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Osoegawa A, Abe M, Miyawaki M, Karashima T, Takumi Y, Takamori S, Sugio K. Challenges in Robotic Lung Lobectomy through the Anterior Approach. Ann Thorac Cardiovasc Surg 2024; 30:n/a. [PMID: 38030280 PMCID: PMC10902646 DOI: 10.5761/atcs.oa.23-00146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Robot-assisted thoracic surgery (RATS) has become popular because of its minimally invasive nature and reduced burden on surgeons. The anterior approach (AA) is beneficial because it utilizes the same field of view and procedures as thoracotomy and video-assisted thoracic surgery, although the disadvantages are less well-known. METHODS We retrospectively examined 35 consecutive patients who underwent RATS lobectomy via the AA, focusing on clinical factors and postoperative complications. RESULTS The study included 12 males and 23 females with a median console time of 177 (120-346) min, median blood loss of 0 (0-100) mL, and median stapler usage of 5 (2-10) units. Postoperative complications, classified as Clavien-Dindo grade ≥III, included three cases of grade IIIa (prolonged air leakage) and one case each of grade IIIb and grade IVa (middle lobe torsion and ventricular arrhythmia). The influence of stapling device operation cannot be ruled out in prolonged air leakage and middle lobe torsion. A moderate correlation (correlation coefficient = 0.492, p = 0.003) was observed between console time and the number of staplers used. CONCLUSION Although no severe incidence of vascular injury was observed with the AA, complications related to the use of stapling devices were noted.
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Affiliation(s)
- Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Takashi Karashima
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Shinkichi Takamori
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan
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Miyawaki M, Karashima T, Abe M, Takumi Y, Hashimoto T, Kamohara R, Osoegawa A, Sugio K. Giant benign intrathoracic schwannoma: a decade-long progression towards fatality. J Cardiothorac Surg 2023; 18:328. [PMID: 37964272 PMCID: PMC10648700 DOI: 10.1186/s13019-023-02375-2] [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: 03/08/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Intrathoracic neurogenic tumors arise from sympathetic nerve trunks and intercostal nerves; more than 90% are benign. Schwannomas are the most common histological variety, but fatalities due to giant schwannomas are rare. CASE PRESENTATION We report a case of a 65-year-old woman who presented with chest pain and cough. Computed tomography (CT) revealed a large left chest wall mass of 130-mm in size, and the patient was referred to our department. Tumor biopsy was performed under local anesthesia, and a diagnosis of schwannoma was made. Ten years previously, a 30-mm tumor had been noted in the left third intercostal space by a previous doctor, but follow-up had been interrupted owing to depressive disorder. Although we planned to perform intercostal artery embolization followed by chest wall tumor resection, the patient did not consent to surgery due to uncontrolled depression. After four months, she developed respiratory failure caused by compression due to an enlarged tumor and died. Autopsy also revealed a benign schwannoma with no malignant findings. CONCLUSIONS Although schwannomas are benign tumors, there are some very rare cases in which they can become huge and life-threatening. Therefore, a benign tumor should not be neglected, and if surgery is not possible at the time of diagnosis, a regular follow up is necessary, in order not to miss the right timing for surgery.
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Affiliation(s)
- Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan.
- Department of Thoracic Surgery, Oita Prefectural Hospital, 8-1 Bunyo 2-chome, Oita, 870-8511, Japan.
| | - Takashi Karashima
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
| | - Ryotaro Kamohara
- Department of Thoracic Surgery, Oita Prefectural Hospital, 8-1 Bunyo 2-chome, Oita, 870-8511, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi Yufu, Oita, 879-5593, Japan
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Osoegawa A, Karashima T, Takumi Y, Sato T, Abe M, Hashimoto T, Sugio K. Osimertinib as first-line treatment for recurrent lung cancer patients with EGFR mutation. J Thorac Dis 2023; 15:5566-5573. [PMID: 37969303 PMCID: PMC10636461 DOI: 10.21037/jtd-23-537] [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: 04/01/2023] [Accepted: 08/18/2023] [Indexed: 11/17/2023]
Abstract
Background Although osimertinib was approved as adjuvant therapy for lung cancer patients with EGFR mutation in various countries, there is still some ongoing debate as osimertinib has been approved based on disease-free survival (DFS) rather than overall survival (OS). We curated a case series in which we documented patterns of recurrence and efficacy and safety of osimertinib after recurrence. Methods Patients who received osimertinib as first-line treatment for postoperative recurrence between September 2018 and January 2023 were included. Clinicopathological factors, duration of osimertinib treatment (DoT), and adverse events were collected and analyzed. Results Twenty patients received osimertinib [male, n=6; median age, 75 years (range, 55-85 years)]. The EGFR mutation type was L858R in 11 patients and exon 19 deletion in eight patients. The performance status (PS) was 0 or 1 in all but two patients, who had symptomatic brain metastasis and were therefore PS 3. The first site of postoperative recurrence was locoregional in five patients and distant in 15 patients, including seven with brain metastasis. As of February 2023, 10 patients were still on osimertinib, including three with brain metastasis. Patients with brain metastasis or poor PS had a considerably shorter DoT than their counterparts. Three patients with symptomatic brain metastasis or leptomeningeal metastasis initially responded to osimertinib, but all died of disease progression. Five patients discontinued osimertinib due to serious adverse effects (pneumonitis, drug eruption, and heart failure). Conclusions Although osimertinib exerts great disease control, even in patients with brain metastasis or poor PS, their presence was associated with a poor prognosis, even with osimertinib treatment. Therefore, adjuvant osimertinib is recommended unless contraindicated.
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Affiliation(s)
- Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Takashi Karashima
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Takahiro Sato
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
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Osoegawa A, Abe M, Takumi Y, Hashimoto T, Karashima T, Miyawaki M, Sugio K. Significance of programmed death-ligand 1 expression in resected lung cancer and its relationship with EGFR mutation. Thorac Cancer 2023; 14:2467-2472. [PMID: 37455369 PMCID: PMC10447166 DOI: 10.1111/1759-7714.15031] [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: 05/25/2023] [Revised: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Several studies have reported that the high expression of programmed death-ligand 1 (PD-L1) within tumor cells predicts a poor prognosis. However, the relationship between the PD-L1 expression and lymph node metastasis or driver mutations in lung cancer remains poorly understood. METHODS A total of 356 consecutive patients who underwent surgical resection for primary lung cancer were included in the study. There were 268 adenocarcinomas including 100 EGFR mutations, 67 squamous cell carcinomas (Sq), and 21 other histologies. The high expression of PD-L1 was defined as a tumor proportion score (TPS) of ≥50. The relationship between the PD-L1 expression and clinicopathological factors and recurrence-free survival (RFS) was analyzed. RESULTS The PD-L1 expression was high in 75 patients. It was significantly related to smoking history, Sq histology, driver mutation negative, elevated serum carcinoembryonic antigen levels, and lymph node metastasis. Among patients with driver mutations, a high PD-L1 TPS was found in patients with EGFR G719X mutation. A significant difference in RFS was observed in adenocarcinoma patients. A multivariate analysis of adenocarcinoma cases revealed that tumor size and lymph node metastasis were independent prognostic factors for poor RFS, while the PD-L1 expression was not. A logistic regression analysis revealed that the absence of driver mutations, lymph node metastasis, and a history of smoking were significantly associated with the high expression of PD-L1. CONCLUSION Lymph node metastasis was positively related with the high expression of PD-L1, resulting in poor RFS. A high PD-L1 TPS was observed in patients with the EGFR G719X mutation.
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Affiliation(s)
- Atsushi Osoegawa
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Miyuki Abe
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Yohei Takumi
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Takashi Karashima
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
| | - Kenji Sugio
- Department of Thoracic and Breast SurgeryOita University Faculty of MedicineYufuJapan
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Takumi Y, Arai S, Suzuki C, Fukuda K, Nishiyama A, Takeuchi S, Sato H, Matsumoto K, Sugio K, Yano S. MET kinase inhibitor reverses resistance to entrectinib induced by hepatocyte growth factor in tumors with NTRK1 or ROS1 rearrangements. Cancer Med 2023; 12:5809-5820. [PMID: 36416133 PMCID: PMC10028024 DOI: 10.1002/cam4.5342] [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: 02/20/2022] [Revised: 07/06/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Entrectinib is an effective drug for treating solid tumors with NTRK gene rearrangement and non-small cell lung cancer (NSCLC) with ROS1 gene rearrangement. However, its efficacy is limited by tolerance and acquired resistance, the mechanisms of which are not fully understood. The growth factors produced by the tumor microenvironment, including hepatocyte growth factor (HGF) produced by tumor-associated fibroblasts, critically affect the sensitivity to targeted drugs. METHODS We investigated whether growth factors that can be produced by the microenvironment affect sensitivity of NTRK1-rearranged colon cancer KM12SM cells and ROS1-rearranged NSCLC HCC78 cells to entrectinib both in vitro and in vivo. RESULTS Among the growth factors assessed, HGF most potently induced entrectinib resistance in KM12SM and HCC78 cells by activating its receptor MET. HGF-induced entrectinib resistance was reversed by the active-HGF-specific macrocyclic peptide HiP-8 and the MET kinase inhibitor capmatinib in vitro. In addition, HGF-producing fibroblasts promoted entrectinib resistance in vitro (culture model) and in vivo (subcutaneous tumor model). The use of capmatinib circumvented entrectinib resistance in a subcutaneous tumor model inoculated with KM12SM and HGF-producing fibroblasts. CONCLUSION Our findings suggest that growth factors in the tumor microenvironment, such as HGF, may induce resistance to entrectinib in tumors with NTRK1 or ROS1 rearrangements. Our results further suggest that optimally co-administering inhibitors of resistance-inducing growth factors may maximize the therapeutic efficacy of entrectinib.
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Affiliation(s)
- Yohei Takumi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Sachiko Arai
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Chiaki Suzuki
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Koji Fukuda
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Shinji Takeuchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Hiroki Sato
- Division of Tumor Dynamics and Regulation, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Kunio Matsumoto
- Division of Tumor Dynamics and Regulation, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
- Department of Respiratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa, Japan
- WPI-Nano Life Science Institute (WPI-Nano LSI), Kanazawa University, Kanazawa, Japan
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6
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Miyawaki M, Ogawa K, Kamada K, Karashima T, Abe M, Takumi Y, Hashimoto T, Osoegawa A, Sugio K. Tracheal injury from dog bite in a child. J Cardiothorac Surg 2023; 18:26. [PMID: 36647124 PMCID: PMC9841626 DOI: 10.1186/s13019-023-02107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Dog bites associated with the head and neck area in children are a common problem. Most of the lacerations are found in the upper lip and the nose region, and tracheal injury is rare [1]. Tracheal injury requires prompt and accurate diagnosis and treatment to rescue the patient. Especially in children, securing the airway is often more difficult than in adults because of their short neck and narrow trachea. In this report, we experienced a pediatric case of multiple dog bites with tracheal injuries in the neck. CASE PRESENTATION We report the case of a 3-year-old girl who presented with multiple dog bites. There were multiple wounds on the head, face, neck, and anterior chest, and air leakage was observed from the cervical wound at the time of transfer. It was difficult to perform oral endotracheal intubation, therefore, we extended the neck wound, probed the trachea with finger, and inserted a tracheal tube directly from the cervical wound in the emergency room. Tracheoplasty and another wound cleansing were performed in the operating room. The patient was discharged on the 18th day after surgery, without further complications. CONCLUSION Tracheal injury from a dog bite is rare. It is important to prompt and accurate diagnosis and treatment. Children should be especially careful because of their short necks and narrow tracheas.
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Affiliation(s)
- Michiyo Miyawaki
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Kazuya Ogawa
- grid.412334.30000 0001 0665 3553Department of Pediatrics, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Kosuke Kamada
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Takashi Karashima
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Miyuki Abe
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Yohei Takumi
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Takafumi Hashimoto
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Atsushi Osoegawa
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Kenji Sugio
- grid.412334.30000 0001 0665 3553Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka Hasama-machi, Yufu, Oita 879-5593 Japan
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Suzuki C, Nishiyama A, Arai S, Tange S, Tajima A, Tanimoto A, Fukuda K, Takumi Y, Kotani H, Takeuchi S, Yanagimura N, Ohtsubo K, Yamamoto N, Omori K, Yano S. Inhibition of EGFR and MEK surmounts entrectinib resistance in a brain metastasis model of NTRK1-rearranged tumor cells. Cancer Sci 2022; 113:2323-2335. [PMID: 35363931 PMCID: PMC9277414 DOI: 10.1111/cas.15354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/14/2022] [Accepted: 03/19/2022] [Indexed: 11/29/2022] Open
Abstract
Tropomyosin receptor kinase (TRK) inhibitors have demonstrated histology-agnostic efficacy in patients with neurotrophic receptor tyrosine kinase (NTRK) gene fusion. Although responses to TRK inhibitors can be dramatic and durable, duration of response may eventually be limited by acquired resistance via several mechanisms, including resistance mutations such as NTRK1-G595R. Repotrectinib is a second-generation TRK inhibitor, which is active against NTRK1-G595R. However, its efficacy against entrectinib-resistant tumors has not been fully elucidated. In the present study, we established entrectinib-resistant tumor cells (M3B) in a brain metastasis model inoculated with NTRK1-rearranged KM12SM cells, and examined the sensitivity of M3B cells to repotrectinib. While M3B cells harbored the NTRK1-G595R mutation, they were unexpectedly resistant to repotrectinib. The resistance was due to extracellular signal-regulated kinase (ERK) reactivation partially mediated by epidermal growth factor receptor (EGFR) activation. We further demonstrate that the triplet combination of repotrectinib, EGFR inhibitor, and MEK inhibitor could sensitize M3B cells in vitro as well as in a brain metastasis model. These results indicate that resistant mutations, such as NTRK1-G595R, and alternative pathway activation, such as ERK activation, could simultaneously occur in entrectinib-resistant tumors, thereby causing resistance to second-generation inhibitor repotrectinib. These findings highlight the importance of intensive examinations to identify resistance mechanisms and application of the appropriate combination treatment to circumvent the resistance.
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Affiliation(s)
- Chiaki Suzuki
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan.,Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Sachiko Arai
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Shoichiro Tange
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Azusa Tanimoto
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Koji Fukuda
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Yohei Takumi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Hiroshi Kotani
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Shinji Takeuchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Naohiro Yanagimura
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Koushiro Ohtsubo
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan.,Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.,Nano Life Science Institute, Kanazawa University, Kanazawa, Japan
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8
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Sakaguchi H, Tanimoto A, Sato S, Yanagimura N, Suzuki C, Takumi Y, Nishiyama A, Yamashita K, Takeuchi S, Ohtsubo K, Yano S. Mediastinal Malignant Melanoma Markedly Shrinking in Response to Nivolumab. Intern Med 2022; 61:75-79. [PMID: 34176837 PMCID: PMC8810244 DOI: 10.2169/internalmedicine.7452-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary malignant melanoma (MM) of the mediastinum is rare, and there is a lack of consensus regarding the preferred treatment because non-cutaneous MM demonstrates an inferior response to systemic therapy. Herein, we describe the case of a 73-year-old man with MM of the anterior mediastinum with multiple liver metastases. Even though the size of lesions increased rapidly following diagnosis, nivolumab monotherapy caused remarkable tumor shrinkage. This is the first report of mediastinal MM showing a significant response to nivolumab. We, therefore, suggest that immunotherapy may be one of the treatment options for primary mediastinal MM.
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Affiliation(s)
- Hiroyuki Sakaguchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Azusa Tanimoto
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Shigeki Sato
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Naohiro Yanagimura
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Chiaki Suzuki
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Yohei Takumi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Kaname Yamashita
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Shinji Takeuchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Koshiro Ohtsubo
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
- WPI-Nano Life Science Institute (WPI-Nano LSI), Kanazawa University, Japan
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9
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Okamoto T, Miyawaki M, Toyokawa G, Karashima T, Abe M, Takumi Y, Hashimoto T, Osoegawa A, Tagawa T, Takeuchi H, Shimokawa M, Sugio K. Clinical significance of part-solid lung cancer in the eighth edition TNM staging system. Interact Cardiovasc Thorac Surg 2021; 34:219-226. [PMID: 34561707 PMCID: PMC8766204 DOI: 10.1093/icvts/ivab255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/01/2021] [Accepted: 08/16/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The ground-glass component of part-solid tumour (PST) was eliminated as a clinical T (cT) descriptor in the eighth edition of the tumour, node and metastasis (TNM) staging system. We aimed to validate the new cT descriptor and investigate the prognostic impact of PST in the new staging system. METHODS Non-small-cell lung cancer (NSCLC) patients (n = 1061) who underwent lung resection and were available for the assessment of thin-section computed tomography images were retrospectively reviewed. Tumours with a solid component (SC) size-to-whole tumour size (STR) ratio of 0, those with 0 < STR < 1 and those with an STR of 1 were defined as pure ground-glass tumours, PSTs and solid tumours (STs), respectively. RESULTS Tumours with an SC diameter of >30 mm were less frequently observed among PSTs than among STs (4.83% vs 32.6%, P < 0.001). The postoperative 5-year survival of NSCLC patients with ground-glass tumour, PST and ST was 97.6%, 89.0% and 76.3%, respectively. In the survival analysis of patients with an SC diameter ≤30 mm, significant differences were observed among PST and ST (5-year survival, 90.7% vs 74.6%, P < 0.001). The multivariable analysis showed that age <70 years old, female sex, procedures with a lobectomy or more, SC size, pN0 disease and PST were independent predictors of a better survival among all PST and ST patients. CONCLUSIONS Among patients with cT1 tumours, those with PST showed a significantly better survival than did those with ST. Small-sized PST tumours may not be suitable for the new cT descriptor.
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Affiliation(s)
- Tatsuro Okamoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.,Department of Surgery and Science, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Gouji Toyokawa
- Department of Surgery and Science, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Takashi Karashima
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Atsuhi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan.,Department of Surgery and Science, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Tetsuzo Tagawa
- Department of Surgery and Science, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Hideya Takeuchi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Mototsugu Shimokawa
- Biostatistics Laboratory, Clinical Research Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.,Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
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10
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Sato S, Tanimoto A, Yanagimura N, Suzuki C, Takumi Y, Nishiyama A, Yamashita K, Takeuchi S, Ohtsubo K, Makino T, Yoshida Y, Hirono Y, Hayashi R, Koizumi T, Nakazawa Y, Ito KI, Motoo Y, Uramoto H, Nakada M, Nishino Y, Yano S. Multi-institutional survey of cancer disparities in disabled patients in the region of northwestern Japan. Int J Clin Oncol 2021; 26:1009-1014. [PMID: 33646436 DOI: 10.1007/s10147-021-01890-3] [Citation(s) in RCA: 3] [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: 10/12/2020] [Accepted: 02/15/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Potential disparities between cancer patients with and without disabilities remained to be validate in Japan. METHODS We surveyed retrospective data on hospital cancer registration as well as information on disability certificates obtained through the Hokushin Ganpro database. In total, 93,545 cancer patients in 10 principal hospitals covering the region of northwestern Japan were registered with the Hokushin Ganpro database between 2010 and 2015. The database included the following data: diagnosis date, cancer type, staging, treatment, cancer detection process, and possession of a disability certificate. RESULTS We found that 2983 patients, which accounted for 3.2% of the total patients, had disabilities. No significant differences in gender, age at diagnosis, cancer stage distribution, and cancer incidence rates were observed between the disabled and non-disabled patients. Even though the proportion of early-stage cancer among disabled patients differed only slightly from that in non-disabled patients, early-stage cancer was more frequently diagnosed in patients with disabilities during their regular hospital visits than in those without disabilities, who had more opportunity for early cancer detection during cancer screening. According to in-house data reflecting treatment period and process from a single hospital, all 16 disabled patients treated with chemotherapy completed the treatment until disease progression or end of predetermined cycles. CONCLUSION These results indicate that deep disparities between cancer patients with and without disabilities are not apparent and that the disabled patients in the region of northwestern Japan receive appropriate hospital follow-up.
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Affiliation(s)
- Shigeki Sato
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Azusa Tanimoto
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan.
| | - Naohiro Yanagimura
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Chiaki Suzuki
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Yohei Takumi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Kaname Yamashita
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Shinji Takeuchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Koushiro Ohtsubo
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
| | - Tomoe Makino
- Division of Adult Nursing Practice, Ishikawa Prefectural Nursing University, Kahoku, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuo Hirono
- Cancer Care Promotion Center, University of Fukui Hospital, Fukui, Japan
| | - Ryuji Hayashi
- Clinical Oncology, Toyama University Hospital, Toyama, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ken-Ichi Ito
- Department of Breast and Endocrine Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshiharu Motoo
- Department of Medical Oncology, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-0934, Japan
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11
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Kamei M, Fujitomi Y, Kondo Y, Adachi T, Shibata K, Takumi Y, Abe M, Sugio K. Cancer-associated retinopathy after surgery for breast cancer: a case report and review of the literature. Surg Case Rep 2018; 4:10. [PMID: 29362998 PMCID: PMC5780336 DOI: 10.1186/s40792-018-0418-3] [Citation(s) in RCA: 3] [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: 09/18/2017] [Accepted: 01/15/2018] [Indexed: 11/12/2022] Open
Abstract
We herein report a 50-year-old Japanese woman with breast cancer who complained of blurred vision and central scotoma in her left eye on the 12th day after surgery. Subsequently, the sudden-onset binocular visual disorder progressed, and she was diagnosed with cancer-associated retinopathy (CAR) based on the clinical findings. Although her visual acuity temporarily improved following the start of adjuvant chemotherapy, reductions in her visual acuity progressed once again. After two courses of steroid pulse therapy initiated from the 59th day following the onset of CAR, although her visual field was still constricted, her binocular visual acuity improved from finger movement to 0.8 2 months later. The shorter the period from onset to treatment, the better the prognosis of the visual function. However, a diagnosis is often delayed because the incidence of this disease is very rare. Therefore, it is important to suspect CAR whenever a sudden visual disorder develops in cancer patients. Furthermore, treatment is believed to be effective even if steroid therapy is started up to 2 months from onset.
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Affiliation(s)
- Mirei Kamei
- Department of Surgery, Tsurumi Hospital, 4333 Tsurumi, Beppu, Oita, 874-8585, Japan.
| | - Yutaka Fujitomi
- Department of Surgery, Tsurumi Hospital, 4333 Tsurumi, Beppu, Oita, 874-8585, Japan
| | - Yoshiyuki Kondo
- Department of Pathology, Tsurumi Hospital, 4333 Tsurumi, Beppu, Oita, 874-8585, Japan
| | - Toru Adachi
- Department of Ophthalmology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5503, Japan
| | - Kohei Shibata
- Department of Surgery, Tsurumi Hospital, 4333 Tsurumi, Beppu, Oita, 874-8585, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5503, Japan
| | - Miyuki Abe
- Department of Surgery, Tsurumi Hospital, 4333 Tsurumi, Beppu, Oita, 874-8585, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5503, Japan
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12
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Osoegawa A, Hiraishi H, Hashimoto T, Takumi Y, Abe M, Takeuchi H, Miyawaki M, Okamoto T, Sugio K. The Positive Relationship Between γH2AX and PD-L1 Expression in Lung Squamous Cell Carcinoma. In Vivo 2018; 32:171-177. [PMID: 29275316 PMCID: PMC5892638 DOI: 10.21873/invivo.11221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 09/19/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIM Lung squamous cell carcinoma often arises from precancerous lesions where alterations in tumor suppressor genes and subsequent chromosomal instability are often observed due to carcinogen exposure. These tumors are often immunogenic; as such, immune checkpoint inhibitors are a promising therapeutic option. We hypothesized that the DNA damage response in tumor cells induces an immune response, thereby up-regulating programmed death-ligand 1 (PD-L1) expression on tumor cells, which in turn sensitizes them to anti-PD-1 therapy. PATIENTS AND METHODS An immunohistochemical analysis was performed in 41 consecutive lung squamous cell carcinoma patients who underwent surgery at our institution between April 2013 and March 2014. RESULTS The analysis revealed a high PD-L1 expression in 15 patients (37%) (p=0.028). The PD-L1 expression was positively associated with the nuclear γH2AX expression (p=0.02), that was confirmed by immunofluorescent staining. CONCLUSION Our findings demonstrate that nuclear γH2AX expression is positively associated with the PD-L1 expression in lung squamous cell carcinoma.
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Affiliation(s)
- Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Hitomi Hiraishi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Hideya Takeuchi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Tatsuro Okamoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Yufu, Japan
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13
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Takeuchi H, Abe M, Takumi Y, Hashimoto T, Kobayashi R, Osoegawa A, Miyawaki M, Okamoto T, Sugio K. The prognostic impact of the platelet distribution width-to-platelet count ratio in patients with breast cancer. PLoS One 2017; 12:e0189166. [PMID: 29216259 PMCID: PMC5720724 DOI: 10.1371/journal.pone.0189166] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 11/20/2017] [Indexed: 11/19/2022] Open
Abstract
Activated platelets promote tumor cell growth, angiogenesis, and invasion. Platelet activity can be inferred by platelet volume indices (PVIs), which include platelet distribution width (PDW), mean platelet volume (MPV), platelet distribution width-to-platelet count ratio (PDW/P), and mean platelet volume-to-platelet count ratio. Platelets and platelet-related markers, such as the platelet-to-lymphocyte ratio, have been found to be significant prognostic factors in patients with breast cancer. However, the role of PVIs for predicting survival in breast cancer remains unknown; hence, we performed this retrospective analysis of 275 patients with breast cancer. PVIs were compared with clinicopathological variables, and were assessed to identify independent indicators associated with disease-free survival (DFS) using the Cox proportional hazards model. An elevated PDW/P significantly correlated with age and HER2 status. Univariate analysis revealed that elevated PDW, MPV, and PDW/P as well as tumor size, nuclear grade, and lymph node involvement were significantly associated with inferior DFS rates (tumor size: p<0.01; nuclear grade, lymph node involvement, PDW, MPV, and PDW/P: p<0.05). On multivariate analysis, a large tumor size and elevated PDW/P were significant prognostic factors for DFS, with hazard ratios of 3.24 (95% confidence interval [CI]: 1.24-8.47) and 2.99 (95% CI: 1.18-7.57), respectively (p<0.05). Our study is the first to reveal that an elevated PDW/P significantly reduces DFS in patients with breast carcinoma. Measuring the PDW/P is simple, relatively inexpensive, and almost universally available using routine blood counts; this makes it an attractive biomarker for improved risk assessment.
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Affiliation(s)
- Hideya Takeuchi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
- * E-mail:
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Ryoji Kobayashi
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Tatsuro Okamoto
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
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14
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Osoegawa A, Hashimoto T, Takumi Y, Kobayashi R, Miyawaki M, Takeuchi H, Okamoto T, Sugio K. P3.02-039 Acquired Resistance to EGFR-TKI in the Uncommon EGFR Mutation, G719S. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Osoegawa A, Yamada T, Hashimoto T, Takumi Y, Kobayashi R, Suehiro S, Miyawaki M, Takeuchi H, Okamoto T, Sugio K. Abstract 4107: Acquired resistance to EGFR-TKI in an uncommon G719S EGFR mutation. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Acquired resistance (AR) to EGFR-TKI is a common event and several underlying mechanisms, including T790M, MET amplification and PTEN downregulation have been reported for the common EGFR mutations: Deletion 19 and L858R. An EGFR G719X mutation is an uncommon mutation that was reported to show sensitivity to EGFR-TKIs in a series of clinical reports and experiments using transformed cultured cells. However, no established lung cancer or resistant cell lines harboring the EGFR G719X mutation have been reported in the literature. We established a lung adenocarcinoma cell line (G719S-GR) from the malignant pleural effusion of a patient whose tumor developed acquired resistance from initial treatment with gefitinib.
Materials and methods: G719S-GR cells were established and maintained in RPMI1640 medium supplemented with 10%FBS and 10 μM ROCK inhibitor (Y-27632, Wako). The ROCK inhibitor was removed from the medium for the following experiments. Cell growth inhibition was examined with gefitinib and afatinib using CellTiter-Glo (Promega), and a comprehensive genomic analysis was performed using hybrid capture-based NGS (NCC oncopanel, Agilent; MiSeq, Illumina) for G719S-GR and MLPA (Salsa, MRC-holland) was used for the analysis of clinical tumor samples.
Results: A cell growth inhibition test revealed EGFR-TKI resistance in G719S-GR cells with an LC50 of more than 100 μM for either gefitinib or afatinib, indicating that the G719S-GR cells are also resistant to EGFR-TKI in vitro. The NGS analysis showed that G719S-GR cells harbor EGFR mutations (G719S and E709A) as well as the amplification of EGFR, IL7R, MYC and the FGFR1 locus. The homozygous deletion of CDKN2A and the loss of PTEN and TSC1 were also detected. In order to estimate the mechanism underlying the development of EGFR-TKI resistance, copy number analyses of several tumor suppressor genes were performed by an MLPA using genomic DNA from G719S-GR and a tumor biopsy sample (obtained before gefitinib treatment). Losses of CDKN2A, PTEN and TSC1 were confirmed in G719S-GR cells. Interestingly, the loss of PTEN was not observed in the gefitinib-naïve tumor sample.
Discussion: Thus far, the mechanisms underlying the development of EGFR-TKI resistance in uncommon mutations have not been investigated. The newly established G719S-GR cell line could be a useful tool for investigating the mechanism underlying the development of AR in the G719X mutation; the loss PTEN could be one such mechanism. Further experiments are warranted.
Citation Format: Atsushi Osoegawa, Tomonori Yamada, Takafumi Hashimoto, Yohei Takumi, Ryoji Kobayashi, Shuji Suehiro, Michiyo Miyawaki, Hideya Takeuchi, Tatsuro Okamoto, Kenji Sugio. Acquired resistance to EGFR-TKI in an uncommon G719S EGFR mutation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4107. doi:10.1158/1538-7445.AM2017-4107
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Affiliation(s)
| | | | | | - Yohei Takumi
- Oita University Faculty of Medicine, Yufu, Japan
| | | | | | | | | | | | - Kenji Sugio
- Oita University Faculty of Medicine, Yufu, Japan
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16
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Osoegawa A, Hashimoto T, Takumi Y, Abe M, Hiraishi H, Suehiro S, Miyawaki M, Sugio K. Abstract 2227: Positive correlation between the gamma-H2AX and PD-L1 expressions in lung squamous cell carcinoma. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-2227] [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
Lung cancer is a leading cause of cancer death worldwide. Recently, molecular targeting therapy has been developed and it has shown promising results against advanced lung cancer. Among them, lung squamous cell carcinoma has fewer treatment options because it is not driven by oncogenic mutations, but by alterations in tumor suppressor genes and subsequent chromosomal instability. Programmed death-ligand 1 (PD-L1) is one of the immune checkpoint molecules that is expressed on the surface of tumor cells, where it inhibits activities of cytotoxic T cells. Recent studies revealed that the PD-1/PD-L1 blockade could improve the overall survival in lung squamous cell carcinoma, potentially because it carries high mutation burdens and neoantigens which could be targeted by cytotoxic T cells. We hypothesized that DNA damage could accumulate in tumors with high mutation burdens, thereby inducing the PD-L1 expression on tumor cells, sensitizing them to anti-PD-1 therapy. An immunohistochemical analysis of 41 consecutive lung squamous cell carcinoma cases, which received surgery at our institution between April 2013 and March 2014, revealed that a high PD-L1 expression was observed in 15 patients (37%) that was associated related with a poor recurrence-free survival (p = 0.028). The PD-L1 expression level was also positively associated with the γH2AX expression (a direct marker for DNA damage) (p = 0.02). The γH2AX expression in tumor cell nuclei was confirmed by immunofluorescent staining. It forms foci in tumor cell nuclei, indicating the incidence of DNA double strand breaks. Our findings demonstrate for the first time that the nuclear γH2AX expression in lung squamous cell carcinoma is positively associated with the PD-L1 expression. Further studies are warranted to investigate whether γH2AX could be a biomarker for PD-1 targeting therapy and whether combination therapy with PD-1 targeting therapy and a DNA-damaging agent has synergistic effects.
Citation Format: Atsushi Osoegawa, Takafumi Hashimoto, Yohei Takumi, Miyuki Abe, Hitomi Hiraishi, Shuji Suehiro, Michiyo Miyawaki, Kenji Sugio. Positive correlation between the gamma-H2AX and PD-L1 expressions in lung squamous cell carcinoma. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2227.
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Affiliation(s)
| | | | - Yohei Takumi
- Oita University Faculty of Medicine, Yufu, Japan
| | - Miyuki Abe
- Oita University Faculty of Medicine, Yufu, Japan
| | | | | | | | - Kenji Sugio
- Oita University Faculty of Medicine, Yufu, Japan
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17
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Suehiro S, Abe M, Takumi Y, Hashimoto T, Kamei M, Osoegawa A, Miyawaki M, Sugio K. The clinical manifestations and treatment of male breast cancer: a report of three cases. Surg Case Rep 2016; 1:92. [PMID: 26943416 PMCID: PMC4593990 DOI: 10.1186/s40792-015-0103-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/01/2015] [Indexed: 11/20/2022] Open
Abstract
Male breast cancer is an extremely rare malignancy. We treated three male breast cancer patients. All three patients showed clinical N0 and received sentinel lymph node biopsy. Because the sentinel lymph node was positive for metastasis in one patient, a total mastectomy with axillary lymph node dissection was performed. The other two patients were negative for sentinel lymph node metastasis, and a simple mastectomy was performed. Two of the patients were postoperatively treated with tamoxifen; another patient was treated with adjuvant chemotherapy using taxotere and cyclophosphamide before tamoxifen. There was no recurrence in any of the three patients during an average follow-up period of 56.7 months (range 11.8–80.3). A sentinel lymph node biopsy is recommended for node staging in both male and female breast cancer patients as it is associated with a lower incidence of complications.
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Affiliation(s)
- Shuji Suehiro
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan.
| | - Miyuki Abe
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Yohei Takumi
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Takafumi Hashimoto
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Mirei Kamei
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Michiyo Miyawaki
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka Hasama-machi, Yufu, Oita, 879-5593, Japan
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18
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Usami S, Takumi Y, Suzuki N, Oguchi T, Oshima A, Suzuki H, Kitoh R, Abe S, Sasaki A, Matsubara A. The localization of proteins encoded by CRYM, KIAA1199, UBA52, COL9A3, and COL9A1, genes highly expressed in the cochlea. Neuroscience 2008; 154:22-8. [PMID: 18448257 DOI: 10.1016/j.neuroscience.2008.03.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Revised: 03/08/2008] [Accepted: 03/11/2008] [Indexed: 11/25/2022]
Abstract
Genes that are highly expressed in the inner ear, as revealed by cDNA microarray analysis, may have a crucial functional role there. Those that are expressed specifically in auditory tissues are likely to be good candidates to screen for genetic alterations in patients with deafness, and several genes have been successfully identified as responsible for hereditary hearing loss. To understand the detailed mechanisms of the hearing loss caused by the mutations in these genes, the present study examined the immunocytochemical localization of the proteins encoded by Crym, KIAA1199 homolog, Uba52, Col9a3, and Col9a1 in the cochlea of rats and mice. Confocal microscopic immunocytochemistry was performed on cryostat sections. Ultrastructurally, postembedding immunogold cytochemistry was applied using Lowicryl sections. Crym protein was predominantly distributed in the fibrocytes in the spiral ligament, as well as the stria vascularis in rats. KIAA1199 protein homolog was localized in various supporting cells, including inner phalangeal, border, inner and outer pillar, and Deiters' cells. Uba52 protein was restrictedly localized within the surface of the marginal cells of the stria vascularis. Collagen type IX was found within the tectorial membrane as well as fibrocytes in the spiral ligament. The present results showed cell-specific localization of the encoded proteins of these highly expressed genes, indicating that the coordinated actions of various molecules distributed in different parts of the cochlea are essential for maintenance of auditory processing in the cochlea.
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Affiliation(s)
- S Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
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Wagatsuma M, Kitoh R, Suzuki H, Fukuoka H, Takumi Y, Usami S. Distribution and frequencies of CDH23 mutations in Japanese patients with non-syndromic hearing loss. Clin Genet 2007; 72:339-44. [PMID: 17850630 DOI: 10.1111/j.1399-0004.2007.00833.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mutations in the CDH23 gene are known to be responsible for both Usher syndrome type ID (USH1D) and non-syndromic hearing loss (DFNB12), and the molecular confirmation of the CDH23 gene has become important in the diagnosis of these conditions. The present study was performed to find whether the CDH23 mutations are also responsible for non-syndromic hearing loss in patients in the Japanese population. A total of 51 sequence variants were found in 64 Japanese probands with non-syndromic sensorineural hearing impairment from autosomal recessive families. Among them, at least four missense mutations in six patients from five families were confirmed to be responsible for deafness by segregation study. All mutations detected were missense mutations, corroborating the previous reports regarding DFNB12. The present data confirmed that CDH23 mutations are frequently found and significantly responsible in Japanese. Interestingly, the CDH23 mutation spectrum in Japanese is very different from that found in Caucasians. This Japanese spectrum may be representative of those in Eastern Asian populations and its elucidation is expected to facilitate the molecular diagnosis of DFNB12 and USH1D.
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Affiliation(s)
- M Wagatsuma
- Department of Otorhinolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
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Oshima A, Suzuki S, Takumi Y, Hashizume K, Abe S, Usami S. CRYM mutations cause deafness through thyroid hormone binding properties in the fibrocytes of the cochlea. J Med Genet 2006; 43:e25. [PMID: 16740909 PMCID: PMC2564543 DOI: 10.1136/jmg.2005.034397] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Revised: 06/11/2005] [Accepted: 06/22/2005] [Indexed: 11/03/2022]
Abstract
BACKGROUND In a search for mutations of mu-crystallin (CRYM), a taxion specific crystalline which is also known as an NADP regulated thyroid hormone binding protein, two mutations were found at the C-terminus in patients with non-syndromic deafness. OBJECTIVE To investigate the mechanism of hearing loss caused by CRYM mutations METHODS T3 binding activity of mutant mu-crystallin was compared with that of wild-type mu-crystallin, because mu-crystallin is known to be identical to T3 binding protein. To explore the sites within the cochlea where mu-crystallin is functioning, its localisation in the mouse cochlea was investigated immunocytochemically using a specific antibody. RESULTS One mutant was shown to have no binding capacity for T3, indicating that CRYM mutations cause auditory dysfunction through thyroid hormone binding properties. Immunocytochemical results indicated that mu-crystallin was distributed within type II fibrocytes of the lateral wall, which are known to contain Na,K-ATPase. CONCLUSIONS CRYM mutations may cause auditory dysfunction through thyroid hormone binding effects on the fibrocytes of the cochlea. mu-Crystallin may be involved in the potassium ion recycling system together with Na,K-ATPase. Future animal experiments will be necessary to confirm a causal relation between Na,K-ATPase, T3, and deafness.
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Asamura K, Abe S, Imamura Y, Aszodi A, Suzuki N, Hashimoto S, Takumi Y, Hayashi T, Fässler R, Nakamura Y, Usami S. Type IX collagen is crucial for normal hearing. Neuroscience 2005; 132:493-500. [PMID: 15802199 DOI: 10.1016/j.neuroscience.2005.01.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2005] [Indexed: 11/24/2022]
Abstract
cDNA microarray analysis indicated that COL9A1 and COL9A3 are highly expressed in the human inner ear, suggesting that type IX collagen has a crucial functional role in the inner ear. This study further confirmed, by means of real-time PCR, the presence of collagen type IX genes in the mouse inner ear. Immunocytochemical analysis also revealed that type IX collagen is distributed in the tectorial membrane, where it co-localizes with type II collagen, indicating that type IX collagen may contribute to the three-dimensional integrated structure of type II collagen molecules. Mice with targeted disruption of the col9a1 gene were shown through assessment by auditory brain stem response to have hearing loss, suggesting an important role of type IX collagen in maintaining normal hearing. At the light microscopic level, the tectorial membrane of knock-out mice was found to be abnormal in shape, and electron microscopy confirmed disturbance of organization of the collagen fibrils. An antibody against type II collagen failed to detect type II collagen in the tectorial membrane of type IX collagen knock-out mice, suggesting that a lack of type IX collagen may affect the three-dimensional structure of type II collagen molecules. These findings indicate that genes encoding each chain of type IX collagen may fulfill an important function associated with the tectorial membrane in the auditory system.
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Affiliation(s)
- K Asamura
- Department of Otorhinolaryngology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
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Usami SI, Takumi Y, Matsubara A, Fujita S, Ottersen OP. Neurotransmission in the vestibular endorgans--glutamatergic transmission in the afferent synapses of hair cells. Biol Sci Space 2001; 15:367-70. [PMID: 12101360 DOI: 10.2187/bss.15.367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the sensory pathways the first synapse is that between hair cells and primary afferent neurons and its most likely neurotransmitter candidate has long been thought to be glutamate. A number of pharmacological and electrophysiological studies have lent credence to this theory (reviewed by Bledsoe et al. 1988, Bobbin 1979, Ehrenberger and Felix 1991, Puel et al. 1991; Puel 1995) as has recent neurochemical and immunocytochemical work (reviewed by Ottersen et al. 1998; Usami et al. 2000). These recent studies reveal that the afferent hair cell synapse resembles the central glutamate synapses in many ways. Of the proteins confirmed to be involved in signal transduction and transmitter metabolism at most central synapses, many are also seen in the afferent hair cell synapse, and have an analogous compartmentation. On the other hand, there are also important differences, especially those related to the molecular mechanisms that underlie transmitter release.
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Affiliation(s)
- S I Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
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Abstract
An improved myringoplasty technique utilizing fibrin glue and carried out through the external auditory canal was recently introduced. This endoscopic-assisted technique allows exquisite views and avoids blind surgical procedures, thereby expanding the indications for minimally invasive myringoplasty. This technique was applied to patients in whom, due to the curved external auditory canal, the margin of the perforation of the tympanic membrane was not visible with an operating microscope. We summarized the results of 22 endoscopic-assisted myringoplasties and concluded that this technique provides satisfactory results both in the success rate of perforation closure and in hearing outcome.
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Affiliation(s)
- S Usami
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
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Abstract
The localization of three glutathione S-transferase (GST) isoforms in the rat cochlea was examined using specific antibodies against each isoform. GST immunoreactivities were found in particular parts of the cochlea, including the intermediate cells and the basal cells of the stria vascularis and various types of fibrocytes in the spiral ligament. The different cell types showed varying combinations of GST isoforms. The GST immunopositive cells identified in the present study may play a central role in the metabolism and inactivation of endogenous and exogenous ototoxic compounds. The specific arrangements also indicated a possible contribution to the detoxification process in the form of a blood-labyrinth barrier.
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Affiliation(s)
- Y Takumi
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Japan
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Masuda M, Usami S, Yamazaki K, Takumi Y, Shinkawa H, Kurashima K, Kunihiro T, Kanzaki J. Connexin 26 distribution in gap junctions between melanocytes in the human vestibular dark cell area. Anat Rec 2001; 262:137-46. [PMID: 11169908 DOI: 10.1002/1097-0185(20010201)262:2<137::aid-ar1018>3.0.co;2-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We have previously demonstrated the presence of gap junctions between melanocytes in the human vestibular organ and have speculated that melanocytes function in maintaining the homeostasis of the microenvironment of the inner ear. The purpose of the present study was to characterize the expression and ultrastructural localization of connexin (Cx) protein in melanocytes of the human vestibular organs. Surgical material was obtained from patients operated on for vestibular schwannoma and was processed for light microscopy, confocal laser scanning microscopy, conventional TEM, and immuno TEM. The specimens were labeled with anti-Cx26, Cx32, and Cx43 antibodies and examined by light microscopy. Specimens were also labeled with anti-Cx26 antibody and examined by laser microscopy and immuno-TEM methods. The specimens examined in this study were mainly dark cell areas from the human vestibular organ, whose epithelial and subepithelial layers are rich in melanocytes. Light-microscopic immunohistochemical studies showed positive labeling for Cx26 protein between subepithelial melanocytes, and Cx32 was also detected. Use of anti-Cx26 antibody and confocal laser scanning microscopy revealed high levels of Cx26 around the subepithelial melanocytes. Post-embedding immuno-gold transmission electron microscopy showed significant aggregation of gold particles (33.97 +/- 8.01% of total gold particles) around the gap junctions of the subepithelial melanocytes. The results of this study indicated that melanocytes are connected through gap junctions that mainly contain Cx26. This suggested that the melanocytes in the human vestibular organ may play a role in transporting material between the endolymph and perilymph.
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Affiliation(s)
- M Masuda
- Department of Otorhinolaryngology, Keio University, School of Medicine, Tokyo, Japan.
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Roberg B, Torgner IA, Laake J, Takumi Y, Ottersen OP, Kvamme E. Properties and submitochondrial localization of pig and rat renal phosphate-activated glutaminase. Am J Physiol Cell Physiol 2000; 279:C648-57. [PMID: 10942715 DOI: 10.1152/ajpcell.2000.279.3.c648] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Two pools of phosphate-activated glutaminase (PAG) were separated from pig and rat renal mitochondria. The partition of enzyme activity corresponded with that of the immunoreactivity and also with the postembedding immunogold labeling of PAG, which was associated partly with the inner membrane and partly with the matrix. The outer membrane was not labeled. PAG in intact mitochondria showed enzymatic characteristics that were similar to that of the membrane fraction and also mimicked that of the polymerized form of purified pig renal PAG. PAG in the soluble fraction showed properties similar to that of the monomeric form of purified enzyme. It is indicated that the pool of PAG localized inside the inner mitochondrial membrane is dormant due to the presence of high concentrations of the inhibitor glutamate. Thus the enzymatically active PAG is assumed to be localized on the outer face of the inner mitochondrial membrane. The activity of this pool of PAG appears to be regulated by compounds in the cytosol, of which glutamate may be most important.
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Affiliation(s)
- B Roberg
- Neurochemical Laboratory, Domus Medica, University of Oslo, 0317 Oslo, Norway
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27
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Abstract
Postembedding immunogold labeling was used to determine the relationship between AMPA and NMDA receptor density and size of Schaffer collateral-commissural (SCC) synapses of the adult rat. All SCC synapses expressed NMDA receptors. AMPA and NMDA receptors were colocalized in at least 75% of SCC synapses; the ratio of AMPA to NMDA receptors was a linear function of postsynaptic density (PSD) diameter, with AMPA receptor number dropping to zero at a PSD diameter of approximately 180 nm. These findings indicate that 'silent' SCC synapses are smaller than the majority of SCC synapses at which AMPA and NMDA receptors are colocalized. Thus synapse size may determine important properties of SCC synapses.
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Affiliation(s)
- Y Takumi
- Department of Anatomy, University of Oslo, Norway
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Laake JH, Takumi Y, Eidet J, Torgner IA, Roberg B, Kvamme E, Ottersen OP. Postembedding immunogold labelling reveals subcellular localization and pathway-specific enrichment of phosphate activated glutaminase in rat cerebellum. Neuroscience 1999; 88:1137-51. [PMID: 10336125 DOI: 10.1016/s0306-4522(98)00298-x] [Citation(s) in RCA: 136] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Phosphate activated glutaminase is a key enzyme in glutamate synthesis. Here we have employed a quantitative and high-resolution immunogold procedure to analyse the cellular and subcellular expression of this enzyme in the cerebellar cortex. Three main issues were addressed. First, is phosphate activated glutaminase exclusively or predominantly a mitochondrial enzyme, as biochemical data suggest? Second, to what extent is the mitochondrial content of glutaminase dependent on cell type and transmitter identity? Third, can individual neurons maintain a subcellular segregation of mitochondria with different glutaminase content? An attempt was also made to disclose the intramitochondrial localization of glutaminase, and to correlate the content of this enzyme with that of glutamate and glutamine in the same mitochondria (by use of triple labelling). Antisera to the N- and C-termini of glutaminase revealed strong labelling of the putatively glutamatergic mossy fibre terminals. The vast majority of gold particles (approximately 96%) was associated with the mitochondria. Equally high labelling intensities were found in mitochondria of perikarya and dendrites in the pontine nuclei, a major source of mossy fibres. The level of glutaminase immunoreactivity in parallel and climbing fibres (which like the mossy fibres are thought to use glutamate as transmitter) was only about 20% of that in mossy fibres, and similar to that in non-glutamatergic neurons (Purkinje and Golgi cells). Glial cell mitochondria were devoid of specific glutaminase labelling and revealed a much lower glutamate:glutamine ratio than did the mitochondria of mossy fibres. As to the submitochondrial localization of glutaminase, immunogold particles were often found to be aligned with the cristae, suggesting an association of the enzyme with the inner mitochondrial membrane. However, the existence of a glutaminase pool in the mitochondrial matrix could not be excluded. The outer mitochondrial membrane was unlabelled. The present study provides quantitative evidence for a substantial heterogeneity in the mitochondrial content of glutaminase. This heterogeneity applies not only to neurons with different transmitter signatures, but also to different categories of glutamatergic pathways. In terms of the routes involved, the synthesis of transmitter glutamate may be less uniform than previously expected.
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Affiliation(s)
- J H Laake
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, Norway
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29
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Abstract
Electron microscopic immunogold analyses have revealed a highly differentiated arrangement of glutamate receptors at excitatory synapses in the central nervous system. Studies focused on the hippocampus and cerebellum have shown that the postsynaptic specialization is the preferential site of NMDA and AMPA receptor expression, and that the delta 2 receptor is similarly concentrated at this site. In cases of colocalization (AMPA and NMDA, or AMPA and delta 2) the two receptor types appear to be intermingled rather than segregated to separate parts of the membrane. The different groups of metabotropic receptor exhibit distinct distributions at the synapse: group I receptors occur in membrane domains lateral to the postsynaptic specialization; group II receptors are expressed in preterminal membranes or extra-synaptically; whereas group III receptors are found in, or close to, the presynaptic active zone consistent with their roles as autoreceptors. The differentiated distribution of glutamate receptors reflects their functional heterogeneity and explains why some receptors are activated only at high firing frequencies.
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Affiliation(s)
- Y Takumi
- Department of Anatomy, University of Oslo, Norway
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Matsubara A, Kawabata Y, Takumi Y, Usami S, Shinkawa H, Haruta A, Matsuda K, Tono T. Quantitative immunogold cytochemistry reveals sources of glutamate release in inner ear ischemia. Acta Otolaryngol Suppl 1999; 539:48-51. [PMID: 10095861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Glutamate is thought to be a major neurotransmitter between hair cells and afferent dendrites in the inner ear. However, excessive glutamate is known to be excitotoxic, and may be involved in ischemic neuronal damage in the central nervous system. The glutamate concentration in the perilymph has been reported to increase during ischemia, but the source of glutamate is still unclear. In the present study, we have used post-embedding immunogold cytochemistry to analyse changes in the cellular distribution of glutamate in the guinea pig organ of Corti during ischemia. The areal gold particle densities in the inner hair cells of the ischemic side were lower than those of the control side, indicating that glutamate may be released from the hair cells during ischemia. Adjacent supporting cells (border cells) also showed a decrease in particle density, suggesting that they constitute an additional source of glutamate.
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Affiliation(s)
- A Matsubara
- Department of Otorhinolaryngology, Hirosaki University School of Medicine, Japan.
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31
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Takumi Y, Matsubara A, Laake JH, Ramírez-León V, Roberg B, Torgner I, Kvamme E, Usami S, Ottersen OP. Phosphate activated glutaminase is concentrated in mitochondria of sensory hair cells in rat inner ear: a high resolution immunogold study. J Neurocytol 1999; 28:223-37. [PMID: 10617904 DOI: 10.1023/a:1007076007642] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Glutamate has been implicated in signal transmission between sensory hair cells and afferent fibers in the inner ear. However, the mechanisms responsible for glutamate replenishment in these cells are not known. Here we provide evidence that phosphate activated glutaminase, which is thought to be the predominant glutamate-synthesizing enzyme in the brain, is concentrated in all types of hair cell in the organ of Corti and vestibular epithelium. By use of two different antibodies (directed to the N and C terminus, respectively) it was shown that glutaminase is largely restricted to mitochondria and that part of the enzyme pool is associated with the inner membrane of this organelle. Quantitative analysis of immunogold labelled Lowicryl sections revealed that the level of glutaminase immunoreactivity in mitochondria of supporting cells is less than 15% of that in hair cell mitochondria. Using triple labelling for glutaminase, glutamate, and glutamine, evidence was provided of a positive correlation between the glutamate/glutamine ratio and the level of glutaminase immunoreactivity, suggesting that the glutaminase antibodies identify a functional enzyme pool. Our results strengthen the idea that glutamate is a hair cell transmitter and indicate that the sensory epithelia in the inner ear show a metabolic compartmentation analogous to that in the brain.
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Affiliation(s)
- Y Takumi
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, 0317 Oslo, Norway and Department of Otorhinolaryngology, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan
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32
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Matsubara A, Takumi Y, Nakagawa T, Usami S, Shinkawa H, Ottersen OP. Immunoelectron microscopy of AMPA receptor subunits reveals three types of putative glutamatergic synapse in the rat vestibular end organs. Brain Res 1999; 819:58-64. [PMID: 10082861 DOI: 10.1016/s0006-8993(98)01345-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
To characterize the synapses between hair cells and afferent nerve endings in the rat vestibular end organs, the ultrastructural localization of AMPA receptor subunits (GluR1-4) was examined by postembedding immunogold cytochemistry. Immunoreactivities for GluR2/3 and GluR4 were associated with the synapses between type I hair cells and the surrounding chaliceal nerve endings and with the bouton type nerve endings contacting type II hair cells. There was no detectable immunoreactivity for GluR1. A third type of immunoreactive synapse was found between the outer face of chalices and type II hair cells. While the linear densities of gold particles (particles per micrometer postsynaptic specialization) of bouton type endings and chaliceal nerve endings were the same, the former type of ending showed larger postsynaptic specializations and, hence, a higher number of receptor molecules. These data indicate that there are three types of putative glutamatergic synapse in the vestibular end organ.
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Affiliation(s)
- A Matsubara
- Department of Otorhinolaryngology, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
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33
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Affiliation(s)
- Y Takumi
- Department of Anatomy, University of Oslo, Norway
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34
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Takumi Y, Nagelhus EA, Eidet J, Matsubara A, Usami S, Shinkawa H, Nielsen S, Ottersen OP. Select types of supporting cell in the inner ear express aquaporin-4 water channel protein. Eur J Neurosci 1998; 10:3584-95. [PMID: 9875338 DOI: 10.1046/j.1460-9568.1998.00360.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aquaporins (AQPs) confer a high water permeability on cell membranes and play important parts in secretory and absorptive epithelia in kidney and other organs. Here we investigate whether AQPs are expressed in the sensory epithelia of the inner ear, where a precise volume regulation is crucial. By use of specific antibodies it was found that the inner ear contains AQP1 and 4 while being devoid of detectable levels of AQP2, 3 or 5. Immunofluorescence and postembedding immunogold labelling revealed a strictly non-epithelial distribution of AQP1, confirming previous data. In contrast, AQP4 protein and mRNA (visualized by in situ hybridization) were concentrated in select types of supporting cell, including Hensen's cells and inner sulcus cells. Immunogold particles signalling AQP4 were confined to the basolateral plasma membrane of Hensen's cells and to the basal plasma membrane of Claudius cells and inner sulcus cells. AQP4 was also found in supporting cells of the vestibular end organs, but was absent from transitional epithelial cells and dark cells. Strong labelling for AQP4 and AQP4-mRNA was associated with the central part of the cochlear and vestibular nerves. Hair cells were consistently unlabelled. Our findings indicate that AQP4 may facilitate osmotically driven water fluxes in the sensory epithelia of the inner ear and thus contribute to the volume and ion homeostasis at these sites.
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Affiliation(s)
- Y Takumi
- Department of Anatomy, University of Oslo, Norway
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Ottersen OP, Takumi Y, Matsubara A, Landsend AS, Laake JH, Usami S. Molecular organization of a type of peripheral glutamate synapse: the afferent synapses of hair cells in the inner ear. Prog Neurobiol 1998; 54:127-48. [PMID: 9481795 DOI: 10.1016/s0301-0082(97)00054-3] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The synapses between sensory cells in the inner ear and the afferent dendrites of ganglion cells are well suited to investigations of fundamental mechanisms of fast synaptic signalling. The presynaptic elements can be isolated for electrophysiological and functional studies while the synapses can be easily recognized in the electron microscope due to their distinct morphological features. This allows for a broader range of correlative functional and structural analyses than can be applied to synapses in the central nervous system (CNS). As in most fast excitatory synapses in the CNS the transmitter in the afferent hair cell synapses appears to be glutamate or a closely related compound. Recent studies have revealed many of the key molecular players at this type of synapse and how they are spatially and functionally coupled. By use of high resolution immunogold cytochemistry it has been shown that AMPA glutamate receptors are specifically expressed in the postsynaptic specialization of afferent hair cell synapses (except at those established by outer hair cells in the organ of Corti) and that their density varies as a function of the distance from the release sites (demonstrated for the afferent contacts of inner hair cells). The glutamate transporter GLAST is localized in supporting cell membranes and concentrated in those membrane domains that face the synaptic regions. Glutamine synthetase and phosphate-activated glutaminase--which are responsible for the interconversion of glutamate and glutamine--are selectively localized in non-neuronal and neuronal elements, respectively. Taken together with quantitative immunogold data on the cellular compartmentation of glutamate and glutamine the above findings suggest that the sensory epithelia in the inner ear sustain a cycling of glutamate carbon skeletons. In this process, the supporting cells may carry out functions analogous to those of glial cells in the CNS. Functional and morphological analyses of the presynaptic membrane indicate that L-type Ca(2+)-channels and Ca(2+)-activated K(+)-channels are colocalized and clustered at the active zone. Influx through the L-type channels triggers synaptic release and their close spatial association with Ca(2+)-activated K(+)-channels appears to be critical for frequency tuning. The focal expression of different Ca(2+)-channels combined with a high intracellular buffering capacity permits several Ca(2+)-signalling pathways to operate in parallel without undue interference. The molecular organization of the afferent hair cell synapses reflects the functional demand for speed and precision and attests to the ability of the pre- and postsynaptic elements to target and anchor key proteins at specific membrane domains.
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Affiliation(s)
- O P Ottersen
- Department of Anatomy, Institute of Basic Medical Sciences, Oslo, Norway
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36
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Takumi Y, Matsubara A, Danbolt NC, Laake JH, Storm-Mathisen J, Usami S, Shinkawa H, Ottersen OP. Discrete cellular and subcellular localization of glutamine synthetase and the glutamate transporter GLAST in the rat vestibular end organ. Neuroscience 1997; 79:1137-44. [PMID: 9219972 DOI: 10.1016/s0306-4522(97)00025-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Glial cells play an important role in the removal and metabolism of synaptically released glutamate in the central nervous system (CNS). It is not clear how glutamate is handled at peripheral glutamate synapses, which are not associated with glia. Glutamate is a likely transmitter in the synapse between the hair cells and afferent dendrites of the vestibular end organ. Immunocytochemistry was performed to investigate the distribution at this site of the high affinity glutamate transporter GLAST and glutamate metabolizing enzyme glutamine synthetase. Confocal microscopy revealed that GLAST and glutamine synthetase were co-localized in supporting cells apposed to the immunonegative hair cells. Postembedding immunoelectron microscopy revealed that GLAST was heterogeneously distributed along the plasma membranes of the supporting cells, with higher concentrations basally (at the level of the afferent synapses) than apically. Both immunoreactivities were also present in non-neuronal cells in the vestibular ganglion. The present findings suggest that glutamate released at the afferent synapse of vestibular hair cells may be taken up by adjacent supporting cells and converted into glutamine. Thus, at this peripheral synapse, the supporting cells may carry out functions similar to those of glial cells in the CNS.
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Affiliation(s)
- Y Takumi
- Department of Otorhinolaryngology, Hirosaki University School of Medicine, Zaifu-cho, Japan
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37
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Abstract
Programmed cell death (apoptosis) in the inner ear of senescence-accelerated mouse was identified using specific labeling of fragmented DNA (the TUNEL method). In spite of some inter-individual differences, the apoptotic cells were predominantly found in the phylogenetically newer part of the inner ear, the cochlea and the saccules. In the saccules, sensory hair cells as well as supporting cells were positively labeled. In the cochlea, positive staining was detected in inner and outer hair cells, pillar cells, Deiters' cells, interdental cells, the stria vascularis (marginal cells, intermediate cells, basal cells), and cells in Reissner's membrane. The present results suggest that age-related cell death, which may cause hearing impairment and dysequilibrium, is due to apoptosis occurring in the inner ear.
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Affiliation(s)
- S Usami
- Dept. of Otorhinolaryngology, Hirosaki University School of Medicine, Japan.
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Okano G, Sato Y, Takumi Y, Sugawara M. Effect of 4h preexercise high carbohydrate and high fat meal ingestion on endurance performance and metabolism. Int J Sports Med 1996; 17:530-4. [PMID: 8912069 DOI: 10.1055/s-2007-972890] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The effect of a single high carbohydrate meal (HCM) and high fat meal (HFM) given 4 h before cycling exercises was determined for performance and metabolism. On the morning of the day of the trial, 10 endurance-trained collegiate males consumed either a single HCM (4669 kj; 79% CHO, 10% F and 11% P) or HFM (4711 kj; 30% CHO, 61% F and 9% P) as a 4 h preexercise meal. The intensity of exercise required was 65% of the maximal oxygen consumption (VO2max) for the first 120 min of exercise, followed by an increased dose of 80% VO2max. Endurance capacity did not differ between the HCM (128 +/- 3 min [SEM]) and HFM (122 +/- 3 min) trials. There was no significant difference in blood glucose levels in the HCM and HFM trials. A significantly higher (p < 0.01) serum insulin level in the HCM trials over the HFM trials was only observed at the start of exercise. Blood lactate levels (< 2.6 mM) during cycling remained below the anaerobic threshold. Respiratory exchange ratio in the HCM trials was significantly higher (p < 0.05 or p < 0.01) than that in HFM trials during the first 40 min of exercise. This was accompanied by significantly lower (p < 0.05 or p < 0.01) levels in serum free fatty acid and beta-HOB for the HCM trial. There was no significant difference between both diet regimens as to heart rate, oxygen consumption and perceived exertion during exercise. These results suggest that a single HCM and HFM given 4 h before exercise influences fuel utilization in the initial stages of prolonged cycling, but these meals may have little effect on endurance capacity.
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Affiliation(s)
- G Okano
- Department of Exercise Science, Sapporo Medical University, Japan
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Sato Y, Okano G, Takumi Y, Murata Y, Mashiko S, Harada Y, Matsuyama T, Amano Y. 1122 LONG-TERM EFFECTS OF VOLUNTARY RUNNING EXERCISE AND HIGH CALCIUM INTAKE ON BONE METABOLISM IN YOUNG GROWING RATS. Med Sci Sports Exerc 1993. [DOI: 10.1249/00005768-199305001-01126] [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: 11/21/2022]
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40
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Fujii A, Yoshikawa K, Iwata T, Akashi M, Noguchi H, Takumi Y. [A method for measurement of circulating blood volume with fluorescein isothiocyanate labeled red blood cells]. Masui 1993; 42:545-51. [PMID: 8315795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We developed a new method to measure the total circulating blood volume using fluorescein isothiocyanate (FITC) labeled autologous red blood cell as an indicator. Red blood cells were labeled by incubation with 0.1 mg.ml-1 FITC in PBS (pH 7.2) for 30 min at 37 degrees C. Eighteen dogs were given an intravenous injection of FITC labeled red blood cells, which were approximately 0.1% of the total circulating red blood cells estimated from the body weight. The ratio of labeled cells to the normal circulating red blood cells was determined by a flow cytometry. The total blood volume was calculated from its dilution rate. The average circulating blood volume determined by this method was 76.8 +/- 9.2 ml.kg-1 (mean +/- SD). This result coincides well with the values reported previously. This method using non radioactive tracers enables a reproducible measurement of circulating blood volume and its change with time.
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Affiliation(s)
- A Fujii
- Department of Anesthesiology and Acute Medicine, Aichi Medical University
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Okamoto K, Noguchi H, Akashi M, Watanabe H, Tsuboi H, Iwata T, Shimada C, Yamamoto Y, Takumi Y. Peripheral vascular permeability following a thermal injury to the airway. J Anesth 1991; 5:79-87. [PMID: 15278673 DOI: 10.1007/s0054010050079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/1990] [Accepted: 08/27/1990] [Indexed: 11/27/2022]
Abstract
Effects of thermal injury to the airway on the vascular permeability in the region of head and neck, were studied in the canine models. The thermal airway injury was produced by an inhalation of a gas burner's flame through the metallic tracheostomy cannula. The changes in vascular permeability were evaluated by calculating the reflection coefficient, which was obtained by the protein washdown technique into lymph. The reflection coefficient after the flame inhalation did not show any increases, while it increased significantly after a histamine infusion into the carotic artery. We concluded, that the vascular permeability in the unburned area does not increase at least in the first 3 hr after a thermal injury to the airway.
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Affiliation(s)
- K Okamoto
- Department of Anesthesiology and Acute Medicine, Aichi Medical University, Aichi-ken, Japan
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Abstract
We have developed a new continuous positive airway pressure (CPAP) system, which consists of an electropneumatic regulator, a microcomputer, and a pneumotachograph placed between the endotracheal tube and the breathing circuit of the CPAP apparatus. This flow-regulated CPAP (FR-CPAP) system delivers a basal flow and also regulates this flow every 20 msec to match the patient's flow demand. To evaluate the performance of this FR-CPAP system, we compared the imposed work of breathing of the FR-CPAP and continuous flow CPAP (CF-CPAP) systems. A model lung was used to simulate spontaneous breathing. The imposed work of breathing of the FR-CPAP system was less than that of the CF-CPAP system. These results indicate that the FR-CPAP system could minimize the imposed work of breathing of a patient receiving CPAP.
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Affiliation(s)
- M Akashi
- Department of Anesthesiology and Acute Medicine, Aichi Medical University Hospital, Japan
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Yamaji A, Watanabe H, Tanaka K, Okamoto K, Hirota T, Noguchi H, Takumi Y. [A case of retrograde amnesia of 22 years, continued for 4 days following a general anesthesia accompanied by a permanent amnesia of these 4 days after the complete recovery from the retrograde amnesia]. Masui 1989; 38:236-40. [PMID: 2733141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of global amnesia which continued for 4 days following a general anesthesia and recovered without any neurological deficits was reported. The patient was a 38-year-old woman suspected of lung cancer, and scheduled for pulmonary lobectomy. She had a history of appendectomy under spinal anesthesia 22 years before. She was premedicated with diazepam (10mg), atropine (0.5mg) and pentazocine (30mg). Anesthesia was induced with thiamylal (500mg) and succinylcholine (140mg) iv and 100% oxygen. Anesthesia was maintained with enflurane and nitrous oxide with oxygen for 3 hours. After her recovery from anesthesia, a retrograde amnesia of 22 years was observed and continued for 4 days. Then the memory was restored completely, but the amnesia during these 4 postoperative days remained permanently. We have documented the case of amnesia in the immediate postoperative period which is similar to transient global amnesia. It seems likely that this amnesia was caused by drug interaction, hypoxia, decreased cerebral perfusion or psychogenic effects of general anesthesia.
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Ohta T, Kato R, Boku K, Kondo M, Kazui H, Naiki K, Tsuchioka H, Inoue Y, Noguchi H, Takumi Y. A case of Vibrio vulnificus infection. Jpn J Surg 1988; 18:580-7. [PMID: 3068394 DOI: 10.1007/bf02471493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Vibrio vulnificus, a recently described strain of the halophilic Vibrio species, was isolated from the blood of a 73-year-old man, who developed rapidly progressive wound infection and fatal septicemia. Twenty-one patients with Vibrio vulnificus infection have been reported in the Japanese literature. Vibrio vulnificus most frequently causes primary septicemia and necrotising cellulitis after the eating of raw fish or shellfish or after exposure to seawater. The infection is characterized by its occurring during the warm months of the year, in patients with underlying diseases, especially liver diseases, and the mortality rate is surprisingly high. Clinicians should therefore consider the possibility of Vibrio vulnificus infection in the differential diagnosis of severe wound infections. Early surgical intervention and intensive antibiotic therapy are recommended for preventing the progress of the septicemia.
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Affiliation(s)
- T Ohta
- Second Department of Surgery, Aichi Medical University
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Kanbayashi T, Noguchi H, Takumi Y, Hirota T, Okamoto K, Watanabe H, Tsuboi H, Matsumoto K, Ono K, Iwata T. [Cause of pulmonary edema associated with acute myocardial ischemia]. Masui 1986; 35:1042-50. [PMID: 3773250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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46
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Takumi Y. [Humidification]. Kokyu To Junkan 1979; 27:1267. [PMID: 531359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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47
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Imazu S, Yamagiwa K, Komatsu T, Saito F, Noguchi H, Takumi Y. [Effects of continuous positive pressure ventilation on the volume of extravascular lung water (author's transl)]. Masui 1978; 27:567-72. [PMID: 351234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Tsuda T, Noguchi H, Takumi Y, Aochi O. Optimum humidification of air administered to a tracheostomy in dogs. Scanning electron microscopy and surfactant studies. Br J Anaesth 1977; 49:965-77. [PMID: 579156 DOI: 10.1093/bja/49.10.965] [Citation(s) in RCA: 72] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The effect of the inhalation of dried (less than 40% water-saturation) or humidified air (100% water-saturation at 25, 30, 35 and 40 degrees C) was studied in dogs in which a tracheostomy had been performed to determine the optimal humidity. After inhalation for various periods, the dogs were killed and pieces of lung tissue were excised for analysis of surfactant. Sections of the trachea and the primary to tertiary bronchi were taken for scanning electron microscopic examination. Structural changes were observed in the trachea of dogs inhaling dried at and in the tertiary bronchi of dogs inhaling 100% water-saturated air at 35 degrees C. No changes was observed after 24 h in dogs which had inhaled 100% water-saturated air at 25 degrees C under anaesthesia or at 30 degrees C without anaesthesia. Consequently, the optimal range of humidity was determined to be 100% water-saturation between 25 and 30 degrees C.
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Takumi Y, Noguchi H, Suzuki S, Yamamoto T. [Significance of increased cardiac output after resuscitation from shock with special reference to oxygen-transport]. Masui 1974; 23:1178-84. [PMID: 4477608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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50
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Noguchi H, Takumi Y, Aochi O. [Experimental study on the effect of doxapram on ventilation and perfusion]. Masui 1974; 23:419-23. [PMID: 4471818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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