1
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Shiraishi Y, Sekino Y, Horinouchi H, Ohe Y, Okamoto I. High incidence of cytokine release syndrome in patients with advanced NSCLC treated with nivolumab plus ipilimumab. Ann Oncol 2023; 34:1064-1065. [PMID: 37666485 DOI: 10.1016/j.annonc.2023.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- Y Shiraishi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Y Sekino
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - H Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - I Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka.
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2
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Mizuno R, Sawada M, Tanaka T, Shiraishi Y, Ohashi T, Shigematsu N, Oya M. Comparison of the Efficacy of Low Dose Tadalafil with Tamsulosin against Lower Urinary Tract Symptoms and Sexual Dysfunction after Low Dose Rate Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2023; 117:e418. [PMID: 37785377 DOI: 10.1016/j.ijrobp.2023.06.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with clinically localized prostate cancer (PCa) can be curatively treated with different modalities, including low dose rate (LDR) prostate brachytherapy (PB). LDR-PB allows the patient a relatively short recovery time compared with other treatment modalities such as prostatectomy. However, PB might exert distinct impact on quality of life, lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) are two major concerns. The aim of present study was to assess prospectively the efficacy of low dose tadalafil treatment on both SD and LUTS compared with tamsulosin treatment in patients treated PB for localized PCa. MATERIALS/METHODS Patients scheduled for PB with I-125 seeds for low or intermediate-risk localized PCa at our institution were eligible for this study. The prescribed dose was set at 160 gray. Participants were randomized into two groups; those started treating with a daily use of 0.2 mg of tamsulosin hydrochloride or 5 mg of tadalafil just after PB. The duration of the study was 12 months and the patients were assessed for urinary and sexual function status at baseline, and 1, 3, 6, and 12 months after PB. The primary study endpoints were both changes from baseline in urinary and sexual function status. RESULTS Between July 2015 and August 2020, 120 participants were enrolled in this study. The median age was 68 years with the median PSA of 6.5 ng/ml. A total 15 patients were excluded within 6 months after randomization. All subjective LUTS findings, including International Prostate Symptom Score (IPSS), and Over Active Bladder Symptom Score (OABSS), were significantly deteriorated at 1, 3, and 6 months after PB compared with baseline in both groups, respectively (p<0.05). Among objective LUTS findings, a significant decrease in maximum urinary flow rate (Qmax) was found at 1, 3, 6, and 12 months after PB compared with baseline in both groups, respectively (p<0.05). A significant increase in post void residual urine (PVR) was found at 1, 3, and 6 months after PB compared to baseline in tadalafil group, whereas no significant increase was seen in tamsulosin group. There were no statistically significant differences between the 2 groups in scores of the total International Index of Erectile Function (IIEF)-15 and Erection Hardness Score (EHS) before and at 1 month post PB. The EHS was significantly higher in tadalafil group compared with tamsulosin group at 3, 6 and 12 months (p = 0.001, p = 0.004, and p = 0.019, respectively). The EHS after PB in tadalafil group was not significantly decreased from baseline. CONCLUSION After LDR-PB, tamsulosin treatment significantly decreased PVR compared with tadalafil. On the other hand, tadalafil contributed to maintain erection hardness compared with tamsulosin.
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Affiliation(s)
- R Mizuno
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
| | - M Sawada
- Keio University Graduate School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - T Tanaka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Y Shiraishi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - T Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - N Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - M Oya
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
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Nag P, Inubushi T, Sasaki JI, Murotani T, Kusano S, Nakanishi Y, Shiraishi Y, Kurosaka H, Imazato S, Yamaguchi Y, Yamashiro T. Tmem2 Deficiency Leads to Enamel Hypoplasia and Soft Enamel in Mouse. J Dent Res 2023; 102:1162-1171. [PMID: 37449307 DOI: 10.1177/00220345231182355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Teeth consist of 3 mineralized tissues: enamel, dentin, and cementum. Tooth malformation, the most common craniofacial anomaly, arises from complex genetic and environmental factors affecting enamel structure, size, shape, and tooth eruption. Hyaluronic acid (HA), a primary extracellular matrix component, contributes to structural and physiological functions in periodontal tissue. Transmembrane protein 2 (TMEM2), a novel cell surface hyaluronidase, has been shown to play a critical role during embryogenesis. In this study, we demonstrate Tmem2 messenger RNA expression in inner enamel epithelium and presecretory, secretory, and mature ameloblasts. Tmem2 knock-in reporter mice reveal TMEM2 protein localization at the apical and basal ends of secretory ameloblasts. Micro-computed tomography analysis of epithelial-specific Tmem2 conditional knockout (Tmem2-CKO) mice shows a significant reduction in enamel layer thickness and severe enamel deficiency. Enamel matrix protein expression was remarkably downregulated in Tmem2-CKO mice. Scanning electron microscopy of enamel from Tmem2-CKO mice revealed an irregular enamel prism structure, while the microhardness and density of enamel were significantly reduced, indicating impaired ameloblast differentiation and enamel matrix mineralization. Histological evaluation indicated weak adhesion between cells and the basement membrane in Tmem2-CKO mice. The reduced and irregular expressions of vinculin and integrin β1 suggest that Tmem2 deficiency attenuated focal adhesion formation. In addition, abnormal HA accumulation in the ameloblast layer and weak claudin 1 immunoreactivity in Tmem2-CKO mice indicate impaired tight junction gate function. Irregular actin filament assembly was also observed at the apical and basal ends of secretory ameloblasts. Last, we demonstrated that Tmem2-deficient mHAT9d mouse ameloblasts exhibit defective adhesion to HA-containing substrates in vitro. Collectively, our data highlight the importance of TMEM2 in adhesion to HA-rich extracellular matrix, cell-to-cell adhesion, ameloblast differentiation, and enamel matrix mineralization.
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Affiliation(s)
- P Nag
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - T Inubushi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - J I Sasaki
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - T Murotani
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Kusano
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Nakanishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - H Kurosaka
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - S Imazato
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Y Yamaguchi
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - T Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
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Morimoto K, Iwai K, Yoshiyama T, Ito M, Uesugi F, Asakura T, Osawa T, Furuuchi K, Kurashima A, Fujiwara K, Hasegawa N, Tanaka Y, Shoji K, Shiraishi Y, Mitarai S, Ato M, Ohta K. Epidemiological characteristics of nontuberculous mycobacteriosis and bronchiectasis: comparative study using national mortality statistics from 1970 to 2015 in Japan. ERJ Open Res 2023; 9:00424-2022. [PMID: 36814552 PMCID: PMC9940714 DOI: 10.1183/23120541.00424-2022] [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: 08/22/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study assessed longitudinal national data on mortality due to nontuberculous mycobacteriosis (NTMosis) and bronchiectasis and the association between the two diseases. Methods We analysed the national death statistics of Japan from 1970 to 2015. The International Classification of Disease (ICD) codes were used to extract the relevant data. Crude mortality, age-adjusted mortality and standardised mortality rates were calculated using vital statistics and the population in 2000. We also identified domestic publications related to NTMosis and bronchiectasis with an internet-based search system. Results The total number of bronchiectasis-related deaths remained at the same level, which was approximately 1000, for 45 years, although the number of deaths has consistently decreased in males but increased in females since the mid-1990s. A substantial increasing trend in females was also observed for NTMosis in the same period. The age-adjusted mortality data showed an increase in mortality in women due to NTMosis and confirmed the trend in bronchiectasis in women. The patterns in the number of domestic reports showed a recent slight increase in bronchiectasis and a marked increase in NTMosis. Conclusions The trends in bronchiectasis-related mortality differed by sex. The epidemiological trends in the two diseases were associated, especially in elderly females since the mid-1990s. It is suggested that pulmonary NTMosis without pre-existing bronchiectasis might be a leading cause of postinfectious bronchiectasis in Japan.
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Affiliation(s)
- Kozo Morimoto
- Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan,The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan,Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan,Corresponding author: Kozo Morimoto ()
| | - Kazuro Iwai
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Takashi Yoshiyama
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan,Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Masashi Ito
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Fumiko Uesugi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan,Department of Clinical Medicine (Laboratory of Bioregulatory Medicine), Kitasato University School of Pharmacy, Tokyo, Japan
| | - Takeshi Osawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Naoki Hasegawa
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kudoh Shoji
- Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Satoshi Mitarai
- The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
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Kaneda H, Hazama D, Kodama H, Miyazaki A, Azuma K, Kawashima Y, Sato Y, Ito K, Shiraishi Y, Miura K, Takahama T, Oizumi S, Namba Y, Ikeda S, Miura S, Tachihara M. 333P Efficacy and safety of immune checkpoint inhibitors alone or combined with chemotherapy in pulmonary sarcomatoid carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.371] [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: 12/07/2022] Open
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6
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Dal Fabbro C, Rompré P, Kato T, Maluly M, Haraki S, Toyota R, Shiraishi Y, Andersen ML, Tufik S, Montplaisir J, Herrero Babiloni A, Lavigne G. The Influence of Age on the Frequency of Rhythmic Masticatory Muscle Activity During Sleep in General Population differs from that in Clinical Research Samples. J Oral Rehabil 2022; 50:54-61. [DOI: 10.1111/joor.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/18/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- C. Dal Fabbro
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Instituto do Sono São Paulo Brazil
- Faculty of Dental Medicine Université de Montréal Montreal Canada
| | - P. Rompré
- Faculty of Dental Medicine Université de Montréal Montreal Canada
| | - T. Kato
- Graduate School of Dentistry Osaka University Suita Japan
| | | | - S. Haraki
- Graduate School of Dentistry Osaka University Suita Japan
| | - R. Toyota
- Graduate School of Dentistry Osaka University Suita Japan
| | - Y. Shiraishi
- Graduate School of Dentistry Osaka University Suita Japan
| | - M. L. Andersen
- Instituto do Sono São Paulo Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo Brazil
| | - S. Tufik
- Instituto do Sono São Paulo Brazil
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo Brazil
| | - J. Montplaisir
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Psychiatry Department, Faculty of Medicine Université de Montréal Montreal Canada
| | - A. Herrero Babiloni
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Division of Experimental Medicine McGill University Montreal Canada
| | - G. Lavigne
- CIUSSS Nord Ile Montreal, CEAMS and research centre Montreal Canada
- Instituto do Sono São Paulo Brazil
- Faculty of Dental Medicine Université de Montréal Montreal Canada
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Ito M, Maeda D, Matsue Y, Shiraishi Y, Dotare T, Sunayama T, Nogi K, Kohsaka S, Yoshikawa T, Saito Y, Minamino T. Increasing the class of foundational medication for heart failure is associated with improved prognosis in hospitalized patients with heart failure with reduced or mildly reduced ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
To clarify the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure and post-discharge prognosis.
Methods and results
We retrospectively analyzed a combined dataset of three large-scale registries of hospitalized patients with heart failure in Japan (NARA-HF, WET-HF, and REALITY-AHF) and included patients already diagnosed with heart failure with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes, namely angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta blockers, and mineralocorticoid receptor blockers, from admission to discharge. The primary endpoint was defined as the combined endpoint of heart failure rehospitalization and all-cause death within 1-year of discharge. The cohort consisted of 1,113 patients, and 482 combined endpoints were observed. In total, 413 (37.1%) patients were on increased FMHF (increased group), 607 (54.5%) remained unchanged (unchanged group), and 93 (8.4%) had a decreased number of FMHF (decreased group) at discharge compared to the time of admission. In multivariable analysis, the increased group was associated with a significantly lower incidence of the primary endpoint compared with the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P<0.001) and decreased group (hazard ratio 0.58, 95% confidence interval 0.40–0.84; P=0.004).
Conclusion
Increasing the number of FMHF cases during heart failure hospitalization is associated with a better prognosis in patients with HFr/mrEF.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): REALITY registry was funded by the Cardiovascular Research Fund of Japan.WET-HF registry was supported by a Grant-in-Aid for Young Scientists (Y.S. JSPS KAKENHI, 18K15860).
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Affiliation(s)
- M Ito
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - D Maeda
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Shiraishi
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Dotare
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - T Sunayama
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - K Nogi
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - S Kohsaka
- Keio University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology , Tokyo , Japan
| | - Y Saito
- Nara Medical University, Department of Cardiovascular Medicine , Nara , Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
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Matsuguma H, Mun M, Sano A, Yoshino I, Hashimoto H, Shintani Y, Iida T, Shiono S, Chida M, Kuroda H, Nakayama M, Shiraishi Y, Funai K, Kawamura M. ASO Visual Abstract: Time to Incurable Recurrence for Patients Who Receive Pulmonary Metastasectomy for Colorectal Cancer. Ann Surg Oncol 2022; 29:6920-6921. [PMID: 35789307 DOI: 10.1245/s10434-022-12073-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Haruhisa Matsuguma
- Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Atsushi Sano
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroshi Hashimoto
- Department of Thoracic Surgery, National Defense Medical College, Saitama, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomohiko Iida
- Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan
| | - Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Mitsuo Nakayama
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Masafumi Kawamura
- Division of General Thoracic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Tachihara M, Tsujino K, Shimokawa M, Ishihara T, Hayashi H, Sato Y, Kurata T, Sugawara S, Shiraishi Y, Teraoka S, Azuma K, Daga H, Yamaguchi M, Kodaira T, satouchi M, Yamamoto N, Nakagawa K. MA06.04 Phase II Study of Durvalumab Plus Concurrent Radiotherapy in Unresectable Locally Advanced NSCLC: DOLPHIN Study (WJOG11619L). J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.107] [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: 11/25/2022]
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10
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Matsuda M, Fukuyama N, Matsuda T, Kikuchi S, Shiraishi Y, Takimoto Y, Kamei Y, Kurata M, Kitazawa R, Kido T. Utility of synthetic MRI in predicting pathological complete response of various breast cancer subtypes prior to neoadjuvant chemotherapy. Clin Radiol 2022; 77:855-863. [DOI: 10.1016/j.crad.2022.06.019] [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: 02/23/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022]
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11
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Hiramatsu M, Atsumi J, Shiraishi Y. Surgical Management of Mycobacterial Infections and Related Complex Pleural Space Problems: From History to Modern Day. Thorac Surg Clin 2022; 32:337-348. [PMID: 35961742 DOI: 10.1016/j.thorsurg.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Owing to the advent of effective drugs for tuberculosis in the mid-twentieth century, few cases require surgery for active tuberculosis in the present day in areas where effective drugs are available. However, surgical techniques developed to combat tuberculosis in the predrug era are still useful to manage the challenging chest pathology of our time surgically, such as destroyed lung or postresectional empyema. Thoracoplasty and open window thoracostomy are representative procedures and discussed in detail in this review.
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Affiliation(s)
- Miyako Hiramatsu
- Section of Chest Surgery, Fukujuji Hospital, Japan Anti Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-0052, Japan.
| | - Jun Atsumi
- Section of Chest Surgery, Fukujuji Hospital, Japan Anti Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-0052, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Japan Anti Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-0052, Japan
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12
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Matsuguma H, Mun M, Sano A, Yoshino I, Hashimoto H, Shintani Y, Iida T, Shiono S, Chida M, Kuroda H, Nakayama M, Shiraishi Y, Funai K, Kawamura M. Time to Incurable Recurrence for Patients Treated With Pulmonary Metastasectomy for Colorectal Cancer. Ann Surg Oncol 2022; 29:6909-6917. [PMID: 35717520 DOI: 10.1245/s10434-022-11904-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 03/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Probability of cure is important for patients with lung metastasis who must decide whether to undergo metastasectomy. Although progression-free survival (PFS) is thought to reflect this, it does not include curative effects by repeat metastasectomy. Thus, the authors developed a new indicator, time to incurable recurrence (TTIR), in which only incurable recurrence was set as an event that included death, with incurable recurrence defined as recurrence not treated by definitive local therapy (DLT), recurrence treated by DLT but with PFS maintained less than 2 years, or recurrence followed by re-recurrence. METHODS This multi-institutional study included 339 patients who underwent lung metastasectomy for colorectal cancer between 1990 and 2008. RESULTS Among the 339 patients, 191 experienced recurrence, 77 received DLT for recurrence, 38 had a PFS of 2 years or longer after the treatment, and 33 had maintained a PFS at the last follow-up date. The patients had PFS ranging from 39 to 212 months (median, 101 months). The 5-year OS, PFS, and TTIR rates were respectively 63.4%, 42.2%, and 51.9%. The TTIR curve was similar to the OS curve 7 years after the initial metastasectomy. The difference between TTIR and PFS at 7 years was 9.7%, indicating probability of cure by repeat DLT. Multivariable analysis showed different prognostic factors among OS, PFS, and TTIR. CONCLUSION At the initial metastasectomy, TTIR may reflect probability of a cure, including cure by repeat DLT, and can be used to analyze prognostic factors associated with cure.
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Affiliation(s)
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsushi Sano
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroshi Hashimoto
- Department of Thoracic Surgery, National Defense Medical College, Saitama, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomohiko Iida
- Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan
| | - Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Mitsuo Nakayama
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Masafumi Kawamura
- Division of General Thoracic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Matsuguma H, Mun M, Sano A, Yoshino I, Hashimoto H, Shintani Y, Iida T, Shiono S, Chida M, Kuroda H, Nakayama M, Shiraishi Y, Funai K, Kawamura M. ASO Author Reflections: New Indicator to Demonstrate Cure Probability: Time to Incurable Recurrence. Ann Surg Oncol 2022; 29:6918-6919. [PMID: 35597842 DOI: 10.1245/s10434-022-11905-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Haruhisa Matsuguma
- Division of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.
| | - Mingyon Mun
- Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsushi Sano
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Ichiro Yoshino
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hiroshi Hashimoto
- Department of Thoracic Surgery, National Defense Medical College, Saitama, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomohiko Iida
- Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan
| | - Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Mitsuo Nakayama
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan
| | - Kazuhito Funai
- First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Masafumi Kawamura
- Division of General Thoracic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Sawada M, Shiraishi Y, Nemoto T, Tanaka T, Kota R, Koike N, Shigematsu N. PO-1796 Dosimetric comparison of rectal dose reduction methods in brachytherapy for cervical cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03759-8] [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: 11/17/2022]
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15
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Hayakawa N, Mizuno R, Shiraishi Y, Tanaka T, Matsumoto K, Kosaka T, Ohashi T, Kikuchi E, Shigematsu N, Oya M. PO-1818 Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03781-1] [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]
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16
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Takamori S, Oku Y, Toyokawa G, Wakasu S, Kinoshita F, Watanabe K, Haratake N, Nagano T, Kosai K, Shiraishi Y, Yamashita T, Shimokawa M, Shoji F, Yamazaki K, Okamoto T, Seto T, Takeo S, Nakashima N, Okamoto I, Takenaka T. 62P Impact of the pretreatment prognostic nutritional index on the survival after first-line immunotherapy in non-small cell lung cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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17
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Watanabe F, Kaburaki S, Furuuchi K, Uesugi F, Fujiwara K, Tanaka Y, Yoshiyama T, Shiraishi Y, Kurashima A, Ohta K, Hanada K, Morimoto K. Low-dosage ethambutol, less than 12.5 mg/kg/day, does not worsen the clinical outcomes of pulmonary Mycobacterium avium and Mycobacterium intracellulare disease: a retrospective cohort study. Infection 2022; 50:879-887. [PMID: 35106717 DOI: 10.1007/s15010-022-01757-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/13/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Multidrug chemotherapy is recommended for treating pulmonary Mycobacterium avium and Mycobacterium intracellulare disease. Although ethambutol has been demonstrated to inhibit macrolide resistance, the ethambutol dosage is sometimes decreased due to concerns about optic neuropathy. We aimed to assess whether lower ethambutol doses impact treatment outcomes. METHODS Patients treated over 12 months between 2016 and 2020 were collected retrospectively. Clinical outcomes, including negative culture conversion, microbiological cure, adverse events, resistance to macrolides, and recurrence, were compared according to daily ethambutol dosage. RESULTS Among 146 patients, 42 were treated with ethambutol dosages over 12.5 mg/kg/day, and 104 were treated with lower dosages. Negative culture conversion was achieved for 125 patients, and 90 patients achieved microbiological cure. Recurrence was identified in 16 patients who achieved microbiological cure. No macrolide resistance was observed, and no significant difference was observed in the percentage of negative culture conversion (P = 1.00) or microbiological cure (P = 0.67) between the high- and low-dosage ethambutol groups. Sputum smear positivity was associated with a lower adjusted odds ratio (aOR) of negative culture conversion (aOR: 0.48, 95% CI: 0.29-0.80). A lower aOR of microbiological cure was independently associated with sputum smear positivity (aOR: 0.52, 95% CI: 0.37-0.74) and with the use of an intermittent regimen (aOR: 0.60, 95% CI: 0.41-0.87). Daily ethambutol dosage was not identified as a prognostic factor for any of the outcomes. Optic neuropathy was observed in 7.1% of the high-dose ethambutol group and 1.0% of the low-dosage ethambutol group (P = 0.07). CONCLUSION An ethambutol dosage of 12.5 mg/kg/day or less in guideline-based chemotherapy may reduce optic neuropathy without worsening clinical outcomes.
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Affiliation(s)
- Fumiya Watanabe
- Department of Pharmacometrics and Pharmacokinetics, Meiji Pharmaceutical University, Tokyo, Japan.,Department of Pharmacy, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Shota Kaburaki
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Fumiko Uesugi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan
| | - Kazuhiko Hanada
- Department of Pharmacometrics and Pharmacokinetics, Meiji Pharmaceutical University, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan. .,Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose, Tokyo, 204-8522, Japan.
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18
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Shimoda M, Tanaka Y, Hiramatsu M, Morimoto K, Arakawa K, Abe T, Ito K, Suga M, Shiraishi Y, Yoshimori K, Ohta K. Analysis of factors predicting the application of chemical pleurodesis for pneumothorax: An observational study. Medicine (Baltimore) 2022; 101:e28537. [PMID: 35029923 PMCID: PMC8735763 DOI: 10.1097/md.0000000000028537] [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] [Received: 07/02/2021] [Accepted: 12/16/2021] [Indexed: 11/26/2022] Open
Abstract
Chemical pleurodesis is performed in pneumothorax patients to treat nonresolving air leakage or prevent recurrence. However, factors that might predict the need for chemical pleurodesis remain unknown. Therefore, this study investigated predictive factors for the application of chemical pleurodesis for pneumothorax.We retrospectively analyzed 401 adult pneumothorax patients who underwent chest tube drain insertion during hospitalization at Fukujuji Hospital from January 2016 to December 2020. The patients were divided into 3 groups: the pleurodesis group, comprising 89 patients treated with chemical pleurodesis; the nonpleurodesis group, comprising 206 patients treated without chemical pleurodesis; and the surgical group, comprising 106 patients treated surgically. Data for patients in the pleurodesis group were compared to those in the nonpleurodesis or surgical group, and a predictive score of the application of chemical pleurodesis for pneumothorax was developed.Compared with the nonpleurodesis group, in the pleurodesis group, patient age was higher (P < .001), emphysema (n = 33 (37.1%) vs 70 (34.0%), P = .045), and interstitial pneumonitis (n = 19 (21.3%) vs 19 (9.2%), P = .022) were more common causes, and chest tube suction was more common (n = 78 (87.96%) vs n = 123 (59.7%), P < .001). Similar results were found between the pleurodesis and surgical groups. We developed a score for predicting the application of chemical pleurodesis for pneumothorax, including the following factors: age ≥55 years; presence of emphysema and/or interstitial pneumonitis; and use of chest tube suction. The score for the pleurodesis group showed a high area under the receiver operating characteristic curve compared with that for the nonpleurodesis group (0.776 [95% confidence interval]: 0.725-0.827). With a score of 2 as the cutoff value, the sensitivity was 91.0% and the specificity was 52.4%. In a comparison between the pleurodesis and surgical groups, the predicting score showed the high AUC of 0.904 (95% confidence interval: 0.863-0.945).This study reveals predictive factors for the application of chemical pleurodesis and provides a predictive score including 3 factors.
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Affiliation(s)
- Masafumi Shimoda
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Miyako Hiramatsu
- Department of Thoracic Surgery, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Kenichi Arakawa
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Taro Abe
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Koki Ito
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Miyuri Suga
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Yuji Shiraishi
- Department of Thoracic Surgery, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Kiyose city, Tokyo, Japan
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Togo T, Atsumi J, Hiramatsu M, Shimoda K, Morimoto K, Shiraishi Y. A Novel Approach to Extensive Clarithromycin-Resistant Mycobacterium avium Complex Pulmonary Disease. Ann Thorac Cardiovasc Surg 2022; 28:444-447. [PMID: 33967121 PMCID: PMC9763718 DOI: 10.5761/atcs.cr.21-00010] [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] [Indexed: 12/30/2022] Open
Abstract
A 48-year-old woman with extensive clarithromycin-resistant Mycobacterium avium complex pulmonary disease (MAC-PD) was successfully treated by left lower lobectomy and lingulectomy following combination treatment of intravenous/inhaled amikacin plus bronchial occlusion by Endobronchial Watanabe Spigots (EWSs). A left pneumonectomy was initially indicated for removing all the lesions, but the procedure would have been barely tolerated by the patient. However, her preoperative combination treatment sufficiently reduced the lesions requiring resection to allow surgical preservation of the left upper division. This novel approach might be promising for patients with Mycobacterium avium complex lung disease whose pulmonary reserve will not allow an extensive parenchymal resection.
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Affiliation(s)
- Takeo Togo
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan,Corresponding author: Takeo Togo, MD. Section of Chest Surgery, Fukujuji Hospital, 3-1-24 Matsuyama, Kiyose, Tokyo 204-8522, Japan
| | - Jun Atsumi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Miyako Hiramatsu
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kiyomi Shimoda
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kozo Morimoto
- Section of Respiratory Medicine, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
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20
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Yumita Y, Nagatomo Y, Takei M, Saji M, Goda A, Kohno T, Nakano S, Nishihata Y, Ikegami Y, Shiraishi Y, Kohsaka S, Yoshikawa T. “Target Heart Rate” calculated aiming at zero overlap of mitral E and A waves is useful for prediction of long-term outcome for patients with heart failure and reduced ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1020] [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
Lower heart rate (HR) is associated with more favourable long-term outcome in patients with heart failure with reduced ejection fraction (HFrEF). However, an optimal threshold of HR remains unclear. Targeted HR (THR), defined by echocardiographic deceleration time (DCT) to eliminated overlap of E and A waves, may aid in risk stratification of HFrEF patients.
Purpose
In this study, we aimed to clarify the impact of on long-term clinical outcome in patients with HFrEF.
Methods
In the multicenter WET-HF registry, 4000 consecutive patients hospitalized for acute decompensated HF (ADHF) were registered between 2006 and 2017. Among them, the patients with EF ≥40% or a history of atrial fibrillation were excluded. THR was calculated based on their DCT value measured in compensated HF phase during the index admission. The following formula was applied; THR (bpm)=93 - 0.13 × deceleration time (DCT, msec). A total of 876 patients with HFrEF were included in the present analysis (age: 72 [60–81], male: 69%) and the patients were divided into the 2 groups of HR at discharge ≤ THR (L group) and > THR (H group). The primary endpoint (PE) was defined as the composite of all-cause death and ADHF re-admission.
Results
Compared to the H group, the L group showed higher prevalence of males (74% vs. 66%, P=0.025) with higher body mass index (BMI, 23.2 vs. 22.2, P=0.016), hemoglobin (Hb, 12.9 vs. 12.4, P=0.031), albumin (Alb, 3.7 vs. 3.6, P=0.039) and larger left atrial diameter (LAD, 44 mm vs. 41 mm, P=0.002) and tricuspid regurgitation pressure gradient (TRPG, 29 mmHg vs. 27 mmHg, P=0.012). Age, estimated glomerular filtration rate (eGFR), LVEF (29% vs. 30%, P=NS) and E/e' (17.7 vs. 16.8, P=NS) were similar for both groups. At discharge, HR was lower in L group (66 [60–71] bpm vs. 80 [74–86] bpm, P<0.001), albeit there were no significant differences in b-blocker prescription (90% vs. 85%, P=0.069) or its dose (3.75 [1.25–7.25] mg vs. 2.5 [1.25–5] mg, P=0.11).
In the survival analysis, the L group showed a significantly lower rate of PE (P=0.03), whereas there was no significant difference in the incidence of PE between the patients with HR at discharge ≥70 bpm and <70 bpm (P=NS).
Multivariate Cox hazard analysis showed that HR at discharge ≤ THR was an independent predictor of PE (hazard ratio 0.67 [0.46–0.97], P=0.037), even after adjusting for confounding factors including age, sex, BMI, Hb, Alb, and b-blocker prescription, whereas HR at discharge <70 bpm was not (hazard ratio 0.94 [0.65–1.33], P=0.71).
Conclusion
THR was associated with long-term outcomes in patients with HFrEF after acute decompensation, suggesting that it may aid in tailored treatment for HR reduction in these patients.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- Y Yumita
- National Defense Medical College, Department of Cardiology, Saitama, Japan
| | - Y Nagatomo
- National Defense Medical College, Department of Cardiology, Saitama, Japan
| | - M Takei
- Saiseikai Central Hospital, Department of Cardiology, Tokyo, Japan
| | - M Saji
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
| | - A Goda
- Kyorin University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Kohno
- Kyorin University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Nakano
- Saitama Medical University, Department of Cardiology, Saitama, Japan
| | - Y Nishihata
- St. Luke's International Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Ikegami
- National Hospital Organization Tokyo Medical Center, Department of Cardiology, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
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Inoue H, Tsutsumi H, Tanaka K, Iwama E, Yoneshima Y, Shiraishi Y, Ota K, Nakanishi Y, Okamoto I. P12.02 Systemic Anticancer Therapy Upregulate Plasma Levels of Damage-Associated Molecular Patterns in Patients With Advanced Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Atsumi J, Shiraishi Y. [Re-operation for Inflammatory Lung Diseases]. Kyobu Geka 2021; 74:867-872. [PMID: 34548461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Two types of re-operations for inflammatory lung diseases are presented:thoracoplasty and cavernostomy. Thoracoplasty is used to obliterate a residual pleural space after upper lung resection with prolonged air leak. Usually, the 2nd to the 6th ribs are resected, according to the extent of the space. Posteriorly the ribs should be removed to the costotransverse joint to achieve sufficient space obliteration. The tip of the scapula is resected in case of the resection of the 6th rib, otherwise the scapula would impinge on the 7th rib. The resection of the 1st rib should be avoided because of a subsequent severe scoliosis. Cavernostomy is a procedure to open the infected cavity of the residual lung. Aspergillus and non-tuberculous mycobacteria are the most frequent pathogens. The site of skin incision depends on the location of the cavity:midaxially incision for an anterior cavity and paravertebral incision for a posterior cavity. Cutting "septum" in the cavity makes it a single space, contributing to sufficient drainage by gauze. The closure of the cavity will be considered after several months or years when the cavity is sterilized and the patient's nutritional status becomes well. These 2 procedures are effective in treating refractory lung inflammation after lung resection, although they are quite traditional.
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Affiliation(s)
- Jun Atsumi
- Department of Thoracic Surgery, Japan Anti Tuberculoisis Association Fukujuji Hospital, Kiyose, Japan
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Makishima H, Nannya Y, Momozawa Y, Gurnari C, Kulasekararaj A, Yoshizato T, Takeda J, Atsuta Y, Shiozawa Y, Iijima-Yamashita Y, Saiki R, Yoshida K, Shiraishi Y, Nagata Y, Onizuka M, Nakagawa M, Itonaga H, Kanda Y, Miyazaki Y, Sanada M, Tsurumi H, Kasahara S, Kondo-Takaori A, Ohyashiki K, Kiguchi T, Matsuda F, Jansen J, Papaemmanuil E, Creignou M, Tobiasson M, Hellström-Lindberg E, Polprasert C, Malcovati L, Cazzola M, Haferlach T, Maciejewski J, Kamatani Y, Miyano S, Ogawa S. Topic: AS04-MDS Biology and Pathogenesis/AS04b-Clonal diversity & evolution. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106679.5] [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: 10/20/2022]
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Saiki R, Momozawa Y, Nannya Y, Nakagawa M, Ochi Y, Yoshizato T, Terao C, Kuroda Y, Shiraishi Y, Chiba K, Tanaka H, Niida A, Imoto S, Matsuda K, Morisaki T, Murakami Y, Kamatani Y, Matsuda S, Kubo M, Miyano S, Makishima H, Ogawa S. Topic: AS04-MDS Biology and Pathogenesis/AS04a-Normal, MDS, and leukemic stem cells. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106679.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Toyozawa R, Itahashi K, Goto Y, Fujiwara Y, Okuma Y, Kurata T, Yokoyama T, Nokihara H, Yokoi T, Yamaguchi T, Shiraishi Y, Takeda M, Tokito T, Nakamura A, Hosomi Y, Ohe Y. 1292P Two single-arm, multicenter phase-II trials of PD-1 inhibitors in patients with pulmonary sarcomatoid carcinoma (NCCH1603/NCCH1703). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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26
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Takeuchi H, Matsumoto T, Morimoto K, Atsumi J, Yamamoto S, Nakagawa T, Yamada S, Kurosaki A, Shiraishi Y, Hasebe T. Pre-operative endovascular coil embolisation for chronic pulmonary aspergillosis. Int J Tuberc Lung Dis 2021; 25:725-731. [PMID: 34802494 DOI: 10.5588/ijtld.21.0028] [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: 11/10/2022] Open
Abstract
OBJECTIVE: To retrospectively evaluate the clinical outcomes of pre-operative endovascular coil embolisation (ECE) for chronic pulmonary aspergillosis (CPA).METHODS: We evaluated surgical patients with CPA between November 2016 and April 2020. Pre-operative ECE for CPA with severe adhesions was selectively performed to reduce intra-operative blood loss. ECE procedures, operative procedures, intra-operative blood loss and complications were evaluated.RESULTS: Twenty-eight patients (21 males and 7 females; median age: 55 years) were included in the study. Of the 28 patients, 8 (28.6%) underwent pre-operative ECE. Technical success rate in pre-operative ECE was 100%. The median time required for ECE procedures was 123 min. The median number of vessels embolised per procedure was 2.5. The median period between embolisation and surgery was 5 days. Major complications were observed in three patients (10.7%). There were no significant differences between patients with and without pre-operative ECE in operative time (284 vs. 365 min, respectively, P = 0.7602) and intra-operative blood loss (294 vs. 228 mL, respectively, P = 0.8987).CONCLUSIONS: Pre-operative ECE for CPA appears to be feasible and safe; however, its role in reducing intra-operative blood loss needs further investigation.
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Affiliation(s)
- H Takeuchi
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - T Matsumoto
- Kochi Medical School, Kochi University, Kochi, Japan, Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - K Morimoto
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - J Atsumi
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - S Yamamoto
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - T Nakagawa
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - S Yamada
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
| | - A Kurosaki
- Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Y Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, JATA, Tokyo, Japan
| | - T Hasebe
- Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Tokyo, Japan
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Kuroyama Y, Tabusadani M, Omatsu S, Hiramatsu M, Shiraishi Y, Kimura H, Senjyu H. Physical Function and Health-Related Quality of Life after Surgery for Nontuberculous Mycobacterium Pulmonary Disease: A Prospective Cohort Study. Ann Thorac Cardiovasc Surg 2021; 28:103-110. [PMID: 34433729 PMCID: PMC9081461 DOI: 10.5761/atcs.oa.21-00125] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose: To investigate the exercise capacity and health-related quality of life (HRQOL) of surgical patients with nontuberculous mycobacterial pulmonary disease (NTM-PD) preoperatively versus 6 months postoperatively. Methods: This prospective observational study included patients with NTM-PD and was conducted at a single center. The intervention was surgical resection plus perioperative and post-discharge physical therapy. The physical function was assessed preoperatively and 6 months postoperatively using the 6-minute walk test (6MWT). HRQOL was assessed preoperatively and 6 months postoperatively using the Short-Form 36 (SF-36) health survey questionnaire and St. George’s Respiratory Questionnaire. The postoperative HRQOL was compared between patients with and without preoperative clinical symptoms. Results: In total, 35 patients were analyzed. The preoperatively symptomatic group had significantly lower preoperative HRQOL than the preoperatively asymptomatic group (p <0.05). Compared with preoperatively, there were significant improvements at 6 months postoperatively in the 6MWT (p <0.01) and HRQOL, mainly in the SF-36 mental component summary (p <0.01). The SF-36 mental component summary in the preoperatively symptomatic group was very significantly improved from preoperatively to 6 months postoperatively (p <0.05). Conclusion: The combination of surgical treatment and physical therapy for NTM-PD contributes to improvements in physical function and HRQOL.
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Affiliation(s)
- Yuki Kuroyama
- Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Mitsuru Tabusadani
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Shunya Omatsu
- Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.,Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Miyako Hiramatsu
- Section of Chest Surgery, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Yuji Shiraishi
- Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.,Section of Chest Surgery, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Hiroshi Kimura
- Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.,Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan.,Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Hideaki Senjyu
- Department of Clinical Mycobacteriosis, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.,Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
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Hoyer K, Hablesreiter R, Inoue Y, Yoshida K, Briest F, Christen F, Kakiuchi N, Yoshizato T, Shiozawa Y, Shiraishi Y, Striefler JK, Bischoff S, Lohneis P, Putter H, Blau O, Keilholz U, Bullinger L, Pelzer U, Hummel M, Riess H, Ogawa S, Sinn M, Damm F. A genetically defined signature of responsiveness to erlotinib in early-stage pancreatic cancer patients: Results from the CONKO-005 trial. EBioMedicine 2021; 66:103327. [PMID: 33862582 PMCID: PMC8054140 DOI: 10.1016/j.ebiom.2021.103327] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background high recurrence rates of up to 75% within 2 years in pancreatic ductal adenocarcinoma (PDAC) patients resected for cure indicate a high medical need for clinical prediction tools and patient specific treatment approaches. Addition of the EGFR inhibitor erlotinib to adjuvant chemotherapy failed to improve outcome but its efficacy in some patients warrants predictors of responsiveness. Patients and Methods we analysed tumour samples from 293 R0-resected patients from the randomized, multicentre phase III CONKO-005 trial (gemcitabine ± erlotinib) with targeted sequencing, copy number, and RNA expression analyses. Findings a total of 1086 mutations and 4157 copy-number aberrations (CNAs) with a mean of 17.9 /tumour were identified. Main pathways affected by genetic aberrations were the MAPK-pathway (99%), cell cycle control (92%), TGFβ signalling (77%), chromatin remodelling (71%), and the PI3K/AKT pathway (65%). Based on genetic signatures extracted with non-negative matrix factorization we could define five patient clusters, which differed in mutation patterns, gene expression profiles, and survival. In multivariable Cox regression analysis, SMAD4 aberrations were identified as a negative prognostic marker in the gemcitabine arm, an effect that was counteracted when treated with erlotinib (DFS: HR=1.59, p = 0.016, and OS: HR = 1.67, p = 0.014). Integration of differential gene expression analysis established SMAD4 alterations with low MAPK9 expression (n = 91) as a predictive biomarker for longer DFS (HR=0.49; test for interaction, p = 0.02) and OS (HR = 0.32; test for interaction, p = 0.001). Interpretation this study identified five biologically distinct patient clusters with different actionable lesions and unravelled a previously unappreciated association of SMAD4 alteration status with erlotinib effectiveness. Confirmatory studies and mechanistic experiments are warranted to challenge the hypothesis that SMAD4 status might guide addition of erlotinib treatment in early-stage PDAC patients.
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Affiliation(s)
- K Hoyer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - R Hablesreiter
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Inoue
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - F Briest
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - F Christen
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - N Kakiuchi
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Yoshizato
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiozawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiraishi
- Laboratory of DNA information Analysis, Human Genome Centre, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - J K Striefler
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Bischoff
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - P Lohneis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany; Institute of Pathology, University of Cologne, Cologne, Germany
| | - H Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - O Blau
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - L Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - U Pelzer
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - M Hummel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Pathology, Berlin, Germany
| | - H Riess
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany
| | - S Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan; Department of Medicine, Centre for Haematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - M Sinn
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany; German Cancer Consortium (DKTK), partner site Berlin, Berlin, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Togo T, Atsumi J, Hiramatsu M, Shimoda K, Morimoto K, Shiraishi Y. Outcomes of Surgical Treatment for Mycobacterium abscessus Complex Pulmonary Disease. Ann Thorac Surg 2021; 113:949-956. [PMID: 33839127 DOI: 10.1016/j.athoracsur.2021.03.088] [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: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mycobacterium abscessus complex pulmonary disease is notoriously difficult to treat by medication alone. We report our experience with resectional surgery combined with pre- and postoperative multidrug chemotherapy for the treatment of patients with Mycobacterium abscessus complex pulmonary disease. METHODS This is a retrospective review of 33 patients undergoing lung resection for Mycobacterium abscessus complex pulmonary disease at a single center in Japan between January 2008 and December 2019. RESULTS The median age of patients was 54.0 (interquartile range, 49.0-66.0) years; 27 were females (81.8%). Nodular-bronchiectatic was the most common disease type (n=24; 72.7%). Disease was limited in 18 (54.5%) patients and extensive in 15 (45.5%). The median duration of preoperative multidrug chemotherapy employing oral and parenteral antibiotics was 10.0 (interquartile range, 3.0-18.0) months. A total of 34 anatomical lung resections were performed as follows: 22 lobectomies, 5 segmentectomies, 4 combined resections, 2 bilobectomies, and 1 pneumonectomy. No operative mortalities and 4 morbidities occurred (13.3%). The median duration of multidrug chemotherapy after the surgery was 18.0 (interquartile range, 12.0-31.0) months. Postoperative sputum-negative status was achieved in 31 patients (93.9%); all 23 patients obtaining preoperative negative conversion remained negative, and 8 of 10 patients with preoperative positive sputum became negative (80.0%) postoperatively. Recurrence was observed in 2 patients (6.5%). The recurrence-free probabilities were 96.3%, 96.3%, and 80.2% at 1, 3, and 5 years, respectively. CONCLUSIONS Combined with pre- and postoperative multidrug chemotherapy, resectional surgery can be performed safely and achieve favorable outcomes for patients with Mycobacterium abscessus complex pulmonary disease.
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Affiliation(s)
- Takeo Togo
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan.
| | - Jun Atsumi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Miyako Hiramatsu
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kiyomi Shimoda
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kozo Morimoto
- Section of Respiratory Medicine, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
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30
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Fujiwara K, Furuuchi K, Aono A, Uesugi F, Shirai T, Nakamoto K, Shimada T, Mochizuki F, Tanaka Y, Iijima H, Yoshiyama T, Shiraishi Y, Kurashima A, Ohta K, Mitarai S, Morimoto K. Clinical risk factors related to treatment failure in Mycobacterium abscessus lung disease. Eur J Clin Microbiol Infect Dis 2021; 40:247-254. [PMID: 32875518 DOI: 10.1007/s10096-020-04026-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
The clinical importance of Mycobacterium abscessus subsp. abscessus (M. abscessus) lung disease has been increasing, but few studies have assessed the clinical characteristics associated with the treatment outcome. We retrospectively analyzed 75 consecutive patients with M. abscessus lung disease diagnosed at a tertiary hospital from January 2004 to April 2018. Among 52 patients with sufficient clinical data, 19 patients (42.2%) achieved treatment success. Compared with 26 (57.8%) patients in the treatment failure group, body mass index (BMI) (19.8 vs 17.5 kg/m2, P = 0.022), previous nontuberculous mycobacterial (NTM) lung disease (26.3% vs 61.5%, P = 0.034), the presence of cavitary lesions (31.6% vs 69.2%, P = 0.017), and the bronchiectasis score (3.0 vs 5.0, P = 0.003) were significantly different in the treatment success group. Multivariate analysis showed that age (adjusted hazard ratio (aHR), 0.94; 95% confidence interval (CI), 0.90 to 0.99; P = 0.010), the presence of cavitary lesions (aHR, 0.34; 95% CI, 0.12 to 0.94; P = 0.039), and previous NTM lung disease (aHR, 0.28; 95% CI, 0.09 to 0.86; P = 0.026) were negatively associated with treatment success. This is the first study to show that previous NTM lung disease might be a clinically important factor related to unfavorable treatment outcomes in M. abscessus lung disease patients. To increase our understanding the characteristics of M. abscessus lung disease, this factor should be independently analyzed in future research.
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Affiliation(s)
- Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Akio Aono
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Fumiko Uesugi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Tatsuya Shirai
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
- Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Keitaro Nakamoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
- Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Takafumi Shimada
- Department of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan
| | - Fumi Mochizuki
- Department of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Hiroaki Iijima
- Department of Respiratory Medicine, Tsukuba Medical Center, Tsukuba, Japan
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama, Kiyose City, Tokyo, 204-8522, Japan.
- Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
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Yorozu A, Sutani S, Soyano T, Matsumoto H, Toya K, Shiraishi Y, Saito S. Long-term Outcomes of Very-high-risk versus High-risk Prostate Cancer Patients Treated with Brachytherapy-based Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shiraishi Y, Tanaka T, Toya K, Yorozu A, Shigematsu N. Machine Learning Algorithms for Late Toxicity Prediction after Prostate Permanent Brachytherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Takei M, Harada K, Miyazaki T, Kohsaka S, Matsushita K, Shiraishi Y, Shinme T, Shindo A, Miyamoto T, Kitano D, Kodera S, Nakano H, Yamamoto T, Takayama M. Effect of air pollution on acute heart failure hospitalization differ across specific heart failure populations. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3074] [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
Introduction
Several report showed the association between ambient air pollution including particular matter under 2.5um (PM2.5) and increasing rate of hospitalization for heart failure. However, these report analyzed mainly cross-sectional, epidemiological data, thus the reports regarding association between vulnerability to PM2.5 and specific populations in acute heart failure (AHF) were scarce.
Purpose
1. To analyze the association between air pollution and rate of hospitalization for AHF
2. To analyze whether the vulnerability to air pollution differ between specific populations in AHF. Methods
A case-cross over analysis was conducted to 4980 consecutive patients registered for multicenter acute heart failure registry in 2017 in our city Japan. This registry enrolled patients transferred to cardiovascular care unit (80 institutions) via emergency medical services across our city area. Logistic regression analysis were conducted to estimate percentage changes in the rate of acute heart failure hospitalization associated with per 1μg/m3 PM2.5 concentration increase. We also conducted subgroup analysis for patients stratified by age, gender, comorbidities, left ventricular ejection fraction, and clinical scenario.
Results
An increase in 1 μg/m3 PM2.5 concentration corresponded to 2.9% (95% CI 1.2–4.6%) increase in AHF hospitalization. Patients with age younger than 75, without prior heart failure hospitalization, without history of hypertension, without anemia, and with reduced ejection fraction were more susceptible to increase in PM2.5 concentration (Figure).
Conclusions
Increase in PM2.5 concentration was associated with increased rate of AHF hospitalization. Effect of PM2.5 may differ across specific AHF subpopulations.
Figure 1
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Tokyo Metropolitan Government
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Affiliation(s)
- M Takei
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - K Harada
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Miyazaki
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - S Kohsaka
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - K Matsushita
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - Y Shiraishi
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Shinme
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - A Shindo
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Miyamoto
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - D Kitano
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - S Kodera
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - H Nakano
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - T Yamamoto
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
| | - M Takayama
- Tokyo CCU Network, Scientific Committee, Tokyo, Japan
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35
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Fujii Y, Sato Y, Suzuki H, Yoshizato T, Yoshida K, Shiraishi Y, Kawai T, Nakagawa T, Nishimatsu H, Okaneya T, Makishima H, Homma Y, Miyano S, Ogawa S, Kume H. Distinct molecular subtypes and a high diagnostic urinary biomarker of upper urinary tract urothelial carcinoma. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34078-7] [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] Open
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36
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Togo T, Atsumi J, Hiramatsu M, Shimoda K, Morimoto K, Uchimura K, Shiraishi Y. Residual Destructive Lesions and Surgical Outcome in Mycobacterium avium Complex Pulmonary Disease. Ann Thorac Surg 2020; 110:1698-1705. [PMID: 32473130 DOI: 10.1016/j.athoracsur.2020.04.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/25/2020] [Accepted: 04/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Successful surgical treatment of patients with Mycobacterium avium complex pulmonary disease is thought to require complete removal of parenchymal destructive lesions. This study aimed to evaluate the short-term and long-term outcomes and the predictors of microbiological recurrence after surgery for M avium complex pulmonary disease. METHODS We conducted a retrospective review of 184 patients undergoing unilateral lung resection for M avium complex pulmonary disease at a single center in Japan between January 2008 and December 2017. RESULTS Median age of the 184 patients was 55.5 years; 133 were female (72.3%). All but 2 patients had anatomical lung resection. A total of 116 patients had limited disease and underwent complete resection (63.0%); the remaining 68 patients had extensive disease and underwent debulking surgery (37.0%). No operative mortalities occurred. In 18 of 184 patients, 21 morbidities occurred (9.8%), including 3 bronchopleural fistulas (1.6%). Postoperative sputum-negative status was achieved in 183 patients (99.5%). Microbiological recurrences occurred in 15 patients (8.2%). By multivariate analysis, extensive disease was an independent risk factor for recurrence (hazard ratio, 5.432; 95% confidence interval, 1.372-21.50; P = .016). Recurrence-free rates were significantly higher in patients with limited disease compared with those with extensive disease (99.0%, 97.4%, and 95.0% versus 93.0%, 89.2%, and 75.1% at 1, 3, and 5 years, respectively; P < .001). CONCLUSIONS Complete resection of parenchymal destructive lesions can achieve excellent microbiological control for patients with limited M avium complex pulmonary disease. The efficacy of debulking surgery in patients with extensive disease needs further investigation.
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Affiliation(s)
- Takeo Togo
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan.
| | - Jun Atsumi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Miyako Hiramatsu
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kiyomi Shimoda
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kozo Morimoto
- Section of Respiratory Medicine, Fukujuji Hospital, Kiyose, Tokyo, Japan
| | - Kazuhiro Uchimura
- Department of Epidemiology and Clinical Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Tokyo, Japan
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Tokyo, Japan
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Matsuda M, Kido T, Tsuda T, Okada K, Shiraishi Y, Suekuni H, Kamei Y, Kitazawa R, Mochizuki T. Utility of synthetic MRI in predicting the Ki-67 status of oestrogen receptor-positive breast cancer: a feasibility study. Clin Radiol 2020; 75:398.e1-398.e8. [PMID: 32019671 DOI: 10.1016/j.crad.2019.12.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 12/31/2019] [Indexed: 01/13/2023]
Abstract
AIM To evaluate the utility of synthetic magnetic resonance imaging (MRI) of the breast in predicting the Ki-67 status in patients with oestrogen receptor (ER)-positive breast cancer. MATERIALS AND METHODS Forty-nine patients with 50 histopathologically proven breast cancers who underwent additional synthetic MRI were enrolled in the present study. Using synthetic MRI images, T1 and T2 relaxation times and their standard deviations (SD) in the breast lesions before (T1-Pre, T2-Pre, PD-Pre, SD of T1-Pre, SD of T2-Pre, SD of PD-Pre) and after (T1-Gd, T2-Gd, PD-Gd, SD of T1-Gd, SD of T2-Gd, SD of PD-Gd) contrast agent injection were obtained. These quantitative values were compared between the low Ki-67 expression (<14%) lesions (low-proliferation group: n=23) and high Ki-67 expression (≥14%) lesions (high-proliferation group: n=27). RESULTS The univariate analysis showed that the SD of T1-Gd (p<0.001) and T2-Gd (p=0.042) were significantly higher in the high-proliferation group than in the low-proliferation group. Multivariate analysis further showed that the SD of T1-Gd was a significant and independent predictor of Ki-67 expression, with an area under the receiver operating characteristic (AUROC) curve of 0.885. The sensitivity, specificity, and accuracy of the SD of T1-Gd with an optimal cut-off value of 98.5 were 77.8%, 87%, and 82%, respectively. CONCLUSION The SD of T1-Gd obtained from synthetic MRI was useful to predict Ki-67 status.
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Affiliation(s)
- M Matsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - T Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - T Tsuda
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - K Okada
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Y Shiraishi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - H Suekuni
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Y Kamei
- Breast Center, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - R Kitazawa
- Division of Diagnostic Pathology, Ehime University Hospital, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - T Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan; Department of Radiology, I.M. Sechenov First Moscow State Medical University, 8-2 Trubetskaya Str, Moscow, 119991, Russian Federation
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Kuroyama Y, Tabusadani M, Omatsu S, Shiraishi Y, Senjyu H. Incremental Shuttle Walk Distance as an Indicator for Functional Exercise Capacity of Pre-Surgical Patients with Nontuberculous Mycobacterial Lung Disease. TOHOKU J EXP MED 2020; 250:43-48. [PMID: 31996491 DOI: 10.1620/tjem.250.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The incidence of nontuberculous mycobacterial lung disease (NTMLD) is increasing worldwide, the number of lung surgeries is increasing accordingly. The disease is progressive and is characterized by exertional intolerance, respiratory dysfunctions, and impaired health-related quality of life (HRQOL). Treatment comprises multidrug antibiotic treatment combined with lung resection. The incremental shuttle walk distance (ISWD) is a standard tool for assessing the patients' tolerance to lung resection. The exertional tolerance, physical functions and HRQOL among pre-surgical patients with NTMLD are clinically important, but not fully studied yet from the viewpoint of physiotherapy. The purpose of this study was to explore the clinical significance of ISWD for assessing the exercise capacity of pre-surgical patients with NTMLD. For peripheral muscle evaluation, the strength of the quadriceps femoris muscle was measured. HRQOL was evaluated using scores of the St. George's Respiratory Questionnaire (SGRQ). Thirty-three patients (mean age 54.9 ± 13 years) were enrolled. The mean ISWD was 505 ± 134 m, shorter than the reference values (ISWD %predicted: 96 ± 27%). Regression analysis showed significant associations between ISWD and percent-predicted vital capacity (r = 0.38, p = 0.03) and percent quadriceps force/body weight (r = 0.54, p = 0.001). HRQOL assessed by SGRQ scores was correlated with ISWD (r < -0.4, p < 0.05). Multiple regression analysis showed that ISWD was significantly associated with leg muscle strength and with HRQOL. In conclusion, ISWD is useful to evaluate the exercise capacity among pre-surgical patients with NTMLD.
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Affiliation(s)
- Yuki Kuroyama
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences.,Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association
| | - Mitsuru Tabusadani
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association
| | - Shunya Omatsu
- Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association
| | - Yuji Shiraishi
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences.,Section of Chest Surgery, Fukujuji Hospital, Japan Anti-Tuberculosis Association
| | - Hideaki Senjyu
- Department of Clinical Mycobacteriology, Nagasaki University Graduate School of Biomedical Sciences.,Respiratory Care and Rehabilitation Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association
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Seto S, Morimoto K, Yoshida T, Hiramatsu M, Hijikata M, Nagata T, Kikuchi F, Shiraishi Y, Kurashima A, Keicho N. Proteomic Profiling Reveals the Architecture of Granulomatous Lesions Caused by Tuberculosis and Mycobacterium avium Complex Lung Disease. Front Microbiol 2020; 10:3081. [PMID: 32010116 PMCID: PMC6978656 DOI: 10.3389/fmicb.2019.03081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/20/2019] [Indexed: 12/28/2022] Open
Abstract
Tuberculosis (TB) and Mycobacterium avium complex lung disease (MAC-LD) are both characterized pathologically by granuloma lesions, which are typically composed of a necrotic caseum at the center surrounded by fibrotic cells and lymphocytes. Although the histological characterization of TB and MAC-LD granulomas has been well-documented, their molecular signatures have not been fully evaluated. In this research we applied mass spectrometry-based proteomics combined with laser microdissection to investigate the unique protein markers in human mycobacterial granulomatous lesions. Comparing the protein abundance between caseous and cellular sub-compartments of mycobacterial granulomas, we found distinct differences. Proteins involved in cellular metabolism in transcription and translation were abundant in cellular regions, while in caseous regions proteins related to antimicrobial response accumulated. To investigate the determinants of their heterogeneity, we compared the protein abundance in caseous regions between TB and MAC-LD granulomas. We found that several proteins were significantly abundant in the MAC-LD caseum of which proteomic profiles were different from those of the TB caseum. Immunohistochemistry demonstrated that one of these proteins, Angiogenin, specifically localized to the caseous regions of selected MAC-LD granulomas. We also detected peptides derived from mycobacterial proteins in the granulomas of both diseases. This study provides new insights into the architecture of granulomatous lesions in TB and MAC-LD.
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Affiliation(s)
- Shintaro Seto
- Department of Pathophysiology and Host Defense, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Tsutomu Yoshida
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Miyako Hiramatsu
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Minako Hijikata
- Department of Pathophysiology and Host Defense, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Toshi Nagata
- Department of Health Science, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Fumihito Kikuchi
- Department of Pathology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Naoto Keicho
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
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Fabbro CD, Rompré P, Kato T, Maluly M, Haraki S, Toyota R, Shiraishi Y, Andersen M, Tufik S, Montplaisir J, Lavigne G. Rhythmic masticatory muscle activity (RMMA) index does not decrease with age, conversely to self reports of sleep bruxism: data from sleep laboratories of 3 Continents. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kitakata H, Kohno T, Kohsaka S, Fujisawa D, Nakano N, Shiraishi Y, Katsumata Y, Yuasa S, Fukuda K. P5411Prognostic communication with hospitalized heart failure patients; the patients' perspective. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Informing heart failure (HF) patients about their prognosis is an important part of clinical management, particularly at the time of hospitalization. Current European Society of Cardiology guidelines recommend communicating this information to HF patients at the time of hospitalization and with any change in clinical status. However, little is known about actual patient preferences, understanding, and attitudes towards prognostic communication with their treating physicians.
Methods
We surveyed 113 consecutive hospitalized HF patients in a single university hospital. We assessed patient understanding of prognosis (likelihood of survival beyond 2 years), and compared patient expectations to model predictions. Model-predicted 2-year survival rate was calculated by the Seattle Heart Failure Model (SHFM). We also assessed patient preferences for information disclosure using the Prognosis and Treatment Perception Questionnaire (PTPQ). The PTPQ assesses patient beliefs regarding 1) the importance of knowing about prognosis, 2) the importance of knowing about treatment option, and 3) frequency of having a conversation about prognosis during the hospital stay.
Results
Enrolled patients were predominantly male (65.5%), with a mean age of 73.6±9.6 years and mean left ventricular ejection fraction was 46.2±15.4%. Median SHFM-estimated 2-year survival rate was 89.2% (interquartile range: 83.8–92.9%). Overall, patient understanding about prognosis was suboptimal. Among patients with a guarded 2-year survival (SHFM <90%: N=60), 44% reported that their likelihood of 2-year survival was >90% (Figure; red box). However, among patients with favorable 2-year survival (>90%: N=53), 38% reported a likelihood of <90% (Figure; blue box). Regarding treatment options, most patients (98%) desired to learn as many details as possible. Responses varied with regard to information on individual prognosis; whereas 51% wanted to know more about prognosis than their present status alone, a significant number (28%) of subjects answered “never” or “less often” to a query on the frequency of discussion about prognosis. Patient preference for more information about prognosis was associated with female sex (odds ratio [OR]: 2.52; 95% confidence interval [CI]: 1.12–5.69), fewer symptoms of depression (1-point increase on Patient Health Questionnaire-2, OR: 0.66; 95% CI: 0.49–0.87), and previous stroke (OR: 2.92; 95% CI: 1.04–8.19), but not other social/demographic or clinical factors (e.g., age, education, caregiver support, HF phenotype and severity, and other comorbid conditions).
Figure 1
Conclusions
There were substantial discrepancies in patient understanding of prognosis and in desire for more information from physicians. Interventions to improve prognostic understanding are warranted for HF patients, and hospitalization for HF could represent an opportunity for optimization.
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Affiliation(s)
- H Kitakata
- Keio University School of Medicine, Tokyo, Japan
| | - T Kohno
- Keio University School of Medicine, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Tokyo, Japan
| | - D Fujisawa
- Keio University School of Medicine, Tokyo, Japan
| | - N Nakano
- Keio University School of Medicine, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Tokyo, Japan
| | - Y Katsumata
- Keio University School of Medicine, Tokyo, Japan
| | - S Yuasa
- Keio University School of Medicine, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Tokyo, Japan
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Shoji S, Sawano M, Shiraishi Y, Ikemura N, Noma S, Suzuki M, Numasawa Y, Fukuda K, Kohsaka S. P6531Evidence-practice gap in the preprocedural risk assessment for contrast-induced acute kidney injury. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Contrast-induced acute kidney injury (CI-AKI) is one of the frequently encountered and costly complications after percutaneous coronary intervention (PCI). Clinical practice guidelines strongly recommend that PCI patients should universally undergo preprocedural assessment for the risk of CI-AKI, and the contrast volume (CV) should be minimized to an achievable level, particularly among the high AKI risk patients. However, data on the CV use based on the comprehensive preprocedural risk assessment is still lacking.
Purpose
Our study aimed to 1) assess the impact of CV increase with the incidence of AKI among high AKI risk patients, and 2) retrospectively evaluate the used CV based on the preprocedural comprehensive risk assessment for patients undergoing PCI within multicenter longitudinal registry.
Methods
Between 2009 and 2018, 22,373 patients underwent PCI in 14 participating facilities, and consecutive patient data was registered. AKI was defined as a >0.3mg/dl absolute or >1.5-fold relative increase in post-PCI creatinine or new initiation of dialysis, based on the Acute Kidney Injury Network criteria. The post-procedural creatinine was defined as the highest value within 30 days after the indexed procedure. Congruent with the National Cardiovascular Data Registry (NCDR) definition, if more than 1 post-procedural creatinine level was measured, the highest value was used for determining AKI. We divided the patients into four groups according to quartile of NCDR AKI risk scores.
Results
Mean age of the patients were 68.7±11.1 years, and 79.1% were male. Mean CV use was 161.4±74.8ml. The incidence of CI-AKI was 8.9%, and was particularly high among high AKI risk patients (21.1%); CV (per 1ml linear increase) was directly associated with the occurrence of AKI (OR: 1.002 per unit in CV; 95% CI: 1.001–1.003; P<0.001) in these patients. CV during PCI decreased with the progression of chronic kidney disease (CKD), but it did not alter by the overall NCDR AKI risk score (Figure). After multivariable adjustment, CV was predicted by stage of CKD (−13.68ml; 95% CI: −12.05 to −15.30ml; P<0.001), but not by the value of pre-procedure prediction score (NCDR AKI risk score, P=0.575).
CV according to CKD/NCDR AKI risk score
Conclusions
Higher CV was directly associated with the occurrence of AKI among higher AKI risk patients. However, CV use was largely influenced by the stage of renal disease, and not with overall patient risk presented by contemporary risk scores. Our results have identified an important evidence-practice gap and emphasizes the importance of total preprocedural assessment to minimize CV and prevent subsequent AKI.
Acknowledgement/Funding
KAKENHI (16KK0186, 16H05215, 25460630, 25460777), Bayer, Daiichi Sankyo, Bristol-Myers Squibb, Teikoku Seiyaku, Sumitomo Dainippon, AstraZeneka, Pfizer
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Affiliation(s)
- S Shoji
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - M Sawano
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - N Ikemura
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - S Noma
- Saiseikai Utsunomiya Hospital, Cardiology, Tochigi, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Cardiology, Saitama, Japan
| | - Y Numasawa
- Japanese Red Cross Ashikaga Hospital, Cardiology, Tochigi, Japan
| | - K Fukuda
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Cardiology, Tokyo, Japan
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Shiraishi Y, Kohsaka S, Katsuki T, Harada K, Miyamoto T, Matsushita K, Iida K, Takei M, Fukuda K, Yamamoto T, Nagao K, Takayama M. P2622Use of intravenous vasodilators in patients hospitalized with acute heart failure: insights from Tokyo cardiovascular care unit network database. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Despite recommendations from clinical practice guidelines, there is scant evidence confirming the effects of vasodilators on clinical outcomes in patients with acute heart failure (AHF).
Purpose
We sought to investigate the effects of intravenous vasodilators on clinical outcomes and to identify the potential patient populations that would benefit from its use.
Methods
Data of 26 212 consecutive patients urgently hospitalized for AHF between 2009 and 2015 were extracted from a multicenter data registration system (Tokyo Cardiovascular Care Unit Network Database, including 72 institutions within the Tokyo metropolitan area in Japan). Patients who did not present with typical AHF episodes, including those without pulmonary congestion on physical and/or chest X-ray and serum B-type natriuretic peptide level <500 pg/ml, as well as those who had hypotension and/or hypoperfusion (systolic blood pressure [SBP] <100 mmHg) as dominant presentation, were excluded. Propensity scores were calculated with multiple imputation and 1:1 matching performed between patients with and without vasodilators. The primary endpoint was in-hospital mortality and the secondary endpoints were length of intensive/cardiovascular care unit (ICU/CCU) stay and hospital stay.
Results
Overall, 8 863 patients were included in the present analysis; they were predominantly male (57%) with a median age of 79 (interquartile range: 70–86) years. Compared with the group without vasodilator use, the vasodilator group had higher SBPs and heart rates and higher frequency of assisted ventilation use, but lower frequency of intravenous diuretics use. After propensity score matching, there were no significant differences in in-hospital mortality rates (7.8% vs. 8.9% in patients without vasodilators, p=0.16) or in length of ICU/CCU stay (5.8 days vs. 5.4 days, p=0.44) and hospital stay (22.7 days vs. 23.8 days, p=0.22) between the groups. However, in subgroup analyses, favorable impacts of vasodilator use on in-hospital mortality were observed among patients who had higher SBPs and among those who had no atrial fibrillation upon admission (Figure). In addition, vasodilators were likely to be more effective in AHF patients with SBP increasing; while levels below 140 mmHg of SBP appeared to be associated with an increased risk for mortality among patients treated with vasodilators compared with those without vasodilators.
Figure 1
Conclusions
In patients with AHF, vasodilator use was not universally associated with improved in-hospital outcomes; however, its effect was dependent of individual clinical presentation. Detailed phenotyping might aid tailoring of treatment strategies for patients with AHF.
Acknowledgement/Funding
the Tokyo Metropolitan Government
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Affiliation(s)
| | | | | | | | | | | | - K Iida
- Tokyo CCU Network, Tokyo, Japan
| | - M Takei
- Tokyo CCU Network, Tokyo, Japan
| | | | | | - K Nagao
- Tokyo CCU Network, Tokyo, Japan
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Togo T, Atsumi J, Shimoda K, Hiramatsu M, Yoshida T, Shiraishi Y. [Nontuberculous Mycobacteriosis Resistant for Chemotherapy which was Suspected to Coexist with Lung Cancer]. Kyobu Geka 2019; 72:576-580. [PMID: 31353347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Nontuberculous mycobacteriosis (NTM) has been increasing recently. The treatment of choice of NTM is chemotherapy. Surgical treatment is sometimes indicated for patients with refractory NTM. When NTM lesion is enlarging despite of chemotherapy, there are 2 possibilities:intractable NTM and co-existing lung cancer. A 67-year-old male had been treated for fibro-cavitary NTM in the right upper lobe with chemotherapy. The cavitary lesion, however, was growing in spite of 6 months treatment. We suspected of a co-existing lung cancer because SCC level and standardized uptake value (SUV) in positron emission tomography (PET)-computed tomography (CT) were high. Bronchoscopy was performed but revealed no malignancy. He underwent a right upper lobectomy and the intraoperative pathology indicated NTM with no malignancy. After the operation, SCC levels decreased. This is a rare case with preoperative high SCC level which seemed to be related to NTM lesion.
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Affiliation(s)
- Takeo Togo
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan
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Furuuchi K, Morimoto K, Yoshiyama T, Tanaka Y, Fujiwara K, Okumura M, Izumi K, Shiraishi Y, Mitarai S, Ogata H, Kurashima A, Yoshimori K, Ohta K, Goto H, Sasaki Y. Interrelational changes in the epidemiology and clinical features of nontuberculous mycobacterial pulmonary disease and tuberculosis in a referral hospital in Japan. Respir Med 2019; 152:74-80. [PMID: 31128614 DOI: 10.1016/j.rmed.2019.05.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [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: 11/09/2018] [Revised: 04/01/2019] [Accepted: 05/04/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVES The incidence of nontuberculous mycobacterial pulmonary disease (NTM-PD) is increasing, while that of tuberculosis (TB) is decreasing in many industrialized countries, including Japan. However, the long-term evaluation of clinico-epidemiological features of NTM-PD in relation to TB are limited. We aimed to clarify the long-term changes in the epidemiology and clinical features of NTM-PD in relation to those of TB at a nationally-designated TB center in Japan. METHODS We reviewed all mycobacterial examination records at Fukujuji Hospital between 2006 and 2016. Cases of NTM-PD were defined according to the 2007 American Thoracic Society/Infectious Disease Society of America microbiologic criteria. The current characteristics of Mycobacterium avium complex pulmonary disease (MAC-PD) were compared with those in the 1980s and circa 2000. RESULTS We identified a total of 3,546 pulmonary TB cases and 2,155 NTM-PD cases. While the annual number of incident pulmonary TB cases remained stable over the study period (P = 0.59), that of NTM-PD cases increased significantly from 165 to 278 (P < 0.01). The mean age of pulmonary TB cases increased from 59.7 ± 16.3 to 66.2 ± 21.7 years, whereas that of NTM-PD cases remained unchanged. Regarding the age distribution, the greatest increases were observed in patients over 75 years for TB and in patients 50-74 years for NTM. The most common causative organism for NTM was Mycobacterium avium complex (87.3%), M. abscessus complex (5.5%) and M. kansasii (3.9%). Among patients with MAC-PD, the proportion of the nodular bronchiectatic (NB) form increased significantly from 60.0% to 84.4% between circa 2000 and 2016 (P < 0.01). Significant increases in the NB form were observed in both males (33.3%-70.7%, P < 0.01) and females (71.3%-89.2%, P < 0.01). CONCLUSIONS The annual number of incident NTM-PD cases increased markedly. In contrast to patients with TB, the mean age of new NTM-PD patients did not increase in the last 10 years. Among MAC-PD patients, the proportions accounted for by the NB form increased significantly in both sexes.
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Affiliation(s)
- Koji Furuuchi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Morimoto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan; Division of Clinical Research, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
| | - Takashi Yoshiyama
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yoshiaki Tanaka
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Keiji Fujiwara
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Masao Okumura
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kiyohiko Izumi
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuji Shiraishi
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hideo Ogata
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Atsuyuki Kurashima
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Kozo Yoshimori
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Ken Ohta
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Hajime Goto
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
| | - Yuka Sasaki
- Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan
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Yorozu A, Sutani S, Toya K, Shiraishi Y, Saito S. PV-0628 Association of androgen deprivation duration and cardiovascular mortality in prostate cancer men. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31048-5] [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: 10/26/2022]
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Van Rossum P, Deng W, Routman D, Liu A, Xu C, Shiraishi Y, Peters M, Merrell K, Hallemeier C, Mohan R, Lin S. PO-0795 Prediction of severe lymphopenia during chemoradiotherapy for esophageal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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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. 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] [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
[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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Affiliation(s)
- T Nishimura
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - K Yoshida
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Y Kawata
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Y Takeuchi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - N Kakiuchi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Y Shiozawa
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - K Aoki
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - M Hirata
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - TR Kataoka
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - T Sakurai
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Baba
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Y Shiraishi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - K Chiba
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - K Takeuchi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - H Haga
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Miyano
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - M Toi
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Ogawa
- Graduate School of Medicine, Kyoto University, Kyoto, Japan; Kyoto University Hospital, Kyoto, Japan; Pathology Project for Molecular Targets, Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Otsubo K, Iwama E, Tanaka K, Shiraishi Y, Yoneshima Y, Inoue H, Tagawa T, Nakanishi Y, Okamoto I. P3.09-15 Genetic Profiling of Idiopathic Pulmonary Fibrosis Associated Non-Small Cell Lung Cancer by Targeted Next-Generation Sequencing. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Non-cystic fibrosis bronchiectasis (bronchiectasis) is an abnormal dilatation of the bronchi and bronchioles, resulting from a prolonged recurrent infectious process due to various causes and predisposing factors. This disease has several etiologies and affects a heterogeneous population of patients. The most important viewpoint for the surgical management of bronchiectasis is to select appropriate candidates for surgery and conduct suitable anatomic lung resections at the right time under appropriate conditions. The ideal candidates for lung resection are symptomatic patients with focal disease due to truly localized bronchial pathology regardless of optimal and absolute medical management.
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Affiliation(s)
| | - Yuji Shiraishi
- Section of Chest Surgery, Fukujuji Hospital, Tokyo, Japan
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