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Findings from a discontinued clinical trial of favipiravir in high-risk patients with early-onset COVID-19. J Infect Chemother 2024; 30:219-227. [PMID: 37832822 DOI: 10.1016/j.jiac.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Favipiravir terminates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication. Accordingly, early administration of favipiravir to SARS-CoV-2-infected coronavirus disease 2019 (COVID-19) patients may be expected to suppress disease progression. METHODS A randomized double-blind placebo-controlled trial was conducted to demonstrate efficacy of favipiravir in reducing disease progression in patients with mild COVID-19. The participants were unvaccinated patients with comorbidities and at risk of progression to severe disease. Patients were enrolled within 72 h of disease onset and randomized to receive either favipiravir (1800 mg/dose on Day 1 followed by 800 mg/dose) or matching placebo twice daily for 10 days. The primary endpoint was the proportion of patients requiring oxygen therapy within 28 days of randomization. RESULTS The trial was discontinued after enrolling 84 patients due to slower than anticipated enrollment caused by rapid uptake of SARS-CoV-2-vaccines and the emergence of the Omicron variant. Results from the 84 patients demonstrated no significant difference in all clinical outcomes. In post-hoc analyses, favipiravir treatment showed higher efficacy in patients within 48 h of onset. No deaths or severe adverse events were documented in the favipiravir group. Plasma concentrations of favipiravir from Day 2 onward were maintained above 40 μg/mL. CONCLUSIONS Conducting clinical trials for pathogens like SARS-CoV-2 that rapidly accumulate mutations leading to altered disease characteristics carries significant risks unless it can be done in a short period. Therefore, it would be important to prepare the comprehensive clinical trial platform that can appropriately and promptly evaluate drugs even under a pandemic.
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Development of a Machine Learning Model to Evaluate Changes during Radiotherapy in Cervical Cancer Tumor Cells. Int J Radiat Oncol Biol Phys 2023; 117:e467-e468. [PMID: 37785488 DOI: 10.1016/j.ijrobp.2023.06.1671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy is considered the standard treatment for advanced cervical cancer. It is known that irradiation changes the morphology of tumor cells during the treatment, though its clinical significance is unknown. Recently, the usefulness of machine learning using medical images has been reported, as also as pathological images. The purpose of this study is to create a classification model for cervical tumor biopsy treated with radiotherapy, visualized on whole slide images using machine learning, in an attempt to explore the clinical significance of morphology changes during radiotherapy. MATERIALS/METHODS Cervical cancer patients who underwent radical irradiation with both pre- and mid-treatment biopsy from April 1, 2013, to December 1, 2020, were retrospectively analyzed. Tumor biopsies were Hematoxylin and eosin stained and digitized to whole slide images (WSIs). WSI s were divided into tiles of 224 × 224 pixels and converted into feature vectors using a pre-trained convolutional neural network (densenet121). A training and test dataset were divided 1:1 on a patient basis, and the model was trained to classify "pre-treatment" and "mid-treatment", and its accuracy was evaluated. The probability obtained from the classification model was defined as the radiation change index (RCI), and its color map was projected on the WSI for visualization. Survival analysis was performed to examine the clinical significance of the RCI values. RESULTS A total of eighty-four patients were analyzed, and the median observation period was 3.2 years. 184 WSIs were obtained, and 2203407 tiles were generated. The classification model was trained using 2500 tiles for each "pre-treatment" and "mid-treatment". The accuracy of the classification model was 70.8 %, with an AUC of 0.77 for the ROC curve. The probability obtained from the classification model was defined as RCI, with 0 being "pre-treatment" and 1 being "mid-treatment", and the mean RCI of "pre-treatment" and "mid-treatment" were 0.38 and 0.61, respectively. When the RCIs were visualized with a color map, the areas considered to be "pre-treatment" were consistent with a viable tumor component, and the areas considered to be "mid-treatment" were consistent with fibrosis supposed to cause by irradiation. To evaluate the clinical significance of RCI, we divide the clinical cohort into two groups with a threshold mean RCI of 0.4 in the pre-treatment biopsy. The disease-free survival was 91 months and 47 months in the RCI<0.4 and RCI≥0.4 groups, respectively. CONCLUSION We created a model to classify tissues before and during radiotherapy and successfully visualized it on slide images. The low RCI group before treatment had a better prognosis than the high RCI group, suggesting that the tumor morphologic features obtained by machine learning may be useful for prognosis prediction. Further studies are planned to develop a model that can accurately predict prognosis.
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Association between Reduction of Muscle Mass and Faster Declines in Global Cognition among Older People: A 4-Year Prospective Cohort Study. J Nutr Health Aging 2023; 27:932-939. [PMID: 37997712 DOI: 10.1007/s12603-023-2007-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/17/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES A few studies reported that both decrease and increase in body mass index (BMI) were associated with the development of dementia in later life. However, it is unclear what changes in body composition are associated with cognitive decline. This study investigated the longitudinal influences of changes in body composition on cognitive function among community-dwelling adults. DESIGN, SETTING AND PARTICIPANTS This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in National Institute for Longevity Sciences - Longitudinal Study of Aging. MEASUREMENTS Cognitive function was assessed using the MMSE. Body composition was measured by a dual-energy X-ray absorptiometry system. Then, BMI, fat mass index (FMI), fat-free mass index (FFMI), and muscle mass index (MMI) were calculated. The changes in body composition over 6 years (second wave to fifth wave) were calculated, and three groups were created: decreased group, decrease of >5%; stable group, change within 5%, and increased group, increase of >5%. In statistical analysis, a linear mixed model was applied by sex to investigate the influences of body composition changes on cognitive function over 4 years (fifth wave to seventh wave). RESULTS This study analyzed 515 participants (mean age, 67.05 years; 53.4% men). Men with decreased group in FFMI and MMI exhibited faster declines in MMSE scores than those with stable group (β [95% CI]: FFMI, -0.293 [-0.719 to -0.020]; MMI, -0.472 [-0.884 to -0.059]). In women, there was no significant association between body composition changes and cognitive functions. CONCLUSIONS Decrease in fat-free mass and muscle mass is associated with faster cognitive declines in men. These results suggest the importance of continuous monitoring of muscle mass to prevent cognitive decline in later life.
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Cross-Sectional Associations of Sarcopenia and Its Components with Neuropsychological Performance among Memory Clinic Patients with Mild Cognitive Impairment and Alzheimer’s Disease. J Frailty Aging 2022; 11:182-189. [DOI: 10.14283/jfa.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Evaluation of elastin fibres in young and aged eyelids and abdominal skin using computational 3D structural analysis. SKIN HEALTH AND DISEASE 2021; 1:e58. [PMID: 35663779 PMCID: PMC9060010 DOI: 10.1002/ski2.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 11/17/2022]
Abstract
Background Aging‐related degeneration of elastic fibres causes skin wrinkles and loss of elasticity. A correlation has been reported between dermal elastic fibre degradation and wrinkles. However, the mechanism of wrinkle formation is complex and unclear. To establish methods for treating wrinkles, it is necessary to understand the aging‐related morphological alterations underlying elastin fibre degradation or disappearance. Objectives To image and analyse aging‐related three‐dimensional (3D) morphological alterations of elastic fibres in the eyelid and abdominal skin. Methods Excised human eyelid and abdominal skin tissues were examined. The structure of elastic fibres in the skin tissues was examined via nuclear, tropoelastin and fibrillin‐1 immunostaining. Then, 3D imaging was performed using a confocal laser microscope and tissue decolourization technology. Images were analysed using a computational method. Results The decolourization technology made it possible to image elastin fibres in 3D, and we devised a method for analyzing the elastin fibre structure using computational methods. It was quantitatively shown that the eyelid skin has a more complex fibrous structure than the abdomen, and the fibres became curved, shortened and thickened with age. Conclusions We provide a novel 3D analysis method for elastin fibres and report age‐related alterations in elastin fibre structure in the human eyelid and abdominal skin. This method contributes to the understanding of elastin fibre degeneration in more detail than conventional methods. Applying this 3D analysis method to skin tissues will contribute to a better understanding of age‐related changes in fibres and to the development of novel wrinkle treatments.
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329 In vitro co-culture models of merkel cell-neurite complex in touch domes. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT): The Study Protocol for an 18-Month, Multicenter, Randomized, Controlled Trial. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 8:465-476. [PMID: 34585222 PMCID: PMC8187136 DOI: 10.14283/jpad.2021.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background/Objectives The Japan-multimodal intervention trial for prevention of dementia (J-MINT) is intended to verify the effectiveness of multi-domain interventions and to clarify the mechanism of cognitive improvement and deterioration by carrying out assessment of dementia-related biomarkers, omics analysis and brain imaging analysis among older adults at high risk of dementia. Moreover, the J-MINT trial collaborates with partnering private enterprises in the implementation of relevant interventional measures. This manuscript describes the study protocol. Design/Setting Eighteen-month, multi-centered, randomized controlled trial. Participants We plan to recruit 500 older adults aged 65–85 years with mild cognitive impairment. Subjects will be centrally randomized into intervention and control groups at a 1:1 allocation ratio using the dynamic allocation method with all subjects stratified by age, sex, and cognition. Intervention The multi-domain intervention program includes: (1) management of vascular risk factors; (2) group-based physical exercise and self-monitoring of physical activity; (3) nutritional counseling; and (4) cognitive training. Health-related information will be provided to the control group every two months. Measurements The primary and secondary outcomes will be assessed at baseline, 6-, 12-, and 18-month follow-up. The primary outcome is the change from baseline to 18 months in a global composite score combining several neuropsychological domains. Secondary outcomes include: cognitive change in each neuropsychological test, incident dementia, changes in blood and dementia-related biomarkers, changes in geriatric assessment including activities of daily living, frailty status and neuroimaging, and number of medications taken. Conclusions This trial that enlist the support of private enterprises will lead to the creation of new services for dementia prevention as well as to verify the effectiveness of multi-domain interventions for dementia prevention. Electronic Supplementary Material Supplementary material is available for this article at 10.14283/jpad.2021.29 and is accessible for authorized users.
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Efficacy and Safety of Favipiravir in Moderate COVID-19 Pneumonia Patients without Oxygen Therapy: A Randomized, Phase III Clinical Trial. Infect Dis Ther 2021; 10:2489-2509. [PMID: 34453234 PMCID: PMC8396144 DOI: 10.1007/s40121-021-00517-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/27/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is an enveloped, single-stranded RNA virus. Favipiravir is an orally administrable antiviral drug whose mechanism of action is to selectively inhibit RNA-dependent RNA polymerase. A preliminary trial in COVID-19 patients reported significant improvements across a multitude of clinical parameters, but these findings have not been confirmed in an adequate well-controlled trial. We conducted a randomized, single-blind, placebo-controlled Phase III trial assessing the efficacy and safety of favipiravir in patients with moderate pneumonia not requiring oxygen therapy. Methods COVID-19 patients with moderate pneumonia (SpO2 ≥ 94%) within 10 days of onset of fever (temperature ≥ 37.5 °C) were assigned to receive either placebo or favipiravir (1800 mg twice a day on Day 1, followed by 800 mg twice a day for up to 13 days) in a ratio of 1:2. An adaptive design was used to re-estimate the sample size. The primary endpoint was a composite outcome defined as the time to improvement in temperature, oxygen saturation levels (SpO2), and findings on chest imaging, and recovery to SARS-CoV-2-negative. This endpoint was re-examined by the Central Committee under blinded conditions. Results A total of 156 patients were randomized. The median time of the primary endpoint was 11.9 days in the favipiravir group and 14.7 days in the placebo group, with a significant difference (p = 0.0136). Favipiravir-treated patients with known risk factors such as obesity or coexisting conditions provided better effects. Furthermore, patients with early-onset in the favipiravir group showed higher odds ratio. No deaths were documented. Although adverse events in the favipiravir group were predominantly transient, the incidence was significantly higher. Conclusions The results suggested favipiravir may be one of options for moderate COVID-19 pneumonia treatment. However, the risk of adverse events, including hyperuricemia, should be carefully considered. Trial registration Clinicaltrials.jp number: JapicCTI-205238. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00517-4.
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P78.14 The Efficacy and Safety of ICIs in Treating Postoperative Recurrence of NSCLC: Results of Two Hospitals in Japan. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reduced-Dose Whole Brain Radiation Therapy Combined With Stereotactic Irradiation For Solitary Or Oligo Brain Metastases Aiming At Minimizing Deterioration Of Neurocognitive Function Without Compromising Intracranial Tumor Control: Preliminary Results. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Does Reduction Of Urethral Dose In Ultra-Hypofractionated Radiotherapy For Prostate Cancer Improve Acute Genitourinary Toxicity? Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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862 Thioredoxin regenerates elastic fibers in the dermis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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[Utility of the Predictive Score for Cisplatin-Induced Nephrotoxicity in Patients with Chemotherapy for Lung Cancer]. Gan To Kagaku Ryoho 2019; 46:1849-1853. [PMID: 31879402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cisplatin(CDDP)-induced nephrotoxicity(CIN)is a critical complication of chemotherapy. Among patients undergoing chemotherapy with CDDP, short-hydration, and magnesium supplementation for lung cancer, this study was conducted to evaluate the frequency of CIN and utility of the predictive score. METHODS Patients who underwent chemotherapy with CDDP for lung cancer were retrospectively investigated. A multiple logistic regression analysis to detect the risk factors for CIN and receiver operating characteristic analysis to examine the discrimination of the predictive score were performed. RESULTS A total of 111 patients were included, with a total count of chemotherapy courses of 402 and a median count of chemotherapy courses of 4. CIN occurred in 9.9% of the patients, with grade 2 and higher in 7.2% and 87% of the CIN cases detected in the initial course, respectively. The significantly independent risk factors for CIN included the number of chemotherapy courses, female gender, and predictive score. The discriminative power of the predictive score was moderate. CONCLUSION The predictive score for CIN was simple and useful in patients undergoing chemotherapy for lung cancer with CDDP, short-hydration, and magnesium supplementation, even in late courses.
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Neural circuits of cataplexy. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The relationship between the gut microbiome and mild cognitive impairment in patients without dementia: A cross-sectional study conducted in Japan. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Analysis of molecular species of phosphatidylcholine hydroperoxide in human native and copper-oxidized triglyceride-rich lipoproteins. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Comparison between stereotactic radiosurgery and whole-brain radiotherapy for 10-20 brain metastases from non-small cell lung cancer. Mol Clin Oncol 2019; 10:560-566. [PMID: 30967951 DOI: 10.3892/mco.2019.1830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/08/2019] [Indexed: 11/05/2022] Open
Abstract
The efficacy and safety of stereotactic radiosurgery (SRS) in comparison with whole brain radiotherapy (WBRT) for brain metastases (BMs) remains unclear. The present study retrospectively reviewed 44 patients who received SRS or WBRT as an initial treatment for 10-20 BMs from non-small cell lung cancer between 2009 and 2016. Of the patients, 24 (54.5%) were treated with SRS and 20 (45.5%) were treated with WBRT. Overall survival (OS), time to intracranial progression (TTIP), neurological survival (NS), and prognostic factors were examined. OS did not significantly differ between the two groups: 7.3 months in the SRS group vs. 7.2 months in the WBRT group (P=0.502). Median TTIP was significantly shorter in the SRS group than in the WBRT group (7.1 vs. 19.1 months, P=0.009). In contrast, there were no significant differences in NS between the two groups (14.5 months in the SRS group vs. 12.9 months in the WBRT group, P=0.346). Univariate and multivariate analysis revealed that the type of initial treatment for BMs (WBRT or SRS) was not a significant prognostic factor (hazard ratio=0.80, 95% confidence interval: 0.42-1.52, P=0.502). However, histology, performance status, subsequent molecular targeted drugs, subsequent chemotherapy and salvage treatment were independent prognostic factors. There were no significant differences in OS and NS between treatment with SRS and treatment with WBRT in patients with 10-20 BMs, although TTIP was improved with WBRT. As an upfront treatment for 10-20 BMs, SRS may delay WBRT and the adverse events associated with WBRT.
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Pressure-tuning the quantum spin Hamiltonian of the triangular lattice antiferromagnet Cs 2CuCl 4. Nat Commun 2019; 10:1064. [PMID: 30842420 PMCID: PMC6403288 DOI: 10.1038/s41467-019-09071-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 02/13/2019] [Indexed: 11/23/2022] Open
Abstract
Quantum triangular-lattice antiferromagnets are important prototype systems to investigate numerous phenomena of the geometrical frustration in condensed matter. Apart from highly unusual magnetic properties, they possess a rich phase diagram (ranging from an unfrustrated square lattice to a quantum spin liquid), yet to be confirmed experimentally. One major obstacle in this area of research is the lack of materials with appropriate (ideally tuned) magnetic parameters. Using Cs2CuCl4 as a model system, we demonstrate an alternative approach, where, instead of the chemical composition, the spin Hamiltonian is altered by hydrostatic pressure. The approach combines high-pressure electron spin resonance and r.f. susceptibility measurements, allowing us not only to quasi-continuously tune the exchange parameters, but also to accurately monitor them. Our experiments indicate a substantial increase of the exchange coupling ratio from 0.3 to 0.42 at a pressure of 1.8 GPa, revealing a number of emergent field-induced phases. Theoretical studies of quantum magnetism typically assume idealised lattices with freely tunable parameters, which are difficult to realise experimentally. Zvyagin et al. perform challenging measurements at high pressures to tune and to accurately monitor the exchange parameters of a triangular lattice antiferromagnet.
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Abstract P2-14-09: A novel nipple aleolar complex involvement predictive index (NACPI) for indicating nipple sparing mastectomy in breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-14-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While Preservation of NAC is concerned to increase the risk of local recurrences in the retroareolar glandular tissue, nipple sparing mastectomy (NSM) is increasing in patients with breast cancer and has been shown to result in better cosmetic outcome and the benefit for quality-of-life. It is necessary to predict accurately NAC involvement in order to select which patients may be candidates to NSM. The distance from the nipple to the tumor (DNT) is proposed as one of the best criteria to select the patient. The purpose of this study is to identify the predictors of NAC involvement retrospectively and to develop a clinical predictive model to select the patients who can be offered preservation of NAC.Methods: A total of 168 patients with primary operable breast cancer who received subcutaneous mastectomy for breast reconstruction at Saitama Medical Center during July 2013 to December 2017 were selected from the hospital's surgical database. NAC involvement was defined by the presence of invasive carcinoma and/or ductal carcinoma in situ at the subareolar margin.
Results: Of the 148 patients who were preserved NAC, 89.9% (133/148) were NAC involvement negative and 10.1% (15/148) were positive in permanent pathological specimens. Of the 20 patients who were resected NAC, NAC involvement positivity was only 50.0% (10/20). This revealed that NAC involvement with a sensitivity (SN) of 40.0%, a specificity (SP) of 93.0%, a positive predictive value (PPV) of 50.0% and a negative predictive value (NPV) of 89.9% (AUC=0.665, 95%CI: 0.5345-0.796). In 140 patients who were performed intraoperative sub-nipple frozen section biopsy, the findings was significantly associated with NAC involvement (P<0.001), and which predict the NAC involvement with a SN of 93.3%, a SP of 89.6%, a PPV of 51.9%, and a NPV of 99.1% (AUC=0.915, 95%CI: 0.835-0.994). In the concordance rate between frozen section findings and definitive pathologic results, DCIS was 53% (9/17), atypical cell was 50% (2/4) and invasive ductal carcinoma was 100% (3/3). Correlation between NAC involvement and clinicopathological factors, tumor size ≥4cm (P<0.001), DNT <1cm by MMG (P=0.002), DNT <1cm by MRI (P<0.001), nipple contrast findings by MRI (P<0.001), tumor in central portion (P<0.001), multicentirc/focal lesion (P<0.001), c(N) positive (P=0.014) were significant relation with NAC involvement. Each predictors were scored 0 or 1, and the total score of 0-3 points was defined as low risk, 4 points as intermediate risk, and 5-7 points as high risk. Depending on this categorized classification, the NAC involvement rate was 3.5% (5/142) in low risk, 68.7% (11/16) in intermediate risk, 90.0% (9/10) in high risk and there was a significant correlation between the risk group and NAC involvement (P <0.001). Notably, assuming that NAC is preserved for low risk patients and is resected for intermediate and high risk patients, NACPI contributes to improve the accuracy of selecting the surgical procedures (SN 80.0%, SP 95.8%, PPV 76.9%, NPV 96.5% (AUC=0.879, 95%CI: 0.784-0.974)).Conclusion: This study suggests that NACPI can help us indicating subcutaneous mastectomy for the breast cancer patients who request preserve NAC with more oncological safety.
Citation Format: Seki H, Sakurai T, Shimizu K, Mizuno S, Tokuda T, Kaburagi T, Seki M, Karahashi T, Nakajima K. A novel nipple aleolar complex involvement predictive index (NACPI) for indicating nipple sparing mastectomy in 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 P2-14-09.
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Abstract P2-14-08: Clinicopathological features and prognosis of nipple–areola and skin flap recurrence after nipple-sparing mastectomy for breast cancer over 20 years. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-14-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nipple-sparing mastectomy (NSM) is an increasingly popular surgical procedure for treatment of breast cancer. However, NSM is controversial because of its association with locoregional recurrence. We started performing NSM in 1978. Methods: We investigated the surgical safety including nipple necrosis, and nipple–areola recurrence (NAR) and skin flap recurrence (SFR) after NSM for 1071 patients with breast cancer, including 31 with stage 0, 414 with stage 1, 479 with stage 2, 141 with stage 3 and 6 with stage 4, from 1985 to 2017. Our NSM method involved creating a thick skin flap to avoid surgical complications. No patients received radiotherapy. In 1034 patients with stage 1–3 breast cancer treated with NSM who developed NAR or SFR, we evaluated cancer stage, nuclear grade, lymph node metastasis, tumor–nipple–areola distance, and histological classification as tubule forming, solid and scirrhous type. In 748 patients with early stage 1 and 2A breast cancer treated with NSM, NAR and SFR were evaluated for estrogen receptor and HER2 expression. We evaluated disease-free interval and frequency of late NAR and SFR. Results: Median follow-up after NSM was 87 (3–397) months. There was only one case of total nipple necrosis among all 1071 patients. There were 96 patients (9.0%) with local recurrence, including 44 (4.0%) with NAR and 52 (4.8%) with SFR. NAR was seen in 1 (3.1%), 14 (3.4%), 17 (5.1%), 5 (3.4%), 7 (5.0%) and 0 patients with stage 0, 1, 2A, 2B, 3 and 4 cancer, respectively. SFR was seen in 0, 15 (3.6%), 8 (2.7%), 7 (4.8%), 22 (15.6%) and 0 patients with stage 0, 1, 2A, 2B, 3 and 4 cancer, respectively. Median disease-free interval of NAR and SFR was 3.4 (0.96–22.3) and 2.5 (0.21–21.2) years, respectively. Twenty-three (53%), 12 (27.9%) and 6 (14%) patients had NAR at more than 3, 5 and 10 years after NSM, respectively. Twenty (38%), 13 (25%) and 6 (11.5%) patients had SFR at more than 3, 5 and 10 years after NSM, respectively. Therefore, late NAR and SFR were observed. Patients with stage 1–3 cancer treated with NSM who had significantly more frequent NAR, were characterized by high nuclear grade and tubule-forming type cancer. Patients with significantly more frequent SFR were characterized by stage 3 cancer, positive lymph node metastasis and age ≤40 years. Patients with early stage breast cancer treated with NSM with significantly more frequent NAR had negative estrogen receptor expression, positive HER2 expression and shorter tumor–nipple–areola distance (≤2 cm). Overall survival was significantly better in patients with NAR (97% at 5 years and 80% at 10 years) than SFR (71% at 5 years and 50% at 10 years). Regarding SFR, overall survival was significantly worse for multiple (≥2) and diffuse (clinical inflammatory syndrome) recurrence than for single-nodule recurrence. There was no significant difference in prognosis between NAR and single-nodule SFR. Conclusions: Our data showed that clinicopathological features and prognosis differed between patients with NAR and SFR. There was no significant difference in prognosis between NAR and single-nodule SFR. Late NAR and SFR were seen, and careful long-term follow-up observation is necessary after NSM.
Citation Format: Sakurai T, Suzuma T, Yoshimura G, Sasaki E, Umemura T, Sakurai T. Clinicopathological features and prognosis of nipple–areola and skin flap recurrence after nipple-sparing mastectomy for breast cancer over 20 years [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 P2-14-08.
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Abstract P3-06-04: Clonal evolution of non-malignant proliferative lesions into breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-06-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
[Introduction] Non-malignant proliferative lesions in the breast have been implicated in the development of invasive breast cancer. Previous studies showed that adjacent atypical proliferative lesions and breast cancers shared common genetic alterations, suggesting that these evolved from the same ancestral cell. However, the clonal structure of atypical proliferative lesions and their clonal dynamics during progression to cancer are poorly understood. In this study, we compared genetic profiles (with and without pathogenic germline mutations) of normal mammary ducts, non-malignant proliferative lesions, and cancer tissues from the same patients to illustrate the clonal evolution of cancer from a non-malignant epithelial cell.
[Methods] Multiple samples were collected from different proliferative lesions within the cancer-borne breast, including invasive cancers, using micro-dissection from formalin-fixed, paraffin-embedded surgical specimens. Somatic mutations and copy number alterations (CNAs) were then evaluated by whole exome sequencing.
[Results] We analyzed a total of 34 samples from 5 premenopausal females carrying estrogen receptor-positive cancers, where the samples were obtained from normal ducts (N = 6), non-atypical (N = 1) and atypical (N = 8) proliferative lesions, and non-invasive (N = 16) and invasive (N = 3) cancers. The number of somatic mutations per sample ranged from 1 to 276 and increased with disease progression, regardless of the germline mutation status. Two cases with bilateral cancers had a pathogenic germline mutation of either BRCA2 or TP53, where no somatic mutations or CNAs were shared by individual proliferative lesions, suggesting multifocal independent cancerous evolutions. By contrast, in the remaining three unilateral cases, no pathogenic germline mutations were detected, but all proliferative lesions, which were separated by a distance of 7-25 mm, shared one or more driver alterations, such as an AKT1 mutation (UID: KU01), concurrent 1q gain and 16q loss (der(1;16)) (UID: KU02), and a GATA3 mutation and der(1;16) (UID: KU03), while harboring private mutations and/or CNAs of their own. The phylogenetic analysis based on the number of shared mutations predicted an early origin of these founder mutations, which frequently predated decades before the onset of cancer.
[Conclusions] Our results suggest that early breast cancer development is shaped by the evolution of multiple precancerous clones. These clones are originated from a common ancestor that acquired a founder mutation long before the onset of cancer, followed by branching evolution of multiple clones that acquired additional driver mutations of their own, from which an invasive cancer ultimately develops. In hereditary cases, this process is thought to be substantially promoted multi-focally from within the entire breasts by a germline mutation shared by all mammary cells, frequently resulting in bilateral and/or multifocal breast cancers. Our findings provide unique insight into the early development of breast cancer.
Citation Format: Nishimura T, Yoshida K, Kawata Y, Takeuchi Y, Kakiuchi N, Shiozawa Y, Aoki K, Hirata M, Kataoka TR, Sakurai T, Baba S, Shiraishi Y, Chiba K, Takeuchi K, Haga H, Miyano S, Toi M, Ogawa S. Clonal evolution of non-malignant proliferative lesions into breast cancers [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 P3-06-04.
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Abstract P6-01-02: Machine learning-based structural analysis and oxygen saturation measurement of tumor-associated vessels in breast cancer using a photoacoustic tomography system. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-01-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Breast cancer induces angiogenesis, one of the primary factors responsible for tumor progression. Therefore, the ability to visualize angiogenesis at a higher resolution is crucial. Photoacoustic tomography is a noninvasive method of visualizing angiogenesis involving light absorption and ultrasonic wave emission. If the irradiation light wavelength is adjusted for hemoglobin, vascular imaging is possible. Furthermore, using two wavelengths for oxidized and reduced hemoglobin, “S-factor,” can be calculated, which nearly corresponds to oxygen saturation. Therefore, photoacoustic imaging allows the assessment of breast lesions from vascular structural and functional viewpoints.
Objectives
This study aimed to demonstrate the possible utility of photoacoustic tomography for clinical application focusing on the morphologic features and oxygen saturation status of breast tumor-related vessels.
Methods
For the morphological analysis, we applied a machine learning-based method for automatic vessel extraction, and for the functional analysis we evaluated hemoglobin oxygen saturation calculating signals obtained at two wavelengths. In our system, a 3D ultrasound image was simultaneously acquired as a volume image of a tumor, which helped analyze the positional relationship between the vessels and the tumor.
Results
On morphological analysis, the fine structure of tumor-related vessels was rendered in high resolution. In our system, the blood vessels branched toward the tumor 2-3 more times more frequently than observed on contrast-enhanced MRI, illustrating a finer level of blood vessels near the tumor on our system than on MRI. Next, we analyzed the six morphologic features of vessels (radius, volume, curvature, contraction, maximum angle and vessel branch number) that are associated with the pathologic condition in neuroscience. We determined that the feature distribution of vessels located close to the tumor differed from that located away from the tumor. For example, vessels near the tumor had higher curvature, which means they are more tortuous than healthy vessels. The difference in the distribution of all six features was statistically significant on the Kolmogorov-Smirnov test.
On functional analysis, S-factor measurement of the healthy human breast demonstrated clearly demarcated arteries and veins. The S-factor of any artery was nearly 100%, while that of the veins inside the breast cancer tended to be a little higher (approximately 5%) compared to that in the healthy part. This tendency of veins was not recognized in benign tumors. This could show arteriovenous shunt in cancer microenvironment. We found low saturation signals emerging in the tumor tissue following bevacizumab-containing chemotherapy, indicating the possibility that our system reveals microenvironment changes.
Discussion
If our system can identify the structure or oxygen saturation characteristics unique to tumor-associated vasculature, it could contribute to the improved accuracy of breast cancer diagnosis and allow the observation of tumor vessel normalization because of the drug treatment. An earlier grasp of the therapeutic effect could lead to the provision of individualized medicine.
Citation Format: Matsumoto Y, Gu L, Bise R, Asao Y, Sekiguchi H, Yoshikawa A, Ishii T, Takada M, Kataoka M, Sakurai T, Yagi T, Sato I, Togashi K, Shiina T, Toi M. Machine learning-based structural analysis and oxygen saturation measurement of tumor-associated vessels in breast cancer using a photoacoustic tomography system [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 P6-01-02.
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A novel nipple aleolar complex involvement predictive index (NACPI) for indicating nipple sparing mastectomy in breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy426.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Development and application of 2.5 GPa-25 T high-pressure high-field electron spin resonance system using a cryogen-free superconducting magnet. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2018; 296:1-4. [PMID: 30165264 DOI: 10.1016/j.jmr.2018.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 06/08/2023]
Abstract
We have developed a high-pressure electron spin resonance probe and successfully installed into the world's highest-field cryogen-free superconducting magnet having a maximum central field of 24.6 T. The high pressure of 2.5 GPa is achieved by the specially designed piston-cylinder pressure cell using THz-wave-transparent components. In the first application of this high-pressure high-field ESR system, we observed that the orthogonal dimer spin system SrCu2(BO3)2 undergoes a quantum phase transition from the dimer singlet ground to the plaquette singlet ground states.
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Identification of specifically reduced Th2 cell subsets in allergic rhinitis patients after sublingual immunotherapy. Allergy 2018. [PMID: 29517806 DOI: 10.1111/all.13436] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although Th2 cells are well known to play important roles in allergic diseases including allergic rhinitis (AR), the factors that induce and sustain the pathogenesis of AR remain unclear. The recent development of sublingual immunotherapy (SLIT) is expected to allow changes to the underlying pathogenesis of AR. However, which Th2 cell subsets are important in house dust mite-induced AR (HDM-AR), the influence of SLIT on the pathogenic Th2 cells, and the association of Th2 cell subsets with SLIT efficacy have not been clarified. METHODS The cytokine production and frequency of HDM-reactive T-cell subsets in peripheral blood mononuclear cells (PBMCs) were evaluated using flow cytometry in 89 HDM-AR patients (placebo [n = 43] and HDM 300 IR [n = 46]) who participated in a placebo-controlled study of SLIT with HDM tablets. All patients provided samples both before treatment as a baseline and at the end of the 52-week study. The PBMCs were stained with CellTrace™ Violet (CTV) before culture with HDM extract, and HDM-reactive T cells were detected as the proliferated cells with diminished CTV. RESULTS HDM-reactive IL-5+ IL-13+ CD27- CD161+ CD4+ cells and ST2+ CD45RO+ CD4+ cells were observed in the peripheral blood from each patient with HDM-AR; these cells significantly decreased after SLIT in the group treated with active tablets. HDM-reactive ST2+ CD45RO+ CD4+ cells were significantly lower in active-responders. CONCLUSION Allergen-reactive ST2+ CD45RO+ CD4+ cells or those combined with IL-5+ IL-13+ CD27- CD161+ CD4+ cells may be useful as markers indicating the successful treatment of SLIT. These cells may play a crucial role in the pathogenesis of AR as pathogenic memory Th2 cells.
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Abstract
Some food-derived opioid peptides have been reported to cause diseases, such as gastrointestinal inflammation, celiac disease, and mental disorders. Bifidobacterium is a major member of the dominant human gut microbiota, particularly in the gut of infants. In this study, we evaluated the potential of Bifidobacterium in the degradation of food-derived opioid peptides. All strains tested showed some level of dipeptidyl peptidase activity, which is thought to be involved in the degradation of food-derived opioid peptides. However, this activity was higher in bifidobacterial strains that are commonly found in the intestines of human infants, such as Bifidobacterium longum subsp. longum, B. longum subsp. infantis, Bifidobacterium breve and Bifidobacterium bifidum, than in those of other species, such as Bifidobacterium animalis and Bifidobacterium pseudolongum. In addition, some B. longum subsp. infantis and B. bifidum strains showed degradative activity in food-derived opioid peptides such as human and bovine milk-derived casomorphin-7 and wheat gluten-derived gliadorphin-7. A further screening of B. bifidum strains revealed some bifidobacterial strains that could degrade all three peptides. Our results revealed the potential of Bifidobacterium species in the degradation of food-derived opioid peptides, particularly for species commonly found in the intestine of infants. Selected strains of B. longum subsp. infantis and B. bifidum with high degradative capabilities can be used as probiotic microorganisms to eliminate food-derived opioid peptides and contribute to host health.
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Abstract
Determination of the standard elimination kinetics of tumor markers will be helpful in the diagnosis of malignancies. We analyzed the disappearance curves for serum tumor marker levels after resection of intrathoracic malignancies. Serum levels of CEA, SLX, AFP, CA 19-9, SCC, TPA and CYFRA were measured several times after surgery in a total of 40 patients. To obtain precise biological half-lives, we applied non-linear least square analysis, taking into consideration the possibility of residual tumor cells. Disappearance curves were monophasic for CEA, SCC, TPA, CYFRA and SLX and biphasic for CA 19-9 and AFP. Temporary elevation of serum levels after surgery was observed for SCC, TPA and CYFRA. The average half-lives of CEA, SLX, SCC, TPA and CYFRA were 1.5 days, 2.7 days, 2.2 hours, 2.5 hours and 1.5 hours, respectively. The average half-life of CA 19-9 was 0.5 days in the first compartment and 4.3 days in the second compartment, while that of AFP was 1.0 days and 6.3 days, respectively. These values will be helpful in the interpretation of serum tumor marker levels after surgery.
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Efficacy and safety of trastuzumab, lapatinib, and paclitaxel neoadjuvant treatment with or without prolonged exposure to anti-HER2 therapy, and with or without hormone therapy for HER2-positive primary breast cancer: a randomised, five-arm, multicentre, open-label phase II trial. Breast Cancer 2018; 25:407-415. [PMID: 29445928 PMCID: PMC5996004 DOI: 10.1007/s12282-018-0839-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 01/21/2018] [Indexed: 12/26/2022]
Abstract
Background Dual blockade of HER2 promises increased pathological complete response (pCR) rate compared with single blockade in the presence of chemotherapy for HER2-positive (+) primary breast cancer. Many questions remain regarding optimal duration of treatment and combination impact of endocrine therapy for luminal HER2 disease. Methods We designed a randomised phase II, five-arm study to evaluate the efficacy and safety of lapatinib and trastuzumab (6 weeks) followed by lapatinib and trastuzumab plus weekly paclitaxel (12 weeks) with/without prolongation of anti-HER2 therapy prior to chemotherapy (18 vs. 6 weeks), and with/without endocrine therapy in patients with HER2+ and/or oestrogen receptor (ER)+ disease. The primary endpoint was comprehensive pCR (CpCR) rate. Among the secondary endpoints, pCR (yT0-isyN0) rate, safety, and clinical response were evaluated. Results In total, 215 patients were enrolled; 212 were included in the full analysis set (median age 53.0 years; tumour size = T2, 65%; and tumour spread = N0, 55%). CpCR was achieved in 101 (47.9%) patients and was significantly higher in ER− patients than in ER+ patients (ER− 63.0%, ER+ 36.1%; P = 0.0034). pCR with pN0 was achieved in 42.2% of patients (ER− 57.6%, ER+ 30.3%). No significant difference was observed in pCR rate between prolonged exposure groups and standard groups. Better clinical response outcomes were obtained in the prolongation phase of the anti-HER2 therapy. No surplus was detected in pCR rate by adding endocrine treatment. No major safety concern was recognised by prolonging the anti-HER2 treatment or adding endocrine therapy. Conclusions This study confirmed the therapeutic impact of lapatinib, trastuzumab, and paclitaxel therapy for each ER− and ER+ subgroup of HER2+ patients. Development of further strategies and tools is required, particularly for luminal HER2 disease. Electronic supplementary material The online version of this article (10.1007/s12282-018-0839-7) contains supplementary material, which is available to authorized users.
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Object-oriented Analysis and Design of an ECG Storage and Retrieval System Integrated with an HIS. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractFor a hospital information system, object-oriented methodology plays an increasingly important role, especially for the management of digitized data, e.g., the electrocardiogram, electroencephalogram, electromyogram, spirogram, X-ray, CT and histopathological images, which are not yet computerized in most hospitals. As a first step in an object-oriented approach to hospital information management and storing medical data in an object-oriented database, we connected electrocardiographs to a hospital network and established the integration of ECG storage and retrieval systems with a hospital information system. In this paper, the object-oriented analysis and design of the ECG storage and retrieval systems is reported.
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Comparison of Computer-based Information Support to Clinical Research in Chinese and Japanese Hospitals. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
The objectives of this research are to examine the current situation of computer-based information support of clinical research in hospitals and to determine the expectations of clinicians toward clinical research support functions of hospital information systems (HISs) in both China and Japan.
Methods:
172 clinicians from 42 major hospitals in China (2 groups), and 568 clinicians from 79 university hospitals in Japan (2 groups), were surveyed by postal questionnaire during July and August, 1999. The Kruskal-Wallis test was performed to analyze the differences among the groups.
Results:
The total response rate was 66.9%. The result shows that 94.8% of the Japanese clinicians, 3.5 times more than those in China, use computers almost every day. High significance was shown for the frequency of non-HIS based information resources used by clinicians between China and Japan (p <0.001), whereas no significance for the frequency of HIS use by clinicians between the China I and Japan I groups (p = 0.725) was found. 33.3% clinicians in China thought they could obtain 30-50% of the necessary patient data for clinical research from the HIS, about 2 times more than in Japan (p = 0.009).
Conclusions:
Although the degree of computer involvement among clinicians in Japan is much higher than in China, the computer-based hospital information systems have not been developed well for supporting clinical research in both countries. The clinicians expect comprehensive computerized patient records (CPRs) and full use of patient related information in the existing HISs to support their clinical research.
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Pathogenicity of memory Th2 cells is linked to stage of allergic rhinitis. Allergy 2018; 73:479-489. [PMID: 28857184 DOI: 10.1111/all.13295] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) consists of three developmental stages that are based on the presence/absence of antigen-specific IgE and symptoms. The pathogenic Th2 (Tpath2) cells constitute a population of Th2 cells with additional potentially pathogenic characteristics. We examined the relationship between Tpath2 cells and the stages of allergic rhinitis by focusing on ST2, which is an IL-33 receptor. METHODS Patients with Japanese cedar pollen-induced AR (JCP-AR) and healthy volunteers were divided into "nonsensitized," "asymptomatic sensitized (AS)," and "JCP-AR" groups. We analyzed the ST2 expression and the Th2 function of cultured CD4+ T cells. Next, we observed the progress of patients in the AS stage around the time of seasonal pollen dispersal, with the characteristics of Th2 cells. RESULTS The ST2 expression of T cells was only upregulated in the AR group. The production of IL-4 and IL-13 was found in CD4+ T cells obtained from AS by stimulation with JCP, but reactivity to IL-33 was not observed. Although IL-33 did not induce the elevation of IL-4 production in the JCP-AR group, IL-33 substantially increased the production of IL-5 and IL-13 in comparison with antigen stimulation alone. In newly afflicted patients, the increased expression of ST2 and elevated reactivity to IL-33 was observed, even before the pollen dispersal season. CONCLUSIONS Our study demonstrated that the pathogenicity of memory Th2 cells is linked to sensitization and the stage of allergic rhinitis. Therefore, Tpath2 cells may provide useful insights into the mechanism of the onset and progression of allergic rhinitis.
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Development of a Medical-text Parsing Algorithm Based on Character Adjacent Probability Distribution for Japanese Radiology Reports. Methods Inf Med 2018; 47:513-21. [DOI: 10.3414/me9127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Summary
Objectives:
The objectives of this study were to investigate the transitional probability distribution of medical term boundaries between characters and to develop a parsing algorithm specifically for medical texts.
Methods:
Medical terms in Japanese computed tomography (CT) reports were identified using the ChaSen morphological analysis system. MeSH-based medical terms (51,385 entries), obtained from the metathesaurus in the Unified Medical Language System (UMLS, 2005AA), were added as a medical dictionary for ChaSen. A radiographer corrected the set of results containing 300 parsed CT reports. In addition, two radiologists checked the medical term parsing of 200 CT sentences.
Results:
We obtained modified inter-annotator agreement scores for the text corrected by the radiologists. We retrieved the transitional probability as the conditional probability of a uni-gram, bi-gram, and tri-gram. The highest transitional probability P(Ci | Ci - 2*Ci - 1) was 1.00. For an example of anatomical location, the term “pulmonary hilum” was parsed as a tri-gram.
Conclusions:
Retrieval of transitional probability will improve the accuracy of parsing compound medical terms.
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Predictors of inhalation burn injury using fire site information. ANNALS OF BURNS AND FIRE DISASTERS 2017; 30:275-277. [PMID: 29983681 PMCID: PMC6033479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 09/23/2017] [Indexed: 06/08/2023]
Abstract
Inhalation burn injury (IBI) is a risk factor for mortality in burn patients. However, it is difficult to diagnose IBI using traditional physical examination alone, especially in prehospital settings. Therefore, facial burn patients are usually treated for suspected IBI. In the present study, we investigated whether fire site information could predict IBI as an alternative to traditional physical examination. This retrospective single-centre analysis involved 27 facial burn patients with suspected IBI who were admitted between 2014 and 2016. The patients were divided into two groups (IBI and non-IBI) according to bronchoscopy findings. Fire site information was compared between the two groups. The IBI (n = 13) and non-IBI (n = 14) groups were compared. Domestic fire was more frequent in the IBI group (69% vs. 29%, P = 0.035). The IBI group included one patient with carboxyhemoglobin ≥10% on admission. Prehospitalization fire site information, particularly domestic fires, might predict IBI in facial burn patients..
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Quantitative evaluation of spatial scale of carrier trapping at grain boundary by GHz-microwave dielectric loss spectroscopy. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/924/1/012002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Biomechanical analysis for the different types of jump shot in basketball – A research of risk factors for ACL injury. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.09.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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674 Discoidin domain receptor 2 signaling regulates matrix remodeling in human skin dermal fibroblast. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Corticobasal syndrome subjects and scans without evidences of dopaminergic deficit; A retrospective neuroimaging study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Efficacy of wide-band electrocorticography on mapping of the primary seonsory-motor area compared with electrical cortical stimulation. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Efficacy of interferential currents stimulation on post-stroke dysphagia: A case control study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Positive rate of giant somatosensory evoked potential (giant SEP) and c reflex in benign adult familial myoclonus epilepsy (BAFME). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Neoadjuvant therapy with trastuzumab emtansine and pertuzumab in patients with HER2-positive primary breast cancer (A randomized, phase 2 study; JBCRG-20). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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GRIP PERFORMANCE AGILITY MEASURED WITH A NEW DYNAMOMETER IN SUBJECTS OF ALZHEIMER’S DEMENTIA PATIENTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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High-field/high-pressure ESR. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2017; 280:3-9. [PMID: 28579100 DOI: 10.1016/j.jmr.2017.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 01/26/2017] [Accepted: 01/27/2017] [Indexed: 06/07/2023]
Abstract
We present a historical review of high-pressure ESR systems with emphasis on our recent development of a high-pressure, high-field, multi-frequency ESR system. Until 2000, the X-band system was almost established using a resonator filled with dielectric materials or a combination of the anvil cell and dielectric resonators. Recent developments have shifted from that in the low-frequency region, such as X-band, to that in multi-frequency region. High-pressure, high-field, multi-frequency ESR systems are classified into two types. First are the systems that use a vector network analyzer or a quasi-optical bridge, which have high sensitivity but a limited frequency region; the second are like our system, which has a very broad frequency region covering the THz region, but lower sensitivity. We will demonstrate the usefulness of our high-pressure ESR system, in addition to its experimental limitations. We also discuss the recent progress of our system and future plans.
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Muscle plasticity related to changes in tubulin and αB-crystallin levels induced by eccentric contraction in rat skeletal muscles. Physiol Int 2017; 103:300-309. [PMID: 28229639 DOI: 10.1556/2060.103.2016.3.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
We used the model of eccentric contraction of the hindlimb muscle by Ochi et al. to examine the role of eccentric contraction in muscle plasticity. This model aims to focus on stimulated skeletal muscle responses by measuring tissue weights and tracing the quantities of αB-crystallin and tubulin. The medial gastrocnemius muscle (GCM) responded to electrically induced eccentric contraction (EIEC) with significant increases in tissue weight (p < 0.01) and the ratio of tissue weight to body weight (p < 0.05); however, there was a decrease in soleus muscle weight after EIEC. EIEC in the GCM caused contractile-induced sustenance of the traced proteins, but the soleus muscle exhibited a remarkable decrease in α-tubulin and a 19% decrease in αB-crystallin. EIEC caused fast-to-slow myosin heavy chain (MHC) isoform type-oriented shift within both the GCM and soleus muscle. These results have shown that different MHC isoform type-expressing slow and fast muscles commonly undergo fast-to-slow type MHC isoform transformation. This suggests that different levels of EIEC affected each of the slow and fast muscles to induce different quantitative changes in the expression of αB-crystallin and α-tubulin.
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Authors. NUCL TECHNOL 2017. [DOI: 10.13182/nt88-a34169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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The Interaction of Iodine with Insoluble Residue in the Dissolution of Simulated Spent-Fuel Pellets. NUCL TECHNOL 2017. [DOI: 10.13182/nt91-a16225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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