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Abe S, Sakata J, Hirose Y, Nomura T, Takano K, Kitami C, Yokoyama N, Aono T, Minagawa M, Tsukahara A, Ohashi T, Takizawa K, Miura K, Ichikawa H, Shimada Y, Kobayashi T, Wakai T. Extent of regional lymphadenectomy and number-based nodal classification for non-ampullary duodenal adenocarcinoma. Eur J Surg Oncol 2023; 49:107122. [PMID: 37897834 DOI: 10.1016/j.ejso.2023.107122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND This study aimed to evaluate the adequate extent of regional lymphadenectomy according to tumor location and the impact of number-based nodal classification on survival in patients with non-ampullary duodenal adenocarcinoma (NADAC). METHODS A total of 85 patients with NADAC who underwent surgery were enrolled. The frequency of metastasis was calculated for each node group in the respective tumor locations for 63 patients who underwent lymphadenectomy for pT2-pT4 tumor. RESULTS The frequency of metastasis in the pancreaticoduodenal (nos. 13 and 17) and superior mesenteric artery (no. 14) nodes was high (16.7 %-52.3 %) regardless of tumor location. Metastasis in the perigastric (nos. 3 and 4d) and right celiac artery (no. 9) nodes was not uncommon (14.3 %-22.2 %) for tumors in the first portion. The frequency of metastasis in the pyloric (nos. 5 and 6) and the other peripancreaticoduodenal (nos. 8 and 12) nodes varied depending on tumor location but could not be ignored for staging. When these nodes were classified as regional nodes, the 5-year survival in patients with pN0, pN1 (1-2 positive nodes), and pN2 (≥3 positive nodes) were 82.9 %, 51.7 %, and 19.2 %, respectively (p < 0.001). pN classification independently predicted survival (pN1, p = 0.022; pN2, p < 0.001). CONCLUSIONS Nos. 5, 6, 8, 12, 13, 14, and 17 nodes in all advanced NADAC and nos. 3, 4d, and 9 nodes in advanced NADAC in the first portion should be considered as regional nodes for accurate staging. The number-based nodal classification allows good patients' prognostic stratification.
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Affiliation(s)
- Shun Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuya Nomura
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Kabuto Takano
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
| | | | - Akihiro Tsukahara
- Department of Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Taku Ohashi
- Department of Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Sato T, Nakajima K, Terao H, Ishii S, Hirai M, Maruyama T, Kaneko K, Suzuki S, Okada T, Aono T. [A Case of De Novo Stage Ⅳ Breast Cancer Successfully Treated with Surgery and Multiple Endocrine Therapies Over a Long Period of Time]. Gan To Kagaku Ryoho 2023; 50:1387-1389. [PMID: 38303283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Here we present a case of de novo Stage Ⅳ breast cancer successfully treated with surgery and multiple endocrine therapies over a long period of time. A 75-year-old female presented with a breast tumor with skin invasion and multiple lung metastases. Diagnosed with infiltrating breast cancer of Luminal A-like subtype, endocrine therapy with anastrozole was initiated. Despite initial response to the treatment in both the primary site and lung metastases, the primary tumor regrew and surgery with lumpectomy was performed. After a 3-year-treatment of tamoxifen, axillary lymphadenopathy and bone metastases developed. The patient was treated with fulvestrant for 5 years, resulting in clinical complete response. The now 88-year-old patient has been free of disease without treatment for a year and a half. Generally, primary tumor resection of Stage Ⅳ breast cancer does not improve prognosis, but in this case it provided good local control and enabled long-term endocrine therapy, resulting in prolonged disease-free survival.
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Affiliation(s)
- Tomoi Sato
- Dept. of Surgery, Niigata Prefectural Central Hospital
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Terao H, Maruyama T, Aono T, Suzuki S, Kaneko K, Sato T, Okada T, Muto I, Hasegawa M, Muneoka Y, Tajima Y, Ichikawa H, Shimada Y, Sakata J, Wakai T. [Resectable Pancreatic Cancer Successfully Treated with Neoadjuvant Chemotherapy Regimen Change to Modified FOLFIRINOX-A Case Report]. Gan To Kagaku Ryoho 2023; 50:1569-1571. [PMID: 38303344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
A 72-year-old woman presented with obstructive jaundice. Computed tomography revealed a 12-mm low-density mass in the head of the pancreas. She was diagnosed as having pancreatic cancer by endoscopic ultrasound-guided fine-needle aspiration. She received gemcitabine plus nab-paclitaxel as preoperative chemotherapy. After 2 courses, hepatoduodenal lymph node metastasis appeared and was accompanied by increased tumor marker levels. The regimen was changed to modified FOLFIRINOX. After 5 courses, the lymph node metastasis was reduced in size and the tumor marker levels were decreased, so subtotal stomach-preserving pancreaticoduodenectomy was performed. Adjuvant chemotherapy was administered postoperatively. The patient was alive and well without recurrence 2 years and 9 months after the surgery, but died of sepsis. Nevertheless, this case highlights that when preoperative chemotherapy for resectable pancreatic cancer appears to be ineffective, a change in regimen may be useful.
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Affiliation(s)
- Hikaru Terao
- Dept. of Surgery, Niigata Prefectural Central Hospital
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Suzuki S, Nakajima K, Terao H, Ishii S, Hirai M, Maruyama T, Kaneko K, Sato T, Okada T, Aono T, Hasegawa M. [A Case of Primary Gastric Lymphoma with Spontaneous Perforation]. Gan To Kagaku Ryoho 2023; 50:1468-1470. [PMID: 38303310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
An 85-year-old female patient presented to the emergency department with the chief complaint of sudden upper abdominal pain. The patient suffered from anorexia and epigastric pain for a month, and a local physician suspected a diagnosis of gastric ulcer. An abdominal computed tomography(CT)scan showed intraperitoneal free air as well as irregular thickening and thinning of the gastric wall. Gastric ulcer perforation was suspected, and an emergency operation was performed. Surgical findings showed thickening of the gastric wall in the pylorus and gastric corpus but partial thinning of areas of the anterior wall of the gastric corpus with a perforation measuring 5 mm. A distal gastrectomy and reconstruction were performed using the Billroth Ⅱ method. The histopathological diagnosis was malignant gastric lymphoma(diffuse large B- cell lymphoma). Considering the patient's age and general condition, chemotherapy was not administered after surgery. The patient was alive without recurrence 8 months after the operation.
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Affiliation(s)
- Susumu Suzuki
- Dept. of Surgery, Niigata Prefectural Central Hospital
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Yajima K, Kim E, Tani K, Arae H, Iwaoka K, Hosoda M, Tokonami S, Kurihara O, Aono T. External dose measurements to investigate the body-size dependence of personal dosemeter responses in areas affected by the Fukushima Daiichi nuclear accident. Radiat Prot Dosimetry 2023; 199:2000-2004. [PMID: 37819292 DOI: 10.1093/rpd/ncac274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/24/2022] [Accepted: 11/14/2022] [Indexed: 10/13/2023]
Abstract
To formulate necessary protective measures after a large-scale nuclear accident, it is crucial to understand the levels of radiation to which persons living in radionuclide-contaminated areas are exposed. Individual monitoring using personal dosemeters (PDs) plays a role in this, although PDs were not originally intended to be used by members of the public. The present study investigated PD responses in areas highly affected by the Fukushima Daiichi nuclear accident, as well as the dependence of those measurements on body size. Three types of commercially available electronic PDs, including D-shuttle, which has often been used in Fukushima, were placed on the front surfaces of three age-specific anthropometric phantoms imitating a 5-y-old, a 10-y-old and an adult male, and these phantoms were then exposed to radiation in an open field in the affected area. In the case of D-shuttle, the ratios of PD readings to the ambient dose rate for the 5-y-old phantom and the adult male phantom were 0.79 and 0.72, respectively. The ratios were somewhat higher for the other PDs; any PDs showed higher readings than the effective doses estimated by simulations based on the assumed ground deposition of 134Cs and/or 137Cs over the affected areas.
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Affiliation(s)
- K Yajima
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - E Kim
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - K Tani
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - H Arae
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - K Iwaoka
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - M Hosoda
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - S Tokonami
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Aomori 036-8564, Japan
| | - O Kurihara
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
| | - T Aono
- National Institutes for Quantum Science and Technology, 4-9-1, Anagawa, Inage, Chiba 263-8555, Japan
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Sakr S, Inoue K, Mohamed A, Ahmed AA, ElFeky MG, Saleh GM, Kamar MS, Arae H, Aono T, Sahoo SK. Distribution of natural radionuclides in NORM samples from North Abu Rusheid area, Egypt. J Environ Radioact 2023; 266-267:107240. [PMID: 37418811 DOI: 10.1016/j.jenvrad.2023.107240] [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: 02/10/2023] [Revised: 06/08/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023]
Abstract
The North Abu Rusheid area in Egypt is a well-known high background natural radiation area (HBNRA) due to the existence of naturally occurring radioactive materials (NORMs) in mylonitic rocks. In this study, 27 rock samples were selected for dose estimation studies. 238U and 232Th were measured using inductively coupled plasma mass spectrometry (ICP-MS) and 40K was measured using sodium iodide (thallium) gamma-ray spectroscopy. The ranges of activity concentrations (Bq/kg) of 238U, 232Th and 40K in the samples varied from 270 ± 2 to 2120 ± 29, 350 ± 2 to 1840 ± 27 and 20 ± 2 to 1390 ± 35 with mean values of 980 ± 349, 770 ± 351, and 640 ± 402 Bq/kg, respectively. The radiological hazard parameters were estimated from activity concentrations of 238U, 232Th and 40K and compared to United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) values. The present study revealed that the hazard parameters were several times higher than the worldwide averages. The U/Th concentration ratio ranged from 0.7 to 3 and could be attributed to the presence of kasolite, uranothorite, zircon, and columbite in mylonitic rocks. From the radiological protection viewpoint, it is necessary to monitor natural radionuclides in these rocks prior to their use in residential and commercial construction materials.
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Affiliation(s)
- S Sakr
- Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, 116-8551, Japan; Department of Physics, Minia University, El-Minia, Egypt; National Institutes for Quantum Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - K Inoue
- Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, 116-8551, Japan
| | - A Mohamed
- Department of Physics, Minia University, El-Minia, Egypt
| | - A A Ahmed
- Department of Physics, Minia University, El-Minia, Egypt
| | - M G ElFeky
- Nuclear Materials Authority, P.O. Box 530, El Maadi, Cairo, Egypt
| | - G M Saleh
- Nuclear Materials Authority, P.O. Box 530, El Maadi, Cairo, Egypt
| | - M S Kamar
- Nuclear Materials Authority, P.O. Box 530, El Maadi, Cairo, Egypt
| | - H Arae
- National Institutes for Quantum Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - T Aono
- National Institutes for Quantum Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - S K Sahoo
- National Institutes for Quantum Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan.
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Suzuki S, Aono T, Maruyama T, Naruse K, Utsumi S, Toge K, Kaneko K, Sato T, Okada T, Muto I, Hasegawa M. [A Case of Pancreatic Invasive Micropapillary Carcinoma That Survived Seven Years after Resection and Chemotherapy]. Gan To Kagaku Ryoho 2022; 49:1500-1502. [PMID: 36733115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We present the case of a 47-year-old man who underwent a subtotal stomach-preserving pancreaticoduodenectomy for pancreatic head cancer. Histopathological diagnosis revealed that the majority of the cancer was an invasive micropapillary carcinoma(IMPC). Postoperative adjuvant chemotherapy using S-1 was continued for 4 years, at the end of which, multiple lymph node metastases were identified. Therefore, gemcitabine plus S-1 therapy was initiated. The treatment reduced the lymph node in size and resulted in the maintenance of a partial response for a year and a half. However, increased lymph node metastases recurred, and multiple lung metastases were noted. The patient died 7 years and 2 months after the resection of the primary lesion. Although pancreatic IMPC has a poor prognosis, long-term survival may be achieved by resection of the primary region, the administration of adjuvant chemotherapy and management of recurrent lesions by chemotherapy.
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Affiliation(s)
- Susumu Suzuki
- Dept. of Surgery, Niigata Prefectural Central Hospital
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8
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Sato T, Muto I, Sakai T, Nakajima K, Utsumi S, Toge K, Maruyama T, Kaneko K, Suzuki S, Okada T, Aono T. [Locally Advanced HER2-Positive Breast Cancer Successfully Treated with Trastuzumab Emtansine]. Gan To Kagaku Ryoho 2022; 49:1405-1407. [PMID: 36733083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Although the prognosis of HER2-positive breast cancer(BC)has been improving than before, that of locally advanced cases is not satisfactory. A 41-year-old female presented with a huge breast lump and massive lymphadenopathy, which was diagnosed as HER2-positive, unresectable, locally advanced BC. The first treatment, consisting of docetaxel, trastuzumab and pertuzumab, had only a limited and temporary effect, with subsequent mass regrowth. After initiation of the second treatment, trastuzumab emtansine(TDM1), the mass gradually shrank, and mastectomy and axillary lymphadenectomy were performed successfully. Histologically, several tiny invasive foci were observed in the mammary gland. No lymph node metastases were observed. The patient subsequently underwent radiation therapy and a 1-year course of TDM1 treatment. The patient has been in remission for 5 years. HER2-positive, locally advanced BC can be successfully treated with multimodal therapy, including anti-HER2 therapy, timely surgery and radiation therapy.
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Affiliation(s)
- Tomoi Sato
- Dept. of Surgery, Niigata Prefectural Central Hospital
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Homma Y, Endo I, Matsuyama R, Sho M, Mizuno S, Seyama Y, Hirano S, Aono T, Kitami C, Morita Y, Takeda Y, Yoshida K, Tani M, Kaiho T, Yamamoto Y, Aoki H, Ogawa M, Niguma T, Mataki Y, Kawasaki H, Baba H, Yokomizo H, Rikiyama T, Yamaue H, Yamamoto M. Outcomes of lung metastasis from pancreatic cancer: A nationwide multicenter analysis. J Hepatobiliary Pancreat Sci 2022; 29:552-561. [PMID: 35179827 DOI: 10.1002/jhbp.1127] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/25/2021] [Accepted: 01/11/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although distant metastasis from pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, some single center studies reported that lung metastasis has a favorable prognosis. The aim of this study is to evaluate the prognostic value of site-specific metastasis after pancreatectomy for PDAC, with a focus on lung metastasis. METHODS Data from 117 cases of lung metastasis after pancreatectomy were collected retrospectively from 23 institutions in Japan. To compare the sites of metastasis we also collected the data of 134 patients with liver only metastasis, 67 patients with peritoneal only metastasis and 121 patients with locoregional recurrence alone. RESULTS In patients with lung only metastasis, the median time from recurrence to death (RTD) was 23.1 months, which was better in comparison to other sites of recurrence. In lung metastasis group, the patients who underwent pulmonary resection had better long-term outcomes in comparison to those who did not. (RTD: 29.2 vs 15.2, P < .001). In the multivariate analysis, solitary metastasis (HR 5.03; 95% CI 1.195-21.144, P = .022) and postoperative chemotherapy (HR 14.089; 95% CI 1.729-114.77, P = .023) were identified as significant prognostic factors after lung resection. CONCLUSIONS Surgical resection is a favorable option for selected patients with a solitary lung metastasis and for whom adjuvant chemotherapy can be administrated.
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Affiliation(s)
- Yuki Homma
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama City, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama City, Japan
| | - Ryusei Matsuyama
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama City, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara City, Japan
| | - Shugo Mizuno
- Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Yasuji Seyama
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery Ⅱ, Faculty of Medicine, Hokkaido University, Sapporo City, Japan
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu City, Japan
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka City, Japan
| | - Yoshifumi Morita
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu City, Japan
| | - Yutaka Takeda
- Department of Surgery, Kansai Rosai Hospital, Amagasaki City, Japan
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu City, Japan
| | - Masaji Tani
- Department of Surgery, Shiga University of Medical Science, Otsu City, Japan
| | - Takashi Kaiho
- Department of Surgery, Kimitsu Chuo Hospital, Kisarazu City, Japan
| | - Yuzo Yamamoto
- Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, Akita City, Japan
| | - Hideki Aoki
- Department of Surgery, Iwakuni Medical Center, Iwakuni City, Japan
| | - Masao Ogawa
- Department of Surgery, Bell Land General Hospital, Sakai City, Japan
| | - Takefumi Niguma
- Department of Surgery, Okayama Saiseikai General Hospital, Okayama City, Japan
| | - Yuko Mataki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima City, Japan
| | - Hiroshi Kawasaki
- Department of Surgery, Ibaraki Prefectural Central Hospital, Kasama City, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Kumamoto University, Kumamoto City, Japan
| | - Hiroshi Yokomizo
- Department of Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto City, Japan
| | - Toshiki Rikiyama
- Department of Surgery, Saitama Medical Center, Jichi Medical University, Sitama City, Japan
| | - Hiroki Yamaue
- 2nd Department of Surgery, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women`s Medical University, Tokyo, Japan
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Naruse K, Maruyama T, Aono T, Okada T, Suzuki S, Kaneko K, Sato T, Muto I, Hasegawa M, Ichikawa H, Takizawa K, Nakano M, Shimada Y, Sakata J, Wakai T. [A Case of Surgical Resection of Anaplastic Carcinoma of the Pancreas(Pleomorphic Cell Type)with Poor Response to Neoadjuvant Chemotherapy]. Gan To Kagaku Ryoho 2021; 48:1601-1603. [PMID: 35046269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 62-year-old man was incidentally found to have a pancreatic tumor by CT. He was diagnosed with pancreatic cancer by EUS-FNAB. Gemcitabine(GEM)plus nab-paclitaxel(PTX)was started as neoadjuvant chemotherapy(NAC)for resectable pancreatic cancer. However, after the end of the second course, the tumor grew rapidly and invaded the stomach, so NAC was discontinued, and surgery was performed. The pathological diagnosis was anaplastic ductal carcinoma of the pleomorphic cell type, and the histological response was Grade 1a. Multiple liver metastases appeared during adjuvant chemotherapy with S-1, so GEM plus nab-PTX and modified FOLFIRINOX were administered, but the therapeutic response was poor, the patient died 9 months after surgery. Anaplastic carcinoma has a poor response to chemotherapy and may be included with cancers showing treatment resistance to NAC, as seen in our case. It is necessary to pay attention to anaplastic carcinoma during the course of NAC for pancreatic cancer.
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Affiliation(s)
- Kana Naruse
- Dept. of Surgery, Niigata Prefectural Central Hospital
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Sakata J, Nomura T, Aono T, Kitami C, Yokoyama N, Minagawa M, Takizawa K, Miura K, Hirose Y, Ichikawa H, Nagahashi M, Shimada Y, Kobayashi T, Wakai T. Oncological outcomes of surgery for recurrent biliary tract cancer: who are the best candidates? HPB (Oxford) 2021; 23:1371-1382. [PMID: 33558069 DOI: 10.1016/j.hpb.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/05/2020] [Accepted: 01/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to investigate the impact of surgery on outcomes in patients with recurrent biliary tract cancer (BTC) and elucidate factors affecting survival after surgery for this disease. METHODS A single-center study was undertaken in 178 patients with recurrent BTC, of whom 24 underwent surgery for recurrence, 85 received chemotherapy, and 69 received best supportive care. Then, we carried out a multicenter study in 52 patients undergoing surgery for recurrent BTC (gallbladder cancer, 39%; distal cholangiocarcinoma, 27%; perihilar cholangiocarcinoma, 21%; intrahepatic cholangiocarcinoma, 13%). RESULTS In the single-center study, 3-year survival after recurrence was 53% in patients who underwent surgery, 4% in those who received chemotherapy, and 0% in those who received best supportive care (p < 0.001). Surgery was an independently prognostic factor (p < 0.001). In the multicenter series, the respective 3-year and 5-year survival after surgery for recurrence was 50% and 29% in the 52 patients. Initial site of recurrence was the only independent prognostic factor (p = 0.019). Five-year survival after surgery for recurrence in patients with single distant, multifocal distant, and locoregional recurrence was 51%, 0%, and 0%, respectively (p = 0.002). Sites of single distant recurrence included the liver (n = 13, 54%), distant lymph nodes (all from gallbladder cancer, n = 7, 29%), lung (n = 2, 9%), peritoneum (n = 1, 4%), and abdominal wall (n = 1, 4%). CONCLUSION Surgery may be an effective option for patients with less aggressive tumor biology characterized by single distant recurrence in recurrent BTC.
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Affiliation(s)
- Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Tatsuya Nomura
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan.
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan.
| | - Naoyuki Yokoyama
- Department of Gastrointestinal Surgery, Niigata City General Hospital, Niigata, Japan.
| | | | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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12
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Kasar S, Mishra S, Sahoo SK, Kavasi N, Omori Y, Arae H, Sorimachi A, Aono T. Sorption-desorption coefficients of uranium in contaminated soils collected around Fukushima Daiichi Nuclear Power Station. J Environ Radioact 2021; 233:106617. [PMID: 33866199 DOI: 10.1016/j.jenvrad.2021.106617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/08/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Various radionuclides including fission products and heavy nuclides were released into the environment during the Fukushima Daiichi Nuclear Power Station (FDNPS) accident. The dissolution followed by migration of deposited radionuclides of Cs, Sr and U on soils could take place to the local environment. Therefore, it is necessary to determine sorption-desorption coefficients of U in soil-water system around the FDNPS from a migration viewpoint. The determination of sorption coefficient Kd(S) as well as desorption coefficient Kd(D) for U has been carried out in the present study using a laboratory batch method. Stable U was used for sorption from simulated ground water onto contaminated soil samples collected from Okuma Town, Fukushima. Different soil parameters were measured to understand their effects on sorption and desorption processes. The obtained Kd(S) and Kd(D) values of U were compared with values of Kd(S) and Kd(D) of Cs and Sr and Kd(S)-U in known Fukushima accident contaminated soils reported in the literature for better understanding. It was observed that Kd(S)-U varied from 160 to 5100 L/kg, whereas Kd(D)-U ranged from 200 to 11000 L/kg. Kd(D) was higher than Kd(S) for U in these soils implying irreversibility of the sorption process. Pearson's correlation of Kd(S) values suggested that U sorption is affected by various soil parameters. However, desorption is decided by the nature of U species formed in sorption process and soil parameters like pH, presence of carbonates, Ca ions, clay minerals etc. to some extent. The comparison between Kd(S) and Kd(D) values for Cs, Sr and U revealed that unsorbed Sr could migrate farther than unsorbed Cs or U under the present experimental conditions. Both sorption and desorption studies are of great importance to understand migration of metal ions from contaminated sites to local uncontaminated areas.
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Affiliation(s)
- S Kasar
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan
| | - S Mishra
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan; Environmental Monitoring and Assessment Division, Bhabha Atomic Research Centre, Mumbai, 400085, India
| | - S K Sahoo
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan.
| | - N Kavasi
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan
| | - Y Omori
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1, Hikarigaoka, Fukushima 960-1295, Japan
| | - H Arae
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan
| | - A Sorimachi
- Integrated Center for Science and Humanities, Fukushima Medical University, 1, Hikarigaoka, Fukushima 960-1295, Japan
| | - T Aono
- Environmental Radionuclides Research Group, National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1Anagawa, Chiba, 263-8555, Japan
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13
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Murugan R, Kavasi N, Sahoo SK, Omori Y, Sorimachi A, Takahashi H, Aono T. Measurement of uranium isotope ratios in Fukushima-accident contaminated soil samples using multi collector inductively coupled plasma mass spectrometry. J Environ Radioact 2021; 232:106568. [PMID: 33740532 DOI: 10.1016/j.jenvrad.2021.106568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
In the present study, 137Cs and 238U activity concentrations, 234U/238U activity ratio, and 235U/238U isotope ratio were measured in fifteen soil samples collected from the exclusion zone around the Fukushima Daiichi Nuclear Power Station (FDNPS). The 137Cs activity concentrations of Fukushima-accident contaminated soil samples ranged from 29.9 to 4780 kBq kg-1 with a mean of 2007 kBq kg-1. On the other hand, the 238U activity concentrations of these soil samples ranged from 5.2 to 22.4 Bq kg-1 with a mean of 13.2 Bq kg-1. The activity ratios of 234U/238U ranged from 0.973 to 1.023. The 235U/238U isotope ratios of these exclusion zone soil samples varied from 0.007246 to 0.007260, and they were similar to the natural terrestrial ratio confirming the natural origin. Using isotope dilution technique, the 235U/137Cs activity ratio was theoretically estimated for highly 137Cs contaminated soil samples from Fukushima exclusion zone ranged from 5.01 × 10-8 - 6.16 × 10-7 with a mean value of 2.51 × 10-7.
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Affiliation(s)
- R Murugan
- National Institutes for Quantum and Radiological Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - N Kavasi
- National Institutes for Quantum and Radiological Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - S K Sahoo
- National Institutes for Quantum and Radiological Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan.
| | - Y Omori
- Fukushima Medical University, Hikarigaoka, Fukushima, 960-1295, Japan
| | - A Sorimachi
- Fukushima Medical University, Hikarigaoka, Fukushima, 960-1295, Japan
| | - H Takahashi
- National Institutes for Quantum and Radiological Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - T Aono
- National Institutes for Quantum and Radiological Sciences and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
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14
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Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, Wakai T. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. World J Surg 2021; 45:1613-1615. [PMID: 33575825 DOI: 10.1007/s00268-021-05991-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Pankaj Prasoon
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata, 940-0861, Japan
| | - Masahiro Minagawa
- Department of Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, Niigata, 940-2085, Japan
| | - Tatsuya Nomura
- Department of Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata, 951-8566, Japan
| | - Naoyuki Yokoyama
- Department of Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, 205 Shinnan-cho, Joetsu, Niigata, 943-0192, Japan
| | - Kizuki Yuza
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Tomohiro Katada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
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15
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Aono T, Watanabe T, Toshima T, Takahashi T, Otaki Y, Wanezaki M, Kutsuzawa D, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. Elevated serum carboxy-terminal telopeptide of type I collagen predicts clinical outcome in patients with acute coronary syndrome who underwent percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1605] [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
Introduction
Serum carboxy-terminal telopeptide of type I collagen (I-CTP) is a collagen degradation product of type I collagen in the extracellular matrix of the heart, blood vessels, and bone. The serum levels of I-CTP were reportedly a predictive marker for cardiac remodeling after acute myocardial infarction. However, it remains unclear whether I-CTP can predict poor clinical outcome in patient with acute coronary syndrome (ACS).
Purpose
The aim of this study was to investigate the association between serum levels of I-CTP and clinical outcome in patients with ACS.
Methods
Serum levels of I-CTP were measured in 200 patients with ACS who underwent percutaneous coronary intervention (PCI). All patients were prospectively followed during the median follow-up period of 1312 days with the end point of major adverse cardiovascular events (MACE). We divided the patients into tertiles according to serum I-CTP level: low I-CTP group (≤4.4 ng/ml, n=72), middle I-CTP group (4.4–6.4 ng/ml, n=65), and high I-CTP group (≥6.5 ng/ml, n=63).
Results
There were 44 MACE, including 24 all-cause death and 9 rehospitalization due to heart failure. I-CTP was significantly higher in patients with MACE than those without (4.90 [interquartile range (IQR): 3.80–6.38] ng/ml vs. 6.65 [IQR: 5.00–10.08] ng/ml, p<0.001). Kaplan-Meier analysis demonstrated that patients in the highest tertile of I-CTP had the greatest risk of MACE. In a univariate analysis, age, Albumin, estimated glomerular filtration rate (eGFR), low-density lipoprotein cholesterol (LDL-C), brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hsCRP) and I-CTP were significant predictors of MACE. A multivariate Cox proportional hazard analysis showed that the high I-CTP group had a higher risk for MACE (Hazard ratio [HR] 2.6, p=0.049) compared with the low I-CTP group after adjusting for confounding factors.
Conclusions
I-CTP was significantly associated with MACE, suggesting that I-CTP could be a reliable marker for clinical outcome in patients with ACS who underwent PCI.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Aono
- Yamagata University, Yamagata, Japan
| | | | - T Toshima
- Yamagata University, Yamagata, Japan
| | | | - Y Otaki
- Yamagata University, Yamagata, Japan
| | | | | | - S Kato
- Yamagata University, Yamagata, Japan
| | - H Tamura
- Yamagata University, Yamagata, Japan
| | | | | | - T Arimoto
- Yamagata University, Yamagata, Japan
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16
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Matsuda K, Okayama H, Kazatani T, Okabe H, Kido S, Aono T, Tanaka Y, Kosaki T, Kawamura G, Shigematsu T, Kawata Y, Hiasa G, Yamada T, Kazatani Y. Clinical usefulness of relative apical sparing pattern for predicting functional recovery after transcatheter aortic valve implantation in patients with severe aortic stenosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Relative apical sparing pattern (RASP) is thought to be associated with prognosis in patients with cardiac amyloidosis or left ventricular hypertrophy (LVH). Although almost all patients with severe aortic stenosis (AS) have LVH, little is known about the effect of transcatheter aortic valve implantation (TAVI) in patients with severe AS exhibiting a RASP.
Purpose
This study aimed to elucidate the effect of TAVI on left ventricular global longitudinal strain (LS; LVGLS) in patients with severe AS exhibiting a RASP.
Methods
Eighty-four patients who underwent transfemoral or subclavian TAVI were evaluated. They were divided into the RASP and non-RASP groups. The average apical LS divided by the sum of the average mid and basal LS values of >1.0 was defined as the RASP. We analyzed the difference between pre- and post-TAVI LVGLS (ΔGLS = post-TAVI LVGLS − pre-TAVI LVGLS).
Results
Of the 84 patients (mean age, 84.5±3.9 years; 24 men), 15 (17.9%) exhibited a RASP. No significant difference in mean pre-TAVI LVGLS was found between the RASP and non-RASP groups (−16.6% ± 3.8% vs. −15.8% ± 3.9%). The ΔGLS in the RASP group was significantly higher than that in the non-RASP group (−0.97% ± 2.5% vs. −2.6% ± 3.0%; P<0.05). Multivariate analysis revealed that relative apical longitudinal strain was an independent predictor of ΔGLS (β = 0.35, p=0.002).
Conclusion
Relative apical longitudinal strain was associated with LVGLS recovery. The effect of TAVI on LVGLS in patients with a RASP is inferior to that in patients without a RASP.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Matsuda
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okabe
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Kido
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Aono
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Tanaka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kosaki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Kawamura
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Shigematsu
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kawata
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Yamada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
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17
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Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, Wakai T. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. World J Surg 2020; 44:3875-3883. [PMID: 32577824 DOI: 10.1007/s00268-020-05656-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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18
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Aono T, Watanabe T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5950Lymphocyte-to-monocyte ratio could predict adverse clinical outcomes in patients with heart failure with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0100] [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
Heart failure with preserved ejection fraction (HFpEF) is increasing with aging of the population, whereas the mechanisms of HFpEF remain poorly understood. It was reported that systemic inflammation is associated with pathophysiology of HFpEF. Lymphocyte-to-monocyte ratio (LMR) is a marker of systemic inflammation, which predicts clinical outcomes in various cancers. However, the prognostic value of LMR has not yet been elucidated in patients with HFpEF.
Purpose
The aim of this study was to investigate the impact of LMR on clinical outcomes in patients with HFpEF.
Methods and results
We prospectively analyzed 414 consecutive patients with HFpEF. Preserved EF was defined as an EF ≥50%. During a median follow-up period of 740 days, there were 111 major adverse cardiovascular events (MACE). When patients were divided into tertiles according to LMR, Kaplan-Meier analysis demonstrated that the low LMR was associated with the greatest risk for MACE. Multivariate Cox proportional hazard regression analysis showed that the low LMR was significantly associated with MACE after adjustment for confounding factors.
Conclusions
Low LMR could predict poor clinical outcomes in patients with HFpEF. LMR is a feasible marker for predicting MACE in patients with HFpEF.
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Affiliation(s)
- T Aono
- Yamagata University, Yamagata, Japan
| | | | - S Kato
- Yamagata University, Yamagata, Japan
| | - H Tamura
- Yamagata University, Yamagata, Japan
| | | | | | - T Arimoto
- Yamagata University, Yamagata, Japan
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19
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Watanabe K, Narumi T, Watanabe T, Aono T, Goto J, Sugai T, Toshima T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. P1626MicroRNA-21 deteriorates left ventricular reverse remodeling by promoting cardiac fibrosis in non-ischemic cardiomyopathy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0385] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Left ventricular reverse remodeling (LVRR) contributes to better outcomes in patients with non-ischemic cardiomyopathy (NICM). It is reported that LVRR is associated with progression of cardiac fibrosis. MicroRNAs (miRs) have emerged as powerful regulators of post-transcriptional gene expression. We focused on miR-21, which plays a key role in pathogenesis of fibrosis in multiple organs. The aim of this study was to clarify the effect of miR-21 on cardiac fibrosis and LVRR in patients with NICM.
Methods
We measured plasma miR-21 levels in 16 patients with NICM. LVRR was defined as increased LVEF by ≥10% and decreased LV end-diastolic diameter index by ≥10% from baseline data after optimal medication treatment at 1-year of follow-up. Further, we examined miR-21 expression and its potential role in cardiac fibrosis induced by transverse aortic constriction (TAC) in mice and angiotensin II (Ang II) stimulation in neonatal rat cardiomyocytes (NRCMs).
Results
There were 12 patients without LVRR and 4 patients with LVRR. Plasma miR-21 levels were significantly higher in patients without LVRR compared with those with LVRR. In TAC mice heart, miR-21 levels were significantly increased and programmed cell death 4 (PDCD4), a main target of miR-21, was decreased. In vitro, miR-21 levels were significantly increased and its upstream transcriptional factor, activator protein 1 (AP-1), was activated by Ang II stimulation in NRCMs. After transfection of miR-21 specific inhibitor, PDCD4 levels were upregulated. Furthermore, AP-1 activity, expression of collagen type I, and α-smooth muscle actin levels were significantly decreased after miR-21 inhibition.
Conclusions
These findings suggested that miR-21/PDCD4/AP-1 feedback loop pathway was involved in LVRR in patients with NICM by promoting cardiac fibrosis. MiR-21 can be the therapeutic target in NICM.
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Affiliation(s)
- K Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Narumi
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Aono
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - J Goto
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Sugai
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Toshima
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - S Kato
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - H Tamura
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - S Nishiyama
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - H Takahashi
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Arimoto
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Shishido
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - M Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
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20
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Kawamura G, Okayama H, Kido S, Aono T, Matsuda K, Tanaka Y, Iseki Y, Hosokawa S, Kosaki T, Shigematsu T, Kawada Y, Hiasa G, Yamada T, Kazatani Y. P6005Incidence and clinical characteristics of coronary artery spasm in patients with out-of-hospital cardiac arrest. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Substantial cases of out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome have been recognized thus far, but there have been few reports about the aetiology of patients with OHCA without the organic heart disease. Especially, coronary artery spasm would be one of the causes of OHCA.
Purpose
This study aimed to investigate causes of OHCA without the organic heart disease and to investigate the characteristics and angiographic findings of OHCA patients with vasospastic angina (VSA).
Methods
Between January 2010 and April 2018, 920 patients with OHCA caused by probable or definite cardiovascular disease were transferred to our hospital. Return of spontaneous contraction was successfully achieved in 151 patients, among whom diagnosis was made in 130 patients. First, we analysed the causes of OHCA in these patients. Second, we compared clinical and angiographic characteristics between the VSA group with OHCA (OHCA-VSA) and the VSA group without OHCA (stable VSA; n=72) from our database.
Results
Among the 130 patients, 95 (73%) had the organic heart disease; 72, acute coronary syndrome; 19, myocardial disease; 2, valvular heart disease; and 1, congenital heart disease. There were 35 patients (27%) without the organic heart disease. Nineteen patients had primary (i.e., Brugada syndrome, QT prolongation) or secondary arrhythmia (i.e. drug adverse effect). Electrocardiogram, coronary angiogram, and LV structure and function were normal in 35 patients. However, there were 16 patients (11%) with VSA defined by Japanese guideline. The OHCA-VSA group was significantly younger (50±14) than the stable VSA group (64±11, P=0.003). The incidence of diffuse-type spasm in the OHCA-VSA group (100%) was significantly higher than that in the stable VSA group (100% vs. 69%, P<0.05). In addition, the incidence of triple-vessel coronary spasm in the OHCA-VSA group was significantly higher than that in the stable VSA group (86% vs. 25%, P=0.003).
Conclusion
OHCA patients without the organic heart disease had considerable cases of VSA, in addition to primary or secondary arrhythmia. Furthermore, the severity of spasm in the OHCA-VSA group was more serious and extensive than in comparison with the stable VSA group.
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Affiliation(s)
- G Kawamura
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Kido
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Aono
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - K Matsuda
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Tanaka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Iseki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Hosokawa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kosaki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Shigematsu
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kawada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Yamada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
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21
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Katoh S, Watanabe T, Arimoto T, Narumi T, Aono T, Goto J, Sugai T, Takahashi T, Tamura H, Nishiyama S, Takahashi H, Shishido T, Watanabe M. P3355Stress-induced left ventricular dyssynchrony predicts future cardiac events in patients with known or suspected coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0231] [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
Prognostic value of stress induced left ventricular (LV) dyssynchrony has not been fully understood.
The aim of this study was to evaluate the possible impact between cardiovascular events and stress induced worsening LV dyssynchrony.
Methods and results
One hundred and eighty consecutive subjects with known or suspected coronary artery disease (CAD) (142 men, mean age 68±12 years) underwent both gated myocardial single photon emission computed tomography (SPECT) with 99mTc-sestamibi or tetrofosmin according to a standard same day stress-rest protocol and coronary angiography or coronary computed tomography. The summed difference score (SDS) was calculated in every subjects. LV ejection fraction (EF) and phase Entropy at after stress and rest were determined by cardioREPO software. We determined %ΔEntropy = (stress Entropy - rest Entropy)/rest Entropy x100, as an indicator of stress-induced LV dyssynchrony. In the study population, the mean SDS was 2.7±3.9 and LVEF was 58±16%, stress and rest Entropy were 0.62±0.15 and 0.57±0.13, respectively.
%ΔEntropy was higher in patients with CAD than in those without CAD (3.3±11.5 vs. 10.2±15.0, respectively). Moreover, there was a strict correlation between the presence of CAD and %ΔEntropy, indicator of stress induced LV dyssynchrony (non-CAD vs. CAD and/or 1 vessel disease vs. multivessel disease: 4.3±12.5 vs. 8.8±15.6 vs. 12.7±14.3, respectively. p<0.05)
We examined all study subjects and they were divided into 2 groups by cut off value of the %ΔEntropy constructed with receiver operating characteristic curve (=15.4). Kaplan-Meier analysis revealed that future cardiovascular event rate was significantly higher in %ΔEntropy >15.4 group (20/57) than in %ΔEntropy <15.4 group (24/123) (Log-rank p<0.01). On the other hand, summed stress score and SDS were no significant differences between 2 groups.
However, SDS was higher in patients with future cardiovascular event than in those without cardiovascular event (4.4±5.4 vs. 2.2±3.2, respectively. p=0.001).
Conclusion
In patients with known or suspected CAD, stress-induced worsening LV dyssynchrony may predict the presence of CAD and future cardiac events.
Acknowledgement/Funding
None
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Affiliation(s)
- S Katoh
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Watanabe
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Arimoto
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Narumi
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Aono
- Yamagata University School of Medicine, Yamagata, Japan
| | - J Goto
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Sugai
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Takahashi
- Yamagata University School of Medicine, Yamagata, Japan
| | - H Tamura
- Yamagata University School of Medicine, Yamagata, Japan
| | - S Nishiyama
- Yamagata University School of Medicine, Yamagata, Japan
| | - H Takahashi
- Yamagata University School of Medicine, Yamagata, Japan
| | - T Shishido
- Yamagata University School of Medicine, Yamagata, Japan
| | - M Watanabe
- Yamagata University School of Medicine, Yamagata, Japan
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22
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Aono T, Watanabe T, Takahashi T, Kato S, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Watanabe M. 5945Single nucleotide polymorphisms of PAR2 gene is associated with subclinical myocardial damage in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The protease activated receptor (PAR) 2 is a G protein-coupled receptor and expressed in cardiomyocytes, vascular cells, and leukocytes. Experimental studies demonstrated that PAR2 signaling is associated with adverse cardiac remodeling, heart failure, vascular inflammation and atherosclerosis. Recently, we and others demonstrated that subclinical myocardial damage is associated with cardiovascular mortality in general population. However, the impact of single nucleotide polymorphisms (SNPs) of PAR2 gene on subclinical myocardial damage in general population is unclear.
Purpose
The aim of this study was to investigate whether SNPs of PAR2 gene is associated with subclinical myocardial damage in general population.
Methods
The present study included 2,926 apparently healthy subjects (aged ≥40) who participated in a community-based health checkup. We investigated 639 SNPs and measured serum heart-type fatty acid binding protein (H-FABP) as markers of subclinical myocardial damage.
Results
We found the association of SNPs rs616235 within a PAR2 gene with subclinical myocardial damage. The homozygous A-allele (AA), heterozygous (AG), and homozygous G-allele (GG) carriers of rs616235 were identified in 2084 (71%), 791 (27%), and 51 (2%) subjects, respectively. The prevalence rates of subclinical myocardial damage were 29% in AA carriers, 23% in AG carriers, and 18% in GG carriers. Multivariate logistic analysis showed that the homozygous (AA) of rs616235 was independently associated with subclinical myocardial damage (odds ratio: 1.330, 95% confidence interval: 1.077–1.641, P=0.0080) after adjustment for conventional cardiovascular risk factors.
Conclusions
Genetic variant of PAR2 gene was independently associated with subclinical myocardial damage in the general population.
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Affiliation(s)
- T Aono
- Yamagata University, Yamagata, Japan
| | | | | | - S Kato
- Yamagata University, Yamagata, Japan
| | - H Tamura
- Yamagata University, Yamagata, Japan
| | | | | | - T Arimoto
- Yamagata University, Yamagata, Japan
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Kasar S, Sahoo SK, Arae H, Mishra S, Tokonami S, Aono T. URANIUM, THORIUM AND RARE EARTH ELEMENTS DISTRIBUTION IN FUKUSHIMA SOIL SAMPLES. Radiat Prot Dosimetry 2019; 184:363-367. [PMID: 31330003 DOI: 10.1093/rpd/ncz075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 06/10/2023]
Abstract
Uranium, thorium and rare earth elements (REEs) in soil samples contaminated by Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident was determined using inductively coupled plasma-mass spectrometry (ICP-MS). This information provides knowledge about concentration levels of REEs in soil samples as a background data after FDNPP accident. Chondrite-normalised REEs pattern does not show enrichment in concentrations of REEs, which could be related to FDNPP accident. The high concentration of these elements at few sampling points may be due to soil formation process from granitic rocks.
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Affiliation(s)
- S Kasar
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - S K Sahoo
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - H Arae
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - S Mishra
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
- Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | - S Tokonami
- Institute of Radiation Emergency Medicine, Hirosaki University, Aomori, Japan
| | - T Aono
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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24
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Goto J, Otaki Y, Watanabe T, Aono T, Watanabe K, Toshima T, Kato S, Tamura H, Nishiyama S, Arimoto T, Takahashi H, Shishido T, Kubota I, Watanabe M. P1615HECT-Type Ubiquitin E3 Ligase ITCH attenuates cardiac hypertrophy by suppressing Wnt signaling pathway. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The homologous to the E6-AP carboxyl terminus (HECT)–type ubiquitin E3 ligase ITCH is an enzyme that plays an important role in ubiquitin proteasomal protein degradation. Dishevelled proteins (Dvl1, Dvl2 and Dvl3), which are involved in canonical Wnt/β catenin signaling pathway, play a role in cardiac hypertrophy.
Purpose
The aim of this study was to examine whether ITCH interacts with Dvls and prevents cardiac hypertrophy induced by pressure overload.
Methods and results
We confirmed the protein interaction between ITCH and Dvls in cardiomyocytes. Overexpression of ITCH decreased protein expression levels of Dvls, phospho-GSK3β and β-catenin. Conversely, knockdown of ITCH using small interfering RNA augmented canonical Wnt/β catenin signaling pathway. Thoracic transverse aortic constriction (TAC) was performed in transgenic mice with cardiac-specific overexpression of ITCH (ITCH-Tg) and wild-type (WT) mice. The canonical Wnt/β catenin signaling pathway was inhibited and cardiac hypertrophy was attenuated in ITCH-Tg mice compared with WT mice after TAC.
Overexpression of ITCH in cardiomyocytes
Conclusion
We demonstrated that ITCH targets Dvls for ubiquitin-proteasome degradation in cardiomyocytes and ameliorates cardiac hypertrophy by suppressing canonical Wnt/β catenin signaling pathway.
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Affiliation(s)
- J Goto
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - Y Otaki
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Aono
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - K Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Toshima
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - S Kato
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - H Tamura
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - S Nishiyama
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Arimoto
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - H Takahashi
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - T Shishido
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - I Kubota
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
| | - M Watanabe
- Yamagata University, Department of Cardiology, Pulmonology, and Nephrology, Yamagata, Japan
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Kawamura G, Okayama H, Kawaguchi N, Kido S, Matsuda K, Aono T, Kosaki T, Hosokawa S, Tanaka Y, Shigematsu T, Kawada Y, Hiasa G, Yamada T, Matsuoka H, Kazatani Y. P1712Diagnostic performance of coronary flow reserve ratio for the detection of coronary artery disease on 13N-ammonia positron emission tomography. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1712] [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: 11/13/2022] Open
Affiliation(s)
- G Kawamura
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Okayama
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - N Kawaguchi
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Kido
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - K Matsuda
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Aono
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Kosaki
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - S Hosokawa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Tanaka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Shigematsu
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kawada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Hiasa
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Yamada
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Matsuoka
- Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Kazatani
- Ehime Prefectural Central Hospital, Matsuyama, Japan
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26
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Seino S, Tsuchiya A, Watanabe Y, Kawata Y, Kojima Y, Ikarashi S, Yanai H, Nakamura K, Kumaki D, Hirano M, Funakoshi K, Aono T, Sakai T, Sakata J, Takamura M, Kawai H, Yamagiwa S, Wakai T, Terai S. Clinical outcome of hepatocellular carcinoma can be predicted by the expression of hepatic progenitor cell markers and serum tumour markers. Oncotarget 2018; 9:21844-21860. [PMID: 29774107 PMCID: PMC5955154 DOI: 10.18632/oncotarget.25074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022] Open
Abstract
The high heterogeneity of hepatocellular carcinomas (HCCs) complicates stratification of HCC patients for treatment. Therefore, it is necessary to establish a comprehensive panel of HCC biomarkers related to tumour behaviour and cancer prognosis. Resected HCCs from 251 patients were stained for hepatic progenitor cell (HPC) markers epithelial cell adhesion molecule (EpCAM), neural cell adhesion molecule (NCAM), delta-like 1 homolog (DLK1), and cytokeratin 19 (CK19). Staining patterns were analysed for their prognostic association with relapse-free survival and overall survival. α-Fetoprotein (AFP), lectin-reactive α-fetoprotein (AFP-L3), and des-γ-carboxy prothrombin (DCP) were assessed as indicators of HPC protein expression. Expression pattern of HPC markers correlated with tumour malignancy indicated by high AFP/AFP-L3 serum levels, more frequent vascular invasion, and poorer tumour differentiation. EpCAM expression, DCP ≥300 mAU/ml, age ≥60, and Child-Pugh score grade B or C were independent prognostic factors of poor outcome and were used in a new scoring system for HCC prognosis after operation. Expression of two or more HPC markers was a significant predictor of poor HCC outcome and serum levels of AFP/AFP-L3 correlated with the expression of HPC proteins. Our study paved the way for further elucidation of the association among HPC markers, serum tumour markers, and HCC clinical outcome for precision medicine.
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Affiliation(s)
- Satoshi Seino
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yusuke Watanabe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yuzo Kawata
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yuichi Kojima
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Shunzo Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Hiroyuki Yanai
- Drug Discovery Laboratories, Chiome Bioscience Inc., 907 Nogawa, Miyamae-Ku, Kawasaki-Shi, Kanagawa 216-0001, Japan
| | - Koji Nakamura
- Drug Discovery Laboratories, Chiome Bioscience Inc., 907 Nogawa, Miyamae-Ku, Kawasaki-Shi, Kanagawa 216-0001, Japan
| | - Daisuke Kumaki
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Masaaki Hirano
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Kazuhiro Funakoshi
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Takashi Aono
- Division of Surgery, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Takeshi Sakai
- Division of Diagnostic Pathology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
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27
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Otani T, Kameyama H, Kaneko K, Sato T, Suzuki S, Okada T, Aono T, Muto I, Hasegawa M, Sakata J, Kobayashi T, Minagawa M, Kosugi SI, Kurosaki I, Wakai T. [A Case of Long-Term Survival of a Patient with Liver Metastasis of Colon Cancer and Suspected Inferior Vena Cava Invasion]. Gan To Kagaku Ryoho 2015; 42:2184-2186. [PMID: 26805305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 58-year-old woman was diagnosed with a sigmoid colon cancer and synchronous liver metastasis. Because an obstruction of the sigmoid colon was identified, the patient underwent sigmoidectomy. Computed tomography(CT)findings suggested possible vena cava and hepatic vein invasion. Therefore, the decision was made to offer systemic chemotherapy. The patient underwent 6 courses of chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin (mFOLFOX6). After 4 courses of chemotherapy, CT scans showed a significant reduction of the liver metastasis (reduction rate of 5 0%; a partial response) and demonstrated improved exclusion of the inferior vena cava and hepatic vein. After 6 courses of chemotherapy, we performed right trisegmentectomy of the liver and resection of the inferior vena cava and diaphragm. Postoperative pathological findings revealed negative margins, and no invasion of the inferior vena cava. The pathological response grade of the tumor after chemotherapy was determined to be Grade 2. Adjuvant chemotherapy was not performed because of the patient 's poor performance status. The patient was alive with no recurrence 8 years after resection of the liver metastasis.
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Affiliation(s)
- Takahiro Otani
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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Bu W, Zheng J, Aono T, Wu J, Tagami K, Uchida S, Guo Q, Yamada M. Pu Distribution in Seawater in the Near Coastal Area off Fukushima after the Fukushima Daiichi Nuclear Power Plant Accident. ACTA ACUST UNITED AC 2015. [DOI: 10.14494/jnrs.15.1_1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- W.T. Bu
- Research Center for Radiation Protection, National Institute of Radiological Sciences
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University
| | - J. Zheng
- Research Center for Radiation Protection, National Institute of Radiological Sciences
| | - T. Aono
- Research Center for Radiation Protection, National Institute of Radiological Sciences
| | - J.W. Wu
- Research Center for Radiation Protection, National Institute of Radiological Sciences
- State Key Laboratory of Marine Environment Science, Xiamen University
| | - K. Tagami
- Research Center for Radiation Protection, National Institute of Radiological Sciences
| | - S. Uchida
- Research Center for Radiation Protection, National Institute of Radiological Sciences
| | - Q.J. Guo
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University
| | - M. Yamada
- Department of Radiation Chemistry, Institute of Radiation Emergency Medicine, Hirosaki University
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29
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Kavasi N, Sahoo SK, Sorimachi A, Tokonami S, Aono T, Yoshida S. Measurement of 90Sr in soil samples affected by the Fukushima Daiichi Nuclear Power Plant accident. J Radioanal Nucl Chem 2014. [DOI: 10.1007/s10967-014-3649-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Takata H, Aono T, Tagami K, Uchida S. Concentration ratios of stable elements for selected biota in Japanese estuarine areas. Radiat Environ Biophys 2010; 49:591-601. [PMID: 20711600 DOI: 10.1007/s00411-010-0317-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 07/29/2010] [Indexed: 05/29/2023]
Abstract
For the estimation of radiation doses to organisms, concentration ratios (C ( R )s) of radionuclides are required. In the present study, C(R)s of various elements were obtained as analogues of radionuclides for algae, molluscs, and crustaceans, in eight estuarine areas around Japan. The elements measured were Na, Mg, K, Ca, V, Mn, Fe, Co, Ni, Cu, Rb, Sr, Y, Mo, Cd, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Pb, and U. The geometric mean (GM) values of C(R)s (GM-C(R)s) for alkali and alkaline earth elements, Mo, and U for all biota, as well as V for crustaceans, were less than 100 L/kg, while GM-C(R)s for the other elements were higher. When the obtained GM-C(R)s were compared with the C(R)s recommended in IAEA Technical Report Series 422 for marine organisms, no big differences between them were found; however, several elements (i.e. Cd and U for algae, Mn for molluscs, and Pb for crustaceans) were lower than the recommended C(R)s. In the present study, conversion factors (the ratio of C(R) for the whole body to that for muscle) for molluscs and crustaceans were also calculated, since data on edible parts of these organisms are generally available in the literature. For crustaceans, GM conversion factors of all the elements were more than one. For molluscs, GM conversion factors of rare earth elements and U were slightly higher than those for crustaceans, while GM conversion factors of the other elements were almost the same and less than 10. These results indicate that some elements tend to be concentrated in the internal organs of biota collected in the estuarine areas. For environmental radiological assessment, conversion factors from tissue to whole-body C(R) values are useful parameters.
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Affiliation(s)
- H Takata
- Office of Biospheric Assessment for Waste Disposal, National Institute of Radiological Sciences, Inage-ku, Chiba, Japan.
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Sato T, Muto I, Hasegawa M, Aono T, Sakai T, Oya T. Ductal carcinoma in situ with isolated tumor cells in the sentinel lymph node in a 17-year-old adolescent girl. Breast Cancer 2010; 20:271-4. [DOI: 10.1007/s12282-010-0205-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 03/05/2010] [Indexed: 01/01/2023]
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33
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Nakanishi T, Kusakabe M, Aono T, Yamada M. Simultaneous measurements of cosmogenic radionuclides 32P, 33P and 7Be in dissolved and particulate forms in the upper ocean. J Radioanal Nucl Chem 2009. [DOI: 10.1007/s10967-008-7374-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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34
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Sato T, Muto I, Hasegawa M, Aono T, Okada T, Hasegawa J, Makino S, Kameyama H, Tanaka R, Sekiya M. Breast signet-ring cell lobular carcinoma presenting with duodenal obstruction and acute pancreatitis. Asian J Surg 2007; 30:220-3. [PMID: 17638643 DOI: 10.1016/s1015-9584(08)60026-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
We report here an extremely rare case of breast signet-ring cell carcinoma (SRCC) initially manifesting as duodenal metastasis and acute pancreatitis. A 62-year-old female presented with duodenal obstruction and swollen head of the pancreas, and the diagnosis of acute pancreatitis was initially made. Upper gastrointestinal endoscopy revealed duodenal stenosis with erosive mucosa, with signet-ring cells infiltrating the submucosal layer, suggesting duodenal metastasis of SRCC. Despite absence of a palpable mass in both breasts, computed tomography revealed diffuse enhancement of the left breast in addition to left axillary lymphadenopathy. Histological examination of mammary needle biopsy samples revealed SRCC with a non-invasive lobular carcinoma component. Primary breast SRCC with duodenal metastasis was therefore diagnosed. The patient underwent palliative surgery twice for intestinal obstruction due to peritoneal dissemination. She has remained alive without bowel obstruction for 18 months while being treated with cytotoxic chemotherapies.
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Affiliation(s)
- Tomoi Sato
- Department of Surgery, Niigata Prefectural Central Hospital, Niigata, Japan.
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Abstract
We report here a rare form of invasive ductal carcinoma composed of a mass protruding from the tip of the nipple in a 43-year-old woman with hyperprolactinemia. She had been amenorrheic for 15 years following an incomplete pituitary adenomectomy for prolactinoma. She presented with a mass on the left nipple that had been growing for 6 months. Morphologically, the mass resembled adenoma of the nipple. Another mass was located in the subareolar region. She underwent mastectomy after invasive ductal carcinoma was diagnosed. Histopathologically, the tumor of the nipple was invasive ductal carcinoma, which had extended intraductally from another invasive ductal carcinoma in the subareolar region, and had infiltrated the epidermis of the nipple (Paget's disease). MR mammography successfully detected the relationship between the tumors. Postoperatively, the plasma prolactin level was abnormally high, while the plasma estradiol level was quite low, although macro-pituitary adenoma was not detected by MRI. The patient was treated with bromocriptine mesilate, in addition to adjuvant chemotherapy for breast cancer, and the plasma prolactin level has since normalized.
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Affiliation(s)
- Tomoi Sato
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu City, Niigata, Japan.
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Zheng J, Yamada M, Aono T, Kusakabe M. Vertical distribution of uranium concentrations and 235U/238U atom ratios in the coastal water off Aomori, Japan: A survey prior to the operation of a nuclear fuel reprocessing facility. J Radioanal Nucl Chem 2006. [DOI: 10.1007/s10967-006-0446-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Golub A, Aono T, Meir Y. Suppression of shot noise in quantum point contacts in the "0.7 regime". Phys Rev Lett 2006; 97:186801. [PMID: 17155566 DOI: 10.1103/physrevlett.97.186801] [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] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Indexed: 05/12/2023]
Abstract
Experimental investigations of current shot noise in quantum point contacts show a reduction of the noise near the 0.7 anomaly. It is demonstrated that such a reduction naturally arises in a model proposed recently to explain the characteristics of the 0.7 anomaly in quantum point contacts in terms of a quasibound state, due to the emergence of two conducting channels. We calculate the shot noise as a function of temperature, applied voltage, and magnetic field, and demonstrate an excellent agreement with experiments. It is predicted that, with decreasing temperature, voltage, and magnetic field, the dip in the shot noise is suppressed due to the Kondo effect.
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Affiliation(s)
- A Golub
- Physics Department, Ben-Gurion University, Beer Sheva 84105, Israel
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Abstract
AIMS To find the new microbial parameters explaining the soil fertility from the microbial community viewpoint. METHODS AND RESULTS Fatty acid methyl ester (FAME) analysis and terminal-restriction fragment length polymorphism (T-RFLP) analysis were carried out using 16 differently treated plots from the same field that had been kept under different fertilizer management systems since 1984. It was found that organic fertilizer application had small impact, whereas chemical fertilizer application, especially ammonium-nitrogen fertilizer, had strong impact on microbial community structures. Principal component analysis was conducted based on soil chemical and physical parameters, crop yields, FAMEs and terminal-restriction fragments (T-RFs) to provide 10 FAMEs and 10 T-RFs showing strong relation with soil fertility. CONCLUSION We defined these 10 FAMEs and 10 T-RFs as 'keystone' biological parameters explaining soil fertility in the soil. SIGNIFICANCE AND IMPACT OF THE STUDY This is the first report on the FAMEs and T-RFs related to soil fertility. Both analyses are rapid, inexpensive and reproducible means. As field assessment needs precise and rapid analysis, FAME and T-RFLP analyses and these new parameters are very useful to analyse soil fertility at biological viewpoint.
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Affiliation(s)
- C Suzuki
- Biotechnology Research Center, The University of Tokyo, Tokyo, Japan
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Hamada SI, Kamada M, Furumoto H, Hirao T, Aono T. Expression of glutathione S
-transferase-π in human ovarian cancer as an indicator of resistance to chemotherapy. Int J Gynaecol Obstet 2004. [DOI: 10.1016/0020-7292(94)90608-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Suzuki K, Kasai E, Aono T, Yamazaki H, Kawamoto K. De novo formation characteristics of dioxins in the dry zone of an iron ore sintering bed. Chemosphere 2004; 54:97-104. [PMID: 14559262 DOI: 10.1016/s0045-6535(03)00708-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The objectives of this work are to understand the details of the mechanism of dioxin formation in the part of a sintering bed termed the dry zone, and to obtain ideas on how to prevent their formation. Sinter mixtures of various composition types were heated in a packed bed reactor, and dioxins in the outlet gas and in the sinter mixture residue were measured. The dioxin formation potential of a simple sinter mixture composed of iron ore, coke and limestone was markedly lower than that of fly ash from a municipal solid waste incinerator (MSWI). In consideration of this result, a series of experiments were conducted using a sinter mixture impregnated with CuCl2. Experimental results showed that dioxin formation was temperature-dependent in the range of 300-550 degrees C, with the maximum observed at around 300 degrees C, which was quite similar to that of fly ash from the MSWI. The homologue distribution of PCDD/Fs in gas and solid reflected the possible difference in carbonaceous materials in coke and activated coke. Gaseous hydrogen chloride acted as a chlorinating reagent for dioxin formation.
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Affiliation(s)
- K Suzuki
- Department of Architectural Environmental Engineering, Kanto Gakuin University, 1-50-1 Mutsuurahigashi, Kanazawa-ku, Yokohama 236-8501, Japan.
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Nakagawa K, Yamano S, Tsutsumi Y, Matsumoto M, Hinokio K, Irahara M, Aono T, Naroda T, Kagawa S. The scheduled ovarian hyperstimulation method makes it easy to perform ICSI with fresh testicular sperm (ICSI/TESE). Arch Androl 2002; 48:329-36. [PMID: 12230818 DOI: 10.1080/01485010290099165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The authors evaluated whether scheduled ovarian stimulation makes it easy to perform ICSI with fresh testicular sperm. Scheduled ovarian hyperstimulation was applied for testicular sperm extraction and ICSI with fresh testicular spermatozoa. Fifteen cycles in 10 couples were included in the present study; all couples were azoospermic, 5 were obstructive, and the remaining 5 were nonobstructive. No cycles were canceled, and all oocyte retrievals were performed on the scheduled day. Testicular sperm were obtained in 14 treatment cycles (93%). The mean numbers of retrieved and injected oocytes were 9.4 and 6.4, respectively. The fertilization and cleavage rates were 47 and 91%, respectively. Embryo transfers were performed in 12 cycles except 2 cycles that had no embryos. The number of transferred embryos was 2.3. Two clinical pregnancies were obtained. This scheduled ovarian hyperstimulation was applicable for ICSI with fresh testicular sperm.
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Affiliation(s)
- K Nakagawa
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, Tokushima, Japan
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43
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Takahash K, Aono T, Shichinohe M, Tamura M, Iwata Y, Yamanishi K, Shigeta S. Herpesvirus DNA in peripheral blood mononuclear cells of some patients with Meniere's disease. Microbiol Immunol 2002; 45:635-8. [PMID: 11694075 DOI: 10.1111/j.1348-0421.2001.tb01296.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Herpes simplex virus-1 (HSV) or varicella zoster virus (VZV) DNA was detected by nested polymerase chain reaction in peripheral blood mononuclear cells of patients with Meniere's disease (one of 28 patients for HSV-1, 2 of 28 patients for VZV) during acute illness (within 5 days after onset). On the other hand, neither HSV-1 DNA or VZV DNA was detected in PBMCs of 50 age- and sex-matched healthy individuals and 50 pregnant women. These findings may imply that reactivation of HSV- 1 or VZV may be associated with the development of some cases of Meniere's disease.
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Affiliation(s)
- K Takahash
- Department of Microbiology, Fukushima Medical University, Fukushima, Japan.
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Yasui T, Uemura H, Tezuka M, Yamada M, Irahara M, Miura M, Aono T. Biological effects of hormone replacement therapy in relation to serum estradiol levels. Horm Res Paediatr 2002; 56:38-44. [PMID: 11815726 DOI: 10.1159/000048088] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Tissues in various parts of the body have different sensitivities to estradiol. However, it is very difficult to measure the serum estradiol levels precisely in women receiving oral conjugated equine estrogen, which is a mixture of estrogens. In the present study, we precisely measured the serum levels of estradiol in postmenopausal women undergoing hormone replacement therapy (HRT), and we clarified the relationships between serum estradiol levels and the effects of HRT on the Kupperman index, bone mineral density (BMD), serum gonadotropin, lipid metabolism and unscheduled bleeding as the clinical endpoints. METHODS Sixty-eight postmenopausal or bilaterally ovariectomized women, aged 30-64 years, who had been suffering from vasomotor symptoms such as hot flush or atrophy of the vagina were randomly assigned to two groups: one group of 34 patients who received oral administration of 0.625 mg conjugated equine estrogen (CEE, Premarin, Wyeth) and 2.5 mg medroxyprogesterone acetate (MPA, Provera, Upjohn) every other day, and another group of 34 patients who received oral administration of 0.625 mg CEE and 2.5 mg MPA every day. All subjects were re-classified into three groups according to the serum estradiol level after 12 months of treatment: (1) low estradiol group (<15 pg/ml, n = 25); (2) middle estradiol group (> or =15 and <25 pg/ml, n = 27), and (3) high estradiol group (> or =25 pg/ml, n = 16). We examined the relationships between serum estradiol level and the effects of estradiol on the Kupperman index, BMD, serum gonadotropin levels, lipid profile and unscheduled bleeding in these three groups. RESULTS RESULTS obtained by using our newly developed high-performance liquid chromatography (HPLC)-radioimmunoassay (RIA) system clearly showed that the effects on each tissue in postmenopausal women receiving oral CEE and MPA is closely related to estradiol level. The effects of HRT on BMD, serum gonadotropin levels and lipid profile were shown to be clearly dependent on the serum estradiol levels, while the effect of HRT on the Kupperman index was independent of the serum estradiol level. Furthermore, it was also found that a very low concentration of estradiol (<15 pg/ml) was sufficient to suppress the serum LH and FSH levels and to relieve vasomotor symptoms, and that the minimum concentration of estradiol required to increase BMD was 15 pg/ml. On the other hand, the level of estradiol required to reduce total cholesterol, low density lipoprotein-cholesterol (LDL-C) and apolipoprotein B (Apo B) was found to be more than 25 pg/ml, while the level required to increase high density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A1) was at least 15 pg/ml. The incidence of unscheduled bleeding was also lower in the low estradiol group than in the other estradiol level groups. CONCLUSION These results suggest that the different clinical endpoints have different response thresholds and thus reflect tissue sensitivity to estradiol levels achieved by HRT.
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Affiliation(s)
- T Yasui
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, Tokyo, Japan.
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Takikawa M, Kamada M, Maegawa M, Yamano S, Irahara M, Aono T, Futaki S, Ohmoto Y, Koide SS. Evaluation of two sperm antigens, rSMP-B and YWK-II, as targets for immunocontraception. ZYGOTE 2002; 9:145-51. [PMID: 11358321 DOI: 10.1017/s0967199401001150] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To determine whether sperm membrane components, rSMP-B and YWK-II, are suitable candidates as immunocontraceptives in humans, antifertility activities of the antibodies to the peptide fragments, rSMP-229 and rSMP-230 of rSMP-B and YAL-198 of YWK-II, were examined. In a previous report, anti-rSMP-230 antibody was shown to immobilise human sperm and to block human fertilisation, and the antigen (rSMP-230) to interact with antisperm antibodies found in sera of infertile women. Antibody to the second synthetic peptide, rSMP-229, corresponding to a different segment of rSMP-B, mimicked the biological activities of the anti-rSMP-230 antibody. Anti-YAL-198 antibody significantly, although weakly, inhibited human fertilisation. In the murine model, the anti-rSMP-B antibodies blocked in vitro fertilisation of mouse eggs but had no influence on embryo growth. Anti-YAL-198 antibody, however, arrested the growth of zygotes. In conclusion, rSMP-B, a human sperm protein, is a promising candidate in the development of an immunocontraceptive for human application. A second sperm protein, YWK-II, is effective as an antifertility immunogen in experimental animals.
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Affiliation(s)
- M Takikawa
- Department of Obstetrics and Gynecology, School of Medicine, The University of Tokushima, Japan
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Irahara M, Uemura H, Yasui T, Kinoshita H, Yamada M, Tezuka M, Kiyokawa M, Kamada M, Aono T. Efficacy of every-other-day administration of conjugated equine estrogen and medroxyprogesterone acetate on gonadotropin-releasing hormone agonists treatment in women with endometriosis. Gynecol Obstet Invest 2002; 52:217-22. [PMID: 11729332 DOI: 10.1159/000052978] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We performed a randomized controlled study to determine the efficacy of add-backed therapy by every-other-day administration of 0.625 mg conjugated equine estrogen (CEE) and 2.5 mg medroxyprogesterone acetate (MPA) on GnRH agonists (GnRH-a) treatment in Japanese women with symptomatic endometriosis. At the end of treatment, serum estrone and estradiol levels in the add-back group (n = 11) were significantly higher than those in the control group (n = 10). The assessment of Beecham classification by bimanual examination, serum CA-125 levels, and the frequency of genital bleeding revealed no significant differences between the two groups. The add-back group showed reduced Kupperman indices relative to those of the control group, and could prevent the loss of bone density. These findings led to a conclusion that GnRH-a therapy added back by every-other-day administration of 0.625 mg CEE and 2.5 mg MPA was a safe and effective treatment for Japanese women with endometriosis.
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Affiliation(s)
- M Irahara
- Department of Obstetrics and Gynecology, University of Tokushima, School of Medicine, Tokushima, Japan.
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Kinoshita H, Yasui T, Ushigoe K, Irahara M, Tanaka M, Nakashima K, Aono T. Expression of ovarian prolactin receptor in relation to hormonal changes during induction of ovulation in the rat. Gynecol Obstet Invest 2002; 52:132-8. [PMID: 11586043 DOI: 10.1159/000052958] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We examined the relationships between the expression of the short and long forms of the prolactin (PRL) receptor (PRLR) mRNA in the ovary and changes in the levels of serum hormones such as sex steroid hormones and PRL during induction of ovulation in the rat. The expression of both forms of PRLR mRNA in the ovary was examined by Northern blot analysis in immature female rats treated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Ovarian tissues and blood samples were obtained before treatment, 24 and 48 h after PMSG injection and 4, 6, 8, 12, 24 and 48 h after hCG treatment. Serum levels of 17beta-estradiol, progesterone and PRL were determined by radioimmunoassay. Serum levels of 17beta-estradiol rapidly increased to a maximal level 48 h after PMSG injection and then rapidly declined until 4 h after hCG injection. Serum levels of progesterone gradually increased after PMSG treatment, markedly increased to 114.2 nmol/l 8 h after hCG treatment and remained high until 48 h after hCG treatment. The serum level of PRL peaked at 66.2 microg/l (p < 0.01) 48 h after PMSG injection, and a temporary decrease after hCG treatment was followed by a continuously high level from 8 to 48 h. The expression of the long form of PRLR mRNA increased significantly (p < 0.01) to 688% of the control level after PMSG treatment, while that of the short form increased to only 184% of the control level. The expression of the long form of PRLR-mRNA rapidly declined until 6 h and then gradually increased until 48 h after hCG treatment. On the other hand, the expression of the short form of PRLR mRNA decreased to a nadir 12 h after hCG injection and then increased significantly (p < 0.01) to 142% of the control level. Our results showed that the changes in the short and long forms of PRLR mRNA differed in a time-specific manner and that these two forms are involved in different functions in the rat ovary during induction of ovulation. It is thought that the long form of PRLR mRNA is involved in folliculogenesis, while the short form of PRLR mRNA may play an important role in the formation and maintenance of the corpus luteum in the rat ovulatory cycle.
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Affiliation(s)
- H Kinoshita
- Department of Obstetrics and Gynecology, The University of Tokushima, School of Medicine, Tokushima, Japan
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Kamada M, Irahara M, Maegawa M, Ohmoto Y, Murata K, Yasui T, Yamano S, Aono T. Transient increase in the levels of T-helper 1 cytokines in postmenopausal women and the effects of hormone replacement therapy. Gynecol Obstet Invest 2002; 52:82-8. [PMID: 11586033 DOI: 10.1159/000052948] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to determine, at least in part, T-cell function in postmenopausal women and the effects of hormone replacement therapy (HRT). Levels of T-helper 1 (Th1) cytokines (IL-2 and IFN-gamma) and T-helper 2 (Th2) cytokines (IL-4 and IL-10) produced by phytohemagglutinin-stimulated whole blood cells from 72 untreated and 44 HRT-treated women were measured by ELISA. Thirteen of the 44 HRT-treated women were examined before and during HRT. The production of IL-2 increased gradually with advance of the postmenopausal period. The levels of IL-2 in women in the early (< or =10 years) and mid (>10 and <30 years) postmenopausal stages were significantly higher than those in women in their second, third and fourth decades. The level in women in the late (> or =30 years) postmenopausal stage, however, was significantly lower than those in women in the early and mid postmenopausal stages. The level of IFN-gamma was highest in women in the mid postmenopausal stage. On the other hand, the levels of Th2 cytokines did not change with age or after menopause until the mid postmenopausal period but were significantly lower in women in the late postmenopausal stage. IFN-gamma levels in women on HRT were significantly lower than those in untreated postmenopausal women at all postmenopausal stages. HRT induced a significant decrease in the production of IL-2 and IL-4. In conclusion, production of Th1 cytokines is augmented in women after menopause. HRT prevents this increase, thereby improving the aberration of Th1/Th2 balance that is implicated in an inadequate immune response and pathological conditions.
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Affiliation(s)
- M Kamada
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, Tokushima, Japan.
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Quan S, Yamano S, Nakagawa K, Irahara M, Kamada M, Aono T. Penetrating capacity of human spermatozoa cool preserved in electrolyte-free solution. J Reprod Med 2001; 46:957-61. [PMID: 11762151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To evaluate whether human spermatozoa preserved in electrolyte-free (EF) solution at 4 degrees C possess normal penetrating capacity. STUDY DESIGN The acrosomal status of human spermatozoa cool preserved in EF solution was evaluated before preservation and before and after reinitiation by using chlortetracycline staining. The zona-free hamster egg sperm penetration test was performed using spermatozoa cool preserved in EF solution. RESULTS The percentages of capacitated and acrosome-reacted spermatozoa cool preserved in EF solution before reinitiation were similar to those of fresh spermatozoa, but they significantly increased after reinitiation. The penetration rate and fertility index of spermatozoa cool preserved in EF solution were comparable to those of fresh spermatozoa (48.3% vs. 50.8% and 1.37 +/- 0.15 vs. 1.29 +/- 0.10, respectively). CONCLUSION Human spermatozoa cool preserved in EF solution for one week can possess as much penetrating capacity as fresh spermatozoa.
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Affiliation(s)
- S Quan
- Department of Obstetrics and Gynecology, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan
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Aono T, Kanada N, Ijima A, Oyaizu H. The response of the phosphate uptake system and the organic acid exudation system to phosphate starvation in Sesbania rostrata. Plant Cell Physiol 2001; 42:1253-1264. [PMID: 11726711 DOI: 10.1093/pcp/pce163] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
It is well known that the P(i) uptake system via the high-affinity P(i) transporter and the organic acid exudation system via PEPC are enhanced in the roots of P(i)-starved plants. In this paper, we compared the expression of these two systems in Sesbania rostrata, a leguminous plant, on whose roots and stems it forms nodules. When S. rostrata plants were transferred to a 0 microM P(i) nutrient solution, the expression of both the high-affinity P(i) transporter and PEPC was enhanced within 2 d. The enhancement of the expression of the high-affinity P(i) transporter genes and the PEPC gene coordinated with the increases in the P(i) uptake rate and the PEPC activity, respectively. This suggests that the expression of the high-affinity P(i) transporters and PEPC is regulated in part at the transcript level. Furthermore, we examined which of the environmental or the endogenous P(i) level regulates the expression of these two systems. The P(i) content in the 6-day-old plants decreased to a lower level than that in the 15-day-old plants when grown in a 30 microM P(i) solution. At that time, the expression of the high-affinity P(i) transporters and PEPC was enhanced only in the 6-day-old plants. Moreover, the P(i) content in plants forming many nodules on their stems decreased. The expression of the high-affinity P(i) transporters and PEPC was then enhanced in the nodulated plants. These facts suggest that the expression of these two systems may be regulated by the P(i) content in the plants, not by the P(i) concentration in the soil.
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Affiliation(s)
- T Aono
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo, 113-8657 Japan
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