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Tada H, Yamagami K, Sakata K, Usui S, Kawashiri MA, Takamura M. Healthy lifestyle, lipoprotein (a) levels and the risk of coronary artery disease. Eur J Clin Invest 2024; 54:e14093. [PMID: 37712231 DOI: 10.1111/eci.14093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Lipoprotein (a) [Lp(a)] is associated with coronary artery disease (CAD). However, the role of healthy lifestyle against the risk of CAD with consideration of high Lp(a) levels remains unclear. METHODS This study examined 4512 participants who underwent serum Lp(a) level assessment at Kanazawa University Hospital from 2008 to March 2016. Their lifestyle habits were examined based on four questionnaires regarding dietary pattern, exercise habits, smoking status and body weight. Logistic regression analyses were performed to identify the association between healthy lifestyle and CAD independent of Lp(a) levels. RESULTS The Lp(a) levels were significantly associated with CAD (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.08-1.17, p = 1.3 × 10-7 per 10 mg/dL). Under these circumstances, the lifestyle risk score was also significantly associated with CAD (OR: 1.24, 95% CI: 1.12-1.36, p = 2.4 × 10-8 ). Compared with patients with a favourable lifestyle who have Lp(a) levels of <30 mg/dL, those with an intermediate or unfavourable lifestyle were at higher risk for CAD (OR: 1.11, 95% CI: 1.02-1.20, p = 0.003 and OR: 1.40, 95% CI: 1.16-1.54, p = 3.6 × 10-5 , respectively). Further, patients with a favourable, intermediate or unfavourable lifestyle who have Lp(a) levels of ≥30 mg/dL were at high risk for CAD (OR: 1.21, 95% CI: 1.08-1.34, p = 0.0014; OR: 1.31, 95% CI: 1.14-1.48, p = 1.2 × 10-4 ; and OR: 1.81, 95% CI: 1.44-2.18, p = 2.2 × 10-7 , respectively). CONCLUSIONS Healthy lifestyle was associated with a lower risk of CAD regardless of Lp(a) levels.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | | | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Hayashi K, Fujino N, Takamura M, Kawashiri MA. Coronary artery calcium among patients with heterozygous familial hypercholesterolaemia. Eur Heart J Open 2023; 3:oead046. [PMID: 37193254 PMCID: PMC10182732 DOI: 10.1093/ehjopen/oead046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/18/2023]
Abstract
Aims We aimed to determine if coronary artery calcium (CAC) is associated with cardiovascular disease (CVD) events, defined as CVD-related death, unstable angina, myocardial infarction, or staged revascularization among patients with heterozygous familial hypercholesterolaemia (HeFH) under primary prevention settings. Methods and results Data of patients with FH admitted to Kanazawa University Hospital between 2000 and 2020, who underwent CAC measurement and were followed up (n = 622, male = 306, mean age = 54 years), were retrospectively reviewed. Risk factors for CVD events were determined using the Cox proportional hazard model. The median follow-up duration was 13.2 years (interquartile range: 9.8-18.4 years). We observed 132 CVD events during the follow-up period. The event rate per 1000 person-years for CAC scores of 0 [n = 283 (45.5%)], 1-100 [n = 260 (41.8%)], and >100 [n = 79 (12.7%)] was 1.2, 17.0, and 78.8, respectively. Log (CAC score + 1) was a significant predictor of the occurrence of CVD events (hazard ratio: 3.24; 95% confidence interval: 1.68-4.80; P < 0.0001) in the multivariate Cox regression analysis, independent of other factors. The risk discrimination of CVD events was enhanced by adding CAC information to other conventional risk factors (C-statistics: 0.833-0.934; P < 0.0001). Conclusion The CAC score helps in further risk stratification in patients with HeFH.
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Affiliation(s)
- Hayato Tada
- Corresponding author. Tel: +81-76-265-2000 (2251), Fax: +81-76-234-4251,
| | - Nobuko Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Atsushi Nohara
- Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Hayashi K, Fujino N, Takamura M, Kawashiri MA. Impact of Healthy Lifestyle in Patients With Familial Hypercholesterolemia. JACC Asia 2023; 3:152-160. [PMID: 36873758 PMCID: PMC9982286 DOI: 10.1016/j.jacasi.2022.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/19/2022] [Accepted: 10/22/2022] [Indexed: 02/04/2023]
Abstract
Background Pathogenic mutations are associated with poor outcomes in patients with familial hypercholesterolemia (FH). However, data on the effects of a healthy lifestyle on FH phenotypes are limited. Objectives The authors investigated the interaction between a healthy lifestyle and FH mutation with prognosis in patients with FH. Methods We investigated the associations of the interaction between genotypes and lifestyle, with the occurrence of major adverse cardiac events (MACE), such as cardiovascular-related mortality, myocardial infarction, unstable angina, and coronary artery revascularization, in patients with FH. We assessed their lifestyle based on 4 questionnaires (healthy dietary pattern, regular exercise, not smoking, and absence of obesity). The Cox proportional hazards model was used to assess the risk for MACE. Results The median follow-up duration was 12.6 (IQR: 9.5-17.9) years. During the follow-up duration, 179 MACE were observed. Independent of classic risk factors, FH mutation and lifestyle score were significantly associated with MACE (HR: 2.73; 95% CI: 1.03-4.43; P = 0.02; and HR: 0.69, 95% CI: 0.40-0.98, P = 0.033, respectively). The estimated risk of coronary artery disease by 75 years of age varied according to lifestyle, ranging from 21.0% among noncarriers with a favorable lifestyle to 32.1% among noncarriers with an unfavorable lifestyle and ranging from 29.0% among carriers with a favorable lifestyle to 55.4% among carriers with an unfavorable lifestyle. Conclusions A healthy lifestyle was associated with reduced risk for MACE among patients with FH with or without genetic diagnosis.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Nobuko Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Atsushi Nohara
- Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Fujino N, Takamura M, Kawashiri MA. Synergistic effect of lipoprotein (a) and C-reactive protein on prognosis of familial hypercholesterolemia. Am J Prev Cardiol 2022; 12:100428. [PMID: 36386253 PMCID: PMC9661434 DOI: 10.1016/j.ajpc.2022.100428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/26/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Lp(a) levels among patients with pathogenic variant FH were significantly elevated. Lp(a) and CRP levels were not associated with MACE by themselves. Lp(a) level was significantly associated with MACE only when the CRP level was elevated.
Objective The synergistic effect of lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) on major adverse cardiovascular events (MACE) among patients with familial hypercholesterolemia (FH) is unknown. This study aimed to investigate the relations between Lp(a) and CRP levels and MACE in patients with FH whose Lp(a) levels are elevated. Methods We retrospectively investigated associations between genotypes and phenotypes, including low-density lipoprotein (LDL) cholesterol level and the occurrence of MACE among patients with FH (N = 786, male/female: 374/412). A Cox proportional hazard model was used to identify factors associated with MACE, adjusting for traditional risk factors. Patients with FH were divided into four groups, based on their Lp(a) and CRP levels, and assessed using Kaplan–Meier curves. Results The median follow-up was 12.6 years (interquartile range [IQR], 9.5–17.9 years). During follow-up, 129 MACE were observed. Median Lp(a) and CRP levels were 21.4 (10.9–38.3) mg/dL and 0.20 (0.11–0.29) mg/dL, respectively. Under these conditions, natural log-transformed Lp(a) and CRP were not associated with MACE (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.91–1.25; P = 0.220; and HR, 1.12; CI, 0.96–1.28; P = 0.190, respectively). However, in Group 4, Lp(a) and CRP were significantly associated with MACE (HR, 2.44; CI, 1.42–3.46; P = 1.8 × 10−7). Conclusions In patients with FH, Lp(a) was significantly associated with MACE only when the CRP level was elevated. Patients with FH whose Lp(a) and CRP levels are elevated should be treated aggressively.
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Takamura M, Kawashiri MA. Early Diagnosis and Treatments in Childhood are Associated with Better Prognosis in Patients with Familial Hypercholesterolemia. Am J Prev Cardiol 2022; 12:100434. [PMID: 36439650 PMCID: PMC9685285 DOI: 10.1016/j.ajpc.2022.100434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
Abstract
Objective The early diagnosis and treatment initiation for children with familial hypercholesterolemia (FH) has been recommended in guidelines. However, there is limited data on the impact of early treatments on the prognosis of children with FH. To investigate if the early initiation of lipid-lowering therapies among Japanese pediatric patients with FH reduced the occurrence of cardiovascular disease (CVD) events in them. Methods We retrospectively investigated the occurrence of CVD events (myocardial infarction, unstable angina, or coronary artery revascularization) in patients with FH (N = 1050, male/female = 490/560), including 106 children below 20 years. We compared a variety of phenotypes, including genetic backgrounds, other complications, LDL cholesterol, medical therapies, and their prognoses between the patients’ diagnoses before the age of 20 years (children, mean age = 15 years) and after that age (adults, mean age = 52 years). Overall, 290 patients (27.6%) had a history of prior CVD events. Results The median follow-up duration was 12.6 [9.5–17.9] years. The baseline LDL cholesterol level, 239 mg/dL, dropped to 112 mg/dL with the treatments. The Achilles tendon thickness was significantly lower in children than that of adults (7.2 vs. 8.9 mm, P < 0.001). Over the follow-up duration, 119 CVD events were observed. Importantly, no CVD event was observed in children despite their median LDL cholesterol level at follow-up being significantly higher than that of adults (122 vs. 111 mg/dL, P < 0.001). Conclusion The likelihood of CVD events in those with FH diagnosed and treated in childhood is low.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
- Corresponding author.
| | - Nobuko Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Atsushi Nohara
- Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
| | - Masa-aki Kawashiri
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-Machi, Kanazawa 920-8641, Japan
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Hayashi K, Fujino N, Takamura M, Kawashiri MA. Impact of Variants of Uncertain Significance of LDL receptor on Phenotypes of Familial Hypercholesterolemia. J Clin Lipidol 2022; 16:863-869. [DOI: 10.1016/j.jacl.2022.09.007] [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] [Received: 05/28/2022] [Revised: 08/18/2022] [Accepted: 09/19/2022] [Indexed: 10/14/2022]
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Tada H, Kojima N, Yamagami K, Nomura A, Nohara A, Usui S, Sakata K, Fujino N, Takamura M, Kawashiri MA. Effects of Different Types of Pathogenic Variants on Phenotypes of Familial Hypercholesterolemia. Front Genet 2022; 13:872056. [PMID: 35480308 PMCID: PMC9035489 DOI: 10.3389/fgene.2022.872056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: It has been shown that pathogenic variants are associated with poor clinical outcomes in patients with familial hypercholesterolemia (FH). However, data on the effect of different types of pathogenic variants on FH phenotype is limited. Methods: We retrospectively investigated the associations between genotypes and phenotypes, including low-density lipoprotein (LDL) cholesterol level and the occurrence of major adverse cardiac events (MACEs), defined as cardiovascular death, myocardial infarction, unstable angina, or coronary artery revascularization, in patients with FH (N = 1,050, male/female = 490/560). Based on genotype, the patients were divided into the following three groups: patients without pathogenic variants, patients with missense variants, and patients with protein-truncating variants (PTVs). Cox proportional hazard model was used to identify the factors associated with MACEs. Results: The median follow-up duration was 12.6 years (interquartile range = 9.5–17.9 years). There were 665 patients with FH-mutation (277 patients with missense variants and 388 patients with PTVs) and 385 patients without FH-mutation. Over the follow-up duration, 175 MACEs were observed. We identified 89 different pathogenic variants in the 665 patients with FH. LDL cholesterol level was found to be significantly higher in patients with PTVs (256 mg/dl) than in patients with missense variants (236 mg/dl) and patients without pathogenic variants (216 mg/dl). It was also found that PTVs and missense variants are significantly associated with MACEs (hazard ratio [HR] = 1.58, 95% confidence interval [CI] = 1.08–2.08, p = 0.0033 and HR = 3.24, 95% CI = 2.12–4.40, p = 3.9 × 10−6, respectively), independent of classical risk factors. Conclusion: Pathogenic variants, especially PTVs, are significantly associated with poor outcomes in patients with FH. Genetic testing is useful for the diagnosis and risk stratification of patients with FH.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
- *Correspondence: Hayato Tada,
| | - Nobuko Kojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Atsushi Nohara
- Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Tada H, Kojima N, Yamagami K, Takamura M, Kawashiri MA. Clinical and Genetic Features of Sitosterolemia in Japan. Clin Chim Acta 2022; 530:39-44. [DOI: 10.1016/j.cca.2022.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 01/17/2023]
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Yamagami K, Tada H, Sakata K, Usui S, Kawashiri MA, Takamura M. Eggplant-Like Coronary Aneurysm With Massive Thrombus. Circ Rep 2022; 4:107-108. [PMID: 35178488 PMCID: PMC8811225 DOI: 10.1253/circrep.cr-21-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kan Yamagami
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masa-aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences
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Yamaguchi T, Yamagami K. Burton's line: a sign of chronic lead poisoning. QJM 2021; 114:752. [PMID: 34264343 DOI: 10.1093/qjmed/hcab192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Yamaguchi
- Primary Care and Advanced Triage Section, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori, Miyakojima-Ku, Osaka 534-0021, Japan
| | - K Yamagami
- Internal Medicine, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori, Miyakojima-Ku, Osaka 534-0021, Japan
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Yamagami K, Nomura A, Kometani M, Shimojima M, Sakata K, Usui S, Furukawa K, Takamura M, Okajima M, Watanabe K, Yoneda T. Early detection of exacerbation of the severe acute respiratory syndrome coronavirus 2 infection using Fitbit (DEXTERITY pilot study). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Some patients with coronavirus disease 2019 (COVID-19) experienced sudden death because of sudden symptom deterioration. Thus, an alarm system that could detect early signs of COVID-19 exacerbation beforehand, to prevent serious illness or death of patients while receiving outpatient treatment at home or in hotels is necessary. Here, we tested whether estimated oxygen variations (EOV), a relative physiological scale that represents users' blood oxygen saturation level during sleep measured by Fitbit, predicted COVID-19 symptom exacerbation. Study period was from August to November 2020. We enrolled 23 COVID-19 patients diagnosed by SARS-CoV-2 polymerase chain reaction-positive (mean age ± standard deviation, 50.9±20 years; 70% female), let each patient wore the Fitbit for 30 days; COVID-19 symptoms were exacerbated in 6 (26%). High EOV signal (a patient's oxygen level exhibits significant dip and recovery within the index period) had 80% sensitivity before symptom exacerbations, whereas resting heart rate signal only had 50% sensitivity. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in a patient by consistently high EOV signals. This pilot study successfully detected early COVID-19 symptoms exacerbation by measuring EOV and may help to identify early signs of COVID-19 exacerbation.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The investigational device used in this study, Fitbit Charge 3, was provided by Fitbit Japan. Summary of high EOV signals and eventsThe clinical course of COVID-19
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Affiliation(s)
- K Yamagami
- Kanazawa University Hospital, Kanazawa, Japan
| | - A Nomura
- Kanazawa University Hospital, Kanazawa, Japan
| | - M Kometani
- Kanazawa University Graduate School of Medicine, Department of Health Promotion and Medicine of the Future, Kanazawa, Japan
| | - M Shimojima
- Kanazawa University Hospital, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Kanazawa, Japan
| | - K Furukawa
- Health Care Center, Japan Advanced Institute of Science and Technology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Kanazawa, Japan
| | - M Okajima
- Kanazawa University Hospital, Intensive Care Unit, Kanazawa, Japan
| | - K Watanabe
- JCHO Kanazawa Hospital, Kaznazawa, Japan
| | - T Yoneda
- Kanazawa University Graduate School of Medicine, Department of Health Promotion and Medicine of the Future, Kanazawa, Japan
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Yamagami K, Nomura A, Kometani M, Shimojima M, Sakata K, Usui S, Furukawa K, Takamura M, Okajima M, Watanabe K, Yoneda T. Early Detection of Symptom Exacerbation in Patients With SARS-CoV-2 Infection Using the Fitbit Charge 3 (DEXTERITY): Pilot Evaluation. JMIR Form Res 2021; 5:e30819. [PMID: 34516390 PMCID: PMC8448084 DOI: 10.2196/30819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/05/2021] [Accepted: 08/01/2021] [Indexed: 12/15/2022] Open
Abstract
Background Some patients with COVID-19 experienced sudden death due to rapid symptom deterioration. Thus, it is important to predict COVID-19 symptom exacerbation at an early stage prior to increasing severity in patients. Patients with COVID-19 could experience a unique “silent hypoxia” at an early stage of the infection when they are apparently asymptomatic, but with rather low SpO2 (oxygen saturation) levels. In order to continuously monitor SpO2 in daily life, a high-performance wearable device, such as the Apple Watch or Fitbit, has become commercially available to monitor several biometric data including steps, resting heart rate (RHR), physical activity, sleep quality, and estimated oxygen variation (EOV). Objective This study aimed to test whether EOV measured by the wearable device Fitbit can predict COVID-19 symptom exacerbation. Methods We recruited patients with COVID-19 from August to November 2020. Patients were asked to wear the Fitbit for 30 days, and biometric data including EOV and RHR were extracted. EOV is a relative physiological measure that reflects users’ SpO2 levels during sleep. We defined a high EOV signal as a patient’s oxygen level exhibiting a significant dip and recovery within the index period, and a high RHR signal as daily RHR exceeding 5 beats per day compared with the minimum RHR of each patient in the study period. We defined successful prediction as the appearance of those signals within 2 days before the onset of the primary outcome. The primary outcome was the composite of deaths of all causes, use of extracorporeal membrane oxygenation, use of mechanical ventilation, oxygenation, and exacerbation of COVID-19 symptoms, irrespective of readmission. We also assessed each outcome individually as secondary outcomes. We made weekly phone calls to discharged patients to check on their symptoms. Results We enrolled 23 patients with COVID-19 diagnosed by a positive SARS-CoV-2 polymerase chain reaction test. The patients had a mean age of 50.9 (SD 20) years, and 70% (n=16) were female. Each patient wore the Fitbit for 30 days. COVID-19 symptom exacerbation occurred in 6 (26%) patients. We were successful in predicting exacerbation using EOV signals in 4 out of 5 cases (sensitivity=80%, specificity=90%), whereas the sensitivity and specificity of high RHR signals were 50% and 80%, respectively, both lower than those of high EOV signals. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in 1 patient via consistently high EOV signals. Conclusions This pilot study successfully detected early COVID-19 symptom exacerbation by measuring EOV, which may help to identify the early signs of COVID-19 exacerbation. Trial Registration University Hospital Medical Information Network Clinical Trials Registry UMIN000041421; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047290
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Affiliation(s)
- Kan Yamagami
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Mitsuhiro Kometani
- Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, Japan
| | - Masaya Shimojima
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kenji Furukawa
- Health Care Center, Japan Advanced Institute of Science and Technology, Ishikawa, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masaki Okajima
- Intensive Care Unit, Kanazawa University Hospital, Kanazawa, Japan
| | - Kazuyoshi Watanabe
- Japan Community Health Care Organization Kanazawa Hospital, Kanazawa, Japan
| | - Takashi Yoneda
- Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, Japan
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13
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Tada H, Yamagami K, Kojima N, Shibayama J, Nishikawa T, Okada H, Nomura A, Usui S, Sakata K, Takamura M, Kawashiri MA. Prevalence and Impact of Apolipoprotein E7 on LDL Cholesterol Among Patients With Familial Hypercholesterolemia. Front Cardiovasc Med 2021; 8:625852. [PMID: 33928131 PMCID: PMC8077497 DOI: 10.3389/fcvm.2021.625852] [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: 11/04/2020] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: It has been suggested that a rare mutant apolipoprotein E7, APOE7 (p.Glu262Lys, p.Glu263Lys), has been identified to be associated with hyperlipoproteinemia in the general population. Moreover, its prevalence has been shown to be 0.005-0.06%. However, there are no prior data regarding its prevalence and impact on serum lipids in patients with familial hypercholesterolemia (FH). Methods: We recruited 1,138 patients with clinically diagnosed FH [mean age = 48, men = 512, median low-density lipoprotein (LDL) cholesterol = 231 mg/dl]. The coding regions of three FH genes (LDLR, APOB, and PCSK9) and apolipoprotein E (APOE) gene were sequenced. We investigated the prevalence and impact of APOE7 mutant on serum lipid levels in patients with FH. Results: We identified 29 patients (2.5 %) with a mutant APOE7 (heterozygote), which is apparently much higher than that of the general population. Moreover, when we focus on those without FH mutation (n = 540), we identified 21 patients (3.9 %) with a mutant APOE7. Patients with a mutant APOE7 exhibited significantly higher median LDL cholesterol and triglyceride levels compared with those without this rare mutant (249 vs. 218 mg/dl, p < 0.05, 216 vs. 164 mg/dl, p < 0.05, respectively). Moreover, LDL cholesterol levels in the APOE7-oligogenic FH individuals, with a pathogenic mutation in FH genes and APOE7 mutant, were significantly higher than that in monogenic FH patients (265 vs. 245 mg/dl, p < 0.05). Conclusion: We identified more patients with a mutant APOE7 than expected among those diagnosed with FH clinically, especially among those without FH-causing mutation. This implies a mutant APOE7 may be one of the causes FH, especially among those without FH mutations.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Nobuko Kojima
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Junichi Shibayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Tetsuo Nishikawa
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hirofumi Okada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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14
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Tanaka Y, Tada H, Hamaya R, Patel RB, Hayashi K, Yamagami K, Hashiba A, Takamura M, Kawashiri MA, Greenland P. First-degree atrioventricular block is significantly associated with incident atrial fibrillation in the population predominantly including participants aged ≥ 60 years. Heart Vessels 2021; 36:1401-1409. [PMID: 33595701 DOI: 10.1007/s00380-021-01805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
Some previous studies demonstrated that first-degree atrioventricular block (f-AVB) was associated with incident atrial fibrillation (AF), while evidence is scarce regarding the association between f-AVB and incident AF in older populations. Therefore, we sought to investigate the association of f-AVB with incident AF in the population predominantly including participants aged ≥ 60 years. Eligible participants were residents in Kanazawa City, Japan aged ≥ 40 years who underwent 12-lead ECG at the National Japanese Health Check-up in 2013. Participants with AF detected at the baseline exam and those without adequate follow-up were excluded. f-AVB was defined as PR interval ≥ 220 ms based on the Minnesota code (6-3). The cumulative incidence of AF was estimated by the Kaplan-Meier curve analysis, and statistical significance was evaluated by the Log-rank test. Unadjusted and adjusted hazard ratios (HRs) were computed by Cox proportional hazard models. HRs were adjusted for conventional risk factors for AF. 37,730 participants (mean age, 72.3 ± 9.6 years; male, 37%) were included. Baseline f-AVB was observed in 667 (1.8%) participants. During the median follow-up period of 5 years (interquartile range, 4.0-5.0 years), 691 cases of incident AF were observed. A 5-year cumulative incidence of AF was significantly higher in f-AVB (+) group compared with f-AVB (-) group (6.8% vs 2.1%, p < 0.01). In the fully adjusted model, f-AVB was significantly associated with incident AF (HR, 1.75; 95% confidence interval 1.25-2.45; p value < 0.01). f-AVB was independently associated with incident AF in the population predominantly including participants aged ≥ 60 years.
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Affiliation(s)
- Yoshihiro Tanaka
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA. .,Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan.
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan
| | - Rikuta Hamaya
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Cardiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ravi B Patel
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan
| | | | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, 920-8641, Japan
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA
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15
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Kang Y, Kikawa Y, Kotake T, Tsuyuki S, Takahara S, Yamashiro H, Yoshibayashi H, Takada M, Yasuoka R, Yamagami K, Suwa H, Okuno T, Nakayama I, Kato T, Moriguchi Y, Ishiguro H, Kagimura T, Taguchi T, Sugie T, Toi M. 52P Chemotherapy selection in routine clinical practice in Japan for HER2-negative advanced or metastatic breast cancer (KBCRN A001: E-SPEC Study). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Tada H, Yamagami K, Nishikawa T, Yoshida T, Teramoto R, Sakata K, Takamura M, Kawashiri MA. Lipoprotein (a) and the Risk of Chronic Kidney Disease in Hospitalized Japanese Patients. Intern Med 2020; 59:1705-1710. [PMID: 32669515 PMCID: PMC7434553 DOI: 10.2169/internalmedicine.4503-20] [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
Objective Lipoprotein (a), or Lp (a), has been shown to be associated with the development of chronic kidney disease (CKD) in populations of various ethnicities. This study aimed to investigate the association between serum Lp (a) and CKD in Japanese patients. Methods A total of 6,130 subjects who underwent a serum Lp (a) level assessment for any reason (e.g. any type of surgery requiring prolonged bed rest or risk factors for atherosclerosis, such as hypertension or diabetes) were retrospectively investigated at Kanazawa University Hospital from April 2004 to March 2014. Of these, 1,895 subjects were excluded because of the lack of clinical data. Subjects were assessed for Lp (a), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, hypertension, diabetes, smoking, body mass index (BMI), coronary artery disease (CAD), and CKD (stage ≥3). Results When the study subjects were divided into quartiles of Lp (a) levels, significant trends were observed with regard to the presence of CKD (p = 2.7×10-13). A multiple regression analysis showed that Lp (a) was significantly associated with CKD [odds ratio (OR), 1.12; 95% confidence interval (CI), 1.08-1.17; p = 1.3×10-7, per 10 mg/dL], independent of other classical risk factors, including age, gender, BMI, hypertension, diabetes, smoking, LDL cholesterol, and triglycerides. Under these conditions, Lp (a) was significantly associated with CAD (OR = 1.11, 95% CI = 1.06-1.16; p = 1.7×10-6, per 10 mg/dL), independent of other risk factors. Conclusion Serum Lp (a) was associated with CKD, independent of other classical risk factors in a Japanese population.
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Affiliation(s)
- Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Kan Yamagami
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Tetsuo Nishikawa
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Taiji Yoshida
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Ryota Teramoto
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, Japan
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17
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Yamagami K, Tanaka Y, Tada H, Fujii H, Takamura M, Kawashiri MA. The First Report of Purulent Pericarditis Associated with Aortic Stent-graft Infection Caused by Methicillin-susceptible Staphylococcus aureus. Intern Med 2019; 58:3103-3106. [PMID: 31292391 PMCID: PMC6875457 DOI: 10.2169/internalmedicine.2994-19] [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: 12/01/2022] Open
Abstract
We herein report the first case of purulent pericarditis associated with aortic stent-graft infection in an 80-year-old Japanese man that was caused by methicillin-susceptible Staphylococcus aureus, which appropriate antibiotics failed to treat. The detailed clinical course and autopsy images revealed that purulent pericarditis associated with aortic stent-graft infection caused cardiac tamponade and eventually led to mortality. We therefore suggest that surgical procedures, including drainage, should be introduced for such cases.
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Affiliation(s)
- Kan Yamagami
- Department of Cardiology, Kanazawa University Graduate School of Medicine, Japan
| | - Yoshihiro Tanaka
- Department of Cardiology, Kanazawa University Graduate School of Medicine, Japan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, USA
| | - Hayato Tada
- Department of Cardiology, Kanazawa University Graduate School of Medicine, Japan
| | - Hiroshi Fujii
- Division of Rheumatology, Kanazawa University Graduate School of Medicine, Japan
| | - Masayuki Takamura
- Department of Cardiology, Kanazawa University Graduate School of Medicine, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiology, Kanazawa University Graduate School of Medicine, Japan
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18
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Miki M, Takao S, Konishi M, Shigeoka Y, Miyashita M, Suwa H, Imamura M, Okuno T, Hirokaga K, Miyoshi Y, Murase K, Yanai A, Yamagami K, Akazawa K. Investigation of the use of a novel S-1 administration method for treating metastatic and recurrent breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz418.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Tada H, Yamagami K, Nishikawa T, Nohara A, Kawashiri M, Takamura M. P6199Lipoprotein(a) and risk of chronic kidney disease among 4,235 Japanese hospitalized patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lipoprotein (a) [Lp(a)] has been shown to be associated with the development of chronic kidney disease (CKD) among various ethnicities. In addition, recent Mendelian randomization studies have suggested that Lp(a) seems to be causally associated with CKD. However, few data exist regarding this issue among Japanese population.
Purpose
We aimed to investigate the association between serum Lp(a) and the CKD among Japanese population.
Methods
We retrospectively investigated 6,130 subjects whose serum Lp(a) had been measured for any reason (e.g. any operations which needs bed rest for a long duration, risk factors for atherosclerosis such as hypertension or diabetes) at our University Hospital from April 2004 to March 2014. We excluded 1,895 subjects due to the lack clinical data. We assessed their Lp(a), LDL cholesterol, HDL cholesterol, triglycerides, presence of hypertension, diabetes, chronic kidney disease, smoking, body mass index, presence of coronary artery disease (CAD), and presence of CKD (stage 3 or greater).
Results
When the study subjects were divided into 5 groups based on their CKD stage, there was a significant trend among their serum Lp(a) levels (P-trend = 2.7×10–13). Under these conditions, multiple regression analysis showed that Lp(a) was significantly associated with CKD [odds ratio (OR): 1.12, 95% confidence interval (CI): 1.08–1.17; p=1.3×10–7: per 10mg/dL)., independent of other classical risk factors, including age, gender, body mass index, hypertension, diabetes, smoking, LDL cholesterol and triglycerides. Under these conditions, Lp(a) was significantly associated with CAD [OR: 1.11, 95% CI: 1.06–1.16; p=1.7×10–6: per 10mg/dL), independent of the presence of CKD.
Conclusion
Serum Lp(a) was associated with the development of CKD independent of other classical risk factors among Japanese population as well.
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Affiliation(s)
- H Tada
- Kanazawa University, Kanazawa, Japan
| | | | | | - A Nohara
- Kanazawa University, Kanazawa, Japan
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20
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Hayashi M, Nakazawa K, Hasegawa Y, Horiguchi J, Miura D, Ishikawa T, Takao S, Kim SJ, Yamagami K, Miyashita M, Konishi M, Shigeoka Y, Suzuki M, Taguchi T, Kubota T, Tanino Y, Yamada K, Kimura K, Akazawa K, Kohno N. Abstract P1-11-07: Risk analysis for chemotherapy induced nausea and vomiting (CINV) in patients receiving FEC100 treatment. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Anthracycline-containing regimens are standard treatment options in adjuvant and neoadjuvant chemotherapy in breast cancer. Chemotherapy-induced nausea and vomiting (CINV) is experienced frequently in patients receiving these regimens, but the risk factors for CINV are unknown.
OBJECTIVE:
The aim of this study was to investigate risk factors for CINV in anthracycline-containing regimens retrospectively.
METHODS:
Data were collected from the JONIE study, which was conducted in order to estimate the efficacy of zoledronic acid in a neoadjuvant setting from March 2010 to June 2012 (UMIN000003261). A total of 180 patients were recruited, and we used CINV data from the first cycle of FEC100 treatment and patient backgrounds. As the protocol regulation allowed the use of antiemetic drugs,in the first cycle of the FEC100 regimen, patients received various types of antiemetic agents, which we classified into four groups: Dexamethasone (DEX)+5-HT3 receptor antagonist (5-HT3)+neurokinin-1 receptor antagonist (NK1) (DEX+5-HT3+NK1) group; Dexamethasone (DEX)+5-HT3 receptor antagonist (5-HT3) (DEX+5HT3) group; Dexamethasone (DEX)+5-HT3 receptor antagonist (5-HT3)+dopamine receptor antagonist (DRA) (DEX+5HT3+DRA) group; and Dexamethasone (DEX)+5-HT3 receptor antagonist (5-HT3)+neurokinin-1 receptor antagonist (NK1)+ dopamine receptor antagonist (DRA) (DEX+5-HT3+NK1+DRA) group. Risk factors were selected from patient backgrounds and the combinations of antiemetic drugs. In patient backgrounds, the body mass index (BMI) was stratified into 3 categories: Less than 18.5 (underweight group); equal to or more than 18.5 but less than 25 (standard BMI group); and equal to or more than 25 (overweight group). The risks for CINV were analyzed by univariate and multivariate analyses. P values of less than 0.05 were defined as significant.
RESULTS:
In a univariate analysis of nausea, the body mass index (BMI) was the only significant factor (P<0.05). On the other hand, BMI and the combination of antiemetic drugs were significant factors in vomiting. (P<0.05 and 0.005, respectively). In a multivariate analysis of nausea, the P value for BMI was 0.02. The odds ratio for the underweight group was 7.745 (confidence interval: 2.171 to 27.634) compared with the standard BMI group. In a multivariate analysis of vomiting, BMI and the combination of antiemetic drugs were significant risk factors (P=0.025 and 0.023, respectively). The odds ratio for the underweight group was 3.481 (confidence interval: 1.183 to 10.241)compared with the standard BMI group. Furthermore, the odds ratios in the DEX+5-HT3+DRA and DEX+5HT3 groups were 5.005 (confidence interval: 1.543 to 16.239) and 4.178 (confidence interval: 1.428 to 12.222), respectively, compared with the DEX+5-HT3+NK1 group, which was consistent with the CINV guidelines in 2011.
CONCLUSIONS:
This study revealed that BMI was the most important risk factor for nausea, and that BMI and the combination of antiemetic drugs were risk factors for vomiting. Underweight-patients tend to have CINV in anthracycline-containing regimen. The DEX+5-HT3+NK1 group was the best antiemetic drug combination. These result show that following the CINV guideline treatment is mandatory in order to prevent CINV.
Citation Format: Hayashi M, Nakazawa K, Hasegawa Y, Horiguchi J, Miura D, Ishikawa T, Takao S, Kim SJ, Yamagami K, Miyashita M, Konishi M, Shigeoka Y, Suzuki M, Taguchi T, Kubota T, Tanino Y, Yamada K, Kimura K, Akazawa K, Kohno N. Risk analysis for chemotherapy induced nausea and vomiting (CINV) in patients receiving FEC100 treatment [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-07.
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Affiliation(s)
- M Hayashi
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - K Nakazawa
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - Y Hasegawa
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - J Horiguchi
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - D Miura
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - T Ishikawa
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - S Takao
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - SJ Kim
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - K Yamagami
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - M Miyashita
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - M Konishi
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - Y Shigeoka
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - M Suzuki
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - T Taguchi
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - T Kubota
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - Y Tanino
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - K Yamada
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - K Kimura
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - K Akazawa
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
| | - N Kohno
- Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan; Niigata University, 951 Asahimachi, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Aomori, Japan; International University of Health and Welfare, 4-3 Kozunomori, Narita, Chiba, Japan; Akasaka Miura Clinic, 2-11-15 Akasaka, Minato-ku, Tokyo, Japan; Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan; Hyogo Cancer Center, 13-70, Kitaoji-machi, Akashi, Hyogo, Japan; Oaska University, 2-2 Yamadagaoka, Suita, Osaka, Japan; Shinko Hospital, 1-4-47, Wakihama-cho, Kobe, Hyogo, Japan; Konan Hospital, 1-5-16 Kamokogahara, Kobe, Hyogo, Japan; Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokujinji-machi, Nishinomiya, Hyogo, Japan; Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashi Yodogawa, Osaka, Japan; National Hospital Organization Chiba Medical Center, 4-1-2 Tsubakimori, Chiba, Japan; Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kyoto, Japan; Kamiiida Daiichi General Hospital, 2-70 Ka
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Maeshima Y, Takahara S, Yamauchi A, Yamagami K, Sugie T, Yamashiro H, Kato H, Torii M, Takada M, Torii M. Abstract P3-03-21: Usefulness of sentinel lymph node biopsy by indocyanine green fluorescence method for cN0 breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background. Indocyanine green (ICG) fluorescence method (ICG-f) has been recently widely used in sentinel lymph node (SLN) detection. The advantages of ICG-f are no radiation exposure, no limitation to use in high-volume medical centers without radioactive facility, and to confirm lymph flow as a real-time image from outside the body. ICG-f identified an average of 2.3-3.4 SLNs and the detection rate was 99%, compared to 1.7-2 SLNs by RI methods. Long-term observation after SNB using ICG-f has not been reported, including arm lymphedema as the complication of this method.We evaluate the usefulness of SLN biopsy (SNB) for cN0 breast cancer patients from data of multicenter cohort study on long-term results after negative SNB by ICG-f.
Methods. Eleven hundred and thirty-two women were enrolled who had histologically proved clinical stage T1-4, pN0, M0 primary invasive breast cancer with SNB using ICG-f (ICG alone or combination of RI/blue dye method) sparing axillary lymph node dissection from May 2007 to December 2015. This study is retrospective, multicenter cohort study conducted at 6 centers in Japan. Primary endpoint is axillary recurrence rate. We analyzed the correlation with the axillary recurrence and adjuvant systemic therapy, adjuvant radiotherapy, and the clinicopathological characteristics. Secondary endpoint is lymphedema.
Results and Discussion. The median follow-up time was 41 (range 21-117) months, and axillary recurrence was found in 6 patients (0.53%). Five out of 6 patients were not received standard adjuvant systemic therapy or adjuvant radiation therapy after breast conserving surgerybecause of patient's preference or old age. Lymphedema was identified only 4 patients in 632 patients. It is reported that axillary recurrence after SNB was 0.3-1.65%, which was consistent with our result. Lymphedema was not frequent in patients received SNB using ICG-f, because SLNs are removed along with lymphatic ducts in the limited area of axillary adipose tissue.
Conclusion.Axillary recurrence after negative SNB using ICG-f was comparable to RI or blue dye method. It might be important to perform appropriate adjuvant medication or radiation therapy for preventing axillary recurrence after SNB using ICG-f.
Next, ICG-f after neoadjuvant chemotherapy is to be investigated, because itis reported that removing more than 2 SLNs were associated with a lower likelihood of false negative ratio in patients with clinically node-positive disease converted to clinically node-negative after chemotherapy, and ICG-f might overcome this issue.
Citation Format: Maeshima Y, Takahara S, Yamauchi A, Yamagami K, Sugie T, Yamashiro H, Kato H, Torii M, Takada M, Torii M. Usefulness of sentinel lymph node biopsy by indocyanine green fluorescence method for cN0 breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-21.
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Affiliation(s)
- Y Maeshima
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - S Takahara
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - A Yamauchi
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - K Yamagami
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - T Sugie
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - H Yamashiro
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - H Kato
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - M Torii
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - M Takada
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
| | - M Torii
- Tazuke Kofukai Foundation, Medical Research Institute, Kitano Hospital, Osaka, Japan; Shinko Hospital, Kobe, Japan; Kansai Medical University Hospital, Osaka, Japan; Tenri Hospital, Nara, Japan; Kobe City Medical Center General Hospital, Kobe, Japan; Kyoto University Hospital, Kyoto, Japan
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Nakatsukasa K, Kikawa Y, Kotake T, Yamagami K, Tsuyuki S, Yamashiro H, Suwa H, Sugie T, Okuno T, Kato H, Takahara S, Nakayama I, Ogura N, Moriguchi Y, Takata M, Suzuki E, Yoshibayashi H, Ishiguro H, Taguchi T, Toi M. Prospective cohort study of real world chemotherapy sequence for metastatic breast cancer (KBCRN A001: E-SPEC study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.305] [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: 11/12/2022] Open
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Yamagami K, Matsumoto H, Hashimoto T, Yanai S, Yuen S, Yata Y, Ichinose Y, Deai T, Toi M. The application of indocyanine green fluorescence navigation method to a sentinel lymph node biopsy after neoadjuvant chemotherapy in node-positive breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tsuyuki S, Yamagami K, Yoshibayashi H, Sugie T, Mizuno Y, Tanaka S, Kato H, Okuno T, Ogura N, Yamashiro H, Takuwa H, Kikawa Y, Hashimoto T, Kato T, Takahara S, Yamauchi A, Inamoto T. Effectiveness of surgical glove compression therapy as a prophylactic method against nab-paclitaxel induced peripheral neuropathy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.117] [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: 11/12/2022] Open
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Ishikawa T, Akazawa K, Hasegawa Y, Tanino H, Horiguchi J, Miura D, Hayashi M, Takao S, Kim SJ, Yamagami K, Miyashita M, Konishi M, Shigeoka Y, Suzuki M, Taguchi T, Kubota T, Kohno N. Abstract P5-16-10: Zoledronic acid combined with neoadjuvant chemotherapy for HER2-negative early breast cancer (JONIE 1 trial): Survival outcomes of a randomized multicenter phase 2 trial. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-10] [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 and AIM:
Findings from a randomized phase 2 JONIE1 trial in women with HER2-negative early breast cancer have shown that the addition of zoledronic acid (ZOL) to neoadjuvant chemotherapy (CT) has potential anticancer benefits in postmenopausal and triple-negative breast cancer patients. We report the data for the prespecified secondary endpoint of disease-free survival (DFS).
METHODS:
We enrolled women with HER2-negative early breast cancer and randomly assigned them to receive CT or CT+ZOL (CTZ). All patients received 4 cycles of FEC100 (fluorouracil 500 mg/m2, epirubicin 100 mg/m2, and cyclophosphamide 500 mg/m2), followed by 12 cycles of paclitaxel at 80 mg/m2 weekly. ZOL (4 mg) was administered 3-4 times weekly for 7 weeks to the CTZ group patients. Definitive surgery was performed 3-4 weeks after the last paclitaxel dose. The primary endpoint was pathological complete response (pCR). The secondary endpoints were the clinical response rates, rate of breast-conserving surgery, safety, and DFS (defined as the time from randomization to disease occurrence or death). The trial is registered as UMIN000003261 (www.umin.ac.jp/english/) with ongoing follow-up.
FINDINGS:
Of the 188 patients enrolled, 95 were assigned to the CT group and 93 to the CTZ group. The mean (95% CI) DFS time of the CT group was 5.15 years (4.83-5.47) and that of the CTZ group was 5.38 years (5.11-5.66). The 3-year DFS rate was 84.6% (95% CI 77.2-92.0) in the CT group and 90.7% (84.6-96.8) in the CTZ group with no significant difference (p = 0.120). The particular benefit from ZOL for the neoadjuvant CT seen as improvement of the pCR rate was indicated in the 3-year DFS period for triple-negative cancer cases (CT vs CTZ: 70.6% vs 94.1%), but not for postmenopausal cases.
CONCLUSIONS:
ZOL slightly improved DFS when combined with CT. Although a significant difference was not found in this study, plans are underway for conducting a combined analysis of 3 neoadjuvant CT trials together with ZOL. The improvement of the pCR rate may be associated with DFS in triple-negative cases. Previous studies have shown that ZOL was more efficacious in an estrogen-suppressed condition. However, the short-term application of ZOL in this study may not be sufficient to improve the outcome in postmenopausal patients.
Citation Format: Ishikawa T, Akazawa K, Hasegawa Y, Tanino H, Horiguchi J, Miura D, Hayashi M, Takao S, Kim SJ, Yamagami K, Miyashita M, Konishi M, Shigeoka Y, Suzuki M, Taguchi T, Kubota T, Kohno N. Zoledronic acid combined with neoadjuvant chemotherapy for HER2-negative early breast cancer (JONIE 1 trial): Survival outcomes of a randomized multicenter phase 2 trial [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-10.
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Affiliation(s)
- T Ishikawa
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - K Akazawa
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - Y Hasegawa
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - H Tanino
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - J Horiguchi
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - D Miura
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - M Hayashi
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - S Takao
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - SJ Kim
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - K Yamagami
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - M Miyashita
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - M Konishi
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - Y Shigeoka
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - M Suzuki
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - T Taguchi
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - T Kubota
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
| | - N Kohno
- Tokyo Medical Univeristy, Tokyo, Japan; Niigata University Medical and Dental Hospital, Niigata, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Kitasato University Hospital, Sagamihara; Gunma University Hospital, Maebashi, Japan; Toranomon Hospital, Tokyo, Japan; Tokyo Medical University Hachioji Medical Center, Tokyo, Japan; Hyogo Cancer Center, Kobe, Japan; Osaka University, Osaka, Japan; Shinko Hospital, Kobe, Japan; Konan Hospital, Kobe, Japan; Hyogo Prefectural Nishinomiya Hospital, Kobe, Japan; Yodogawa Christian Hospital, Osaka, Japan; National Hospital Organization, Chiba Medical Center, Chiba, Japan; Kyoto Prefectural University of Medicine, Kyoto, Japan; Kamiiida Daiichi General Hospital, Nagoya, Japan; Kobe Kaisei Hospital, Kobe, Japan
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Kaise H, Ishikawa T, Miura D, Hasegawa Y, Horiguchi J, Hayashi M, Takao S, Kim SJ, Tanino H, Miyashita M, Konishi M, Shigeoka Y, Yamagami K, Suzuki M, Taguchi T, Akazawa K, Kohno N. Abstract P3-07-50: Early and accurate prediction of pathological response by magnetic resonance imaging and ultrasonography in patients undergoing neoadjuvant chemotherapy for operable breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant chemotherapy (NAC) reduces tumor size, and increases the frequency of breast-conserving surgery in operable breast cancers. Response predictions to NAC are made based on diagnostic imaging.
Although various studies have reported the optimal timing for diagnostic imaging, this still remains unclear.
Purpose: To identify the optimal timing of diagnostic imaging for the response prediction to NAC, and to evaluate the accuracy of response prediction.
Methods: We evaluated 146 cases enrolled in the JONIE-1 study (a randomized controlled trial comparing zoledronic acid plus chemotherapy with chemotherapy alone as a NAC in patients with HER2-negative primary breast cancer). The chemotherapy regimen was FEC100×4 courses followed by weekly paclitaxel 80×12 courses (± zoledronic acid). Statistical analysis of the association between the tumor reduction ratio and the histopathological response and the prediction of pathological complete response (pCR) was performed using JMP software. The maximum tumor diameter was evaluated using magnetic resonance imaging and ultrasound on each patient 3 times (before NAC, after FEC treatment, after NAC) and tumor reduction ratios were calculated.
Results: The average age of the patients was 49.8 years old. The menopause status was pre-menopause in 84 patients, and post-menopause in 58 patients. Regarding the subtype classification, 116 patients were of the luminal type (Lum) and 26 patients were triple negative (TN), and the Ki-67 labeling index had a median of 25% (1%-93%).
Pathological examination demonstrated that 16 patients had pCR(11.3%, Lum, 9;TN: 7), and 126 patients had non-pCR (88.7%, Lum:107; TN:19). Seven patients had clinical-CR (4.8%, Lum: 4; TN: 3) at post-FEC, and 26 patients (17.8%, Lum: 20; TN: 6) at post-NAC. The prediction of pCR at post-FEC and post-NAC was evaluated by single variable analysis, resulting in an AUC (0.75645) p=0.0017 at post-FEC, and AUC (0.76563) p=0.0001 at post-NAC. The sensitivity / specificity / positive predictive value / negative predictive value were 0.625 / 0.873 / 0.385 / 0.948 at post-FEC, 0.250 / 0.976 / 0.571 / 0.911 at post-NAC, respectively. In TN cases, the values were 0.714 / 0.947 / 0.833 / 0.900 in post-FEC, and 0.429 / 1.000 / 1.000 / 0.826 in post-NAC.
Conclusions: Diagnostic imaging evaluation performed after FEC treatment was useful for the prediction of pCR. Furthermore, the reliability was high in Triple Negative Sub type, but is affected by the existence of residual tumors in Luminal type.
Citation Format: Kaise H, Ishikawa T, Miura D, Hasegawa Y, Horiguchi J, Hayashi M, Takao S, Kim SJ, Tanino H, Miyashita M, Konishi M, Shigeoka Y, Yamagami K, Suzuki M, Taguchi T, Akazawa K, Kohno N. Early and accurate prediction of pathological response by magnetic resonance imaging and ultrasonography in patients undergoing neoadjuvant chemotherapy for operable breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-50.
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Affiliation(s)
- H Kaise
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - T Ishikawa
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - D Miura
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - Y Hasegawa
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - J Horiguchi
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - M Hayashi
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - S Takao
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - SJ Kim
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - H Tanino
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - M Miyashita
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - M Konishi
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - Y Shigeoka
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - K Yamagami
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - M Suzuki
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - T Taguchi
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - K Akazawa
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
| | - N Kohno
- Tokyo Medical University Hospital, Tokyo, Japan; Yokohama City University Medical Center; Toranomon Hospital; Hirosaki Municipal Hospital; Gunma University Hospital; Tokyo Medical University Hachioji Medical Center; Hyogo Cancer Center; Osaka University Hospital; Naga Municipal Hospital; Konan Hospital; Hyogo Prefectural Nishinomiya Hospital; Yodogawa Christian Hospital; Shinko Hospital; Niigata University Medical and Dental Hospital; Kobe Kaisei Hospital; National Hospital Organization Chiba Medical Center; University Hospital, Kyoto Prefectural University of Medicine
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Yamazaki S, Morio H, Inami M, Ito M, Fujii Y, Hanaoka K, Yamagami K, Okuma K, Morita Y, Shirakami S, Inoue T, Miyata S, Higashi Y, Seki N. THU0101 ASP015K: A Novel Jak Inhibitor Demonstrated Potent Efficacy in Adjuvant-Induced Arthritis Model in Rats. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Uchitomi N, Oomae H, Toyota H, Yamagami K, Kambayashi T. Magnetic, electrical and structural properties of annealed ferromagnetic (Zn,Sn)As 2:Mn thin films on InP substrates: comparison with undoped ZnSnAs 2. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20147503007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fukami H, Hatano Y, Kishi M, Katagiri K, Fujiwara S, Yamagami K. Ingestion of sphingolipids restores the skin permeability barrier after damage caused by repeated ultraviolet B irradiation in mice. Clin Exp Dermatol 2013; 39:71-2. [DOI: 10.1111/ced.12162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2013] [Indexed: 11/30/2022]
Affiliation(s)
- H. Fukami
- Central Research Institute, Mizkan Group Corporation; Handa Aichi 475-8585 Japan
| | - Y. Hatano
- Research Team for Functional Genomics, Department of Dermatology, Faculty of Medicine; Oita University; Oita Japan
| | - M. Kishi
- Central Research Institute, Mizkan Group Corporation; Handa Aichi 475-8585 Japan
| | - K. Katagiri
- Research Team for Functional Genomics, Department of Dermatology, Faculty of Medicine; Oita University; Oita Japan
- Department of Dermatology; Koshigaya Hospital, Dokkyo Medical University; Saitama Japan
| | - S. Fujiwara
- Research Team for Functional Genomics, Department of Dermatology, Faculty of Medicine; Oita University; Oita Japan
| | - K. Yamagami
- Central Research Institute, Mizkan Group Corporation; Handa Aichi 475-8585 Japan
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Azhim A, Yamagami K, Muramatsu K, Morimoto Y, Furukawa KS, Tanaka M, Fukui Y, Ushida T. The Use of Sonication Treatment to Completely Decellularize Aorta Tissue. IFMBE Proceedings 2013. [DOI: 10.1007/978-3-642-29305-4_522] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Saeki T, Takahashi T, Okabe M, Furuya A, Hanai N, Yamagami K, Mandai K, Moriwaki S, Doihara H, Takashima S, Salomon D. Immunohistochemical detection of ribonucleotide reductase in human breast-tumors. Int J Oncol 2012; 6:523-9. [PMID: 21556566 DOI: 10.3892/ijo.6.3.523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Ribonucleotide reductase (RNR) consists of two non-identical subunits, R1 and R2 and is one of the key enzymes involved in DNA biosynthesis. RNR activity is considerably higher in malignant tumors than in normal tissues in the rat suggesting that RNR may play an important role in the pathogenesis of human tumors. In order to obtain immunological reagents to study the localization and level of expression of RNR in various human tissues, a synthetic peptide containing sequences corresponding to the COOH-terminal region of the human R2 subunit was used to generate rat monoclonal antibodies. The generated rat monoclonal antibodies (IgG) inhibited RNR enzymatic activity purified from murine P388 leukemia cells. These antibodies were used to immunohistochemically examine the distribution of RNR in a small panel of 8 malignant and 4 benign human breast tumors. Positive immunostaining for RNR was observed in the cytoplasm of human breast carcinoma cells in which a specific 44 kDa specific band of R2 subunit was also detected by Western blot analysis. The immunostaining was blocked by preabsorption of the antibody with an excess amount of the synthetic peptide immunogen. In 8 of 8 breast carcinomas, positive immunostaining for the R2 subunit was observed whereas noninvolved, adjacent breast tissue showed no staining with this antibody. In addition, few of the benign breast lesions exhibited staining with this antibody. These data indicate that these antibodies can immunohistochemically detect RNR in frozen or formalin-fixed, paraffin- embedded tissues and that there is a differential expression of RNR between breast tumors and non-involved breast tissue. Immunohistochemical detection of RNR using these antibodies may therefore be useful for the diagnosis of human breast tumors.
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Affiliation(s)
- T Saeki
- NCI,TUMOR GROWTH FACTOR SECT,TUMOR IMMUNOL & BIOL LAB,BETHESDA,MD 20892. KYOWA HAKKO KOGYO CO LTD,TOKYO RES LABS,TOKYO,JAPAN. KYOWA HAKKO KOGYO CO LTD,PHARMATHEUT RES LABS,SHIZUOKA,JAPAN
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Winchester CL, Ohzeki H, Vouyiouklis DA, Thompson R, Penninger JM, Yamagami K, Norrie JD, Hunter R, Pratt JA, Morris BJ. Converging evidence that sequence variations in the novel candidate gene MAP2K7 (MKK7) are functionally associated with schizophrenia. Hum Mol Genet 2012; 21:4910-21. [DOI: 10.1093/hmg/dds331] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sugie T, Sawada T, Tagaya N, Kinoshita T, Yamagami K, Suwa H, Yoshimura K, Nimi M, Toi M. 72 Identification of Sentinel Lymph Node Metastasis and Axillary Status in Early Breast Cancer by Indocyanine Green Fluorescence Method. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70140-5] [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: 11/29/2022]
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Sugie T, Sawada T, Tagaya N, Kinoshita T, Yamagami K, Suwa H, Yoshimura K, Sumi M, Toi M. Validation study on the clinical usefulness of the ICG fluorescence method for detecting sentinel lymph node in early-stage breast cancer in comparison with the dye method. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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35
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Azhim A, Yamagami K, Muramatsu K, Morimoto Y, Tanaka M. The use of sonication treatment to completely decellularize blood arteries: a pilot study. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2011:2468-2471. [PMID: 22254841 DOI: 10.1109/iembs.2011.6090685] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We have developed a novel sonication decellularization system to prepare completely decellularized bioscaffolds in a short treatment time. The aim of the study is to investigate the sonication decellularization efficiency and its relation with ultrasonic power output and dissolved oxygen (DO) concentration in different detergent solution. In the study, we used aorta samples to evaluate sonication decellularization efficiency, which assessed treatment duration, sonication power and SDS detergent with/without saline. The treated samples were evaluated histologically by Hematoxylin Eosin (HE) staining and scanning electron microscopic (SEM) photographs. The concentration of DO was monitored to identify the effect of sonication on cavitation-related DO concentration in the solution. From histological results, the sonication decellularization efficiency was better than the other preparation methods. Decellularization efficiency was tended to increase significantly when DO value decreasing after 6 hours of treatment. In conclusion, we conclude that sonication treatment can be used to prepare the complete decellularized scaffolds in short treatment time.
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Affiliation(s)
- A Azhim
- Frontier R& D Center, Tokyo Denki University, Hatoyama 350-0394, Japan.
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Sugie T, Kassim KA, Takeuchi M, Hashimoto T, Yamagami K, Masai Y, Toi M. Abstract P1-01-12: A Novel Method for Sentinel Lymph Node Biopsy by Indocyanine Green Fluorescence Technique in Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p1-01-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Sentinel lymph node (SLN) biopsy is the standard method to assess the actual axillary lymph node status in breast cancer. Currently dye techniques, radioisotope techniques or combined techniques are usually used for SLN detection. Recently, near infrared fluorescence imaging has been applied clinically in a breast cancer patient to identify SLN. In this study, the feasibility of SLN biopsy using the indocyanine green (ICG) technique were evaluated.
Methods: The study involved four hundreds eleven patients with clinically node negative early breast cancer who underwent SLN in three institutes. A combination of ICG as a fluorescence emitting source and blue dyes were injected in the subareolar area and lymphatic flows were traced with a charge coupled device camera and a real-time image guided surgery enabled to identify the fluorescence image of SLN after meticulous dissection.
Results: The subcutaneous lymphatic channels were detected precisely in all cases. The identification rate of SLN was 99%, (408/411) with a mean number of 2.3±1.2 (range, 1-9) nodes identified per patient. Only one SLN harvested in 30.1% of patients, two in 29.4%, three in 23.9% and four or more in 15.9% of patients. Thirty nine cases (9.5%) had SLNs involved and all of them were ICG positive and 30 of 39 patients (77%) had one SLN involved.
Conclusions: This ICG fluorescence method is simple and achieves a high SLN identification rate. This technique does not require a facility equipped to use radioisotopes. This means that SLN biopsies could even be performed in a small hospital. Orderly and sequential dissection along the lymphatic flow may provide higher sensitivity compared with the conventional radioisotope method. A direct comparison between the radioisotope and ICG fluorescence methods is now required.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-12.
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Affiliation(s)
- T Sugie
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - KA Kassim
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - M Takeuchi
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - T Hashimoto
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - K Yamagami
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - Y Masai
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
| | - M. Toi
- Kyoto University Hospital, Kyoto, Japan; South Egypt Cancer Institute, Assiut University, Assiut, Egypt; Shinko Hospital, Kobe, Japan; Kobe City Medical Center, General Hospital, Kobe, Japan
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Yamagami K, Hashimoto T, Yamamoto M. The efficacy of sentinel lymph node and lymphatic tracts detection using fluorescence navigation with indocyanine green in breast cancer: An analysis of 410 patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.633] [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: 11/20/2022] Open
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38
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Yamagami K, Hosoi M, Yamamoto T, Fukumoto M, Yamakita T, Miyamoto M, Yoshioka K, Ishii T, Sato T, Tanaka S, Fujii S. Coronary arterial calcification is associated with albuminuria in type 2 diabetic patient. Diabetes Obes Metab 2005; 7:390-6. [PMID: 15955125 DOI: 10.1111/j.1463-1326.2004.00408.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Although microalbuminuria has been suggested as an independent risk factor for ischemic heart disease, the relationship between diabetic nephropathy and macroangiopathy remains unclear. Previously, we reported that coronary artery calcification detected by electron beam computed tomography (EBCT) could indicate the degree of coronary atherosclerosis in type 2 diabetic patients. In this study, we examine the association between coronary arterial calcification and microalbuminuria and aortic calcification and microalbuminuria. METHODS Two hundred and fifty-six patients, including 177 type 2 diabetic patients (106 patients with normoalbuminuria, 71 with microalbuminuria) and 79 non-diabetic patients were evaluated by assessing the urinary albumin excretion rate and using EBCT to determine a coronary calcification score (CCS) and an aortic calcification score (ACS). RESULTS No differences were observed regarding age, smoking index or BMI. Diabetic patients exhibited a greater CCS than non-diabetic subjects (non-diabetes 33 +/- 75 vs. diabetes 203 +/- 467, p < 0.05). Diabetic patients with microalbuminuria exhibited the most advanced CCS (253 +/- 491, p < 0.05). In contrast, no difference was observed in ACS among three groups. Multiple regression analysis showed that CCS is significantly associated with urinary albumin excretion rate as well as age, duration of diabetes and serum creatinine (R(2) = 0.31), while ACS is strongly associated with age, smoking, serum creatinine, systolic blood pressure and low-density lipoprotein cholesterol level (R(2) = 0.29). CONCLUSION Increased urinary albumin excretion is associated with coronary arterial calcification in diabetic patients.
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Affiliation(s)
- K Yamagami
- Department of Metabolism and Endocrinology, Osaka City General Hospital, Miyakojima, Japan
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Ishii T, Yamakita T, Yamagami K, Yamamoto T, Miyamoto M, Kawasaki K, Hosoi M, Yoshioka K, Sato T, Tanaka S, Fujii S. Effect of exercise training on serum leptin levels in type 2 diabetic patients. Metabolism 2001; 50:1136-40. [PMID: 11586483 DOI: 10.1053/meta.2001.26745] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To evaluate the effect of exercise training on serum leptin levels 50 sedentary subjects with type 2 diabetes were enrolled in either 6 weeks of aerobic exercise training with diet therapy (n = 23) or diet therapy alone (n = 27). The training program consisted of walking and cycle ergometer exercise for 1 hour at least 5 times per week, with the intensity of exercise maintained at 50% of maximum oxygen uptake. Serum leptin levels decreased significantly in the exercise training (TR) group (7.2 +/- 3.6 to 4.6 +/- 2.5 ng/mL, P <.05), but not in the sedentary (SED) group (6.9 +/- 3.4 to 5.6 +/- 2.9 ng/mL). Leptin levels standardized for percentage body fat (dividing serum leptin level by percentage body fat) after treatment were lower in the TR subjects compared with the SED subjects. Body weight and percentage body fat decreased in all patients; however, no significant changes were observed in either group. Fasting concentrations of plasma insulin and cortisol and the urinary excretion of 17-hydroxycorticosteroid (17-OHCS) did not differ between the groups either before or after treatment. Fasting plasma glucose and hemoglobin A(1c) (HbA(1c)) improved significantly in both groups, although no significant differences were observed between the groups either before or after treatment. Ventilatory threshold increased significantly in the exercise training subjects. This study demonstrates that exercise training in type 2 diabetic subjects reduces serum leptin levels independent of changes in body fat mass, insulin, or glucocorticoids.
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Affiliation(s)
- T Ishii
- Department of Internal Medicine, Osaka City General Hospital, Japan
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Dai CL, Xia ZL, Kume M, Yamamoto Y, Yamagami K, Ozaki N, Yamaoka Y. Heat shock protein 72 normothermic ischemia, and the impact of congested portal blood reperfusion on rat liver. World J Gastroenterol 2001; 7:415-8. [PMID: 11819802 PMCID: PMC4688734 DOI: 10.3748/wjg.v7.i3.415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- C L Dai
- Department of Surgery, The Second Clinical College of China Medical University, No.36 San Hao Street, He-Ping District, Shenyang 110003, Liaoning Province,China
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Abstract
Cholecystokinin-8 (CCK-8) dose-dependently increased the cytosolic Ca2+ concentration ([Ca]i) in ventromedial hypothalamic neurons acutely dissociated from the immature rat brain. The CCK-8 response was mimicked by caerulein, but not by CCK(B) agonists, and was often inhibited by CCK(A) receptor antagonists, but rarely by CCK(B) receptor antagonists. The response was dependent on external Ca2+ and Na+, and was inhibited by voltage-dependent Ca2+ channel blockers. The results suggest that CCK-8-induced depolarization via CCK(A) receptors increased Ca2+ influx through a voltage-dependent Ca2+ channel, which in turn increased [Ca]i.
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Affiliation(s)
- M Sorimachi
- Department of Physiology, Faculty of Medicine, Kagoshima University, Japan.
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Abstract
ATP increased the cytosolic Ca(2+) concentration ([Ca](i)) in nucleus accumbens neurons acutely dissociated from rat brain. The ATP response was dependent on external Ca(2+) and Na(+), and was blocked by voltage-dependent Ca(2+) channel blockers. The results suggest that the ATP-induced depolarization increases Ca(2+) influx resulting in the increase in [Ca](i).
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Affiliation(s)
- M Sorimachi
- Department of Physiology, Kagoshima University, Faculty of Medicine, 890-8520, Kagoshima, Japan.
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Fujimura M, Hashimoto K, Yamagami K. The effect of the antipsychotic drug mosapramine on the expression of Fos protein in the rat brain: comparison with haloperidol, clozapine and risperidone. Life Sci 2000; 67:2865-72. [PMID: 11106001 DOI: 10.1016/s0024-3205(00)00872-9] [Citation(s) in RCA: 20] [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: 11/17/2022]
Abstract
In this study, we examined the effect of the acute p.o. administration of the antipsychotic drug mosapramine, as well as the antipsychotic drugs clozapine, haloperidol and risperidone, on the expression of Fos protein in the medial prefrontal cortex, nucleus accumbens and dorsolateral striatum of rat brain. The administration of mosapramine (1 or 3 mg/kg) significantly increased the number of Fos protein positive neurons in the medial prefrontal cortex, but not in the dorsolateral striatum. In addition, mosapramine (1, 3 or 10 mg/kg) produced a dose-dependent increase in the number of Fos protein positive neurons in the nucleus accumbens. The acute administration of 10 mg/kg of mosapramine significantly increased the number of Fos protein positive neurons in all brain regions. The acute administration of clozapine (30 mg/kg), similarly to mosapramine at lower doses (1 or 3 mg/kg), significantly increased the number of Fos protein positive neurons in the medial prefrontal cortex and nucleus accumbens, but not dorsolateral striatum. In contrast, haloperidol (0.3 mg/kg) significantly increased the number of Fos protein positive neurons in the nucleus accumbens and dorsolateral striatum, but not medial prefrontal cortex. The acute administration of risperidone (0.3 or 1 mg/kg) did not affect the number of Fos protein positive neurons in the medial prefrontal cortex, nucleus accumbens or dorsolateral striatum of rat brain, whereas a 3 mg/kg dose of risperidone significantly increased the number of Fos protein positive neurons in all brain regions. These results suggest that the ability of mosapramine to enhance expression of Fos protein in the medial prefrontal cortex may contribute to a clozapine-like profile with respect to actions on negative symptoms in schizophrenia. Furthermore, the lack of effect of low doses of mosapramine on Fos protein expression in the dorsolateral striatum, an area believed to play a role in movement, suggests that it may have a lower tendency to induce neurological side effects.
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Affiliation(s)
- M Fujimura
- Tokyo Laboratories, Pharmaceutical Research Division, Welfide Corporation, LTD, Saitama, Japan.
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Kume M, Yamamoto Y, Yamagami K, Ishikawa Y, Uchinami H, Yamaoka Y. Pharmacological hepatic preconditioning: involvement of 70-kDa heat shock proteins (HSP72 and HSP73) in ischaemic tolerance after intravenous administration of doxorubicin. Br J Surg 2000; 87:1168-75. [PMID: 10971423 DOI: 10.1046/j.1365-2168.2000.01509.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Pharmacological preconditioning may induce a stress response which protects liver against ischaemia-reperfusion injury (IRI). The aim of this study was to determine, in an animal model, whether intravenous administration of doxorubicin induces heat shock proteins (HSPs) in liver tissue and facilitates liver tolerance to subsequent warm IRI. METHODS Male Wistar rats were used. Production of HSPs was determined in liver tissue sequentially after the injection of doxorubicin 1 mg/kg body-weight. Acquisition of tolerance for 30 min warm ischaemia and reperfusion of the liver was determined in animals pretreated (48 h beforehand) with doxorubicin, and in controls. Biochemical liver function and liver adenine nucleotide concentration 40 min after reperfusion and survival rate at 7 days after the ischaemic insult were recorded. RESULTS Expression of HSP72 and HSP73 in the liver was confirmed 48 h after doxorubicin administration. Biochemical parameters and survival rates were significantly better in pretreated animals than in controls. CONCLUSION These results indicate that doxorubicin has the potential to provide the liver with tolerance against IRI. A simultaneous increase of both HSP72 and HSP73 in liver tissue may explain the acquisition of tolerance following the administration of doxorubicin.
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Affiliation(s)
- M Kume
- Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507, Japan
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Fujimura M, Hashimoto K, Yamagami K. Effects of antipsychotic drugs on neurotoxicity, expression of fos-like protein and c-fos mRNA in the retrosplenial cortex after administration of dizocilpine. Eur J Pharmacol 2000; 398:1-10. [PMID: 10856442 DOI: 10.1016/s0014-2999(00)00235-1] [Citation(s) in RCA: 25] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, we examined the effect of clozapine, olanzapine, risperidone and haloperidol on the neuropathology (i.e. neuronal vacuolization) and the expression of Fos-like protein and c-fos mRNA in the retrosplenial cortex of female Sprague-Dawley rats induced by the NMDA receptor antagonist dizocilpine. Pretreatment (15 min) with clozapine or olanzapine, but not risperidone or haloperidol, blocked the neuronal vacuolization produced by dizocilpine (0.5 mg/kg, s.c.) in the rat retrosplenial cortex in a dose-dependent manner. Furthermore, pretreatment (15 min) with clozapine or olanzapine, but not risperidone or haloperidol, significantly attenuated the expression of Fos-like protein in the retrosplenial cortex induced by dizocilpine (0.5 mg/kg, s.c.) in a dose-dependent manner. The marked expression of c-fos mRNA in the rat retrosplenial cortex induced by the administration of dizocilpine (0.5 mg/kg, s.c.) was significantly attenuated by pretreatment (15 min) with clozapine (10 mg/kg) or olanzapine (10 mg/kg), but not risperidone (10 mg/kg) or haloperidol (10 mg/kg). The present results suggest that pharmacologically relevant doses of clozapine or olanzapine, but not risperidone or haloperidol, block the neuropathological changes and the expression of Fos-like protein and c-fos mRNA in the rat retrosplenial cortex elicited by the administration of dizocilpine. It is possible that the blockade of dizocilpine-induced neuropathological changes by clozapine and olanzapine may be related to the unique antipsychotic actions of these drugs in schizophrenic patients, although this remains to be verified.
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Affiliation(s)
- M Fujimura
- Tokyo Laboratories, Pharmaceutical Research Division, Yoshitomi Pharmaceutical Industries, Ltd, Saitama, Iruma, Japan
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Yamagami K, Yamamoto Y, Ishikawa Y, Yonezawa K, Toyokuni S, Yamaoka Y. Effects of geranyl-geranyl-acetone administration before heat shock preconditioning for conferring tolerance against ischemia-reperfusion injury in rat livers. J Lab Clin Med 2000; 135:465-75. [PMID: 10850646 DOI: 10.1067/mlc.2000.106806] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of geranyl-geranyl-acetone (GGA) administration before heat shock preconditioning on heat shock protein (HSP) 72 induction and on the acquisition of tolerance against ischemia-reperfusion Injury was studied in rat livers. Male Wistar rats were divided into four groups: a control group (group C); a GGA group (group G); a simple heat shock group (group VH); and a heat shock with GGA premedication group (group GH). Five-, 10-, and 15-minute periods of heat shock preconditioning at 42 degrees C were performed in groups VH and GH. Subgroups were determined according to the period of heat shock exposure. After a 48-hour recovery, rats in groups C, VH5, VH15, and GH5 received a 30-minute period of hepatic ischemia. Induction of HSP72, survival rates, and changes in biochemical and histologic parameters were compared among the groups. Five-minute heat shock preconditioning was not enough to Induce HSP72. However, livers in group GH5 expressed approximately the same amount of HSP72 as those in group VH15. The expression of HSP72 in group GH15 was stronger than that found in group VH15. The degree and location of HSP72 expression were not different between groups GH5 and VH15. Seven-day survival was significantly better in groups GH5 (16/16) and VH15 (15/16) than in group C (8/16) or VH5 (9/16). The recovery of adenosine triphosphate in liver tissue was faster, and the release of liver-related enzymes during reperfusion was lower in groups GH5 and VH15 than in group C or VH5. Administration of GGA before heat shock preconditioning augmented the induction of HSP72 by decreasing the threshold for triggering the stress response.
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Affiliation(s)
- K Yamagami
- Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Japan
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Yamamoto H, Yamamoto Y, Yamagami K, Kume M, Kimoto S, Toyokuni S, Uchida K, Fukumoto M, Yamaoka Y. Heat-shock preconditioning reduces oxidative protein denaturation and ameliorates liver injury by carbon tetrachloride in rats. Res Exp Med (Berl) 2000; 199:309-18. [PMID: 10945649 DOI: 10.1007/s004339900040] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Membrane lipids and cytosolic proteins are major targets of oxidative injury. This study examined the effect of heat-shock preconditioning associated with the induction of heat-shock protein 72 on liver injury, from the aspect of lipid peroxidation and protein denaturation after carbon tetrachloride (CCl4) administration in rats--one of the representative oxidative injuries. Male Wistar rats were divided into two groups, group HS (preconditioned by heat exposure) and group C (not preconditioned). Expression of HSP72 in the liver tissue was confirmed by Western blot analysis. After a 48-h recovery period, all rats were given CCl4 intragastrically. Liver damage was assessed by measuring serum liver-related enzyme levels and adenine nucleotide concentration in the liver tissue. Lipid peroxidation and protein denaturation were evaluated by measuring tiobarbituric acid reactive substances (TBARS) and by immunohistochemical staining of 4-hydroxy-2-nonenal(HNE)-modified proteins in the liver. Survival rates of the rats after CCl4 administration were also compared. Expression of HSP72 was clearly detected in group HS, but not in group C. Heat-shock preconditioning significantly improved the survival rate, suppressed the increase in liver-related enzyme levels and maintained adenosine triphosphate levels (P<0.01 each). HNE-modified proteins--denatured proteins by free radical attack--were significantly less stained in group HS than in group C (P<0.05). However, TBARS levels did not differ between groups. Because heat-shock preconditioning did not alter TBARS levels but reduced HNE-modified proteins in association with the expression of HSP72, it is suggested that HSP72 did not prevent lipid peroxidation but decreased the lipid peroxidation-induced denaturation of proteins. This seemed to be a mechanism of heat-shock preconditioning to ameliorate oxidative liver injury.
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Affiliation(s)
- H Yamamoto
- Department of Gastroenterological Surgery, Kyoto University, Graduate School of Medicine, Japan
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Kimoto S, Yamamoto Y, Yamagami K, Ishikawa Y, Kume M, Yamamoto H, Ozaki N, Yamaoka Y. The augmentative effect of repeated heat shock preconditioning on the production of heat shock protein 72 and on ischemic tolerance in rat liver tissue. Int J Hyperthermia 2000; 16:247-61. [PMID: 10830587 DOI: 10.1080/026567300285268] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Heat shock pretreatment induces heat shock protein (HSP)72 strongly in rat livers and provides the tolerance against subsequent ischemia-reperfusion injury. In this study, the effects of repeated heat shock pretreatment on the production of HSP72 in rat livers and on subsequent ischemic tolerance were investigated. METHODS Rats pretreated with repeated heat shock were compared with those that received a single heat shock pretreatment. The production of HSP72 was analysed using Western-blotting and densitometer. At 48 h after heat shock pretreatment, all rats were subjected to warm liver ischemia for 30 or 45 min and then reperfused. Survival rate of the animals and liver functions during reperfusion were analysed. RESULTS The production of HSP72 increased in the repeated heat shock group more than in the single heat shock group. Although there were no significant differences in animal survival or in liver functions after a 30-min ischemia between the single heat shock group and the repeated heat shock group, animal survival and liver functions after a 45-min ischemia were significantly better in the repeated heat shock group. CONCLUSION In rats, repetition of heat shock pretreatment augmented the production of HSP72 in liver tissue and protected the liver from ischemia-reperfusion injury.
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Affiliation(s)
- S Kimoto
- Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Japan
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Hashimoto K, Fujimura M, Yamagami K. Dizocilpine-induced neuropathological changes in rat retrosplenial cortex are reversed by subsequent clozapine treatment. Life Sci 2000; 66:1071-8. [PMID: 10737357 DOI: 10.1016/s0024-3205(00)00410-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we examined the effect of post-treatment with clozapine on the neuropathological changes in the rat retrosplenial cortex induced by the administration of non-competitive NMDA receptor antagonist dizocilpine ((+)-MK-801). The maximal increase in vacuolized neurons, which are representative of neuropathology, was observed 4 hours after a single injection of dizocilpine (0.5 mg/kg s.c.), with a complete reversal of the neuropathology after 16-24 hours. The administration of clozapine (10 mg/kg, i.p.,) 4 hours after the administration of dizocilpine significantly decreased the number of vacuolized neurons in the retrosplenial cortex 6, 8 or 10 hours after administration of dizocilpine, compared to vehicle-treated animals. Furthermore, the administration of clozapine (5, 10 or 20 mg/kg i.p.) 4 hours after the administration of dizocilpine produced a significant decrease in the number of vacuolized neurons in the retrosplenial cortex in a dose-dependent manner when measure 6 hours post-dizocilpine. These results show that neuropathological changes in the rat retrosplenial cortex produced by dizocilpine can be attenuated by post-treatment with clozapine.
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Affiliation(s)
- K Hashimoto
- Tokyo Laboratories, Yoshitomi Pharmaceutical Industries, Ltd., Iruma, Saitama, Japan.
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Yamagami K, Yamamoto Y, Kume M, Ishikawa Y, Yamaoka Y, Hiai H, Toyokuni S. Formation of 8-hydroxy-2'-deoxyguanosine and 4-hydroxy-2-nonenal-modified proteins in rat liver after ischemia-reperfusion: distinct localization of the two oxidatively modified products. Antioxid Redox Signal 2000; 2:127-36. [PMID: 11232593 DOI: 10.1089/ars.2000.2.1-127] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Ischemia-reperfusion (IR) injury is an intractable process associated not only with therapeutic recanalization of vessels, but also with partial resection or transplantation of solid organs including liver. To develop methods for predicting the degree of hepatic IR injury and further to identify injured cells, we studied the formation of 8-hydroxy-2'-deoxy-guanosine (8-OHdG) and 4-hydroxy-2-nonenal (HNE)-modified proteins in the normothermic hepatic IR model of rats using immunohistochemistry, high-performance liquid chromatography (HPLC) determination and Western blot. The Pringle maneuver for either 15 or 30 min duration produced reversible or lethal damage, respectively. The levels of both products were significantly increased in proportion to ischemia duration 40 min after reperfusion, suggesting the involvement of hydroxyl radicals. Increased immunoreactivity of 8-OHdG was observed not only in the nuclei of hepatocytes but also in those of bile canalicular and endothelial cells. However, immunoreactivity of HNE-modified proteins was detected in the cytoplasm of hepatocytes, which was confirmed by Western blot, and in addition, in the nuclei of hepatocytes after severe injury. Thus, localization of the two oxidatively modified products was not identical. Our data suggest that these two products could be used for the assessment of hepatic IR injury in tissue, but that the biological significance of the two products might be different.
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Affiliation(s)
- K Yamagami
- Department of Gastroenterological Surgery, Graduate School of Medicine, Kyoto University, Japan
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