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Nakai S, Morikawa M, Hiramatsu T, Murakami Y, Nishimoto K, Matsushima S, Harada M, Uto T, Sato J, Imokawa S, Suda T. Tracheobronchitis and laryngitis associated with Crohn's disease. Respir Med Case Rep 2023; 46:101918. [PMID: 37822764 PMCID: PMC10562908 DOI: 10.1016/j.rmcr.2023.101918] [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: 04/16/2023] [Revised: 08/17/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023] Open
Abstract
We report a 68-year-old woman with tracheobronchitis and laryngitis associated with Crohn's disease (CD), which was discovered during the evaluation of suspected lung cancer. She had no symptoms induced by these upper airway diseases (UADs). Bronchoscopy revealed swelling of the epiglottis with edematous change and a mass like epiglottis fold. There were nodular and edematous changes in the trachea and bilateral main bronchus. Histological findings demonstrated infiltration by numerous lymphocytes and plasma cells. Dexamethasone as the premedication for chemotherapy against lung cancer was efficacious for these extraintestinal manifestations of CD. Our case was rare in that bronchial lesion and UADs appeared concomitantly.
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Affiliation(s)
- Shogo Nakai
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Moeko Morikawa
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Toshiya Hiramatsu
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Yurina Murakami
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Koji Nishimoto
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Sayomi Matsushima
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Masanori Harada
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Tomohiro Uto
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Jun Sato
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Shiro Imokawa
- Division of Respiratory Medicine, Iwata City Hospital, 512-3, Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatus, 431-3192, Japan
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Shirai T, Tanino Y, Nikaido T, Takaku Y, Hashimoto S, Taguchi Y, Baba T, Ogura T, Kataoka K, Nakayama M, Yamada Y, Matsushima S, Minami K, Miyazaki Y. Utility of budgerigar/pigeon/parrot-specific IgG antibody with ImmunoCAP® in bird-related hypersensitivity pneumonitis caused by other bird species and duvet. Respir Investig 2023; 61:520-526. [PMID: 37295290 DOI: 10.1016/j.resinv.2023.05.001] [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: 12/16/2022] [Revised: 04/11/2023] [Accepted: 05/01/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Bird-related hypersensitivity pneumonitis (BRHP) is an extrinsic allergic alveolitis caused by inhalation of bird antigens. Although the measurement of serum-specific IgG antibodies against budgerigar, pigeon, and parrot with ImmunoCAP® is available in Japan, the utility of the test for patients with causes by bird breeding other than these three species, including contact with wild birds/poultry/bird manure, and use of a duvet is unknown. METHODS Of the 75 BRHP patients who participated in our previous study, 30 were included. Six cases were caused by bird breeding of species other than pigeon, budgerigar, and parrot, seven were in contact with wild birds/poultry/bird manure, and 17 were using a duvet. Bird-specific IgG antibodies were compared among the patients, 64 controls, and 147 healthy participants. RESULTS In patients with BRHP caused by bird breeding, budgerigar and parrot-specific IgG levels were significantly higher than in disease controls. Only parrot-specific IgG was significantly higher than in disease controls in patients caused by duvet use. However, among patients with acute episodes (acute and recurrent type of chronic BRHP), IgG antibodies against all three species were significantly higher than those of disease controls caused by bird breeding and the use of a duvet. CONCLUSIONS Bird-specific IgG antibody with ImmunoCAP® was useful for screening and diagnosing BRHP caused by other bird species and duvets.
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Affiliation(s)
- Tsuyoshi Shirai
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Tanino
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takefumi Nikaido
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yotaro Takaku
- Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Saitama, Japan
| | | | - Yoshio Taguchi
- Department of Respiratory Medicine, Tenri Hospital, Nara, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Kanagawa, Japan
| | - Kensuke Kataoka
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan
| | - Masayuki Nakayama
- Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Yoshihito Yamada
- Department of Respiratory Medicine, JR Tokyo General Hospital, Tokyo, Japan
| | - Sayomi Matsushima
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Keiichiro Minami
- Immuno Diagnostic Division, Thermo Fisher Scientific, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
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Nakane C, Nishimoto K, Kishimoto E, Suzuki K, Nakagawa E, Morikawa M, Murakami Y, Aoshima Y, Matsushima S, Harada M, Uto T, Imokawa S. A case of severe thrombocytopenia after the first exposure to rifampicin. Respir Med Case Rep 2023; 42:101823. [PMID: 36915472 PMCID: PMC10006502 DOI: 10.1016/j.rmcr.2023.101823] [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: 10/30/2022] [Revised: 01/04/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023] Open
Abstract
Severe immune thrombocytopenia is a rare side-effect of rifampicin (RFP) and can be life-threatening. Here, we report the case of a 74-year-old male with tuberculous pleurisy who developed severe thrombocytopenia after first exposure to RFP. Platelet count decreased to 1 × 103/μL after 7 days of treatment with RFP, isoniazid, ethambutol, and pyrazinamide. After all the drugs were discontinued, the platelet count recovered. As thrombocytopenia did not occur after re-administration of drugs other than RFP, the patient was diagnosed with RFP-induced thrombocytopenia. Clinicians should be aware that RFP can induce acute and severe thrombocytopenia even without previous exposure to this drug.
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Affiliation(s)
- Chinatsu Nakane
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Koji Nishimoto
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Ei Kishimoto
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Kosuke Suzuki
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Emiko Nakagawa
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Moeko Morikawa
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Yurina Murakami
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Yoichiro Aoshima
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | | | - Masanori Harada
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Tomohiro Uto
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
| | - Shiro Imokawa
- Division of Respiratory Medicine, Iwata City Hospital, Iwata, Japan
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Morikawa MM, Harada M, Kishimoto E, Suzuki K, Nakagawa E, Hiramatsu T, Nakai S, Murakami Y, Nishimoto K, Matsushima S, Uto T, Imokawa S. BNT162b2 coronavirus disease-2019 vaccination accelerated rheumatoid arthritis disease activity in chronic eosinophilic pneumonia: A case report. Medicine (Baltimore) 2022; 101:e30806. [PMID: 36181091 PMCID: PMC9524534 DOI: 10.1097/md.0000000000030806] [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: 01/05/2023] Open
Abstract
RATIONALE The relationship between rheumatoid arthritis (RA) and eosinophilic inflammation is unclear. According to recent studies, it has been suggested that T helper 2 cell responses play a role in the inhibition of RA. It is unclear how the immunological response after coronavirus disease-2019 (COVID-19) vaccination affects T cell immune reactions. PATIENT CONCERNS AND DIAGNOSES Here, we report the case of an 88-year-old woman diagnosed with RA and chronic eosinophilic pneumonia (CEP). She was diagnosed with CEP about 20 years ago, and, through steroid treatment, she improved and had no relapse for 16 years. At the time of diagnosis of CEP, the rheumatoid factor (RF) was increased; however, there were no joint symptoms. After receiving the COVID-19 vaccine, joint and respiratory symptoms gradually worsened. Laboratory examinations showed increased RF, anti-cyclin citrullinated peptide antibody, and peripheral absolute eosinophil count. Musculoskeletal ultrasonography showed synovitis. INTERVENTION AND OUTCOME Methylprednisolone pulse therapy improved respiratory and joint symptoms immediately; RA and CEP stabilized with no relapses. LESSONS Eosinophilic and rheumatoid reactions following COVID-19 vaccination were an-reported adverse events. Eosinophilic inflammation might be reflected on an anti-inflammatory reaction in initial phase of RA.
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Affiliation(s)
- Moeko Murano Morikawa
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Masanori Harada
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
- *Correspondence: Masanori Harada, Department of Respiratory Medicine, Iwata City Hospital, 512-3 Okubo, Iwata 438-8550, Japan (e-mail: )
| | - Ei Kishimoto
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Kosuke Suzuki
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Emiko Nakagawa
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Toshiya Hiramatsu
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Shogo Nakai
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Yurina Murakami
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Koji Nishimoto
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Sayomi Matsushima
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Tomohiro Uto
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
| | - Shiro Imokawa
- Department of Respiratory Medicine, Iwata City Hospital, Iwata, Shizuoka Province, Japan
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Molnar S, Sirohey A, Assaf J, Bard PY, Castellaro S, Cornou C, Cox B, Guillier B, Hassani B, Kawase H, Matsushima S, Sánchez-Sesma FJ, Yong A. A review of the microtremor horizontal-to-vertical spectral ratio (MHVSR) method. J Seismol 2022; 26:653-685. [PMID: 35313617 PMCID: PMC8926454 DOI: 10.1007/s10950-021-10062-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
The single-station microtremor horizontal-to-vertical spectral ratio (MHVSR) method was initially proposed to retrieve the site amplification function and its resonance frequencies produced by unconsolidated sediments overlying high-velocity bedrock. Presently, MHVSR measurements are predominantly conducted to obtain an estimate of the fundamental site frequency at sites where a strong subsurface impedance contrast exists. Of the earthquake site characterization methods presented in this special issue, the MHVSR method is the furthest behind in terms of consensus towards standardized guidelines and commercial use. The greatest challenges to an international standardization of MHVSR acquisition and analysis are (1) the what - the underlying composition of the microtremor wavefield is site-dependent, and thus, the appropriate theoretical (forward) model for inversion is still debated; and (2) the how - many factors and options are involved in the data acquisition, processing, and interpretation stages. This paper reviews briefly a historical development of the MHVSR technique and the physical basis of an MHVSR (the what). We then summarize recommendations for MHVSR acquisition and analysis (the how). Specific sections address MHVSR interpretation and uncertainty assessment.
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Affiliation(s)
- S. Molnar
- University of Western Ontario, London, ON Canada
| | - A. Sirohey
- University of Western Ontario, London, ON Canada
| | - J. Assaf
- University of Western Ontario, London, ON Canada
| | - P.-Y. Bard
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, IRD, UGE, ISTerre, Grenoble, France
| | - S. Castellaro
- Dipartimento Di Fisica E Astronomia, Alma Mater Studiorum, Università Di Bologna, Bologna, Italy
| | - C. Cornou
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, IRD, UGE, ISTerre, Grenoble, France
| | - B. Cox
- Utah State University, Logan, UT USA
| | - B. Guillier
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, IRD, UGE, ISTerre, Grenoble, France
| | | | - H. Kawase
- Disaster Prevention Research Institute, Kyoto University, Uji, Kyoto Japan
| | - S. Matsushima
- Disaster Prevention Research Institute, Kyoto University, Uji, Kyoto Japan
| | - F. J. Sánchez-Sesma
- Instituto de Ingeniería, Universidad Nacional Autónoma de México, CDMX, Circuito Escolar s/n, Ciudad Universitaria, 04510 Coyoacán, Mexico
| | - A. Yong
- US Geological Survey, Pasadena, CA USA
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Hiramatsu T, Murano M, Nakai S, Murakami Y, Nishimoto K, Matsushima S, Harada M, Uto T, Sato J, Imokawa S, Suda T. Clinically amyopathic dermatomyositis with interstitial lung disease double-positive for anti-MDA5 and anti-PL12 antibodies. Respir Med Case Rep 2022; 36:101606. [PMID: 35242519 PMCID: PMC8866888 DOI: 10.1016/j.rmcr.2022.101606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/06/2022] [Accepted: 02/15/2022] [Indexed: 12/01/2022] Open
Abstract
Anti-melanoma differentiation-associated gene 5 (MDA5) and anti-aminoacyl-tRNA synthetase (ARS) antibodies are two major myositis-specific autoantibodies with distinct clinical features. However, the clinical course remains unclear in patients with clinically amyopathic dermatomyositis (CADM)-interstitial lung disease (ILD) who have co-existing anti-MDA5 and anti-ARS antibodies. Here, we describe the case of a 32-year-old woman with CADM-ILD who had anti-MDA5 and anti-PL12 antibodies. Her serum ferritin level was within the normal range. However, chest computed tomography revealed bilateral lower-lobe consolidation and ground-glass opacities. Treatment with prednisolone and immunosuppressants was successful in improving the skin lesion and ILD, but relapse occurred on reducing the dose of prednisolone. These clinical features match those of anti-ARS antibody-positive dermatomyositis-ILD. Because these two conditions show significantly different clinical features and require different intensities of treatment, clinicians should carefully follow-up these patients throughout the course of the disease.
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Aoshima Y, Enomoto Y, Fukada A, Kurita Y, Matsushima S, Meguro S, Kosugi I, Kawasaki H, Katsura H, Fujisawa T, Enomoto N, Nakamura Y, Inui N, Suda T, Iwashita T. Metformin reduces pleural fibroelastosis by inhibition of extracellular matrix production induced by CD90-positive myofibroblasts. Am J Transl Res 2021; 13:12318-12337. [PMID: 34956455 PMCID: PMC8661163] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/01/2021] [Indexed: 06/14/2023]
Abstract
Metformin, an AMP-activated protein kinase activator used to treat diabetes mellitus, has recently attracted attention as a promising anti-fibrotic agent. However, its anti-fibrotic effects on pleural fibroelastosis remain unknown. We induced mouse pleural fibroelastosis by intra-pleural coadministration of bleomycin and carbon and evaluated its validity as a preclinical model for human pleural fibrosis. We assessed the expression of the myofibroblast surface marker CD90 in the fibrotic pleura and the effects of metformin in vivo and in vitro. Finally, we evaluated the effects of metformin on human pleural mesothelial cells stimulated by transforming growth factor β1 (TGFβ1). The fibrotic pleura in mice had collagen and elastin fiber deposition similar to that seen in human fibrotic pleura. Moreover, CD90-positive myofibroblasts were detected in and successfully isolated from the fibrotic pleura. Metformin significantly suppressed the deposition of collagen and elastic fibers in the fibrotic pleura and decreased the expression of extracellular matrix (ECM)-related genes, including Col1a1, Col3a1, Fn1, and Eln, in pleural CD90-positive myofibroblasts. In human pleural mesothelial cells, metformin decreased TGFβ1-induced upregulation of ECM-related genes and SNAI1. Overall, metformin suppresses pleural fibroelastosis by inhibition of ECM production by pleural myofibroblasts, suggesting that this drug has therapeutic potential against human pleural fibrosis, including pleuroparenchymal fibroelastosis.
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Affiliation(s)
- Yoichiro Aoshima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Laboratory for Lung Development and Regeneration, Riken Center for Biosystems Dynamics Research (BDR)Kobe 650-0047, Japan
| | - Atsuki Fukada
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Yuki Kurita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Hiroaki Katsura
- Laboratory for Lung Development and Regeneration, Riken Center for Biosystems Dynamics Research (BDR)Kobe 650-0047, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of MedicineShizuoka 431-3192, Japan
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Enzan N, Matsushima S, Ide T, Tohyama T, Funakoshi K, Higo T, Tsutsui H. The use of angiotensin receptor blockers is associated with greater recovery of cardiac function than angiotensin-converting-enzyme inhibitors among patients with dilated cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
We previously showed that angiotensin-converting-enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) were associated with heart failure with recovered ejection fraction (HFrecEF) in patients with dilated cardiomyopathy (DCM). However, the different effects of these drugs on cardiac reverse remodeling have not been fully elucidated. The aim of this study was to assess comparative effectiveness of ACEi versus ARB on recovery of left ventricular ejection fraction (LVEF) among patients with DCM.
Methods
We analyzed the clinical personal records of DCM, a national database of Japanese Ministry of Health, Labour and Welfare, from 2003 to 2014. Patients with LVEF <40% and on either ACEi or ARB were included. Eligible patients were divided into two groups according to the use of ACEi or ARB. A one-to-one propensity case-matched analysis was used. A propensity score was estimated by fitting a logistic-regression model which adjusted for age, sex, duration of HF, NYHA functional class (I-II vs. III-IV), systolic blood pressure, diastolic blood pressure, heart rate, atrial fibrillation, pacing, left bundle branch block, LVEF, hypertension, diabetes mellitus, hyperuricemia, chronic kidney disease, B-type natriuretic peptide (BNP), beta-blockers, mineralocorticoid receptor antagonists, loop diuretics, thiazides, digitalis, amiodarone, and oral inotropes. The primary outcome was defined as LVEF ≥40% at 3 years of follow-up.
Results
Out of 4,618 eligible patients, 2,238 patients received ACEi and 2,380 patients received ARB. Propensity score matching yielded 1,341 pairs. Mean age was 56.0 years and 2,041 (76.1%) was male. Mean LVEF was 27.6%, and median duration of HF was 1 year. The primary outcome was observed more frequently in ARB group than in ACEi group (59.8% vs. 54.1%; odds ratio [OR] 1.26; 95% confidence interval [CI] 1.08–1.47; P=0.003). The change in LVEF from baseline to 3 years of follow-up was greater in ARB group than in ACEi group (15.8±0.4 vs. 14.0±0.4%, P=0.002). In the ACEi group, 946 patients (70.6%) continued to receive ACEi at 3 years of follow-up, while 1,088 patients (81.3%) continued to receive ARB in the ARB group. Per-protocol analysis consistently showed that ARB increased the prevalence of HFrecEF (62.0% vs. 54.0%; OR 1.39; 95% CI 1.17–1.66; P<0.001). Subgroup analysis showed that ARB increased frequency of HFrecEF regardless systolic blood pressure, heart rate, LVEF, chronic kidney disease, and concomitant use of beta-blockers and mineralocorticoid receptor antagonists.
Conclusions
The use of ARB was associated with HFrecEF more frequently than ACEi among patients with DCM and reduced LVEF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Sciences Research Grants from the Japanese Ministry of Health, Labour and Welfare (Comprehensive Research on Cardiovascular Diseases)Japan Agency for Medical Research and Development (AMED) grant
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Affiliation(s)
- N Enzan
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - S Matsushima
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - T Ide
- Kyushu University, Department of Experimental and Clinical Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka, Japan
| | - T Tohyama
- Kyushu University Hospital, Center for Clinical and Translational Research, Fukuoka, Japan
| | - K Funakoshi
- Kyushu University Hospital, Center for Clinical and Translational Research, Fukuoka, Japan
| | - T Higo
- Kyushu University Hospital, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
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9
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Miyashita K, Karayama M, Inoue Y, Hozumi H, Suzuki Y, Furuhashi K, Fujisawa T, Enomoto N, Nakamura Y, Kono M, Matsui T, Niwa M, Koda K, Toyoshima M, Matsushima S, Matsuura S, Asada K, Fujii M, Kusagaya H, Matsuda H, Inui N, Suda T. Efficacy of immune checkpoint inhibitors in non-small cell lung cancer with uncommon histology: a propensity-score-matched analysis. BMC Pulm Med 2021; 21:309. [PMID: 34600514 PMCID: PMC8487118 DOI: 10.1186/s12890-021-01681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/29/2021] [Indexed: 11/30/2022] Open
Abstract
Background Clinical efficacy of immune checkpoint inhibitors (ICIs) for non-small cell lung cancer (NSCLC) with uncommon histology (uNSCLC) is unknown. Methods Patients with NSCLC treated with ICI monotherapy between January 2014 and December 2018 in 10 Japanese hospitals were retrospectively evaluated. The patients were divided into: (1) NSCLC with common histology (cNSCLC), defined as adenocarcinoma and squamous cell carcinoma; and (2) uNSCLC, defined as incompatibility with morphological and immunohistochemical criteria for adenocarcinoma or squamous cell carcinoma. Propensity score matching was performed to balance the two groups. Results Among a total of 175 patients included, 44 with uNSCLC (10 pleomorphic carcinomas, 9 large cell neuroendocrine carcinomas, 2 large cell carcinomas, and 23 not otherwise specified) and 44 with matched cNSCLC (32 adenocarcinomas and 12 squamous cell carcinomas) were selected for analyses. Median progression-free survival (PFS) (4.4 months, 95% confidence interval [CI] 1.8–7.7 months) and overall survival (OS) (11.4 months, 95% CI 7.4–27.4 months) in the uNSCLC patients were not significantly different from those in matched cNSCLC patients (5.4 months, 95% CI 3.1–7.6 months, p = 0.761; and 14.1 months, 95% CI 10.6–29.6 months, p = 0.381). In multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0–1 and programmed death ligand-1 (PD-L1) expression were predictive for PFS and OS in uNSCLC. Conclusions ICIs had similar clinical efficacy for treatment of uNSCLC and cNSCLC. Good ECOG-PS and PD-L1 expression were predictive for efficacy of ICIs in uNSCLC. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01681-6.
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Affiliation(s)
- Koichi Miyashita
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Masato Karayama
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.
| | - Yusuke Inoue
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Yuzo Suzuki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Kazuki Furuhashi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.,Department of Chemotherapy, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Masato Kono
- Department of Respiratory Medicine, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu, 430-8558, Japan
| | - Takashi Matsui
- Department of Respiratory Medicine, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Hamamatsu, 433-8558, Japan
| | - Mitsuru Niwa
- Department of Respiratory Medicine, Hamamatsu Medical Center, 328 Tomitsuka-cho, Hamamatsu, 432-8580, Japan
| | - Keigo Koda
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, 25 Shougen-cho, Hamamatsu, 430-8525, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, 25 Shougen-cho, Hamamatsu, 430-8525, Japan
| | - Sayomi Matsushima
- Department of Respiratory Medicine, Iwata City Hospital, 513-2 Ohkubo, Iwata, 438-8550, Japan
| | - Shun Matsuura
- Department of Respiratory Medicine, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, 426-8677, Japan
| | - Kazuhiro Asada
- Department of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita-ando, Shizuoka, 420-0881, Japan
| | - Masato Fujii
- Department of Respiratory Medicine, Shizuoka City Hospital, 10-93 Ote-cho, Shizuoka, 420-8630, Japan
| | - Hideki Kusagaya
- Department of Respiratory Medicine, Shizuoka Saiseikai Hospital, 1-1-1 Oshika, Shizuoka, 422- 8527, Japan
| | - Hiroyuki Matsuda
- Department of Respiratory Medicine, Japanese Red Cross Shizuoka Hospital, 8-2 Otemachi, Shizuoka, 420-0853, Japan
| | - Naoki Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan
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10
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Nakai S, Murano M, Hiramatsu T, Matsushima S, Uto T, Sato J, Imokawa S, Suda T. Multicentric Castleman disease with infiltration of eosinophils to the lung. Respir Med Case Rep 2021; 34:101458. [PMID: 34381678 PMCID: PMC8339229 DOI: 10.1016/j.rmcr.2021.101458] [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: 03/27/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
A 41-year-old man presented with multiple superficial lymph nodes (LNs) swollen with elevated levels of serum immunoglobulin (Ig)G4 and C-reactive protein. Histological findings of his left inguinal LN revealed lymphoplasmacytic infiltration with numerous IgG4-positive plasma cells; IgG4+/IgG+ plasma cell ratio >40%. Chest computed tomography (CT) showed poorly defined centrilobular nodules, interlobular septal thickening, consolidations, and mediastinal LNs swelling. Bronchoalveolar lavage fluid (BALF) showed elevated eosinophils. A surgical lung biopsy showed focal dense eosinophil infiltration, in addition to lymphoplasmacytic infiltration, but few IgG4+ plasma cells. The diagnosis of multicentric Castleman disease (MCD) was made because of serum interleukin-6elevation. Treatment with prednisolone and tocilizumab improved his symptoms and lung lesions. This case shows that overlapping clinical and pathological features of MCD and IgG4-related disease may present in a single patient, showing the difficulty in distinguishing between these two diseases.
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Affiliation(s)
- Shogo Nakai
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Moeko Murano
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Toshiya Hiramatsu
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Sayomi Matsushima
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Tomohiro Uto
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Jun Sato
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Shiro Imokawa
- Division of Respiratory Medicine, Iwata City Hospital, 512-3 Ookubo, Iwata, Shizuoka, 438-8550, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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11
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Shirai T, Tanino Y, Nikaido T, Takaku Y, Hashimoto S, Taguchi Y, Baba T, Ogura T, Kataoka K, Nakayama M, Yamada Y, Matsushima S, Nakayama S, Miyazaki Y. Screening and diagnosis of acute and chronic bird-related hypersensitivity pneumonitis by serum IgG and IgA antibodies to bird antigens with ImmunoCAP®. Allergol Int 2021; 70:208-214. [PMID: 33041192 DOI: 10.1016/j.alit.2020.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/20/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Bird antigens are some of the most relevant antigens in hypersensitivity pneumonitis (HP). Possible sources of bird antigens are bird breeding, feather products and fertilizer with fowl droppings. For the screening and diagnosis of HP, the measurement of bird-specific antibodies should be standardized. The aim of this study was to clarify the utility of serum IgG (sIgG) and IgA (sIgA) antibodies to bird antigens in screening and diagnosing acute/chronic bird-related HP with ImmunoCAP® in multi-centre clinical research. METHODS We executed a clinical performance test by conducting a multi-institutional study to measure the levels of sIgG/sIgA against pigeon, parrot and budgerigar antigens by the ImmunoCAP® system in 29 acute and 46 chronic bird-related HP patients. RESULTS The levels of sIgG/sIgA against the bird antigens of the three species were significantly higher in subjects with acute bird-related HP and chronic bird-related HP with acute episodes (recurrent type) than in the control subjects. For sIgG, the optimal cutoff values by receiver operating characteristic (ROC) analysis were 24.6 mgA/L for pigeon, 14.0 mgA/L for parrot, and 8.7 mgA/L for budgerigar. By measuring multiple bird antigens and combining sIgG values of two species, the sensitivity and specificity for acute and recurrent-type chronic bird-related HP patients were 85-91% and 73-80%, respectively. For recurrent and insidious types of chronic bird-related HP, the sensitivity and specificity were 48-61% and 73-80%, respectively. CONCLUSIONS Measurement of the levels of sIgG/sIgA against pigeon, budgerigar and parrot antigens by ImmunoCAP® was useful for screening and diagnosis in bird-related HP.
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12
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Onodera H, Mogamiya T, Mori M, Matsushima S, Sase T, Nakamura H, Sakakibara Y. High protein intake after subarachnoid hemorrhage improves ingestion function and temporal muscle volume. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Yamamoto T, Matsushima S, Okabe K, Ikeda S, Ishikita A, Enzan N, Sada M, Tsutsui Y, Miyake R, Tsutsui H. Cyclin dependent kinase 1 (CDK1) positively regulates cardiac hypertrophy and fibrosis via TGF-beta pathway. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3743] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Transforming growth factor beta (TGF-β) critically mediates cardiac fibrosis by transforming fibroblasts to myofibroblasts in pathological conditions. Cyclin dependent kinases (CDKs), cell cycle-regulating proteins, are known to be intimately involved in cardiac fibrosis. Among CDK isoforms, CDK1 is essential for cell cycle progression and cell division. It is reported some interphase CDKs such as CDK4 or CDK6 were involved in cardiac fibrosis, however, detailed mechanisms of cardiac fibrosis through CDK1 and its interactions with TGF-β in cardiac fibrotic process haven't been elucidated. We hypothesize that CDK1 is involved in cardiac fibrotic process via TGF-β pathway and its suppression decreases TGF-β expression and transformation to myofibroblasts from fibroblasts presenting antifibrotic effect.
Methods and results
Isolated neonatal rat cardiac fibroblasts were treated with angiotensin II (ANG II, 1 μM, 24 h) or phosphate-buffered saline (PBS). ANG II increased CDK1 and TGF-β in cardiac fibroblasts, by 97% and 292%, respectively (p<0.05). Administration of Ro-3306, a specific CDK1 inhibitor (1 μM, 24 h), suppressed TGF-β protein levels in ANG II-treated cardiac fibroblasts by 58% (p<0.05). Similarly, knockdown of CDK1 by RNA silencing also inhibited ANG II-induced increases in TGF-β in cardiac fibroblasts by 39% (p<0.05). ANG II increased alpha-smooth muscle actin (α-SMA), which is a marker of myofibroblasts, and knockdown of CDK1 significantly suppressed it by 49% (p<0.05). In vivo study, 11-week-old male C57BL/6J mice were administered ANG II continuously with infusion pump, at a dose of 1000 ng/kg/min, for a week. Also, Ro-3306 was intraperitoneally injected at a dose of 2 mg/kg/day, every other day, for a week. First, Ro-3306 attenuated ANG II-mediated cardiac hypertrophy indicated by heart weight and echocardiographic parameter as to left ventricular wall thickness. Second, CDK1 and TGF-β expression were significantly augmented in ANG II-infused mice by 404% and 113%, respectively (p<0.05). Injection of Ro-3306 suppressed TGF-β protein levels by 48%, although the difference wasn't statistically significant (p=0.09). Finally, histopathological examination (Masson's trichrome stain) demonstrated remarkable repression of ANG II-induced cardiac fibrosis by Ro-3306.
Conclusions
CDK1 positively controls cardiac fibrotic process by regulating transformation to cardiac myofibroblasts from fibroblasts via TGF-β pathway. It also presents an antihypertrophic effect on ANG II stimulation. CDK1 is a potential therapeutic target of cardiac fibrosis and hypertrophy.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): KAKENHI
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Affiliation(s)
- T Yamamoto
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - K Okabe
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - A Ishikita
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - N Enzan
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M Sada
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Y Tsutsui
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - R Miyake
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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14
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Ide T, Kaku H, Matsushima S, Tohyama T, Enzan N, Funakoshi K, Sumita Y, Nakai M, Nishimura K, Fukuda H, Hatano M, Komuro I, Tsutsui H. The nationwide registry of hospitalized heart failure patients in Japan: Japanese Registry Of Acute Decompensated Heart Failure (JROADHF). Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1182] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aim
Heart failure (HF) is a growing healthcare problem worldwide. This study aimed to describe clinical characteristics and long-term outcomes of HF patients in Japan.
Methods and results
JROADHF (the Japanese Registry Of Acute Decompensated Heart Failure) is a retrospective, multicentre, nationwide observational database of 13,238 patients hospitalized due to HF in 128 hospitals randomly selected from Japanese Circulation Society (JCS)-certified teaching hospitals during 2013. At inclusion, demographic and clinical data were collected from medical records with linkage to a nationwide claim-based database, the Japanese Diagnosis Procedure Combination (DPC). Patients were followed up to 5 years after discharge at each participating site. Patients were old as the median age of 81 years and women were older (74.8±12.8 vs 81.6±11.1 y.o). Mean left ventricular ejection fraction (LVEF) was 47%, and 45% were HF with preserved ejection fraction of >50% (HFpEF). Causes of HF included ischemic in 27%, valvular in 19%, arrhythmia in 17%, and hypertensive in 16%. Median length of hospital stay was 18 days and in-hospital mortality was 7.7%. All-cause mortality during 1 and 4 years were 22.3% and 48.4%, respectively. Hospitalization rates due to HF within 1 and 4 years were as high as 30.5 and 48.4%, respectively.
Conclusions
Contemporary nationwide registry revealed that hospitalized HF patients were elder and had more HFpEF, and their prognosis was still poor compared to the data shown in prior registries.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development (AMED) Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus
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Affiliation(s)
- T Ide
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Kaku
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - T.I Tohyama
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - N Enzan
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - K Funakoshi
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Y Sumita
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - M Nakai
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - K Nishimura
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Fukuda
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M Hatano
- University of Tokyo, Tokyo, Japan
| | - I Komuro
- University of Tokyo, Tokyo, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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15
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Enzan N, Matsushima S, Ide T, Kaku H, Tohyama T, Funakoshi K, Higo T, Tsutsui H. Use of direct oral anticoagulants is associated with better long-term outcomes in patients with atrial fibrillation and heart failure as compared with vitamin K antagonists. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Direct oral anticoagulants (DOACs) have been shown to be safe and effective in patients with atrial fibrillation (AF) as compared with warfarin, a vitamin K antagonist. However, the safety and efficacy of DOACs in patients with AF and heart failure (HF) have been unclear.
Purpose
The purpose of this study was to determine whether DOACs can improve long-term outcomes in patients with AF and HF as compared with warfarin.
Methods
We analyzed the JROADHF registry, which was a multicenter registry of patients hospitalized for the worsening HF in Japan. Baseline data were collected during the episode of index hospitalization from April 2013 to March 2014. Follow-up data were collected up to 4.5 years after the index hospitalization. Patients with AF and creatinine clearance ≥15 ml/min/1.73m2 were included. Valvular heart disease, congenital heart disease, and constrictive pericarditis were excluded. Eligible patients were divided into two groups according to the use of warfarin or DOACs. The primary outcome was defined as all-cause death. The secondary outcomes were defined as cardiovascular death, composite of all-cause death or cardiovascular hospitalization, and composite of stroke death or stroke related hospitalization. A one to one propensity case-matched analysis was used. Complete case analysis and multiple imputation analysis were also conducted as sensitivity analyses.
Results
Out of the 14,847 patients in this registry, 2,175 had AF, creatinine clearance ≥15 ml/min/1.73m2 and discharged alive. Propensity score matching yielded 475 pairs. In matching cohort, mean age was 76.5 years and 513 (54.0%) was male. Mean left ventricular ejection fraction was 48.6±16.4%. During a mean follow-up of 3.2 years, patients with DOACs had a lower incidence rate of all-cause death than those with warfarin (75.2 vs. 99.9 death per 1000 patient-years; rate ratio (RR) 0.75; 95% confidence interval [CI] 0.59–0.96; P=0.022). The incidence of cardiovascular death tended to be lower in DOAC group (30.9 vs. 43.1; incidence rate ratio 0.72; 95% CI 0.49–1.04; P=0.081). There were no significant differences in the incidence of composite of all cause death or cardiovascular hospitalization (252.3 vs. 269.4; RR 0.94; 95% CI 0.79–1.11; P=0.45) or composite of stroke death or stroke related hospitalization (13.1 vs. 16.7; RR 0.79; 95% CI 0.39–1.59; P=0.50). Cox regression model showed that DOAC was associated with lower mortality than warfarin (hazard ratio (HR) 0.75; 95% CI 0.59–0.96; P=0.023). Complete case analysis (HR 0.78; 95% CI 0.63–0.98; P=0.035) and multiple imputation analysis (HR 0.78; 95% CI 0.68–0.84; P<0.001) also showed the same results. A restricted cubic spline analysis demonstrated that the effectiveness of DOACs over warfarin waned with age, and DOACs were effective in patients younger than 80 years old.
Conclusion
Use of DOACs was associated with better long-term outcome in patients with HF as compared with warfarin.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- N Enzan
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Hospital, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - T Ide
- Kyushu University, Department of Experimental and Clinical Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Kaku
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - T Tohyama
- Kyushu University Hospital, Center for Clinical and Translational Research, Fukuoka, Japan
| | - K Funakoshi
- Kyushu University Hospital, Center for Clinical and Translational Research, Fukuoka, Japan
| | - T Higo
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
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16
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Kadoya Y, Zen K, Tamaki N, Yashige M, Takamatsu K, Ito N, Kuwabara K, Yamano M, Yamano T, Nakamura T, Matsushima S, Yaku H, Matoba S. Prognostic value of cardiac 123I-metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In patients with aortic valve stenosis (AS), cardiac sympathetic nervous (CSN) dysfunction and its improvement after TAVR have been reported; however, the prognostic impact of CSN function remains unclear. This study investigated the prognostic value of cardiac 123I-metaiodobenzylguanidine (MIBG) imaging for the prediction of cardiac events after transcatheter aortic valve replacement (TAVR).
Methods
This study was a single-center prospective observational study that enrolled patients with AS or failed surgical bioprostheses between July 2017 and May 2019. MIBG scintigraphy was performed before and after TAVR to evaluate the delayed heart–mediastinum ratio (d-H/M). Patients were classified into three pairs of groups based on the baseline and post-TAVR d-H/M (≥2.0 or <2.0) and on the presence of TAVR-related improvement of d-H/M. The study endpoints were major adverse cardiac events (MACE), including all-cause death, myocardial infarction, and hospitalization due to heart failure. The association of d-H/M with MACE following TAVR was based on a Cox proportional hazards ratio model adjusted for multiple prognostic variables.
Results
Of 187 consecutive patients who underwent TAVR, 111 (31 men; median age: 86 years) were evaluated. Over a median follow-up of 366 days, 16 (14.4%) patients had MACE. The incidence of MACE was significantly lower in patients with d-H/M improvement and/or the high post-TAVR d-H/M (≥2.0). Post-TAVR d-H/M had significant impacts on MACE, with an adjusted hazard ratio of 1.326 (95% confidence interval, 0.139–2.515; p=0.027).
Conclusions
Both d-H/M improvement and high post-TAVR d-H/M were associated with better prognosis in patients who underwent TAVR. Cardiac MIBG imaging was useful for predicting cardiac events after TAVR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Kadoya
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K Zen
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Tamaki
- Kyoto Prefectural University of Medicine, Department of Radiology, Kyoto, Japan
| | - M Yashige
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K Takamatsu
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - N Ito
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K Kuwabara
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - M Yamano
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Yamano
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Nakamura
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - S Matsushima
- Kyoto Prefectural University of Medicine, Department of Radiology, Kyoto, Japan
| | - H Yaku
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Surgery, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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17
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Tohyama T, Funakoshi K, Kaku H, Enzan N, Ikeda M, Matsushima S, Ide T, Todaka K, Tsutsui H. Artificial intelligence-based analysis of payment system data can predict one-year mortality of hospitalized patients with heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3492] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Individual risk stratification is fundamental in the care of heart failure (HF) patients. However, the prediction performance of risk scores, such as MAGGIC and SHFM, is not adequate and, more importantly, they need additional predictors including various biomarkers, imaging data, and environmental factors. Data from a case-mix payment system including diagnosis and procedures with outcomes can be used to develop the risk prediction models, allowing the use of big data for a more accurate prediction of mortality.
Purpose
This study aimed to develop artificial intelligence (AI) models for predicting 1-year mortality in patients hospitalized due to HF.
Methods
We analyzed the data from 10175 patients enrolled in the Japanese Registry Of Acute Decompensated Heart Failure (JROADHF). Candidate variables included the data obtained from a payment system introduced by the Japanese government, the Diagnosis Procedure Combination (DPC), which included each patient profile (age, sex, height, weight), principal diagnosis for hospitalization, comorbidities, procedures, length of hospital stay, and discharge status. They did not include clinical data available from patients such as vital status, laboratory data including bio-makers, electrocardiographic and echocardiographic data. The collected data were divided into the training set and the validation set (80%: 20%). With the training set, 5 AI models (logistic regression, random forest, support vector machine, neural network, and ensemble classifier) learned the one-year mortality results. AI models were evaluated by using the validation set with ROC analysis. The training and validation steps were repeated 10 times with different seed values to calculate the C-statistic of each model. We also identified the predictors for one-year prognosis acquired from the AI models.
Results
At 1-year of follow-up, a total of 1727 patients had died (17%). Among the machine learning models, the ensemble classifier showed the highest C-statistic of 0.76 (95% confidence interval: 0.75 to 0.77) for predicting mortality. Top predictors acquired from the random forest classifier was ADL (Barthel Index) at discharge, age, body mass index, and length of hospital stay.
Conclusion
By using AI-based analysis of a national case-mix payment system data, the present risk stratification model could predict the one-year mortality of hospitalized HF patients without any quantitative laboratory and physiological data. Furthermore, the present results could emphasize the advantage of this approach using the claim-based data that are routinely collected in a usual daily practice with no need to collect any additional information.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- T Tohyama
- Kyushu University Hospital, Fukuoka, Japan
| | | | - H Kaku
- Kyushu University Graduate School of Medical Sciences, Cardiovascular disease, Fukuoka, Japan
| | - N Enzan
- Kyushu University Graduate School of Medical Sciences, Cardiovascular disease, Fukuoka, Japan
| | - M Ikeda
- Kyushu University Graduate School of Medical Sciences, Cardiovascular disease, Fukuoka, Japan
| | | | - T Ide
- Kyushu University Graduate School of Medical Sciences, Cardiovascular disease, Fukuoka, Japan
| | - K Todaka
- Kyushu University Hospital, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Cardiovascular disease, Fukuoka, Japan
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18
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Enzan N, Matsushima S, Ide T, Kaku H, Higo T, Tsutsui H. Beta-blocker use is associated with prevention of left ventricular remodeling in recovered dilated cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Withdrawal of optimal medical therapy has been reported to relapse cardiac dysfunction in patients with dilated cardiomyopathy (DCM) whose cardiac function had improved. However, it is unknown whether beta-blockers can prevent deterioration of cardiac function in those patients.
Purpose
We examined the effect of beta-blockers on left ventricular ejection fraction (LVEF) in recovered DCM.
Methods
We analyzed the clinical personal records of DCM, a national database of Japanese Ministry of Health, Labor and Welfare, between 2003 and 2014. Recovered DCM was defined as a previously documented LVEF <40% and a current LVEF ≥40%. Patients with recovered DCM were divided into two groups according to the use of beta-blockers. The primary outcome was defined as a decrease in LVEF >10% at two years of follow-up. A one to one propensity case-matched analysis was used. A per-protocol analysis was also performed. Considering intra- and inter-observer variability of echocardiographic evaluations, we also examined outcomes by multivariable logistic regression model after changing the inclusion criteria as follows; (1) previous LVEF <40% and current LVEF ≥40%; (2) previous LVEF <35% and current LVEF ≥40%; (3) previous LVEF <30% and current LVEF ≥40%; (4) previous LVEF <40% and current LVEF ≥50%. Outcomes were also changed as (1) decrease in LVEF ≥5% (2) decrease in LVEF ≥10% (3) decrease in LVEF ≥15%. The analysis of outcomes by using combination of multiple imputation and inverse probability of treatment weighting was also conducted to assess the effects of missing data and selection bias attributable to propensity score matching on outcomes.
Results
From 2003 to 2014, 40,794 consecutive patients with DCM were screened. Out of 5,338 eligible patients, 4,078 received beta-blockers. Propensity score matching yielded 998 pairs. Mean age was 61.7 years and 1,497 (75.0%) was male. Mean LVEF was 49.1±8.1%. The primary outcome was observed less frequently in beta-blocker group than in no beta-blocker group (18.0% vs. 23.5%; odds ratio [OR] 0.72; 95% confidence interval [CI] 0.58–0.89; P=0.003). The prevalence of increases in LVDd (11.5% vs. 15.8%; OR 0.70; 95% CI 0.54–0.91; P=0.007) and LVDs (23.1% vs. 27.2%; OR 0.80; 95% CI 0.65–0.99; P=0.041) was also lower in the beta-blocker group. Similar results were obtained in per-protocol analysis. These results were robust to several sensitivity analyses. As a result of preventing a decrease in LVEF, the deterioration to HFrEF was also prevented by the use of beta-blocker (23.6% vs. 30.6%). Subgroup analysis demonstrated that beta-blocker prevented decrease in LVEF regardless of atrial fibrillation.
Conclusion
Use of beta-blocker was associated with prevention of decrease in left ventricular ejection fraction in patients with recovered DCM.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Health Sciences Research Grants from the Japanese Ministry of Health, Labour and Welfare (Comprehensive Research on Cardiovascular Diseases)
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Affiliation(s)
- N Enzan
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Hospital, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - T Ide
- Kyushu University, Department of Experimental and Clinical Cardiovascular Medicine, Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Kaku
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
| | - T Higo
- Kyushu University Hospital, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Department of Cardiovascular Medicine, Faculty of Medical Sciences, Fukuoka, Japan
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19
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Meguro S, Kusama Y, Matsushima S, Yagi H, Kawasaki H, Kosugi I, Tsuchida T, Baba S, Enomoto Y, Hosokawa S, Iwashita T. Nasal glomus tumor: A rare nasal tumor with diffuse and strongly positive synaptophysin expression. Pathol Int 2020; 69:672-674. [PMID: 31682049 PMCID: PMC6899972 DOI: 10.1111/pin.12866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 08/10/2019] [Accepted: 09/28/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yukiko Kusama
- Division of Diagnostic Pathology, Nagano Municipal Hospital, Nagano, Japan
| | - Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Haruna Yagi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takashi Tsuchida
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Seiji Hosokawa
- Department of Otorhinolaryngology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
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20
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Watanabe H, Kitahara Y, Murakami Y, Nihashi F, Matsushima S, Eifuku T, Uto T, Sato J, Imokawa S, Suda T. Pneumocystis jirovecii Pneumonia in a Patient with Breast Cancer Receiving Neoadjuvant Dose-dense Chemotherapy. Intern Med 2020; 59:987-990. [PMID: 31839658 PMCID: PMC7184075 DOI: 10.2169/internalmedicine.3907-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
We herein report a 38-year-old woman with breast cancer who developed Pneumocystis jirovecii pneumonia (PCP) during neoadjuvant dose-dense chemotherapy combined with dexamethasone as antiemetic therapy. Chest computed tomography showed bilateral ground-glass opacities and consolidation. The serum β-D-glucan levels were elevated, and P. jirovecii DNA was detected from the bronchoalveolar lavage fluid by polymerase chain reaction. Her clinical findings improved with trimethoprim/sulfamethoxazole and adjunctive steroid therapy. Clinicians must be mindful of the manifestations of PCP in non-human immunodeficiency virus (HIV)-infected immunocompromised patients and include the possibility of PCP in the differential diagnosis when confronted with breast cancer on dose-dense chemotherapy showing diffuse lung disease.
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Affiliation(s)
| | | | - Yurina Murakami
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Fumiya Nihashi
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | | | - Tatsuru Eifuku
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Tomohiro Uto
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Jun Sato
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Shiro Imokawa
- Division of Respiratory Medicine, Iwata City Hospital, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
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21
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Matsushima S, Aoshima Y, Akamatsu T, Enomoto Y, Meguro S, Kosugi I, Kawasaki H, Fujisawa T, Enomoto N, Nakamura Y, Inui N, Funai K, Suda T, Iwashita T. CD248 and integrin alpha-8 are candidate markers for differentiating lung fibroblast subtypes. BMC Pulm Med 2020; 20:21. [PMID: 31964365 PMCID: PMC6975017 DOI: 10.1186/s12890-020-1054-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/13/2020] [Indexed: 12/31/2022] Open
Abstract
Background Lung fibrosis is a serious life-threatening condition whose manifestation varies according to the localization and characteristics of fibroblasts, which are considered heterogeneous. Therefore, to better understand the pathology and improve diagnosis and treatment of this disease, it is necessary to elucidate the nature of this heterogeneity and identify markers for the accurate classification of human lung fibroblast subtypes. Methods We characterized distinct mouse lung fibroblast subpopulations isolated by fluorescence-activated cell sorting (FACS) and performed microarray analysis to identify molecular markers that could be useful for human lung fibroblast classification. Based on the expression of these markers, we evaluated the fibroblast-like cell subtype localization in normal human lung samples and lung samples from patients with idiopathic pulmonary fibrosis (IPF). Results Mouse lung fibroblasts were classified into Sca-1high fibroblasts and Sca-1low fibroblasts by in vitro biological analyses. Through microarray analysis, we demonstrated CD248 and integrin alpha-8 (ITGA8) as cell surface markers for Sca-1high fibroblasts and Sca-1low fibroblasts, respectively. In mouse lungs, Sca-1high fibroblasts and Sca-1low fibroblasts were localized in the collagen fiber-rich connective tissue and elastic fiber-rich connective tissue, respectively. In normal human lungs and IPF lungs, two corresponding major fibroblast-like cell subtypes were identified: CD248highITGA8low fibroblast-like cells and CD248lowITGA8high fibroblast-like cells, localized in the collagen fiber-rich connective tissue and in the elastic fiber-rich connective tissue, respectively. Conclusion CD248highITGA8low fibroblast-like cells and CD248lowITGA8high fibroblast-like cells were localized in an almost exclusive manner in human lung specimens. This human lung fibroblast classification using two cell surface markers may be helpful for further detailed investigations of the functions of lung fibroblast subtypes, which can provide new insights into lung development and the pathological processes underlying fibrotic lung diseases.
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Affiliation(s)
- Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan.,Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Yoichiro Aoshima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan.,Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Taisuke Akamatsu
- Division of Respiratory Medicine, Shizuoka General Hospital, 4-27-1 Kita Ando Aoi-ku, Shizuoka City, Shizuoka, 420-8527, Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan.,Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Naoki Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan.
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22
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Karliova I, Lämmerzahl J, Schneider U, Garibli M, Matsushima S, Abdul-Khaliq H, Schäfers HJ. Mid and Long-Term Results after Aortic Valve Repair in Children and Adolescents. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Ikeda S, Matsushima S, Okabe K, Ishikita A, Tadokoro T, Enzan N, Yamamoto T, Sada M, Deguchi H, Ikeda M, Ide T, Tsutsui H. P6283Downregulation of Tim44 exacerbates oxidative stress-induced ROS production and cardiomyocytes death by reducing mitochondrial SOD2. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Mitochondrial dysfunction has been highlighted as a critical driver of cardiac remodeling and failure. Mitochondria contains about 1500 proteins, 99% of which are encoded in the nuclear genome. Therefore, protein import into mitochondria is essential to maintain mitochondrial function. Previous reports suggest that nuclear-encoded mitochondrial precursor proteins import into mitochondria by multiple complex; translocase of outer membrane (TOM), translocase of inner membrane (TIM), and protein associated motor (PAM). However, the role of these protein import machineries of mitochondria in cardiac remodeling remains to be elucidated.
Objective
The purpose of this study was to elucidate the role of TOM, TIM, and PAM complex in cardiac remodeling and cardiomyocyte death.
Methods and results
C57BL/6J mice were subjected to myocardial infarction (MI) by permanent ligation of left anterior descending artery. Four weeks after operation, MI-mice demonstrated left ventricular (LV) dilation (LV end-diastolic dimension: 3.91 vs. 5.54 mm, n=8–11, p<0.05) and dysfunction (LV fractional shortening: 33.3 vs. 7.7%, n=8–11, p<0.05). Tim44 protein levels, a component of PAM complex, in mitochondrial fraction from non-infarcted left ventricle were significantly decreased compared with those in the heart from sham-operated mice by 39% (p<0.05), whereas other proteins related to TOM, TIM and PAM complex such as Tom20, Tom22, Tom40, Tom70, Tim22, Tim23 and mtHSP70 were not altered between MI-mice and sham-mice. In addition, blue-native polyacrylamide gel electrophoresis revealed that a protein complex associated to Tim44 was significantly decreased in non-infarcted LV by 40% (p<0.05). Superoxide dismutase 2 (SOD2), a mitochondrial matrix protein, was decreased in mitochondrial fraction from non-infarcted LV by 20% (p<0.05), accompanied by enhancing protein carbonylation, a marker of oxidative stress, by 40% (p<0.05). To assess the role of Tim44, it was downregulated by small interfering RNA in cultured neonatal rat ventricular myocytes (NRVMs). Knockdown of Tim44 significantly decreased SOD2 protein levels in mitochondrial fractionation (22%, p<0.05), with no significant changes in its mRNA levels. Furthermore, knockdown of Tim44 significantly increased protein carbonylation (20%, p<0.05) and cleaved caspase 3 (47%, p<0.05) and decreased cell viability (69%, p<0.05), assessed by cell titer assay, in H2O2-treatred NRVMs.
Conclusions
Downregulation of Tim44 exacerbates oxidative stress-induced ROS production and cardiomyocytes death, which is associated with a decrease in mitochondrial SOD2. Endogenous Tim44 might play a protective role in cardiac remodeling by attenuating oxidative stress and cardiomyocyte death via SOD2 import into mitochondria.
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Affiliation(s)
- S Ikeda
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Hospital, Department of Cardiovascular medicine, Fukuoka, Japan
| | - K Okabe
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - A Ishikita
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - T Tadokoro
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - N Enzan
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - T Yamamoto
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - M Sada
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - H Deguchi
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - M Ikeda
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
| | - T Ide
- Kyushu University, Faculty of Medical Sciences, Department of Experimental and Clinical Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular medicine, Fukuoka, Japan
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24
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Ishikita A, Matsushima S, Ikeda S, Okabe K, Tadokoro T, Enzan N, Yamamoto T, Sada M, Deguchi H, Ikeda M, Ide T, Tsutsui H. P1606Glutamine-fructose-6-phosphate amidotransferase 2 mediates isoproterenol-induced cardiac hypertrophy by increasing Akt O-GlcNAcylation through hexosamine biosynthesis pathway. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac hypertrophy is an independent risk factor for heart failure and cardiac death. Hexosamine biosynthesis pathway (HBP), an accessory pathways of glycolysis, is known to be involved in the attachment of O-linked N-acetylglucosamine motif (O-GlcNAcylation) to proteins, a post-translational modification. However, the role of HBP has not been determined in pathological cardiac hypertrophy.
Purpose
The purpose of this study to examine whether glutamine-fructose-6-phosphate amidotransferase 2 (GFAT2), a critical enzyme of HBP, mediates cardiac hypertrophy by protein O-GlcNAcylation and activating hypertrophic signaling in cardiomyocytes.
Methods and results
C57BL/6J mice were treated with isoproterenol (ISO: 15 mg/kg/day, 1 week) with or without 6-Diazo-5-oxo-L-norleucine (DON, an inhibitor of GFAT: 500 μg/kg/day, 1week). ISO-treated mice (ISO+vehicle) showed cardiac hypertrophy, which were attenuated in ISO and DON-treated mice (ISO+DON) (heart weight to tibial length ratio: 7.70±0.09 vs. 7.11±0.15 mg/mm, n=12, p<0.05, left ventricular wall thickness: 1.05±0.02 vs. 0.86±0.03 mm, n=6, p<0.05). Cardiomyocyte cross-sectional area was also decreased in ISO+DON compared with ISO+vehicle (309±25 vs. 252±13 mm2, n=,3 p<0.05). Whereas expression levels of GFAT2 and protein O-GlcNAcylation in the heart were increased in ISO+vehicle compared with control+vehicle by 3.3 and 1.5 folds, respectively (n=9 and n=9, p<0.05), expression levels of O-GlcNAc transferase (OGT) and the β-N-acetylglucosaminidase (OGA), other enzymes regulating O-GlcNAcylation, were not altered in both groups, indicating that ISO activated HBP by GFAT2. Protein O-GlcNAcylation in ISO+DON was lower than that in ISO+vehicle by 83% (n=9, p<0.05). In addition, phosphorylation of Akt, a critical mediator of cardiac hypertrophy, but not other mediators of cardiac hypertrophy such as ERK, JNK, or p38MAPK, was significantly decreased in ISO+DON by 76% (n=9, p<0.05). In cultured neonatal rat ventricular myocytes, treatment with ISO (1μM, 12h) increased the expression levels of GFAT2 and protein O-GlcNAcylation by 1.3 and 1.5 folds, respectively (n=6 and n=6, p<0.05), but not GFAT1. Furthermore, ISO stimulation increased a direct O-GlcNAcylation of Akt by 1.4 folds (n=3, p<0.05). Downregulation of GFAT2 by RNA silencing decreased cell size by 82% (n=6, p<0.05) and protein O-GlcNAcylation and phosphorylation of Akt by 76% and 54%, respectively (n=9 and n=9, p<0.05) in cardiomyocyte treated with ISO. Conversely, administration of glucosamine, a substrate of HBP, increased protein of O-GlcNAcylation and phosphorylation of Akt by 1.3 and 1.8 folds, respectively (n=6 and n=6, p<0.05).
Conclusions
GFAT2, a limiting enzyme of HBP, mediates pathological cardiac hypertrophy by Akt activation probably due to its O-GlcNAcylation. GFAT2-O-GlcNAcylation-Akt pathway might be a potential novel therapeutic target for cardiac hypertrophy.
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Affiliation(s)
- A Ishikita
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Hospital, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Okabe
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - T Tadokoro
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - N Enzan
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - T Yamamoto
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - M Sada
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Deguchi
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - M Ikeda
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - T Ide
- Kyushu University, Faculty of Medical Sciences, Department of Experimental and Clinical Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Faculty of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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25
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Sada M, Matsushima S, Ikeda S, Okabe K, Ishikita A, Tadokoro T, Enzan N, Yamamoto T, Deguchi Y, Ikeda M, Ide T, Tsutsui H. P6305Activation of invariant natural killer T cells ameliorates doxorubicin-induced cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Invariant natural killer T (iNKT) cells orchestrate tissue inflammation via regulating various cytokine productions, especially strongly upregulating interferon (IFN)-γ. Activation of iNKT cells have been previously reported to exert protective effects against post-infarcted cardiac remodeling and cardiac ischemia/reperfusion injury. However, the role of iNKT cells has not been determined in doxorubicin (DOX)-induced cardiomyopathy.
Purpose
The purpose of this study was to examine whether the activation of iNKT cells by α-galactosylceramide (αGC), which specifically activates iNKT cells, could affect DOX-induced cardiomyopathy, and if so, to elucidate its downstream target.
Methods
C57BL/6J mice were received the intraperitoneal injection of either αGC (0.1μg/g, n=11) or vehicle (n=13). After 1 week, these mice were treated with a low dose of DOX (18mg/kg via intravenous 3 injections over 1 week), and were followed during 14 days.
Results
DOX mice (DOX+vehicle) showed left ventricular (LV) dysfunction and dilatation, which were significantly ameliorated in DOX mice receiving αGC (DOX+αGC) (LV fractional shortening: 27.4±4.31 vs. 31.5±4.62%, p<0.05, LV end-diastolic diameter: 3.70±0.16 vs. 3.32±0.23mm, p<0.05), with no significant changes in arterial pressure, body weight, and food consumption, 14 days after DOX injection. DOX+vehicle demonstrated a significant decrease in myocardial gene expression of Vα14Jα18, a specific marker of iNKT cells, and IFN-γ compared with control mice. Vα14Jα18 expression levels were higher in DOX+αGC than DOX+vehicle by 9.2 folds (p<0.05). Consistent with this change, IFN-γ was higher in DOX+αGC than DOX+vehicle by 4.4 folds (p<0.05), whereas interleukin (IL)-1, IL-4, IL-6, IL-10, IL-17, IL-23, and tumor necrosis factor (TNF)-α were not altered in both groups. Phosphorylation of Akt, its active form, in the heart was significantly increased in DOX+αGC compared with DOX+vehicle by 1.8 folds (p<0.05).
Conclusions
Activation of iNKT cells by αGC play a protective role against DOX-induced cardiac dysfunction, which was associated with enhancing expression of IFN-γ and activating Akt. Therapies designed to activate iNKT cells might be beneficial to protect the heart from DOX injury.
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Affiliation(s)
- M Sada
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Hospital, Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - K Okabe
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - A Ishikita
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - T Tadokoro
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - N Enzan
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - T Yamamoto
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - Y Deguchi
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - M Ikeda
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
| | - T Ide
- Kyushu University Graduate School of Medical Sciences, Exerimental and Clinical Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Faculty of Medical Sciences, Cardiovascular Medicine, Fukuoka, Japan
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Meguro S, Matsushima S, Enomoto Y, Kawasaki H, Kosugi I, Tsuchida T, Baba S, Fukamizu H, Yamato Y, Iwashita T. Immunohistochemical examination using the pericyte marker myosin 1B in a perivascular myoid tumor of soft tissue with definitive pericytic differentiation. Pathol Int 2019; 69:246-248. [PMID: 30791193 PMCID: PMC6850187 DOI: 10.1111/pin.12777] [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] [Indexed: 11/27/2022]
Affiliation(s)
- Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takashi Tsuchida
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Shizuoka, Japan
| | - Hidekazu Fukamizu
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yu Yamato
- Department of Orthopediatric Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
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Okabe K, Matsushima S, Ikeda M, Ikeda S, Ishikita A, Tadokoro T, Ide T, Tsutsui H. P2826Teneligliptin attenuated AngII-induced cardiac hypertrophy by inhibiting Nox4-HDAC4 axis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Okabe
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Matsushima
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Ikeda
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Ikeda
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Ishikita
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Tadokoro
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ide
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University, Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ikeda S, Matsushima S, Ikeda M, Ishikita A, Tadokoro T, Ide T, Tsutsui H. P5694L-type calcium channel blocker attenuates doxorubicine-induced cardiomyopathy by inhibiting CaMKII-NF-kB axis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - S Matsushima
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - M Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - A Ishikita
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - T Tadokoro
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - T Ide
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of cardiology, Fukuoka, Japan
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29
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Enomoto Y, Matsushima S, Meguro S, Kawasaki H, Kosugi I, Fujisawa T, Enomoto N, Inui N, Nakamura Y, Suda T, Iwashita T. Podoplanin-positive myofibroblasts: a pathological hallmark of pleuroparenchymal fibroelastosis. Histopathology 2018; 72:1209-1215. [PMID: 29468722 DOI: 10.1111/his.13494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 02/15/2018] [Indexed: 01/28/2023]
Abstract
Pathological differential diagnoses of pleuroparenchymal fibroelastosis (PPFE) include usual interstitial pneumonia (UIP) and pulmonary apical cap (PAC); however, there are no specific immunostaining makers to distinguish between these diseases. We performed immunohistochemistry using several pleural mesothelial cell-related markers, including cytokeratin-5/6, CAM5.2, WT-1, calretinin, desmin and podoplanin, for PPFE (n = 4), UIP (n = 10) and PAC (n = 3) lung sections. Among the examined markers, in PPFE and PAC lungs podoplanin commonly showed positivity for spindle cells both in thickened pleura and subpleural fibroelastosis lesions; these cells were also stained with α-smooth muscle actin, a marker of myofibroblasts. However, even in elastic fibre-rich cases, UIP lungs did not show such podoplanin-positive myofibroblasts in pleura/subpleura and fibroblastic foci. These findings were also verified using immunofluorescence. By contrast, immunohistochemically as well as morphologically, the difference between PPFE and PAC was not apparent. The presence of podoplanin-positive myofibroblasts could be a pathological hallmark of PPFE, suggesting a pathogenic process distinct from UIP but common to PAC.
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Affiliation(s)
- Yasunori Enomoto
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan.,Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan.,Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
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Matsushima S, Burri M, Strbad M, Ruf B, Lange R, Cleuziou J. Twenty-Year Experience with the Konno Operation: A Definitive Option for Multilevel Left Ventricular Outflow Tract Obstruction. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Matsushima
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany
| | - M. Burri
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany
| | - M. Strbad
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany
| | - B. Ruf
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich at the Technical University of Munich, Munich, Germany
| | - R. Lange
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany
| | - J. Cleuziou
- Department of Cardiovascular Surgery, German Heart Center Munich at the Technical University of Munich, Munich, Germany
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31
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Meguro S, Yamazaki S, Matsushima S, Kawata K, Kawasaki H, Tsuchida T, Kosugi I, Kobayashi Y, Baba S, Iwashita T. A case of a primary hepatic so-called adenosarcoma with heterotopic ossification: possibly of biliary adenofibroma origin. Hum Pathol 2017; 73:108-113. [PMID: 29079182 DOI: 10.1016/j.humpath.2017.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/30/2017] [Accepted: 10/09/2017] [Indexed: 12/27/2022]
Abstract
We present an autopsy case of a "so-called adenosarcoma with ossification of the liver" in a 63-year-old man. Macroscopically, the well-circumscribed tumor with portal vein invasion was observed in the right lobe of the liver. The cut surface of the tumor had a solid and microcystic appearance. Microscopically, the tumor was characterized by a benign epithelial component and a malignant mesenchymal component. We believe the presence of biliary adenofibroma-like areas and the von Meyenburg complexes suggests that the tumor is possibly associated with a biliary adenofibroma. In addition, the present tumor was unique in that it showed scattered heterotopic ossification. Immunohistochemical study showed that the mesenchymal atypical spindle cells had characteristics of undifferentiated mesenchymal cells. This is the first report of a primary hepatic so-called adenosarcoma.
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Affiliation(s)
- Shiori Meguro
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Satoru Yamazaki
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Sayomi Matsushima
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kazuhito Kawata
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Hideya Kawasaki
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Takashi Tsuchida
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yoshimasa Kobayashi
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Satoshi Baba
- Department of Diagnostic Pathology, Hamamatsu University Hospital, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, 431-3192, Japan
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Enomoto Y, Nakamura Y, Colby TV, Johkoh T, Sumikawa H, Nishimoto K, Yoshimura K, Matsushima S, Oyama Y, Hozumi H, Kono M, Fujisawa T, Enomoto N, Inui N, Iwashita T, Suda T. Radiologic pleuroparenchymal fibroelastosis-like lesion in connective tissue disease-related interstitial lung disease. PLoS One 2017; 12:e0180283. [PMID: 28666014 PMCID: PMC5493376 DOI: 10.1371/journal.pone.0180283] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/13/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Radiologic pleuroparenchymal fibroelastosis (PPFE)-like lesion including pulmonary apical cap can be occasionally observed in clinical settings. However, the significance of radiologic PPFE-like lesion is unclear in connective tissue disease (CTD)-related interstitial lung disease (ILD). MATERIALS AND METHODS A total of 113 patients with CTD-related ILD were enrolled and assessed for radiologic PPFE-like lesion, which was defined as bilateral, upper lobe, and subpleural dense consolidations with or without pleural thickening on chest high-resolution computed tomography. The clinical, radiologic, and pathologic characteristics were evaluated. RESULTS Radiologic PPFE-like lesion was found in 21 patients (19%) and were relatively frequent in those with systemic sclerosis (6/14: 43%) and primary Sjögren's syndrome (4/14: 29%). Patients with PPFE-like lesion were significantly older, had lower body mass index, higher ratio of residual volume to total lung capacity, and higher complication rate of pneumothorax and/or pneumomediastinum than those without. Twelve of the 21 patients were diagnosed radiologically as usual interstitial pneumonia (UIP) or possible UIP pattern. Two of three patients who underwent surgical lung biopsy of the upper lobes showed UIP on histopathology. Another patient was confirmed to have upper lobe PPFE on autopsy. During the clinical course, progression of the radiologic PPFE-like lesions was observed in 13 of 21 patients. Six patients died (mortality rate: 29%) and their PPFE-like lesions were commonly progressive. In the total cohort, our multivariate analysis identified the presence of PPFE-like lesion as a significant risk factor for respiratory death (hazard ratio: 4.10, 95% confidence interval: 1.33-12.65, p = 0.01). CONCLUSION In patients with CTD-related ILD, radiologic PPFE-like lesion, which may present as not only PPFE but also apical cap and upper lobe subpleural fibrosis commonly due to UIP, was not uncommon and was associated with poor prognosis. Clinicians should be cautious with this radiologic finding, particularly when it is progressive.
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Affiliation(s)
- Yasunori Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
- * E-mail: (YE); (YN)
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- * E-mail: (YE); (YN)
| | - Thomas V. Colby
- Department of Laboratory Medicine and Pathology (Emeritus), Mayo Clinic Arizona, Scottsdale, AZ, United States of America
| | - Takeshi Johkoh
- Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public Teachers, Hyogo, Japan
| | - Hiromitsu Sumikawa
- Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Koji Nishimoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Katsuhiro Yoshimura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Sayomi Matsushima
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yoshiyuki Oyama
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Masato Kono
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
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Meguro S, Akamatsu T, Matsushima S, Kosugi I, Kawasaki H, Arai Y, Baba S, Tsuchida T, Shido Y, Suda T, Iwashita T. Phenotypic characterization of perivascular myoid cell neoplasms, using myosin 1B, a newly identified human pericyte marker. Hum Pathol 2017; 62:187-198. [DOI: 10.1016/j.humpath.2016.12.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/29/2016] [Accepted: 12/30/2016] [Indexed: 11/25/2022]
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Inui N, Matsushima S, Kato S, Yasui H, Kono M, Fujisawa T, Enomoto N, Nakamura Y, Toyoshima M, Suda T. Effects of indacaterol versus tiotropium on respiratory mechanics assessed by the forced oscillation technique in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10:1139-46. [PMID: 26124653 PMCID: PMC4476438 DOI: 10.2147/copd.s87058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The forced oscillation technique (FOT) can measure respiratory mechanics and has attracted attention in chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects of only indacaterol and tiotropium monotherapies on airflow limitation and respiratory impedance. Pulmonary function tests, COPD assessment test (CAT), and multifrequency FOT with MostGraph-01 were performed at the beginning and after 8 weeks of treatment with indacaterol or tiotropium. The resistance index, resistance at 5 Hz (R5), resistance at 20 Hz (R20), reactance index, reactance at 5 Hz (X5), resonant frequency (Fres), and low-frequency reactance area (ALX) were determined at whole-breath, inspiratory, and expiratory phases. Eighty-two patients (mean age: 73 years; mean forced expiratory volume in 1 second (FEV1): 61.6%±19.0% predicted) were randomized to indacaterol or tiotropium treatment. Both bronchodilators improved airflow limitation, with mean trough improvements in FEV1 of 165 mL and 80 mL in the indacaterol and tiotropium groups, respectively. The CAT score decreased in the indacaterol group (P<0.001; 11.2±6.6 to 7.5±5.6). Compared with tiotropium, indacaterol significantly improved FEV1, percent predicted FEV1, and CAT score (P=0.042, P=0.008, and P=0.027, respectively). For respiratory impedance, indacaterol and tiotropium changed R5, X5, Fres, and ALX at whole-breath, inspiratory, and expiratory phases. In the indacaterol group, the changes in R5, R5–R20, X5, Fres, and ALX were significantly correlated with the changes in FEV1. The use of the FOT may enable the evaluation of the effects of bronchodilators in addition to FEV1-indicated therapeutic effects in COPD.
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Affiliation(s)
- Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan ; Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Sayomi Matsushima
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Shinpei Kato
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Hideki Yasui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Masato Kono
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Shougen-cho, Hamamatsu, Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Handayama, Hamamatsu, Japan
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Matsushima S, Inui N, Yasui H, Kono M, Nakamura Y, Toyoshima M, Shirai T, Suda T. Indacaterol and tiotropium combination therapy in patients with chronic obstructive pulmonary disease. Pulm Pharmacol Ther 2015; 30:11-5. [DOI: 10.1016/j.pupt.2014.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/14/2014] [Accepted: 10/22/2014] [Indexed: 01/30/2023]
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Kurihara M, Kirita T, Sasahira T, Ohmori H, Matsushima S, Yamamoto K, Bosserhoff AK, Kuniyasu H. Protumoral roles of melanoma inhibitory activity 2 in oral squamous cell carcinoma. Br J Cancer 2013; 108:1460-9. [PMID: 23511560 PMCID: PMC3629429 DOI: 10.1038/bjc.2013.27] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [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] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 01/02/2013] [Accepted: 01/07/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The role of melanoma inhibitory activity 2 (MIA2) was examined in human oral squamous cell carcinoma (OSCC). METHODS MIA2 role was examined by immunohistochemistry of human OSCCs and knockdown studies using human 3 OSCC cell lines with MIA2 expression. RESULTS MIA2 expression was observed in 62 (66.7%) of 93 OSCCs and was associated with tumour expansion and nodal metastasis. Melanoma inhibitory activity 2 expression was inversely correlated with intratumoral infiltration of lymphocytes. Invasion and anti-apoptotic survival were reduced by MIA2 knockdown in HSC3 cells. MOLT-3 lymphocytes infiltrating the HSC3 cell layer was enhanced by MIA2 knockdown or MIA2 depletion with the antibody. In HSC3 cells, MIA2 knockdown decreased the expressions of vascular endothelial growth factor (VEGF), VEGF-C, and VEGF-D. The downregulation of VEGF-C and -D was caused by inhibition of p38 and extracellular signal-regulated kinase (ERK)1/2, respectively. Melanoma inhibitory activity 2 was co-precipitated with integrin α4 andα5 in HSC3 cells. Integrin α4 knockdown decreased p38 phosphorylation and increased apoptosis, whereas integrin α5 knockdown decreased c-Jun N-terminal kinase (JNK) phosphorylation and apoptosis. Inhibition of JNK decreased apoptosis in the HSC3 cells. CONCLUSION These findings suggest that the roles of MIA2 might be based on the variety of the integrins and the subtypes of mitogen-activated protein kinase.
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Affiliation(s)
- M Kurihara
- Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan
| | - T Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan
| | - T Sasahira
- Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - H Ohmori
- Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - S Matsushima
- Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
| | - K Yamamoto
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan
| | - A K Bosserhoff
- Department of Molecular Pathology, Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - H Kuniyasu
- Department of Molecular Pathology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan
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Kondo M, Tokuda T, Itsukage M, Kuriyama N, Matsushima S, Yamada K, Nakanishi H, Ishikawa M, Nakagawa M. Distribution of amyloid burden differs between idiopathic normal pressure hydrocephalus and Alzheimer's disease. Neuroradiol J 2013; 26:41-6. [PMID: 23859166 DOI: 10.1177/197140091302600107] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 02/19/2013] [Indexed: 11/15/2022] Open
Abstract
This study aimed to elucidate the incidence and distribution of the cortical retention of Pittsburgh compound B (PIB) in patients with idiopathic normal pressure hydrocephalus (iNPH) and clarify the differences from those in patients with Alzheimer's disease (AD). Ten patients with iNPH without any clinical signs indicative of AD were enrolled in this study. Cerebral retention of PIB in positron emission tomography (PET) in iNPH patients was compared with those in seven age-matched AD patients. The CSF levels of β-amyloid 1-42 peptide (Aβ42), which inversely decrease with cerebral amyloid burden, were also measured. Three of the ten patients with iNPH showed increased cortical PIB retention. Although the mean cortical SUV ratios were similar, the distribution of PIB retention differed widely between the patients with iNPH and AD. PIB retention was limited to the high-convexity parasagittal areas in iNPH patients, whereas it spread over the frontal and parietotemporal areas in AD. The coronal images of PIB-PET were more informative than conventional transverse images in evaluating the distribution pattern of cortical PIB retention. Two iNPH patients with higher cortical PIB retention had the lowest levels of CSF Aβ42, indicating that PIB retention in iNPH would not reflect a simple delay in PIB clearance but its binding to existing Aβ amyloid in the brain. Our results indicate that iNPH is one of the diseases exhibiting cortical PIB retention. The characteristic distribution of PIB retention in iNPH could be useful in the differential diagnosis between iNPH and AD.
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Affiliation(s)
- M Kondo
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J, Inoue M, Tsugane S, Sobue T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, K. Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Machida M, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Abe T, Katagiri M, Suzuki M, Matsui K, Doi M, Terao A, Ishikawa Y, Tagami T, Doi H, Urata M, Okamoto N, Ide F, Sueta H, Sakiyama H, Onga N, Takaesu H, Uehara M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Matsushima S, Natsukawa S, Akabane M, Konishi M, Okada K, Honda Y, Sakurai KYS, Tsuchiya N, Sugimura H, Tsubono Y, Kabuto M, Tominaga S, Iida M, Ajiki W, Ioka A, Sato S, Yasuda N, Nakamura K, Kono S, Suzuki K, Takashima Y, Yoshida M, Maruyama E, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Kadowaki T, Noda M, Mizoue T, Kawaguchi Y, Shimizu H. Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: the JPHC Study. Eur Heart J 2013; 34:1225-32. [DOI: 10.1093/eurheartj/eht043] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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39
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Yaginuma T, Yamamoto H, Mitome J, Tanno Y, Yamamoto I, Kobayashi A, Mafune A, Hayakawa H, Yokoyama K, Mori R, Ohashi H, Kaito N, Joki T, Miki J, Yamada H, Furuta N, Matsushima S, Fukuda T, Hosoya T. Successful treatment of monomorphic primary central nervous system post-transplantation lymphoproliferative disorder 5 years after kidney transplantation. Transpl Infect Dis 2012; 14:E102-6. [PMID: 22931101 DOI: 10.1111/j.1399-3062.2012.00781.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/03/2012] [Accepted: 05/17/2012] [Indexed: 11/27/2022]
Abstract
A 31-year-old man underwent living-related kidney transplantation in 2004 as a consequence of primary focal segmental glomerulosclerosis (FSGS). Four years after the transplantation, we confirmed nephrotic syndrome caused by recurrent FSGS. We performed plasmapheresis and low-density lipoprotein adsorption. We also combined steroid therapy with a reduction in the dose of tacrolimus and an increased dose of mycophenolate mofetil. The nephrotic syndrome improved dramatically with this combined therapeutic approach. However, 10 months after these treatments, he revisited our hospital because of altered consciousness. We detected multiple tumor masses in his brain that were ring enhanced on contrast magnetic resonance imaging. Consequently, we suspected primary central nervous system post-transplantation lymphoproliferative disorder (CNS-PTLD). We performed a craniotomy to biopsy the brain tumors. The biopsy specimen showed Epstein-Barr virus-associated diffuse large B-cell lymphoma. There is no definitive treatment for CNS-PTLD. Therefore, we treated the primary CNS-PTLD successfully with whole-brain radiation and discontinuation of immunosuppression therapy.
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Affiliation(s)
- T Yaginuma
- Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
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Abstract
MicroRNAs (miRNAs) are short, noncoding RNAs that function as posttranscriptional regulators of gene expression by controlling translation of mRNAs. A subset of miRNAs may be critical for the control of cell death, including the p53-regulated miRNA, miR-34a. Because seizures activate p53, and p53-deficient mice are reportedly resistant to damage caused by prolonged seizures, we investigated the role of miR-34a in seizure-induced neuronal death in vivo. Status epilepticus was induced by intra-amygdala microinjection of kainic acid in mice. This led to an early (2 h) multifold upregulation of miR-34a in the CA3 and CA1 hippocampal subfields and lower protein levels of mitogen-activated kinase kinase kinase 9, a validated miR-34a target. Immunoprecipitation of the RNA-induced silencing complex component, Argonaute-2, eluted significantly higher levels of miR-34a after seizures. Injection of mice with pifithrin-α, a putative p53 inhibitor, prevented miR-34a upregulation after seizures. Intracerebroventricular injection of antagomirs targeting miR-34a reduced hippocampal miR-34a levels and had a small modulatory effect on apoptosis-associated signaling, but did not prevent hippocampal neuronal death in models of either severe or moderate severity status epilepticus. Thus, prolonged seizures cause subfield-specific, temporally restricted upregulation of miR-34a, which may be p53 dependent, but miR-34a is probably not important for seizure-induced neuronal death in this model.
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Affiliation(s)
- T Sano
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
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Matsushima S, Yokomura K, Matsui T, Suda T, Chida K. [A case of pulmonary alveolar proteinosis presenting with miniscule ground-glass opacity in the apex of the left lung]. Nihon Kokyuki Gakkai Zasshi 2011; 49:553-557. [PMID: 21842696] [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: 05/31/2023]
Abstract
A 66-year-old man was found to have a very small ground-glass opacity in the apex of the left lung. Because the ground-glass opacity had slightly enlarged after 2 years, video-assisted thoracic surgery (VATS) biopsy was performed. The histological findings showed the alveolar spaces to be filled with PAS-positive granular materials, so pulmonary alveolar proteinosis was diagnosed. Although his bronchoalveolar lavage fluid (BALF) did not have a milky appearance, his serum and BALF GM-CSF autoantibody and serum KL-6 levels were elevated. Asymptomatic pulmonary alveolar proteinosis may appear as very small ground-grass opacities.
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Yamada K, Akazawa K, Yuen S, Goto M, Matsushima S, Takahata A, Nakagawa M, Mineura K, Nishimura T. MR imaging of ventral thalamic nuclei. AJNR Am J Neuroradiol 2009; 31:732-5. [PMID: 19926703 DOI: 10.3174/ajnr.a1870] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The Vim and VPL are important target regions of the thalamus for DBS. Our aim was to clarify the anatomic locations of the ventral thalamic nuclei, including the Vim and VPL, on MR imaging. MATERIALS AND METHODS Ten healthy adult volunteers underwent MR imaging by using a 1.5T whole-body scanner. The subjects included 5 men and 5 women, ranging in age from 23 to 38 years, with a mean age of 28 years. The subjects were imaged with STIR sequences (TR/TE/TI = 3200 ms/15 ms/120 ms) and DTI with a single-shot echo-planar imaging technique (TR/TE = 6000 ms/88 ms, b-value = 2000 s/mm(2)). Tractography of the CTC and spinothalamic pathway was used to identify the thalamic nuclei. Tractography of the PT was used as a reference, and the results were superimposed on the STIR image, FA map, and color-coded vector map. RESULTS The Vim, VPL, and PT were all in close contact at the level through the ventral thalamus. The Vim was bounded laterally by the PT and medially by the IML. The VPL was bounded anteriorly by the Vim, laterally by the internal capsule, and medially by the IML. The posterior boundary of the VPL was defined by a band of low FA that divided the VPL from the pulvinar. CONCLUSIONS The ventral thalamic nuclei can be identified on MR imaging by using reference structures such as the PT and the IML.
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Affiliation(s)
- K Yamada
- Departments of Radiology, Kyoto Prefectural University of Medicine, Japan.
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Yokomura K, Matsushima S, Oyama Y, Kusagaya H, Yasui H, Matsui T, Matsuda H, Nakano Y, Suda T, Chida K. [Two cases of pneumonitis caused by Seishinrenshiin, Chinese herbal medicine]. Arerugi 2009; 58:1441-1446. [PMID: 19901514] [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] [Received: 03/03/2009] [Accepted: 07/23/2009] [Indexed: 05/28/2023]
Abstract
We report two cases of pneumonitis caused by Seishinrenshiin. A 54-year-old woman and a 80-year-old man had taken Seishinrenshiin for cystitis and benign prostatic hypertrophy. Their chest radiograph showed diffuse ground-glass shadows in the whole lung fields and chest CT showed diffuse ground-glass-opacities predominantly in the lower lung fields of both lungs. Biochemical tests revealed mild liver dysfunction and inflammatory reactions. Their abnormal chest shadows disappeared after discontinuation of Seishinrenshiin. We should be aware that Seishinrenshiin, as well as other Chinese herbal medicine, could be cause of drug-induced pneumonitis.
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Affiliation(s)
- Koshi Yokomura
- Department of Respiratory Medicine, Seirei Mikatahara Hospital, Japan
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44
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Hyogo T, Taki W, Negoro M, Takahashi A, Edura M, Hyodo A, Kobayashi S, Komiyama M, Kuwayama N, Matsumaru Y, Miyachi S, Murao K, Murayama Y, Nakahara I, Nemoto S, Sakai N, Satoh K, Sonobe M, Sugiu K, Terada T, Yoshimura S, Abe T, Itoh Y, Kiyosue H, Nagashima H, Nakamura M, Matsushima S. Japanese society of neuro-endovascular treatment specialist qualification system. Six years' experience and introduction of an animal model examination. Interv Neuroradiol 2008; 14:235-40. [PMID: 20557719 DOI: 10.1177/159101990801400302] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 07/01/2008] [Indexed: 11/15/2022] Open
Affiliation(s)
- T Hyogo
- The members of the board of Specialist Qualification System of the JSNET -
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45
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Uto T, Inui N, Miyazaki H, Matsushima S, Kuroishi S, Hashimoto D, Naito T, Nakamura Y, Sato J, Suda T, Chida K. [Thyroid involvement of sarcoidosis]. Nihon Kokyuki Gakkai Zasshi 2008; 46:667-672. [PMID: 18788438] [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: 05/26/2023]
Abstract
A 54-year-old woman was found to have abnormal shadows on her chest radiograph taken on an annual medical examination. The chest radiograph showed multiple nodules in the bilateral middle and lower lung fields accompanied with bilateral hilar lymphadenopathy. A computed tomography of the neck and chest revealed nodules in her right middle lobe and bilateral lower lobes with an enlarged thyroid. A metastatic malignant disease involving both thyroid and lungs was suspected, therefore thyroid and lung biopsies were performed. The histological examination of the thyroid and the lung specimens revealed non-caseating epithelioid cell granulomas which were compatible with sarcoidosis. Although the thyroid involvement of sarcoidosis is rare, it should be included in the differential diagnosis with patients with thyroid swelling.
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Affiliation(s)
- Tomohiro Uto
- Department of Respiratory Medicine, Hamamatsu University School of Medicine
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46
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Asaoka Y, Yoshida K, Oka M, Shinomura T, Mishima H, Matsushima S, Nishizuka Y. The signal-induced phospholipid degradation cascade and protein kinase C activation. Ciba Found Symp 2007; 164:50-9; discussion 59-65. [PMID: 1395935 DOI: 10.1002/9780470514207.ch5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Acting in synergy with diacylglycerol, unsaturated free fatty acids such as arachidonic, oleic, linoleic, linolenic and docosahexaenoic acids dramatically activate some members of the protein kinase C family at the basal level of Ca2+ concentration. It is plausible that phospholipase C and phospholipase A2, and possibly phospholipase D as well, are involved in the activation of protein kinase C. Presumably, this enzyme activation is integrated into the signal-induced membrane phospholipid degradation cascade, prolonging the activation of protein kinase C. The sustained activity of this enzyme appears to be of importance for long-term cellular responses such as development of neuronal plasticity and gene activation.
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Affiliation(s)
- Y Asaoka
- Biosignal Research Center, Kobe University, Japan
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47
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Yamada K, Sakai K, Hoogenraad FGC, Holthuizen R, Akazawa K, Ito H, Oouchi H, Matsushima S, Kubota T, Sasajima H, Mineura K, Nishimura T. Multitensor tractography enables better depiction of motor pathways: initial clinical experience using diffusion-weighted MR imaging with standard b-value. AJNR Am J Neuroradiol 2007; 28:1668-73. [PMID: 17885245 PMCID: PMC8134192 DOI: 10.3174/ajnr.a0640] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this work was to test the feasibility of using high angular resolution diffusion imaging (HARDI)-based multitensor tractography to depict motor pathways in patients with brain tumors. MATERIALS AND METHODS Ten patients (6 males and 4 females) with a mean age of 52 years (range, 9-77 years) were scanned using a 1.5T clinical MR unit. Single-shot echo-planar imaging was used for diffusion-weighted imaging (repetition time, 6000 ms; excitation time, 88 ms) with a diffusion-sensitizing gradient in 32 orientations and a b-value of 1000 s/mm(2). Data postprocessing was performed using both the conventional single- and multitensor methods. The depiction rate of the 5 major components of the motor pathways, that is, the lower extremity, trunk, hand, face, and tongue, was assessed. RESULTS Motor fibers on both lesional and contralesional sides were successfully depicted by both the single-tensor and multitensor techniques. However, with the single-tensor model, the depiction of motor pathways was typically limited to the fibers of trunk areas. With the multitensor technique, at least 4 of 5 major fiber bundles arising from the primary motor cortex could be identified. CONCLUSION HARDI-based multitensor tractography using a standard b-value (1000 s/mm(2)) can depict the fiber tracts from the face and tongue regions of the primary motor cortex.
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Affiliation(s)
- K Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto City, Kyoto, Japan.
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Hatazaki S, Bellver-Estelles C, Jimenez-Mateos EM, Meller R, Bonner C, Murphy N, Matsushima S, Taki W, Prehn JHM, Simon RP, Henshall DC. Microarray profile of seizure damage-refractory hippocampal CA3 in a mouse model of epileptic preconditioning. Neuroscience 2007; 150:467-77. [PMID: 17935890 DOI: 10.1016/j.neuroscience.2007.09.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2007] [Revised: 08/21/2007] [Accepted: 09/11/2007] [Indexed: 12/15/2022]
Abstract
A neuroprotected state can be acquired by preconditioning brain with a stimulus that is subthreshold for damage (tolerance). Acquisition of tolerance involves coordinate, bi-directional changes to gene expression levels and the re-programmed phenotype is determined by the preconditioning stimulus. While best studied in ischemic brain there is evidence brief seizures can confer tolerance against prolonged seizures (status epilepticus). Presently, we developed a model of epileptic preconditioning in mice and used microarrays to gain insight into the transcriptional phenotype within the target hippocampus at the time tolerance had been acquired. Epileptic tolerance was induced by an episode of non-damaging seizures in adult C57Bl/6 mice using a systemic injection of kainic acid. Neuron and DNA damage-positive cell counts 24 h after status epilepticus induced by intraamygdala microinjection of kainic acid revealed preconditioning given 24 h prior reduced CA3 neuronal death by approximately 45% compared with non-tolerant seizure mice. Microarray analysis of over 39,000 transcripts (Affymetrix 430 2.0 chip) from microdissected CA3 subfields was undertaken at the point at which tolerance was acquired. Results revealed a unique profile of small numbers of equivalently up- and down-regulated genes with biological functions that included transport and localization, ubiquitin metabolism, apoptosis and cell cycle control. Select microarray findings were validated post hoc by real-time polymerase chain reaction and Western blotting. The present study defines a paradigm for inducing epileptic preconditioning in mice and first insight into the global transcriptome of the seizure-damage refractory brain.
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Affiliation(s)
- S Hatazaki
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
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50
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Miyachi K, Hosaka H, Nakamura N, Miyakawa H, Mimori T, Shibata M, Matsushima S, Chinoh H, Horigome T, Hankins RW, Zhang M, Fritzler MJ. Anti-p97/VCP antibodies: an autoantibody marker for a subset of primary biliary cirrhosis patients with milder disease? Scand J Immunol 2006; 63:376-82. [PMID: 16640662 DOI: 10.1111/j.1365-3083.2006.01747.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [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: 12/12/2022]
Abstract
We previously reported that 12.5% of primary biliary cirrhosis (PBC) sera reacted with a 95 kDa cytosol protein (p95c) that was subsequently identified as a p97/valosin-containing protein (VCP). The clinical features and course of the six anti-p97/VCP-positive PBC patients with Scheuer's stage 1 and 2 liver biopsies were monitored for an average of 15 years. This group was compared with 50 PBC patients that did not have detectable anti-VCP. Autoantibodies to a full-length recombinant p97/VCP were assayed by immunoprecipitation. All six PBC patients with anti-VCP had antibodies to the mitochondrial pyruvate dehydrogenase complex-E2 antigen as measured by an addressable laser bead immunoassay. The first was a male with no evidence of liver failure that died of cerebral infarction at the age of 85. The second was a 73-year-old female with Hashimoto's thyroiditis who has remained clinically stable without ursodeoxycolic acid (UDCA) treatment. Although the third had no HCV antibodies, he developed hepatocellular carcinoma at the age of 76 and died of renal failure at 78. The fourth was a 50-year-old female who remained clinically stable during follow-up and the fifth with Hashimoto's thyroiditis and stable liver function following UCDA treatment. The sixth was a male patient presenting a mild clinical course. The clinical course of these patients was in contrast to the 50 comparison group PBC patients who did not have anti-p97/VCP. As the six PBC patients with anti-p97/VCP antibodies had slowly progressive liver disease and no mortality related to autoimmune liver disease, our observations suggest that this autoantibody might be an indicator of a favourable prognosis.
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Affiliation(s)
- K Miyachi
- First Diagnostic Division, Health Sciences Research Institute, Inc., Yokohama, Japan.
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