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Miyamoto K, Kurokouchi K, Ishizuka S, Takahashi S, Idota M, Haga T, Imagama S. Arthroscopic All-Suture Anchor Technique for Unstable Ramp Lesions with Medial Meniscal Defects. Arthrosc Tech 2023; 12:e1837-e1842. [PMID: 37942093 PMCID: PMC10628196 DOI: 10.1016/j.eats.2023.06.015] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/22/2023] [Indexed: 11/10/2023] Open
Abstract
A ramp lesion is a specific type of tear in the meniscocapsular junction of the posterior horn of the medial meniscus, usually associated with anterior cruciate ligament (ACL) injury. Biomechanical cadaveric studies have shown that ACL injury combined with ramp lesions significantly increases anterior tibial translation and external rotation, which ACL reconstruction alone cannot completely control. Additionally, ramp lesions are sometimes associated with medial meniscal defects, especially in cases of chronic ACL deficiency after repetitive traumatic events, in which the anatomical repair of the meniscocapsular junction is infeasible. This report describes a new arthroscopic repair technique using an all-suture anchor through a posteromedial portal for unstable ramp lesions with medial meniscal defects.
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Affiliation(s)
- Kentaro Miyamoto
- Department of Orthopaedic Surgery and Arthroscopy Center, Juko Memorial Hospital, Nagoya, Japan
| | - Kazutoshi Kurokouchi
- Department of Orthopaedic Surgery and Arthroscopy Center, Juko Memorial Hospital, Nagoya, Japan
| | - Shinya Ishizuka
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeo Takahashi
- Department of Orthopaedic Surgery and Arthroscopy Center, Juko Memorial Hospital, Nagoya, Japan
| | - Masaru Idota
- Department of Orthopaedic Surgery and Arthroscopy Center, Juko Memorial Hospital, Nagoya, Japan
| | - Takahiro Haga
- Department of Orthopaedic Surgery and Arthroscopy Center, Juko Memorial Hospital, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Idota M, Ishizuka S, Hiraiwa H, Yamashita S, Oba H, Kawamura Y, Sakaguchi T, Haga T, Mizuno T, Kawashima I, Kuriyama K, Imagama S. 4-Methylumbelliferone suppresses catabolic activation in anterior cruciate ligament-derived cells via a mechanism independent of hyaluronan inhibition. J Orthop Surg Res 2021; 16:507. [PMID: 34404442 PMCID: PMC8369759 DOI: 10.1186/s13018-021-02637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The anterior cruciate ligament (ACL) has a key role as a dynamic stabilizer of the knee joints, and ACL dysfunction caused by traumatic or degenerative rupture accelerates osteoarthritis progression. Thus, it is important to prevent the degenerative rupture of the ACL. 4-Methylumbelliferone (4-MU), a pre-approved drug, exerts anti-inflammatory effects in osteoarthritis chondrocytes. It was originally used as an inhibitor of hyaluronan synthesis in chondrocytes. METHODS In this study, we investigated whether 4-MU affects the expression of catabolic factors, such as matrix metalloproteinase (MMP)-1, MMP-3, and interleukin (IL)-6, in ACL-derived cells and ACL explant cultures using immunohistochemistry, real-time RT-qPCR, and capillary western immunoassay. Furthermore, the hyaluronan concentration was evaluated using a colorimetric assay. Statistical analyses were conducted using analysis of variance for multi-group comparisons, followed by Tukey or Tukey-Kramer post hoc test. RESULTS Our results revealed, for the first time, that 4-MU suppressed the IL-β-induced upregulation of pro-catabolic factors, such as MMP-1, MMP-3, and IL-6, in ACL-derived cells. This suppressive effect was also observed in the cultured ligament tissues in ex vivo experiments. 4-MU also reversed an enhanced dependence on glycolysis in IL-1β-activated ACL-derived cells. Furthermore, we found that the suppressive effects of 4-MU were exerted directly and not through the inhibition of hyaluronan synthesis. CONCLUSIONS We conclude that 4-MU could be an effective and useful treatment for knee osteoarthritis, owing to its anti-inflammatory effect on, not only chondrocytes but also on ligament cells.
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Affiliation(s)
- Masaru Idota
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Shinya Ishizuka
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan.
| | - Hideki Hiraiwa
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Satoshi Yamashita
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Hiroki Oba
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Yusuke Kawamura
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takefumi Sakaguchi
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takahiro Haga
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Takafumi Mizuno
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Itaru Kawashima
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Kanae Kuriyama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho Shouwaku Nagoya, Aichi, 4668550, Japan
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Kobayakawa A, Hiraiwa H, Ishizuka S, Yamashita S, Oba H, Kawamura Y, Sakaguchi T, Idota M, Haga T, Mizuno T, Kawashima I, Kuriyama K, Imagama S. Spontaneous Pneumomediastinum in an Adolescent Soccer Player. J Sports Sci Med 2021; 20:52-55. [PMID: 33707986 DOI: 10.52082/jssm.2021.52] [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] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/03/2020] [Indexed: 11/24/2022]
Abstract
Spontaneous pneumomediastinum (SPM) is an uncommon and usually benign self-limiting clinical disorder found in young people, often without apparent precipitating factors or diseases. A pressure gradient exists between the peripheral pulmonary alveoli and the hilum, and increased intra-alveolar pressure causes rupture of the terminal alveoli. We present the case of a 15-year-old male soccer player who presented with a complaint of anterior chest pain and dysphagia after stopping the strong ball with his chest. His symptom gradually progressed over hours. We can make the diagnosis of SPM using by chest X-ray and computed tomography (CT) scanning. His symptoms were gradually resolved over the course of approximately one week with no exercise and careful observation. We believe that our case provides very useful information to alert clinicians and coaches regarding this rare disease that may occur in anyone including adolescent soccer players.
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Affiliation(s)
| | - Hideki Hiraiwa
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Shinya Ishizuka
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | | | - Hiroki Oba
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Yusuke Kawamura
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | | | - Masaru Idota
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Takahiro Haga
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Takafumi Mizuno
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Itaru Kawashima
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Kanae Kuriyama
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
| | - Shiro Imagama
- Department of Orthopedic Surgery, Nagoya University, Nagoya, Japan
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4
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Okumura T, Oishi H, Kondo T, Arao Y, Kato H, Haga T, Yamaguchi S, Kuwayama T, Yokoi T, Hiraiwa H, Sawamura A, Morimoto R, Murohara T. P6452Circulating human epididymis protein 4 is a novel prognostic predictor in ambulatory patients with non-ischemic dilated cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1045] [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
Myofibroblasts, which are activated fibroblasts, play an important role in interstitial fibrosis in non-ischemic dilated cardiomyopathy (NIDCM). Recently, human epididymal body protein 4 (HE4) has attracted attention as a marker specific to myofibroblasts. However, the prognostic impact of HE-4 on cardiovascular events in NIDCM patients has not been reported.
Purposes
The purpose of this study was to investigate the impact of circulating serum HE4 on the prognosis in patients with NIDCM.
Methods
Forty-four NIDCM patients underwent echocardiography, laboratory measurements, cardiac catheterization, and endomyocardial biopsy within one week under stable heart failure condition. Patients with cancer were excluded from this study. We collected blood samples from peripheral vain, ascending aorta, and coronary sinus during cardiac catheterization and measured serum HE4 level. They were divided into two groups at the median of HE4 level: High-HE4 group (HE4 >69 pmol/L); n=22, Low-HE4 group (HE4 <69 pmol/L); n=22. Cardiac composite event was defined as cardiac related deaths and hospitalization due to worsening heart failure.
Results
The mean age, left ventricular ejection fraction (LVEF), and plasma brain natriuretic peptide level were 56 years, 32%, and 205 pg/mL. Between two groups, there were no significant differences in age, gender, LVEF, left ventricular end-diastolic diameter, cardiac index, and pulmonary capillary wedge pressure. However, estimated glomerular filtration rate was significantly lower in the High-HE4 group (p=0.025). Kaplan-Meier survival analysis revealed that the High-HE group had a higher rate of cardiac composite event (p=0.011, see Figure). However, as for the pathological analysis, not only the peripheral HE4 level but also HE4 value subtracting coronary sinus from ascending aorta did not significantly correlate with collagen volume fraction in biopsy samples.
Circulating HE4 level and prognosis
Conclusion
Elevated circulating HE4 is associcated with poor prognosis in ambulatory patients with NIDCM.
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Affiliation(s)
- T Okumura
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Oishi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - Y Arao
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Kato
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Haga
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Yamaguchi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kuwayama
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Yokoi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Hiraiwa
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - A Sawamura
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - R Morimoto
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
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Hiraiwa H, Okumura T, Sawamura A, Kondo T, Arao Y, Oishi H, Kato H, Kuwayama T, Yamaguchi S, Haga T, Yokoi T, Fukaya K, Furusawa K, Morimoto R, Murohara T. P5417Splenic volume changes as a hemodynamic parameter in advanced heart failure with left ventricular assist device. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0375] [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
The spleen has been recognized as an important organ to reserve 20–30% of the total blood volume. Generally, splenomegaly has been thought to be related to congestion. However, in the setting of hypovolemic shock or hypoxemia, it has been reported that spleen contracted and splenic volume decreased. On the other hand, in advanced heart failure (HF), the hemodynamics is characterized by both low cardiac output (LO) and systemic congestion, and patients sometimes need support of left ventricular assist device (LVAD). However, it remains unclear about the association between spleen size and hemodynamic parameters in patients with LO who need LVAD support.
Purpose
The purpose of this study was to investigate the relationship between spleen size and hemodynamic parameters in advanced HF before and after LVAD implantation.
Methods
We enrolled 12 advanced HF patients with LVAD (11 males, 45±10 years). All patients underwent blood test, echocardiography, right heart catheterization, and computed tomography (CT) before and after LVAD implantation. Spleen size was measured by CT volumetry. We excluded patients with splenic infarction, or any infections, or mean right atrial pressure (RAP) <5mmHg because of a possibility of hypovolemic status. LO was defined as CI less than 2.2L/min/m2.
Results
At pre- and post-LVAD implantation, cardiac output, cardiac index (CI), mean RAP, and mean pulmonary capillary wedge pressure were 3.1±0.6 vs. 4.9±0.9L/min, p=0.002; 1.7±0.3 vs. 2.8±0.3L/min/m2, p=0.002; 14±5 vs. 9±3mmHg, p=0.059; and 30±7 vs. 10±3mmHg, p=0.002, respectively. The serum brain natriuretic peptide level had significantly decreased (1101 [517–1446] vs 74 [35–216] pg/mL, p=0.002). In all patients, CI had increased to over 2.2L/min/m2. The splenic volume significantly increased from pre- to post-LVAD implantation (172±48 vs. 233±78mL, p=0.002) (Figure). Furthermore, all patients were divided into two groups; elevated RAP group (n=4) and non-elevated RAP group (n=8) after LVAD support. In elevated RAP group, there were no significant changes in the spleen size between pre- and post-LVAD implantation (167±45 vs. 223±111mL, p=0.068). On the other hand, in non-elevated RAP group, the spleen volume had significantly increased from pre- to post-LVAD support (172±53 vs. 231±62mL, p=0.011). In addition, there was one patient whose hemodynamic state had changed to LO again because of LVAD failure due to pump thrombosis. In this case, the splenic volume was 212mL before LVAD implantation with LO, and increased to 418mL after LVAD implantation with non-LO, although decreased to 227mL after LVAD pump failure with LO again.
Splenic volume changes
Conclusions
The spleen may change its size in order to keep cardiac output by regulating cardiac preload depending on the systemic perfusion in advanced HF with LVAD.
Acknowledgement/Funding
None
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Affiliation(s)
- H Hiraiwa
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Okumura
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - A Sawamura
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - Y Arao
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Oishi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - H Kato
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kuwayama
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Yamaguchi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Haga
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Yokoi
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - K Fukaya
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - K Furusawa
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - R Morimoto
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
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Arao Y, Sawamura A, Nakatochi M, Oishi H, Kato H, Yamaguchi S, Haga T, Kuwayama T, Yokoi T, Hiraiwa H, Kondo T, Morimoto R, Okumura T, Murohara T. P1581Early blood pressure reduction by intravenous vasodilators associates with acute kidney injury in patients with hypertensive acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0341] [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
In patients with hypertensive acute decompensated heart failure (ADHF), intravenous vasodilators are commonly used. However, little is known about optimal use in blood pressure (BP) management to avoid acute kidney injury (AKI).
Purpose
To investigate the association between systolic BP (SBP) changes in first 6 h and incidence of AKI within 48 h in patients with hypertensive ADHF.
Methods
Post-hoc analysis was performed on a prospectively enrolled cohort. We investigated 245 patients with ADHF and SBP >140 mmHg on arrival (mean age, 76 years; 40% female). We defined “SBP-fall” as maximum percent reduction in SBP 6h after intravenous treatment. AKI was defined as serum creatinine (SCr) ≥0.3 mg/dL, or urine output <0.5 mL/kg/h at 48 h.
Results
Mean SBP, SBP-fall and SCr level at arrival were 180 mmHg, 29.4%, and 1.21 mg/dL, respectively. Sixty-six patients experienced AKI. There were no significant differences in age, NYHA functional class, SBP and SCr at admission between AKI and Non-AKI group. AKI group had the greater SBP-fall compared with Non-AKI (36.7%versus 27.2%, p≤0.0001). Logistic regression analyses revealed that SBP-fall had an independent predictor of AKI (Table). In addition, SBP-fall had positive association with the number of concomitant used intravenous vasodilators in first 6 h (Figure).
Logistic regression analyses for AKI Univariate Multivariate AUC OR 95% CI P OR 95% CI P Ages, years, per 10 years 1.04 0.82–1.33 0.17 0.75 SBP at arrival, per 10 mmHg 1.01 0.93–1.11 0.77 SBP-fall, per 10% 1.49 1.22–1.81 <0.001 1.54 1.24–1.91 <0.001 HR, per 10 beat/min 1.12 1.00–1.25 0.049 1.07 0.95–1.21 0.28 COPD 2.95 1.06–8.21 0.04 3.06 0.99–9.43 0.054 SCr, per 1 mg/dL 1.40 0.83–2.37 0.21 Furosemide i.v. 1.12 0.42–2.95 0.82 Carperitide 3.22 1.69–6.13 0.0002 4.39 2.16–8.93 <0.001 NTG/ISDN i.v. 0.97 0.54–1.74 0.92 CCB i.v. 1.86 0.76–4.53 0.18 OR, odds ratio; CI, confidence interval; AUC, area under the curve; SBP, systolic blood pressure; COPD, chronic obstructive pulmonary disease; SCr, serum creatinine; i.v., intravenous; NTG, nitroglycerin; ISDN, isosorbide dinitrate; CCB, calcium channel blocker.
SBP-fall odds ration for AKI
Conclusion
In the first 6h of management for hypertensive ADHF patients, aggressive SBP reduction by the combination use of vasodilator agents predicted the incidence of AKI.
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Affiliation(s)
- Y Arao
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - A Sawamura
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - M Nakatochi
- Nagoya University Hospital, Data Science Division, Data Coordinating Center, Advanced Medicine, Nagoya, Japan
| | - H Oishi
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - H Kato
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - S Yamaguchi
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Haga
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Kuwayama
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Yokoi
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - H Hiraiwa
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Kondo
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - R Morimoto
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Okumura
- Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Aichi, Japan
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7
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Affiliation(s)
- Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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8
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Haga T, Ito K, Sakashita K, Iguchi M, Ono M, Tatsumi K. Risk factors for pneumonia in patients with schizophrenia. Neuropsychopharmacol Rep 2018; 38:204-209. [PMID: 30353691 PMCID: PMC7292272 DOI: 10.1002/npr2.12034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 06/18/2018] [Revised: 09/03/2018] [Accepted: 09/06/2018] [Indexed: 11/10/2022] Open
Abstract
AIM Pneumonia is a major cause of death in patients with schizophrenia. Preventive strategies based on identifying the risk factors are needed to reduce pneumonia-related mortality. This study aimed to clarify the risk factors for pneumonia in patients with schizophrenia. METHODS We retrospectively reviewed the clinical files of consecutive patients with schizophrenia admitted to Tokyo Metropolitan Matsuzawa Hospital during a four-year period from January 2014 to December 2017. We analyzed the clinical differences between patients with and without pneumonia. RESULTS Of the 2209 patients enrolled, 101 (4.6%) received the diagnosis of pneumonia at the time of hospital admission while 2108 (95.4%) did not have pneumonia. Multivariable analysis to determine the risk factors related to pneumonia showed that the use of atypical antipsychotics had the highest odds ratio among the predictive factors (2.7; 95% confidence interval [CI] 1.0-17.7; P = 0.046), followed by a total chlorpromazine equivalent dose ≥600 mg (2.6; 95% CI 1.7-4.0; P < 0.001), body mass index <18.5 kg/m2 (2.3; 95% CI 1.6-3.6; P < 0.001), smoking history (2.0; 95% CI 1.3-3.1; P < 0.001), and age ≥50 years (1.7; 95% CI 1.2-2.6; P = 0.002). CONCLUSIONS We found that advanced age, underweight, smoking habit, use of atypical antipsychotics, and large doses of antipsychotics were risk factors for pneumonia in patients with schizophrenia. Among these factors, it was unclear whether the use of antipsychotics was a direct cause of pneumonia due to is uncertain because our retrospective study design. However, our result might be a good basis of further study focused on reducing pneumonia-related fatalities in schizophrenic patients with pneumonia.
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Affiliation(s)
- Takahiro Haga
- Department of Psychiatry, Kanto Rosai Hospital, Kawasaki, Japan.,Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kae Ito
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Kentaro Sakashita
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Mari Iguchi
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Masahiro Ono
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Abstract
Objectives Pneumonia is a major cause of death among inpatients at psychiatric hospitals. Psychiatric hospital-acquired pneumonia (PHAP) is defined as pneumonia developed in inpatients at psychiatric hospitals. PHAP is a type of nursing and healthcare-associated pneumonia (NHCAP). The purpose of this study was to clarify the risk factors for mortality among PHAP patients. Methods We retrospectively reviewed the clinical files of patients transferred to Tokyo Metropolitan Matsuzawa Hospital from psychiatric hospitals for PHAP treatment during the 10-year period from September 2007 to August 2017. We analyzed the clinical differences between the survivors and non-survivors and assessed the usefulness of severity classifications (A-DROP, I-ROAD, and PSI) in predicting the prognosis of PHAP. Results This study included a total of 409 PHAP patients, 87 (21.3%) of whom expired and 322 (78.7%) of whom survived. The mortality rates, according to the A-DROP classifications, were 4.9% in the mild cases, 21.6% in the moderate cases, 40.7% in the severe cases, and 47.6% in the very severe cases. The mortality rates, according to the I-ROAD classifications, were 9.5% in group A, 34.7% in group B, and 36.2% in group C. The mortality rates, according to the PSI classifications, were 0% in class II and III, 23.1% in class IV, and 44.9% in class V. The mortality rate increased as the severity increased. We identified 3 factors (age ≥65 years, body mass index ≤18.5 kg/m2, and bilateral pneumonic infiltration) as significant predictors of mortality. We therefore added two factors (body mass index ≤18.5 kg/m2 and bilateral pneumonic infiltration) to the A-DROP classification and established a modified A-DROP classification with a range of 0 to 7. The area under the receiver operation characteristic curves for predicting mortality were 0.699 for the A-DROP classification and 0.807 for the modified A-DROP classification. Conclusion The mortality rate in PHAP patients tended to increase with increasing classifications of severity. The modified A-DROP classification may be useful for predicting the prognosis of PHAP patients.
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Affiliation(s)
- Takahiro Haga
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
| | - Kae Ito
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Japan
| | - Kentaro Sakashita
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Japan
| | - Mari Iguchi
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Japan
| | - Masahiro Ono
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Japan
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10
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Yokoi T, Morimoto R, Okumura T, Yamaguchi S, Kuwayama T, Hiraiwa H, Haga T, Kondo T, Sugiura Y, Watanabe N, Kano N, Sawamura A, Murohara T. P6514Tau as a predictor of cardiac events in cardiomyopathy with systolic and/or diastolic dysfunction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6514] [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)
- T Yokoi
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - R Morimoto
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - T Okumura
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - S Yamaguchi
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - T Kuwayama
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - H Hiraiwa
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - T Haga
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - T Kondo
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - Y Sugiura
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - N Watanabe
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - N Kano
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - A Sawamura
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya City, Japan
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11
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Haga T, Ito K, Ono M, Maruyama J, Iguchi M, Suzuki H, Hayashi E, Sakashita K, Nagao T, Ikemoto S, Okaniwa A, Kitami M, Inuo E, Tatsumi K. Underweight and hypoalbuminemia as risk indicators for mortality among psychiatric patients with medical comorbidities. Psychiatry Clin Neurosci 2017; 71:807-812. [PMID: 28715136 DOI: 10.1111/pcn.12553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/12/2017] [Accepted: 07/11/2017] [Indexed: 01/19/2023]
Abstract
AIM Medical comorbidities are a major cause of death among patients with mental illness. The purpose of this study was to clarify the risk factors for mortality among psychiatric patients with medical comorbidities. METHODS We retrospectively reviewed the clinical files of patients transferred to Tokyo Metropolitan Matsuzawa Hospital from a psychiatric hospital to treat medical comorbidities during the 3-year period from January 2014 to December 2016. We analyzed the clinical differences between the expired and alive patients. RESULTS Of the 287 patients included, 29 (10.1%) had expired at the time of hospital discharge, while 258 (89.9%) were living. A multivariable analysis to determine the prognostic factors related to mortality from medical comorbidities showed that body mass index <18.5 had the highest odds ratio among the predictive factors (5.1; 95% confidence interval, 1.5-17.1; P < 0.05), followed by a serum albumin level < 3.0 mg/dL (3.0; 95% confidence interval, 1.1-8.1; P < 0.05). CONCLUSION We found that underweight and hypoalbuminemia were risk factors for mortality among psychiatric patients with medical comorbidities. Physicians at psychiatric hospitals should consider transferring patients with medical comorbidities to a general medical hospital in the presence of underweight and/or hypoalbuminemia.
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Affiliation(s)
- Takahiro Haga
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.,Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kae Ito
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Masahiro Ono
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Jiro Maruyama
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Mari Iguchi
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Hitoe Suzuki
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Eiji Hayashi
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Kentaro Sakashita
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Tomoko Nagao
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Shohei Ikemoto
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Asuka Okaniwa
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Makiko Kitami
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Eriko Inuo
- Department of Internal Medicine, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Koichiro Tatsumi
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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12
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Ebana H, Mizobuchi T, Kurihara M, Kobayashi E, Haga T, Okamoto S, Takahashi K, Seyama K. Novel clinical scoring system to identify patients with pneumothorax with suspicion for Birt-Hogg-Dubé syndrome. Respirology 2017; 23:414-418. [PMID: 28960698 DOI: 10.1111/resp.13191] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/09/2017] [Accepted: 08/13/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Birt-Hogg-Dubé syndrome (BHDS) is a rare hereditary disease that presents with multiple lung cysts and pneumothorax (PTX). Although some reports propose that findings from chest computed tomography enable one to distinguish BHDS from primary spontaneous pneumothorax (PSP), it is still unclear whether clinical features are useful for identifying patients with suspicion of BHDS from those with PTX. METHODS We retrospectively reviewed the medical records of patients with PTX who underwent video-assisted thoracoscopic surgery at Nissan Tamagawa Hospital from January 2012 to December 2015. RESULTS We identified a total of 1141 patients with PTX, including 54 with BHDS and 517 with PSP. Among them, logistic regression analysis segregated five features that were significantly associated with BHDS: familial history of PTX, past history of bilateral PTX, age at the first episode of PTX (≥25 years old (y.o.)), body mass index (≥18.5) and gender (female). We assigned scores of 3, 3, 2, 2 and 1 to the five features, respectively, to establish a system with a calculated score from 0 to 11. The cut-off value of a calculated score ≥ 4 yielded the highest sensitivity of 93% and specificity of 86%. Receiver operating characteristic (ROC) analysis showed the area under the curve reflecting an accuracy of this diagnostic test as 0.953. CONCLUSION BHDS has several clinical features distinct from PSP. Our scoring system consists of only five clinical variables that are easily evaluated and efficiently separate BHDS patients from those who have PTX without relying on an imaging study. Further prospective study is needed to confirm our findings.
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Affiliation(s)
- Hiroki Ebana
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.,Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Teruaki Mizobuchi
- Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Masatoshi Kurihara
- Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Etsuko Kobayashi
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Takahiro Haga
- The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Shoichi Okamoto
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
| | - Kazuhisa Takahashi
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Kuniaki Seyama
- Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.,The Study Group for Pneumothorax and Cystic Lung Diseases, Tokyo, Japan
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13
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Fujimura T, Takahashi K, Kambayashi Y, Furudate S, Hidaka T, Kakizaki A, Watabe A, Haga T, Hashimoto A, Aiba S. Retrospective Investigation of Cutaneous Squamous Cell Carcinoma on the Lip Treated with Peplomycin Administered Through a Superficial Temporal Artery. Anticancer Res 2017; 37:1885-1889. [PMID: 28373456 DOI: 10.21873/anticanres.11526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Continuous intra-arterial (IA) administration of peplomycin (PEP) through a tumor-feeding artery is one of the most effective treatments for cutaneous squamous cell carcinoma (cSCC) in cosmetic areas. PATIENTS AND METHODS In order to determine the effective and safe dose of PEP and the curative rate of IA-PEP, we retrospectively investigated a case series of 24 patients with cSCC on the lips who were treated with IA-PEP. RESULTS IA-PEP reduced the tumor mass in all 24 cases (100%). A complete response occurred in 17 patients (70.8%), and a partial response occurred in seven (29.2%). Moreover, 17 patients (70.8%) were cured, three patients developed cervical lymph node metastasis (12.5%), and four developed local recurrence (16.7%). Three out of the 24 patients developed interstitial pneumonia (12.5%). CONCLUSION Low-dose IA-PEP administered through a superficial temporal artery was a highly effective treatment that achieved a curative response for 70.8% of patients with cSCC on the lips.
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Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aya Kakizaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Watabe
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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14
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Fujimura T, Hidaka T, Kambayashi Y, Furudate S, Kakizaki A, Tono H, Tsukada A, Haga T, Hashimoto A, Morimoto R, Yamaguchi T, Takano T, Aiba S. Phase I study of nivolumab combined with IFN-β for patients with advanced melanoma. Oncotarget 2017; 8:71181-71187. [PMID: 29050354 PMCID: PMC5642629 DOI: 10.18632/oncotarget.17090] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/21/2017] [Indexed: 01/10/2023] Open
Abstract
The efficacy of nivolumab is greater than that of other anti-melanoma drugs, so nivolumab-based combined therapies that enhance anti-tumor immune responses in patients with metastatic melanoma are of great interest to dermato-oncologists. As we have previously reported, IFN-β enhances the anti-tumor immune response of anti-PD-1 antibodies against B16F10 melanoma in vivo. To explore the potential of this property of IFN-β as part of a combination therapy for the treatment of metastatic melanoma patients, we performed a phase 1 trial, using a traditional rule-based 3 + 3 design, on patients with advanced melanoma. The nivolumab dose was fixed at 2 mg/kg, every 3 weeks. IFN-β was administered to three groups at doses of 1 million, 2 million, and 3 million units, respectively. Dose-limiting toxicities were defined as any grade 3-5 adverse events occurring between day 0 and day 42 that might possibly be related to nivolumab and IFN-β. Of the nine patients who received this combined therapy, none experienced dose-limiting toxicities, and all completed the treatment phase of the study. Patient follow-up continued for 6 months following the final treatment. There were two complete responses (22%) and one partial response (11%), all of which occurred in patients who had received monthly IFN-β immediately prior to the study. In this study, we determined the safe dose of IFN-β, when combined with nivolumab, to be 3 million units. To determine the efficacy of this combination therapy, further phase II trials are required.
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Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aya Kakizaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hisayuki Tono
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Tsukada
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryo Morimoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University Hospital, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tadao Takano
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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15
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Chikaraishi H, Inoue T, Takami T, Aoyama K, Haga T. DC Power Supplies for LHD Superconducting Magnets and Their Enhancement for Dynamic Control of the Magnetic Field. Fusion Science and Technology 2017. [DOI: 10.13182/fst10-a10846] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- H. Chikaraishi
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - T. Inoue
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - T. Takami
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Aoyama
- Aichi Electric Co., Ltd., Kasugai 486-8666, Japan
| | - T. Haga
- Asort Co., Ltd., Akashi 673-011, Japan
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16
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Sato Y, Fujimura T, Kambayashi Y, Tsukada A, Hidaka T, Tanita K, Haga T, Hashimoto A, Aiba S. Recurrent Multiple Squamous Cell Carcinomas on the Scalp in a Patient with Juvenile Dermatomyositis. Case Rep Oncol 2017; 10:106-111. [PMID: 28203172 PMCID: PMC5301118 DOI: 10.1159/000456001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 01/11/2017] [Indexed: 12/04/2022] Open
Abstract
Both long-term administration of immunosuppressive agents and chronic inflammatory conditions, such as autoimmune disease, could be risk factors for the development of cutaneous squamous cell carcinoma (cSCC). In this report, we present a case of recurrent multiple cSCC on the scalp in a patient with juvenile dermatomyositis who had been administered cyclosporine and Predonine since she was a 1-year-old infant. Interestingly, immunohistochemical staining revealed IL-17-producing cells adjacent to IL-17R-expressing atypical keratinocytes. Our present case suggested that IL-17/IL-17R signaling might contribute to the carcinogenesis of cSCC.
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Affiliation(s)
- Yota Sato
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Tsukada
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kayo Tanita
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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17
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Furudate S, Fujimura T, Tsukada A, Sato Y, Hidaka T, Tanita K, Kambayashi Y, Haga T, Hashimoto A, Aiba S. Successful Treatment of Advanced Primary Cutaneous Apocrine Carcinoma on the Scrotum with Systemic Chemotherapy and Radiotherapy Followed by Denosumab. Case Rep Oncol 2017; 10:52-56. [PMID: 28203164 PMCID: PMC5301092 DOI: 10.1159/000455091] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 11/19/2022] Open
Abstract
Primary cutaneous apocrine carcinoma (PCAC) is a rare and highly aggressive cutaneous adnexal type of tumor that has a high metastasis rate and a poor prognosis. Although there are several case reports describing the successful treatment of PCAC with chemoradiotherapy or molecular targeting therapy, no standard therapy for the treatment of advanced PCAC has been established yet. Since receptor activator of nuclear factor kappa-B ligand (RANKL) is expressed in cancers of apocrine origin, leading to immunosuppression at the tumor site, we hypothesized that targeting RANKL with denosumab might be useful for the treatment of PCAC. In this report, we describe a case with advanced PCAC on the scrotum successfully treated with systemic chemotherapy using carboplatin and paclitaxel, and radiotherapy followed by denosumab.
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Affiliation(s)
- Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Tsukada
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yota Sato
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kayo Tanita
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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18
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Fujimura T, Furudate S, Kambayashi Y, Kakizaki A, Haga T, Hashimoto A, Aiba S. Multiple metastasized extramammary Paget's disease cured with bisphosphonate risedronate sodium after CyberKnife radiosurgery and docetaxel chemotherapy. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
We evaluated the brain lesions of patients with chronic alcoholism (n = 34) in comparison with age- and sex-matched controls (n = 40) by MR imaging. T1-weighted sagittal and axial images and T2-weighted axial images were obtained with a 0.5 T superconducting MR unit. Various brain measurements were then performed, and the presence of regions of abnormal signal intensity was also compared between the two groups. The brain measurements revealed significant cerebral atrophy (characterized by lateral and 3rd ventricular dilatation, and widening of the interhemispheric fissure) as well as significant cerebellar atrophy (represented by 4th ventricular dilatation) in the alcoholic group. These changes were more prominent in patients in their fifties and sixties than in those aged in the thirties and forties. Focal hypointense lesions were observed in 20.6% of the alcoholics and in 5% of the controls (p < 0.01), while focal hyperintense lesions were observed in 61.8% of the alcoholics and in 20% of the controls (p < 0.001). The severity of these MR findings correlated well with the age of the patients. These observations suggest that alcohol is an important promotor of brain aging.
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20
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Fujimura T, Kambayashi Y, Furudate S, Kakizaki A, Hidaka T, Haga T, Hashimoto A, Morimoto R, Aiba S. Isolated adrenocorticotropic hormone deficiency possibly caused by nivolumab in a metastatic melanoma patient. J Dermatol 2016; 44:e13-e14. [PMID: 27440178 DOI: 10.1111/1346-8138.13532] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aya Kakizaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takanori Hidaka
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryo Morimoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University Hospital, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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21
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Azmahani A, Nakamura Y, Ishida H, McNamara KM, Fujimura T, Haga T, Hashimoto A, Aiba S, Sasano H. Estrogen receptor β in Merkel cell carcinoma: its possible roles in pathogenesis. Hum Pathol 2016; 56:128-33. [PMID: 27343835 DOI: 10.1016/j.humpath.2016.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/30/2016] [Accepted: 06/11/2016] [Indexed: 12/27/2022]
Abstract
Sex steroids have been postulated to influence skin development and functions as well as its pathogenesis. MCC occurs in both sexes; however, the specific differences in pathogenesis among sexes have yet to be conclusively defined. The detailed status of sex steroid receptors (AR, PRA and PRB, and ERα, ERβ) are also unknown in MCC patients. We first immunolocalized sex steroid receptors and compared the results with immunolocalization of relevant transcription factors including SOX2, FOXA1, and Bcl-2 and Ki-67 in 18 cases of MCCs. AR, PRA, PRB, ERα, ERβ, Bcl-2, SOX2, and FOXA1 immunoreactivity was evaluated by using the modified H score method, and Ki-67 was quantified using labeling index. ERβ immunoreactivity was markedly present in all the cases of MCC examined, with relatively weak immunoreactivity of ERα, AR, PRA, and PRB. The status of ERβ immunoreactivity was also significantly correlated with Ki-67 labeling index and Bcl-2 score. These results demonstrated that ERβ could be associated with regulation of both cell proliferation and apoptosis in MCCs.
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Affiliation(s)
- Abdullah Azmahani
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; Faculty of Health Sciences, University Sultan Zainal Abidin, 21300 Kuala Terengganu, Terengganu, Malaysia
| | - Yasuhiro Nakamura
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan.
| | - Hirotaka Ishida
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Keely M McNamara
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
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22
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Shipway JR, O’Connor R, Stein D, Cragg SM, Korshunova T, Martynov A, Haga T, Distel DL. Zachsia zenkewitschi (Teredinidae), a Rare and Unusual Seagrass Boring Bivalve Revisited and Redescribed. PLoS One 2016; 11:e0155269. [PMID: 27171209 PMCID: PMC4865151 DOI: 10.1371/journal.pone.0155269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/26/2016] [Indexed: 11/19/2022] Open
Abstract
The sea-grass borer Zachsia zenkewitschi belongs to a group of economically and ecologically important bivalves, commonly referred to as shipworms. The sole recognized representative of the genus Zachsia, this species displays an unusual life history and reproductive strategy that is now understood to include: environmental sex determination of free swimming larvae, extreme sexual and size dimorphism between males and females, internal fertilization, maintenance of often large harems of male dwarfs within a specialized cavity of the female mantle, and complex maternal care of larvae in specialized brood pouches within the gill. It is also the only shipworm species known to burrow in sea grass rhizomes rather than terrestrial wood. Although Z. zenkewitschi is rare and little studied, understanding of its biology and anatomy has evolved substantially, rendering some aspects of its original description inaccurate. Moreover, no existing type specimens are known for this species. In light of these facts, we designate a neotype from among specimens recently collected at the type location, and undertake a re-description of this species, accounting for recent reinterpretation of its life history and functional anatomy.
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Affiliation(s)
- J. R. Shipway
- Ocean Genome Legacy, Marine Science Center, Northeastern University, Nahant, Massachusetts, United States of America
| | - R. O’Connor
- Tufts Medical Centre, Boston, Massachusetts, United States of America
| | - D. Stein
- Ocean Genome Legacy, Marine Science Center, Northeastern University, Nahant, Massachusetts, United States of America
| | - S. M. Cragg
- The Institute of Marine Sciences, School of Biological Sciences, University of Portsmouth, Portsmouth, P04 9LY, United Kingdom
| | - T. Korshunova
- Koltzov Institute of Developmental Biology RAS, 26 Vavilov St, Moscow, 119334, Russia
| | - A. Martynov
- Zoological Museum, Moscow State University, Bolshaya Nikitskaya St. 6, Moscow, 125009, Russia
| | - T. Haga
- Toyohashi Museum of Natural History, 1–238 Ôana, Ôiwa-chô, Toyohashi, Aichi, 441–3147, Japan
| | - D. L. Distel
- Ocean Genome Legacy, Marine Science Center, Northeastern University, Nahant, Massachusetts, United States of America
- * E-mail:
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Haga T, Cho K, Nakagawa A, Takagiwa J, Arakawa S, Sakamoto Y, Kichikawa Y, Nakamori Y, Tatsumi K. Complications of Fiberoptic Bronchoscopy in Very Elderly Adults. J Am Geriatr Soc 2016; 64:676-7. [DOI: 10.1111/jgs.13999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Takahiro Haga
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Kohei Cho
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
| | - Atsushi Nakagawa
- Division of Respiratory Medicine; Tokyo Kyosai Hospital; Tokyo Japan
| | - Jun Takagiwa
- Division of Respiratory Medicine; Tokyo Kyosai Hospital; Tokyo Japan
| | - Sayaka Arakawa
- Division of Respiratory Medicine; Kanto Central Hospital; Tokyo Japan
| | - Yoshio Sakamoto
- Division of Respiratory Medicine; Kanto Central Hospital; Tokyo Japan
| | | | | | - Koichiro Tatsumi
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
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Abstract
OBJECTIVE We herein assessed the utility of computed tomography (CT) for the diagnosis and ascertainment of the severity of community-acquired pneumonia (CAP) in the elderly. METHODS The utility of CT compared with chest radiography (CR) for the diagnosis of CAP was prospectively studied among elderly inpatients with clinical symptoms and signs indicative of CAP at the Department of Respiratory Medicine in Nissan Tamagawa Hospital during the one-year period from January 2013 to December 2013. Additionally, we evaluated whether the findings of CT were useful as predictive factors related to the mortality rate associated with CAP. RESULTS One hundred and forty-two patients, 65 years of age or older, were surveyed upon hospital admission for suspected CAP. Of the 142 patients included, 127 (89.4%) had pneumonic infiltration diagnosed by CT, however, CR could not recognize pneumonic infiltration in 9.4% (12/127) of these patients. In 127 CAP-positive patients, bilateral pneumonic infiltration was more frequently detected by CT in non-survivors than survivors (79.0% vs. 53.7%; p <0.05). By a multivariable analysis to determine the prognostic factors related to mortality from CAP, oxygen desaturation showed the greatest odds ratio among the other predictive factors, followed by comorbid neoplastic disease, blood urea nitrogen ≥21 mg/dL, male gender, and bilateral pneumonic infiltration diagnosed by CT. CONCLUSION We herein demonstrated that CT was superior to CR for diagnosing and evaluating the severity of CAP in elderly patients.
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Affiliation(s)
- Takahiro Haga
- Division of Respiratory Medicine, Nissan Tamagawa Hospital, Japan
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Fujimura T, Furudate S, Kakizaki A, Kambayashi Y, Haga T, Hashimoto A, Aiba S. Contact immunotherapy enhances the therapeutic effects of nivolumab in treating in-transit melanoma: Two cases reports. J Dermatol 2015; 43:686-9. [PMID: 26663262 DOI: 10.1111/1346-8138.13229] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022]
Abstract
Because nivolumab significantly prolongs survival in patients with metastatic melanoma, enhancing its antitumor immune response is of great interest to dermato-oncologists. In this report, we describe two cases of metastatic melanoma successfully treated with nivolumab in combination with contact immunotherapy, using contact sensitizing agents, such as squaric acid dibutylester and diphencyprone. In addition, immunohistochemical staining supported one of the possible mechanisms of this combination therapy. Our present cases suggested a possible therapy for metastatic melanoma using nivolumab in combination with contact immunotherapy.
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Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aya Kakizaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Haga T, Fukuoka M, Morita M, Cho K, Tatsumi K. Radiographic evaluation of nursing- and healthcare-associated pneumonia. Geriatr Gerontol Int 2015; 17:41-47. [DOI: 10.1111/ggi.12669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Takahiro Haga
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Mizuki Fukuoka
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Mizuo Morita
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
| | - Kohei Cho
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
| | - Koichiro Tatsumi
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
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Iwama E, Fujimura T, Kusakari Y, Haga T, Aiba S. Multifocal BRAF(V600E)-Mutated Melanoma in situ on the Foot. Case Rep Dermatol 2015; 7:322-7. [PMID: 26594172 PMCID: PMC4650989 DOI: 10.1159/000441601] [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] [Indexed: 11/19/2022] Open
Abstract
Melanoma is an aggressive skin cancer that originates from melanocytes, and about one half of melanoma cases possess a BRAF mutation. Together with PD-L1 expression, the BRAF(V600E) mutation is one of the optimal therapeutic targets for the treatment of melanoma. In this report, we describe a case of multifocal melanoma in situ on the foot, which carried the p.V600E mutation in the BRAF gene. Interestingly, the spotted melanoma lesion is demarcated by normal skin, and in all spotted pigmented lesions, there were no signs of dermal invasion of melanoma cells or spontaneous regression. Our case presented atypical clinical features, which might correlate with the local mutations of BRAF gene and the immunological expression of PD-L1.
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Affiliation(s)
- Eimei Iwama
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Kusakari
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Azmahani A, Nakamura Y, Ozawa Y, McNamara KM, Fujimura T, Haga T, Hashimoto A, Aiba S, Sasano H. Androgen receptor, androgen-producing enzymes and their transcription factors in extramammary Paget disease. Hum Pathol 2015; 46:1662-9. [DOI: 10.1016/j.humpath.2015.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/06/2015] [Accepted: 07/10/2015] [Indexed: 11/16/2022]
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Iwama E, Fujimura T, Hashimoto A, Numata Y, Haga T, Aiba S. Successful control of recurrent angiosarcoma in the external auditory canal with CyberKnife radiosurgery and bisphosphonate risedronate sodium. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2014.12.003] [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: 10/24/2022] Open
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Fukuoka M, Kurihara M, Haga T, Ebana H, Kataoka H, Mizobuchi T, Tatsumi K. Clinical characteristics of catamenial and non-catamenial thoracic endometriosis-related pneumothorax. Respirology 2015; 20:1272-6. [DOI: 10.1111/resp.12610] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/20/2015] [Accepted: 06/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Mizuki Fukuoka
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chuo-ku Chiba Japan
| | - Masatoshi Kurihara
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
| | - Takahiro Haga
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chuo-ku Chiba Japan
| | - Hiroki Ebana
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
| | - Hideyuki Kataoka
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
| | - Teruaki Mizobuchi
- Pneumothorax Research Center and Division of Thoracic Surgery; Nissan Tamagawa Hospital; Tokyo Japan
| | - Koichiro Tatsumi
- Department of Respirology; Graduate School of Medicine; Chiba University; Chuo-ku Chiba Japan
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Fujimura T, Kambayashi Y, Furudate S, Kakizaki A, Haga T, Hashimoto A, Aiba S. Immunomodulatory effects of peplomycin on immunosuppressive and cytotoxic cells in the lesional skin of cutaneous squamous cell carcinoma. Dermatology 2015; 230:250-5. [PMID: 25678188 DOI: 10.1159/000369166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 10/03/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Continuous intra-arterial administration of peplomycin (PEP) through a tumor-feeding artery using an intravascular indwelling catheter is one of the best treatments for cutaneous squamous cell carcinoma (SCC) on cosmetic areas. Although this reagent is useful for the treatment of SCC, its immunomodulatory effect on the tumor microenvironment is still unknown. OBJECTIVE/METHODS In this study, we investigated the immunomodulatory effects of PEP on the tumor-infiltrating regulatory T cells and tumor-associated macrophages as well as CD8(+)TIA-1(+) cytotoxic T cells in the lesional skin of 5 patients with SCC on the lips. RESULTS Our data suggest that, in addition to the direct antitumor effects, PEP decreased immunosuppressive cells and increased cytotoxic T lymphocytes at the tumor sites, which might maintain antitumor immune response against SCC.
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Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tono H, Fujimura T, Iwama E, Kusakari Y, Furudate S, Kambayashi Y, Haga T, Hashimoto A, Aiba S. Merkel Cell Carcinoma Concomitant with Invasive Bowen's Disease: Immunohistochemical Investigation of Tumor-Infiltrating Leukocytes. Case Rep Dermatol 2015; 7:1-6. [PMID: 25759650 PMCID: PMC4327548 DOI: 10.1159/000371732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Merkel cell carcinoma (MCC) is an aggressive, cutaneous, neuroendocrine carcinoma and, in rare cases, occurs with Bowen's disease (BD). In this report, we describe a case of MCC concurrent with invasive BD and compare the profiles of tumor-infiltrating leukocytes in the lesional skin of MCC and invasive BD. Interestingly, immunohistochemical study revealed significant numbers of CD8+ cells and caspase 3-expressing cells in the same areas of invasive BD and MCC. Our present case suggests that MCC concurrent with invasive BD might have a good prognosis because of the substantial number of CD8+ cells in the tumor.
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Affiliation(s)
- Hisayuki Tono
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eimei Iwama
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Kusakari
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Kuwabara K, Higuchi Y, Ogasawara T, Koizumi H, Haga T. Wearable blood flowmeter appcessory with low-power laser Doppler signal processing for daily-life healthcare monitoring. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:6274-7. [PMID: 25571431 DOI: 10.1109/embc.2014.6945063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A new appcessory for monitoring peripheral blood flow in daily life consists of a wearable laser Doppler sensor device and a cooperating smart phone application. Bluetooth Low Energy connects them wirelessly. The sensor device features ultralight weight of 15 g and an intermittent signal processing technique that reduces power consumption to only 7 mW at measurement intervals of 0.1 s. These features enable more than 24-h continuous monitoring of peripheral blood flow in daily life, which can provide valuable vital-sign information for healthcare services.
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Haga T, Fujimura T, Takeuchi I, Deguchi M, Aiba S. Successful Treatment of Two Cases of Squamous Cell Carcinoma on the Ear with Intra-Arterial Administration of Peplomycin through a Superficial Temporal Artery. Case Rep Dermatol 2014; 6:207-12. [PMID: 25408647 PMCID: PMC4209265 DOI: 10.1159/000367804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cutaneous squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer and tends to develop in sun-exposed cosmetic areas, including the ear. In this report, we describe two cases of SCC on the ear successfully treated with intra-arterial administration of peplomycin through a superficial temporal artery. In addition to this selective chemotherapy, we administered oral tegafur, which achieved complete remission of the tumor. These findings suggest that intra-arterial administration of peplomycin with tegafur is one of the optimal therapies for the treatment of SCC developing on the ear.
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Affiliation(s)
- Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Izuho Takeuchi
- Department of Dermatology, Kurihara Central Hospital, Kurihara, Japan
| | - Masatoshi Deguchi
- Department of Dermatology, Kurihara Central Hospital, Kurihara, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Haga T, Fukuoka M, Morita M, Cho K, Tatsumi K. Indications and Complications Associated with FiberOptic Bronchoscopy in Very Elderly Adults. J Am Geriatr Soc 2014; 62:1803-5. [DOI: 10.1111/jgs.12996] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Takahiro Haga
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Mizuki Fukuoka
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Mizuo Morita
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
| | - Kohei Cho
- Division of Respiratory Medicine; Nissan Tamagawa Hospital; Tokyo Japan
| | - Koichiro Tatsumi
- Department of Respirology; Graduate School of Medicine; Chiba University; Chiba Japan
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Furudate S, Fujimura T, Kambayashi Y, Kawano M, Ogasawara K, Tsukada A, Tamabuchi E, Haga T, Hashimoto A, Aiba S. Successful treatment of adult onset Langerhans cell histiocytosis with bi-weekly administration of pegylated interferon-α. Acta Derm Venereol 2014; 94:611-2. [PMID: 24514957 DOI: 10.2340/00015555-1807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan
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Fujimura T, Hashimoto A, Furudate S, Kambayashi Y, Haga T, Aiba S. Successful Treatment of Eccrine Porocarcinoma Metastasized to a Cervical Lymph Node with CyberKnife Radiosurgery. Case Rep Dermatol 2014; 6:159-63. [PMID: 25076888 PMCID: PMC4105948 DOI: 10.1159/000365348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Eccrine porocarcinoma is a rare type of skin cancer that originates from eccrine sweat glands or acrosyringium and mainly occurs in the elderly. In this report, we describe an 85-year-old Japanese woman with eccrine porocarcinoma that metastasized to a cervical lymph node who was cured with CyberKnife radiosurgery. Because our patient had a high risk of perioperative complication, standard surgical therapy with a wide margin was impractical. Our present study suggests the novel possibility of using CyberKnife for the treatment of inoperable metastatic porocarcinoma.
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Affiliation(s)
- Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Abstract
Hidroacanthoma simplex (HAS), also known as intraepidermal eccrine poroma, is a rare eccrine adnexal tumor that tends to be misdiagnosed as other types of benign skin tumor, including clonal seborrheic keratosis. Notably, HAS is sometimes misdiagnosed and treated by cryosurgery as seborrheic keratosis, which could trigger the later development of porocarcinoma. Therefore, accurate diagnosis of HAS is indispensable for dermatologists to avoid the development of malignant tumors by an unsuitable treatment. In this report, we present the characteristic dermoscopy findings of HAS. Indeed, the dermoscopy findings might be related to the melanin-rich necrotic cells in the epidermis, which are quite different from dermoscopy findings of clonal seborrheic keratosis. As a previous report suggested, it is difficult for a dermatologist to differentiate HAS from clonal seborrheic keratosis by the naked eye. Our findings might be supportive for the early diagnosis of HAS.
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Affiliation(s)
- Yota Sato
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Taku Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Erika Tamabuchi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takahiro Haga
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Haga T, Kataoka H, Ebana H, Otsuji M, Seyama K, Tatsumi K, Kurihara M. Thoracic endometriosis-related pneumothorax distinguished from primary spontaneous pneumothorax in females. Lung 2014; 192:583-7. [PMID: 24831784 DOI: 10.1007/s00408-014-9598-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/26/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Thoracic endometriosis-related pneumothorax (TERP) is a secondary condition specific for females, but in a clinical setting, TERP often is difficult to distinguish from primary spontaneous pneumothorax (PSP) based on a relationship between the dates of pneumothorax and menstruation. The purpose of this study was to clarify the clinical features of TERP compared with PSP. METHODS We retrospectively reviewed the clinical and histopathological files of female patients with pneumothorax who underwent video-assisted thoracoscopic surgery in the Pneumothorax Research Center during the 6-year period from January 2005 to December 2010. We analyzed the clinical differences between TERP and PSP. RESULTS The study included a total of 393 female patients with spontaneous pneumothorax, of whom 92 (23.4 %) were diagnosed as having TERP and 33.6 % (132/393) as having PSP. We identified four factors (right-sided pneumothorax, history of pelvic endometriosis, age ≥31 years, and no smoking history) that were statistically significant for predicting TERP and assigned 6, 5, 4, and 3 points, respectively, to establish a scoring system with a calculated score from 0 to 18. The cutoff values of a calculated score ≥12 yielded the highest positive predictive value (86 %; 95 % confidence interval (CI) 81.5-90.5 %) for TERP and negative predictive value (95.2 %; 95 % CI 92.3-98 %) for PSP. CONCLUSIONS TERP has several distinct clinical features from PSP. Our scoring system consists of only four clinical variables that are easily obtainable and enables us to suspect TERP in female patients with pneumothorax.
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Affiliation(s)
- Takahiro Haga
- Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan
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Furudate S, Fujimura T, Kambayashi Y, Haga T, Hashimoto A, Aiba S. Immunosuppressive and cytotoxic cells in invasive vs. non-invasive Bowen's disease. Acta Derm Venereol 2014; 94:337-9. [PMID: 24158393 DOI: 10.2340/00015555-1729] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sadanori Furudate
- Department of Dermatology, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan
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Hagiwara A, Fujimura T, Furudate S, Kambayashi Y, Numata Y, Haga T, Aiba S. Generalized granulomatous dermatitis accompanied by myelodysplastic syndrome. Acta Derm Venereol 2014; 94:223-4. [PMID: 23817627 DOI: 10.2340/00015555-1656] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Akiko Hagiwara
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Kondo Y, Iwata T, Haga T, Kimura O, Ninomiya M, Kakazu E, Kogure T, Morosawa T, Aiba S, Shimosegawa T. Eradication of hepatitis C virus could improve immunological status and pyoderma gangrenosum-like lesions. Hepatol Res 2014; 44:238-45. [PMID: 23551965 DOI: 10.1111/hepr.12102] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 02/12/2013] [Accepted: 02/21/2013] [Indexed: 12/19/2022]
Abstract
Hepatitis C virus (HCV) can affect immune cells and induce various kinds of immune-related diseases including pyoderma gangrenosum. We experienced a difficult-to-treat case of pyoderma gangrenosum-like lesions in a patient with HCV infection. The patient was treated with pegylated interferon (PEG IFN)-α-2b and ribavirin (RBV) therapy and achieved a sustained virological response. Before the eradication of HCV, the frequency of T-helper 17 cells was remarkably high in comparison to chronic hepatitis C patients without extrahepatic immune-related diseases. Moreover, we could detect negative and positive strand-specific HCV RNA in the CD19(+) B lymphocytes and CD4(+) T lymphocytes. However, after the eradication of HCV, the immunological status became normal and the pyoderma gangrenosum-like lesions became stable without immunosuppressive therapy. Here, we report a sequential immunological analysis during PEG IFN/RBV therapy and the beneficial effect of HCV eradication in difficult-to-treat pyoderma gangrenosum-like lesions.
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Affiliation(s)
- Yasuteru Kondo
- Division of Gastroenterology, Tohoku University Hospital, Sendai, Japan
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Haga T, Kurihara M, Kataoka H, Ebana H. Clinical-Pathological Findings of Catamenial Pneumothorax: Comparison between Recurrent Cases and Non-Recurrent Cases. Ann Thorac Cardiovasc Surg 2014; 20:202-6. [DOI: 10.5761/atcs.oa.12.02227] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kambayashi Y, Fujimura T, Ishibashi M, Haga T, Aiba S. Eosinophilic cellulitis induced by subcutaneous administration of interferon-β. Acta Derm Venereol 2013; 93:755-6. [PMID: 23604053 DOI: 10.2340/00015555-1611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yumi Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, 980-8574, Japan
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Haga T, Kumasaka T, Kurihara M, Kataoka H, Miura M. Immunohistochemical analysis of thoracic endometriosis. Pathol Int 2013; 63:429-34. [PMID: 24200154 DOI: 10.1111/pin.12089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/17/2013] [Indexed: 11/28/2022]
Abstract
Thoracic endometriosis is a rare disease responsible for catamenial pneumothorax. The immunohistochemical features of thoracic endometriosis are not well understood. An immunohistochemical examination of 84 diaphragmatic specimens of catamenial pneumothorax using antibodies against estrogen receptor (ER), progesterone receptor (PgR), CD10 and smooth muscle actin (SMA) was conducted. The endometrial tissue was small, and focally located around the chasm of the tendon on the side of the thoracic cavity. Endometrial stroma were detected in 84/84 (100%) of the specimens, endometrial glands were detected in 21/84 (25%) and smooth muscle was detected in 1/84 (1.2%). The endometrial stroma exhibited positive staining for ER in 74/84 (88.1%) of the specimens, PgR in 84/84 (100%), CD10 in 74/84 (88.1%) and SMA in 46/84 (54.8%). Because thoracic endometriosis is small in size, and only 25% of the resected tissue specimens were accompanied with the endometrial gland, an immunohistochemical analysis can be useful for their detection. The fact that over half of the thoracic endometrial stroma showed positive staining for SMA, and the existence of thoracic endometriosis accompanied by smooth muscle, indicated that some part of the thoracic endometriosis may have the ability to differentiate into smooth muscle, although further studies are needed to confirm this hypothesis.
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Affiliation(s)
- Takahiro Haga
- Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Tokyo, Japan
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Kambayashi Y, Fujimura T, Furudate S, Hashimoto A, Haga T, Aiba S. Comparison of Immunosuppressive and Cytotoxic Cells in Angiosarcoma: Development of a Possible Supportive Therapy for Angiosarcoma. Dermatology 2013; 227:14-20. [DOI: 10.1159/000351316] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 04/02/2013] [Indexed: 11/19/2022] Open
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Sadayasu A, Fujimura T, Haga T, Kambayashi Y, Furudate S, Aiba S. Pigmented epithelioid melanocytoma: immunohistochemical profiles of tumour-infiltrating histiocytes. Acta Derm Venereol 2013; 93:481-2. [PMID: 23165929 DOI: 10.2340/00015555-1507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Furudate S, Fujimura T, Tojo GI, Haga T, Aiba S. Basal cell carcinoma arising from xeroderma pigmentosum: a case report and an immunohistochemical study. Case Rep Dermatol 2013; 5:64-8. [PMID: 23626541 PMCID: PMC3617891 DOI: 10.1159/000350182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a 26-year-old Japanese patient with basal cell carcinoma arising from xeroderma pigmentosum (XP). Immunohistochemical staining revealed dense infiltration of CD163+ M2 macrophages, together with Foxp3+ regulatory T cells. Interestingly, MMP9, which was reported as one of the functional markers for immunosuppressive macrophages, was also detected in the CD163+ M2 macrophage-infiltrated areas. Our case suggests the immunological background of tumor development in a patient with XP.
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Kambayashi Y, Fujimura T, Furudate S, Hashimoto A, Haga T, Aiba S. Comparison of immunosuppressive cells and immunomodulatory cells in Angiosarcoma; the possible novel supportive therapies for angiosarcoma. J Dermatol Sci 2013. [DOI: 10.1016/j.jdermsci.2012.11.394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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