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Katayama A, Maffucci P, Domanski A, Wang R, Sakai T. Abdominal Organ Transplantation: Noteworthy Literature in 2023. Semin Cardiothorac Vasc Anesth 2024; 28:113-126. [PMID: 38598365 DOI: 10.1177/10892532241247122] [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] [Indexed: 04/12/2024]
Abstract
This review highlights noteworthy literature published in 2023 and pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We feature 9 studies from 593 peer-reviewed papers on pancreatic transplantation, 3 from 194 on intestinal transplantation, and 28 from over 4513 on kidney transplantation. The liver transplantation section includes a special focus on 20 studies from 5666 clinical trial publications. We explore a broad range of topics, including donor management, perioperative recipient management, and innovative pharmacologic and mechanical interventions tested for the improvement of patient and graft outcomes and survival.
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Affiliation(s)
- Akira Katayama
- Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama, Japan
| | - Patrick Maffucci
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alex Domanski
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Wang
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, UPMC (University of Pittsburgh Medical Center), Pittsburgh, PA, USA
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Chadha R, Sakai T, Rajakumar A, Shingina A, Yoon U, Patel D, Spiro M, Bhangui P, Sun LY, Humar A, Bezinover D, Findlay J, Saigal S, Singh S, Yi NJ, Rodriguez-Davalos M, Kumar L, Kumaran V, Agarwal S, Berlakovich G, Egawa H, Lerut J, Clemens Broering D, Berenguer M, Cattral M, Clavien PA, Chen CL, Shah S, Zhu ZJ, Ascher N, Bhangui P, Rammohan A, Emond J, Rela M. Anesthesia and Critical Care for the Prediction and Prevention for Small-for-size Syndrome: Guidelines from the ILTS-iLDLT-LTSI Consensus Conference. Transplantation 2023; 107:2216-2225. [PMID: 37749811 DOI: 10.1097/tp.0000000000004803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND During the perioperative period of living donor liver transplantation, anesthesiologists and intensivists may encounter patients in receipt of small grafts that puts them at risk of developing small for size syndrome (SFSS). METHODS A scientific committee (106 members from 21 countries) performed an extensive literature review on aspects of SFSS with proposed recommendations. Recommendations underwent a blinded review by an independent expert panel and discussion/voting on the recommendations occurred at a consensus conference organized by the International Liver Transplantation Society, International Living Donor Liver Transplantation Group, and Liver Transplantation Society of India. RESULTS It was determined that centers with experience in living donor liver transplantation should utilize potential small for size grafts. Higher risk recipients with sarcopenia, cardiopulmonary, and renal dysfunction should receive small for size grafts with caution. In the intraoperative phase, a restrictive fluid strategy should be considered along with routine use of cardiac output monitoring, as well as use of pharmacologic portal flow modulation when appropriate. Postoperatively, these patients can be considered for enhanced recovery and should receive proactive monitoring for SFSS, nutrition optimization, infection prevention, and consideration for early renal replacement therapy for avoidance of graft congestion. CONCLUSIONS Our recommendations provide a framework for the optimal anesthetic and critical care management in the perioperative period for patients with grafts that put them at risk of developing SFSS. There is a significant limitation in the level of evidence for most recommendations. This statement aims to provide guidance for future research in the perioperative management of SFSS.
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Affiliation(s)
- Ryan Chadha
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Akila Rajakumar
- Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India
| | - Alexandra Shingina
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, TN
| | - Uzung Yoon
- Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Dhupal Patel
- Department of Anesthesia and Intensive Care Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Michael Spiro
- Department of Anaesthesia, Royal Devon and Exeter and Department of Anaesthesia and Intensive Care Medicine, The Royal Free Hospital, London, United Kingdom
| | - Pooja Bhangui
- Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Delhi, NCR, India
| | - Li-Ying Sun
- Department of Critical Liver Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Abhinav Humar
- Division of Transplantation, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Dmitri Bezinover
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA
| | - James Findlay
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Sanjiv Saigal
- Centre of Liver and Biliary Sciences, Centre of Gastroenterology, Hepatology and Endoscopy, Max Super Specialty Hospital, New Delhi, India
| | - Shweta Singh
- Department of Anesthesiology and Critical Care, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Nam-Joon Yi
- Division of HBP Surgery, Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea
| | - Manuel Rodriguez-Davalos
- Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT
| | - Lakshmi Kumar
- Department of Anesthesiology, Amrita Hospital, Kochi, India
| | - Vinay Kumaran
- Division of Transplant Surgery, Department of Surgery, VCU Medical Center, Richmond, VA
| | - Shaleen Agarwal
- Centre of Liver and Biliary Sciences, Centre of Gastroenterology, Hepatology and Endoscopy, Max Super Specialty Hospital, New Delhi, India
| | | | - Hiroto Egawa
- Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Jan Lerut
- Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Dieter Clemens Broering
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Marina Berenguer
- Liver Transplantation and Hepatology Unit, La Fe University Hospital and IISLaFe and Ciberehd, Valencia, Spain
| | - Mark Cattral
- Ajmera Transplant Center, University of Toronto, Toronto, ON, Canada
| | | | - Chao-Long Chen
- Liver Transplantation Centre, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Samir Shah
- Department of Hepatology, Institute of Liver Disease, HPB Surgery and Transplant, Global Hospitals, Mumbai, India
| | - Zhi-Jun Zhu
- Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Clinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, China
| | - Nancy Ascher
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Prashant Bhangui
- Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Delhi, NCR, India
| | - Ashwin Rammohan
- Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India
| | - Jean Emond
- Liver and Abdominal Transplant Surgery, Columbia University Irving Medical Center, New York, NY
| | - Mohamed Rela
- Institute of Liver Disease and Transplantation, Dr Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India
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Seki K, Seki T, Imagama T, Matsuki Y, Kawakami T, Sakai T. Efficacy of repeated administration of intravenous acetaminophen for pain management after total knee arthroplasty. Acta Orthop Belg 2023; 89:469-475. [PMID: 37935231 DOI: 10.52628/89.3.10347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Intravenous acetaminophen is an integral component of multimodal postoperative pain management. This prospective study aims to assess the efficacy of the repeated administration of intravenous acetaminophen and the impact on postoperative patient satisfaction with postoperative pain management after total knee arthroplasty (TKA). We enrolled 98 patients scheduled for unilateral TKA. Patients were randomly assigned to receive either 1000 mg of intravenous acetaminophen at 6-hour intervals (AAP group) or not to receive intravenous acetaminophen (control group). All patients underwent single-shot femoral nerve block after general anesthesia, as well as intraoperative periarticular infiltration of analgesia prior to implantation. The primary outcome was the postoperative numerical rating scale (NRS) pain score at rest. The NRS score was measured just before the administration of study drugs, immediately after arrival in the ward (time 0), and at 6, 12, 18, 24, and 48 h (time 1 to time 5, respectively) postoperatively. We also evaluated the mean doses of rescue opioid use for 24 h postoperatively. At time 5, the AAP group had significantly improved mean NRS score than controls (3.0 vs. 4.0; P < 0.01). Rescue opioid use was significantly lower in the AAP group for 24 hours compared to controls (0.3 μg vs. 0.9 μg; P < 0.01). Repeated intravenous acetaminophen administration after TKA may provide better analgesia and reduce opioid use.
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Hiraoka E, Tanabe K, Izuta S, Kubota T, Kohsaka S, Kozuki A, Satomi K, Shiomi H, Shinke T, Nagai T, Manabe S, Mochizuki Y, Inohara T, Ota M, Kawaji T, Kondo Y, Shimada Y, Sotomi Y, Takaya T, Tada A, Taniguchi T, Nagao K, Nakazono K, Nakano Y, Nakayama K, Matsuo Y, Miyamoto T, Yazaki Y, Yahagi K, Yoshida T, Wakabayashi K, Ishii H, Ono M, Kishida A, Kimura T, Sakai T, Morino Y. JCS 2022 Guideline on Perioperative Cardiovascular Assessment and Management for Non-Cardiac Surgery. Circ J 2023; 87:1253-1337. [PMID: 37558469 DOI: 10.1253/circj.cj-22-0609] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Affiliation(s)
- Eiji Hiraoka
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center
| | - Kengo Tanabe
- Division of Cardiology, Mitsui Memorial Hospital
| | | | - Tadao Kubota
- Department of General Surgery, Tokyo Bay Urayasu Ichikawa Medical Center
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Amane Kozuki
- Division of Cardiology, Osaka Saiseikai Nakatsu Hospital
| | | | | | - Toshiro Shinke
- Division of Cardiology, Showa University School of Medicine
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Susumu Manabe
- Department of Cardiovascular Surgery, International University of Health and Welfare Narita Hospital
| | - Yasuhide Mochizuki
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Taku Inohara
- Department of Cardiovascular Medicine, Keio University Graduate School of Medicine
| | - Mitsuhiko Ota
- Department of Cardiovascular Center, Toranomon Hospital
| | | | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital
| | - Yumiko Shimada
- JADECOM Academy NP·NDC Training Center, Japan Association for Development of Community Medicine
| | - Yohei Sotomi
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Tomofumi Takaya
- Department of Cardiovascular Medicine, Hyogo Prefectural Himeji Cardiovascular Center
| | - Atsushi Tada
- Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
| | - Tomohiko Taniguchi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | - Kazuya Nagao
- Department of Cardiology, Osaka Red Cross Hospital
| | - Kenichi Nakazono
- Department of Pharmacy, St. Marianna University Yokohama Seibu Hospital
| | | | | | - Yuichiro Matsuo
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center
| | | | | | | | | | | | - Hideki Ishii
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine
| | - Minoru Ono
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University
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Cerza DA, Battista CF, Sharma G, Sakai T. Publication Rate of Abstracts Presented at the 2011-2019 Society for Education in Anesthesia Meetings. J Educ Perioper Med 2023; 25:E707. [PMID: 37720367 PMCID: PMC10502582 DOI: 10.46374/volxxv_issue3_cerza] [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] [Indexed: 09/19/2023]
Abstract
Introduction The Society for Education in Anesthesia (SEA) promotes dissemination of discoveries and innovations. We investigated the rate of publication of SEA Spring Meeting abstracts, hypothesizing that Research abstracts were published more frequently than Innovative Curriculum abstracts. We also studied the time between abstract presentation and publication and tracked the journals in which they were published. Methods All abstracts presented at SEA spring meetings from 2011-2019 were included. We searched PubMed for published articles that were based on those SEA abstracts. We calculated the overall publication rate and the respective publication rates for Research and Innovative Curriculum abstracts. We calculated odds ratio (OR) and performed the Pearson χ2 test to compare publication rates between Research abstracts and Innovative Curriculum abstracts. We calculated the mean number of years between meeting presentation and publication and tabulated the number of works published in each journal. Results A total of 351 abstracts (128 Research and 223 Curriculum) were presented at SEA spring meetings. The overall publication rate was 15% (52/351). Research abstracts were published more frequently than Curriculum abstracts: 24.2% (31/128) versus 9.4% (21/223); OR = 3.1 (95% confidence interval, 1.7-5.6); P = .0003. The mean time from presentation to publication was 1.7 ± 1.3 years. The works appeared in 20 different journals. Conclusion SEA Spring Meeting abstracts were published less frequently than abstracts from other medical professional society meetings (21%-72.3%). Although the lower publication rate of Innovative Curriculum abstracts unique to the SEA meeting largely explains this shortfall, a relatively low publication rate, even for the Research abstracts, signals opportunities for growth.
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Affiliation(s)
- Dante A. Cerza
- Dante A. Cerza is an Attending Physician at Nemours Children’s Hospital, Delaware, Wilmington, DE, and Chair-Designee of the Society for Education in Anesthesia Research Committee, Milwaukee, WI. Collin F. Battista is a Resident Physician at New York University Grossman School of Medicine, New York, NY. Gautam Sharma is an Assistant Professor of Anesthesiology at the University of Arizona, Tucson, AZ. Tetsuro Sakai is a Professor of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA, and Chair of the Society for Education in Anesthesia Research Committee, Milwaukee, WI
| | - Collin F. Battista
- Dante A. Cerza is an Attending Physician at Nemours Children’s Hospital, Delaware, Wilmington, DE, and Chair-Designee of the Society for Education in Anesthesia Research Committee, Milwaukee, WI. Collin F. Battista is a Resident Physician at New York University Grossman School of Medicine, New York, NY. Gautam Sharma is an Assistant Professor of Anesthesiology at the University of Arizona, Tucson, AZ. Tetsuro Sakai is a Professor of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA, and Chair of the Society for Education in Anesthesia Research Committee, Milwaukee, WI
| | - Gautam Sharma
- Dante A. Cerza is an Attending Physician at Nemours Children’s Hospital, Delaware, Wilmington, DE, and Chair-Designee of the Society for Education in Anesthesia Research Committee, Milwaukee, WI. Collin F. Battista is a Resident Physician at New York University Grossman School of Medicine, New York, NY. Gautam Sharma is an Assistant Professor of Anesthesiology at the University of Arizona, Tucson, AZ. Tetsuro Sakai is a Professor of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA, and Chair of the Society for Education in Anesthesia Research Committee, Milwaukee, WI
| | - Tetsuro Sakai
- Dante A. Cerza is an Attending Physician at Nemours Children’s Hospital, Delaware, Wilmington, DE, and Chair-Designee of the Society for Education in Anesthesia Research Committee, Milwaukee, WI. Collin F. Battista is a Resident Physician at New York University Grossman School of Medicine, New York, NY. Gautam Sharma is an Assistant Professor of Anesthesiology at the University of Arizona, Tucson, AZ. Tetsuro Sakai is a Professor of Anesthesiology and Perioperative Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA, and Chair of the Society for Education in Anesthesia Research Committee, Milwaukee, WI
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Nolasco L, Igwe D, Smith NK, Sakai T. Abdominal Organ Transplantation: Noteworthy Literature in 2022. Semin Cardiothorac Vasc Anesth 2023; 27:97-113. [PMID: 37037789 DOI: 10.1177/10892532231169075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
This review highlights noteworthy literature published in 2022 pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We begin by exploring the impacts that the COVID-19 pandemic has had across the field of abdominal organ transplantation, including the successful use of grafts procured from COVID-19-infected donors. In pancreatic transplantation, we highlight several studies on dexmedetomidine and ischemia-reperfusion injury, equity in transplantation, and medical management, as well as studies comparing pancreatic transplantation to islet cell transplantation. In our section on intestinal transplantation, we explore donor selection. Kidney transplantation topics include cardiovascular risk management, obesity, and intraoperative management, including fluid resuscitation, dexmedetomidine, and sugammadex. The liver transplantation section focuses on clinical trials, systematic reviews, and meta-analyses published in 2022 and covers a wide range of topics, including machine perfusion, cardiovascular issues, renal issues, and coagulation/transfusion.
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Affiliation(s)
- Lyle Nolasco
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Divya Igwe
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Natalie K Smith
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, 6595University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Iesato A, Ueno T, Takahashi Y, Kataoka A, Matsunaga Y, Saeki S, Ozaki Y, Inoue Y, Maeda T, Uehiro N, Kobayashi T, Sakai T, Takano T, Kogawa T, Kitano S, Ono M, Osako T, Ohno S. P145 Postpartum breast cancer diagnosed within 10 years of last childbirth is a prognostic factor for distant metastasis – analysis of lymphovascular invasion relating factors. Breast 2023. [DOI: 10.1016/s0960-9776(23)00262-x] [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: 03/15/2023] Open
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Abe S, Asami S, Eizuka M, Futagi S, Gando A, Gando Y, Gima T, Goto A, Hachiya T, Hata K, Hayashida S, Hosokawa K, Ichimura K, Ieki S, Ikeda H, Inoue K, Ishidoshiro K, Kamei Y, Kawada N, Kishimoto Y, Koga M, Kurasawa M, Maemura N, Mitsui T, Miyake H, Nakahata T, Nakamura K, Nakamura K, Nakamura R, Ozaki H, Sakai T, Sambonsugi H, Shimizu I, Shirai J, Shiraishi K, Suzuki A, Suzuki Y, Takeuchi A, Tamae K, Ueshima K, Watanabe H, Yoshida Y, Obara S, Ichikawa AK, Chernyak D, Kozlov A, Nakamura KZ, Yoshida S, Takemoto Y, Umehara S, Fushimi K, Kotera K, Urano Y, Berger BE, Fujikawa BK, Learned JG, Maricic J, Axani SN, Smolsky J, Fu Z, Winslow LA, Efremenko Y, Karwowski HJ, Markoff DM, Tornow W, Dell'Oro S, O'Donnell T, Detwiler JA, Enomoto S, Decowski MP, Grant C, Li A, Song H. Search for the Majorana Nature of Neutrinos in the Inverted Mass Ordering Region with KamLAND-Zen. Phys Rev Lett 2023; 130:051801. [PMID: 36800472 DOI: 10.1103/physrevlett.130.051801] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/10/2022] [Accepted: 11/29/2022] [Indexed: 06/18/2023]
Abstract
The KamLAND-Zen experiment has provided stringent constraints on the neutrinoless double-beta (0νββ) decay half-life in ^{136}Xe using a xenon-loaded liquid scintillator. We report an improved search using an upgraded detector with almost double the amount of xenon and an ultralow radioactivity container, corresponding to an exposure of 970 kg yr of ^{136}Xe. These new data provide valuable insight into backgrounds, especially from cosmic muon spallation of xenon, and have required the use of novel background rejection techniques. We obtain a lower limit for the 0νββ decay half-life of T_{1/2}^{0ν}>2.3×10^{26} yr at 90% C.L., corresponding to upper limits on the effective Majorana neutrino mass of 36-156 meV using commonly adopted nuclear matrix element calculations.
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Affiliation(s)
- S Abe
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Asami
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - M Eizuka
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Futagi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Gando
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Gando
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Gima
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Goto
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Hachiya
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Hata
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Hayashida
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Hosokawa
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Ichimura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Ieki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Ikeda
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Inoue
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Ishidoshiro
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Kamei
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - N Kawada
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Kishimoto
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Koga
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Kurasawa
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - N Maemura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Mitsui
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Miyake
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - T Nakahata
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - R Nakamura
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Ozaki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
- Graduate Program on Physics for the Universe, Tohoku University, Sendai 980-8578, Japan
| | - T Sakai
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Sambonsugi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - I Shimizu
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - J Shirai
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Shiraishi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Suzuki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Suzuki
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - A Takeuchi
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Tamae
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - K Ueshima
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - H Watanabe
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - Y Yoshida
- Research Center for Neutrino Science, Tohoku University, Sendai 980-8578, Japan
| | - S Obara
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - A K Ichikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - D Chernyak
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Kozlov
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Z Nakamura
- Kyoto University, Department of Physics, Kyoto 606-8502, Japan
| | - S Yoshida
- Graduate School of Science, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Takemoto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Umehara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - K Fushimi
- Department of Physics, Tokushima University, Tokushima 770-8506, Japan
| | - K Kotera
- Graduate School of Integrated Arts and Sciences, Tokushima University, Tokushima 770-8502, Japan
| | - Y Urano
- Graduate School of Integrated Arts and Sciences, Tokushima University, Tokushima 770-8502, Japan
| | - B E Berger
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - J Maricic
- Department of Physics and Astronomy, University of Hawaii at Manoa, Honolulu, Hawaii 96822, USA
| | - S N Axani
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Smolsky
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Z Fu
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Efremenko
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Department of Physics and Astronomy, University of Tennessee, Knoxville, Tennessee 37996, USA
| | - H J Karwowski
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - D M Markoff
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - W Tornow
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
| | - S Dell'Oro
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J A Detwiler
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - S Enomoto
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Center for Experimental Nuclear Physics and Astrophysics, University of Washington, Seattle, Washington 98195, USA
| | - M P Decowski
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, Chiba 277-8583, Japan
- Nikhef and the University of Amsterdam, Science Park, Amsterdam, Netherlands
| | - C Grant
- Boston University, Boston, Massachusetts 02215, USA
| | - A Li
- Triangle Universities Nuclear Laboratory, Durham, North Carolina 27708, USA; Physics Departments at Duke University, Durham, North Carolina 27708, USA; North Carolina Central University, Durham, North Carolina 27707, USA; and The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA
- Boston University, Boston, Massachusetts 02215, USA
| | - H Song
- Boston University, Boston, Massachusetts 02215, USA
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9
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Yamashina H, Sakai T, Akatsu T, Takatsu Y, Okuda Y. Current Status on Medical Radiation Safety Management in Asia: A Questionnaire Survey. J Med Imaging Radiat Sci 2022. [DOI: 10.1016/j.jmir.2022.10.169] [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: 12/03/2022]
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10
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Hendrickse A, Ko J, Sakai T. The care of donors and recipients in adult living donor liver transplantation. BJA Educ 2022; 22:387-395. [PMID: 36132878 PMCID: PMC9482866 DOI: 10.1016/j.bjae.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- A. Hendrickse
- University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - J. Ko
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - T. Sakai
- UPMC (University of Pittsburgh Medical Center), Pittsburgh, PA, USA
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11
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Izumi H, Sakamoto T, Uchibori K, Nishino K, Sakakibara-Konishi J, Nomura S, Ryohei K, Udagawa H, Shibata Y, Ikeda T, Niho S, Sakai T, Zenke Y, Nosaki K, Matsumoto S, Yoh K, Goto K. 997P Phase I study of brigatinib plus panitumumab in patients with advanced EGFR-mutated non-small cell lung cancer resistant to osimertinib (BEBOP): Early termination due to severe early onset pneumonitis by brigatinib. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Okahisa M, Udagawa H, Matsumoto S, Kato T, Oizumi S, Furuya N, Hayakawa D, Toyozawa R, Nishiyama A, Ohashi K, Miyamoto S, Nishino K, Oi H, Sakai T, Shibata Y, Izumi H, Sugiyama E, Nosaki K, Zenke Y, Yoh K, Goto K. EP08.02-113 Clinico-genomic Characteristics of Patients with Non-small Cell Lung Cancer Harboring EGFR Exon 20 Insertion Mutations. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.796] [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: 10/14/2022]
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13
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Frabitore SZ, Brea F, Emerick T, Sakai T, Lebovitz E, Adams PS. Creating anesthesiologist-innovators: An integrated innovation curriculum addressing barriers to physician-led innovation. J Clin Anesth 2022; 82:110947. [PMID: 35961225 DOI: 10.1016/j.jclinane.2022.110947] [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] [Received: 05/26/2022] [Revised: 07/18/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Stephen Z Frabitore
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America.
| | - Fernando Brea
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America
| | - Trent Emerick
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America
| | - Tetsuro Sakai
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America
| | - Evan Lebovitz
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America
| | - Phillip S Adams
- UPMC, Department of Anesthesiology and Perioperative Medicine, 3471 Fifth Avenue, Suite 402, Pittsburgh, PA 15213, United States of America
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14
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Sakai T. Acute kidney injury after adult liver transplantation-Doesn't intraoperative management matter? Liver Transpl 2022; 28:1131-1132. [PMID: 35380742 DOI: 10.1002/lt.26469] [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] [Received: 03/03/2022] [Accepted: 03/03/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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15
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Yamada K, Sakai T, Mizushima I, Hoshiba R, Suzuki F, Mizutomi K, Kawano M, Masaki Y. POS0615 CLINICAL DEMOGRAPHICS AND FACTORS AFFECTING DRYNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSjogren’s syndrome (SS) is known to coexist with rheumatoid arthritis (RA). However, the prevalence of RA with SS varies widely, from 2.4% to 30%, and some patients with RA without SS also show dryness. The prevalence and clinical demographics of dryness in patients with RA are not well recognized.ObjectivesThe aim of this study was to clarify the prevalence, clinical demographics, and related factors of dryness in patients with RA who have not been diagnosed with (SS).MethodsWe enrolled 166 patients with RA (129 females, 37 males; mean age 65.8±14.3 years; disease duration 14.1±10.9 years; DAS28-CRP 2.30±0.92) who were not diagnosed with SS. We analyzed CRP, the estimated glomerular filtration rate (eGFR), RF, anti-CCP antibody, antinuclear antibody, anti-SS-A antibody (SSA), and disease activity score (DAS) 28-CRP, and identified treatments for RA. We used each question item of the EULAR SS Patient Reported Index (ESSPRI) to clarify dryness, somatic and mental fatigue, and pain. History of smoking, comorbidities, such as interstitial pneumonia, fibromyalgia, and psychiatric disorders, and narcotic and/or psychotropic medication use were determined from the medical records. We defined patients with dryness as greater than or equal to one point, and those with severe dryness as greater than or equal to five points, of the visual analog scale (VAS).ResultsDryness was observed in 93/166 (56.0%) patients and severe dryness was identified in 57/166 (34.4%) patients, and SSA was positive in 23/139 patients(13.9%). We divided our patients into dryness and non-dryness groups and compared their clinical demographics. The dryness group was relatively younger (64.0±14.5 vs. 68.1±13.8 years, p=0.052), had a female predominance (89.2% vs. 63.0%, p<0.001), had severe fatigue (4.06±2.59 vs 2.60±2.78, p<0.001), and had severe pain (3.52±2.41 vs. 2.73±2.32, p=0.020). However, the prevalence of SSA did not significantly differ in this cohort, compared with the non-dryness group (19.3% vs. 11.8%, p=0.248). Next, we analyzed the clinical characteristics of the patients with severe dryness. The severe dryness group was younger (61.9±15.5 vs. 67.9±13.2 years, p=0.022), had higher eGFR (76.1±15.5 vs. 68.9±22.7, p=0.020), had more severe fatigue (4.89±2.42 vs. 2.85±2.63), p<0.001), and had more severe pain (4.16±2.51 vs. 2.65±2.18, p<0.001), compared with non-severe dryness group. The prevalence of SSA was also significantly higher in the severe dryness group (91.2% vs. 70.6%, p=0.002). We then performed a multifactorial analysis using logistic regression analysis with a stepwise method. Female sex (OR 3.739, 1.247-11.207) and VAS of fatigue (OR 1.269, 1.054-1.526) were found to independently relate to dryness.ConclusionMore than half of the patients with RA had dryness, although only 13.9% of patients were SSA positive. Dryness was related to female predominance and fatigue. Simon et al. reported that SS was found in 2.42% of patients with RA (1). On the other hand, Harrold et al. reported that SS was found in 30% of patients with RA, and the prevalence of SS increased with duration of RA (2). Our data indicate that patients with fatigue, regardless of pain, tend to have dryness, which may be a key factor in diagnosing SS in patients with RA.References[1]Simon TA, Kawabata H, Ray N, et.al. Prevalence of Co-existing Autoimmune Disease in Rheumatoid Arthritis: A Cross-Sectional Study. Adv Ther. 2017 Nov;34(11):2481-2490.[2]Harrold LR, Shan Y, Rebello S, et al. Prevalence of Sjögren’s syndrome associated with rheumatoid arthritis in the USA: an observational study from the Corrona registry. Clin Rheumatol. 2020 Jun;39(6):1899-1905.Disclosure of InterestsNone declared
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St Jules R, Blech D, Smith NK, Sakai T. Abdominal Organ Transplantation: Noteworthy Literature in 2021. Semin Cardiothorac Vasc Anesth 2022; 26:140-153. [PMID: 35608409 DOI: 10.1177/10892532221093955] [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] [Indexed: 11/15/2022]
Abstract
This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. In 2021, we identified noteworthy papers from over 1,200 peer-reviewed publications on pancreatic transplantation, over 1,400 on intestinal transplantation, and over 9,000 on kidney transplantation. The liver transplantation section focuses on clinical trials and systematic reviews and meta-analyses published in 2021 and features 20 selected papers. COVID-19 and abdominal organ transplantation are featured in an independent section.
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Affiliation(s)
- Robert St Jules
- Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Daniel Blech
- Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Natalie K Smith
- Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, UPMC (University of Pittsburgh Medical Center), Pittsburgh, PA, USA
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17
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Goda AE, Sakai T. Molecular insights into the microtubules depolymerizing activity of the IL-8 receptor B antagonist SB225002. Eur Rev Med Pharmacol Sci 2022; 26:3726-3734. [PMID: 35647855 DOI: 10.26355/eurrev_202205_28869] [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: 06/15/2023]
Abstract
OBJECTIVE We have previously reported the novel off-target microtubules destabilizing activity of SB225002, a compound that was originally designed as a selective and potent IL-8 receptor B antagonist. In the present study we investigated the reversibility of SB225002 antimitotic effect and provided additional mechanistic insights underlying cell death induction in SW480 human colorectal adenocarcinoma cells. MATERIALS AND METHODS Mitotically arrested cells by SB225002 treatment were isolated by shake-off, and their identity was verified by both flow cytometry and immunoblotting. The reversibility of SB225002 antimitotic effects was investigated by flow cytometry and immunoblotting. Prometaphase arrested cells were imaged via indirect immunofluorescence and confocal microscopy. Activation of CHK1 in mitotically arrested cells was assessed by immunoblotting, and the relationship between CHK1 and mitotic arrest was examined via siRNA-mediated knockdown of CHK1. JNK signaling was evaluated via immunoblotting as well as pharmacological inhibition, followed by flow cytometry. The role of reactive oxygen species (ROS) in cytotoxicity was evaluated by ROS scavenging and flow cytometry. RESULTS Following SB225002 washout, the mitotic checkpoint was abrogated, and cell cycle perturbations were gradually restored with induction of cell death. Mechanistically, CHK1 checkpoint was activated by SB225002 and occurred downstream of the mitotic checkpoint. In addition, SB225002 activated JNK signaling which contributed to cell death and restrained polyploidy. Furthermore, SB225002 increased intracellular ROS which played a role in mediating SB225002 cytotoxicity. CONCLUSIONS Findings of the present study warrants further development of SB225002 as a lead compound that uniquely targets microtubules dynamics and IL-8 signaling.
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Affiliation(s)
- A E Goda
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
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Sakai T, Ko JS, Crouch CE, Kumar S, Choi GS, Hackl F, Han DH, Kaufman M, Kim SH, Luzzi C, McCluskey S, Shin WJ, Sirianni J, Song KW, Sullivan C, Hendrickse A. Perioperative management of living donor liver transplantation: Part 2 - Donors. Clin Transplant 2022; 36:e14690. [PMID: 35477939 DOI: 10.1111/ctr.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/26/2022] [Accepted: 04/23/2022] [Indexed: 01/10/2023]
Abstract
Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation method has become a widely practiced and established transplantation option for adult patients suffering with end-stage liver disease, and it has successfully helped address the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplantation Anesthesiologists jointly reviewed published studies on the perioperative management of adult live liver donors undergoing donor hemi-hepatectomy. The goal of the review is to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live donors. We featured the current status, donor selection process, outcomes and complications, surgical procedure, anesthetic management, Enhanced Recovery After Surgery protocols, avoidance of blood transfusion, and considerations for emergency donation. Recent surgical advances, including laparoscopic donor hemi-hepatectomy and robotic laparoscopic donor surgery, are also addressed.
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Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.,Clinical and Translational Science Institute, University of Pittsburgh, Pennsylvania, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pennsylvania, USA
| | - Justin Sangwook Ko
- Department of Anesthesiology & Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cara E Crouch
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Sathish Kumar
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Florian Hackl
- Department of Anesthesiology and Interventional Pain Management, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Dai Hoon Han
- Department of HBP Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Michael Kaufman
- Department of Anesthesiology and Interventional Pain Management, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Seong Hoon Kim
- Organ Transplantation Center, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Carla Luzzi
- Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stuart McCluskey
- Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Won Jung Shin
- Department of Anesthesiology & Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joel Sirianni
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ki Won Song
- Department of Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
| | - Cinnamon Sullivan
- Department of Anesthesiology, Emory University, Atlanta, Georgia, USA
| | - Adrian Hendrickse
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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19
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Sakai T, Ko JS, Crouch CE, Kumar S, Little MB, Chae MS, Ganoza A, Gómez-Salinas L, Humar A, Kim SH, Koo BN, Rodriguez G, Sirianni J, Smith NK, Song JG, Ullah A, Hendrickse A. Perioperative management of adult living donor liver transplantation: Part 1 - recipients. Clin Transplant 2022; 36:e14667. [PMID: 35435293 DOI: 10.1111/ctr.14667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/06/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
Living donor liver transplantation was first developed to mitigate the limited access to deceased donor organs in Asia in the 1990s. This alternative liver transplantation option has become an established and widely practiced transplantation method for adult patients suffering from end-stage liver disease. It has successfully addressed the shortage of deceased donors. The Society for the Advancement of Transplant Anesthesia and the Korean Society of Transplant Anesthesia jointly reviewed published studies on the perioperative management of live donor liver transplant recipients. The review aims to offer transplant anesthesiologists and critical care physicians a comprehensive overview of the perioperative management of adult live liver transplantation recipients. We feature the status, outcomes, surgical procedure, portal venous decompression, anesthetic management, prevention of acute kidney injury, avoidance of blood transfusion, monitoring and therapeutic strategies of hemodynamic derangements, and Enhanced Recovery After Surgery protocols for liver transplant recipients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,Clinical and Translational Science Institute, University of Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, PA, USA
| | - Justin Sangwook Ko
- Department of Anesthesiology & Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Cara E Crouch
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sathish Kumar
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael B Little
- Department of Anesthesiology, UT Health San Antonio, San Antonio, TX, USA
| | - Min Suk Chae
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Armando Ganoza
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Luis Gómez-Salinas
- Department of Anesthesiology and Pain Medicine, Hospital General Universitario de Alicante, Alicante, Spain
| | - Abhi Humar
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sang Hyun Kim
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggi-do, Republic of Korea
| | - Bon-Nyeo Koo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gonzalo Rodriguez
- Department of Surgery, Hospital General Universitario de Alicante, Alicante, Spain
| | - Joel Sirianni
- Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Natalie K Smith
- Department of Anesthesiology, Perioperative & Pain Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Jun-Gol Song
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Aisha Ullah
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Adrian Hendrickse
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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20
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Li H, Sakai T, Tanaka A, Ogura M, Lee C, Yamaguchi S, Imazato S. Interpretable AI Explores Effective Components of CAD/CAM Resin Composites. J Dent Res 2022; 101:1363-1371. [DOI: 10.1177/00220345221089251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
High flexural strength of computer-aided manufacturing resin composite blocks (CAD/CAM RCBs) are required in clinical scenarios. However, the conventional in vitro approach of modifying materials’ composition by trial and error was not efficient to explore the effective components that contribute to the flexural strength. Machine learning (ML) is a powerful tool to achieve the above goals. Therefore, the aim of this study was to develop ML models to predict the flexural strength of CAD/CAM RCBs and explore the components that affect flexural strength as the first step. The composition of 12 commercially available products and flexural strength were collected from the manufacturers and literature. The initial data consisted of 16 attributes and 12 samples. Considering that the input data for each sample were recognized as a multidimensional vector, a fluctuation range of 0.1 was proposed for each vector and the number of samples was augmented to 120. Regression algorithms—that is, random forest (RF), extra trees, gradient boosting decision tree, light gradient boosting machine, and extreme gradient boosting—were used to develop 5 ML models to predict flexural strength. An exhaustive search and feature importance analysis were conducted to analyze the effective components that affected flexural strength. The R2 values for each model were 0.947, 0.997, 0.998, 0.983, and 0.927, respectively. The relative errors of all the algorithms were within 15%. Among the high predicted flexural strength group in the exhaustive search, urethane dimethacrylate was contained in all compositions. Filler content and triethylene glycol dimethacrylate were the top 2 features predicted by all models in the feature importance analysis. ZrSiO4 was the third important feature for all models, except the RF model. The ML models established in this study successfully predicted the flexural strength of CAD/CAM RCBs and identified the effective components that affected flexural strength based on the available data set.
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Affiliation(s)
- H. Li
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - T. Sakai
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - A. Tanaka
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - M. Ogura
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - C. Lee
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - S. Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - S. Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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21
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Vogt KM, Citro AT, Adams PS, Metro DG, Sakai T. Early immersion in a dedicated one-month Anesthesiology Professional Practice rotation for Post-Graduate Year-1 interns is associated with an increase in scholarly activity during residency. J Clin Anesth 2022; 76:110566. [PMID: 34695751 PMCID: PMC8904148 DOI: 10.1016/j.jclinane.2021.110566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/23/2021] [Accepted: 10/17/2021] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVE Despite the Accreditation Council for Graduate Medical Education scholarly activity requirement, incorporating education on scholarly fundamentals into residency is challenging. We designed and implemented an academic non-clinical rotation for Post Graduate Year-1 (PGY-1) interns and its association with subsequent resident scholarly productivity was determined. We hypothesized that early immersion in such a rotation would be associated with increased scholarly activity during residency. DESIGN Retrospective educational comparative study, of two cohorts of anesthesiology residents in the graduating classes of 2015-2020. SETTING Large anesthesiology residency program at a U.S. academic medical center. INTERVENTION A one-month academic rotation titled Anesthesia Professional Practice for PGY-1 interns has been implemented since 2014. The rotation curriculum broadly covers important topics for scholarly projects and provides introductions to academic faculty and institutional resources. MEASUREMENTS The scholarly products (abstracts, publications, book chapters, research protocols, and grant applications) were quantified using Scholarly Activity Points, a previously described metric that accounts for significance and the resident's contribution. Total Scholarly Activity Points for each resident and number of publications prior to residency were determined for both cohorts. Segmented regression was employed with Scholarly Activity Points as the outcome; participation in the early immersion rotation and prior publications were used as input variables. MAIN RESULTS Resident participation in the early immersion rotation was significantly associated with higher Scholarly Activity Points. The confounding variable of pre-residency publication count was not significantly correlated to this increase. CONCLUSIONS Immersion in a one-month academic program during PGY-1 internship may contribute to increased scholarly productivity during residency.
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Affiliation(s)
- Keith M. Vogt
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine,Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh,Center for the Neural Basis of Cognition
| | - Ally T. Citro
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine
| | - Philip S. Adams
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine
| | - David G. Metro
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine,Clinical and Translational Science Institute, University of Pittsburgh,McGowan Institute of Regenerative Medicine, University of Pittsburgh,Corresponding author: Tetsuro Sakai, Address: 3459 Fifth Avenue, UPMC Montefiore - Suite 469.4, Pittsburgh, PA 15213, Phone: (412)-648-6943,
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22
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Nagae M, Umegaki H, Yoshiko A, Fujita K, Komiya H, Watanabe K, Yamada Y, Sakai T. Muscle Evaluation and Hospital-Associated Disability in Acute Hospitalized Older Adults. J Nutr Health Aging 2022; 26:681-687. [PMID: 35842758 PMCID: PMC9194346 DOI: 10.1007/s12603-022-1814-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We aimed to examine the association of muscle evaluation, including muscle ultrasound, with hospital-associated disability (HAD), focusing on ADL categories. DESIGN A prospective observational cohort study. SETTING AND PARTICIPANTS We recruited patients aged 65 years or older who were admitted to the geriatric ward of an acute hospital between October 2019 and September 2021. MEASUREMENTS Handgrip strength, bioimpedance analyzer-determined skeletal muscle mass, bilateral thigh muscle thickness (BATT), and the echo intensity of the rectus femoris on muscle ultrasound were performed as muscle assessments. HAD was evaluated separately for mobility impairments and self-care impairments. RESULTS In total, 256 individuals (mean age, 85.2 years; male sex, 41.8%) were analyzed. HAD in mobility was more common than HAD in self-care (37.5% vs. 30.0%). Only BATT was independently associated with HAD in mobility in multiple logistic regression analysis. There was no significant association between muscle indicators and HAD in self-care. CONCLUSION A lower BATT was associated with a higher prevalence of HAD in mobility, suggesting the need to reconsider muscle assessment methods in hospitalized older adults. In addition, approaches other than physical may be required, such as psychosocial and environmental interventions to improve HAD in self-care.
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Affiliation(s)
- M Nagae
- Hiroyuki Umegaki. Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. E-mail:
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23
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Souki FG, Chadha R, Planinsic R, Zerillo J, Nguyen-Buckley C, Smith N, Mandell MS, Sakai T, Nicolau-Raducu R. Recommendations From the Society for the Advancement of Transplant Anesthesiology Fellowship Committee: Core Competencies and Milestones for the Kidney/Pancreas Component of Abdominal Organ Transplant Anesthesia Fellowship. Semin Cardiothorac Vasc Anesth 2021; 26:15-26. [PMID: 34872395 DOI: 10.1177/10892532211058574] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Society for the Advancement of Transplant Anesthesia (SATA) is dedicated to improving patient care in all facets of transplant anesthesia. The anesthesia fellowship training recommendations for thoracic transplantation (heart and lungs) and part of the abdominal organ transplantation (liver) have been presented in previous publications. The SATA Fellowship Committee has completed the remaining component of abdominal transplant anesthesia (kidney/pancreas) and has assembled core competencies and milestones derived from expert consensus to guide the education and overall preparation of trainees providing care for kidney/pancreas transplant recipients. These recommendations provide a comprehensive approach to pre-operative evaluation, vascular access procedures, advanced hemodynamic monitoring, assessment of coagulation and metabolic abnormalities, operative techniques, and post-operative pain control. As such, this document supplements the current liver/hepatic transplant anesthesia fellowship training programs to include all aspects of "Abdominal Organ Transplant Anesthesia" recommended knowledge.
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Affiliation(s)
- Fouad G Souki
- Department of Anesthesiology, 12235University of Miami, Jackson Memorial Hospital, Miami, FL, USA
| | - Ryan Chadha
- Department of Anesthesiology, 23389Mayo Clinic, Jacksonville, FL, USA
| | - Raymond Planinsic
- Department of Anesthesiology, 6595University of Pittsburgh Medical Center, Pittsburgh, AR, USA
| | - Jeron Zerillo
- Department of Anesthesiology, 5944Mount Sinai Medical Center, New York, NY, USA
| | | | - Natalie Smith
- Department of Anesthesiology, 5944Mount Sinai Medical Center, New York, NY, USA
| | - M Susan Mandell
- Department of Anesthesiology, 129263University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Tetsuro Sakai
- Department of Anesthesiology, 6595University of Pittsburgh Medical Center, Pittsburgh, AR, USA
| | - Ramona Nicolau-Raducu
- Department of Anesthesiology, 12235University of Miami, Jackson Memorial Hospital, Miami, FL, USA
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24
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Crouch C, Sakai T, Aniskevich S, Damian D, De Marchi L, Kaufman M, Kumar S, Little M, McCluskey S, Pivalizza E, Sellers D, Sridhar S, Stoll W, Sullivan C, Hendrickse A. Adult liver transplant anesthesiology practice patterns and resource utilization in the United States: Survey results from the society for the advancement of transplant anesthesia. Clin Transplant 2021; 36:e14504. [PMID: 34637561 DOI: 10.1111/ctr.14504] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Liver transplant anesthesiology is an evolving and expanding subspecialty, and programs have, in the past, exhibited significant variations of practice at transplant centers across the United States. In order to explore current practice patterns, the Quality & Standards Committee from the Society for the Advancement of Transplant Anesthesia (SATA) undertook a survey of liver transplant anesthesiology program directors. METHODS Program directors were invited to participate in an online questionnaire. A total of 110 program directors were identified from the 2018 Scientific Registry of Transplant Recipients (SRTR) database. Replies were received from 65 programs (response rate of 59%). RESULTS Our results indicate an increase in transplant anesthesia fellowship training and advanced training in transesophageal echocardiography (TEE). We also find that the use of intraoperative TEE and viscoelastic testing is more common. However, there has been a reduction in the use of veno-venous bypass, routine placement of pulmonary artery catheters and the intraoperative use of anti-fibrinolytics when compared to prior surveys. CONCLUSION The results show considerable heterogeneity in practice patterns across the country that continues to evolve. However, there appears to be a movement towards the adoption of specific structural and clinical practices.
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Affiliation(s)
- Cara Crouch
- Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA
| | - Tetsuro Sakai
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephen Aniskevich
- Department of Anesthesiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Daniela Damian
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lorenzo De Marchi
- Department of Anesthesiology, Medstar-Georgetown University Hospital, Washington, DC, USA
| | - Michael Kaufman
- Department of Anesthesiology, Beth Israel Lahey Health, Burlington, Massachusetts, USA
| | - Sathish Kumar
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Little
- Department of Anesthesiology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
| | - Stuart McCluskey
- Department of Anesthesiology, University of Toronto, Toronto, Ontario, Canada
| | - Evan Pivalizza
- Department of Anesthesiology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Daniel Sellers
- Department of Anesthesiology, University of Toronto, Toronto, Ontario, Canada
| | - Srikanth Sridhar
- Department of Anesthesiology, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - William Stoll
- Department of Anesthesiology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cinnamon Sullivan
- Department of Anesthesiology, Emory University, Atlanta, Georgia, USA
| | - Adrian Hendrickse
- Department of Anesthesiology, University of Colorado, Aurora, Colorado, USA
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25
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Tamura T, Sakai T, Henker R, O'Donnell JM. Certified registered nurse anesthetist and anesthesiologist assistant education programs in the United States. Nagoya J Med Sci 2021; 83:609-626. [PMID: 34552293 PMCID: PMC8437993 DOI: 10.18999/nagjms.83.3.609] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
In Japan, a relative shortage of practicing anesthesiologists continues to be a national issue. To address this issue, some Japanese medical institutions have started developing curriculums to train non-physician perioperative anesthesia personnel, including nurse practitioners and perianesthesia nurses. We urgently need to establish a national standard for the education programs that train these extended non-physician anesthesia care providers. A certified registered nurse anesthetist educational program at a large academic medical center in the United States is described in detail as a reference. Highly systematic educational programs using simulation, didactics, and full clinical subspecialty rotations are ideal if not easily achievable in many current training institutions in Japan. Anesthesia assistant education programs in the United States can be used as an additional reference to create a national educational program in Japan.
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Affiliation(s)
- Takahiro Tamura
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Tetsuro Sakai
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Richard Henker
- Department of Nurse Anesthesia, University of Pittsburgh School of Nursing, Pittsburgh, USA
| | - John M O'Donnell
- Department of Nurse Anesthesia, University of Pittsburgh School of Nursing, Pittsburgh, USA
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26
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Armstead V, Bucklin B, Bustillo M, Hastie MJ, Lane-Fall M, Lee A, Leffert L, Mackensen GB, Minhaj M, Sakai T, Straker T, Thenuwara K, Whitlock E, Whittington R, Wiener-Kronish J, Wong C. On the Importance of Language in Reports Discussing Racial Inequities. Anesth Analg 2021; 132:e117-e118. [PMID: 34032683 DOI: 10.1213/ane.0000000000005534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Valerie Armstead
- Leadership Advisory Board, Association of University Anesthesiologists, San Francisco, California,
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Abstract
In 2020, we identified and screened over 490 peer-reviewed publications on pancreatic transplantation, over 500 on intestinal transplantation, and over 5000 on kidney transplantation. The liver transplantation section specially focused on clinical trials and systematic reviews published in 2020 and featured selected articles. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a wide range of topics, including COVID-19 and organ transplantation, risk factors and outcomes, pain management, artificial intelligence, robotic donor surgery, and machine perfusion.
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Affiliation(s)
- Ryan F Wang
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Erica J Fagelman
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Natalie K Smith
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Tetsuro Sakai
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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28
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Yamauchi Y, Saito Y, Shirai S, Yokote F, Sakai T, Dejima H, Sakao Y, Kawamura M. P04.08 Dynamics of Coagulation Factor XIII Activity After Thoracoscopic Lobectomy for Early-Stage Lung Cancer Patients. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Mandell MS, Sakai T, Wagener G, De Marchi L, Subramaniam K, JHuang J, Hendrickse A, Deshpande R, Ryan C, Pretto EA. The Society for the Advancement of Transplant Anesthesia (SATA) enters a new partnership with Clinical Transplantation. Clin Transplant 2021; 35:e14203. [PMID: 33475197 DOI: 10.1111/ctr.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- M Susan Mandell
- Department of Anesthesiology, University of Colorado Anschutz Medical Center, Denver, CO, USA
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gebhard Wagener
- Department of Anesthesiology, Columbia University Medical Center, New York, NY, USA
| | - Lorenzo De Marchi
- Department of Anesthesiology, MedStar-Georgetown University Hospital, Washington, DC, USA
| | - Kathirvel Subramaniam
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jiapeng JHuang
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Adrian Hendrickse
- Department of Anesthesiology, University of Colorado Anschutz Medical Center, Denver, CO, USA
| | - Ranjit Deshpande
- Department of Anesthesiology, Yale University, New Haven, CT, USA
| | - Chadha Ryan
- Department of Anesthesiology, Mayo Clinic, Jacksonville, FL, USA
| | - Ernesto A Pretto
- Department of Anesthesiology and Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, FL, USA
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30
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Smith NK, Zerillo J, Kim SJ, Efune GE, Wang C, Pai SL, Chadha R, Kor TM, Wetzel DR, Hall MA, Burton KK, Fukazawa K, Hill B, Spad MA, Wax DB, Lin HM, Liu X, Odeh J, Torsher L, Kindscher JD, Mandell MS, Sakai T, DeMaria S. Intraoperative Cardiac Arrest During Adult Liver Transplantation: Incidence and Risk Factor Analysis From 7 Academic Centers in the United States. Anesth Analg 2021; 132:130-139. [PMID: 32167977 DOI: 10.1213/ane.0000000000004734] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Intraoperative cardiac arrest (ICA) has a reported frequency of 1 in 10,000 anesthetics but has a much higher estimated incidence in orthotopic liver transplantation (OLT). Single-center studies of ICA in OLT are limited by small sample size that prohibits multivariable regression analysis of risks. METHODS Utilizing data from 7 academic medical centers, we performed a retrospective, observational study of 5296 adult liver transplant recipients (18-80 years old) between 2000 and 2017 to identify the rate of ICA, associated risk factors, and outcomes. RESULTS ICA occurred in 196 cases (3.7% 95% confidence interval [CI], 3.2-4.2) and mortality occurred in 62 patients (1.2%). The intraoperative mortality rate was 31.6% in patients who experienced ICA. In a multivariable generalized linear mixed model, ICA was associated with body mass index (BMI) <20 (odds ratio [OR]: 2.04, 95% CI, 1.05-3.98; P = .0386), BMI ≥40 (2.16 [1.12-4.19]; P = .022), Model for End-Stage Liver Disease (MELD) score: (MELD 30-39: 1.75 [1.09-2.79], P = .02; MELD ≥40: 2.73 [1.53-4.85], P = .001), postreperfusion syndrome (PRS) (3.83 [2.75-5.34], P < .001), living donors (2.13 [1.16-3.89], P = .014), and reoperation (1.87 [1.13-3.11], P = .015). Overall 30-day and 1-year mortality were 4.18% and 11.0%, respectively. After ICA, 30-day and 1-year mortality were 43.9% and 52%, respectively, compared to 2.6% and 9.3% without ICA. CONCLUSIONS We established a 3.7% incidence of ICA and a 1.2% incidence of intraoperative mortality in liver transplantation and confirmed previously identified risk factors for ICA including BMI, MELD score, PRS, and reoperation and identified new risk factors including living donor and length of surgery in this multicenter retrospective cohort. ICA, while rare, is associated with high intraoperative mortality, and future research must focus on therapy to reduce the incidence of ICA.
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Affiliation(s)
- Natalie K Smith
- From the Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Jeron Zerillo
- From the Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Sang Jo Kim
- Department of Anesthesiology, Hospital for Special Surgery, New York City, New York
| | - Guy E Efune
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Cynthia Wang
- Department of Anesthesiology, Greater Los Angeles VA Healthcare System, Los Angeles, California
| | - Sher-Lu Pai
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida
| | - Ryan Chadha
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, Florida
| | - Todd M Kor
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - David R Wetzel
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael A Hall
- Department of Anesthesiology, Christiana Care Health System, Newark, Delaware
| | - Kristen K Burton
- Department of Anesthesiology and Critical Care, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kyota Fukazawa
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Bryan Hill
- Department of Anesthesiology, The Ohio State University, Columbus, Ohio
| | | | - David B Wax
- From the Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Hung-Mo Lin
- Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Xiaoyu Liu
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jaffer Odeh
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Laurence Torsher
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - James D Kindscher
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas
| | - M Susan Mandell
- Department of Anesthesiology, University of Colorado Hospital, Aurora, Colorado.,The Center for Perioperative & Pain Quality, Safety and Outcomes-PPQiSO, University of Washington Medical Center, Seattle, Washington
| | - Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Samuel DeMaria
- From the Department of Anesthesiology, Perioperative and Pain Medicine, The Icahn School of Medicine at Mount Sinai, New York City, New York
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Amino M, Kabuki S, Kunieda E, Sakai T, Sakama S, Ayabe K, Yagishita A, Shimokawa T, Yamazaki M, Ikari Y, Kodama I, Yoshioka K. Basic mechanism of atrial and ventricular arrhythmia suppression by heavy ion irradiation in hypercholesterolemic elderly rabbits. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3695] [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
Recent development of electrophysiology-guided noninvasive cardiac radioablation therapy for ventricular tachycardia attracts a great deal of attention as a novel antiarrhythmic strategy (Robinson CG, Circulation 2019). As to underlying mechanisms, however, much remains to be clarified. We reported before that a single targeted heavy ion irradiation (THIR 15Gy) to rabbit hearts increased connexin43 (Cx43) expression, and a reduction of vulnerability to ventricular arrhythmias after myocardial infarction.
Purpose
We investigated the effects of THIR on in-vivo cardiac electrophysiology and vulnerability to atrial and ventricular tachyarrhythmias in aged rabbits with hypercholesterolemia.
Methods
Sixteen three-year old rabbits were fed with high fat/cholesterol chow (0.5% cholesterol and 10% coconut oil) for 14 weeks. A single THIR 15Gy was applied to 8 rabbits (HC+THIR) with a heavy ion medical accelerator. Eight rabbits without THIR were used as control (HC).
Results
Serum cholesterol levels in the HC and HC+THIR were 1545+386 and 1569+328 mg/dl (n=8, NS). Atrial (P-wave) late potential in signal-averaged ECG in HC+THIR showed a significantly larger root mean square voltage (RMS) than those in HC (12+0.5 vs. 2+0.5μV, n=4, p<0.01). Ventricular late potentials in HC+THIR showed significantly less fQRS-D than HC (81+5 vs. 89+7 ms); less LAS40 (21+7 vs. 30+4 ms), and larger RMS (99+27 vs. 44+13μV) (n=4, p<0.04). Atrial tachycardia or fibrillation (AT/AF) was induced spontaneously or by programmed/burst pacing of the left atria (LA) in 4 out of 4 HC, whereas in only 1 out of 4 HC+THIR. Ventricular tachycardia or fibrillation (VT/VF) was induced spontaneously or by programmed pacing or left stellate stimulation in 4 out of 4 HC rabbits, whereas in only 1 out of 4 HC+THIR. Immunolabeled Cx40 densities in LA and RA tissue from HC+THIR rabbits were significantly higher than those from HC rabbits by 44% and 60%, respectively (n=4, p<0.01). Comparable upregulation of immunoreactive Cx43 was observed in LV and RV tissue from HC+THIR rabbits. Sympathetic nerve densities in LA, RA, LV and RV tissues, which was labeled with anti-neuronal growth-associated protein 43 (GAP43) antibody and tyrosine hydroxylase (TH) antibody were both significantly less in HC+THIR than those in HC.
Conclusion
These results suggest that THIR may improve cardiac conductivity of HC rabbits in favor of reduction of vulnerability to atrial and ventricular tachycardia/fibrillation, and that this antiarrhythmic effect is attributed to upregulation of gap junction protein (Cx40 and Cx43) and in part to prevention of sympathetic nerve sprouting.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): KAKENHI KIBAN (C) 53020
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Affiliation(s)
- M Amino
- Tokai University Hospital, Isehara, Japan
| | - S Kabuki
- Tokai University Hospital, Isehara, Japan
| | - E Kunieda
- Tokai University Hospital, Isehara, Japan
| | - T Sakai
- Tokai University Hospital, Isehara, Japan
| | - S Sakama
- Tokai University Hospital, Isehara, Japan
| | - K Ayabe
- Tokai University Hospital, Isehara, Japan
| | | | - T Shimokawa
- National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - M Yamazaki
- University of Tokyo, Medical Device Development and Regulation Research Center, Tokyo, Japan
| | - Y Ikari
- Tokai University Hospital, Isehara, Japan
| | - I Kodama
- Nagoya University, Nagoya, Japan
| | - K Yoshioka
- Tokai University Hospital, Isehara, Japan
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32
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Sakai T. Viscoelastic testing in liver transplantation. Transfusion 2020; 60 Suppl 6:S61-S69. [PMID: 33089935 DOI: 10.1111/trf.16077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 01/24/2023]
Abstract
Despite the lack of large randomized clinical studies, viscoelastic tests (VETs) have been a critical armamentarium for hemostatic control in liver transplantation (LT) since the 1960s. Many transplant institutions have adopted VETs in their clinical practice. Several small-size randomized clinical trials on LT patients have suggested that VET-guided hemostatic treatment algorithms have led to decreased indications for and amounts of transfused blood products, especially fresh-frozen plasma, compared to standard laboratory-based hemostatic management. VETs have also been reported to offer insight into the diagnosis and prediction of LT patients' development of hypercoagulability-related morbidity and mortality. There is still a need for VET device-specific hemostatic algorithms in LT, and clinicians must take into account the tendency to underestimate the coagulation capacity of VETs in patients with end-stage liver disease where hemostasis is rebalanced.
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Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, UPMC (University of Pittsburgh Medical Center), Pittsburgh, Pennsylvania, USA
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Marumo F, Sakai T, Shirataka M. A multivariate factor analysis of the high plasma concentration of cyclic AMP in patients with chronic renal failure. Int J Artif Organs 2020. [DOI: 10.1177/039139888000300107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The concentration of cyclic AMP which is known as an intracellular mediator of hormone action increased in the plasma of patients with chronic renal failure (CRF). In the present study, the plasma concentration of cyclic AMP significantly correlated not only with serum, creatinine, and urea levels, but also with plasma PTH and glucagon in patients with CRF. Furthermore, plasma concentrations of PTH and glucagon correlated with the serum creatinine concentration to a significant extent. To discuss the cause of the increased cyclic AMP concentration in plasma of patients with CRF, multivariate analyses were carried out on the obtained clinical data from patients and normal subjects. In the factor analysis on the clinical data from 61 subjects, cyclic AMP, creatinine and BUN correlated with the first factor and PTH correlated with the second factor. The cumulative contribution ratio by the second factor was 76%. The results of the cluster analysis indicated that cyclic AMP, creatinine, and BUN formed a cluster and PTH glucagon made another cluster. These results suggest that the elevated plasma concentration of cyclic AMP in patients with CRF was mainly introduced not by overproduction but by the retention of cyclic AMP due to the decreased renal function.
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Affiliation(s)
- F. Marumo
- Department of Medicine Kitasato University School of Medicine Sagamihara, Kanagawa, Japan
| | - T. Sakai
- Department of Medicine Kitasato University School of Medicine Sagamihara, Kanagawa, Japan
| | - M. Shirataka
- Department of Medicine Kitasato University School of Medicine Sagamihara, Kanagawa, Japan
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Siegrist KK, Latham GJ, Huang J, Subramaniam K, Zerillo JD, Sakai T, Weitzel N, Kertai MD. Anesthesia Professionals: Helping to Lead the COVID-19 Pandemic Response From Behind the Drape and Beyond. Semin Cardiothorac Vasc Anesth 2020; 24:121-126. [PMID: 32342723 DOI: 10.1177/1089253220922327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Gregory J Latham
- Seattle Children's Hospital, Seattle, WA, USA.,University of Washington Medical Center, Seattle, WA, USA
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Abstract
In the year 2019, we identified and screened over 400 peer-reviewed publications on pancreatic transplantation, over 200 on intestinal transplantation, and over 1900 on kidney transplantation. The liver transplantation section focuses on and features selected articles among 70 clinical trials published in 2019. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a broad range of topics, including risks for and prediction of perioperative complications, updated indications for transplantation, recommendations on perioperative management, including Enhanced Recovery After Surgery programs, and topics relevant to optimization of patient and graft outcomes and survival.
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Affiliation(s)
- Diana N Romano
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Natalie K Smith
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Corey R Vasisko
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Jeron Zerillo
- The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Tetsuro Sakai
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Hendrickse A, Crouch C, Sakai T, Stoll WD, McNulty M, Pivalizza E, Sridhar S, Diaz G, Sheiner P, Nevah Rubin MI, Al-Khafaji A, Pomposelli J, Mandell MS. Service Requirements of Liver Transplant Anesthesia Teams: Society for the Advancement of Transplant Anesthesia Recommendations. Liver Transpl 2020; 26:582-590. [PMID: 31883291 DOI: 10.1002/lt.25711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/13/2019] [Indexed: 12/13/2022]
Abstract
There are disparities in liver transplant anesthesia team (LTAT) care across the United States. However, no policies address essential resources for liver transplant anesthesia services similar to other specialists. In response, the Society for the Advancement of Transplant Anesthesia appointed a task force to develop national recommendations. The Conditions of Transplant Center Participation were adapted to anesthesia team care and used to develop Delphi statements. A Delphi panel was put together by enlisting 21 experts from the fields of liver transplant anesthesiology and surgery, hepatology, critical care, and transplant nursing. Each panelist rated their agreement with and the importance of 17 statements. Strong support for the necessity and importance of 13 final items were as follows: resources, including preprocedure anesthesia assessment, advanced monitoring, immediate availability of consultants, and the presence of a documented expert in liver transplant anesthesia credentialed at the site of practice; call coverage, including schedules to assure uninterrupted coverage and methods to communicate availability; and characteristics of the team, including membership criteria, credentials at the site of practice, and identification of who supervises patient care. Unstructured comments identified competing time obligations for anesthesia and transplant services as the principle reason that the remaining recommendations to attend integrative patient selection and quality review committees were reduced to a suggestion rather than being a requirement. This has important consequences because deficits in team integration cause higher failure rates in service quality, timeliness, and efficiency. Solutions are needed that remove the time-related financial constraints of competing service requirements for anesthesiologists. In conclusion, using a modified Delphi technique, 13 recommendations for the structure of LTATs were agreed upon by a multidisciplinary group of experts.
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Affiliation(s)
| | - Cara Crouch
- Department of Anesthesiology, University of Colorado, Aurora, CO
| | - Tetsuro Sakai
- Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA
| | - William D Stoll
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC
| | - Monica McNulty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Evan Pivalizza
- Department of Anesthesiology, UTHealth McGovern Medical School, Houston, TX
| | - Srikanth Sridhar
- Department of Anesthesiology, UTHealth McGovern Medical School, Houston, TX
| | - Geraldine Diaz
- Department of Anesthesiology, SUNY Downstate Medical Center, State University of New York, Brooklyn, NY
| | | | | | - Ali Al-Khafaji
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA
| | | | - M Susan Mandell
- Department of Anesthesiology, University of Colorado, Aurora, CO
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Lebovitz EE, Nguyen AVT, Sakai T. Economic considerations in abdominal transplantation. Best Pract Res Clin Anaesthesiol 2020; 34:15-23. [DOI: 10.1016/j.bpa.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/26/2019] [Accepted: 01/08/2020] [Indexed: 12/16/2022]
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Nagumo M, Wada S, Saitou T, Li H, Sakai T, Iwanaga S. 88 Severe tricuspid regurgitation due to papillary muscle rupture: A rare complication of anterior myocardial infarction and ventricular septal perforation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.011] [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
INTRODUCTION
Papillary muscle rupture (PMR) of the mitral valve is a fatal complication of acute myocardial infarction (MI). As a complication of anterior MI, PMR of the tricuspid valve is extremely rare. We experienced a case of acute anterior MI complicated with tricuspid PMR and ventricular septal perforation (VSP).
REPORT
An 85-year-old woman was admitted with general fatigue and appetite loss. Her consciousness was alert, but she was pale, and had cold extremities. Her blood pressure was 74/62 mmHg, and pulse was 99/min. There was no leg edema. Pan systolic regurgitant murmur (Levine III/VI) was audible at the lower left sternal border. Her oxygen saturation was 86% under room air. Electrocardiogram revealed ST segment elevation and QS pattern in V1 to V3. Transthoracic echocardiography revealed dyskinesis of the apical anterior septum, VSP with bidirectional shunt, and severe pulmonary hypertension. Left ventricular ejection fraction was preserved (58%). The anterior tricuspid leaflet was flail due to PMR, resulting in severe tricuspid regurgitation and right ventricular dilatation. Coronary angiography revealed a single vessel disease of the left anterior descending artery (LAD). We recommended surgical treatment, and transferred her to another hospital.
DISCUSSION
Common causes of tricuspid PMR are infective endocarditis and chest trauma. Right ventricular infarction, usually caused by right coronary artery (RCA) occlusion, may cause tricuspid PMR. In our case, however, tricuspid PMR was complicated with anterior MI. The tricuspid anterior, posterior, and septal leaflets are attached to anterolateral RV wall, inferior septum, and infundibular septum, respectively, via papillary muscles. Right ventricular branches and septal branches of the RCA usually supply these papillary muscles. Anterior leaflet PMR in this case was possibly due to anomalous blood supply of anterolateral RV wall by the right ventricular branches of the LAD. Right ventricular overload due to large VSP shunt elevated RV diastolic pressure and right atrial pressure, and might worsen ischemia of the RV wall.
Abstract 88 Figure. severe TR & shunt flow through VSP
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Affiliation(s)
- M Nagumo
- Nippon Koukan Hospital, Kawasaki, Japan
| | - S Wada
- Nippon Koukan Hospital, Kawasaki, Japan
| | - T Saitou
- Nippon Koukan Hospital, Kawasaki, Japan
| | - H Li
- Nippon Koukan Hospital, Kawasaki, Japan
| | - T Sakai
- Nippon Koukan Hospital, Kawasaki, Japan
| | - S Iwanaga
- Saitama Medical University International medical Center, saitama, Japan
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Ungerman EA, Vogt KM, Sakai T, Metro DG, Adams PS. Wellness Principles Correlate With More Favorable Burnout Scores in Junior Anesthesiology Residents. J Educ Perioper Med 2020; 22:E636. [PMID: 32432151 PMCID: PMC7219025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Strategies to prevent or reduce burnout for anesthesiology residents remain relatively unexplored. We aimed to determine if participation in a wellness course would be associated with lower burnout. METHODS A prospective, case-control survey/questionnaire study was implemented within a single anesthesiology residency in a large academic medical center program. One class participated in an inaugural wellness course (n = 15) promoting particular wellness principles 4 months into their postgraduate year (PGY)-1, while another class with no course participation served as controls (n = 13). Both groups completed the Maslach Burnout Inventory (MBI) 6 months into their PGY-2 year. In addition, a survey measuring their perceived ability to implement wellness principles (regardless of course participation) as well as validated questionnaires measuring stress, depression, and sleep quality were administered. RESULTS Course participants had a trend toward lower MBI depersonalization scores; however, this was not statistically significant (MBI score 7 versus 12, P = .078, Cohen d 0.71). In a multivariable model, course participation yielded lower exhaustion scores (P = .011) whereas higher stress yielded higher exhaustion scores (P = .013), and higher depression scores yielded higher depersonalization scores (P = .019). A higher perceived ability to implement the wellness principles resulted in significantly better scores in all 3 burnout components (exhaustion P = .049, depersonalization P = .004 achievement P = .001). CONCLUSION Residents who felt they could implement wellness principles had lower burnout, regardless of course participation. Our brief course exposure had only marginal independent effects, suggesting that more longitudinal and repeated exposures to wellness training are likely required to produce a more effective outcome for mitigating burnout.
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Arikawa E, Kaneko N, Nohara K, Yamaguchi T, Mitsuyama M, Sakai T. Influence of Olfactory Function on Appetite and Nutritional Status in the Elderly Requiring Nursing Care. J Nutr Health Aging 2020; 24:398-403. [PMID: 32242207 DOI: 10.1007/s12603-020-1334-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate olfactory function in elderly subjects requiring nursing care to clarify its association with appetite and nutritional status. SETTING Facility for the elderly requiring nursing care. PARTICIPANTS The subjects were 158 elderly people requiring nursing care and 37 elderly people not requiring nursing care. MEASUREMENTS Experiment I: Olfactory function and factors (cognitive function, appetite, and nutritional status) that may be associated with it were compared between the elderly subjects requiring nursing care and those not requiring nursing care using covariance analysis in consideration of age. For evaluation, the OSIT-J was used for olfactory function, the HDS-R for cognitive function, the CNAQ for appetite, and BMI for nutritional status. Experiment II: The subjects were the same elderly subjects requiring nursing care in Experiment I, and food intake was surveyed in addition to the OSIT-J, HDS-R, CNAQ, and BMI. A univariate linear regression analysis was performed with OSIT-J as the response variable, and age, HDS-R, CNAQ, BMI, and food intake as the explanatory variables. RESULTS Experiment I: On covariance analysis, the OSIT-J score was significantly lower for the elderly subjects requiring nursing care than for those not requiring nursing care (p<0.01). The mean score was 8 or lower in both groups, demonstrating lower olfactory function in both groups. Regarding factors that may be associated with olfactory function, a significant difference was noted in the HDS-R (p<0.01), confirming significantly lower cognitive function in the elderly subjects requiring nursing care. No significant difference was noted in the CNAQ or BMI. Experiment II: On a univariate linear regression analysis, an association with the OSIT-J was noted for age and HDS-R. Age was inversely correlated and the HDS-R was positively correlated. Factors associated with lower olfactory function in the elderly subjects requiring nursing were age and cognitive function, whereas appetite, nutritional status, and food intake were not associated. CONCLUSION Olfactory function in elderly subjects requiring nursing care was poorer than that in those not requiring nursing care, suggesting that aging and cognitive decline are associated with lower olfactory function. In addition, no association of lower olfactory function with appetite, nutritional status, or food intake was noted in the elderly subjects requiring nursing care.
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Affiliation(s)
- E Arikawa
- Kanji Nohara, Department of Oral-facial Disorders, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka 565-0871, Japan, , Tel: +81-06-6879-2278, Fax: +81-06-6879-2279
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Sakai T, Yanagihara S, Ushio K. Restoration of lead-inhibited 5-aminolevulinate dehydratase activity in whole blood by heat, zinc ion, and (or) dithiothreitol. Clin Chem 2019. [DOI: 10.1093/clinchem/26.5.0625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
We examined effects of heat, zinc, ion, and dithiothreitol in restoring the activity of lead-inhibited-5-aminolevulinate dehydratase (EC 4.2.1.24). The ratio of non-activated to activated activity produced by dithiothreitol correlated well with blood lead concentration among 35 lead workers. The individual effects of heat, zinc, or dithiothreitol differ from each other in the shift of pH optimum as well as in the extent to which activity is restored. Dual or triple combinations of these agents show additive or complementary restoration of activity. The combination of heat and zinc or zinc and dithiothreitol expands the range of optimum concentration of zinc in restoring activity. Using these combinations of agents, we can expect more accurate evaluation of lead exposure than by measuring only activation of zinc. Although dithiothreitol most powerfully restores activity, it restores not only the activity inhibited by lead exposure but also the activity removed by oxidation of SH-groups in the enzyme molecule.
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42
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Adams DR, Tollinche LE, Yeoh CB, Artman J, Mehta M, Phillips D, Fischer GW, Quinlan JJ, Sakai T. Short-term safety and effectiveness of sugammadex for surgical patients with end-stage renal disease: a two-centre retrospective study. Anaesthesia 2019; 75:348-352. [PMID: 31721151 DOI: 10.1111/anae.14914] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/17/2022]
Abstract
Sugammadex is a novel reversal agent for aminosteroid neuromuscular blocking drugs, especially rocuronium. Given its renal excretion, sugammadex is not recommended for patients with end-stage renal disease; however, reports exist of its use in this group of patients. This two-institutional retrospective observational study aimed to review the safety profile and effectiveness of sugammadex in surgical patients with end-stage renal disease who required pre-operative renal replacement therapy. Adult surgical patients with end-stage renal disease requiring pre-operative renal replacement therapy, who received sugammadex between April 2016 and January 2019, were studied. The primary outcome was the incidence of postoperative tracheal re-intubation within 48 h. The secondary outcome was the incidence of deferred tracheal extubation in the operating theatre. One hundred and fifty-eight patients were identified from 125,653 surgical patients: 48 patients (30%) underwent renal transplantation and 110 (70%) underwent non-renal transplantation procedures. There were 22 instances (14%) of deferred tracheal extubation due to surgical and/or pre-existing medical conditions. Out of the 136 patients who had the tracheal tube removed at the end of the procedure, three patients had their trachea re-intubated within 48 h: two patients developed pulmonary oedema resulting from volume overload; and one patient had worsening sepsis. No incidence of recurrence of neuromuscular blockade was observed. Of note, 24 (18%) patients were found to have incomplete neuromuscular blockade reversal with neostigmine but administration of sugammadex led to successful tracheal extubation. In conclusion, sugammadex appears to be safe and effective in adult patients with end-stage renal disease receiving pre-operative renal replacement therapy.
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Affiliation(s)
- D R Adams
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - L E Tollinche
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C B Yeoh
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Artman
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - M Mehta
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Phillips
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - G W Fischer
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J J Quinlan
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - T Sakai
- Department of Anesthesiology and Peri-operative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Abstract
Two of the most commonly used viscoelastic hemostatic assays, thromboelastometry (ROTEM) and thrombelastography (TEG), have proven to decrease allogenic blood transfusions with cost reduction and possibly decrease mortality and morbidity in cardiac, trauma, and other bleeding patients. This article compares the two devices to provide guidance on the selection and use of these monitoring systems. Their second-generation assays, TEG 6S and ROTEM Sigma, are also discussed.
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Affiliation(s)
- Tetsuro Sakai
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA -
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Nagae A, Nishikawa K, Fujimori K, Katoh T, Miura T, Miyashita Y, Kashiwagi D, Senda K, Sakai T, Saigusa T, Ebisawa S, Motoki H, Okada A, Kuwahara K. P943The impact of diabetes on patients with frail after endovascular treatments: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0537] [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
Diabetes mellitus (DM) is known to be one of the risks of arteriosclerosis. However, it is still unknown whether DM is a risk factor also in secondary prevention of frail patients after endovascular treatments (EVT)
Purpose
To investigate impact of diabetes on patients with frail after EVT.
Methods
From July 2015 to July 2016, 371 consecutive PAD patients who performed EVT were enrolled in I-PAD registry. We could conduct follow up survey 361 patients (446 lesions) and divided into 2 groups; with diabetes (185 patients, 226 lesions) or without diabetes (176 patients, 220 lesions) and analyzed. And among them,we selected 96 patients with frail and divided into 2 groups; with diabetes (49 patients, 70 lesions) or without diabetes (46 patients, 58 lesions) and analyzed. We defined frail patients as the patients with Clinical Frailty Scale 5 (mild frail) or higher. The primary end point was all-cause-death and major adverse limb events (MALE: TLR, TVR, major amputations) at 1 year.
Result
At 1 years in the patients group with diabetes, overall survival and freedom from MALE were significantly lower (81.7% vs 95.8% P<0.0001; 80.0% vs 94.6%, P<0.0001) than the group without diabetes.Among the patients with frail, between the patients group with diabetes and the group without, there is no significant differences in overall survival and freedom from MALE (88.2% vs 88.9% P=0.83; 80.7% vs 84.1%, P=0.55) at 5 years.
Conclusion
The prognosis of patients with diabetes after EVT was worse than the patient without. On the other hand, the prognosis of frail patients with diabetes after EVT was no difference with the frail patient without diabetes in this study.
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Affiliation(s)
- A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - K Nishikawa
- Shinshu University Hospital, Matsumoto, Japan
| | - K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, Cardiology, Nagano, Japan
| | - Y Miyashita
- Nagano Red Cross Hospital, Cardiology, Nagano, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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Goto H, Takaoka H, Sakai T, Ochi S, Wakabayashi S, Ishikawa K, Kanaeda T, Daimon M, Ueda M, Funabashi N, Sano K, Kobayashi Y. P599Native T1 mapping is useful for detection of myocardial fibrosis in cases with ischemic and non-ischemic myocardial diseases. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0208] [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
Evaluation of myocardial fibrosis (MF) as late gadolinium enhancement (LGE) on MRI is useful for differential diagnosis of various myocardial diseases and prediction of future adverse cardiac events in some specific myocardial diseases. Gadolinium contrast is contraindicated for cases with severe renal dysfunction, therefore non contrast MRI is necessary for detection of MF in cases with both myocardial disease and severe renal dysfunction.
Purpose
We aimed to evaluate diagnostic accuracy of native T1 mapping for detection of MF compared with LGE in cases with various myocardial diseases, including ischemic and non-ischemic myocardial diseases.
Methods
We selected consecutive 40 patients who were suspected of having various myocardial diseases and underwent cardiac MRI, using 1.5T MRI (Ingenia, Philips) in 10 cases (25%) or 3T MRI (Ingenia, Philips) in 30 cases (75%), including native T1 mapping (without contrast) and LGE using contrast media from Jan 2018 to Feb 2019 in our institution. We evaluated diagnostic accuracy for detection of MF in left ventricular myocardium (LVM) of native T1 mapping image compared with LGE as the gold standard, in a patient-based and segment-based analysis. In T1 mapping images, segmental high T1 lesions were defined as MF. In a segment-based analysis, MF was evaluated using 17 LVM segments model in American Heart Association.
Results
MF was detected in 139 LVM segments in 25 (63%) cases. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of native T1 mapping for detection of MF were 90%, 89%, 95%, 80% and 90% in a patient-based analysis, and 63%, 96%, 84%, 89% and 88% in a segment-based analysis (left figure). Native T1-values of LVM with MF were significantly higher than LVM without LGE (1351±79 vs 1093±124 in 1.5T and 1562±131 vs 1291±43 in 3T) (p<0.05 and p<0.01). Interobserver agreement of native T1 mapping and LGE were not significantly different (0.88 and 0.89, P=0.70). Overall diagnostic accuracy of native T1 mapping for detection of MF in a patient-based analysis, was not significantly different in between the cases with ischemic (n=18) and non-ischemic (n=22) myocardial disease (90% and 83.3%, P=0.10).
Conclusion
Native T1 mapping (without contrast) is useful for detection of MF in various myocardial diseases and high diagnostic accuracy is expected especially in a patient-based analysis.
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Affiliation(s)
- H Goto
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - H Takaoka
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - T Sakai
- Eastern Chiba Medical Center, Radiology, Togane, Japan
| | - S Ochi
- Eastern Chiba Medical Center, Radiology, Togane, Japan
| | - S Wakabayashi
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - K Ishikawa
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - T Kanaeda
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - M Daimon
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - M Ueda
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - N Funabashi
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Sano
- Eastern Chiba Medical Center, Cardiology, Togane, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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Fujimori K, Nagae A, Miura T, Katoh T, Hirabayashi M, Kashiwagi D, Yokota D, Yanagisawa T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P942Impact of left ventricular ejection fraction in patients with critical limb ischemia: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0536] [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
Introduction
In patients with critical limb ischemia (CLI) it is known that malnutrition, low BMI, inflammation and so on are prognostic factors. But, it is unclear whether left ventricular ejection fraction (LVEF) affects prognosis of CLI patients. So we investigated that LVEF affects prognosis of CLI patients.
Methods
From July 2015 to July 2016, 371 consecutive peripheral artery disease patients who performed endovascular treatment (EVT) were enrolled in I-PAD registry. 179 of them were patients with CLI. We could conduct follow up survey about 126 (age 75.5±11.1, men 63.5%) and divided two groups according to their LVEF (group with LVEF≤40%, n=13, group without LVEF≤40%, n=113). The primary end point was major adverse limb events (MALE: TLR, TVR, major amputations) and secondary end point was all-cause death.
Results
The median follow-up period was 11.5±6.7 months. The 18 months MALE rate was significant higher in the group with low LVEF than group without low LVEF (76.9% vs 37.2% p<0.05). The 18months all-cause death tended to be higher in the group with low LVEF, however there was not statistical significance in the two groups (53.8% vs 24.8% p=0.09).
Conclusion
LVEF was associated with MALE in patients with CLI.
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Affiliation(s)
- K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, cardiology, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - M Hirabayashi
- Shinonoi General Hospital, cardiology, Matsumoto, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - D Yokota
- Iida Hospital, cardiology, iida, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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47
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Ono H, Horinaka M, Yasuda S, Morita M, Nishimoto E, Sakai T. A novel RAF/MEK inhibitor CH5126766 in phase I clinical trial has an effectiveness in the combination with eribulin for the treatment of triple negative breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz268.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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48
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Nishigawa K, Nagae A, Miura T, Katoh T, Hirabayashi M, Miyashita Y, Kashiwagi D, Mochidome T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P1957Impact of fraility on the super elderly patients with peripheral artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0704] [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
The current consensus is that frail patients have high risks of mortality. However, it remains unclear whether frailty is associated with mortality risks in super-elderly patients with peripheral artery disease (PAD).
Methods
The I-PAD registry was a prospective multicenter observational study involving 12 institutions in Nagano prefecture in Japan. From July 2015 to July 2016, the I-PAD registry enrolled 371 consecutive PAD patients who had undergone endovascular therapy (EVT). Among them, we selected and analysed 109 PAD patients who were >80 years old when they had undergone EVT and divided them into two groups: those with frailty (Clinical Frailty Scale≥5, n=47) and those without frailty (Clinical Frailty Scale≤4, n=62). The primary endpoints were overall survival and major adverse limb events (MALE), defined as a composite of all-cause death, major amputation and revascularization.
Results
The median follow-up period was 1.58±0.3 years. Overall, 109 patients with a mean age of 84.8±4.0 years, of whom 63.3% were men, were included. Overall survival and freedom from MALE were significantly lower among patients with frailty than among those without frailty (60.5% vs. 91.6%, P<0.001; 51.4% vs. 87.5%, P<0.001; respectively).
Conclusion
The prognosis of super-elderly patients with frailty is worse than that of patients without frailty.
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Affiliation(s)
- K Nishigawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano Municipal Hospital, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | | | | | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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Fujimori K, Nagae A, Miura T, Katoh T, Hirabayashi M, Kashiwagi D, Yokota D, Yanagisawa T, Sakai T, Senda K, Saigusa T, Ebisawa S, Okada A, Motoki H, Kuwahara K. P936Impact of left ventricular ejection fraction in patients with peripheral artery disease: from I-PAD registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0530] [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
In patients with peripheral artery disease (PAD) it is known that CVD is one of prognostic factors. But, it is unclear whether left ventricular ejection fraction (LVEF) affects prognosis of PAD patients. So we investigated that LVEF affects prognosis of PAD patients.
Methods
From July 2015 to July 2016, 371 consecutive PAD patients who performed endovascular treatment (EVT) were enrolled in I-PAD registry. We could conduct follow up survey about 337 (age 73.8±9.6, men 72.4%) patients and divided two groups according to their LVEF (group with LVEF≤40%, n=18, group without LVEF≤40%, n=319). The primary end point was major adverse limb events (MALE: TLR, TVR, major amputations) and secondary end point was all-cause death.
Results
The median follow-up period was 13.6±5.7 months. The 18 months MALE and all-cause death rate were significantly higher in the group with low LVEF than group without low LVEF (61.1% vs 21.6% p<0.001, 44.4% vs 11.6% p<0.001).
Conclusion
LVEF was significantly associated with MALE and all-cause death in patients with PAD.
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Affiliation(s)
- K Fujimori
- Shinshu University Hospital, Matsumoto, Japan
| | - A Nagae
- Shinshu University Hospital, Matsumoto, Japan
| | - T Miura
- Nagano municipal hospital, cardiology, Nagano, Japan
| | - T Katoh
- Shinshu University Hospital, Matsumoto, Japan
| | - M Hirabayashi
- Shinonoi General Hospital, cardiology, Matsumoto, Japan
| | - D Kashiwagi
- Shinshu University Hospital, Matsumoto, Japan
| | - D Yokota
- Iida Hospital, cardiology, iida, Japan
| | | | - T Sakai
- Shinshu University Hospital, Matsumoto, Japan
| | - K Senda
- Shinshu University Hospital, Matsumoto, Japan
| | - T Saigusa
- Shinshu University Hospital, Matsumoto, Japan
| | - S Ebisawa
- Shinshu University Hospital, Matsumoto, Japan
| | - A Okada
- Shinshu University Hospital, Matsumoto, Japan
| | - H Motoki
- Shinshu University Hospital, Matsumoto, Japan
| | - K Kuwahara
- Shinshu University Hospital, Matsumoto, Japan
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50
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Sakai T, Yamauchi Y, Yokote F, Saito Y, Uehara H, Saito K, Sakao Y, Kawamura M. EP1.15-23 Cardiac Tamponade Caused by a Type A Thymoma: A Case Report. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2358] [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: 10/25/2022]
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