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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Sawada H, Yabuuchi T, Higashi N, Iwasaki T, Kawasaki K, Maeda Y, Izumi T, Nakagawa Y, Shigemori K, Sakawa Y, Curry CB, Frost M, Iwata N, Ogitsu T, Sueda K, Togashi T, Glenzer SH, Kemp AJ, Ping Y, Sentoku Y. Ultrafast time-resolved 2D imaging of laser-driven fast electron transport in solid density matter using an x-ray free electron laser. Rev Sci Instrum 2023; 94:033511. [PMID: 37012804 DOI: 10.1063/5.0130953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
High-power, short-pulse laser-driven fast electrons can rapidly heat and ionize a high-density target before it hydrodynamically expands. The transport of such electrons within a solid target has been studied using two-dimensional (2D) imaging of electron-induced Kα radiation. However, it is currently limited to no or picosecond scale temporal resolutions. Here, we demonstrate femtosecond time-resolved 2D imaging of fast electron transport in a solid copper foil using the SACLA x-ray free electron laser (XFEL). An unfocused collimated x-ray beam produced transmission images with sub-micron and ∼10 fs resolutions. The XFEL beam, tuned to its photon energy slightly above the Cu K-edge, enabled 2D imaging of transmission changes induced by electron isochoric heating. Time-resolved measurements obtained by varying the time delay between the x-ray probe and the optical laser show that the signature of the electron-heated region expands at ∼25% of the speed of light in a picosecond duration. Time-integrated Cu Kα images support the electron energy and propagation distance observed with the transmission imaging. The x-ray near-edge transmission imaging with a tunable XFEL beam could be broadly applicable for imaging isochorically heated targets by laser-driven relativistic electrons, energetic protons, or an intense x-ray beam.
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Affiliation(s)
- H Sawada
- Department of Physics, University of Nevada, Reno, Nevada 89557, USA
| | - T Yabuuchi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - N Higashi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - T Iwasaki
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - K Kawasaki
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - Y Maeda
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - T Izumi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - Y Nakagawa
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - K Shigemori
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - Y Sakawa
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - C B Curry
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - M Frost
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - N Iwata
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - T Ogitsu
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - K Sueda
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - T Togashi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - S H Glenzer
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - A J Kemp
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Ping
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - Y Sentoku
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
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Katsumi K, Watanabe K, Yamazaki A, Hirano T, Ohashi M, Mizouchi T, Sato M, Sekimoto H, Izumi T, Shibuya Y, Kawashima H. Predictive biomarkers of ossification progression and bone metabolism dynamics in patients with cervical ossification of the posterior longitudinal ligament. Eur Spine J 2023; 32:1282-1290. [PMID: 36757615 DOI: 10.1007/s00586-023-07565-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/12/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE This study aimed to establish biomarkers to predict the progression of ossification by examining ossification volume and bone metabolism dynamics in patients with ossification of the posterior longitudinal ligament (OPLL). METHODS We assessed OPLL progression using computed tomography-based three-dimensional (3D) image analysis and examined bone metabolism dynamics in 107 patients with OPLL (men, 72; women, 35; mean age, 63.6 years). The volume of OPLL was calculated twice during the follow-up period, and OPLL progression was evaluated by the annual rate of ossification increase. Bone metabolism dynamics were assessed by routine blood tests and analysis of various serum biomarkers (including 25-hydroxyvitamin D, intact parathyroid hormone, fibroblast growth factor 23, intact N-terminal propeptide of type 1, tartrate-resistant acid phosphatase isoform 5b, sclerostin, and Dickkopf-1) and bone mineral density (BMD). Patients were classified into the progression (P) or non-progression (NP) group according to the annual rate of increase in previous 3D image analyses, and associated factors between these groups were compared. RESULTS The P and NP groups consisted of 29 patients (23 men and 6 women) and 78 patients (49 men and 29 women), respectively. Univariate analysis revealed significant differences in terms of age, body mass index, serum phosphorus, serum sclerostin, and BMD. In multivariate analysis, age, serum phosphorus, and serum sclerostin were identified as independent factors associated with OPLL progression. CONCLUSION Younger age, hypophosphatemia, and high serum sclerostin are risk factors for OPLL progression. Serum phosphorus and sclerostin could serve as important biomarkers for predicting ossification progression.
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Affiliation(s)
- Keiichi Katsumi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-Ku, Niigata, 950-8556, Japan. .,Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-Ku, Niigata, 951-8510, Japan.
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-Ku, Niigata, 951-8510, Japan
| | - Akiyoshi Yamazaki
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-Ku, Niigata, 950-8556, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-Uonuma City, Niigata, 949-7302, Japan
| | - Masayuki Ohashi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-Ku, Niigata, 951-8510, Japan
| | - Tatsuki Mizouchi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-Ku, Niigata, 950-8556, Japan
| | - Masayuki Sato
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-Ku, Niigata, 950-8556, Japan
| | - Hiroyuki Sekimoto
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinkocho, Chuo-Ku, Niigata, 950-8556, Japan
| | - Tomohiro Izumi
- Department of Orthopedic Surgery, Niigata Minami Hospital, 2007-6, Toyano, Chuo-Ku, Niigata, 950-8601, Japan
| | - Yohei Shibuya
- Department of Orthopedic Surgery, Niigata Prefectural Shibata Hospital, 1-2-8, Honcho, Shibata, Niigata, 957-8588, Japan
| | - Hiroyuki Kawashima
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-Ku, Niigata, 951-8510, Japan
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Chow Z, Johnson J, Chauhan A, Izumi T, Cavnar M, Weiss H, Anthony L, Evers B, Rychahou P. Inhibition of Ribonucleotide Reductase Subunit 2 (RRM2) Induces Radiosensitization in Gastroenteropancreatic Neuroendocrine Tumors. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.648] [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: 10/31/2022]
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Yamanaka A, Eura N, Shiota T, Yamaoka M, Nishimori Y, Iguchi N, Ozaki M, Nanaura H, Iwasa N, Kiriyama T, Izumi T, Kataoka H, Sugie K. VP.48 Clinicopathological characteristics of 105 patients with idiopathic inflammatory myopathy based on muscle specific antibodies. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.179] [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: 11/05/2022]
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Matsukiyo S, Yamazaki R, Morita T, Tomita K, Kuramitsu Y, Sano T, Tanaka SJ, Takezaki T, Isayama S, Higuchi T, Murakami H, Horie Y, Katsuki N, Hatsuyama R, Edamoto M, Nishioka H, Takagi M, Kojima T, Tomita S, Ishizaka N, Kakuchi S, Sei S, Sugiyama K, Aihara K, Kambayashi S, Ota M, Egashira S, Izumi T, Minami T, Nakagawa Y, Sakai K, Iwamoto M, Ozaki N, Sakawa Y. High-power laser experiment on developing supercritical shock propagating in homogeneously magnetized plasma of ambient gas origin. Phys Rev E 2022; 106:025205. [PMID: 36109929 DOI: 10.1103/physreve.106.025205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
A developing supercritical collisionless shock propagating in a homogeneously magnetized plasma of ambient gas origin having higher uniformity than the previous experiments is formed by using high-power laser experiment. The ambient plasma is not contaminated by the plasma produced in the early time after the laser shot. While the observed developing shock does not have stationary downstream structure, it possesses some characteristics of a magnetized supercritical shock, which are supported by a one-dimensional full particle-in-cell simulation taking the effect of finite time of laser-target interaction into account.
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Affiliation(s)
- S Matsukiyo
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
- International Research Center for Space and Planetary Environmental Science, Kyushu University, Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - R Yamazaki
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - T Morita
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - K Tomita
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
- Division of Quantum Science and Engineering, Hokkaido University, Sapporo 060-8628, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - T Sano
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - S J Tanaka
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - T Takezaki
- Faculty of Engineering, University of Toyama, 3190, Gofuku, Toyama 930-8555, Japan
- Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminamiku, Kitakyushu, Fukuoka 802-0985, Japan
| | - S Isayama
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
- International Research Center for Space and Planetary Environmental Science, Kyushu University, Motooka, Nishi-Ku, Fukuoka 819-0395, Japan
| | - T Higuchi
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - H Murakami
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - Y Horie
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - N Katsuki
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - R Hatsuyama
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - M Edamoto
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - H Nishioka
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - M Takagi
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - T Kojima
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - S Tomita
- Astronomical Institute, Tohoku University, 6-3 Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - N Ishizaka
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Kakuchi
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Sei
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - K Sugiyama
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - K Aihara
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Kambayashi
- Department of Physical Science, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - M Ota
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - S Egashira
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - T Izumi
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - T Minami
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Nakagawa
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - K Sakai
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - M Iwamoto
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
- Department of Earth and Planetary Science, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - N Ozaki
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Sakawa
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
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Saito M, Hirano M, Izumi T, Mori Y, Ito K, Saitoh Y, Terada N, Sato T, Sukegawa J. Cytoskeletal Protein 4.1G Is Essential for the Primary Ciliogenesis and Osteoblast Differentiation in Bone Formation. Int J Mol Sci 2022; 23:ijms23042094. [PMID: 35216233 PMCID: PMC8878336 DOI: 10.3390/ijms23042094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/06/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022] Open
Abstract
The primary cilium is a hair-like immotile organelle with specific membrane receptors, including the receptor of Hedgehog signaling, smoothened. The cilium organized in preosteoblasts promotes differentiation of the cells into osteoblasts (osteoblast differentiation) by mediating Hedgehog signaling to achieve bone formation. Notably, 4.1G is a plasma membrane-associated cytoskeletal protein that plays essential roles in various tissues, including the peripheral nervous system, testis, and retina. However, its function in the bone remains unexplored. In this study, we identified 4.1G expression in the bone. We found that, in the 4.1G-knockout mice, calcium deposits and primary cilium formation were suppressed in the trabecular bone, which is preosteoblast-rich region of the newborn tibia, indicating that 4.1G is a prerequisite for osteoblast differentiation by organizing the primary cilia in preosteoblasts. Next, we found that the primary cilium was elongated in the differentiating mouse preosteoblast cell line MC3T3-E1, whereas the knockdown of 4.1G suppressed its elongation. Moreover, 4.1G-knockdown suppressed the induction of the cilia-mediated Hedgehog signaling and subsequent osteoblast differentiation. These results demonstrate a new regulatory mechanism of 4.1G in bone formation that promotes the primary ciliogenesis in the differentiating preosteoblasts and induction of cilia-mediated osteoblast differentiation, resulting in bone formation at the newborn stage.
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Affiliation(s)
- Masaki Saito
- Department of Molecular Pharmacology, Tohoku University School of Medicine, Sendai 980-8575, Japan; (M.H.); (T.I.); (T.S.)
- Correspondence: ; Tel.: +81-22-717-8207
| | - Marina Hirano
- Department of Molecular Pharmacology, Tohoku University School of Medicine, Sendai 980-8575, Japan; (M.H.); (T.I.); (T.S.)
- Department of Human Health and Nutrition, Shokei Gakuin University, Natori 981-1295, Japan;
| | - Tomohiro Izumi
- Department of Molecular Pharmacology, Tohoku University School of Medicine, Sendai 980-8575, Japan; (M.H.); (T.I.); (T.S.)
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan; (Y.M.); (K.I.)
| | - Kentaro Ito
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan; (Y.M.); (K.I.)
| | - Yurika Saitoh
- Center for Medical Education, Teikyo University of Science, Adachi-ku, Tokyo 120-0045, Japan;
| | - Nobuo Terada
- Health Science Division, Department of Medical Sciences, Shinshu University Graduate School of Medicine, Science and Technology, Matsumoto 390-0802, Japan;
| | - Takeya Sato
- Department of Molecular Pharmacology, Tohoku University School of Medicine, Sendai 980-8575, Japan; (M.H.); (T.I.); (T.S.)
| | - Jun Sukegawa
- Department of Human Health and Nutrition, Shokei Gakuin University, Natori 981-1295, Japan;
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Yamazaki R, Matsukiyo S, Morita T, Tanaka SJ, Umeda T, Aihara K, Edamoto M, Egashira S, Hatsuyama R, Higuchi T, Hihara T, Horie Y, Hoshino M, Ishii A, Ishizaka N, Itadani Y, Izumi T, Kambayashi S, Kakuchi S, Katsuki N, Kawamura R, Kawamura Y, Kisaka S, Kojima T, Konuma A, Kumar R, Minami T, Miyata I, Moritaka T, Murakami Y, Nagashima K, Nakagawa Y, Nishimoto T, Nishioka Y, Ohira Y, Ohnishi N, Ota M, Ozaki N, Sano T, Sakai K, Sei S, Shiota J, Shoji Y, Sugiyama K, Suzuki D, Takagi M, Toda H, Tomita S, Tomiya S, Yoneda H, Takezaki T, Tomita K, Kuramitsu Y, Sakawa Y. High-power laser experiment forming a supercritical collisionless shock in a magnetized uniform plasma at rest. Phys Rev E 2022; 105:025203. [PMID: 35291161 DOI: 10.1103/physreve.105.025203] [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] [Received: 09/23/2020] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
We present an experimental method to generate quasiperpendicular supercritical magnetized collisionless shocks. In our experiment, ambient nitrogen (N) plasma is at rest and well magnetized, and it has uniform mass density. The plasma is pushed by laser-driven ablation aluminum (Al) plasma. Streaked optical pyrometry and spatially resolved laser collective Thomson scattering clarify structures of plasma density and temperatures, which are compared with one-dimensional particle-in-cell simulations. It is indicated that just after the laser irradiation, the Al plasma is magnetized by a self-generated Biermann battery field, and the plasma slaps the incident N plasma. The compressed external field in the N plasma reflects N ions, leading to counterstreaming magnetized N flows. Namely, we identify the edge of the reflected N ions. Such interacting plasmas form a magnetized collisionless shock.
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Affiliation(s)
- R Yamazaki
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - S Matsukiyo
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - T Morita
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - S J Tanaka
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - T Umeda
- Institute for Space-Earth Environmental Research, Nagoya University, Furo-cho, Chikusa, Nagoya, Aichi 464-8602, Japan
| | - K Aihara
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - M Edamoto
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - S Egashira
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - R Hatsuyama
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - T Higuchi
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - T Hihara
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Horie
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - M Hoshino
- Department of Earth and Planetary Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - A Ishii
- Max Planck Institute for Gravitational Physics (Albert Einstein Institute), Am Mühlenberg 1, Potsdam-Golm 14476, Germany
| | - N Ishizaka
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - Y Itadani
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - T Izumi
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - S Kambayashi
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Kakuchi
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - N Katsuki
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - R Kawamura
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - Y Kawamura
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Kisaka
- Department of Physical Science, Hiroshima University, Higashi-Hiroshima 739-8526, Japan
| | - T Kojima
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - A Konuma
- Institute for Laser Science, University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan
| | - R Kumar
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - T Minami
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - I Miyata
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - T Moritaka
- Fundamental Physics Simulation Research Division, National Institute for Fusion Science, 322-6 Oroshi-cho, Toki 509-5292, Japan
| | - Y Murakami
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - K Nagashima
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - Y Nakagawa
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - T Nishimoto
- School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Nishioka
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - Y Ohira
- Department of Earth and Planetary Science, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - N Ohnishi
- Department of Aerospace Engineering, Tohoku University, 6-6 Aramaki Aza Aoba, Aoba, Sendai, Miyagi 980-8579, Japan
| | - M Ota
- Graduate School of Science, Osaka University, 1-1 Machikane-yama, Toyonaka, Osaka 560-0043, Japan
| | - N Ozaki
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - T Sano
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - K Sakai
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - S Sei
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - J Shiota
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - Y Shoji
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - K Sugiyama
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - D Suzuki
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - M Takagi
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga 816-8580, Japan
| | - H Toda
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - S Tomita
- Astronomical Institute, Tohoku University, 6-3 Aramaki, Aoba-ku, Sendai, Miyagi 980-8578, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - S Tomiya
- Department of Physical Sciences, Aoyama Gakuin University, 5-10-1 Fuchinobe, Sagamihara, Kanagawa 252-5258, Japan
| | - H Yoneda
- Institute for Laser Science, University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan
| | - T Takezaki
- Department of Creative Engineering, National Institute of Technology, Kitakyushu College, 5-20-1 Shii, Kokuraminamiku, Kitakyushu, Fukuoka 802-0985, Japan
- Faculty of Engineering, University of Toyama, 3190, Gofuku, Toyama 930-8555, Japan
| | - K Tomita
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
- Division of Quantum Science and Engineering, Hokkaido University, Sapporo 060-8628, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Y Sakawa
- Institute of Laser Engineering, Osaka University, 2-6, Yamadaoka, Suita, Osaka 565-0871, Japan
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Makino T, Katsumi K, Yamazaki A, Izumi T, Yajiri Y, Takahashi K, Hirano T, Watanabe K, Kawashima H. Detailed features and prognostic factors of twenty-three patients with drop finger caused by cervical radiculopathy: a retrospective multicentre study. Int Orthop 2021; 45:2909-2916. [PMID: 34453192 DOI: 10.1007/s00264-021-05197-w] [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] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/16/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE It has been reported that C7 and C8 nerve root impairment can cause drop finger; however, the clinical characteristics of each injured nerve root and post-operative outcomes remain unclear. This study aimed to investigate the detailed features and surgery-related prognostic factors of drop finger caused by cervical radiculopathy. METHODS We retrospectively investigated the clinical characteristics, paralysis patterns and surgery-related prognostic factors of 23 patients with drop finger caused by cervical radiculopathy who underwent posterior cervical foraminotomy. We classified paralysis into three patterns based on the fingers predominantly exhibiting extensor digitorum communis (EDC) muscle weakness: index finger side-dominant, middle and ring fingers-dominant and little finger side-dominant. RESULTS The aetiologies were cervical disc hernia (CDH) in ten patients, cervical spondylotic radiculopathy (CSR) in eight and both CDH and CSR in five. The levels of the decompressed root were C7 in one patient, C8 in 11 and both C7 and C8 in 11. Scapular pain was frequently observed as the initial symptom (78%), especially in patients with only C8 nerve root disorder (91%). Drop finger recovered to a score of ≥ 3 on manual muscle testing in 17 patients; patients with the little finger side-dominant pattern tended to have poor recoveries. Patients with CDH improved significantly than those with CSR or both CDH and CSR (p < 0.05). CONCLUSIONS Good surgical recovery of drop finger can be expected in patients with CDH and in those with index fingers-dominant and middle and ring fingers-dominant patterns.
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Affiliation(s)
- Tatsuo Makino
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
- Spine Centre, Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan.
| | - Keiichi Katsumi
- Spine Centre, Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan
| | - Akiyoshi Yamazaki
- Spine Centre, Department of Orthopaedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan
| | - Tomohiro Izumi
- Department of Orthopaedic Surgery, Niigata Minami Hospital, Niigata City, Niigata, Japan
| | - Yoichi Yajiri
- Department of Orthopaedic Surgery, Nagaoka Chuo General Hospital, Nagaoka City, Niigata , Japan
| | - Kazuo Takahashi
- Department of Orthopaedic Surgery, Nagaoka Chuo General Hospital, Nagaoka City, Niigata , Japan
| | - Toru Hirano
- Department of Orthopaedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-uonuma City, Niigata, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Hiroyuki Kawashima
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
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11
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Eura N, Yamanaka A, Shiota T, Nishimori Y, Iguchi N, Ozaki M, Nanaura H, Iwasa N, Kiriyama T, Izumi T, Kataoka H, Sugie K. AUTOIMMUNE MYOPATHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.292] [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: 11/28/2022]
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Mizouchi T, Katsumi K, Izumi T, Yamazaki A, Shoji H, Tashi H, Ohashi M, Hirano T, Endo N, Watanabe K. Three-dimensional morphological analysis of cervical foraminal stenosis using dynamic flexion-extension computed tomography images. J Orthop Sci 2020; 25:805-811. [PMID: 31831318 DOI: 10.1016/j.jos.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/18/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Morphological features of foraminal stenosis in cervical spondylotic radiculopathy and the adequate extent of facet resection in posterior cervical foraminotomy remain uncertain. Herein, we evaluated quantitatively foraminal widths in cervical spondylotic radiculopathy on dynamic flexion-extension computed tomography using a novel three-dimensional analysis method and determined the extent of facet resection in posterior cervical foraminotomy. METHODS Seventeen patients undergoing posterior cervical foraminotomy for cervical spondylotic radiculopathy were evaluated. A neuroforamen three-dimensional model was built from preoperative images of flexion-extension computed tomography myelography, and an ordinary cervical spine coordinate system and an original neuroforaminal coordinate system, were established. In the neuroforaminal coordinate system, minimum areas perpendicular to the long axis by the slices from inlet to outlet of neuroforamen and narrowest foraminal width in a slice of minimum area were measured. The location of the narrowest region from inlet of the foramen was calculated. Ratios of minimum and sufficient facet resection were obtained from the location of the narrowest region in the neuroforaminal coordinate system. RESULTS The narrowest foraminal widths (flexion/extension) in the cervical spine coordinate system and the neuroforaminal coordinate system were 2.9/2.3 and 2.6/1.9 mm, respectively. The mean values of the location of the narrowest region (flexion/extension) were 0.27/0.22 and 0.50/0.45 mm, respectively, and the narrowest region in the neuroforaminal coordinate system was located on the outer side than in the cervical spine coordinate system (p < 0.001). The ratios of minimum and sufficient facet resection were 23 ± 8% and 32 ± 9%, respectively. CONCLUSIONS The narrowest regions both in flexion and extension are located at the middle of the foramen based on the neuroforaminal coordinate system. Ordinary evaluation of axial computed tomography images likely underestimates the extent of facet resection, whereas certain extent of facet resection does not exceed 50% in cases with single-level cervical spondylotic radiculopathy. STUDY DESIGN A retrospective case control study.
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Affiliation(s)
- Tatsuki Mizouchi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata, 951-8510, Japan.
| | - Keiichi Katsumi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinko-cho, Chuoku, Niigata City, Niigata, 950-8556, Japan
| | - Tomohiro Izumi
- Department of Orthopedic Surgery, Niigata Minami Hospital, 2007-6 Toyano, Chuoku, Niigata City, Niigata, 950-8601, Japan
| | - Akiyoshi Yamazaki
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinko-cho, Chuoku, Niigata City, Niigata, 950-8556, Japan
| | - Hirokazu Shoji
- Department of Orthopedic Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuoku, Niigata City, Niigata, 950-1197, Japan
| | - Hideki Tashi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata, 951-8510, Japan
| | - Masayuki Ohashi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata, 951-8510, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-uonuma City, Niigata, 949-7302, Japan
| | - Naoto Endo
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata, 951-8510, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori, Chuoku, Niigata City, Niigata, 951-8510, Japan
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13
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Ishikawa Y, Watanabe K, Katsumi K, Ohashi M, Shibuya Y, Izumi T, Hirano T, Endo N, Kaito T, Yamashita T, Fujiwara H, Nagamoto Y, Matsuoka Y, Suzuki H, Nishimura H, Terai H, Tamai K, Tagami A, Yamada S, Adachi S, Yoshii T, Ushio S, Harimaya K, Kawaguchi K, Yokoyama N, Oishi H, Doi T, Kimura A, Inoue H, Inoue G, Miyagi M, Saito W, Nakano A, Sakai D, Nukaga T, Ikegami S, Shimizu M, Futatsugi T, Ohtori S, Furuya T, Orita S, Imagama S, Ando K, Kobayashi K, Kiyasu K, Murakami H, Yoshioka K, Seki S, Hongo M, Kakutani K, Yurube T, Aoki Y, Oshima M, Takahata M, Iwata A, Endo H, Abe T, Tsukanishi T, Nakanishi K, Watanabe K, Hikata T, Suzuki S, Isogai N, Okada E, Funao H, Ueda S, Shiono Y, Nojiri K, Hosogane N, Ishii K. Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study. BMC Musculoskelet Disord 2020; 21:513. [PMID: 32738900 PMCID: PMC7395972 DOI: 10.1186/s12891-020-03539-0] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Vertebroplasty with posterior spinal fusion (VP + PSF) is one of the most widely accepted surgical techniques for treating osteoporotic vertebral collapse (OVC). Nevertheless, the effect of the extent of fusion on surgical outcomes remains to be established. This study aimed to evaluate the surgical outcomes of short- versus long-segment VP + PSF for OVC with neurological impairment in thoracolumbar spine. Methods We retrospectively collected data from 133 patients (median age, 77 years; 42 men and 91 women) from 27 university hospitals and their affiliated hospitals. We divided patients into two groups: a short-segment fusion group (S group) with 2- or 3-segment fusion (87 patients) and a long-segment fusion group (L group) with 4- through 6-segment fusion (46 patients). Surgical invasion, clinical outcomes, local kyphosis angle (LKA), and complications were evaluated. Results No significant differences between the two groups were observed in terms of neurological recovery, pain scale scores, and complications. Surgical time was shorter and blood loss was less in the S group, whereas LKA at the final follow-up and correction loss were superior in the L group. Conclusion Although less invasiveness and validity of pain and neurological relief are secured by short-segment VP + PSF, surgeons should be cautious regarding correction loss.
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Affiliation(s)
- Yuya Ishikawa
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Keiichi Katsumi
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Masayuki Ohashi
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Yohei Shibuya
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Tomohiro Izumi
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Toru Hirano
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Naoto Endo
- Department of Orthopaedic Surgery, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Tomoya Yamashita
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Hiroyasu Fujiwara
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yuji Matsuoka
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hidekazu Suzuki
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hirosuke Nishimura
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Koji Tamai
- Department of Orthopaedic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Atsushi Tagami
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Shuta Yamada
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Shinji Adachi
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shuta Ushio
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Hidekazu Oishi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Toshiro Doi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Hirokazu Inoue
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Wataru Saito
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Atsushi Nakano
- Department of Orthopedic Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka, 569-8686, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Tokai University, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Tadashi Nukaga
- Department of Orthopaedic Surgery, Tokai University, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Masayuki Shimizu
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Toshimasa Futatsugi
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, Nankoku City, Kochi, 783-8505, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.,Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-8641, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-8641, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, University of Toyama, 2630 Sugitani, Toyama City, Toyama, 930-0194, Japan
| | - Michio Hongo
- Department of Orthopaedic Surgery, Akita University, 1-1-1 Hondo, Akita City, 010-8543, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University, 7-5-1 Kusunoki-cho, chuou-ku, Kobe City, Hyogo, 650-0017, Japan
| | - Takashi Yurube
- Department of Orthopaedic Surgery, Kobe University, 7-5-1 Kusunoki-cho, chuou-ku, Kobe City, Hyogo, 650-0017, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane City, Chiba, 283-8686, Japan
| | - Masashi Oshima
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University, North-15, West-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University, North-15, West-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan
| | - Hirooki Endo
- Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Toshinori Tsukanishi
- Department of Orthopaedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomohiro Hikata
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Seiji Ueda
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuta Shiono
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenya Nojiri
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naobumi Hosogane
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Mita, Minato-ku, Tokyo, 108-8329, Japan
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14
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Nishimoto Y, Yamashita Y, Morimoto T, Saga S, Amano H, Takase T, Hiramori S, Kim K, Oi M, Akao M, Kobayashi Y, Toyofuku M, Izumi T, Sato Y, Kimura T. P5592Thrombolysis with tissue plasminogen activator for patients with acute pulmonary embolisms in the real world: from the COMMAND VTE Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0536] [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
Background/Introduction
There is still uncertainty about the optimal usage of thrombolysis for acute pulmonary embolisms (PEs), leading to widely varying usage of thrombolysis in the real world. However, these have not been fully evaluated yet.
Purpose
We sought to evaluate the management strategies and clinical outcomes of thrombolysis for acute PEs in the real world.
Methods
The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive patients with acute symptomatic venous thromboembolisms in Japan between January 2010 and August 2014. The present study population consisted of 1,549 patients with PEs who received tissue plasminogen activator (t-PA) thrombolysis (N=180, 12%), or those who did not (N=1,369). The effectiveness outcome was all-cause death. The safety outcome was major bleeding. We used a multivariable logistic regression analysis to estimate the odds ratio (OR) and 95% confidence intervals (CI), to adjust clinically relevant confounders (age, sex, history of major bleeding, active cancer, and anemia). Additionally, we conducted stratified analysis by clinical severity, and we also evaluated clinical outcomes according to dosages of t-PA.
Results
Patients with t-PA thrombolysis were younger, and more frequently had higher body weight, but less frequently had active cancer, history of major bleeding, and anemia. More than half of patients with t-PA thrombolysis were patients with mild PEs, and the proportions of t-PA thrombolysis varied widely across the participating centers. More than half of patients received low-dose of t-PA (<20,000 IU/kg). As for the effectiveness, 9 (5.0%) patients in the t-PA thrombolysis group and 95 (6.9%) patients in the non t-PA thrombolysis group died at 30 days (Crude OR, 0.71; 95% CI 0.35–1.42, P=0.33). As for the safety, 7 (3.9%) patients in the t-PA thrombolysis group and 22 (1.6%) patients in the non t-PA thrombolysis group experienced major bleeding events at 10 days (Crude OR, 2.48; 95% CI 1.04–5.88, P=0.04). T-PA thrombolysis group had a significantly higher risk for 10-day major bleeding (Adjusted OR, 4.01; 95% CI 1.57–10.2, P=0.004), but not a lower risk for 30-day mortality (Adjusted OR, 1.10; 95% CI 0.53–2.28, P=0.79), although the risk for 30-day mortality was significantly lower in those with severe PEs (Adjusted OR, 0.36; 95% CI 0.15–0.88, P=0.02). After adjusting confounders, the 10-day major bleeding risk of the low-dose of t-PA group relative to the standard-dose of t-PA group tended to be lower (Adjusted OR, 0.07; 95% CI 0.004–1.05, P=0.05).
Conclusions
In the present real-world registry, relatively large number of patients received t-PA thrombolysis with wide variation across the participating centers. T-PA thrombolysis was significantly associated with a higher risk for major bleeding, but not a lower risk for mortality, although there appeared to be a benefit of t-PA thrombolysis in decreasing the risk for mortality in patients with severe PEs.
Acknowledgement/Funding
Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation
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Affiliation(s)
- Y Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Department of Cardiology, Amagasaki, Japan
| | - Y Yamashita
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - S Saga
- Hyogo Prefectural Amagasaki General Medical Center, Department of Cardiology, Amagasaki, Japan
| | - H Amano
- Kurashiki Central Hospital, Department of Cardiovascular Medicine, Kurashiki, Japan
| | - T Takase
- Kinki University Hospital, Department of Cardiology, Osaka, Japan
| | - S Hiramori
- Kokura Memorial Hospital, Department of Cardiology, Kokura, Japan
| | - K Kim
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - M Oi
- Japanese Red Cross Otsu Hospital, Department of Cardiology, Otsu, Japan
| | - M Akao
- National Hospital Organization Kyoto Medical Center, Department of Cardiology, Kyoto, Japan
| | - Y Kobayashi
- Osaka Red Cross Hospital, Department of Cardiovascular Center, Osaka, Japan
| | - M Toyofuku
- Japan Red Cross Society Wakayama Medical Center, Department of Cardiology, Wakayama, Japan
| | - T Izumi
- The Tazuke Kofukai Medical Research Institute, Cardiovascular Center, Osaka, Japan
| | - Y Sato
- Hyogo Prefectural Amagasaki General Medical Center, Department of Cardiology, Amagasaki, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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15
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Eura N, Shiota T, Ozaki M, Iguchi N, Uchihara Y, Nanaura H, Fukushima K, Kiriyama T, Izumi T, Kataoka H, Sugie K. P.11Clinicopathological difference between anti-SRP and anti-HMGCR myopathy. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.040] [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: 11/15/2022]
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16
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Mizouchi T, Watanabe K, Izumi T, Katsumi K, Shoji H, Ohashi M, Tashi H, Hirano T, Yamazaki A, Endo N. Quantitative radiographic analysis of foraminal re-stenosis after posterior cervical foraminotomy with laminoplasty. J Clin Neurosci 2019; 67:99-104. [PMID: 31227405 DOI: 10.1016/j.jocn.2019.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/25/2019] [Accepted: 06/09/2019] [Indexed: 11/26/2022]
Abstract
Few studies have performed detailed radiographic evaluation of the cause of recurrent cervical radiculopathy. In this study, we aimed to perform quantitative analyses of foraminal re-stenosis after posterior cervical foraminotomy (PCF) concomitant with laminoplasty. Seventy-eight consecutive patients (50 males and 28 females, mean age of 62 years at surgery) with cervical spondylotic radiculomyelopathy who underwent PCF concomitant with open-door laminoplasty were included. A total of 133 foramina undergoing PCF were radiographically evaluated using the following parameters: disc height, focal range of motion at the corresponding disc level, foraminal diameter (FD) and facet joint width (FJW) in the axial view on computed tomography, and re-stenosis rate (RR) of foramina. RR was calculated as follows: (foraminal regrowth at 2 years after surgery)/(foraminal enlargement immediate postoperatively) × 100% (RR2y). FDs preoperatively, postoperatively, and at 2-year follow-up were 2.2, 6.6, and 4.6 mm, respectively, and FJWs were 14.5, 9.0, and 10.6 mm, respectively. Both parameters significantly increased at the 2-year follow-up (p < 0.001). The mean RR2y was 42% (range, -16 to 108%). On logistic regression analysis of risk factors for higher RR2y (>50%), only preoperative posterior disc height (PDH) (OR = 0.33; 95% CI = 0.193-0.563; p < 0.001) was identified. Receiver operating characteristic curve analysis showed that the cut-off value of RR2y 50% was 1-mm PDH (AUC 0.73, sensitivity 52%, specificity 86%, p value < 0.001). After posterior foraminotomy with laminoplasty, the enlarged foraminal space gradually decreased during the 2-year follow-up. Foraminal re-stenosis was mainly due to bone regrowth of the resected facet joint, which is caused by disc degeneration with loss of PDH.
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Affiliation(s)
- Tatsuki Mizouchi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan.
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
| | - Tomohiro Izumi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinko-cho, Chuoku, Niigata City, Niigata 950-8556, Japan
| | - Keiichi Katsumi
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-uonuma City, Niigata 949-7302, Japan
| | - Hirokazu Shoji
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
| | - Masayuki Ohashi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
| | - Hideki Tashi
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
| | - Akiyoshi Yamazaki
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, 1-18 Shinko-cho, Chuoku, Niigata City, Niigata 950-8556, Japan
| | - Naoto Endo
- Department of Orthopedic Surgery, Niigata University, Medical and Dental General Hospital, 1-757 Asahimachidori Chuoku, Niigata City, Niigata 951-8510, Japan
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17
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Watanabe K, Katsumi K, Ohashi M, Shibuya Y, Izumi T, Hirano T, Endo N, Kaito T, Yamashita T, Fujiwara H, Nagamoto Y, Matsuoka Y, Suzuki H, Nishimura H, Terai H, Tamai K, Tagami A, Yamada S, Adachi S, Yoshii T, Ushio S, Harimaya K, Kawaguchi K, Yokoyama N, Oishi H, Doi T, Kimura A, Inoue H, Inoue G, Miyagi M, Saito W, Nakano A, Sakai D, Nukaga T, Ikegami S, Shimizu M, Futatsugi T, Ohtori S, Furuya T, Orita S, Imagama S, Ando K, Kobayashi K, Kiyasu K, Murakami H, Yoshioka K, Seki S, Hongo M, Kakutani K, Yurube T, Aoki Y, Oshima M, Takahata M, Iwata A, Endo H, Abe T, Tsukanishi T, Nakanishi K, Watanabe K, Hikata T, Suzuki S, Isogai N, Okada E, Funao H, Ueda S, Shiono Y, Nojiri K, Hosogane N, Ishii K. Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome? BMC Musculoskelet Disord 2019; 20:103. [PMID: 30851739 PMCID: PMC6408814 DOI: 10.1186/s12891-019-2473-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction. METHODS Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 patients with PD (mean age, 76 years; 3 men and 23 women) with thoracolumbar OVF who underwent spinal fusion with a minimum of 2 years of follow-up were included (PD group). Surgical invasion, perioperative complications, radiographic sagittal alignment, mechanical failure (MF) related to instrumentation, and clinical outcomes were evaluated. A control group of 296 non-PD patients (non-PD group) matched for age, sex, distribution of surgical procedures, number of fused segments, and follow-up period were used for comparison. RESULTS The PD group showed higher rates of perioperative complications (p < 0.01) and frequency of delirium than the non-PD group (p < 0.01). There were no significant differences in the degree of kyphosis correction, frequency of MF, visual analog scale of the symptoms, and improvement according to the Japanese Orthopaedic Association scoring system between the two groups. However, the PD group showed a higher proportion of non-ambulators and dependent ambulators with walkers at the final follow-up (p < 0.01). CONCLUSIONS A similar surgical strategy can be applicable to patients with PD with OVF in the thoracolumbar junction. However, physicians should pay extra attention to intensive perioperative care to prevent various adverse events and implement a rehabilitation regimen to regain walking ability.
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Affiliation(s)
- Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Keiichi Katsumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Masayuki Ohashi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Yohei Shibuya
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Tomohiro Izumi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Naoto Endo
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Tomoya Yamashita
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Hiroyasu Fujiwara
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka University, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan
| | - Yuji Matsuoka
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hidekazu Suzuki
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hirosuke Nishimura
- Department of Orthopaedic Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Koji Tamai
- Department of Orthopaedic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Atsushi Tagami
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Syuta Yamada
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Shinji Adachi
- Department of Orthopaedic Surgery, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shuta Ushio
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Hidekazu Oishi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Toshiro Doi
- Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Hirokazu Inoue
- Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke City, Tochigi, 329-0498, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Wataru Saito
- Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan
| | - Atsushi Nakano
- Department of Orthopaedic Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka, 569-0801, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Tokai University, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Tadashi Nukaga
- Department of Orthopaedic Surgery, Tokai University, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Masayuki Shimizu
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Toshimasa Futatsugi
- Department of Orthopaedic Surgery, Shinshu University, 3-1-1, Asahi, Matsumoto City, Nagano, 390-8621, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8670, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8670, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8670, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Kazuyoshi Kobayashi
- Department of Orthopaedic Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8560, Japan
| | - Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, Nankoku City, Kochi, 783-8505, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-8641, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-8641, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, University of Toyama, 2630 Sugitani, Toyama City, Toyama, 930-0194, Japan
| | - Michio Hongo
- Department of Orthopaedic Surgery, Akita University, 1-1-1 Hondo, Akita City, Akita, 010-8543, Japan
| | - Kenichiro Kakutani
- Department of Orthopaedic Surgery, Kobe University, 7-5-1 Kusunoki-cho, chuou-ku, Kobe City, Hyogo, 650-0017, Japan
| | - Takashi Yurube
- Department of Orthopaedic Surgery, Kobe University, 7-5-1 Kusunoki-cho, chuou-ku, Kobe City, Hyogo, 650-0017, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane City, Chiba, 283-8686, Japan
| | - Masashi Oshima
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University, North-15, West-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University, North-15, West-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan
| | - Hirooki Endo
- Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Toshinori Tsukanishi
- Department of Orthopaedic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8577, Japan
| | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomohiro Hikata
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare School of Medicine, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare School of Medicine, Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Seiji Ueda
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuta Shiono
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenya Nojiri
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naobumi Hosogane
- Department of Orthopaedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare School of Medicine, Mita, Minato-ku, Tokyo, 108-8329, Japan
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18
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Tamai K, Terai H, Suzuki A, Nakamura H, Watanabe K, Katsumi K, Ohashi M, Shibuya Y, Izumi T, Hirano T, Kaito T, Yamashita T, Fujiwara H, Nagamoto Y, Matsuoka Y, Suzuki H, Nishimura H, Tagami A, Yamada S, Adachi S, Yoshii T, Ushio S, Harimaya K, Kawaguchi K, Yokoyama N, Oishi H, Doi T, Kimura A, Inoue H, Inoue G, Miyagi M, Saito W, Nakano A, Sakai D, Nukaga T, Ikegami S, Shimizu M, Futatsugi T, Ohtori S, Furuya T, Orita S, Imagama S, Ando K, Kobayashi K, Kiyasu K, Murakami H, Yoshioka K, Seki S, Hongo M, Kakutani K, Yurube T, Aoki Y, Oshima M, Takahata M, Iwata A, Endo H, Abe T, Tsukanishi T, Nakanishi K, Watanabe K, Hikata T, Suzuki S, Isogai N, Okada E, Funao H, Ueda S, Shiono Y, Nojiri K, Hosogane N, Ishii K. Risk Factors for Proximal Junctional Fracture Following Fusion Surgery for Osteoporotic Vertebral Collapse with Delayed Neurological Deficits: A Retrospective Cohort Study of 403 Patients. Spine Surg Relat Res 2018; 3:171-177. [PMID: 31435571 PMCID: PMC6690093 DOI: 10.22603/ssrr.2018-0068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/17/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Approximately 3% of osteoporotic vertebral fractures develop osteoporotic vertebral collapse (OVC) with neurological deficits, and such patients are recommended to be treated surgically. However, a proximal junctional fracture (PJFr) following surgery for OVC can be a serious concern. Therefore, the aim of this study is to identify the incidence and risk factors of PJFr following fusion surgery for OVC. Methods This study retrospectively analyzed registry data collected from facilities belonging to the Japan Association of Spine Surgeons with Ambition (JASA) in 2016. We retrospectively analyzed 403 patients who suffered neurological deficits due to OVC below T10 and underwent corrective surgery; only those followed up for ≥2 years were included. Potential risk factors related to the PJFr and their cut-off values were calculated using multivariate logistic regression analysis and receiver operating characteristic (ROC) analysis. Results Sixty-three patients (15.6%) suffered PJFr during the follow-up (mean 45.7 months). In multivariate analysis, the grade of osteoporosis (grade 2, 3: adjusted odds ratio (aOR) 2.92; p=0.001) and lower instrumented vertebra (LIV) level (sacrum: aOR 6.75; p=0.003) were independent factors. ROC analysis demonstrated that lumbar bone mineral density (BMD) was a predictive factor (area under curve: 0.72, p=0.035) with optimal cut-off value of 0.61 g/cm2 (sensitivity, 76.5%; specificity, 58.3%), but that of the hip was not (p=0.228). Conclusions PJFr was found in 16% cases within 4 years after surgery; independent risk factors were severe osteoporosis and extended fusion to the sacrum. The lumbar BMD with cut-off value 0.61 g/cm2 may potentially predict PJFr. Our findings can help surgeons select perioperative adjuvant therapy, as well as a surgical strategy to prevent PJFr following surgery.
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Affiliation(s)
- Koji Tamai
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Japan
| | - Hidetomi Terai
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Japan
| | - Akinobu Suzuki
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University, Osaka City, Japan
| | - Kei Watanabe
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Keiichi Katsumi
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Masayuki Ohashi
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Yohei Shibuya
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Tomohiro Izumi
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Toru Hirano
- Department of Orthopaedic Surgery, Niigata University, Niigata City, Japan
| | - Takashi Kaito
- Department of Orthopaedic Surgery, Osaka University, Suita City, Japan
| | - Tomoya Yamashita
- Department of Orthopaedic Surgery, Osaka University, Suita City, Japan
| | - Hiroyasu Fujiwara
- Department of Orthopaedic Surgery, Osaka University, Suita City, Japan
| | - Yukitaka Nagamoto
- Department of Orthopaedic Surgery, Osaka University, Suita City, Japan
| | - Yuji Matsuoka
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hidekazu Suzuki
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hirosuke Nishimura
- Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Atsushi Tagami
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Syuta Yamada
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Shinji Adachi
- Department of Orthopaedic Surgery, Nagasaki University, Nagasaki City, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shuta Ushio
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsumi Harimaya
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka city, Japan
| | - Kenichi Kawaguchi
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka city, Japan
| | - Nobuhiko Yokoyama
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka city, Japan
| | - Hidekazu Oishi
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka city, Japan
| | - Toshiro Doi
- Department of Orthopaedic Surgery, Kyushu University, Fukuoka city, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke city, Japan
| | - Hirokazu Inoue
- Department of Orthopaedic Surgery, Jichi Medical University, Shimotsuke city, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara city, Japan
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara city, Japan
| | - Wataru Saito
- Department of Orthopaedic Surgery, Kitasato University, Sagamihara city, Japan
| | - Atsushi Nakano
- Department of Orthopaedic Surgery, Osaka Medical College, Takatsuki city, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Tokai University, Isehara city, Japan
| | - Tadashi Nukaga
- Department of Orthopaedic Surgery, Tokai University, Isehara city, Japan
| | - Shota Ikegami
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto city, Japan
| | - Masayuki Shimizu
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto city, Japan
| | - Toshimasa Futatsugi
- Department of Orthopaedic Surgery, Shinshu University, Matsumoto city, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Chiba University, Chiba city, Japan
| | - Takeo Furuya
- Department of Orthopaedic Surgery, Chiba University, Chiba city, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Chiba University, Chiba city, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University, Nagoya city, Japan
| | - Kei Ando
- Department of Orthopaedic Surgery, Nagoya University, Nagoya city, Japan
| | | | - Katsuhito Kiyasu
- Department of Orthopaedic Surgery, Kochi University, Nankoku city, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa city, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa city, Japan
| | - Shoji Seki
- Department of Orthopaedic Surgery, University of Toyama, Toyama city, Japan
| | - Michio Hongo
- Department of Orthopaedic Surgery, Akita University, Akita city, Japan
| | | | - Takashi Yurube
- Department of Orthopaedic Surgery, Kobe University, Kobe city, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane city, Japan
| | - Masashi Oshima
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Masahiko Takahata
- Department of Orthopaedic Surgery, Hokkaido University, Sapporo city, Japan
| | - Akira Iwata
- Department of Orthopaedic Surgery, Hokkaido University, Sapporo city, Japan
| | - Hirooki Endo
- Department of Orthopaedic Surgery, Iwate Medical University, Morioka city, Japan
| | - Tetsuya Abe
- Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba city, Japan
| | | | - Kazuyoshi Nakanishi
- Department of Orthopaedic Surgery, Hiroshima University, Hiroshima city, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Tomohiro Hikata
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Norihiro Isogai
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Eijiro Okada
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Haruki Funao
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Seiji Ueda
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Yuta Shiono
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Kenya Nojiri
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Naobumi Hosogane
- Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa city, Japan.,Department of Orthopaedic Surgery, Keio University, Tokyo, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, Keio University, Tokyo, Japan.,Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan
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19
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Maekawa T, Osawa Y, Izumi T, Nagao S, Takano K, Okada Y, Tachi N, Teramoto M, Kawamura T, Horiuchi T, Saga R, Kato S, Yamamura T, Watanabe J, Kobayashi A, Kobayashi S, Sato K, Hashimoto M, Suzu S, Kimura F. Correction: Myeloproliferative leukemia protein activation directly induces fibrocyte differentiation to cause myelofibrosis. Leukemia 2018; 32:2729-2730. [PMID: 30232464 DOI: 10.1038/s41375-018-0237-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Owing to the insufficient specificity of the anti-myeloproliferative leukemia protein (MPL) antibody in the original version of this Article, Figure 6 and parts of Figures 2a, 4e, and 5a do not represent the correct information. The corrected version of Figure 6 is in this correction and those of Figures 2a, 4e, and 5a are shown in the supplemental information.
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Affiliation(s)
- T Maekawa
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
| | - Y Osawa
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - T Izumi
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - S Nagao
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - K Takano
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Y Okada
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - N Tachi
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - M Teramoto
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - T Kawamura
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - T Horiuchi
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - R Saga
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - S Kato
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - T Yamamura
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - J Watanabe
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - A Kobayashi
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - S Kobayashi
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - K Sato
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - M Hashimoto
- Suzu Project Laboratory, Center for AIDS Research, Kumamoto University, Kumamoto, Japan
| | - S Suzu
- Suzu Project Laboratory, Center for AIDS Research, Kumamoto University, Kumamoto, Japan
| | - F Kimura
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
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20
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Kawagishi N, Suda G, Onozawa M, Kimura M, Maehara O, Ohara M, Izumi T, Umemura M, Ito J, Nakai M, Sho T, Natsuizaka M, Morikawa K, Ogawa K, Sakamoto N. Comparing the risk of hepatitis B virus reactivation between direct-acting antiviral therapies and interferon-based therapies for hepatitis C. J Viral Hepat 2017. [PMID: 28632923 DOI: 10.1111/jvh.12737] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) reactivation has been reported during antihepatitis C treatment in patients with hepatitis C virus (HCV) and HBV co-infection. We aimed to evaluate the frequency and risk factors of HBV reactivation during anti-HCV therapy and compared those between interferon (IFN)-free direct-acting antiviral (DAA) therapies and IFN-based therapies. Three hundred and twenty-two patients with HCV infection receiving anti-HCV therapy were retrospectively screened. The baseline HBV infection statuses of all eligible patients and the HBV-DNA level of all patients with current or previous HBV infection were examined at the end of treatment. In patients with baseline anti-HBs positivity, changes in anti-HBs titre were evaluated. Of 287 patients who met the inclusion criteria, 157 had current (n=4) or previous (n=153) HBV infection; 85 were treated with IFN-free DAA therapies and 72 were treated with IFN-based therapies. Six patients experienced HBV reactivation (n=2) or HBV reappearance (n=4) after IFN-free DAA therapies, while no patient developed HBV reactivation after IFN-based therapies. The risk factors of HBV reactivation or reappearance were DAA therapies and a reduction in anti-HBs titre to <12 mIU mL-1 by the end of treatment. The decline changes of anti-HBs titre were significantly higher in patients treated with DAA therapies. Although HBV reactivation hepatitis was not observed, three of four patients with HBV reactivation or reappearance after achieving HCV eradication had viremia 8 weeks after completion of therapy. A significant proportion of patients develop HBV reactivation or reappearance without hepatitis after IFN-free DAA therapies. Low levels of anti-HBs and their decrease to <12 mIU mL-1 after treatment are significant risk factors for HBV reactivation or reappearance.
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Affiliation(s)
- N Kawagishi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Onozawa
- Department of Hematology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Kimura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - O Maehara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Ohara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Izumi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Umemura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - J Ito
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Nakai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Natsuizaka
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Morikawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Ogawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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21
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Katsumi K, Watanabe K, Izumi T, Hirano T, Ohashi M, Mizouchi T, Ito T, Endo N. Natural history of the ossification of cervical posterior longitudinal ligament: a three dimensional analysis. Int Orthop 2017; 42:835-842. [PMID: 29067483 DOI: 10.1007/s00264-017-3667-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/06/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Three-dimensional (3D) imaging using computed tomography (CT) has made it possible to accurately evaluate ossification of the posterior longitudinal ligament (OPLL). Recently, we developed a novel technique to measure ossification volume using the 3D analysis. The purpose of this study was to investigate the natural course of OPLL and the risk factors for volume progression. METHODS Forty-one patients (22 males and 19 females) diagnosed with cervical OPLL who had been non-surgically treated were included in this study. We evaluated clinical examination, radiological findings, and the volume of ossified lesions during at least 1-year intervals. Furthermore, we performed risk factor analysis for OPLL volume progression. RESULTS The mean ossification volume was 2047.4 ± 1437.3 mm3 in the first examination and 2201.0 ± 1524.1 mm3 in the final examination, indicating a significant increase during the follow-up period (p < 0.001). The mean annual rate of lesion increase was 4.1 ± 2.7%. Univariate regression analysis demonstrated significant relationships between the annual rate of lesion increase and age (β = -0.48; p = 0.001), body weight (BW) (β = 0.36; p = 0.02), and body mass index (BMI) (β = 0.35; p = 0.03). Furthermore, age was the only significant predictor of OPLL progression (R2 = 0.23; p = 0.001) in multivariate liner regression analysis. CONCLUSIONS Younger age, higher BW, and higher BMI are predictors of OPLL progression. Younger age is the most significant predictor in non-surgically treated patients.
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Affiliation(s)
- Keiichi Katsumi
- Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-uonuma City, Niigata, Japan
| | - Kei Watanabe
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Tomohiro Izumi
- Spine Center, Department of Orthopedic Surgery, Niigata Central Hospital, Niigata City, Niigata, Japan
| | - Toru Hirano
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Masayuki Ohashi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Tatsuki Mizouchi
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Takui Ito
- Department of Orthopedic Surgery, Niigata City General Hospital, Niigata City, Niigata, Japan
| | - Naoto Endo
- Department of Orthopedic Surgery, Niigata University Medical and Dental General Hospital, 1-757 Asahimachidori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
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22
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Eura N, Sugie K, Ozaki M, Shiota T, Uchihara Y, Nanaura H, Fukushima K, Kiriyama T, Izumi T, Kataoka H, Ueno S. Clinicopathological evaluation of anti-SRP versus anti-HMGCR myopathy: What are the similarities and differences? J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.780] [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: 10/18/2022]
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23
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Seko Y, Kato T, Haruna T, Izumi T, Miyamoto S, Nakane E, Sasaki K, Funasako M, Inoko M. P3573Evaluation of the relationship between atrial fibrillation and left ventricular geometric patterns. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3573] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Seko Y, Kato T, Haruna T, Izumi T, Miyamoto S, Nakane E, Sasaki K, Funasako M, Inoko M. P4513Characteristics of ECG in Patients with hypertrophic cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4513] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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25
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Kato T, Sasaki K, Funasako M, Miyamoto S, Izumi T, Haruna T, Yaku H, Kawase Y, Yamamoto E, Tamaki Y, Inuzuka Y, Inoko M, Ozasa N, Kimura T. P5291Nutritional status in acute decompensated heart failure was closely linked to high in-hospital mortality (from the KCHF registry). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T. Kato
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - K. Sasaki
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - M. Funasako
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - S. Miyamoto
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - T. Izumi
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - T. Haruna
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - H. Yaku
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y. Kawase
- Kurashiki Central Hospital, Kurashiki, Japan
| | - E. Yamamoto
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - Y. Tamaki
- Tenri Hospital, Department of Cardiology, Tenri, Japan
| | - Y. Inuzuka
- Shiga Medical Center for Adults, Department of Cardiology, Moriyama, Japan
| | - M. Inoko
- The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Cardiovascular Center, Osaka, Japan
| | - N. Ozasa
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
| | - T. Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Seko Y, Kato T, Funasako M, Sasaki K, Nakane E, Miyamoto S, Izumi T, Haruna T, Inoko M. P4396Characteristics of patients with small left ventricular diastolic dimension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4396] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kimura Y, Kato T, Nagao K, Izumi T, Haruna T, Ueyama K. Outcomes and Radiographic Findings of Isolated Spontaneous Superior Mesenteric Artery Dissection. J Vasc Surg 2017. [DOI: 10.1016/j.jvs.2017.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shibata H, Kato S, Sekine I, Abe K, Araki N, Iguchi H, Izumi T, Inaba Y, Osaka I, Kato S, Kawai A, Kinuya S, Kodaira M, Kobayashi E, Kobayashi T, Sato J, Shinohara N, Takahashi S, Takamatsu Y, Takayama K, Takayama K, Tateishi U, Nagakura H, Hosaka M, Morioka H, Moriya T, Yuasa T, Yurikusa T, Yomiya K, Yoshida M. Diagnosis and treatment of bone metastasis: comprehensive guideline of the Japanese Society of Medical Oncology, Japanese Orthopedic Association, Japanese Urological Association, and Japanese Society for Radiation Oncology. ESMO Open 2016; 1:e000037. [PMID: 27843593 PMCID: PMC5070259 DOI: 10.1136/esmoopen-2016-000037] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/02/2016] [Indexed: 01/14/2023] Open
Abstract
Diagnosis and treatment of bone metastasis requires various types of measures, specialists and caregivers. To provide better diagnosis and treatment, a multidisciplinary team approach is required. The members of this multidisciplinary team include doctors of primary cancers, radiologists, pathologists, orthopaedists, radiotherapists, clinical oncologists, palliative caregivers, rehabilitation doctors, dentists, nurses, pharmacists, physical therapists, occupational therapists, medical social workers, etc. Medical evidence was extracted from published articles describing meta-analyses or randomised controlled trials concerning patients with bone metastases mainly from 2003 to 2013, and a guideline was developed according to the Medical Information Network Distribution Service Handbook for Clinical Practice Guideline Development 2014. Multidisciplinary team meetings are helpful in diagnosis and treatment. Clinical benefits such as physical or psychological palliation obtained using the multidisciplinary team approaches are apparent. We established a guideline describing each specialty field, to improve understanding of the different fields among the specialists, who can further provide appropriate treatment, and to improve patients’ outcomes.
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Affiliation(s)
- H Shibata
- Department of Clinical Oncology , Akita University Graduate School of Medicine , Akita , Japan
| | - S Kato
- Department of Clinical Oncology , Juntendo University , Tokyo , Japan
| | - I Sekine
- Department of Clinical Oncology , University of Tsukuba , Tsukuba , Japan
| | - K Abe
- Department of Rehabilitation , Chiba Prefectural University of Health Sciences , Chiba , Japan
| | - N Araki
- Department of Orthopedic Surgery , Osaka Medical Center for Cancer and Cardiovascular Diseases , Osaka , Japan
| | - H Iguchi
- Department of Gastroenterology , National Hospital Organization Shikoku Cancer Center , Matsuyama , Japan
| | - T Izumi
- Division of Hematology , Tochigi Cancer Center , Utsunomiya , Japan
| | - Y Inaba
- Department of Diagnostic and Interventional Radiology , Aichi Cancer Center Hospital , Nagoya , Japan
| | - I Osaka
- Division of Palliative Medicine , Shizuoka Cancer Center , Sunto-gun , Japan
| | - S Kato
- Department for Cancer Chemotherapy , Iwate Prefectural Central Hospital , Morioka , Japan
| | - A Kawai
- Division of Musculoskeletal Oncology , National Cancer Center Hospital , Tokyo , Japan
| | - S Kinuya
- Department of Nuclear Medicine , Kanazawa University Hospital , Kanazawa , Japan
| | - M Kodaira
- Department of Breast and Medical Oncology , National Cancer Center Hospital , Tokyo , Japan
| | - E Kobayashi
- Division of Musculoskeletal Oncology , National Cancer Center Hospital , Tokyo , Japan
| | - T Kobayashi
- Department of Diagnostic and Interventional Radiology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - J Sato
- Department of Clinical Pharmaceutics , School of Pharmacy, Iwate Medical University , Morioka , Japan
| | - N Shinohara
- Department of Renal and Genitourinary Surgery , Hokkaido University Graduate School of Medicine , Sapporo , Japan
| | - S Takahashi
- Department of Medical Oncology , Cancer Institute Hospital of Japanese Foundation for Cancer Research , Tokyo , Japan
| | - Y Takamatsu
- Division of Medical Oncology , Hematology and Infectious Diseases, Fukuoka University Hospital , Fukuoka , Japan
| | - K Takayama
- Seirei Christopher University , Hamamatsu , Japan
| | - K Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
| | - U Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine , Tokyo Medical and Dental University , Tokyo , Japan
| | - H Nagakura
- Department of Radiology , KKR Sapporo Medical Center , Sapporo , Japan
| | - M Hosaka
- Department of Orthopaedic Surgery , Tohoku University Graduate School of Medicine , Sendai , Japan
| | - H Morioka
- Department of Orthopaedic Surgery , Keio University School of Medicine , Tokyo , Japan
| | - T Moriya
- Department of Pathology 2 , Kawasaki Medical School , Kurashiki , Japan
| | - T Yuasa
- Department of Urology , Cancer Institute Hospital, Japanese Foundation for Cancer Research , Tokyo , Japan
| | - T Yurikusa
- Division of Dentistry and Oral Surgery , Shizuoka Cancer Center , Sunto-gun , Japan
| | - K Yomiya
- Department of Palliative Care , Saitama Cancer Center , Kitaadachi-gun , Japan
| | - M Yoshida
- Department of Hemodialysis and Surgery , Chemotherapy Research Institute, International University of Health and Welfare , Ichikawa , Japan
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Katsumi K, Izumi T, Ito T, Hirano T, Watanabe K, Ohashi M. Posterior instrumented fusion suppresses the progression of ossification of the posterior longitudinal ligament: a comparison of laminoplasty with and without instrumented fusion by three-dimensional analysis. Eur Spine J 2015; 25:1634-1640. [DOI: 10.1007/s00586-015-4328-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 11/10/2015] [Accepted: 11/10/2015] [Indexed: 10/22/2022]
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Motomura K, Izumi T, Tateishi S, Tamaki Y, Ito Y, Horinouchi T, Nakanishi K. Superparamagnetic iron oxide-enhanced MRI at 3 T for accurate axillary staging in breast cancer. Br J Surg 2015; 103:60-9. [PMID: 26572241 DOI: 10.1002/bjs.10040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/08/2015] [Accepted: 09/25/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND The aim of this study was to evaluate whether MRI at 3 T with superparamagnetic iron oxide (SPIO) enhancement is an accurate and useful method for detecting metastases in sentinel nodes identified by CT-lymphography (CT-LG) in patients with breast cancer. The results were compared with those obtained using CT-LG alone and diagnosing metastasis according to size criteria. METHODS Patients with clinically node-negative breast cancer were included. Sentinel nodes identified by CT-LG were evaluated prospectively using SPIO-enhanced MRI at 3 T. Sentinel node size was measured on CT-LG, and a node larger than 5 mm in short-axis diameter was considered metastatic. Sentinel nodes localized by CT-LG were removed, and imaging results and histopathological findings were compared. RESULTS Sentinel nodes were identified successfully by CT-LG in 69 (99 per cent) of 70 patients. All 19 patients with a finding of metastasis in sentinel nodes at pathology were also shown to have metastases on MRI. Forty-eight of 50 patients with non-metastatic sentinel nodes diagnosed at pathology were classified as having non-metastatic nodes on MRI. On a patient-by-patient basis, the sensitivity, specificity and accuracy of MRI for the diagnosis of sentinel node metastases were 100, 96 and 97 per cent; respective values for CT-LG were 79, 56 and 62 per cent. The specificity and accuracy of MRI were superior to those of CT-LG (P < 0·001 and P = 0·002 respectively). CONCLUSION SPIO-enhanced MRI at 3 T is useful for accurate diagnosis of metastatic sentinel nodes, indicating that sentinel node biopsy may be avoided in patients with breast cancer who have non-metastatic sentinel nodes on imaging.
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Affiliation(s)
- K Motomura
- Departments of Breast and Endocrine Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - T Izumi
- Departments of Radiology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - S Tateishi
- Departments of Radiology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Y Tamaki
- Departments of Breast and Endocrine Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Y Ito
- Centre for Cancer Control and Statistics, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - T Horinouchi
- Departments of Radiology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - K Nakanishi
- Departments of Radiology, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan
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Sugie K, Sugie M, Taoka T, Tonomura Y, Kumazawa A, Izumi T, Ueno S, Kichikawa K. Characteristic MRI findings of upper limb muscle involvement in myotonic dystrophy type 1. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.312] [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: 11/26/2022]
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Taniguchi Y, Takahashi Y, Toba T, Yamada S, Yokoi K, Kobayashi S, Okajima S, Shimane A, Kawai H, Yasaka Y, Smanio P, Oliveira MA, Machado L, Cestari P, Medeiros E, Fukuzawa S, Okino S, Ikeda A, Maekawa J, Ichikawa S, Kuroiwa N, Yamanaka K, Igarashi A, Inagaki M, Patel K, Mahan M, Ananthasubramaniam K, Mouden M, Yokota S, Ottervanger J, Knollema S, Timmer J, Jager P, Padron K, Peix A, Cabrera L, Pena Bofill V, Valera D, Rodriguez Nande L, Carrillo Hernandez R, Mena Esnard E, Fernandez Columbie Y, Bertella E, Baggiano A, Mushtaq S, Segurini C, Loguercio M, Conte E, Beltrama V, Petulla' M, Andreini D, Pontone G, Guzic Salobir B, Dolenc Novak M, Jug B, Kacjan B, Novak Z, Vrtovec M, Mushtaq S, Pontone G, Bertella E, Conte E, Segurini C, Volpato V, Baggiano A, Formenti A, Pepi M, Andreini D, Ajanovic R, Husic-Selimovic A, Zujovic-Ajanovic A, Mlynarski R, Mlynarska A, Golba K, Sosnowski M, Ameta D, Goyal M, Kumar D, Chandra S, Sethi R, Puri A, Dwivedi SK, Narain VS, Saran RK, Nekolla S, Rischpler C, Nicolosi S, Langwieser N, Dirschinger R, Laugwitz K, Schwaiger M, Goral JL, Napoli J, Forcada P, Zucchiatti N, Damico A, Damico A, Olivieri D, Lavorato M, Dubesarsky E, Montana O, Salgado C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez De Mora E, Lopez-Aguilar R, Manovel A, Martinez A, Rivera F, Soriano E, Maroz-Vadalazhskaya N, Trisvetova E, Vrublevskaya O, Abazid R, Kattea M, Saqqah H, Sayed S, Smettei O, Winther S, Svensson M, Birn H, Jorgensen H, Botker H, Ivarsen P, Bottcher M, Maaniitty T, Stenstrom I, Saraste A, Pikkarainen E, Uusitalo V, Ukkonen H, Kajander S, Bax J, Knuuti J, Choi T, Park H, Lee C, Lee J, Seo Y, Cho Y, Hwang E, Cho D, Sanchez Enrique C, Ferrera C, Olmos C, Jimenez - Ballve A, Perez - Castejon MJ, Fernandez C, Vivas D, Vilacosta I, Nagamachi S, Onizuka H, Nishii R, Mizutani Y, Kitamura K, Lo Presti M, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Madeo A, Malouf J, Buffa V, Musumeci F, Rosales S, Puente A, Zafrir N, Shochat T, Mats A, Solodky A, Kornowski R, Lorber A, Boemio A, Pellegrino T, Paolillo S, Piscopo V, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Perrone-Filardi P, Cuocolo A, Piscopo V, Pellegrino T, Boemio A, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Petretta M, Cuocolo A, Amirov N, Ibatullin M, Sadykov A A, Saifullina G, Ruano R, Diego Dominguez M, Rodriguez Gabella T, Diego Nieto A, Diaz Gonzalez L, Garcia-Talavera J, Sanchez Fernandez P, Leen A, Al Younis I, Zandbergen-Harlaar S, Verberne H, Gimelli A, Veltman C, Wolterbeek R, Bax J, Scholte A, Mooney D, Rosenblatt J, Dunn T, Vasaiwala S, Okuda K, Nakajima K, Nystrom K, Edenbrandt L, Matsuo S, Wakabayashi H, Hashimoto M, Kinuya S, Iric-Cupic V, Milanov S, Davidovic G, Zdravkovic V, Ashikaga K, Yoneyama K, Akashi Y, Shugushev Z, Maximkin D, Chepurnoy A, Volkova O, Baranovich V, Faibushevich A, El Tahlawi M, Elmurr A, Alzubaidi S, Sakrana A, Gouda M, El Tahlawi R, Sellem A, Melki S, Elajmi W, Hammami H, Okano M, Kato T, Kimura M, Funasako M, Nakane E, Miyamoto S, Izumi T, Haruna T, Inoko M, Massardo T, Swett E, Fernandez R, Vera V, Zhindon J, Fernandez R, Swett E, Vera V, Zhindon J, Alay R, Massardo T, Ohshima S, Nishio M, Kojima A, Tamai S, Kobayashi T, Murohara T, Burrell S, Van Rosendael A, Van Den Hoogen I, De Graaf M, Roelofs J, Kroft L, Bax J, Scholte A, Rjabceva I, Krumina G, Kalvelis A, Chanakhchyan F, Vakhromeeva M, Kankiya E, Koppes J, Knol R, Wondergem M, Van Der Ploeg T, Van Der Zant F, Lazarenko SV, Bruin VS, Pan XB, Declerck JM, Van Der Zant FM, Knol RJJ, Juarez-Orozco LE, Alexanderson E, Slart R, Tio R, Dierckx R, Zeebregts C, Boersma H, Hillege H, Martinez-Aguilar M, Jordan-Rios A, Christensen TE, Ahtarovski KA, Bang LE, Holmvang L, Soeholm H, Ghotbi AA, Andersson H, Ihlemann N, Kjaer A, Hasbak P, Gulya M, Lishmanov YB, Zavadovskii K, Lebedev D, Stahle M, Hellberg S, Liljenback H, Virta J, Metsala O, Yla-Herttuala S, Saukko P, Knuuti J, Saraste A, Roivainen A, Thackeray J, Wang Y, Bankstahl J, Wollert K, Bengel F, Saushkina Y, Evtushenko V, Minin S, Efimova I, Evtushenko A, Smishlyaev K, Lishmanov Y, Maslov L, Okuda K, Nakajima K, Kirihara Y, Sugino S, Matsuo S, Taki J, Hashimoto M, Kinuya S, Ahmadian A, Berman J, Govender P, Ruberg F, Miller E, Piriou N, Pallardy A, Valette F, Cahouch Z, Mathieu C, Warin-Fresse K, Gueffet J, Serfaty J, Trochu J, Kraeber-Bodere F, Van Dijk J, Mouden M, Ottervanger J, Van Dalen J, Jager P, Zafrir N, Ofrk H, Vaturi M, Shochat T, Hassid Y, Belzer D, Sagie A, Kornowski R, Kaminek M, Metelkova I, Budikova M, Koranda P, Henzlova L, Sovova E, Kincl V, Drozdova A, Jordan M, Shahid F, Teoh Y, Thamen R, Hara N, Onoguchi M, Hojyo O, Kawaguchi Y, Murai M, Udaka F, Matsuzawa Y, Bulugahapitiya DS, Avison M, Martin J, Liu YH, Wu J, Liu C, Sinusas A, Daou D, Sabbah R, Bouladhour H, Coaguila C, Aguade-Bruix S, Pizzi M, Romero-Farina G, Candell-Riera J, Castell-Conesa J, Patchett N, Sverdlov A, Miller E, Daou D, Sabbah R, Bouladhour H, Coaguila C, Smettei O, Abazid R, Boulaamayl El Fatemi S, Sallam L, Snipelisky D, Park J, Ray J, Shapiro B, Kostkiewicz M, Szot W, Holcman K, Lesniak-Sobelga A, Podolec P, Clerc O, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Herzog B, Gaemperli O, Kaufmann P. Poster Session 1: Sunday 3 May 2015, 08:30-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Izumi T, Aoki M, Tanaka Y, Fujimiya M, Uchiyama E, Miyamoto S. Evaluation of stretching positions of the capsulo-ligamentous complex of the glenohumeral joint: a quantitative analysis using fresh frozen cadaver specimens. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3504] [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: 11/27/2022]
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Ikezoe K, Handa T, Tanizawa K, Kubo T, Ito I, Sokai A, Nakatsuka Y, Nagai S, Izumi T, Mishima M. A toll-like receptor 3 single nucleotide polymorphism in Japanese patients with sarcoidosis. ACTA ACUST UNITED AC 2015; 85:204-8. [DOI: 10.1111/tan.12535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 01/18/2015] [Accepted: 02/02/2015] [Indexed: 12/26/2022]
Affiliation(s)
- K. Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Handa
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - K. Tanizawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Kubo
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - I. Ito
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - A. Sokai
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Y. Nakatsuka
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - S. Nagai
- Kyoto Central Clinic; Clinical Research Center; Kyoto Japan
| | - T. Izumi
- Kyoto Central Clinic; Clinical Research Center; Kyoto Japan
| | - M. Mishima
- Department of Respiratory Medicine, Graduate School of Medicine; Kyoto University; Kyoto Japan
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Sawamura R, Kazui M, Kurihara A, Izumi T. Pharmacokinetics of loxoprofen and its active metabolite after dermal application of loxoprofen gel to rats. Pharmazie 2015; 70:74-80. [PMID: 25997245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was conducted to evaluate the pharmacokinetics of loxoprofen (LX) and its active metabolite (trans-OH form) after a single dermal application of LX gel (LX-G) to rats. In the skin at the treated site, generation of the trans-OH form was detected and both LX and the trans-OH form remained at high concentrations for 24 h after dermal application. Furthermore, both LX and the trans-OH form also remained in the skeletal muscle over 24 h after the single dermal application, while they eliminated rapidly after the single oral administration. The area under the curve up to the last measurable point (AUC(0-t)) for plasma concentrations of LX or the trans-OH form after dermal application of LX-G was less than 11% of that after oral administration of LX. In addition, C(max) and AUC(0-t) increased in a saturable manner while increasing the dose. Overall, these results demonstrated that the trans-OH form was generated at the treated site with the process of dermal absorption of LX and it remained at the target site for a long period with low systemic exposure compared to oral administration.
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Nishiyama T, Kaneko K, Yamada K, Teranishi R, Kato T, Hirayama T, Tobita H, Izumi T, Shiohara Y. Three-dimensional characterization of BaHfO3 precipitates in GdBa2Cu3O7-y flim using STEM tomography. Microscopy (Oxf) 2014; 63 Suppl 1:i26-i27. [PMID: 25359824 DOI: 10.1093/jmicro/dfu080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IntroductionSince the discovery of REBa2Cu3O7-y (RE: Rare Earth element, REBCO) superconductors, they have been expected as the best candidates for the power cable application due to its high critical temperature (Tc) and critical current density (Jc). Among those REBCO superconductors, GdBa2Cu3O7-y (GdBCO) have been receiving great interest because they have higher Tc and Jc than YBa2Cu3O7-y [1].GdBCO with various types of precipitates as artificial pinning centers (APCs) have been proposed to minimize the anisotropy of Jc characteristics under the magnetic field. Among those precipitates, BaHfO3 (BHO) was found most effective precipitates as APCs in GdBCO film prepared by pulsed laser deposition (PLD) method [2]. It is therefore necessary to investigate not only the morphologies but also the dispersion of BHO precipitates within the GdBCO, to understand the role of BHO for the superconducting characteristics. In this study, morphologies and dispersions of BHO precipitates were characterized three-dimensional by scanning transmission electron tomography ExperimentalBHO dispersed GdBCO films were fabricated on Hastelloy C-276TM substrates with buffer layers of CeO2/LaMnO3/MgO/ Gd2ZrO7 by PLD method.To observe microstructure of GdBCO film with BHO precipitates, cross-section TEM specimens were prepared by FIB method using Quanta 3D-200 (FEI, USA) with acceleration voltage from 2 to 30 kV. Three-dimensional information such as morphology and dispersion, of BHO precipitates were characterized by electron tomography using STEM-HAADF. Result and discussionFigure 1 shows three-dimensional reconstructed volume of BHO precipitates in GdBCO, which revealed that fine BHO precipitates have rod- and plate-like morphologies with homogeneous dispersion in GdBCO. In addition, growth directions of these precipitates were found with wide angular distributions from growth direction of GdBCO. Anisotropy of Jc in the magnetic fields was probably enhanced by various growth directions and homogeneous dispersion of nanosized BHO within GdBCO.jmicro;63/suppl_1/i26/DFU080F1F1DFU080F1Fig. 1.Three-dimensional reconstructed volume of BHO.
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Affiliation(s)
- T Nishiyama
- Department of Materials Science and Engineering, Kyushu University 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - K Kaneko
- Department of Materials Science and Engineering, Kyushu University 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - K Yamada
- Department of Materials Science and Engineering, Kyushu University 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - R Teranishi
- Department of Materials Science and Engineering, Kyushu University 744 Motooka, Nishi-ku, Fukuoka 819-0395, Japan
| | - T Kato
- Nanostructures Research Laboratory, Japan Fine Ceramics Center 2-4-1 Mutsuno, Atsuta-ku, Nagoya, 456-8587, Japan
| | - T Hirayama
- Nanostructures Research Laboratory, Japan Fine Ceramics Center 2-4-1 Mutsuno, Atsuta-ku, Nagoya, 456-8587, Japan
| | - H Tobita
- Superconductivity Research Laboratory, International Superconductivity Technology Center A-9 KSP R&D Business Park Building, 2-1, Sakado, 3-chome, Takatsu-ku, Kawasaki-shi, Kanagawa-ken 213-0012, Japann
| | - T Izumi
- Superconductivity Research Laboratory, International Superconductivity Technology Center A-9 KSP R&D Business Park Building, 2-1, Sakado, 3-chome, Takatsu-ku, Kawasaki-shi, Kanagawa-ken 213-0012, Japann
| | - Y Shiohara
- Superconductivity Research Laboratory, International Superconductivity Technology Center A-9 KSP R&D Business Park Building, 2-1, Sakado, 3-chome, Takatsu-ku, Kawasaki-shi, Kanagawa-ken 213-0012, Japann
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Izumi T, Hirano T, Watanabe K, Sano A, Ito T, Endo N. Three-dimensional evaluation of volume change in ossification of the posterior longitudinal ligament of the cervical spine using computed tomography. Eur Spine J 2013; 22:2569-74. [PMID: 24000076 DOI: 10.1007/s00586-013-2989-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 07/03/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Two-dimensional imaging is not adequate for evaluating ossification of the posterior longitudinal ligament (OPLL). This study was designed to evaluate the accuracy of a novel computed tomography (CT)-based three-dimensional (3D) analysis method that we had devised to measure volume changes in OPLL. SUBJECTS AND METHODS Twenty OPLL patients (12 male and 8 female; mean age 63.6 years) who were being followed conservatively were examined twice with an interval of at least 1 year between the two scans. The mean interval was 22 (range 12-45) months. A 3D model was created with DICOM data from CT images, using the MIMICS(®) software to calculate the volume. The mean ossification volume was determined from two measurements. Since ossification size varies widely, evaluation of change in volume is generally affected by the original size. Therefore, the change in ossification volume between the first and second CT examinations was calculated as the annual rate of progression. RESULTS The type of OPLL was classified as continuous in 3 patients, segmented in 3, and mixed in 14. The mean ossification volume was 1,831.68 mm(3) at the first examination and 1,928.31 mm(3) at the second, showing a significant mean increase in ossification volume. The mean annual rate of lesion increase was 3.33% (range 0.08-7.79%). CONCLUSION The 3D method used allowed detailed OPLL classification and quantification of change in the ossified volume. Thus, this method appears to be very useful for quantitative evaluation of OPLL with only minimal measurement error.
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Affiliation(s)
- Tomohiro Izumi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Chuo-ku, Niigata, 951-8510, Japan,
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Sano A, Hirano T, Watanabe K, Izumi T, Endo N, Ito T, Inagawa S. Preoperative evaluation of the vertebral arteries and posterior portion of the circle of Willis for cervical spine surgery using 3-dimensional computed tomography angiography. Spine (Phila Pa 1976) 2013; 38:E960-7. [PMID: 23609201 DOI: 10.1097/brs.0b013e318296e542] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective analysis using prospectively collected data from 3-dimensional computed tomography angiography (3D-CTA). OBJECTIVE To investigate the frequency of anomalous vertebral arteries (VA) and variations of the posterior portion of the circle of Willis (PPCW) using 3D-CTA for preventing perioperative iatrogenic vascular complications. SUMMARY OF BACKGROUND DATA Some studies have reported that preoperative 3D-CTA is useful for determining the VA blood flow in the cervical spine. However, preoperative 3D-CTA has not been used for evaluating PPCW, which functions as vessels collateral to the basilar artery in the case of iatrogenic VA injury. METHODS The study included 100 consecutive patients (61 males and 39 females; mean age, 60.4 ± 15.4 yr; range, 11-86 yr) who underwent cervical decompression and/or instrumentation between April 2008 and May 2012. We measured the diameters of the VA (VAD), posterior communicating artery (PCOMD), first segment of the posterior cerebral artery (P1D), and basilar artery (BAD) twice and determined the frequency of anomalous VA and PPCW variations. RESULTS Hypoplastic VA, hypoplastic PCOM, and hypoplastic P1 were detected in 11 (11.0%), 81 (81.0%), and 13 patients (13.0%), respectively. Hypoplastic PCOM-P1 and hypoplastic basilar artery were observed in 87 (87.0%) and 3 patients (3.0%), respectively. Overall, 47 patients (47.0%) possessed some degree of abnormal VA blood flow.There were 7 patients (7.0%) with both unilaterally hypoplastic VA and bilaterally hypoplastic PCOM-P1s, in whom iatrogenic VA injury on the dominant side could have caused lethal vascular complications. We termed the hypoplastic VA of the contralateral side without collateral vessels as "critical VA." CONCLUSION The VAs and PPCW vary considerably. Preoperative 3D-CTA provides important information for preventing tragic vascular complications caused by iatrogenic VA injury. Taking the risk of radiation into consideration, we recommend this method for patients at the highest risk for iatrogenic VA injury.
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Affiliation(s)
- Atsuki Sano
- Department of Orthopaedic Surgery, Niigata University Medical and Dental General Hospital, Niigata, Japan.
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Haraguchi K, Miyachi S, Matsubara N, Nagano Y, Yamada H, Marui N, Sano A, Fujimoto H, Izumi T, Yamanouchi T, Asai T, Wakabayashi T. A mechanical coil insertion system for endovascular coil embolization of intracranial aneurysms. Interv Neuroradiol 2013; 19:159-66. [PMID: 23693038 DOI: 10.1177/159101991301900203] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/09/2013] [Indexed: 11/16/2022] Open
Abstract
Like other fields of medicine, robotics and mechanization might be introduced into endovascular coil embolization of intracranial aneurysms for effective treatment. We have already reported that coil insertion force could be smaller and more stable when the coil delivery wire is driven mechanically at a constant speed. Another background is the difficulty in synchronizing operators' minds and hands when two operators control the microcatheter and the coil respectively. We have therefore developed a mechanical coil insertion system enabling a single operator to insert coils at a fixed speed while controlling the microcatheter. Using our new system, the operator manipulated the microcatheter with both hands and drove the coil using foot switches simultaneously. A delivery wire force sensor previously reported was used concurrently, allowing the operator to detect excessive stress on the wire. In vitro coil embolization was performed using three methods: simple mechanical advance of the coil; simple mechanical advance of the coil with microcatheter control; and driving (forward and backward) of the coil using foot switches in addition to microcatheter control. The system worked without any problems, and did not interfere with any procedures. In experimental coil embolization, delivery wire control using the foot switches as well as microcatheter manipulation helped to achieve successful insertion of coils. This system could offer the possibility of developing safer and more efficient coil embolization. Although we aim at total mechanization and automation of procedures in the future, microcatheter manipulation and synchronized delivery wire control are still indispensable using this system.
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Affiliation(s)
- K Haraguchi
- Department of Neurosurgery, Nagoya University, Nagoya, Japan
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Tanaka M, Sugawara M, Ogasawara Y, Suminoe I, Izumi T, Hiramatsu O, Kajiya F. Noninvasive assessment of left ventricular force-frequency relationships by measuring carotid arterial wave intensity during exercise stress. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:687-690. [PMID: 24109780 DOI: 10.1109/embc.2013.6609593] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Evaluation of the contractile state of the left ventricle during exercise is important in drawing up a protocol of cardiac rehabilitation. It has been demonstrated that color Doppler- and echo tracking-derived carotid arterial wave intensity is a sensitive index of global left ventricular (LV) contractility. OBJECTIVES We assessed the feasibility of measuring carotid arterial wave intensity and determining force-frequency (contractility-heart rate) relationships (FFR's) during exercise totally noninvasively. METHODS We measured carotid arterial wave intensity with a combined color Doppler and echo tracking system in 15 healthy young male volunteers (age 20.8 ± 1.3 years) at rest and during exercise. FFR's were constructed by plotting the maximum value of wave intensity (WD1) against heart rate (HR). RESULTS WD1 increased linearly with an increase in HR. The goodness-of-fit of the regression line of WD1 on HR in each subject was very high (r2 0.67 ~ 0.91, p < 0.0001 respectively). The slope of the WD1-HR relation ranged from 0.31 to 1.52 [m/s(3)(beat/min)]. CONCLUSIONS A global LV FFR can be generated in healthy young volunteers with an entirely noninvasive combination of exercise and wave intensity. These data should show the potential usefulness of FFR in the context of cardiac rehabilitation.
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Iwamoto C, Utsunomiya H, Tamii A, Akimune H, Nakada H, Shima T, Yamagata T, Kawabata T, Fujita Y, Matsubara H, Shimbara Y, Nagashima M, Suzuki T, Fujita H, Sakuda M, Mori T, Izumi T, Okamoto A, Kondo T, Bilgier B, Kozer HC, Lui YW, Hatanaka K. Separation of pygmy dipole and M1 resonances in 90Zr by a high-resolution inelastic proton scattering near 0°. Phys Rev Lett 2012; 108:262501. [PMID: 23004969 DOI: 10.1103/physrevlett.108.262501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Indexed: 06/01/2023]
Abstract
A high-resolution measurement of inelastic proton scattering off (90)Zr near 0° was performed at 295 MeV with a focus on a pronounced strength previously reported in the low-energy tail of giant dipole resonance. A forest of fine structure was observed in the excitation energy region 7-12 MeV. A multipole decomposition analysis of the angular distribution for the forest was carried out using the ECIS95 distorted-wave Born approximation code with the Hartree-Fock plus random-phase approximation model of E1 and M1 transition densities and inclusion of E1 Coulomb excitation. The analysis separated pygmy dipole and M1 resonances in the forest at E(PDR)=9.15±0.18 MeV with Γ(PDR)=2.91±0.64 MeV and at E(M1)=9.53±0.06 MeV with Γ(M1)=2.70±0.17 MeV in the Lorentzian function, respectively. The B(E1)↑ value for pygmy dipole resonance over 7-11 MeV is 0.75±0.08 e(2)fm(2), which corresponds to 2.1±0.2% of the Thomas-Reiche-Kuhn sum rule.
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Affiliation(s)
- C Iwamoto
- Department of Physics, Konan University, Okamoto 8-9-1, Higashinada, Kobe 658-8501, Japan
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Ohyama T, Sato K, Kishimoto K, Yamazaki Y, Horiguchi N, Ichikawa T, Kakizaki S, Takagi H, Izumi T, Mori M. Azelnidipine is a calcium blocker that attenuates liver fibrosis and may increase antioxidant defence. Br J Pharmacol 2012; 165:1173-87. [PMID: 21790536 DOI: 10.1111/j.1476-5381.2011.01599.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND PURPOSE Oxidative stress plays a critical role in liver fibrogenesis. Reactive oxygen species (ROS) stimulate hepatic stellate cells (HSCs), and ROS-mediated increases in calcium influx further increase ROS production. Azelnidipine is a calcium blocker that has been shown to have antioxidant effects in endothelial cells and cardiomyocytes. Therefore, we evaluated the anti-fibrotic and antioxidative effects of azelnidipine on liver fibrosis. EXPERIMENTAL APPROACH We used TGF-β1-activated LX-2 cells (a human HSC line) and mouse models of fibrosis induced by treatment with either carbon tetrachloride (CCl(4) ) or thioacetamide (TAA). KEY RESULTS Azelnidipine inhibited TGF-β1 and angiotensin II (Ang II)-activated α1(I) collagen mRNA expression in HSCs. Furthermore, TGF-β1- and Ang II-induced oxidative stress and TGF-β1-induced p38 and JNK phosphorylation were reduced in HSCs treated with azelnidipine. Azelnidipine significantly decreased inflammatory cell infiltration, pro-fibrotic gene expressions, HSC activation, lipid peroxidation, oxidative DNA damage and fibrosis in the livers of CCl(4) - or TAA-treated mice. Finally, azelnidipine prevented a decrease in the expression of some antioxidant enzymes and accelerated regression of liver fibrosis in CCl(4) -treated mice. CONCLUSIONS AND IMPLICATIONS Azelnidipine inhibited TGF-β1- and Ang II-induced HSC activation in vitro and attenuated CCl(4) - and TAA-induced liver fibrosis, and it accelerated regression of CCl(4) -induced liver fibrosis in mice. The anti-fibrotic mechanism of azelnidipine against CCl(4) -induced liver fibrosis in mice may have been due an increased level of antioxidant defence. As azelnidipine is widely used in clinical practice without serious adverse effects, it may provide an effective new strategy for anti-fibrotic therapy.
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Affiliation(s)
- T Ohyama
- Departments of Medicine and Molecular Science Biochemistry, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Shimizu J, Izumi T, Arimitsu N, Fujiwara N, Ueda Y, Wakisaka S, Yoshikawa H, Kaneko F, Suzuki T, Takai K, Suzuki N. Skewed TGFβ/Smad signalling pathway in T cells in patients with Behçet's disease. Clin Exp Rheumatol 2012; 30:S35-S39. [PMID: 22935165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 07/06/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Behçet's disease (BD) is a multi-systemic inflammatory disease, characterised by recurrent oral aphthosis, genital ulcers, skin lesions and uveitis. We have reported excessive Th1 cell activity in patients with BD. More recently, Th17 cells were suggested to associate with several autoimmune diseases. This study was designed to investigate the role of Th17 related cytokines and signalling molecules in patients with BD. METHODS We examined mRNA expressions of Th1 and Th17 related cytokines and related signalling molecules in PBMC of 12 patients with BD and 14 normal controls (NC) using quantitative RT-PCR. We studied expressions of the Th17 related cytokines in other four BD patients' skin lesions by immunofluorescence. RESULTS Major Th17 related cytokines were not detected in unstimulated PBMC in patients with BD. After stimulation, mRNA expressions of TGFβ receptor type 1, IL-12 receptor β2 and suppressor of cytokine signalling protein (SOCS) 1 on PBMC were significantly enhanced in patients with BD, as compared with NC (p<0.05). mRNA expression of RORC, a key transcription factor for Th17 cell differentiation, was comparable between BD and NC. CD4+ T cells infiltrating into BD skin lesion expressed TGFβ1 much more than those infiltrating into non-Behçet's disease erythema nodosum. CONCLUSIONS These findings suggest that TGFβ/Smad signalling pathway of T cells is overactive in patients with BD.
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Affiliation(s)
- J Shimizu
- Department of Immunology and Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan
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Tanizawa K, Handa T, Nagai S, Ito I, Kubo T, Ito Y, Watanabe K, Aihara K, Mishima M, Izumi T. A CD40 single-nucleotide polymorphism affects the lymphocyte profiles in the bronchoalveolar lavage of Japanese patients with sarcoidosis. ACTA ACUST UNITED AC 2012; 78:442-5. [PMID: 22077624 DOI: 10.1111/j.1399-0039.2011.01783.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
CD40 plays a critical role in adaptive immunity, and alveolar macrophages in patients with sarcoidosis express higher levels of CD40. This study investigated the association of rs1883832, a functional single-nucleotide polymorphism in the CD40 gene with susceptibility to sarcoidosis and phenotypes of sarcoidosis. Genotyping of rs1883832 in 175 Japanese patients with sarcoidosis and 150 age- and sex-matched controls revealed no significant difference between the genotypes of the patient and control groups (CC/CT/TT, 32.8/52.0/14.7% in the patients; 37.3/48.0/14.7% in the controls, P = 0.66; allele C, 59.1% in the patients, 61.3% in the controls, P = 0.57). T-cell and CD4+ cell counts in the bronchoalveolar lavage fluid were significantly higher in the TT genotype group than in the CC and CT genotype group.
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Affiliation(s)
- K Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Lapong E, Fujihara M, Izumi T, Hamagami K, Kakihara T, Kobayashi N. Suspended sediment estimation and analysis in river basins with rice paddy fields. Water Sci Technol 2012; 66:918-926. [PMID: 22797217 DOI: 10.2166/wst.2012.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Suspended sediment, which is an important water quality characteristic concerning effluents from agricultural areas, was studied in relatively small rivers that drain agricultural watersheds with considerable rice paddy areas. Suspended sediment load (SL) was observed daily for thirty three months and analysed--applying data stratification. Suspended sediment prediction models were established and the effect of rice transplanting activities on the rivers' SL was estimated. Results showed that data stratification improved the discharge-SL correlation and reduced regression and curve-fitting errors, thereby improving the efficiency of the derived model equations. Clustering the months into the rice- and non-rice transplanting seasons also improved the resulting regression equations, although not statistically significantly. Suspended SL was found to be higher during the rice transplanting season and the activities contributed a considerable amount of suspended sediment during the period, supporting the conjecture that sediments come from sources other than natural soil erosion.
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Affiliation(s)
- E Lapong
- The United Graduate School of Agricultural Sciences, Ehime University, 3-5-7 Tarumi, Matsuyama City, 790-8566, Japan.
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S Miyachi E, Izumi T, Matsubara N, Naito T, Haraguchi K, Wakabayashi T. Mechanism of the formation of dural arteriovenous fistula: the role of the emissary vein. Interv Neuroradiol 2011; 17:195-202. [PMID: 21696658 DOI: 10.1177/159101991101700209] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2010] [Accepted: 11/07/2010] [Indexed: 11/15/2022] Open
Abstract
Dural arteriovenous fistula (DAVF) can be separated into two types: DAVF which drains through an affected sinus (sinus type) and DAVF with direct reflux to the cortical vein (non-sinus type). The present report attempted to clarify the mechanism of formation and development of DAVF focusing on the emissary vein (EV) hypothesis.First, inflammation occurs at the penetrating point of the EV on the dura due to idiopathic or secondary causes. Local inflammatory reactions induce vessel dilatation and neovascularization, and subsequently create arteriovenous (AV) connections on the arteriole level. Although EV communicating with dural arteries might play a role as draining routes at first, they start to degrade due to compression of enlarged emissary arteries or to a hemodynamic shift to the drainage pathway of least resistance. Following the occlusion of drainage pathway through EV into the sinus or cortical veins may form, resulting in clinically detectable DAVF. The AV shunt then expands to the surrounding dura associated with recruitment of feeders from distant sites induced by expression of angiogenetic factors and a shift in the hemodynamic balance. In sinus type DAVF, the sinus is progressively compartmentalized and finally occludes due to thrombogenesis with activated coagulopathy or to hemodynamic hypertrophy of the sinus wall. This progression results in the mature, aggressive DAVF with drainage impairments. Previous mechanistic hypotheses focusing on sinus hypertension and sinus thromboses cannot explain the pathogenesis of non-sinus type of DAVF. Although the etiology of DAVF may be concerned by the thrombo-occlusive change of sinus, the unique theory presented in this report may enable an understanding of the common etiology of both types of DAVF.
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Affiliation(s)
- E S Miyachi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Japan.
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Platou ES, Knutsen TM, Steen T, Kirkfeldt R, Johansen J, Nohr E, Moller M, Arnsbo P, Nielsen J, Pruiti GP, Conti S, Puzzangara E, Di Grazia A, Ussia GP, Tamburino C, Calvi V, Nielsen JC, Bloch Thomsen PE, Hojberg S, Moller M, Riahi S, Dalsgaard D, Mortensen LS, Andersen HR, Kolodzinska A, Kutarski A, Grabowski M, Malecka B, Jarzyna I, Opolski G, Mabo P, Solnon A, Tassin A, Martins R, Graindorge L, Cebron JP, Rodriguez-Diez G, Moreno I, Bello E, Olmedo F, Vargas E, Leal R, Ortiz M, Robledo-Nolasco R, Schau T, Seifert M, Meyhoefer J, Neuss M, Butter C, Miyamoto S, Ishimura T, Inoko M, Haruna T, Izumi T, Ueyama K, Fujita M, Nohara R. Hot topics in pacing therapy. Europace 2011. [DOI: 10.1093/europace/eur228] [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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Matsumoto T, Wada T, Naito Y, Takahashi Y, Izumi T, Inoue D, Abe D, Asai T, Aoba T. The influence of high speed swimsuits on the lactate curve test among competitive swimmers. J Sci Med Sport 2010. [DOI: 10.1016/j.jsams.2010.10.544] [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: 10/18/2022]
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Miyachi S, Izumi T, Matsubara N, Naito T, Haraguchi KI, Wakabayashi T. The mechanism of catheter kickback in the final stage of coil embolization for aneurysms: the straightening phenomenon. Interv Neuroradiol 2010; 16:353-60. [PMID: 21162765 PMCID: PMC3278017 DOI: 10.1177/159101991001600401] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 10/11/2010] [Indexed: 11/15/2022] Open
Abstract
The catheter kickback phenomenon often occurs in the last stage of coil packing for cerebral aneurysms. This behavior is considered the result of either a lack of space in the sac or a stiff detaching zone. In order to clarify its mechanism, focused stretch-resistance (SR) coil simulation models were tested. Various commercially available SR coils were inserted into a cylinder or an aneurismal sac made from a silicone tube with a smaller than prescribed diameter. A magnified SR coil model (straight type) of fishing line was created for simulation. Numerical analysis for the changes in coil behavior were verified. All SR coils showed hardening and straightening at the last few millimeters, resulting in catheter kickback. In a magnified coil experiment, straightening was also realized when folding into a narrow cylinder. The SR line coursed in the canal of the first loops and shifted to the outside in the middle portion. Gaps among first coil pitches were enlarged on after insertion into the narrower space. Shortage of the SR line was calculated to reach a maximum of 32%. The straightening phenomenon is due to SR line shortening and subsequent condensation of pitches of the first loops at the coil end. Coil tail flexibility was lost, and the coil behaved as a stiff wire. Straightening is an important factor in the kickback phenomenon. Shorter final SR coils should be selected, and coil designs should be improved.
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Affiliation(s)
- S Miyachi
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
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Imamura Y, Murayama N, Okudaira N, Kurihara A, Okazaki O, Izumi T, Inoue K, Yuasa H, Kusuhara H, Sugiyama Y. Prediction of fluoroquinolone-induced elevation in serum creatinine levels: a case of drug-endogenous substance interaction involving the inhibition of renal secretion. Clin Pharmacol Ther 2010; 89:81-8. [PMID: 21124314 DOI: 10.1038/clpt.2010.232] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to examine the mechanism underlying the elevation in serum creatinine levels caused by a novel des-fluoro(6)-quinolone antibacterial agent, DX-619, in healthy subjects. hOCT2 showed a prominent uptake of creatinine (K(m) = 56.4 mmol/l) among renal organic ion transporters. DX-619 is a potent inhibitor of hOCT2 (K(i) = 0.94 micromol/l), hMATE1 (0.82 µmol/l), and hMATE2-K (0.10 micromol/l). The pharmacokinetic model involving the inhibition of hOCT2 (model 1), hOCT2, and MATE1 or MATE2-K (model 2) could predict the elevation in serum creatinine levels in individual subjects receiving DX-619. This assumes that a significant contribution of tubular secretion (59, 38, and 31%) and reabsorption ranged from 3-50, 4-30, and 5-21% in model 1, -2a (hOCT2/hMATE1), and -2b (hOCT2/hMATE2-K), respectively, for creatinine. In conclusion, DX-619, at its therapeutic dose, is able to inhibit hOCT2, hMATE1, and hMATE2-K, leading to a significant inhibition of tubular secretion of creatinine and consequently to elevation of serum creatinine levels.
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Affiliation(s)
- Y Imamura
- Drug Metabolism and Pharmacokinetics Research Laboratories, R&D Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan
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