has various clinical signs and symptoms, and steroidal therapy with corticosteroids has been found to be effective for treatment. Few cases of IgG4-related disease associated with paravertebral tumor have been reported, and there have been no reports on complete resection of such a tumor. Here, we report a case of IgG4-related disease associated with a paravertebral tumor that was successfully resected without the need for postoperative medication. An 84-year-old woman was admitted to our hospital with a paravertebral tumor. She underwent thoracoscopic surgery, and pathological examination of the tumor specimen revealed that the tumor resulted from IgG4-related disease. After resection, there was no need for postoperative medication. Our case indicates the rare possibility of a paravertebral tumor associated with IgG4-related disease and the potential for complete resection as a treatment for such a tumor.
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Affiliation(s)
- Tsuyoshi Uchida
- Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Hirochika Matsubara
- Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Satoshi Nagasaka
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satsuki Kina
- Department of Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomofumi Ichihara
- Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Hiroyasu Matsuoka
- Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan
| | - Hiroyuki Nakajima
- Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan
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Takeda Y, Miura K, Sato T, Tsujimoto Y, Nagano N, Nagasaka S, Kina S, Sugiyama H. Clinically simplified screening methods to evaluate maximum standard uptake value from F-18-FDG-PET/CT in patients with non-small-cell lung cancer. Medicine (Baltimore) 2018; 97:e11226. [PMID: 29952981 PMCID: PMC6039694 DOI: 10.1097/md.0000000000011226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Maximum standard uptake value (SUVmax) of F-18-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) is reportedly useful for evaluating regional lymph nodes (RLNs) of non-small-cell lung cancer (NSCLC) to predict malignancy. However, it is difficult for clinicians to measure SUVmax (mSUVmax) as calculated by a workstation.We assessed the utility of simplified SUVmax (sSUVmax) in screening RLNs for pathologic malignancy. The highest color was visually defined in the region of interest. The resulting color can be quantified using the color bar, and interpreted as sSUVmax. Patients in respiratory medicine and surgery who underwent both contrast-enhanced CT and FDG-PET/CT within 3 months before radical lobectomy were evaluated retrospectively. The correlation was examined by regression analysis and receiver operating characteristic (ROC) curve analyses.Participants comprised 69 patients with NSCLC treated between May 2009 and April 2016. Medical group comprised 22 patients from respiratory medicine. The prediction model could be written as a linear relationship (mSUVmax = 1.019 × sSUVmax; R = 0.930). A total of 316 RLNs resected by surgery in total cohort were pathologically determined. From ROC curves, area under curve for sSUVmax was 0.72 (95% confidence interval, 0.61-0.83; P < .0002). The cutoff sSUVmax was 2.42 (sensitivity, 52%; specificity, 88%; accuracy, 85%).The sSUVmax allows quantification of colors from FDG-PET/CT and shows a close correlation to mSUVmax. This value may have potential in screening for RLNs, and thoracic clinicians can readily determine the value. These findings may facilitate better planning of therapeutic strategy in the real world.
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Affiliation(s)
| | | | | | | | | | - Satoshi Nagasaka
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satsuki Kina
- Department of General Thoracic Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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Ogata H, Tokuyama K, Nagasaka S, Ando A, Kusaka I, Sato N, Goto A, Ishibashi S, Kiyono K, Struzik Z, Yamamoto Y. Long-range Correlated Glucose Fluctuations in Diabetes. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1625411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives
: Our objective is to investigate diabetes- related alteration of glucose control in diurnal fluctuations in normal daily life by detrended fluctuation analysis (DFA).
Methods
: The fluctuations of glucose of 12 non-diabetic subjects and 15 diabetic patients were measured using a continuous glucose monitoring system (CGMS) over a period of one day. The glucose data was calculated by the DFA method, which is capable of revealing the presence of long-range correlations in time series with inherent non-stationarity.
Results
: Compared with the non-diabetic subjects, the mean glucose level and the standard deviation are significantly higher in the diabetic group.The DFA exponent α is calculated, and glucose time series are searched for the presence of negatively (0.5 < α <1.5) or positively (1.5 < α) correlated fluctuations. A crossover phenomenon, i.e. a change in the level of correlations, is observed in the non-diabetic subjects at about two hours; the net effects of glucose flux/reflux causing temporal changes in glucose concentration are negatively correlated in a “long-range" (> two hours) regime. However, for diabetic patients, the DFA exponent α = 1.65 ± 0.30, and in the same regime positively correlated fluctuations are observed, suggesting that the net effects of the flux and reflux persist for many hours.
Conclusions
: Such long-range positive correlation in glucose homeostasis may reflect pathogenic mechanisms of diabetes, i.e., the lack of the tight control in blood glucose regulation. Using modern time series analysis methods such as DFA, continuous evaluation of glucose dynamics could promote better diagnoses and prognoses of diabetes and a better understanding of the fundamental mechanism of glucose dysregulation in diabetes.
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Nagasaka S, Kina S, Arimoto Y, Yokote F, Setojima Y, Sumiya R. Salvage Surgery for Non-small Cell Lung Carcinoma in Our Hospital. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.04.199] [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]
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25
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Fukuda S, Nakamura Y, Egi K, Fujioka S, Nagasaka S, Minh PN, Toguchi K, Wada T, Izumi-Nakaseko H, Ando K, Mizoue T, Takazawa K, Hosaka S, Sugiyama A. Comparison of direct effects of clinically available vasodilators; nitroglycerin, nifedipine, cilnidipine and diltiazem, on human skeletonized internal mammary harvested with ultrasonic scalpel. Heart Vessels 2016; 31:1681-4. [PMID: 26820407 DOI: 10.1007/s00380-016-0797-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/15/2016] [Indexed: 12/20/2022]
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26
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Enkhtuvshin B, Nagashima S, Saito N, Wakabayashi T, Ando A, Takahashi M, Sakai K, Yamamuro D, Nagasaka S, Tamemoto H, Ishibashi S. Successful pregnancy outcomes in a patient with type A insulin resistance syndrome. Diabet Med 2015; 32:e16-9. [PMID: 25472847 PMCID: PMC5034500 DOI: 10.1111/dme.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The management of severe insulin resistance during pregnancy is challenging because of the increased risk of perinatal complications for both mother and fetus. We describe two consecutive pregnancies in a patient with severe insulin resistance caused by a mutation in the β subunit of the insulin receptor. CASE REPORT A non-obese Japanese woman was diagnosed as having diabetes mellitus during her first pregnancy at age 31 years. She presented at 6 weeks' gestation with a fasting plasma glucose concentration of 15.1 mmol/l and an HbA(1c) level of 95 mmol/mol (10.8%). Fasting insulin concentration was high at 68.8 μU/ml, suggesting severe insulin resistance. Anti-insulin and insulin-receptor antibodies were both negative. Genetic analysis revealed an in-frame heterozygous deletion mutation (∆Leu(999)) in the insulin receptor gene. Despite large daily doses (up to 480 units per day) of insulin aspart and isophane, the patient's postprandial plasma glucose level exceeded 11.1 mmol/l. In the patient's second pregnancy, the addition of metformin at a dose of 2250 mg per day achieved tighter glycaemic control, with lower doses of insulin lispro and isophane (up to 174 units/day). Both newborns, who were found to carry the same mutation, were small for gestational age and developed transient hypoglycaemia after birth. CONCLUSION Adding metformin to the conventional insulin regimen effectively achieved tight glycaemic control with a lower dose of insulin. The mutation of the insulin receptor gene might underlie the intrauterine growth retardation of the newborns. To our knowledge, this is the first report of successful management of diabetes mellitus in a pregnant woman with type A insulin resistance syndrome.
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Affiliation(s)
- B Enkhtuvshin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - S Nagashima
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - N Saito
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - T Wakabayashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - A Ando
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - M Takahashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - K Sakai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - D Yamamuro
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - S Nagasaka
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
| | - H Tamemoto
- Division of Medical Biochemistry, Department of Biochemistry, School of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - S Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Shimotsuke, Tochigi, Japan
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27
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Kawai T, Watanabe N, Yokoyama M, Nakazawa Y, Goto F, Uchiyama T, Higuchi M, Maekawa T, Tamura E, Nagasaka S, Hojo M, Onodera M. Interstitial lung disease with multiple microgranulomas in chronic granulomatous disease. J Clin Immunol 2014; 34:933-40. [PMID: 25186973 DOI: 10.1007/s10875-014-0089-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 08/20/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Chronic granulomatous disease (CGD) is a primary immunodeficiency disease that is characterized by susceptibility to bacterial and fungal infections. CGD patients also suffer from immune regulatory disorders, such as CGD-associated bowel inflammation with granuloma, which could be caused by excessive inflammation without demonstrable infection. PURPOSE We investigated the clinical manifestation of interstitial lung disease (ILD) resulting from excessive inflammation in X-linked CGD patients. METHODS Pulmonary CT images and testing of serum KL-6 levels were performed to assess ILD in the patients. For this study, patients with pulmonary lesions due to demonstrable infections were excluded from among ILD patients. RESULTS Among 33 CGD patients, four developed ILD; they had increased reticulo-nodular opacities on CT images and elevated serum KL-6 levels. Histopathological examinations revealed multiple homogeneous microgranulomas in the lesions of inflammatory cell infiltration. Mononuclear cells obtained from their pulmonary lesions produced higher amounts of inflammatory cytokines than the peripheral blood mononuclear cells of CGD patients, suggesting that the only infiltrating cells in the pulmonary lesions were activated and produced large amounts of inflammatory cytokines in ILD patients. Interestingly, an anti-inflammatory drug, such as a corticosteroid or thalidomide, but not anti-bacterial or anti-fungal drugs, improved CT image findings and reduced their KL-6 levels. CONCLUSIONS CGD patients' daily exposures to inhaled antigens may induce excessive reactions with the production of inflammatory cytokines leading to the development of ILD with multiple microgranulomas, which could be due to an inadequate production of reactive oxygen species in CGD.
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Affiliation(s)
- Toshinao Kawai
- Department of Human Genetics, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan,
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Ishii E, Shimizu A, Kuwahara N, Kanzaki G, Higo S, Kajimoto Y, Arai T, Nagasaka S, Masuda Y, Fukuda Y. Hepatic artery reconstruction prevents ischemic graft injury, inhibits graft rejection, and mediates long-term graft acceptance in rat liver transplantation. Transplant Proc 2014; 45:1748-53. [PMID: 23769037 DOI: 10.1016/j.transproceed.2013.01.086] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/24/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Hepatic artery (HA) reconstruction is performed in the clinical liver transplantation. METHODS We assessed the importance of HA reconstruction in the success of liver transplantation. Orthotopic liver transplantation was performed without immunosspression from Lewis (RT1l) to Lewis rats (syngeneic transplantation) as well as Lewis to BN (RT1n) rats (allogeneic transplantation) with or without HA reconstruction. We examined graft function, pathology, and mRNA levels using DNA arrays in both arterialized and nonarterialized liver grafts. RESULTS In Lewis-to-Lewis syngeneic grafts, both the arterialized and nonarterialized grafts survived >120 days with normal graft function. lnfiltration of CD3(+) T cells and CD68(+) macrophages, marked bile duct proliferation with apoptotic epithelial cells, and expansion and increasing fibrosis of portal areas were evident in the nonarterialized grafts at day 120, although preservation of architecture was noted in the arterialized grafts. DNA array analysis of nonarterialized syngeneic grafts demonstrated the upregulation of mRNA of cell death-related proteins, cell cycle-related proteins, and inflammation-related proteins than those in arterialized grafts. Moreover, the arterialized Lewis-to-BN allogeneic grafts could survive for a long time with less severe graft dysfunction than those in non-arterialized allogeneic grafts. CONCLUSIONS HA reconstruction in liver transplantation inhibited hypoxic injury and subsequent inflammation and bile duct proliferation, prevented the augmentation of T-cell-and antibody-mediated rejection, and mediated long-term graft acceptance. HA reconstruction is essential factor in the success of liver transplantation.
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Affiliation(s)
- E Ishii
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan.
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29
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Shimizu A, Ishii E, Kuwahara N, Arai T, Kanzaki G, Higo S, Kajimoto Y, Nagasaka S, Masuda Y, Fukuda Y. Chronic Antibody-Mediated Responses May Mediate Chronic Rejection in Rat Orthotopic Liver Transplantation. Transplant Proc 2013; 45:1743-7. [DOI: 10.1016/j.transproceed.2013.02.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 01/23/2013] [Accepted: 02/01/2013] [Indexed: 11/26/2022]
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30
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Ishii E, Shimizu A, Kuwahara N, Arai T, Kataoka M, Wakamatsu K, Ishikawa A, Nagasaka S, Fukuda Y. Lymphangiogenesis associated with acute cellular rejection in rat liver transplantation. Transplant Proc 2011; 42:4282-5. [PMID: 21168683 DOI: 10.1016/j.transproceed.2010.09.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 09/20/2010] [Indexed: 11/15/2022]
Abstract
Lymphangiogenesis may be important for the cellular immune response in liver transplantation. In the present study, we examined lymphangiogenesis in liver allografts displaying acute cellular rejection (ACR), or long-term acceptance, or severe ACR plus antibody-mediated rejection (AMR). ACR and subsequent long-term graft acceptance developed in liver transplantations from DA to PVG rats without immunosuppression (mean survival time more than 90 days). Severe ACR and AMR developed in liver transplantations from DA to Lewis rats without immunosuppression (mean survival = 11 days). Normal DA donor livers before transplantation showed a small number of lymphatic vessels around portal veins. DA liver grafts in PVG showed ACR with lymphangiogenesis in portal areas and portal-portal bridging areas with cellular infiltration. Newly formed lymphatic vessels in ACR were characterized by proliferating endothelial cells with expression of the homeobox transcription factor PROX-1 and surrounded by discontinuous basement membranes. Thereafter, the infiltrates spontaneously disappeared, and the grafts survived more than 90 days. During the resolution of the cellular infiltration, expanded lymphatic vessels were packed with many lymphocytes. Thereafter, the number of lymphatic vessels decreased. In contrast, severe ACR and AMR in DA-to-Lewis transplantations showed lymphatic vessels disappeared with edema in the portal areas at day 11. In conclusion, lymphangiogenesis occurred during ACR. It may be involved in the resolution of ACR and reduction of inflammation. In severe ACR and AMR, lymphatic vessels were destroyed, which may be involved in persistent severe inflammation.
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Affiliation(s)
- E Ishii
- Department of Analytic Human Pathlogy, Nippon Medical School, Tokyo, Japan
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31
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Morishima A, Kaneda K, Yoshida Y, Heima D, Hirao S, Nagasaka S, Yokoyama S, Nishiwaki N. [Coronary artery aneurysm with various clinical course]. Kyobu Geka 2009; 62:1145-1149. [PMID: 19999092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Case 1: A 77-year-old woman had effort angina pectoris. Coronary angiography (CAG) revealed a coronary artery aneurysm on the left descending artery. Coronary artery bypass grafting (CABG) and patch angioplasty for the aneurysm were performed. Case 2 : A 69-year-old woman had effort dyspnea CAG showed dilation of the left main trunk and beaded aneurysms (maximum 6 cm in diameter) behind the ascending aorta with a fistula to the right atrium. We closed the fistula and performed CABG to the circumflex branch. Case 3 : A 78-year-old woman had had general fatigue for 2 weeks. Previous CAG had revealed coronary artery aneurysms and current chest computered tomography revealed pericardial effusion. She was, therefore, diagnosed with the rupture of the coronary artery aneurysm. We closed the coronary artery aneurysm and performed CABG. Case 4: A 55-year-old man had been diagnosed with acute myocardial infarction and had undergone percutaneous coronary intervention 3 years before. CAG revealed a coronary artery aneurysm on the right coronary artery. We resected the aneurysm and interposed with saphenous vein graft. Although coronary artery aneurysm often has no symptoms, in the cases of angina, myocardial infarction, rupture or large aneurysm more than 3 times larger than the normal diameter, surgical repair should be considered.
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Affiliation(s)
- A Morishima
- Department of Cardiovascular Surgery, Nara Hospital Kinki University School of Medicine, Ikoma, Japan
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32
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Kaneda K, Nishiwaki N, Yokoyama S, Nagasaka S, Hirao S, Heima D, Morishima A, Yoshida Y, Nagato H. [Preservation of aortic root with severe destruction in Stanford type A acute aortic dissection]. Kyobu Geka 2009; 62:966-970. [PMID: 19827549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
From November 1999 to December 2008, 197 patients with Stanford type A acute aortic dissection underwent the surgical treatment on an emergency basis. In 19 cases, we preserved the severely destroyed aortic root using gelatin-resorcin-formalin (GRF) glue avoiding aortic root replacement. We examined the indication and limitation of repair of the destroyed aortic root. The 19 patients were classified into 3 groups (A, B and C). Group A consisted of 7 patients who had no aortic regurgitation (AR). Group B consisted of 6 patients who had moderate to severe AR. Group C consisted of 6 patients who had coronary involvement. We preserved the broken aortic root in group A and group B. But it seemed to be rather difficult to repair the destroyed aortic root in some cases of group C.
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Affiliation(s)
- Kozo Kaneda
- Department of Cardiovascular Surgery, Nara Hospital, Kinki University School of Medicine, Ikoma, Japan
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Kusaka I, Nagasaka S, Horie H, Ishibashi S. Metformin, but not pioglitazone, decreases postchallenge plasma ghrelin levels in type 2 diabetic patients: a possible role in weight stability? Diabetes Obes Metab 2008; 10:1039-46. [PMID: 18355332 DOI: 10.1111/j.1463-1326.2008.00857.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [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] [Indexed: 11/28/2022]
Abstract
AIM Effects of metformin and pioglitazone on body weight are clearly different. Recently, the role of ghrelin, an orexigenic peptide derived from stomach, has been appreciated. Plasma ghrelin levels display a preprandial peak and postprandial suppression, suggesting its physiological role. We hypothesized that metformin or pioglitazone may modulate circulating ghrelin levels and this modulation may be related to differential effects on body weight with these agents. METHODS Thirty-five Japanese type 2 diabetic patients [21 men and 14 women, age 62 +/- 2 years, body mass index (BMI) 26.6 +/- 0.5 kg/m(2) and haemoglobin A1c (HbA1c) 8.2 +/- 0.1%, mean +/- s.e.] were randomly assigned to groups for the addition of metformin or pioglitazone. At baseline and 4 months later, a 75-g oral glucose tolerance test (OGTT) was performed to measure plasma ghrelin levels. RESULTS In 33 subjects who completed the study, the overall decrease in HbA1c ( approximately 1%) was comparable between the two groups. As expected, BMI increased in the pioglitazone group but not in the metformin group. After the treatment, plasma ghrelin levels at each point of OGTT remained unchanged in the pioglitazone group. In the metformin group, fasting ghrelin levels were unaltered, whereas the absolute levels at 30, 60 and 120 min decreased significantly. The area under the curve for the 2-h ghrelin profile also decreased significantly. CONCLUSIONS Metformin, but not pioglitazone, decreased plasma ghrelin levels after the glucose load. This decrease may in part account for weight stability in type 2 diabetic patients treated with metformin.
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Affiliation(s)
- I Kusaka
- Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
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34
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Matsubara H, Mizutani E, Okuwaki H, Nagasaka S, Miyauchi Y, Oyachi N, Shindo S, Dobashi Y, Matsumoto M. Recurrent mediastinal liposarcoma twenty years after the initial operation: case report. Ann Thorac Cardiovasc Surg 2007; 13:407-409. [PMID: 18292725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 02/28/2007] [Indexed: 05/25/2023] Open
Abstract
We report a case of mediastinal liposarcoma, recurrent after 20 years. A 58-year-old man who presented with dyspnea on exertion was found to have a large mediastinal tumor in chest computed tomography (CT), and he was referred to our hospital. He had undergone an extirpation of a mediastinal liposarcoma about 20 years earlier, and we suspected its recurrence. Because the tumor was very large, it was removed in two stages. Histologically it was diagnosed as a recurrence of the previous well-differentiated liposarcoma. Although liposarcoma is one of the most common soft-tissue sarcomas in adults, a mediastinal liposarcoma is rare. Because the recurrence rate is very high, it is necessary to follow up carefully over a long term.
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Affiliation(s)
- Hirochika Matsubara
- Department of Surgery, Facultyof Medicine, University of Yamanashi, Chuo, Japan
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Kasuya S, Nagasaka S, Hanyuda A, Ishimura S, Hirashita A. The effect of ligation on the load deflection characteristics of nickel titanium orthodontic wire. Eur J Orthod 2007; 29:578-82. [PMID: 17873145 DOI: 10.1093/ejo/cjm068] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study examined the effect of ligation on the load-deflection characteristics of nickel-titanium (NiTi) orthodontic wire. A modified three-point bending system was used for bending the NiTi round wire, which was inserted and ligated in the slots of three brackets, one of which was bonded to each of the three bender rods. Three different ligation methods, stainless steel ligature (SSL), slot lid (SL), and elastomeric ligature (EL), were employed, as well as a control with neither bracket nor ligation (NBL). The tests were repeated five times under each condition. Comparisons were made of load-deflection curve, load at maximum deflection of 2,000 microm, and load at a deflection of 1,500 microm during unloading. Analysis of Variance (ANOVA) and Dunnett's test were conducted to determine method difference (alpha = 0.05). The interaction between deflection and ligation was tested, using repeated-measures ANOVA (alpha = 0.05). The load values of the ligation groups were two to three times greater than the NBL group at a deflection of 1,500 microm during unloading: 4.37 N for EL, 3.90 N for SSL, 3.02 N for SL, and 1.49 N for NBL (P < 0.01). For the EL, a plateau region disappeared in the unloading curve. SL showed the smallest load. The ligation of the bracket wire may make NiTi wire exhibit a significantly heavier load than that traditionally expected. NiTi wire exhibited the majority of its true superelasticity with SL, whereas EL may act as a restraint on its superelasticity.
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Affiliation(s)
- Shugo Kasuya
- Department of Orthodontic, Tsurumi University School of Dental Medicine, Yokohama, Japan.
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Kitatani N, Taniguchi A, Fukushima M, Nakai Y, Nagasaka S, Ohgushi M, Ohya M, Kuroe A, Inagaki N, Seino Y. Association of serum resistin with TNF system activity in Japanese type 2 diabetic patients. Diabetes Metab 2007; 33:156-7. [PMID: 17392006 DOI: 10.1016/j.diabet.2006.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 10/30/2006] [Indexed: 11/25/2022]
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Nabeya D, Taniguchi A, Fukushima M, Nakai Y, Matsumoto K, Kuroe A, Ohgushi M, Ohya M, Nagasaka S, Inagaki N, Seino Y. Soluble vascular cell adhesion molecule-1 is independently associated with soluble tumor necrosis factor receptor 2 in Japanese type 2 diabetic patients. Diabetes Metab 2007; 33:81-2. [PMID: 17258924 DOI: 10.1016/j.diabet.2006.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 10/26/2006] [Indexed: 11/30/2022]
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38
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Ogata H, Tokuyama K, Nagasaka S, Ando A, Kusaka I, Sato N, Goto A, Ishibashi S, Kiyono K, Struzik ZR, Yamamoto Y. Long-range correlated glucose fluctuations in diabetes. Methods Inf Med 2007; 46:222-6. [PMID: 17347760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVES Our objective is to investigate diabetes-related alteration of glucose control in diurnal fluctuations in normal daily life by detrended fluctuation analysis (DFA). METHODS The fluctuations of glucose of 12 non-diabetic subjects and 15 diabetic patients were measured using a continuous glucose monitoring system (CGMS) over a period of one day. The glucose data was calculated by the DFA method, which is capable of revealing the presence of long-range correlations in time series with inherent non-stationarity. RESULTS Compared with the non-diabetic subjects, the mean glucose level and the standard deviation are significantly higher in the diabetic group. The DFA exponent alpha is calculated, and glucose time series are searched for the presence of negatively (0.5 < alpha < 1.5) or positively (1.5 < alpha) correlated fluctuations. A crossover phenomenon, i.e. a change in the level of correlations, is observed in the non-diabetic subjects at about two hours; the net effects of glucose flux/reflux causing temporal changes in glucose concentration are negatively correlated in a "long-range" (> two hours) regime. However, for diabetic patients, the DFA exponent alpha = 1.65 +/- 0.30, and in the same regime positively correlated fluctuations are observed, suggesting that the net effects of the flux and reflux persist for many hours. CONCLUSIONS Such long-range positive correlation in glucose homeostasis may reflect pathogenic mechanisms of diabetes, i.e., the lack of the tight control in blood glucose regulation. Using modern time series analysis methods such as DFA, continuous evaluation of glucose dynamics could promote better diagnoses and prognoses of diabetes and a better understanding of the fundamental mechanism of glucose dysregulation in diabetes.
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Affiliation(s)
- H Ogata
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan
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39
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Muroi R, Yagyu H, Kobayashi H, Nagata M, Sato N, Ideno J, Fujita N, Ando A, Okada K, Takiyama Y, Nagasaka S, Miyajima H, Nakano I, Ishibashi S. Early onset insulin-dependent diabetes mellitus as an initial manifestation of aceruloplasminaemia. Diabet Med 2006; 23:1136-9. [PMID: 16978380 DOI: 10.1111/j.1464-5491.2006.01883.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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] [Indexed: 12/21/2022]
Abstract
BACKGROUND Aceruloplasminaemia is an autosomal recessive disorder caused by specific mutations in the ceruloplasmin gene. Aceruloplasminaemia is clinically characterized by diabetes mellitus, pigment degeneration of the retina, and neurological abnormalities, such as cerebellar ataxia, extrapyramidal signs, and dementia. We present a patient with aceruloplasminaemia who, until progressive neurological abnormalities were noticed, had been treated for more than 30 years as having Type 1 diabetes mellitus requiring multiple insulin injection therapy. CASE REPORT The patient was a 58-year-old man. At the age of 23 years, he developed diabetes that required multiple insulin injection therapy. At the age of 39 years, he was commenced on continuous subcutaneous insulin infusion (CSII) therapy. Despite CSII therapy, the patient's blood glucose levels were poorly controlled (HbA(1c), approximately 9.5%). He was diagnosed as having aceruloplasminaemia at 58 years of age when he presented with progressive cerebellar ataxia, extrapyramidal signs of recent onset and pigment degeneration of the retina. CONCLUSIONS It is possible that some diabetic patients with aceruloplasminaemia are mistakenly diagnosed as having Type 1 diabetes mellitus, as they have reduced insulin secretion and develop diabetes at a younger age, before neurological abnormalities associated with aceruloplasminaemia are apparent. Therefore, aceruloplasminaemia should be considered in patients with insulin-dependent diabetes mellitus who develop progressive neurological abnormalities of unknown aetiology along with a microcytic hypochromic anaemia and retinal degeneration.
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Affiliation(s)
- R Muroi
- Division of Neurology, Jichi Medical School, Kawachi, Tochigi, Japan
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40
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Nakata M, Nagasaka S, Kusaka I, Matsuoka H, Ishibashi S, Yada T. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia 2006; 49:1881-92. [PMID: 16685502 DOI: 10.1007/s00125-006-0269-5] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.2] [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: 12/31/2005] [Accepted: 03/09/2006] [Indexed: 01/06/2023]
Abstract
AIMS/HYPOTHESIS Hyperlipidaemia often occurs in patients with type 2 diabetes mellitus. Though HMG-CoA reductase inhibitors (statins) are widely used for controlling hypercholesterolemia, atorvastatin has also been reported to have an adverse effect on glucose metabolism. Based on these findings, the aim of this study was to investigate the effects of statins on adipocytes, which play pivotal roles in glucose metabolism. METHODS In 3T3-L1 cells, effects of statins on adipocyte maturation were determined morphologically. Protein and mRNA levels of SLC2A4 and adipocyte marker proteins were determined by immunoblotting and RT-PCR, respectively. Type 2 diabetic NSY mice were treated with atorvastatin for 15 weeks, followed by glucose and insulin tolerance tests and examination of SLC2A4 expression in white adipose tissue (WAT). Seventy-eight Japanese subjects with type 2 diabetes and hypercholesterolaemia were treated with atorvastatin (10 mg/day), and its effects on lipid and glycaemic profiles were measured 12 weeks after treatment initiation. RESULTS Treatment with atorvastatin inhibited adipocyte maturation, SLC2A4 and C/EBPalpha expressions and insulin action in 3T3-L1 cells. Atorvastatin also attenuated SLC2A4 and C/EBPalpha expressions in differentiated 3T3-L1 adipocytes. These effects were reversed by L. mevalonate or geranylgeranyl pyrophosphate. In NSY mice, atorvastatin accelerated glucose intolerance as a result of insulin resistance and decreased SLC2A4 expression in WAT. In addition to improving hyperlipidaemia, atorvastatin treatment significantly increased HbA(1c) but not fasting glucose levels in diabetic patients, and this effect was greater in the non-obese subgroup. CONCLUSIONS/INTERPRETATION These results demonstrate that atorvastatin attenuates adipocyte maturation and SLC2A4 expression by inhibiting isoprenoid biosynthesis, and impairs glucose tolerance. These actions of atorvastatin could potentially affect the control of type 2 diabetes.
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Affiliation(s)
- M Nakata
- Department of Physiology, Division of Integrative Physiology, Jichi Medical University, School of Medicine, Shimotsuke, Tochigi 329-0498, Japan
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41
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Paik CH, Nagasaka S, Hirashita A. Class III nonextraction treatment with miniscrew anchorage. J Clin Orthod 2006; 40:480-4. [PMID: 16963819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Cheol Ho Paik
- Department of Orthodontics, Seoul National University and Dankook University, Korea
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Kawano M, Nagasaka S, Yagyu H, Ihibashi S. Th-P16:405 Pitavastatin decreases plasma prebeta1-HDL concentration and promotes its conversion rate to alpha-HDL in hypercholesterolemic patient. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)82363-9] [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: 11/16/2022]
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Kuga A, Uesaka Y, Kunimoto M, Nagasaka S, Itami J, Iwamura A, Yuasa T. [32 year old male case of paraneoplastic non-herpetic limbic encephalitis with thymoma]. Nihon Naika Gakkai Zasshi 2005; 94:2385-7. [PMID: 16363744 DOI: 10.2169/naika.94.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Atsushi Kuga
- Department of Neurology, International Medical Center of Japan, Tokyo
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44
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Kawasaki Y, Taniguchi A, Fukushima M, Nakai Y, Kuroe A, Ohya M, Nagasaka S, Yamada Y, Inagaki N, Seino Y. Soluble TNF receptors and albuminuria in non-obese Japanese type 2 diabetic patients. Horm Metab Res 2005; 37:617-21. [PMID: 16278784 DOI: 10.1055/s-2005-870536] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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] [Indexed: 10/25/2022]
Abstract
The aim of this study was to investigate the relationships between albuminuria and tumor necrosis factor (TNF)-alpha or soluble TNF receptors (sTNF-R1, sTNF-R2) in eighty-eight non-obese Japanese type 2 diabetic patients stratified into two groups according to albuminuria status-microalbuminuria or normoalbuminuria. Patients with microalbuminuria were older and had significantly higher concentrations of sTNF-R1 and sTNF-R2 than those with normoalbuminuria. There was, however, no significant difference in sex, diabetes duration, smoking, BMI, systolic and diastolic blood pressure, HbA (1c), serum creatinine, and lipid profile between the two groups. Although serum TNF-alpha was positively correlated to serum sTNF-R1 and sTNF-R2, serum TNF-alpha level did not differ with respect to albuminuria. Univariate regression analysis showed that urinary albumin concentration was positively correlated to age (r=0.380, p<0.001), serum creatinine (r=0.214, p<0.05) and concentrations of sTNF-R1 (r=0.364, p<0.001) and sTNF-R2 (r=0.342, p<0.005). Other variables, including TNF-alpha, were not associated with albuminuria. Multiple regression analyses showed that urinary albumin concentration was independently predicted by the level of sTNF-R1 (F=32.1), which explained 26.3% of the variability of urinary albumin concentration. From these results, it can be concluded that serum soluble TNF receptor is an important independent factor associated with albuminuria in non-obese Japanese type 2 diabetic patients.
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Affiliation(s)
- Y Kawasaki
- Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, and Division of Diabetes and Clinical Nutrition, Kansai-Denryoku Hospital, Osaka, Japan
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Naito H, Nishizaki K, Yoshikawa M, Yamada T, Satoh H, Nagasaka S, Kiji T, Taniguchi S. Xenogeneic embryonic stem cell-derived cardiomyocyte transplantation. Transplant Proc 2005; 36:2507-8. [PMID: 15561297 DOI: 10.1016/j.transproceed.2004.06.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to investigate the survival of xenogeneic embryonic stem cell (ES cell)-derived cardiomyocytes transplanted into the normal myocardium. MATERIAL AND METHODS Undifferentiated mouse ES cells carrying the enhanced green fluorescent protein (EGFP) were cultured in hanging drops and then plated onto dishes. These cells were identified as cardiomyocytes by the expression of cardiac-specific genes, recording of action potential, and immunostaining with anti-sarcomeric myosin antibody. Donor cells were injected into the normal myocardium, with cyclosporine administered daily. One week after the transplantation, we investigated donor cell survival by examining EGFP expression, hematoxylin and eosin staining, and immunostaining with anti-sarcomeric myosin antibody. RESULTS In vitro donor cells derived from ES cells expressed myosin light chain-2v and alpha-myosin heavy chain genes, had action potentials of a ventricular myocyte type, and were stained by anti-sarcomeric myosin antibody. In vivo 1 week after transplantation, EGFP-expressed cells were detected in the cell transplanted area. No lymphocytic infiltration was observed around these cells. CONCLUSIONS ES cell-derived cardiomyocytes survived in the normal myocardium after the transplantation, even in a discordant xenogeneic transplantation model. These results indicate that cell transplantation using cardiomyocytes derived from ES cells, even if xenogeneic represents an attractive strategy for treating heart disease.
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Affiliation(s)
- H Naito
- Department of Surgery III, Nara Medical University, Nara, Japan.
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Kiji T, Dohi Y, Nishizaki K, Sakaguchi H, Nagasaka S, Hayata Y, Yonemasu K, Taniguchi S. Relationship between immunological rejection and matrix GLA protein in cryopreserved vascular allografts. Transplant Proc 2004; 36:2415-7. [PMID: 15561265 DOI: 10.1016/j.transproceed.2004.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cryopreserved tissue allografts used for cardiovascular diseases become calcified as a late complication after transplantation, probably caused by immunological rejection. Recent attention has been focused on the inhibitory effect of matrix Gla protein (MGP) on ectopic vascular calcification, but the behavior of MGP in cryopreserved allografts is uncertain. In this study we examined the relationship between immunological rejection and MGP in cryopreserved rat aortic grafts after transplantation. METHODS Cryopreserved rat aortae were isografted or allografted intraperitoneally. Fresh isografts were also tested. The grafts were retrieved 9 days after transplantation and the intragraft MGP mRNA was measured by a real-time quantitative PCR method. The effect of daily administration of FK506 on MGP mRNA levels in cryopreserved isografts and allografts after transplantation was also evaluated. RESULTS There was no significant difference in intragraft MGP mRNA levels between fresh and cryopreserved isografts 9 days after transplantation. MGP expression levels in cryopreserved allografts were significantly lower as compared to those in cryopreserved isografts (P < .01). Daily administration of FK506 enhanced intragraft MGP mRNA (ninefold) in cryopreserved allografts (P < .01), but not in cryopreserved isografts. CONCLUSIONS Immunological rejection is likely to inhibit MGP expression in cryopreserved vascular allografts, resulting in late-onset calcification.
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Affiliation(s)
- T Kiji
- Department of Surgery III, Nara Medical University, Nara, Japan.
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Nagasaka S, Matsuta M, Kuwata T, Kuwata T, Taniguchi S. Surgical closure of coronary arteriovenous fistulas draining into the pulmonary artery using off-pump coronary artery bypass technique. J Cardiovasc Surg (Torino) 2004; 45:159-60. [PMID: 15179353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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48
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Kuroe A, Taniguchi A, Sekiguchi A, Ogura M, Murayama Y, Nishimura F, Iwamoto Y, Seino Y, Nagasaka S, Fukushima M, Soga Y, Nakai Y. Prevalence of periodontal bacterial infection in non-obese Japanese type 2 diabetic patients: relationship with C-reactive protein and albuminuria. Horm Metab Res 2004; 36:116-8. [PMID: 15002063 DOI: 10.1055/s-2004-814221] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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] [Indexed: 10/26/2022]
Abstract
The aim of the present study was to investigate the relationship between periodontal bacteria infection ( Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedius) and C-reactive protein (CRP) and albuminuria in non-obese Japanese type 2 diabetic patients. One hundred and thirty-four non-obese Japanese type 2 diabetic patients without evidence of current acute illness including clinically significant acute infectious disease were enrolled into the study. The degree of periodontal bacterial infection was evaluated using IgG titer against Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, or Prevotella intermedius. The bacterial sonic extracts were used as antigens. High-sensitivity CRP (hCRP), glucose, glycosylated hemoglobin (HbA (1c)), and lipids were also measured after an overnight fast. Urinary albumin excretion rate as a ratio of urinary albumin and urinary creatinine was assessed in a morning spot urine sample using a commercial enzymatic immunoassay. The prevalence of Porphyromonas gingivalis infection was 52.2 % and that of Actinobacillus actinomycetemcomitans and Prevotella intermedius was 7.5 and 14.2 %, respectively. IgG titer against Porphyromonas gingivalis significantly correlated with CRP (r = 0.225, p < 0.001) and albuminuria (r = 0.185, p < 0.05), while IgG titer against Actinobacillus actinomycetemcomitans or Prevotella intermedius was not associated with either parameter. These results suggest that among periodontal bacteria, Porphyromonas gingivalis infection is associated with atherosclerosis in non-obese Japanese type 2 diabetic patients.
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Affiliation(s)
- A Kuroe
- Division of Diabetes, Kansai-Denryoku Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka-city, Osaka 553-0003, Japan
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Abstract
AIMS To compare clinical efficacy of two different insulin sensitizers, pioglitazone and metformin, and to reveal factors that influence the clinical efficacy. METHODS Seventy-eight Japanese subjects with Type 2 diabetes mellitus poorly controlled with sulphonylureas [38 men and 40 women, aged 57 +/- 9 years, body mass index 25.2 +/- 1.4 kg/m2, and HbA1c 8.3 +/- 0.6% (means +/- SD)] were randomly assigned to groups for the addition of either pioglitazone or metformin and followed up for 4 months. A decrease in HbA1c levels was compared with baseline factors including homeostasis model assessment of insulin sensitivity (HOMA-R) and beta-cell function (HOMA-beta) with 71 subjects who completed the study. RESULTS The overall decrease in HbA1c levels was similar for the pioglitazone (-1.2 +/- 0.2%) and metformin (-1.3 +/- 0.1%) groups. In the pioglitazone group, the decrease in HbA1c levels was negatively correlated with baseline HOMA-R (r=-0.698, P<0.0001) and HOMA-beta (r=-0.680, P<0.0001). In contrast, the decrease was positively correlated with baseline HOMA-beta (r=0.556, P=0.0004) in the metformin group. Multivariate analysis revealed that either HOMA-R or HOMA-beta was a main determinant of the decrease in HbA1c levels in the pioglitazone group. In the metformin group, baseline levels of fasting glucose were also included as an independent determinant in addition to HOMA-beta. The subjects with greater HOMA-R (> or =4.0) or HOMA-beta (> or =40%) displayed better response to pioglitazone than to metformin, and vice versa. CONCLUSIONS In Type 2 diabetic subjects poorly controlled with sulphonylureas, addition of pioglitazone or metformin resulted in a comparable reduction in HbA1c levels. Subjects with greater insulin resistance or preserved beta-cell function displayed better response to pioglitazone, whereas subjects with reduced beta-cell function displayed better response to metformin.
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Affiliation(s)
- S Nagasaka
- Division of Endocrinology and Metabolism, Jichi Medical School, Tochigi, Japan.
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Ueda T, Kawata T, Tsuji T, Sakaguchi H, Tabayashi N, Yoshikawa Y, Nagasaka S, Abe T, Naito H, Taniguchi S. "All in one" cardiopulmonary bypass circuit for aortic surgery. Int J Artif Organs 2003; 26:924-8. [PMID: 14636009 DOI: 10.1177/039139880302601009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We devised an "all in one" cardiopulmonary bypass circuit for aortic surgery, and evaluated its efficacy and safety. The circuit consisted of a venous line, reservoir, single centrifugal pump, membrane oxygenator and arterial line bifurcated into two lines for systemic perfusion and selective branch perfusion. The perfusion volume was regulated by an occluder and measured by a flow sensor. A closed partial bypass was established using a shunt line bypassing the reservoir. We applied this circuit to 25 patients with aortic disease. Regulation of both the selective cerebral perfusion (SCP) and the selective branch perfusion was easily performed. There was neither stroke nor organ dysfunction postoperatively. There are some cases in which it is difficult to decide the necessity for SCP preoperatively; the use of this circuit may resolve this problem. This circuit can be easily and safely applied to any type of aortic surgery.
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Affiliation(s)
- T Ueda
- Department of Surgery III, Nara Medical University, Kashihara, Nara, Japan.
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