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Kai K, Nakashima K, Kawakami H, Takeno S, Hishikawa Y, Ikenoue M, Hamada T, Imamura N, Shibata T, Noritomi T, Sasaki F, Nakamura Y, Nanashima A. Clinical Impact of the Charlson Comorbidity Index on the Efficacy of Salvage Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer. Intern Med 2024; 63:903-910. [PMID: 37558484 PMCID: PMC11045372 DOI: 10.2169/internalmedicine.1907-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/02/2023] [Indexed: 08/11/2023] Open
Abstract
Introduction Photodynamic therapy (PDT) is a salvage treatment for local failure after chemoradiotherapy for esophageal cancer. Salvage PDT is the treatment available for vulnerable patients with various comorbidities at risk of salvage esophagectomy. This study assessed the impact of the Charlson comorbidity index (CCI) on the outcomes of salvage PDT using talaporfin sodium (TS) for esophageal cancer. Metohds Consecutive patients with esophageal cancer who underwent salvage TS-PDT from 2016 to 2022 were included in this retrospective study. We investigated the local complete response (L-CR), progression-free survival (PFS) and overall survival (OS) and evaluated the relationship between the CCI and therapeutic efficacy. Results In total, 25 patients were enrolled in this study. Overall, 12 patients (48%) achieved an L-CR, and the 2-year PFS and OS rates were 24.9% and 59.4%, respectively. In a multivariate analysis, a CCI ≥1 (p=0.041) and deeper invasion (p=0.048) were found to be significant independent risk factors for not achieving an L-CR. To evaluate the efficacy associated with comorbidities, we divided the patients into the CCI=0 group (n=11) and the CCI ≥1 group (n=14). The rate of an L-CR (p=0.035) and the 2-year PFS (p=0.029) and OS (p=0.018) rates in the CCI ≥1 group were significantly lower than those in the CCI=0 group. Conclusion This study found that the CCI was negatively associated with the efficacy of salvage TS-PDT for esophageal cancer.
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Affiliation(s)
- Kengo Kai
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Koji Nakashima
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Hiroshi Kawakami
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Shinsuke Takeno
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Yoshitaka Hishikawa
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Makoto Ikenoue
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
- Department of Anatomy, Histochemistry and Cell Biology, Faculty of Medicine, University of Miyazaki, Japan
| | - Takeomi Hamada
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Naoya Imamura
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Japan
| | | | - Fumisato Sasaki
- Department of Gastroenterology, Ikeda Hospital, Japan
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Japan
| | - Yoshitaka Nakamura
- Department of Gastroenterology, Kagoshima Prefectural Oshima Hospital, Japan
| | - Atsushi Nanashima
- Department of Surgery, Faculty of Medicine, University of Miyazaki, Japan
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Fuchino T, Kurogi S, Tsukamoto Y, Shibata T, Fumoto S, Fujishima H, Kinoshita K, Hirashita Y, Fukuda M, Nakada C, Itai Y, Suzuki K, Uchida T, Shiroshita H, Matsumoto T, Yamaoka Y, Tsutsumi K, Fukuda K, Ogawa R, Mizukami K, Kodama M, Inomata M, Murakami K, Moriyama M, Hijiya N. Characterization of residual cancer by comparison of a pair of organoids established from a patient with esophageal squamous cell carcinoma before and after neoadjuvant chemotherapy. Hum Cell 2024; 37:491-501. [PMID: 38184488 DOI: 10.1007/s13577-023-01020-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 01/08/2024]
Abstract
Neoadjuvant chemotherapy (NAC) followed by surgery is a standard approach for management of locally advanced esophageal squamous cell carcinoma (ESCC). Patients who do not respond well to NAC have a poor prognosis. Despite extensive research, the mechanisms of chemoresistance in ESCC remain largely unknown. Here, we established paired tumor organoids-designated as PreNAC-O and PostNAC-O-from one ESCC patient before and after NAC, respectively. Although the two organoids did not exhibit significant differences in proliferation, morphology or drug sensitivity in vitro, the tumorigenicity of PostNAC-O in vivo was significantly higher than that of PreNAC-O. Xenografts from PreNAC-O tended to exhibit keratinization, while those from PostNAC-O displayed conspicuous necrotic areas. The tumorigenicity of PostNAC-O xenografts during the chemotherapy was comparable to that of PreNAC-O without treatment. Furthermore, the gene expression profiles of the xenografts suggested that expression of genes involved in the EMT and/or hypoxia response might be related to the tumorigenicity of PostNAC-O. Our data suggested that the tumorigenicity of residual cancer had been enhanced, outweighing the effects of chemotherapy, rather than being attributable to intrinsic chemoresistance. Further studies are required to clarify the extent to which residual cancers share a common mechanism similar to that revealed here.
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Affiliation(s)
- Takafumi Fuchino
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Shusaku Kurogi
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan.
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Shoichi Fumoto
- Department of Surgery, Oita Nakamura Hospital, Oita, Japan
| | - Hajime Fujishima
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Keisuke Kinoshita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yuka Hirashita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masahide Fukuda
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Chisato Nakada
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
- Department of Urology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yusuke Itai
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Takashi Matsumoto
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Koshiro Tsutsumi
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kensuke Fukuda
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Ryo Ogawa
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazuhiro Mizukami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masaaki Kodama
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Naoki Hijiya
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Oita, 879-5593, Japan
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Robalo A, Brandão J, Shibata T, Solo-Gabriele H, Santos R, Monteiro S. Detection of enteric viruses and SARS-CoV-2 in beach sand. Sci Total Environ 2023; 901:165836. [PMID: 37517729 DOI: 10.1016/j.scitotenv.2023.165836] [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: 05/09/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
Beach sand harbors a diverse group of microbial organisms that may be of public health concern. Nonetheless, little is known about the presence and distribution of viruses in beach sand. In this study, the first objective was to evaluate the presence of seven viruses (Aichi virus, enterovirus, hepatitis A virus, human adenovirus, norovirus, rotavirus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) in sands collected at public beaches. The second objective was to assess the spatial distribution of enteric viruses in beach sand. To that end, 27 beach sand samples from different beaches in Portugal were collected between November 2018 and August 2020 and analyzed for the presence of viruses. At seven beaches, samples were collected in the supratidal and intertidal zones. Results show that viruses were detected in 89 % (24/27) of the sand samples. Aichi virus was the most prevalent (74 %). Noroviruses were present in 19 % of the samples (norovirus GI - 15 %, norovirus GII - 4 %). Human adenovirus and enterovirus were detected in 48 % and 22 % of the samples, respectively. Hepatitis A virus and rotavirus were not detected. Similarly, SARS-CoV-2 in beach sand collected during the initial stages of the pandemic was also not detected. The detection of three or more viruses occurred in 15 % of the samples. Concentrations of viruses were as high as 7.2 log copies (cp)/g of sand. Enteric viruses were found in higher prevalence in sand collected from the supratidal zone compared to the intertidal zone. Human adenovirus was detected in 43 % of the supratidal and 14 % in the intertidal samples and Aichi virus in 57 % and 86 % of the intertidal and supratidal areas, respectively. Our findings suggest that beach sand can be a reservoir of enteric viruses, suggesting that it might be a vehicle for disease transmission, particularly for children, the elderly, and immunocompromised users.
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Affiliation(s)
- A Robalo
- Laboratorio Analises, Técnico Lisboa, Universidade Lisboa, Portugal
| | - J Brandão
- Department of Environmental Health, National Institute of Health Dr. Ricardo Jorge, Lisboa, Portugal
| | - T Shibata
- Institute for the Study of the Environment, Sustainability, and Energy, Northern Illinois University, DeKalb, IL, USA; Center for Southeast Asian Studies, Northern Illinois University, DeKalb, IL, USA
| | - H Solo-Gabriele
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL, USA
| | - R Santos
- Laboratorio Analises, Técnico Lisboa, Universidade Lisboa, Portugal; Departamento de Engenharia e Ciências Nucleares, Técnico Lisboa, Universidade de Lisboa, Portugal
| | - S Monteiro
- Laboratorio Analises, Técnico Lisboa, Universidade Lisboa, Portugal; Departamento de Engenharia e Ciências Nucleares, Técnico Lisboa, Universidade de Lisboa, Portugal.
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Hirano T, Moriyama M, Abe N, Tateyama K, Shibata T, Takeno S, Inomata M, Suzuki M. Reconstruction using a free jejunal patch flap in salvage head and neck surgery after radiotherapy. Acta Otolaryngol 2023; 143:996-1000. [PMID: 38189417 DOI: 10.1080/00016489.2023.2298472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Chemoradiotherapy is a standard treatment for functional preservation in patients with advanced head and neck carcinoma. However, chemoradiotherapy increases the risk of postoperative complications. AIMS/OBJECTIVES We report the usefulness of reconstruction using a free jejunal patch flap in treating recurrence or residual head and neck carcinoma after radiotherapy. Furthermore, we investigated the factors for the occurrence of postoperative complications in patients who underwent salvage surgery using a free flap transfer. MATERIAL AND METHODS This study included 41 patients with head and neck carcinoma who underwent salvage surgery using a free flap transfer, including 11 patients who underwent reconstruction using a free jejunal patch flap. Prognostic analysis was performed for the development of complications. RESULTS Ten jejunal patch flaps survived without microvascular problems. One patient underwent revision reconstructive surgery because of flap failure. However, no patient had a pharyngocutaneous fistula. Oral intake could be resumed in all patients at a median 14 days postoperatively. Multivariate logistic regression analysis indicated that the use of cutaneous flaps was significantly associated with the development of complications. CONCLUSIONS AND SIGNIFICANCE Free jejunal patch flaps can be considered useful for head and neck reconstruction after radiotherapy for early intake resumption and complication prevention.
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Affiliation(s)
- Takashi Hirano
- Department of Otolaryngology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Munehito Moriyama
- Department of Otolaryngology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Nobuyuki Abe
- Department of Otolaryngology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kaori Tateyama
- Department of Otolaryngology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shinsuke Takeno
- Department of Surgery, Faculty of Medicine, Miyazaki University, Miyazaki, Japan
| | - Masafumi Inomata
- Department of Gastroenterological Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Masashi Suzuki
- Department of Otolaryngology, Faculty of Medicine, Oita University, Yufu, Japan
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Tsukamoto Y, Kurogi S, Fujishima H, Shibata T, Fumoto S, Nishiki K, Suzuki K, Etoh T, Shiraishi N, Fuchino T, Hirashita Y, Nakada C, Uchida T, Inomata M, Moriyama M, Hijiya N. Association of immune-related expression profile with sensitivity to chemotherapy in esophageal squamous cell carcinoma. Cancer Sci 2023; 114:4459-4474. [PMID: 37715346 PMCID: PMC10637075 DOI: 10.1111/cas.15942] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/22/2023] [Accepted: 08/04/2023] [Indexed: 09/17/2023] Open
Abstract
Neoadjuvant chemotherapy (NAC) followed by surgery is one of the standard therapeutic approaches in Japan for patients with locally advanced esophageal carcinoma. Recently, the JCOG1109 study revealed that NAC with docetaxel, cisplatin and 5-fluorouracil (5-FU) (DCF-NAC) is superior to NAC with cisplatin and 5-FU, and has now become the standard preoperative chemotherapy. Using a microarray system, we have previously investigated the expression profiles of endoscopic biopsy samples from patients with esophageal squamous cell carcinoma (ESCC) before DCF-NAC (preNAC) and identified 17 molecules as biomarkers predictive of a pathologically complete response to DCF-NAC. Here, we re-grouped our previous dataset based on the histopathological response grade with the addition of several microarray profiles and conducted a re-analysis using bioinformatic web tools including DAVID, GSEA, UALCAN, and CIBERSORTx. We identified 204 genes that were differentially expressed between the highly resistant and sensitive groups. Some of these differentially expressed genes (DEGs) were related to the immune response and showed higher expression in the sensitive group. UALCAN showed that high expression of 28 of the top 50 DEGs was associated with a favorable prognosis (p < 0.25), and that this reached a significant (p < 0.05) level for 18 of them, suggesting that patients with high expression of these genes might have benefited from chemotherapy and thus had a better outcome. In preNAC biopsy tissues from a DCF-sensitive case, we demonstrated the presence of cells expressing mRNA for CXCL9, one of the prognosis-related DEGs. Our results highlight the association of immune-related expression profile in preNAC ESCC with the DCF-NAC efficacy.
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Affiliation(s)
- Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
| | - Shusaku Kurogi
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
| | - Hajime Fujishima
- Department of Gastroenterological and Pediatric Surgery, Faculty of MedicineOita UniversityOitaJapan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Faculty of MedicineOita UniversityOitaJapan
| | | | - Kohei Nishiki
- Department of SurgeryOita Nakamura HospitalOitaJapan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Faculty of MedicineOita UniversityOitaJapan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Faculty of MedicineOita UniversityOitaJapan
| | - Norio Shiraishi
- Comprehensive Surgery for Community Medicine, Oita University Faculty of MedicineOita UniversityOitaJapan
| | - Takafumi Fuchino
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
- Department of Gastroenterology, Faculty of MedicineOita UniversityOitaJapan
| | - Yuka Hirashita
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
- Department of Gastroenterology, Faculty of MedicineOita UniversityOitaJapan
| | - Chisato Nakada
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
- Department of Urology, Faculty of MedicineOita UniversityOitaJapan
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of MedicineOita UniversityOitaJapan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
| | - Naoki Hijiya
- Department of Molecular Pathology, Faculty of MedicineOita UniversityOitaJapan
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Takahashi S, Anada M, Kinoshita T, Nishide T, Shibata T. Dosimetric Comparison of Nodal Clinical Target Volume for Locally Advanced Non-Small Cell Lung Cancer: Options for Geometric Expansion vs. Lymph Node Stations. Int J Radiat Oncol Biol Phys 2023; 117:e62-e63. [PMID: 37785858 DOI: 10.1016/j.ijrobp.2023.06.784] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We investigated whether dosimetric differences existed in nodal clinical target volume (CTV) using options for geometric expansion and lymph node stations based on the European Society for Radiotherapy and Oncology (ESTRO) guideline for locally advanced non-small cell lung cancer (NSCLC). MATERIALS/METHODS With treatment planning computed tomographic images in 17 patients who underwent radiotherapy for cT4N2M0 NSCLC from 2017 to 2022 at our institution, we retrospectively contoured nodal CTVs based on the guideline's options of: (1) geometric expansion, CTV including the nodal gross tumor volume plus 5 mm margin: (2) lymph node stations, CTV including the affected lymph node stations. The 5 mm margins for planning target volume (PTV) were added to the nodal and primary tumors' CTVs. Treatment planning of 60 Gy in 30 fractions to the PTV D50% was performed using volumetric modulated arc therapy; Dn% was irradiated dose to n% of volume of the structure; VnGy was percentage of volume of the structure at least irradiated n Gy. We compared dose-volume parameters between the two options using Wilcoxon rank sum test. RESULTS Primary tumors were located in the right and left lobes in 12 and five patients, and in the upper and lower lobes in 13 and four patients, respectively. Median PTV size/D95% of the options for geometric expansion and lymph node stations were 569 cc (range, 149-2005 cc)/58.2 Gy (range, 57.5-58.7 Gy) and 635 cc (range, 184-2109 cc)/58.1 Gy (range, 57.5-58.7 Gy), respectively. Median mean dose of the esophagus/heart in the two options were 12.2 Gy (range, 6.6-24.9 Gy)/3.3 Gy (range, 0.6-19.1 Gy) and 16.1 Gy (range, 13.6-30.5 Gy)/4.6 Gy (range, 0.7-18.9 Gy), respectively. Median V20 Gy/mean dose of the lungs in the options for geometric expansion and lymph node stations were 20.5% (range, 14.8-33.9%)/12.2 Gy (range, 8.7-18.4 Gy) and 24.0% (range, 15.1-36.7%)/13.5 Gy (range, 9.5-19.4 Gy), respectively. In the eight patients (47%) with lymph node metastases in stations 2 or 3, a significant dosimetric difference between the two options existed on V20 Gy of the lungs; median values of the difference were 2.8% and 0.5% with and without lymph node metastases in stations 2 or 3, respectively (p = 0.027). CONCLUSION Of the ESTRO guideline for the nodal CTV, using the option for geometric expansion might be able to reduce V20 Gy of the lungs in patients with lymph node metastases in stations 2 or 3.
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Affiliation(s)
- S Takahashi
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
| | - M Anada
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
| | - T Kinoshita
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
| | - T Nishide
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
| | - T Shibata
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
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Tsukamoto Y, Hirashita Y, Shibata T, Fumoto S, Kurogi S, Nakada C, Kinoshita K, Fuchino T, Murakami K, Inomata M, Moriyama M, Hijiya N. Patient-Derived Ex Vivo Cultures and Endpoint Assays with Surrogate Biomarkers in Functional Testing for Prediction of Therapeutic Response. Cancers (Basel) 2023; 15:4104. [PMID: 37627132 PMCID: PMC10452496 DOI: 10.3390/cancers15164104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Prediction of therapeutic outcomes is important for cancer patients in order to reduce side effects and improve the efficacy of anti-cancer drugs. Currently, the most widely accepted method for predicting the efficacy of anti-cancer drugs is gene panel testing based on next-generation sequencing. However, gene panel testing has several limitations. For example, only 10% of cancer patients are estimated to have druggable mutations, even if whole-exome sequencing is applied. Additionally, even if optimal drugs are selected, a significant proportion of patients derive no benefit from the indicated drug treatment. Furthermore, most of the anti-cancer drugs selected by gene panel testing are molecularly targeted drugs, and the efficacies of cytotoxic drugs remain difficult to predict. Apart from gene panel testing, attempts to predict chemotherapeutic efficacy using ex vivo cultures from cancer patients have been increasing. Several groups have retrospectively demonstrated correlations between ex vivo drug sensitivity and clinical outcome. For ex vivo culture, surgically resected tumor tissue is the most abundant source. However, patients with recurrent or metastatic tumors do not usually undergo surgery, and chemotherapy may be the only option for those with inoperable tumors. Therefore, predictive methods using small amounts of cancer tissue from diagnostic materials such as endoscopic, fine-needle aspirates, needle cores and liquid biopsies are needed. To achieve this, various types of ex vivo culture and endpoint assays using effective surrogate biomarkers of drug sensitivity have recently been developed. Here, we review the variety of ex vivo cultures and endpoint assays currently available.
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Affiliation(s)
- Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
| | - Yuka Hirashita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Shoichi Fumoto
- Department of Surgery, Oita Nakamura Hospital, Oita 879-5593, Japan
| | - Shusaku Kurogi
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
| | - Chisato Nakada
- Department of Urology, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Keisuke Kinoshita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Takafumi Fuchino
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita 879-5593, Japan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
| | - Naoki Hijiya
- Department of Molecular Pathology, Faculty of Medicine, Oita University, 1-1 Hasama-machi, Oita 879-5593, Japan
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Hayakawa M, Tagami T, Kudo D, Ono K, Aoki M, Endo A, Yumoto T, Matsumura Y, Irino S, Sekine K, Ushio N, Ogura T, Nachi S, Irie Y, Hayakawa K, Ito Y, Okishio Y, Muronoi T, Kosaki Y, Ito K, Nakatsutsumi K, Kondo Y, Ueda T, Fukuma H, Saisaka Y, Tominaga N, Kurita T, Nakayama F, Shibata T, Kushimoto S. The Restrictive Red Blood Cell Transfusion Strategy for Critically Injured Patients (RESTRIC) trial: a cluster-randomized, crossover, non-inferiority multicenter trial of restrictive transfusion in trauma. J Intensive Care 2023; 11:34. [PMID: 37488591 PMCID: PMC10364403 DOI: 10.1186/s40560-023-00682-3] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The efficacies of fresh frozen plasma and coagulation factor transfusion have been widely evaluated in trauma-induced coagulopathy management during the acute post-injury phase. However, the efficacy of red blood cell transfusion has not been adequately investigated in patients with severe trauma, and the optimal hemoglobin target level during the acute post-injury and resuscitation phases remains unclear. Therefore, this study aimed to examine whether a restrictive transfusion strategy was clinically non-inferior to a liberal transfusion strategy during the acute post-injury phase. METHODS This cluster-randomized, crossover, non-inferiority multicenter trial was conducted at 22 tertiary emergency medical institutions in Japan and included adult patients with severe trauma at risk of major bleeding. The institutions were allocated a restrictive or liberal transfusion strategy (target hemoglobin levels: 7-9 or 10-12 g/dL, respectively). The strategies were applied to patients immediately after arrival at the emergency department. The primary outcome was 28-day survival after arrival at the emergency department. Secondary outcomes included transfusion volume, complication rates, and event-free days. The non-inferiority margin was set at 3%. RESULTS The 28-day survival rates of patients in the restrictive (n = 216) and liberal (n = 195) strategy groups were 92.1% and 91.3%, respectively. The adjusted odds ratio for 28-day survival in the restrictive versus liberal strategy group was 1.02 (95% confidence interval: 0.49-2.13). Significant non-inferiority was not observed. Transfusion volumes and hemoglobin levels were lower in the restrictive strategy group than in the liberal strategy group. No between-group differences were noted in complication rates or event-free days. CONCLUSIONS Although non-inferiority of the restrictive versus liberal transfusion strategy for 28-day survival was not statistically significant, the mortality and complication rates were similar between the groups. The restrictive transfusion strategy results in a lower transfusion volume. TRIAL REGISTRATION NUMBER umin.ac.jp/ctr: UMIN000034405, registration date: 8 October 2018.
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Affiliation(s)
- Mineji Hayakawa
- Department of Emergency Medicine, Hokkaido University Hospital, N14W5 Kita-ku, Sapporo, 060-8648, Japan.
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Japan
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Daisuke Kudo
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kota Ono
- Ono Biostat Consulting, Tokyo, Japan
| | - Makoto Aoki
- Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akira Endo
- Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Yumoto
- Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Matsumura
- Department of Intensive Care, Chiba Emergency Medical Centre, Chiba, Japan
| | - Shiho Irino
- Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kazuhiko Sekine
- Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Noritaka Ushio
- Department of Emergency and Critical Care Medicine, Japan Red Cross Maebashi Hospital, Maebashi, Japan
| | - Takayuki Ogura
- Department of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Centre, Imperial Gift Foundation Saiseikai, Utsunomiya Hospital, Utsunomiya, Japan
| | - Sho Nachi
- Advanced Critical Care Centre, Gifu University Hospital, Gifu, Japan
| | - Yuhei Irie
- Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Katsura Hayakawa
- Advanced Emergency and Critical Care Centre, Saitama Red Cross Hospital, Saitama, Japan
| | - Yusuke Ito
- Senri Critical Care Medical Centre, Saiseikai Senri Hospital, Suita, Japan
| | - Yuko Okishio
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tomohiro Muronoi
- Department of Acute Care Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yoshinori Kosaki
- Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kaori Ito
- Department of Surgery, Division of Acute Care Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Keita Nakatsutsumi
- Trauma and Acute Critical Care Centre, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Taichiro Ueda
- Shock and Trauma Centre, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Hiroshi Fukuma
- Senshu Trauma and Critical Care Centre, Rinku General Medical Centre, Izumisano, Japan
| | - Yuichi Saisaka
- Emergency and Critical Care Centre, Kochi Health Sciences Centre, Kochi, Japan
| | - Naoki Tominaga
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Takeo Kurita
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Fumihiko Nakayama
- Department of Emergency and Critical Care Medicine, Nippon Medical School Tama Nagayama Hospital, Tama, Japan
| | - Tomotaka Shibata
- Advanced Trauma, Emergency and Critical Care Centre, Oita University Hospital, Yufu, Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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9
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Lin C, Ahn JK, Choi JM, Farrington MS, Gonzalez M, Grethen N, Hsiung YB, Inagaki T, Kamiji I, Kim EJ, Kim JL, Kim HM, Kawata K, Kitagawa A, Komatsubara TK, Kotera K, Lee SK, Lee JW, Lim GY, Luo Y, Matsumura T, Nakagiri K, Nanjo H, Nomura T, Ono K, Redeker JC, Sato T, Sasse V, Shibata T, Shimizu N, Shinkawa T, Shinohara S, Shiomi K, Shiraishi R, Suzuki S, Tajima Y, Tung YC, Wah YW, Watanabe H, Wu T, Yamanaka T, Yoshida HY. Search for the Pair Production of Dark Particles X with K_{L}^{0}→XX, X→γγ. Phys Rev Lett 2023; 130:111801. [PMID: 37001070 DOI: 10.1103/physrevlett.130.111801] [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: 09/23/2022] [Accepted: 02/08/2023] [Indexed: 06/19/2023]
Abstract
We present the first search for the pair production of dark particles X via K_{L}^{0}→XX with X decaying into two photons using the data collected by the KOTO experiment. No signal was observed in the mass range of 40-110 MeV/c^{2} and 210-240 MeV/c^{2}. This sets upper limits on the branching fractions as B(K_{L}^{0}→XX)<(1-4)×10^{-7} and B(K_{L}^{0}→XX)<(1-2)×10^{-6} at the 90% confidence level for the two mass regions, respectively.
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Affiliation(s)
- C Lin
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - J M Choi
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - M S Farrington
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - M Gonzalez
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Grethen
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - Y B Hsiung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Inagaki
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - I Kamiji
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - E J Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J L Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - H M Kim
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - K Kawata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - A Kitagawa
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T K Komatsubara
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Kotera
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S K Lee
- Division of Science Education, Jeonbuk National University, Jeonju 54896, Republic of Korea
| | - J W Lee
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - G Y Lim
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - Y Luo
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Matsumura
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - K Nakagiri
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Nanjo
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Nomura
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - K Ono
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - J C Redeker
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Sato
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - V Sasse
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - T Shibata
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - N Shimizu
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Shinkawa
- Department of Applied Physics, National Defense Academy, Kanagawa 239-8686, Japan
| | - S Shinohara
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - K Shiomi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - R Shiraishi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - S Suzuki
- Department of Physics, Saga University, Saga 840-8502, Japan
| | - Y Tajima
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - Y-C Tung
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - Y W Wah
- Enrico Fermi Institute, University of Chicago, Chicago, Illinois 60637, USA
| | - H Watanabe
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- J-PARC Center, Tokai, Ibaraki 319-1195, Japan
| | - T Wu
- Department of Physics, National Taiwan University, Taipei, Taiwan 10617, Republic of China
| | - T Yamanaka
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - H Y Yoshida
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
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10
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Sakai M, Saeki H, Sohda M, Korematsu M, Miyata H, Murakami D, Baba Y, Ishii R, Okamoto H, Shibata T, Shirabe K, Toh Y, Shiotani A. Primary tracheobronchial necrosis after esophagectomy: A nationwide multicenter retrospective study in Japan. Ann Gastroenterol Surg 2023; 7:236-246. [DOI: doi.org/10.1002/ags3.12625] [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] [Received: 05/29/2022] [Accepted: 09/14/2022] [Indexed: 09/03/2023] Open
Abstract
AbstractBackgroundThe clinical features of postoperative primary tracheobronchial necrosis (P‐TBN; the necrosis without anastomotic leakage or other cervical and mediastinal abscess) remains unclear. This nationwide multicenter retrospective study first investigated the clinical features of P‐TBN after esophagectomy for upper aerodigestive tract cancer with a large cohort.MethodsAs a study of the Japan Broncho‐Esophagological Society, a nationwide questionnaire survey was conducted in 67 institutions. The clinical data of 6370 patients who underwent esophagectomy for laryngeal, pharyngeal, and esophageal cancer between 2010 and 2019 were collected. Grades of P‐TBN were defined as follows: Grade 1, mucosal necrosis; Grade 2, transmural bronchial wall necrosis without fistula or perforation; Grade 3, transmural bronchial wall necrosis with fistula or perforation.ResultsP‐TBN was observed in 48 (0.75%) of 6370 patients. The incidences of P‐TBN for pharyngo‐laryngo‐cervical esophagectomy (PLCE; n = 1650), total pharyngo‐laryngo‐esophagectomy (TPLE; n = 205), and subtotal esophagectomy (SE; n = 4515) were 2.0%, 5.4%, and 0.1%, respectively. The upper mediastinal LN dissection (P = 0.016) and the higher level of the tracheal resection (P = 0.039) were significantly associated with a higher grade of necrosis in PLCE and TPLE. Overall survival rates were significantly lower in patients with Grade 2 (P = 0.009) and Grade 3 (P = 0.004) than in those with Grade 1.ConclusionThe incidence of TBN restricted to P‐TBN was lower than previously reported. Maintaining the tracheal blood flow is essential to prevent worsening P‐TBN, especially in PLCE and TPLE. Our new P‐TBN severity grade may predict the outcome of patients with P‐TBN.
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Affiliation(s)
- Makoto Sakai
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of Medicine Gunma University Maebashi Japan
| | - Hiroshi Saeki
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of Medicine Gunma University Maebashi Japan
| | - Makoto Sohda
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of Medicine Gunma University Maebashi Japan
| | - Mizuki Korematsu
- Department of Head and Neck Surgery Osaka International Cancer Institute Osaka Japan
| | - Hiroshi Miyata
- Department of Digestive Surgery Osaka International Cancer Institute Osaka Japan
| | - Daizo Murakami
- Department of Otolaryngology‐Head and Neck Surgery, Graduate School of Medicine Kumamoto University Kumamoto Japan
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science Kumamoto University Kumamoto Japan
| | - Ryo Ishii
- Department of Otolaryngology‐Head and Neck Surgery Tohoku University Graduate School of Medicine Sendai Japan
| | - Hiroshi Okamoto
- Department of Gastroenterological Surgery Tohoku University Graduate School of Medicine Sendai Japan
| | - Tomotaka Shibata
- Advanced Trauma, Emergency and Critical Care Center/Gastroenterological and Pediatric Surgery Oita University Hospital Yufu Japan
| | - Ken Shirabe
- Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi Japan
| | - Yasushi Toh
- National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Akihiro Shiotani
- Department of Otolaryngology‐ Head and Neck Surgery National Defense Medical College Saitama Japan
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11
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Tsukamoto Y, Kurogi S, Shibata T, Suzuki K, Hirashita Y, Fumoto S, Yano S, Yanagihara K, Nakada C, Mieno F, Kinoshita K, Fuchino T, Mizukami K, Ueda Y, Etoh T, Uchida T, Hanada T, Takekawa M, Daa T, Shirao K, Hironaka S, Murakami K, Inomata M, Hijiya N, Moriyama M. Enhanced phosphorylation of c-Jun by cisplatin treatment as a potential predictive biomarker for cisplatin response in combination with patient-derived tumor organoids. J Transl Med 2022; 102:1355-1366. [PMID: 35922477 DOI: 10.1038/s41374-022-00827-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 11/09/2022] Open
Abstract
Despite recent advances in sequencing technology and large-scale drug screenings employing hundreds of cell lines, the predictive accuracy of mutation-based biomarkers is still insufficient as a guide for cancer therapy. Therefore, novel types of diagnostic methods using alternative biomarkers would be highly desirable. We have hypothesized that sensitivity-specific changes in the phosphorylation of signaling molecules could be useful in this respect. Here, with the aim of developing a method for predicting the response of cancers to cisplatin using a combination of specific biomarker(s) and patient-derived tumor organoids (PDOs), we found that cisplatin-sensitive cell lines or PDOs showed enhanced phosphorylation of c-Jun (p-c-Jun) within 24 h after cisplatin treatment. We also compared the responses of 6 PDOs to cisplatin with the therapeutic effect of neoadjuvant chemotherapy (docetaxel/cisplatin/5-fluorouracil) in 6 matched patients. Mechanistically, the c-Jun induction was partly related to TNF signaling induced by cisplatin. Our data suggest that enhanced phosphorylation of c-Jun in response to cisplatin treatment could be a predictive biomarker for the efficacy of cisplatin in selected cancer patients.
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Affiliation(s)
- Yoshiyuki Tsukamoto
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan.
| | - Shusaku Kurogi
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Yuka Hirashita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan.,Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Shoichi Fumoto
- Department of Surgery, Oita Nakamura Hospital, Oita, Japan
| | - Shinji Yano
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazuyoshi Yanagihara
- Exploratory Oncology Research and Clinical Trial Center, National Cancer Center Hospital East, Chiba, Japan
| | - Chisato Nakada
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan.,Department of Urology, Faculty of Medicine, Oita University, Oita, Japan
| | - Fumi Mieno
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Keisuke Kinoshita
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan.,Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Takafumi Fuchino
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan.,Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazuhiro Mizukami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshitake Ueda
- Department of Comprehensive Surgery for Community Medicine, Oita University, Oita, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Tomohisa Uchida
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Toshikatsu Hanada
- Department of Cell Biology, Oita University Faculty of Medicine, Oita University, Oita, Japan
| | - Mutsuhiro Takekawa
- Division of Cell Signaling and Molecular Medicine, Institute of Medical Sciences, University of Tokyo, Tokyo, Japan
| | - Tsutomu Daa
- Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kuniaki Shirao
- Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Oita, Japan
| | - Shuichi Hironaka
- Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan
| | - Naoki Hijiya
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Masatsugu Moriyama
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
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12
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Sakai M, Saeki H, Sohda M, Korematsu M, Miyata H, Murakami D, Baba Y, Ishii R, Okamoto H, Shibata T, Shirabe K, Toh Y, Shiotani A. Primary tracheobronchial necrosis after esophagectomy: A nationwide multicenter retrospective study in Japan. Ann Gastroenterol Surg 2022; 7:236-246. [PMID: 36998306 PMCID: PMC10043765 DOI: 10.1002/ags3.12625] [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] [Received: 05/29/2022] [Accepted: 09/14/2022] [Indexed: 04/01/2023] Open
Abstract
Background The clinical features of postoperative primary tracheobronchial necrosis (P-TBN; the necrosis without anastomotic leakage or other cervical and mediastinal abscess) remains unclear. This nationwide multicenter retrospective study first investigated the clinical features of P-TBN after esophagectomy for upper aerodigestive tract cancer with a large cohort. Methods As a study of the Japan Broncho-Esophagological Society, a nationwide questionnaire survey was conducted in 67 institutions. The clinical data of 6370 patients who underwent esophagectomy for laryngeal, pharyngeal, and esophageal cancer between 2010 and 2019 were collected. Grades of P-TBN were defined as follows: Grade 1, mucosal necrosis; Grade 2, transmural bronchial wall necrosis without fistula or perforation; Grade 3, transmural bronchial wall necrosis with fistula or perforation. Results P-TBN was observed in 48 (0.75%) of 6370 patients. The incidences of P-TBN for pharyngo-laryngo-cervical esophagectomy (PLCE; n = 1650), total pharyngo-laryngo-esophagectomy (TPLE; n = 205), and subtotal esophagectomy (SE; n = 4515) were 2.0%, 5.4%, and 0.1%, respectively. The upper mediastinal LN dissection (P = 0.016) and the higher level of the tracheal resection (P = 0.039) were significantly associated with a higher grade of necrosis in PLCE and TPLE. Overall survival rates were significantly lower in patients with Grade 2 (P = 0.009) and Grade 3 (P = 0.004) than in those with Grade 1. Conclusion The incidence of TBN restricted to P-TBN was lower than previously reported. Maintaining the tracheal blood flow is essential to prevent worsening P-TBN, especially in PLCE and TPLE. Our new P-TBN severity grade may predict the outcome of patients with P-TBN.
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Affiliation(s)
- Makoto Sakai
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of MedicineGunma UniversityMaebashiJapan
| | - Hiroshi Saeki
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of MedicineGunma UniversityMaebashiJapan
| | - Makoto Sohda
- Division of Gastroenterological Surgery, Department of General Surgical Science, Graduate School of MedicineGunma UniversityMaebashiJapan
| | - Mizuki Korematsu
- Department of Head and Neck SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Hiroshi Miyata
- Department of Digestive SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Daizo Murakami
- Department of Otolaryngology‐Head and Neck Surgery, Graduate School of MedicineKumamoto UniversityKumamotoJapan
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical ScienceKumamoto UniversityKumamotoJapan
| | - Ryo Ishii
- Department of Otolaryngology‐Head and Neck SurgeryTohoku University Graduate School of MedicineSendaiJapan
| | - Hiroshi Okamoto
- Department of Gastroenterological SurgeryTohoku University Graduate School of MedicineSendaiJapan
| | - Tomotaka Shibata
- Advanced Trauma, Emergency and Critical Care Center/Gastroenterological and Pediatric SurgeryOita University HospitalYufuJapan
| | - Ken Shirabe
- Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiJapan
| | - Yasushi Toh
- National Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Akihiro Shiotani
- Department of Otolaryngology‐ Head and Neck SurgeryNational Defense Medical CollegeSaitamaJapan
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13
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Shibao K, Kitamura C, Matushima Y, Yanai T, Shibata T, Honma T, Otsuka M, Fukumoto Y. The Pitfall of VA ECMO management in the Impella era. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
VA ECMO is effective in cardiogenic shock, but complications of cardiogenic pulmonary edema due to increased afterload are problematic. The advent of percutaneous left ventricular assist devices (Impella) has enabled effective reduction of left ventricular intraventricular pressure and has avoided these complications, but differential hypoxia can still occur during VA ECMO + Impella (Ecpella) management, requiring conversion to V-AV ECMO. Cases may be experienced.
Purpose
Elucidate the frequency of differential hypoxia and its pathogenesis, which requires the transition from VA ECMO to V-AV ECMO.
Methods
We retrospectively reviewed 52 consecutive patients who underwent E-CPR from January 2017 through November 2021 in our institute. 8 patients who received ECMO alone were excluded, and 44 patients were recruited. 22 patients underwent VA ECMO with IABP (VA ECMO + IABP group) and 22 patients underwent VA ECMO with Impella (VA ECMO + Impella group). The 30-day survival rate and the rate of transition VA ECMO to VA-V ECMO, The date just before VA ECMO to V-AV ECMO were assessed.
Results
The 30-day all-cause mortality was no significant difference between the two groups. 2 patients (9%) in the VA ECMO + IABP group and 8 patients (36%) in the VA ECMO + Impella group were transferred to V-AV ECMO (P=0.025). At the time of addition of V-AV ECMO, SaO2 (right radial artery) was 87±7.1% and 91.3±1.9% (p=0.112) in the VA ECMO + IABP and VA ECMO + Impella groups, respectively, and the P/F ratio was 86±37.1 and 95±24.6 (p=0.685). Mean pulmonary artery wedge pressure was 23±1.4 mmHg in the VA ECMO + IABP group and 16.3±3 mmHg in the VA ECMO + Impella group (p=0.0193), significantly lower in the Impella group.
Conclusion
The Impella group was more likely to have hypoxia due to factors other than cardiogenic pulmonary edema. In cases of cardiopulmonary arrest requiring V-AV ECMO management, differential hypoxia due to causes other than cardiogenic pulmonary edema may become apparent earlier in the Impella group, suggesting that careful management, including the addition of V-AV ECMO, is required.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Shibao
- Kurume University , Fukuoka , Japan
| | | | | | - T Yanai
- Kurume University , Fukuoka , Japan
| | | | - T Honma
- Kurume University , Fukuoka , Japan
| | - M Otsuka
- Kurume University , Fukuoka , Japan
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14
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Shibata T, Iwaki T, Ito M. Ir‐Catalyzed Intramolecular Cyclization of 2‐Alkynyl Diaryl Sulfides for the Selective Synthesis of Sulfur‐Containing Polycyclic Compounds. Adv Synth Catal 2022. [DOI: 10.1002/adsc.202201004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- T. Shibata
- Department of Chemistry and Biochemistry School of Advanced Science and Engineering Waseda University 3-4-1 Okubo, Shinjuku Tokyo 169-8555 Japan
| | - T. Iwaki
- Department of Chemistry and Biochemistry School of Advanced Science and Engineering Waseda University 3-4-1 Okubo, Shinjuku Tokyo 169-8555 Japan
| | - M. Ito
- Department of Chemistry and Biochemistry School of Advanced Science and Engineering Waseda University 3-4-1 Okubo, Shinjuku Tokyo 169-8555 Japan
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15
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Ueno M, Morizane C, Ikeda M, Ozaka M, Nagashima F, Kataoka T, Mizusawa J, Ohba A, Kobayashi S, Imaoka H, Kasuga A, Okano N, Nagasaka Y, K. Kurishita, Tomatsuri S, Sasaki M, Shibata T, Nakamura K, Furuse J, Okusaka T. 64P Phase I/II study of nivolumab plus lenvatinib for advanced biliary tract cancer (JCOG1808/NCCH1817, SNIPE). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.092] [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: 11/01/2022] Open
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16
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Akagi T, Suzuki K, Kono Y, Ninomiya S, Shibata T, Ueda Y, Shiroshita H, Etoh T, Shiomi A, Ito M, Watanabe J, Murata K, Hirano Y, Shimomura M, Tsukamoto S, Kanemitsu Y, Inomata M. Success rate of acquiring informed consent and barriers to participation in a randomized controlled trial of laparoscopic versus open surgery for non-curative stage IV colon cancer in Japan (JCOG1107). Jpn J Clin Oncol 2022; 52:1270-1275. [PMID: 35863012 DOI: 10.1093/jjco/hyac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful achievement of randomized controlled trials (RCTs) is dependent on the acquisition of informed consent (IC) from patients. The aim of this study was to prospectively calculate the proportion of participation in a surgical RCT and to identify the reasons for failed acquisition of IC. METHODS A 50-insitution RCT was conducted to evaluate oncological outcomes of open and laparoscopic surgery for stage IV colon cancer (JCOG1107: UMIN-CTR 000000105). The success rate of obtaining IC was evaluated in eight periods between January 2013 and January 2021. In addition, reasons for failed acquisition of IC were identified from questionnaires. RESULTS In total, 391 patients were informed of their eligibility for the trial, and 168 (42%) were randomly assigned to either the laparoscopic surgery group (n = 84) or open surgery group (n = 84). The success rate of IC acquisition ranged from 33 to 58% in three periods. The most common reasons for failed IC acquisition were the patients' preference for one approach of surgery based on recommendations from referring doctors and family members, and anxiety/unhappiness about randomization. CONCLUSIONS The success rate of acquiring IC from patients for an RCT of laparoscopic versus open surgery for stage IV colon cancer was lower than the expected rate planned in the protocol. To obtain the planned rate, investigators should make efforts to inform patients and their families about the medical contributions a surgical RCT can make and recognize that the period in equipoise may be limited.
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Affiliation(s)
- Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yohei Kono
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Shigeo Ninomiya
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yoshitake Ueda
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Jun Watanabe
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Kohei Murata
- Department of Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Manabu Shimomura
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Shunsuke Tsukamoto
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
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17
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Inoue T, Ishihara R, Shibata T, Suzuki K, Kitagawa Y, Miyazaki T, Yamaji T, Nemoto K, Oyama T, Muto M, Takeuchi H, Toh Y, Matsubara H, Mano M, Kono K, Kato K, Yoshida M, Kawakubo H, Booka E, Yamatsuji T, Kato H, Ito Y, Ishikawa H, Tsushima T, Kawachi H, Oyama T, Kojima T, Kuribayashi S, Makino T, Matsuda S, Doki Y. Endoscopic imaging modalities for diagnosing the invasion depth of superficial esophageal squamous cell carcinoma: a systematic review. Esophagus 2022; 19:375-383. [PMID: 35397101 DOI: 10.1007/s10388-022-00918-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/16/2022] [Indexed: 02/03/2023]
Abstract
Endoscopic diagnosis of the invasion depth of superficial esophageal squamous cell carcinoma (ESCC) is an important determinant of the treatment strategy. The three endoscopic imaging modalities commonly used to predict the invasion depth of superficial ESCC in Japan are non-magnifying endoscopy (non-ME), magnifying endoscopy (ME), and endoscopic ultrasonography (EUS). However, which of these three modalities is most effective remains unclear. We performed a systematic review of the literature to compare the diagnostic accuracy of the three modalities for prediction of the invasion depth of superficial ESCC. We used Medical Subject Heading terms and free keywords to search the PubMed, Cochrane Central, and Ichushi databases to identify direct comparison studies published from January 2000 to August 2020. The results of direct comparison studies were used to compare the diagnostic accuracy of each modality. The primary outcome was defined as the proportion of overdiagnosis of pT1b-SM2/3 cancers, and the main secondary outcome was the proportion of underdiagnosis of pT1b-SM2/3 cancers. Other secondary outcomes were the sensitivity and specificity values of the modalities. Four articles were finally selected for qualitative evaluation. Although ME showed no significant advantages over non-ME in terms of sensitivity and specificity, it had a slightly lower proportion of overdiagnosis. EUS had sensitivity and specificity similar to those of non-ME and ME, but EUS had a higher proportion of overdiagnosis. Non-ME and ME are useful for the diagnosis of cancer invasion depth. EUS may increase overdiagnosis, and caution is required in determining its indications.
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Affiliation(s)
- Takahiro Inoue
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan.,Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan.
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University, Oita, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuya Miyazaki
- Department of Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Japan
| | - Taiki Yamaji
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kenji Nemoto
- Department of Radiology, Yamagata University Graduate School of Medicine, Yamagata, Japan
| | - Tsuneo Oyama
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
| | - Manabu Muto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yasushi Toh
- National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masayuki Mano
- Department of Central Laboratory and Surgical Pathology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Koji Kono
- Department of Gastrointestinal Tract Surgery, Fukushima Medical University, Fukushima, Japan
| | - Ken Kato
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Ichikawa, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Eisuke Booka
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School, Okayama, Japan
| | | | - Yoshinori Ito
- Department of Radiation Oncology, Showa University School of Medicine, Tokyo, Japan
| | - Hitoshi Ishikawa
- National Institutes for Quantum and Radiological Science and Technology, QST Hospital, Chiba, Japan
| | - Takahiro Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroshi Kawachi
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Oyama
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Shiko Kuribayashi
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tomoki Makino
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Satoru Matsuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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18
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Oyama T, Akagi T, Etoh T, Shiroshita H, Amano S, Fujishima H, Kawano Y, Kono Y, Suzuki K, Ninomiya S, Shibata T, Ueda Y, Shiraishi N, Inomata M. Intussusception in the ascending colon caused by cecal chronic diverticulitis: a case report. J Surg Case Rep 2022; 2022:rjac204. [PMID: 35665390 PMCID: PMC9156004 DOI: 10.1093/jscr/rjac204] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Although intussusception in adults generally results from malignant tumors and polyps, intussusception caused by chronic diverticulitis is extremely rare. We present the case of a 59-year-old man treated with steroids and biopharmaceuticals at the Department of Dermatology for psoriasis vulgaris. Cecal diverticulitis frequently recurred, for which he was treated during follow-up. This time, endoscopy showed a circumferential stenosis in the ascending colon, and computed tomography showed the appearance of a target sign in the right colon. As a result, the patient was preoperatively diagnosed as having intussusception of the ascending colon triggered by diverticulitis of the cecum and underwent laparoscopic right colectomy. Pathological findings of the specimen revealed multiple diverticulitis of the cecum. Therefore, we thought that the intussusception was caused by chronic inflammation of the diverticula and surrounding fibrosis. Among intussusception in adults, chronic diverticulitis should be considered as a target of surgical treatment on rare occasions.
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Affiliation(s)
- Tabito Oyama
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Shota Amano
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Hajime Fujishima
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Yoko Kawano
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Yohei Kono
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Shigeo Ninomiya
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
| | - Yoshitake Ueda
- Department of Comprehensive Surgery for Community Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Norio Shiraishi
- Department of Comprehensive Surgery for Community Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Japan
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19
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Yoshida N, Sasaki K, Kanetaka K, Kimura Y, Shibata T, Ikenoue M, Nakashima Y, Sadanaga N, Eto K, Tsuruda Y, Kobayashi S, Nakanoko T, Suzuki K, Takeno S, Yamamoto M, Morita M, Toh Y, Baba H. High Pretreatment Mean Corpuscular Volume Can Predict Worse Prognosis in Patients With Esophageal Squamous Cell Carcinoma who Have Undergone Curative Esophagectomy: A Retrospective Multicenter Cohort Study. Ann Surg Open 2022; 3:e165. [PMID: 37601605 PMCID: PMC10431247 DOI: 10.1097/as9.0000000000000165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To establish the prognostic value of mean corpuscular volume (MCV) in patients with esophageal squamous cell carcinoma (ESCC) who have undergone esophagectomy. Background The MCV increases in patients with high alcohol and tobacco consumption. Such a lifestyle can be a risk factor for malnutrition, comorbidities related to those habits, and multiple primary malignancies, which may be associated with frequent postoperative morbidity and poor prognosis. Methods This study included 1673 patients with ESCC who underwent curative esophagectomy at eight institutes between April 2005 and November 2020. Patients were divided into normal and high MCV groups according to the standard value of their pretreatment MCV. Clinical background, short-term outcomes, and prognosis were retrospectively compared between the groups. Results Overall, 26.9% of patients had a high MCV, which was significantly associated with male sex, habitual smoking and drinking, multiple primary malignancies, and malnutrition, as estimated by the body mass index, hemoglobin and serum albumin values, and the Geriatric Nutritional Risk Index. Postoperative respiratory morbidity (P = 0.0075) frequently occurred in the high MCV group. A high MCV was an independent prognostic factor for worse overall survival (hazard ratio, 1.27; 95% confidence interval, 1.049-1.533; P = 0.014) and relapse-free survival (hazard ratio, 1.23; 95% confidence interval, 1.047-1.455; P = 0.012). Conclusions A high MCV correlates with habitual drinking and smoking, malnutrition, and multiple primary malignancies and could be a surrogate marker of worse short-term and long-term outcomes in patients with ESCC who undergo esophagectomy.
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Affiliation(s)
- Naoya Yoshida
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuoku, Kumamoto, Japan
| | - Ken Sasaki
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yasue Kimura
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Hasama, Oita, Japan
| | - Makoto Ikenoue
- Division of Gastrointestinal-Endocrine-Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Yuichiro Nakashima
- Department of Gastroenterological Surgery, National Hospital Organization, Kyushu Cancer Center, Miniami-ku, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Chuo-ku, Fukuoka, Japan
| | - Kojiro Eto
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuoku, Kumamoto, Japan
| | - Yusuke Tsuruda
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima, Japan
| | - Shinichiro Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomonori Nakanoko
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University, Hasama, Oita, Japan
| | - Shinsuke Takeno
- Division of Gastrointestinal-Endocrine-Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki, Japan
| | - Manabu Yamamoto
- Department of Gastroenterological Surgery, National Hospital Organization, Kyushu Cancer Center, Miniami-ku, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization, Kyushu Cancer Center, Miniami-ku, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization, Kyushu Cancer Center, Miniami-ku, Fukuoka, Japan
| | - Hideo Baba
- From the Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Chuoku, Kumamoto, Japan
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20
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Kobayashi K, Shikino K, Sano H, Shibata T, Higuchi S, Miyamoto M, Ban T. Family cluster of Japanese spotted fever. QJM 2022; 115:169-170. [PMID: 35021228 DOI: 10.1093/qjmed/hcac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Kobayashi
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - K Shikino
- Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-city, Chiba 260-8677, Japan
| | - H Sano
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - T Shibata
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - S Higuchi
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - M Miyamoto
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
| | - T Ban
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
- Department of Internal Medicine, Isumi Medical Center, 1177, Kariya, Isumi-city, Chiba 298-0123, Japan
- Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-city, Chiba 260-8677, Japan
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21
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Okamura A, Watanabe M, Mukoyama N, Ota Y, Shiraishi O, Shimbashi W, Baba Y, Matsui H, Shinomiya H, Sugimura K, Morita M, Sakai M, Sato H, Shibata T, Nasu M, Matsumoto S, Toh Y, Shiotani A. A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan. Ann Gastroenterol Surg 2022; 6:54-62. [PMID: 35106415 PMCID: PMC8786680 DOI: 10.1002/ags3.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/25/2021] [Accepted: 09/05/2021] [Indexed: 12/14/2022] Open
Abstract
AIM Digestive reconstruction after pharyngolaryngectomy with total esophagectomy (PLTE) remains challenging, with the optimal method remaining unclear. The current study aimed to clarify the short-term outcomes after PLTE and determine the optimal digestive reconstruction method. METHODS Based on a nationwide survey of 151 patients who underwent PLTE, outcomes of digestive reconstruction methods are described. RESULTS Among digestive reconstruction methods, a simple gastric tube was most frequently used (37.1%), followed by gastric tube combined with free graft transfer (FGT) (35.1%), gastric tube with microvascular anastomosis (22.5%), and other procedures (5.3%). Intraoperative evaluation of microcirculation (IOEM) was utilized in 29 patients (19.2%). Among the included patients, 66.9% developed any-grade complications, 41.0% developed severe complications, and 23.8% developed digestive reconstruction-related complications (DRRCs; leakage or necrosis). Reoperation within 30 days for any complications and DRRCs was required in 13.9% and 8.6% of the patients, respectively. Mortality within 90 days was observed in 4.6%. Among the three major methods, gastric tube combined with FGT promoted the least DRRCs in the gastric tube (P = .005), although the overall incidence of DRRCs was comparable. The use of IOEM was significantly associated with a reduction of severe DRRCs (P = .005). CONCLUSIONS Pharyngolaryngectomy with total esophagectomy is a high-risk surgery significantly associated with the occurrence of postoperative morbidity and mortality. Nonetheless, the addition of FGT can help prevent gastric tip complications, while IOEM can be an effective method for improving outcomes.
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Affiliation(s)
- Akihiko Okamura
- Department of Esophageal SurgeryGastroenterology CenterCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Masayuki Watanabe
- Department of Esophageal SurgeryGastroenterology CenterCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Nobuaki Mukoyama
- Department of OtolaryngologyGraduate School of MedicineNagoya UniversityNagoyaJapan
| | - Yoshihiro Ota
- Department of Gastrointestinal and Pediatric SurgeryTokyo Medical UniversityTokyoJapan
| | - Osamu Shiraishi
- Department of SurgeryFaculty of MedicineKindai UniversityOsakaJapan
| | - Wataru Shimbashi
- Department of Head and Neck SurgeryCancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Yoshifumi Baba
- Department of Gastroenterological SurgeryGraduate School of Medical SciencesKumamoto UniversityKumamotoJapan
| | - Hidetoshi Matsui
- Department of Head and Neck SurgeryHyogo Cancer CenterHyogoJapan
| | - Hirotaka Shinomiya
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineHyogoJapan
| | - Keijiro Sugimura
- Department of Digestive SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Masaru Morita
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Makoto Sakai
- Department of General Surgical ScienceGunma University Graduate School of MedicineGunmaJapan
| | - Hiroshi Sato
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterSaitamaJapan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric SurgeryOita University Faculty of MedicineOitaJapan
| | - Motomi Nasu
- Department of Esophageal and Gastroenterological SurgeryJuntendo University School of MedicineTokyoJapan
| | - Shuichi Matsumoto
- Department of Otolaryngology‐Head and Neck SurgeryKochi UniversityKochiJapan
| | - Yasushi Toh
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
- The Japan Broncho‐Esophagological SocietyJapan
| | - Akihiro Shiotani
- The Japan Broncho‐Esophagological SocietyJapan
- Department of Otolaryngology‐Head and Neck SurgeryNational Defense Medical CollegeSaitamaJapan
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22
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Hatanaka N, Xu B, Yasugi M, Morino H, Tagishi H, Miura T, Shibata T, Yamasaki S. Chlorine dioxide is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite. J Hosp Infect 2021; 118:20-26. [PMID: 34536532 PMCID: PMC8442261 DOI: 10.1016/j.jhin.2021.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A new coronavirus (SARS-CoV-2) abruptly emerged in Wuhan, China, in 2019 and rapidly spread globally to cause the COVID-19 pandemic. AIM To examine the anti-SARS-CoV-2 activity of the potent disinfectant Cleverin, the major disinfecting component of which is chlorine dioxide (ClO2); and to compare the results with that of sodium hypochlorite in the presence or absence of 0.5% or 1.0% foetal bovine serum (FBS). METHODS Concentrated SARS-CoV-2 viruses were treated with various concentrations of ClO2 and sodium hypochlorite and 50% tissue culture infective dose was calcurated to evaluate the antiviral activity of each chemical. FINDINGS When SARS-CoV-2 viruses were treated with 0.8 ppm ClO2 or sodium hypochlorite, viral titre was decreased only by 1 log10 TCID50/mL in 3 min. However, the viral titre was decreased by more than 4 log10 TCID50/mL when treated with 80 ppm of each chemical for 10 s regardless of presence or absence of FBS. It should be emphasized that treatment with 24 ppm of ClO2 inactivated more than 99.99% SARS-CoV-2 within 10 s or 99.99% SARS-CoV-2 in 1 min in the presence of 0.5% or 1.0% FBS, respectively. By contrast, 24 ppm of sodium hypochlorite inactivated only 99% or 90% SARS-CoV-2 in 3 min under similar conditions. Notably, except for ClO2, the other components of Cleverin such as sodium chlorite, decaglycerol monolaurate, and silicone showed no significant antiviral activity. CONCLUSION Altogether, the results strongly suggest that although ClO2 and sodium hypochlorite are strong antiviral agents in absence of organic matter but in presence of organic matter, ClO2 is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite.
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Affiliation(s)
- N Hatanaka
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - B Xu
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - M Yasugi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - H Morino
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - H Tagishi
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Miura
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Shibata
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - S Yamasaki
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan.
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Suzuki K, Etoh T, Shibata T, Nishiki K, Fumoto S, Ueda Y, Shiroshita H, Shiraishi N, Inomata M. Positron emission tomography complete metabolic response as a favorable prognostic predictor in esophageal cancer following neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil. World J Clin Oncol 2021; 12:249-261. [PMID: 33959478 PMCID: PMC8085515 DOI: 10.5306/wjco.v12.i4.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/25/2020] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND 18F-fluorodeoxyglucose-positron emission tomography (PET)/computed tomography is useful in diagnosing lymph node and distant metastases of esophageal cancer. However, its value for predicting survival is controversial.
AIM To evaluate the value of PET complete metabolic response (CMR) as a prognostic predictor for esophageal cancer.
METHODS Between June 2013 and December 2017, 58 patients with squamous cell esophageal cancer who underwent neoadjuvant chemotherapy (NAC) in Oita University were enrolled in this retrospective cohort study. Tumors were clinically staged using fluorodeoxyglucose-PET/computed tomography before and after NAC. After NAC, maximal standardized uptake value ≤ 2.5 was defined as PET-CMR, and maximal standardized uptake value > 2.5 was defined as non-PET-CMR. We compared short-term outcomes between the PET-CMR group and non-PET-CMR group and evaluated prognostic factors by univariate and multivariate analyses.
RESULTS The PET-CMR group included 22 patients, and the non-PET-CMR group included 36 patients. There were no significant differences in intraoperative and postoperative complications between the two groups. Five-year relapse-free survival and overall survival in the PET-CMR group were significantly more favorable than those in the non-PET-CMR group (38.6 mo vs 20.8 mo, P = 0.021; 42.8 mo vs 25.1 mo, P = 0.011, respectively). PET-CMR was a significant prognostic factor in terms of relapse-free survival by univariate analysis (hazard ratio: 2.523; 95% confidence interval: 1.034–7.063; P < 0.041). Particularly, PET-computed tomography negative N was an independent prognostic factor of relapse-free survival and overall survival by multivariate analysis.
CONCLUSION PET-CMR after NAC is considered a favorable prognostic factor for esophageal cancer. Evaluation by PET-computed tomography could be useful in clinical decision making for esophageal cancer.
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Affiliation(s)
- Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Kohei Nishiki
- Department of Surgery, Oita Nakamura Hospital, Oita 870-0022, Japan
| | - Shoichi Fumoto
- Department of Surgery, Oita Nakamura Hospital, Oita 870-0022, Japan
| | - Yoshitake Ueda
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Norio Shiraishi
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu 879-5593, Oita, Japan
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Kunitoh H, Tsuboi M, Wakabayashi M, Okada M, Suzuki K, Watanabe SI, Asamura H, Fukuda H, Shibata T, Kazato T, Mizutani T, Eba J. A phase III study of adjuvant chemotherapy in patients with completely resected, node-negative non–small cell lung cancer (JCOG 0707). JTCVS Open 2020; 4:90-102. [PMID: 36004301 PMCID: PMC9390442 DOI: 10.1016/j.xjon.2020.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 01/16/2023]
Abstract
Objective To evaluate efficacy of S-1 (tegafur/gimeracil/oteracil), an active novel fluoropyrimidine, as compared to UFT (tegafur/uracil) as a postoperative adjuvant therapy in patients with node-negative non–small cell lung cancer (NSCLC). Methods Eligible patients had undergone complete resection of p-stage I (T1 with tumor diameter >2 cm or T2-N0M0 by 5th edition Union for International Cancer Control TNM) NSCLC, and were randomized to receive oral UFT 250 mg/m2/day for 2 years (Arm A) or oral S-1 80 mg/m2/day for 2 weeks with a 1-week rest period, for 1 year (Arm B). The primary end point was relapse-free survival (RFS), with 80% power and a one-sided type I error of 0.05. Results From November 2008 to December 2013, 963 patients were enrolled (Arm A: 482, Arm B: 481). Toxicities (hematologic/nonhematologic) of grade 3 or more were observed in 15.9 (1.5/14.7)% in Arm A, and in 14.9 (3.6/12.1)% in Arm B, respectively. At data cut-off in December 2018, the hazard ratio for RFS was 1.06 (95% confidence interval, 0.82-1.36), showing no superiority of S-1 over UFT. The hazard ratio of overall survival (OS) was 1.10 (95% confidence interval, 0.81-1.50). The 5-year RFS/OS were 79.4%/88.8% in Arm A and 79.5%/89.7% in Arm B, respectively. The original NSCLC accounted for 58%/53%, respectively, of the Arm A/Arm B OS events. Secondary malignancies were observed in 85 (17.8%) and 84 (17.8%) individuals in Arm A and Arm B, respectively. Conclusions S-1 was not superior to UFT as postoperative adjuvant therapy in node-negative NSCLC. Future investigation should incorporate identification of high-risk populations for recurrence.
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Yanai T, Yasukawa H, Mawatari K, Sasaki T, Takahashi J, Nohara S, Shimozono K, Shibata T, Okabe K, Yamamoto M, Fukumoto Y. Smooth muscle cell-specific SOCS3 deficiency promote pericardial fibrosis and diastolic dysfunction in aging mice. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3742] [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
Suppressor of cytokine signaling-3 (SOCS3) is a cytokine-inducible negative regulator of signal transducer and activator of transcription-3 (STAT3) signaling pathway. We have previously shown that cardiac-specific SOCS3 deficiency spontaneously develop cardiac dysfunction with advanced age. However, the role of SOCS3 in smooth muscle cells in cardiovascular pathophysiology remains elusive. In this study, we determined whether STAT3 and SOCS3 in smooth muscle cells would play a role in cardiovascular pathophysiology.
Methods and results
To target inactivation of the SOCS3 gene to smooth muscle cells, SOCS3-flox mice were bred with transgenic mice expressing Cre recombinase under control of the mouse SM22-α promoter (sm-SOCS3-KO mice). Left ventricular weight to body weight ratio was significantly increased in sm-SOCS3-KO mice compared with wild-type mice at 12 months of age (p<0.05). Echocardiographic analyses of smSOCS3-KO mice showed significantly increased left ventricular diastolic dysfunction compared with wild-type from 12 months of age (p<0.05). Sirius-red staining revealed that thickness of pericardium and cardiac interstitial fibrosis in sm-SOCS3-KO mice were markedly greater compared with wild-type mice at 12 months of age (p<0.05). Western blot analyses showed that phosphorylated STAT3 was significantly increased in sm-SOCS3-KO hearts compared with wild-type mice at 12 months of age (p<0.05), whereas no significant differences were observed at 2 months of age. To investigate the mechanism that gave rise to promoted cardiac fibrosis and diastolic dysfunction during aging in sm-SOCS3-KO, we conducted a real-time PCR array analysis for fibrosis. The expression of pro-fibrotic CTGF (connective tissue growth factor), PDGFb (platelet growth factor-b), and TGF (transforming growth factor) family genes including TGFb1, TGFb2, and TGFb3, were significantly higher in sm-SOCS3-KO hearts than those in wild-type at 6 months of age.
Conclusion
Thus, smooth muscle cell-specific SOCS3 deletion induces increased pericardial fibrosis, cardiac interstitial fibrosis, and increased diastolic dysfunction in aging mice, possibly through the augmentation of pro-fibrotic growth factors.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant JSPS KAKENHI
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Affiliation(s)
- T Yanai
- Kurume University School of Medicine, Kurume, Japan
| | - H Yasukawa
- Kurume University School of Medicine, Kurume, Japan
| | - K Mawatari
- Kurume University School of Medicine, Kurume, Japan
| | - T Sasaki
- Kurume University School of Medicine, Kurume, Japan
| | - J Takahashi
- Kurume University School of Medicine, Kurume, Japan
| | - S Nohara
- Kurume University School of Medicine, Kurume, Japan
| | - K Shimozono
- Kurume University School of Medicine, Kurume, Japan
| | - T Shibata
- Kurume University School of Medicine, Kurume, Japan
| | - K Okabe
- Kurume University School of Medicine, Kurume, Japan
| | - M Yamamoto
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Kurume, Japan
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26
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Ma J, Akagi T, Etoh T, Kono Y, Hiratsuka T, Suzuki K, Ninomiya S, Shibata T, Ueda Y, Toujigamori M, Shiroshita H, Shiraishi N, Inomata M. Quadruple advanced synchronous colorectal cancers successfully treated by laparoscopic surgery: a case report. J Surg Case Rep 2020; 2020:rjaa256. [PMID: 32864094 PMCID: PMC7445674 DOI: 10.1093/jscr/rjaa256] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022] Open
Abstract
Among synchronous colorectal cancers (SCRCs) reported previously, the incidence of quadruple advanced SCRCs is very rare. We present the case who underwent laparoscopic two-segment resection of the colon requiring two anastomoses that was performed for quadruple advanced cancers, and four tumors were curatively removed. There were no signs of recurrence at 64 months after surgery. Laparoscopic surgery provided less invasiveness even for quadruple advanced SCRCs in terms of early recovery with an acceptable long-term outcome.
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Affiliation(s)
- Jianwei Ma
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.,Department of General Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yohei Kono
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Takahiro Hiratsuka
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Shigeo Ninomiya
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yoshitake Ueda
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Manabu Toujigamori
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Norio Shiraishi
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
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Fujinaga A, Shibata T, Etoh T, Tada K, Suzuki K, Nishiki K, Ogawa K, Kono Y, Hiratsuka T, Akagi T, Ueda Y, Toujigamori M, Shiroshita H, Shiraishi N, Inomata M. Laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus: a case report. Surg Case Rep 2020; 6:151. [PMID: 32601779 PMCID: PMC7324458 DOI: 10.1186/s40792-020-00900-2] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022] Open
Abstract
Background An esophageal diverticulum is rare and is frequently associated with esophageal motility disorders. Jackhammer esophagus is also rare, is characterized by esophageal hypercontraction, and comprises 4.1% of esophageal motility disorders. Here, we report a case of a patient successfully treated by laparoscopic transhiatal surgery for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus diagnosed with high-resolution manometry (HRM). Case presentation The patient was a 78-year-old man who presented to the hospital with dysphagia. A diverticulum was detected in the lower part of his esophagus by upper gastrointestinal endoscopy. HRM was performed to investigate esophageal motility disorders. His integrated relaxation pressure was normal at 25.9 (< 26) mmHg, but his distal contractile integral (DCI) was very high at 21,464 (1500–13,000) mmHg s cm. Esophageal peristalsis was preserved. Therefore, the patient was diagnosed as having an epiphrenic esophageal diverticulum derived from a jackhammer esophagus for which laparoscopic transhiatal diverticulectomy and Heller-Dor procedure were performed. The postoperative course was uneventful. His symptoms improved, and the level of DCI also returned to a normal level of 3867 mmHg s cm at 2 months after the operation. Conclusion Laparoscopic transhiatal diverticulectomy and esophagomyotomy can be useful procedures for an epiphrenic esophageal diverticulum derived from a jackhammer esophagus due to their lower invasiveness.
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Affiliation(s)
- Atsuro Fujinaga
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan.
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Kazuhiro Tada
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Kohei Nishiki
- Department of Gastroenterological Surgery, Oita Nakamura Hospital, Oita, Japan
| | - Katsuhiro Ogawa
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Yohei Kono
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Takahiro Hiratsuka
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Yoshitake Ueda
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Manabu Toujigamori
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
| | - Norio Shiraishi
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Hasama-machi, Oita, 879-5593, Japan
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Shibata T, Tsukamoto N, Fukuda H, Nabeta Y, Kurosawa K, Matsunari O, Takenaka R, Kanezaki S, Ishii K, Sakamoto T. Successful treatment of left subclavian artery penetration due to ingestion of a safety pin by an elderly person. Acute Med Surg 2020; 7:e526. [PMID: 32547771 PMCID: PMC7289644 DOI: 10.1002/ams2.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background Ingestion cases are increasing in elderly persons. Herein, we report a rare case of ingestion of a safety pin by an elderly person. Case presentation The patient was an 87‐year‐old bedridden woman who had fever with left pleural effusion. Chest X‐ray revealed a foreign body, confirmed to be a safety pin, in the cervical esophagus. A contrast multidetector row computed tomography scan revealed that the opened safety pin penetrated the left subclavian artery, leading to the diagnosis of an esophageal foreign body penetrating the left subclavian artery. The safety pin was removed, and the subclavian artery aneurysm caused by the penetration was embolized by interventional radiology. After treatment, she was returned to the nursing home on postoperative day 8. Conclusion Penetration by ingestion of a safety pin is rare; in this case, safe treatment was possible due to a team of certified specialist physicians and surgeons.
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Affiliation(s)
- Tomotaka Shibata
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Nao Tsukamoto
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Haruka Fukuda
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Yusuke Nabeta
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Keiko Kurosawa
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Osamu Matsunari
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Ryuichi Takenaka
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Shozo Kanezaki
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Keisuke Ishii
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
| | - Teruo Sakamoto
- Advanced TraumaEmergency and Critical Care CenterOita UniversityOitaJapan
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Fujinaga A, Akagi T, Etoh T, Tada K, Itai Y, Kono Y, Hiratsuka T, Suzuki K, Shibata T, Ueda Y, Toujigamori M, Shiroshita H, Shiraishi N, Inomata M. Laparoscopic two-stage operation for rectal cancer with refractory obstructive colitis after kidney transplantation: a case report. Surg Case Rep 2020; 6:33. [PMID: 32016598 PMCID: PMC6997309 DOI: 10.1186/s40792-020-0798-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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Although obstructive colitis with colon cancer is not a rare disease, most cases can be improved with conservative therapy. We report a case of a patient who underwent a laparoscopic two-stage operation for rectal cancer with refractory obstructive colitis after kidney transplantation. Case presentation The patient was a 71-year-old man taking immunosuppressants who had previously undergone right living kidney transplantation for chronic nephritis. He presented to hospital complaining of abdominal pain and was diagnosed as having rectal cancer with obstructive colitis. Although conservative therapy by fasting was continued for 5 weeks, his obstructive colitis did not improve. Therefore, we decided to perform a two-stage operation. First, we performed a laparoscopic Hartmann’s operation. It took 6 months for his obstructive colitis to improve after this operation, and then we performed a laparoscopic colorectal anastomosis. There were no postoperative complications in either operation. Conclusion A laparoscopic two-stage operation could be one of the operative options to reduce postoperative complications in patients with comorbidities such as taking immunosuppressants.
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Affiliation(s)
- Atsuro Fujinaga
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tsuyoshi Etoh
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Kazuhiro Tada
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yusuke Itai
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yohei Kono
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Takahiro Hiratsuka
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Kosuke Suzuki
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yoshitake Ueda
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Manabu Toujigamori
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hidefumi Shiroshita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Norio Shiraishi
- Department of Comprehensive Surgery for Community Medicine, Oita University Faculty of Medicine, Oita, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
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Okai T, Mizutani K, Yamaguchi T, Ogawa M, Kajio K, Ito A, Iwata S, Takahashi Y, Izumiya Y, Murakami T, Shibata T, Yoshiyama M. P107 Predictors of increased d-dimer level at follow-up period after transcatheter aortic valve implantation.Is oral anticoagulation therapy better? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.050] [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
Recently, there are some reports that hypo-attenuated leaflet thickening (HALT) following transcatheter aortic valve implantation (TAVI) is incidentally detected by multi-slice computed tomography. It is believed that valve thrombosis causes HALT, because oral anticoagulation therapy (OAC) is effective for HALT regression. Furthermore, it is reported that d-dimer level increases in patients with HALT, and might be a key biomarker to detect HALT.
Purpose
We sought to investigate the predictors related to increased d-dimer level at 6 months after follow-up TAVI.
Methods
We enrolled 124 consecutive patients who underwent successful TAVI between 2016 and 2018. Study patients were classified into two groups according to antithrombotic therapy resume (OAC therapy or anti-platelet therapy).We set the primary endpoint as the d-dimer levels at 6 months after TAVI. To evaluate the risks of the primary endpoint, we employed a multivariable linear regression model, setting the primary endpoint as an objective variable and patient and clinical backgrounds as explanatory variables. Furthermore, we set the secondary endpoint as one-year bleeding event.
Results
The median age of patients was 83 years old (quartile 80-87). Patients who had taken OAC at 6 months follow-up after TAVI were 29.8%. The median d-dimer level at 6 months after TAVI was 1.3 (1.0-2.2) µg/ml, and OAC group had statistically lower d-dimer level at 6 months follow-up than those in non-OAC group (p = 0.020). Uni-variable liner regression model demonstrated that increased d-dimer level at follow-up had significant relationship with large effective orifice area (EOA) (p = 0.002) and low left ventricular ejection fraction (LVEF) (p = 0.048) after TAVI. Furthermore, large EOA (p = 0.003) and OAC therapy (p = 0.027) were independently associated with increased d-dimer level in multivariate analysis. Kaplan-Meier estimates revealed that there were no significant difference regarding one-year bleeding event between OAC group and non-OAC group (long-rank p = 0.167).
Conclusions
This study suggests that large EOA after TAVI is associated with increased d-dimer levels at 6 months after TAVI, and OAC therapy might have a potential to decrease d-dimer level after TAVI without increase of bleeding events.
Abstract P107 Figure: One-year bleeding event
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Affiliation(s)
- T Okai
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - K Mizutani
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - T Yamaguchi
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - M Ogawa
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - K Kajio
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - A Ito
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - S Iwata
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - Y Takahashi
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - Y Izumiya
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
| | - T Murakami
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - T Shibata
- Osaka City University Graduate School of Medicine, Cardiovascular Surgery, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Cardiovascular Medicine, Osaka, Japan
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Wada M, Shinto K, Shibata T, Sasao M. Measurement of a time dependent spatial beam profile of an RF-driven H - ion source. Rev Sci Instrum 2020; 91:013330. [PMID: 32012539 DOI: 10.1063/1.5128015] [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: 09/15/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
The AC component of a beam current extracted from a negative hydrogen (H-) ion source was detected through a 0.1 mm wide, 66.5 mm long entrance slit to observe the spatial distribution. An internal antenna type multicusp source driven by a 2 MHz radio frequency (RF) power delivered beams to an electrostatic accelerator coupled to a pair of magnetic lenses. The local beam intensity measured by a Faraday cup after the entrance slit exhibited an oscillation showing two main frequency components: the RF power supply frequency and the frequency two times the driving RF. The frequency spectrum of the detected signal showed sharp peaks at 2 MHz, 4 MHz, and 6 MHz as well as at 3 MHz and 5 MHz. A 1 mm displacement of the Faraday cup slit position from the center of the beam axis increased the oscillation amplitude, corresponding to a larger amplitude of the AC component at the beam edge.
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Affiliation(s)
- M Wada
- School of Science and Engineering, Doshisha University, Kyotanabe, Kyoto 610-0321, Japan
| | - K Shinto
- J-PARC Center, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - T Shibata
- J-PARC Center, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - M Sasao
- Organization for Research Initiatives and Development, Doshisha University, Kamigyoku, Kyoto 602-8580, Japan
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Kodaira T, Kagami Y, Shibata T, Shikama N, Nishimura Y, Ishikura S, Nakamura K, Saito Y, Matsumoto Y, Teshima T, Ito Y, Akimoto T, Nakata K, Toshiyasu T, Nakagawa K, Nagata Y, Nishimura T, Uno T, Kataoka M, Yorozu A, Hiraoka M. Results of a multi-institutional, randomized, non-inferiority, phase III trial of accelerated fractionation versus standard fractionation in radiation therapy for T1-2N0M0 glottic cancer: Japan Clinical Oncology Group Study (JCOG0701). Ann Oncol 2019; 29:992-997. [PMID: 29401241 DOI: 10.1093/annonc/mdy036] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background We assessed the non-inferiority of accelerated fractionation (AF) (2.4 Gy/fraction) compared with standard fractionation (SF) (2 Gy/fraction) regarding progression-free survival (PFS) in patients with T1-2N0M0 glottic cancer (GC). Patients and methods In this multi-institutional, randomized, phase III trial, patients were enrolled from 32 Japanese institutions. Key inclusion criteria were GC T1-2N0M0, age 20-80, Eastern Cooperative Oncology Group performance status of 0-1, and adequate organ function. Patients were randomly assigned to receive either SF of 66-70 Gy (33-35 fractions), or AF of 60-64.8 Gy (25-27 fractions). The primary end point was the proportion of 3-year PFS. The planned sample size was 360 with a non-inferiority margin of 5%. Results Between 2007 and 2013, 370 patients were randomized (184/186 to SF/AF). Three-year PFS was 79.9% (95% confidence interval [CI] 73.4-85.4) for SF and 81.7% (95% CI 75.4-87.0) for AF (difference 1.8%, 91% CI-5.1% to 8.8%; one-sided P = 0.047 > 0.045). The cumulative incidences of local failure at 3 years for SF/AF were 15.9%/10.3%. No significant difference was observed in 3-year overall survival (OS) between SF and AF. Grade 3 or 4 acute and late toxicities developed in 22 (12.4%)/21 (11.5%) and 2 (1.1%)/1 (0.5%) in the SF/AF arms. Conclusion Although the non-inferiority of AF was not confirmed statistically, the similar efficacy and toxicity of AF compared with SF, as well as the practical convenience of its fewer treatment sessions, suggest the potential of AF as a treatment option for early GC. Clinical trials registration UMIN Clinical Trial Registry, number UMIN000000819.
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Affiliation(s)
- T Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
| | - Y Kagami
- Department of Radiation Oncology, Showa University, Tokyo, Japan
| | - T Shibata
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - N Shikama
- Department of Radiation Oncology, Juntendo University, Tokyo, Japan
| | - Y Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Ishikura
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - K Nakamura
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Y Saito
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, Japan
| | - Y Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - T Teshima
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Y Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - K Nakata
- Department of Radiology, Sapporo Medical University, Sapporo, Japan
| | - T Toshiyasu
- Department of Radiation Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - K Nakagawa
- Department of Radiology, Tokyo University, Tokyo, Japan
| | - Y Nagata
- Department of Radiation Oncology, Hiroshima University, Hiroshima, Japan
| | - T Nishimura
- Department of Radiation Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - T Uno
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - M Kataoka
- Department of Radiation Oncology, Shikoku Cancer Center, Matsuyama, Japan
| | - A Yorozu
- Department of Radiology, Tokyo Medical Center, Tokyo, Japan
| | - M Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Hospital, Kyoto, Japan
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Shibata T, Sata K, Oroguchi T, Ishii N. Development of health management system with recording daily living habits and body compositions. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
It is difficult for university students to maintain their health. Department of health management was opened at April 2018 in Tokai university, Japan. About two hundred students entered it last year. Health management system was developed to maintain their health through the college life. The system is named THINKss (Tokai Health INtelligence Knowledge Support System). The number of registered students increased about four hundred this year. Every student can record their daily physical and mental conditions, meal photos with the time, body temperature, blood pressure, bone density, body compositions on their smartphone. If they use activity trackers with a wrist-based heart rate sensor (Garmin co. ltd.), their daily activities and sleeping status are corrected through API automatically. The weather information around university is also recorded everyday. Every student can browse own measurements on their smartphones. Because physical status includes cold symptoms (sneeze, throat pain, cough, fatigue, articular pain, muscle pain, chill, and body temperature), the system can recommend visiting a clinic. Because three meal photos are shown alongside, the balance of the meals is known. It may improve their meals. Because the activity tracker records advanced sleeping status (rem, light, deep, and moving), the relationships between mental conditions and sleeping status should be analyzed. Our previous study for common workers showed that mental status related with sleeping status, taking lunch of convenience-store, standard deviation of time of taking lunch, and oversensitivity to noise. Relationships between body composition changes and the lifestyles should be analyzed for university students. Some alert logics for body composition changes and exacerbating mental conditions may be provided based on the evidences from cumulative data of the health management system. These evidence-based alerts will contribute to maintain student’s health through a college life.
Key messages
Health management system was developed to maintain student’s health through the college life. Evidence-based alerts will contribute to maintain student’s health through a college life.
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Affiliation(s)
- T Shibata
- Department of Health Management, Tokai University, Kanagawa, Japan
| | - K Sata
- Lifecare Center, Tokai University, Kanagawa, Japan
| | - T Oroguchi
- Lifecare Center, Tokai University, Kanagawa, Japan
| | - N Ishii
- Department of Health Management, Tokai University, Kanagawa, Japan
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Shinada K, Kohno T, Fukuda K, Higashitani M, Kawamatsu N, Kitai T, Shibata T, Takei M, Nochioka K, Nakazawa G, Shiomi H, Miyashita M, Mizuno A. 2206Prevalence and determinants of complicated grief in bereaved caregivers of patients admitted for cardiovascular diseases. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Few studies have examined complicated grief in bereaved caregivers of patients with cardiovascular diseases (CVD), in contrast with studies in caregivers of patients with cancers. We examined the prevalence and determinants of complicated grief among bereaved caregivers of patients with CVD.
Methods
We conducted a cross-sectional survey using a self-administered questionnaire for bereaved family members of CVD patients who had died in the cardiology departments of 9 tertiary care centers in Japan. We assessed bereaved caregiver grief status using the Brief Grief Questionnaire (BGQ), and its association with their depression (Patient Health Questionnaire-9 [PHQ-9]). Questionnaire also covered following associated factors: bereaved family member and patient characteristics, end-of-life care (Care Evaluation Scale [CES], a scale for assessment of the structure and process of care); and the quality of the deceased patients' death (Good Death Inventory [GDI]).
Results
A total of 269 bereaved caregivers (mean age, 64±12 years; 35% male) of patients with CVD (heart failure n=155 myocardial infarction n=32, cardiopulmonary arrest n=15, arrhythmia n=8, and others n=59) were enrolled in the study. Overall, 14.1% of the bereaved caregivers had complicated grief (BGQ≥8), 32.3% had subthreshold complicated grief (BGQ=5–7), and 13.3% had depression (PHQ-9≥10). Bereaved caregivers with complicated grief frequently developed depression (58% vs. 6%, p<0.001). Among the bereaved caregivers with complicated grief, the assessment of end-of-life care was worse (CES score: 28 [21–40] vs. 23 [19–39], p=0.04), and the assessment of the deceased patients' quality of death tended to be worse (GDI score: 4.0 [3.0–4.8] vs. 4.3 [3.7–4.9], p=0.05). The cause of admission as well as preferences of the patient and family (e.g., treatment [focusing on extending life vs. relieving discomfort], desire for information, place of end-of-life) were not associated with the prevalence of complicated grief. The prevalence of complicated grief was associated with loss of a spouse, poor psychological health during the deceased patients' admission, and poor preparation for the patient's imminent death (all p<0.05). Bereaved caregivers with complicated grief had experienced more decisional burdens regarding the deceased patients' treatment (55% vs. 25%, p=0.001). Notably, 64% of bereaved caregivers with complicated grief were not treated (i.e., neither routine follow-up by psychiatrists/psychotherapist nor prescription for anti-depressants/tranquilizers).
Conclusions
The prevalence of complicated grief of bereavement was 14.0%. When subthreshold complicated grief was included, the prevalence of complicated grief increased to include half of the caregivers; therefore, routine screening of the bereaved could be recommended. Clinicians should pay particular attention to bereaved families with high risk factors to identify those at risk for future development of complicated grief.
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Affiliation(s)
- K Shinada
- Keio University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - T Kohno
- Keio University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Division of Cardiology, Department of Medicine, Tokyo, Japan
| | - M Higashitani
- Tokyo Medical University Ibaraki Medical Center, Department of Cardiology, Ibaraki, Japan
| | - N Kawamatsu
- Mito Saiseikai General Hospital, Department of Cardiology, Ibaraki, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Departments of 1) Cardiovascular Medicine and 2) Clinical Research Support, Kobe, Japan
| | - T Shibata
- Kurume University School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Fukuoka, Japan
| | - M Takei
- Tokyo Saiseikai Central Hospital, Department of Cardiology, Tokyo, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - G Nakazawa
- Tokai University School of Medicine, Department of Cardiology, Kanagawa, Japan
| | - H Shiomi
- Kyoto University Graduate School of Medicine, Department of Cardiology, Kyoto, Japan
| | - M Miyashita
- Tohoku University Graduate School of Medicine, Division of Palliative Nursing, Health Sciences, Sendai, Japan
| | - A Mizuno
- St. Luke's International Hospital, Department of Cardiology, Tokyo, Japan
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Ogawa M, Mizutani K, Okai T, Kajio K, Ito A, Iwata S, Takahashi Y, Murakami T, Shibata T, Yoshiyama M. P3693Self-expandable transcatheter aortic valve implantation is associated with frequent periprocedural stroke detected by diffusion-weighted magnetic resonance imaging -Insight from propensity score match. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0547] [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
Little evidence is available regarding the risk of peri-procedural stroke detected by diffusion-weighted magnetic resonance imaging (DW-MRI) after transcatheter aortic valve implantation (TAVI). Our purpose was to evaluate stroke risk after TAVI using DW-MRI by enrolling consecutive patients who underwent transfemoral TAVI and post-procedural DW-MRI.
Methods
We prospectively enrolled 113 consecutive patients who underwent transfemoral TAVI and post-procedural DW-MRI. We used balloon-expandable valves as first-line therapy and selected self-expandable valves only for patients with narrow sinotubular junctions or annuli. We set the primary endpoint as the number of high intensity areas (HIA) detected by DW-MRI regardless of the size of the area. To evaluate the risks of the primary endpoint, we employed a multivariable linear regression model, setting the primary endpoint as an objective variable and patient and clinical backgrounds as explanatory variables. In addition, the relationship between valve type and the number of HIAs on DW-MRI was also confirmed by the propensity score matching analysis to evaluate the robustness of the result, using a multivariable linear regression model with the protocol described in the previous manuscript. Shortly, the propensity score was calculated with a logistic regression model by setting the treatment as the response variable and baseline characteristics and procedural information that were significantly different between 2 groups (balloon expandable and self-expandable) as explanatory variables, which included age, estimated glomerular filtration rate, oversizing rate, and BAV before THV deployment.
Results
Median patient age was 84 years, and 36.3% were men. Ninety-three patients underwent balloon-expandable TAVI and 20 underwent self-expandable TAVI. Symptomatic stroke occurred in 6 (5.3%) whereas asymptomatic stroke occurred in 59 (52.2%) patients. The incidence of symptomatic and total stroke was higher in patients who underwent self-expandable TAVI than those who underwent balloon-expandable TAVI (30.0% vs 0.0%, p<0.001 and 90.0% vs 50.5%, p=0.001, respectively). A multivariable linear regression model demonstrated an increased primary endpoint when self-expandable TAVI was performed (p<0.001). The other covariates had no significant relationship to the primary endpoint. Akaike information criterion-based stepwise statistical model selection revealed that valve type was the only explanatory variable for the best predictive model. This result was also confirmed with the propensity score matching analysis (estimate, 2.359; 95% CI, 0.426–4.292; p=0.019) after adjustments of propensity score, in which 28 patients were matched (n=14 in each group).
Conclusions
Self-expandable valves were associated with increased numbers of HIA on DW-MRI after TAVI in patients with severe aortic stenosis.
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Affiliation(s)
- M Ogawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Mizutani
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Okai
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Kajio
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Ito
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Iwata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Takahashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Murakami
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Shibata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Yanai T, Yasukawa H, Mawatari K, Sasaki T, Takahashi J, Nohara S, Shimozono K, Shibata T, Okabe K, Yamamoto M, Fukumoto Y. P1627Increased pericardial fibrosis and cardiac dysfunction in smooth muscle cell-specific SOCS3 deficient mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Suppressor of cytokine signaling-3 (SOCS3) is an intrinsic negative-feedback regulator of signal transducer and activator of transcription-3 (STAT3) signaling pathway. We have previously shown that myocardial SOCS3 plays an important role in cardiac hypertrophy and survival; however, the role of SOCS3 in smooth muscle cells in cardiovascular pathophysiology remains elusive. In this study, we determined whether STAT3 and SOCS3 in smooth muscle cells would play a role in cardiovascular pathophysiology.
Methods and results
To target inactivation of the SOCS3 gene to smooth muscle cells, SOCS3-flox mice were bred with transgenic mice expressing Cre recombinase under control of the mouse SM22-α promoter (sm-SOCS3-KO mice). Left ventricular weight to body weight ratio was significantly increased in sm-SOCS3-KO mice compared with wild-type mice at 52 weeks of age (p<0.05). Echocardiographic analyses of sm-SOCS3-KOmice showed significantly decreased cardiac function compared with wild-typefrom 52 weeks of age (p<0.05). Interestingly, Sirius-red staining revealed that thickness of pericardium in sm-SOCS3-KOmice was markedly greater compared with wild-typemice at 52 weeks of age (p<0.05). Cardiac interstitial fibrosis in sm-SOCS3-KOmice was also greater compared with wild-typemice (p<0.05). Western blot analyses showed that phosphorylated STAT3 was significantly increased in sm-SOCS3-KOhearts compared with wild-typemice at 52 weeks of age (p<0.05), whereas no significant differences were observed at 7 weeks of age. Immunostaining revealed that phosphorylated STAT3 positive cells were in thickened pericardial area in sm-SOCS3-KOhearts. Some infiltrated inflammatory cells were also found in thickened pericardial area in sm-SOCS3-KOmice hearts.
Conclusion
These results suggest that STAT3 and its negative-feedback regulator SOCS3 in smooth muscle cells play an important role in the pathogenesis of pericardial fibrosis and cardiac dysfunction.
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Affiliation(s)
- T Yanai
- Kurume University School of Medicine, Kurume, Japan
| | - H Yasukawa
- Kurume University School of Medicine, Kurume, Japan
| | - K Mawatari
- Kurume University School of Medicine, Kurume, Japan
| | - T Sasaki
- Kurume University School of Medicine, Kurume, Japan
| | - J Takahashi
- Kurume University School of Medicine, Kurume, Japan
| | - S Nohara
- Kurume University School of Medicine, Kurume, Japan
| | - K Shimozono
- Kurume University School of Medicine, Kurume, Japan
| | - T Shibata
- Kurume University School of Medicine, Kurume, Japan
| | - K Okabe
- Kurume University School of Medicine, Kurume, Japan
| | - M Yamamoto
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Kurume, Japan
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Nishio S, Matsuo K, Shibata T, Yamaguchi S, Kanao H, Takehara K, Kado N, Tozawa A, Tokunaga H, Matsunaga T, Kato H, Horie K, Kikuchi A, Enomoto T, Mikami M. Changes in clinico-pathological characteristics of vulvar cancer in Japan: Increasing oldest-old, stage-shifting, and decreasing cohort-level survival. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.066] [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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Shibata T, Nohara S, Nagafuji K, Fukumoto Y. P1575Cardiovascular toxicity following modern multiple myeloma therapy in Japanese cohort. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Multiple myeloma (MM) is a plasma cell dyscrasia accounting for approximately 13% of hematologic malignancies. Patients with MM have an increased risk of cardiovascular adverse events (CAEs) due to disease burden and/or anti-myeloma treatment-related risk factors. However, little is known about the incidence of cardiovascular toxicity of patients with MM.
Methods
We analyzed 42 consecutive patients (Male/Female 22/20, age 67±10 years old) who received anti-MM therapies between October 2016 and September 2018 from our University Cardio-REnal Oncology (CREO) registry. We examined the incidence of CAEs through January 2019 including congestive heart failure and cardiomyopathy (CHF/CM), ischemic cardiac event, newly symptomatic arrhythmias included atrial fibrillation or flutter requiring treatment, and venous thromboembolism (VTE).
Results
Within the 408-day median follow-up period (range 15–844 days), CAEs occurred in 23.8% (n=10); CHF/CM in 11.9%, newly diagnosed atrial fibrillation in 4.8%, VTE in 4.8%, vasospastic angina in 2.4%, and death in 28.6%. There were no significant differences between CAEs group and non-CAEs group in terms of sex, body mass index (BMI), incidence of hypertension, ischemic heart disease, prior history of heart failure, cardiovascular medications, left ventricular ejection fraction, serum high-sensitivity troponin-I, estimated glomerular filtration rate, blood urea nitrogen and N-terminal pro-brain natriuretic peptide levels at the time of enrollment. The use of various types of proteasome inhibitors and immunomodulatory drugs were not associated with the increased risk of CAEs. By multivariate analysis, a history of prior anti-myeloma therapies was identified as an independent risk factor for CAEs.
Conclusion
CAEs were significantly associated with the recurrent MM in Japanese MM patients.
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Affiliation(s)
- T Shibata
- Kurume University School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume, Japan
| | - S Nohara
- Kurume University School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume, Japan
| | - K Nagafuji
- Kurume University School of Medicine, Division of Hematology and Oncology, Department of Internal Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume, Japan
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Yamazaki N, Kikuchi K, Nozawa K, Fukuda H, Shibata T, Hamaguchi T, Takashima A, Shoji H, Boku N, Takatsuka S, Takenouchi T, Nishina T, Hino K, Yoshikawa S, Yamazaki K, Takahashi M, Hasegawa A, Bando H, Masuishi T, Kiyohara Y. Primary analysis results of randomized controlled trial evaluating reactive topical corticosteroid strategies for the facial acneiform rash by EGFR inhibitors (EGFRIs) in patients (pts) with RAS wild-type (wt) metastatic colorectal cancer (mCRC): FAEISS study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.090] [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: 11/14/2022] Open
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Nohara S, Shibata T, Ishi K, Obara H, Miyamoto T, Kakuma T, Fukumoto Y. P3121Cancer therapeutics-related heart failure from a cohort study using big data of electronic health record in Japan. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
The prognosis of cancer patients has been improved partly because of the progress in cancer therapy, which increases the cancer survivors in the society. It may raise a concern regarding the development of heart failure (HF), because the anticancer agents have some serious side effects on cardiovascular system, especially in the aging society including Japan. However, the epidemiological data for the risk of HF in the cancer survivors is limited due to the lack of comprehensive dataset in the aging society. In this regard, the electronic health record (EHR), a big data, from the National Health Insurance in Japan provides a unique opportunity to obtain the suitable dataset.
Purpose
The purpose of this study was to clarify the prevalence and the risk factors of HF in cancer survivors, focusing on the impact of their age, using EHR in Japan.
Methods
We examined the EHR of 17.8 million patients, covering 14% of the total Japanese population. The EHR includes the diagnoses as coded with International Classification of Diseases, 10th revision (ICD-10), and the information for therapeutics. We extracted 159,380 patients who received anticancer agents between April 2008 to January 2017. HF patients were identified accordingto ICD-10 codes and the record for the use of therapeutic drugs for HF at least once after the HF diagnosis following the treatment with anticancer agents. We excluded the patients if they had other conditions indistinguishable from HF or if they had past history of HF before receiving anticancer agents.
Results
The mean follow-up period was 1.75 years and mean age (standard deviation) was 68.9 (11.6) years. The population over 75 years old were 37%, while males were 59.5%. There were prostate cancer (28.1%), lung cancer (13.4%), and colon cancer (12.6%)in males, and breast cancer (42.8%), colon cancer (11.5%), and lung cancer (8.6%)in females. Among them, 5,529 patients were diagnosed with HF, corresponding to the prevalence of 3.8%. The mean time form the initiation of chemotherapy to the HF onset was 1.03 year. In the Cox's proportional hazard model after the adjustments for comorbidity, HF was more prevalent in males with hazard ratio (HR) 1.07 and 95% C.I. 1.01–1.13 (p<0.05) and in those with obesity (HR 1.18, 95% C.I. 1.09–1.26, p<0.01).We divided the subjects into three age groups (younger; <65 years, intermediate; 65–74 years, older; ≥75 years). HF was more prevalent in older group than younger group (HR 1.72, 95% C.I. 1.60–1.85, p<0.01). Among the anticancer agents, doxorubicin showed HR 2.09 (95% C.I. 1.89–2.3, p<0.01), and trastuzumab showed HR 1.47 (95% C.I 1.25–1.73, p<0.01).
Conclusion
We showed that the average prevalence of HF after anticancer agentwas 3.8%. The independent risk factors for HF were older age, male, obesity, and the use of doxorubicin or trastuzumab. This study also demonstrated the usefulness of EHR in Japan, to investigate the cardiovascular risk associated with the anticancer agents.
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Affiliation(s)
- S Nohara
- Kurume University School of Medicine, Kurume, Japan
| | - T Shibata
- Kurume University School of Medicine, Kurume, Japan
| | - K Ishi
- Kurume University School of Medicine, Biostatistics Center, Kurume, Japan
| | - H Obara
- Kurume University School of Medicine, Biostatistics Center, Kurume, Japan
| | - T Miyamoto
- Kurume University School of Medicine, Biostatistics Center, Kurume, Japan
| | - T Kakuma
- Kurume University School of Medicine, Biostatistics Center, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Kurume, Japan
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Yamamoto M, Yasukawa H, Takahashi J, Nohara S, Sasak T, Shimozono K, Shibata T, Yanai T, Okabe K, Mawatari K, Fukumoto Y. P5374Genetic deletion of IL-22 increased cardiac rupture after myocardial infarction in mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Interleukin-22 (IL-22) is a member of the IL-10 cytokine family, which mainly targets epithelial cells and does not target immune cells. Recently, it has been reported that IL-22 play roles in tissue repair in the skin and the liver; however, role of IL-22 in the process of tissue repair after myocardial infarction (MI) is unknown. Here, we investigated the role of IL-22 in tissue repair process after MI.
Methods and results
First, we examined the expression of IL-22 and its receptor IL-22RA1 in the wild type (WT) mice by real-time PCR. The expression of IL-22 and IL-22RA1 in the hearts were significantly increased 3 days after MI (p<0.05). To clarify the role of IL-22 in the heart after MI, we produced MI model in the WT mice and IL-22 knockout (KO) mice. We found that the IL-22 KO mice had significantly higher mortality than the WT mice after MI (p<0.05). Approximately 80% of the IL-22 KO mice died with cardiac rupture after MI. The infarct size which was estimated by evans blue dye and triphenyltetrazolium chloride staining at 3 days after MI was comparable between the IL-22 KO mice and the WT mice. Next, we performed real time PCR and PCR array analysis for tissue fibrosis and repair genes. We found that alpha-smooth muscle actin (aSMA), NF-kB, TNF-a and MMP13 (also known as collagenase-3) were significantly increased in the infarct area of IL-22 KO mice compared to WT mice. Immunostaining showed that the myofibroblast marker aSMA positive cells in the border area after MI were markedly higher in the IL-22 KO mice compared with the WT mice (p<0.05). Approximately 70% of cardiac rupture after MI in the IL-22 KO mice were occurred in the infarct area adjacent to the border area. Furthermore, we found aSMA positive cells and MMP13 positive cells around the ruptured site of the heart.
Conclusion
Thus, IL-22 KO mice exhibit high mortality and increased cardiac rupture after MI. And expression of aSMA and MMP13 were highly expressed in the ruptured site after MI in the IL-22 KO mice. These results suggest that IL-22 may play an important role in the tissue repair process after MI.
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Affiliation(s)
- M Yamamoto
- Cardiovascular Research Institute of Kurume University, Kurume, Japan
| | - H Yasukawa
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - J Takahashi
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Nohara
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - T Sasak
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - K Shimozono
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - T Shibata
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - T Yanai
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - K Okabe
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - K Mawatari
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
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Ikeda M, Maruki Y, Ueno M, Ioka T, Naganuma A, Furukawa M, Mizuno N, Uwagawa T, Nakai Y, Kanai M, Asagi A, Shimizu S, Miyamoto A, Yukisawa S, Kadokura M, Yamanaka T, Arai Y, Shibata T, Morizane C, Okusaka T. Frequency and clinicopathological characteristics of biliary tract carcinomas harboring the FGFR2-fusion gene: A prospective observational study (PRELUDE study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Takami H, Fukushima S, Aoki K, Satomi K, Narumi K, Hama N, Matsushita Y, Fukuoka K, Yamasaki K, Nakamura T, Mukasa A, Saito N, Suzuki T, Yanagisawa T, Nakamura H, Sugiyama K, Tamura K, Maehara T, Nakada M, Nonaka M, Asai A, Yokogami K, Takeshima H, Iuchi T, Kanemura Y, Kobayashi K, Nagane M, Kurozumi K, Yoshimoto K, Matsuda M, Matsumura A, Hirose Y, Tokuyama T, Kumabe T, Ueki K, Narita Y, Shibui S, Totoki Y, Shibata T, Nakazato Y, Nishikawa R, Matsutani M, Ichimura K. Intratumoural immune cell landscape in germinoma reveals multipotent lineages and exhibits prognostic significance. Neuropathol Appl Neurobiol 2019; 46:111-124. [PMID: 31179566 DOI: 10.1111/nan.12570] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/03/2019] [Indexed: 12/13/2022]
Abstract
AIMS Alterations in microenvironments are a hallmark of cancer, and these alterations in germinomas are of particular significance. Germinoma, the most common subtype of central nervous system germ cell tumours, often exhibits massive immune cell infiltration intermingled with tumour cells. The role of these immune cells in germinoma, however, remains unknown. METHODS We investigated the cellular constituents of immune microenvironments and their clinical impacts on prognosis in 100 germinoma cases. RESULTS Patients with germinomas lower in tumour cell content (i.e. higher immune cell infiltration) had a significantly longer progression-free survival time than those with higher tumour cell contents (P = 0.03). Transcriptome analyses and RNA in-situ hybridization indicated that infiltrating immune cells comprised a wide variety of cell types, including lymphocytes and myelocyte-lineage cells. High expression of CD4 was significantly associated with good prognosis, whereas elevated nitric oxide synthase 2 was associated with poor prognosis. PD1 (PDCD1) was expressed by immune cells present in most germinomas (93.8%), and PD-L1 (CD274) expression was found in tumour cells in the majority of germinomas examined (73.5%). CONCLUSIONS The collective data strongly suggest that infiltrating immune cells play an important role in predicting treatment response. Further investigation should lead to additional categorization of germinoma to safely reduce treatment intensity depending on tumour/immune cell balance and to develop possible future immunotherapies.
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Affiliation(s)
- H Takami
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - S Fukushima
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - K Aoki
- Division of Gene and Immune Medicine, National Cancer Center Research Institute, Tokyo, Japan
| | - K Satomi
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - K Narumi
- Division of Gene and Immune Medicine, National Cancer Center Research Institute, Tokyo, Japan
| | - N Hama
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Y Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Fukuoka
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Division of Pediatric Neuro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - K Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - T Nakamura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - A Mukasa
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - N Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - T Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - T Yanagisawa
- Division of Pediatric Neuro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - H Nakamura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Neurosurgery, Kurume University, Fukuoka, Japan
| | - K Sugiyama
- Department of Neurosurgery, Faculty of Medicine, Hiroshima University, Hiroshima, Japan
| | - K Tamura
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Maehara
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - M Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - M Nonaka
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - A Asai
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - K Yokogami
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - H Takeshima
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - T Iuchi
- Department of Neurosurgery, Chiba Cancer Center, Chiba, Japan
| | - Y Kanemura
- Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Japan.,Department of Biomedical Research and Innovation, Institute for Clinical Research, Osaka National Hospital, National Hospital Organization, Osaka, Japan
| | - K Kobayashi
- Department of Neurosurgery, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - M Nagane
- Department of Neurosurgery, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - K Kurozumi
- Department of Neurological Surgery, Dentistry, and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - K Yoshimoto
- Department of Neurosurgery, Kyusyu University Hospital, Fukuoka, Japan
| | - M Matsuda
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - A Matsumura
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - Y Hirose
- Department of Neurosurgery, Fujita Health University Hospital, Aichi, Japan
| | - T Tokuyama
- Department of Neurosurgery, Hamamatsu University Hospital, Shizuoka, Japan
| | - T Kumabe
- Department of Neurosurgery, Kitasato University, Kanagawa, Japan
| | - K Ueki
- Department of Neurosurgery, Dokkyo Medical Univeristy, Tochigi, Japan
| | - Y Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Shibui
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Totoki
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - T Shibata
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Y Nakazato
- Department of Pathology, Hidaka Hospital, Gunma, Japan
| | - R Nishikawa
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - M Matsutani
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - K Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
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Affiliation(s)
- R. P. Joshi
- Graduate School of Life Science and System Engineering, Kyushu Institute of Technology, Wakamatsu, Kitakyushu, Japan
| | - N. Koganti
- Graduate School of Information Science, Nara Institute of Science and Technology, Ikoma, Nara Japan
| | - T. Shibata
- Graduate School of Life Science and System Engineering, Kyushu Institute of Technology, Wakamatsu, Kitakyushu, Japan
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Sato N, Yoshimoto S, Kohara N, Eguchi K, Tsuruta Y, Yagi M, Shibata T, Ichihashi M, Ando H. 798 Autophagosome-like vacuoles in vitiligo melanocytes are associated with cell viability and intracellular glutathione levels. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.874] [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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Doi N, Izaki T, Miyake S, Shibata T, Ishimatsu T, Shibata Y, Yamamoto T. Intraoperative evaluation of blood flow for soft tissues in orthopaedic surgery using indocyanine green fluorescence angiography: A pilot study. Bone Joint Res 2019; 8:118-125. [PMID: 30997037 PMCID: PMC6444017 DOI: 10.1302/2046-3758.83.bjr-2018-0151.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objectives Indocyanine green (ICG) fluorescence angiography is an emerging technique that can provide detailed anatomical information during surgery. The purpose of this study is to determine whether ICG fluorescence angiography can be used to evaluate the blood flow of the rotator cuff tendon in the clinical setting. Methods Twenty-six patients were evaluated from October 2016 to December 2017. The participants were categorized into three groups based on their diagnoses: the rotator cuff tear group; normal rotator cuff group; and adhesive capsulitis group. After establishing a posterior standard viewing portal, intravenous administration of ICG at 0.2 mg/kg body weight was performed, and fluorescence images were recorded. The time from injection of the drug to the beginning of enhancement of the observed area was measured. The hypovascular area in the rotator cuff was evaluated, and the ratio of the hypovascular area to the anterolateral area of the rotator cuff tendon was calculated (hypovascular area ratio). Results ICG fluorescence angiography allowed for visualization of blood flow in the rotator cuff in all groups. The adhesive capsulitis group showed significantly earlier enhancement than the other groups. Furthermore, the adhesive capsulitis group had a significantly smaller hypovascular area ratio than the other groups. Conclusion ICG fluorescence angiography allowed for evaluation of real-time blood flow of the rotator cuff in arthroscopic shoulder surgery. The techniques of ICG fluorescence angiography are simple and easy to observe, observer reliability is high, and it has utility for evaluating blood flow during surgery.Cite this article: N. Doi, T. Izaki, S. Miyake, T. Shibata, T. Ishimatsu, Y. Shibata, T. Yamamoto. Intraoperative evaluation of blood flow for soft tissues in orthopaedic surgery using indocyanine green fluorescence angiography: A pilot study. Bone Joint Res 2019;8:118-125. DOI: 10.1302/2046-3758.83.BJR-2018-0151.R1.
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Affiliation(s)
- N Doi
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - T Izaki
- Chief of Shoulder Surgery Department, Fukuoka University, Fukuoka, Japan
| | - S Miyake
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - T Shibata
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - T Ishimatsu
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Y Shibata
- Department of Orthopaedic Surgery, Fukuoka University, Chikushi Hospital, Fukuoka, Japan
| | - T Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Nozaki M, Kagami Y, Takahashi M, Machida R, Shibata T, Ito Y, Nishimura Y, Kawaguchi Y, Saito Y, Nagata Y, Matsumoto Y, Akimoto T, Hoiraoka M. EP-1276 A Comparison of Breast Cosmetic Evaluation Methods in Hypofractionated Whole Breast Irradiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hojo T, Masuda N, Shibata T, Mizutani T, Shien T, Kinoshita T, Iwatani T, Kanbayashi C, Kitagawa D, Tsuneizumi M, Iwata H. Abstract OT2-01-05: A randomized controlled trial comparing post-operative intensive follow-up with standard follow-up in high-risk breast cancer patients (JCOG1204: INSPIRE). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-01-05] [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: 11/16/2022]
Abstract
Abstract
Background: The standard follow-up after surgery for breast cancer includes periodic interviews, clinical examinations, and mammography, but many institutions are conducting intensive follow-up including periodic computed tomography(CT), magnetic resonance imaging(MRI), and bone scintigraphy in the world, despite the lack of evidence to support this approach. While intensive follow-up may contribute to prolonged survival through earlier diagnosis and treatment of relapse, it has the disadvantages of high effort and costs placed on patients(pts) and healthcare workers, radiation exposure for imaging examinations, and overtreatment owing to false-positive results. Although past two randomized trials could not show significant difference in overall survival (OS), as imaging methods have remarkably improved, leading to the earlier detection of relapse, and medical therapies have remarkably improved in recent years, randomized controlled trials are needed to confirm whether intensive follow-up can really prolong survival sufficiently to offset these disadvantages in high-risk breast cancer pts.
Trial design: This study is a multi-institutional two-arm open label randomized controlled phase III trial being conducted with the participation of 42 hospitals belonging to the Breast Cancer Study Group of Japan Clinical Oncology Group. Eligible pts are randomized either to the intensive follow-up group or to the standard follow-up group; the former will undergo physical examination, bone scintigraphy, chest and abdominal CT, brain MRI/CT and frequent tumor markers, whereas the latter will undergo physical examination at the same frequency and tumor markers will be evaluated once a year. Mammography once a year is planned for both groups. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000012429.
Eligibility criteria: High-risk breast cancer pts, who are expected to have recurrence rates of over 30% within 5 years after surgery. The main inclusion criteria are as follows: four or more axillary nodal metastases in the estrogen receptor (ER) positive pts without neoadjuvant chemotherapy(NC)., axillary node metastases in ER-negative pts without NC, axillary nodal metastases in ER-positive pts with NC, histologically proven residual invasive cancer in the breast or axilla in ER-negative with NC.
Specific Aims: The primary endpoint is OS, and secondary endpoints are disease-free survival, relapse-free survival, distant metastasis–free survival, OS in intrinsic subtypes, actual number of implemented examinations, compliance with pre-specified examinations, and adverse events.
Statistical methods: The primary endpoint will require a total of 538 events to be assessed in order to obtain a statistical power of 80% with a one-sided significance level of 0.05. Thus, the planned sample size to compare the two survival curves is set at 1500 pts, assuming an accrual time of 6 years and a follow-up time of 7 years according to the Schoenfeld and Richter's method.
Present accrual and target accrual: The trial was activated in November 2013. 773 pts have been enrolled by the end of June 2018.
Contact: Principal investigator Takashi Hojo MD tahojo@east.ncc.go.jp
Citation Format: Hojo T, Masuda N, Shibata T, Mizutani T, Shien T, Kinoshita T, Iwatani T, Kanbayashi C, Kitagawa D, Tsuneizumi M, Iwata H. A randomized controlled trial comparing post-operative intensive follow-up with standard follow-up in high-risk breast cancer patients (JCOG1204: INSPIRE) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-01-05.
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Affiliation(s)
- T Hojo
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - N Masuda
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Shibata
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Mizutani
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Shien
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Kinoshita
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Iwatani
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - C Kanbayashi
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - D Kitagawa
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Tsuneizumi
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
| | - H Iwata
- National Cancer Center Hospital East, Chiba, Japan; NHO Osaka National Hospital, Osaka, Japan; National Cancer Center Hospital, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; St. Marianna University School of Medicine, Kanagawa, Japan; Niigata Cancer Center, Niigata, Japan; Cancer Institute Hospital, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Aichi Cancer Center Hospital, Nagoya, Japan
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Shibata T, Takita K, Inomata M. Observation of the cytoarchitecture of the human esophageal mucosa with special attention to the lamina muscularis mucosae and the distribution of lymphatic vessels. Esophagus 2019; 16:44-51. [PMID: 30073428 DOI: 10.1007/s10388-018-0632-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/29/2018] [Indexed: 02/03/2023]
Abstract
The cytoarchitecture of the esophageal mucosa was examined by using light microscopy, transmission electron microscopy, and scanning electron microscopy. The cytoarchitecture of the muscularis mucosae varied greatly among the cervical, thoracic, and abdominal esophagus, especially in the cervical esophagus, the muscularis mucosae suffered a loss and the distribution of lymphatic vessels also varied according to the site. It was suggested that these morphological differences would have a strong influence on the infiltration of esophageal cancer and the mode of lymph node metastasis.
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Affiliation(s)
- Tomotaka Shibata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Yufu, Oita, 879-5593, Japan.
| | - Kaoruko Takita
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Yufu, Oita, 879-5593, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Idaigaoka 1-1, Yufu, Oita, 879-5593, Japan
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Takahashi S, Nishide T, Anada M, Kinoshita T, Shibata T. Feasibility of Hippocampal Dose–Volume Parameters Associated with Memory Decline in Volumetric Modulated Arc Therapy for Supratentorial Tumors. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1097] [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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