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Kawamura T, Sekine Y, Sugai K, Yanagihara T, Saeki Y, Kitazawa S, Kobayashi N, Goto Y, Ichimura H, Ohigashi T, Maruo K, Sato Y. Three-dimensional analysis reveals a high incidence of lung adenocarcinoma in the upper region. Surg Today 2024; 54:634-641. [PMID: 38055104 DOI: 10.1007/s00595-023-02776-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/08/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE The lung is a unique organ with a ventilation-perfusion mismatch, which can cause inhomogeneous incidence rates of lung cancer depending on the location in the lung. We aimed to evaluate the incidence of lung adenocarcinoma in each lobe by analyzing the incidence per unit volume, to evaluate the incidence without being affected by differences in the size of each lobe or in the size of the lungs between individuals. METHODS The number of adenocarcinomas in each lobe was counted. Lung volumes were measured using a three-dimensional computer workstation. The tumor incidence per unit volume was analyzed based on the number of tumors in each lobe. RESULTS The number of tumors per unit volume was 0.467 in the right upper lobe (RUL), 0.182 in the right middle lobe, 0.209 in the right lower lobe, 0.306 in the left upper segment (LUS), 0.083 in the left lingular segment, and 0.169 in the left lower lobe. The tumor incidence rate of RUL + LUS was 2.269 times that of the other lobes, a value that was significantly higher when using the bootstrap method (p < 0.001). CONCLUSIONS The incidence of adenocarcinoma per unit volume in both upper lobes was higher than that in other lobes.
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Affiliation(s)
- Tomoyuki Kawamura
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Yasuharu Sekine
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Kazuto Sugai
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan
| | - Tomohiro Ohigashi
- Department of Biostatistics, Tsukuba Clinical Research and Development Organization, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, 1‑1‑1 Tennodai, Tsukuba, Ibaraki, 305‑8575, Japan.
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Saeki Y, Maki N, Nemoto T, Inada K, Minami K, Tamura R, Imamura G, Cho-Isoda Y, Kitazawa S, Kojima H, Yoshikawa G, Sato Y. Lung cancer detection in perioperative patients' exhaled breath with nanomechanical sensor array. Lung Cancer 2024; 190:107514. [PMID: 38447302 DOI: 10.1016/j.lungcan.2024.107514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/12/2024] [Accepted: 02/24/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Breath analysis using a chemical sensor array combined with machine learning algorithms may be applicable for detecting and screening lung cancer. In this study, we examined whether perioperative breath analysis can predict the presence of lung cancer using a Membrane-type Surface stress Sensor (MSS) array and machine learning. METHODS Patients who underwent lung cancer surgery at an academic medical center, Japan, between November 2018 and November 2019 were included. Exhaled breaths were collected just before surgery and about one month after surgery, and analyzed using an MSS array. The array had 12 channels with various receptor materials and provided 12 waveforms from a single exhaled breath sample. Boxplots of the perioperative changes in the expiratory waveforms of each channel were generated and Mann-Whitney U test were performed. An optimal lung cancer prediction model was created and validated using machine learning. RESULTS Sixty-six patients were enrolled of whom 57 were included in the analysis. Through the comprehensive analysis of the entire dataset, a prototype model for predicting lung cancer was created from the combination of array five channels. The optimal accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 0.809, 0.830, 0.807, 0.806, and 0.812, respectively. CONCLUSION Breath analysis with MSS and machine learning with careful control of both samples and measurement conditions provided a lung cancer prediction model, demonstrating its capacity for non-invasive screening of lung cancer.
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Affiliation(s)
- Yusuke Saeki
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Naoki Maki
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Takahiro Nemoto
- Center for Functional Sensor & Actuator (CFSN), Research Center for Functional Materials, National Institute for Materials Science (NIMS), Ibaraki, Japan; Research Center for Macromolecules and Biomaterials, National Institute for Materials Science (NIMS), Ibaraki, Japan
| | - Katsushige Inada
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Kosuke Minami
- Center for Functional Sensor & Actuator (CFSN), Research Center for Functional Materials, National Institute for Materials Science (NIMS), Ibaraki, Japan; Research Center for Macromolecules and Biomaterials, National Institute for Materials Science (NIMS), Ibaraki, Japan; International Center for Young Scientists (ICYS), National Institute for Materials Science (NIMS), Ibaraki, Japan
| | - Ryo Tamura
- World Premier International (WPI) Research Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Ibaraki, Japan; Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan; Research and Services Division of Materials Data and Integrated System (MaDIS), National Institute for Materials Science (NIMS), Ibaraki, Japan; Center for Basic Research on Materials, National Institute for Materials Science (NIMS), Ibaraki, Japan
| | - Gaku Imamura
- Research Center for Macromolecules and Biomaterials, National Institute for Materials Science (NIMS), Ibaraki, Japan; World Premier International (WPI) Research Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Ibaraki, Japan; Graduate School of Information Science and Technology, Osaka University, Osaka, Japan
| | - Yukiko Cho-Isoda
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Hiroshi Kojima
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Ibaraki, Japan; Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Ibaraki, Japan
| | - Genki Yoshikawa
- Center for Functional Sensor & Actuator (CFSN), Research Center for Functional Materials, National Institute for Materials Science (NIMS), Ibaraki, Japan; Research Center for Macromolecules and Biomaterials, National Institute for Materials Science (NIMS), Ibaraki, Japan; Materials Science and Engineering, Graduate School of Pure and Applied Science, University of Tsukuba, Ibaraki, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan.
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Ichimura H, Kobayashi K, Gosho M, Sekine Y, Sugai K, Kawamura T, Saeki Y, Suzuki H, Kobayashi N, Goto Y, Sato Y. Relationship between changes in pulmonary function and patient-reported outcomes of lung cancer surgery. Surg Today 2024; 54:195-204. [PMID: 37306743 DOI: 10.1007/s00595-023-02716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/29/2023] [Indexed: 06/13/2023]
Abstract
PURPOSE To investigate the relationship between changes in pulmonary function (PF) and patient-reported outcomes (PROs) of lung cancer surgery. METHODS We recruited 262 patients who underwent lung resection for lung cancer, to evaluate the PROs, using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)-C30 and the Lung Cancer 13-question supplement (LC13). The patients underwent PF tests and PRO assessments preoperatively (Pre) and 1 year after surgery (Y1). Changes were calculated by subtracting the value at Pre from the value at Y1. We set two cohorts: patients under the ongoing protocol (Cohort 1) and patients who were eligible for lobectomy with clinical stage I lung cancer (Cohort 2). RESULTS Cohorts 1 and 2 comprised 206 and 149 patients, respectively. In addition to dyspnea, changes in PF were also correlated with scores for global health status, physical and role function scores, fatigue, nausea and vomiting, pain, and financial difficulties. Absolute correlation coefficient values ranged from 0.149 to 0.311. Improvement of emotional and social function scores was independent of PF. Sublobar resection preserved PF more than lobectomy did. Wedge resection mitigated dyspnea in both cohorts. CONCLUSION The correlation between PF and PROs was found to be weak; therefore, further studies are needed to improve the patient's postoperative experience.
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Affiliation(s)
- Hideo Ichimura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan.
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Keisuke Kobayashi
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yasuharu Sekine
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Kazuto Sugai
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Hisashi Suzuki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Wijesinghe AI, Kobayashi N, Kitazawa S, Maki N, Yanagihara T, Saeki Y, Kikuchi S, Goto Y, Ichimura H, Sato Y. Sex-specific emphysematous changes evaluated by a three-dimensional computed tomography volumetric analysis among patients with smoking histories who underwent resection for lung cancer. Surg Today 2024; 54:113-121. [PMID: 37271799 DOI: 10.1007/s00595-023-02707-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE The present study evaluated the sex-specific susceptibility to the development of emphysema in patients with smoking histories who underwent lung cancer surgeries. METHODS Lung cancer patients with smoking histories who underwent lung resection at the University of Tsukuba Hospital, Japan, were enrolled. Radiologic emphysematous changes were analyzed using three-dimensional computed tomography (3D-CT). The volume proportion of emphysematous lung per unit of smoking and the relationship between emphysematous change and clinicopathologic factors were evaluated. RESULTS Radiologic emphysematous changes analyzed using 3D-CT per pack-year smoked, defined as the Smoking-Emphysema Index (SEI), were greater in females than males. The difference was more profound in adenocarcinoma patients than in non-adenocarcinoma patients (0.70 ± 2.30 vs. 0.21 ± 0.28, P = 0.037). CONCLUSION Female lung cancer patients are more susceptible to smoking-induced emphysema than males. The SEI may be an effective indicator for evaluating smoking-induced emphysema.
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Affiliation(s)
- Ashoka Indranatha Wijesinghe
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Naoki Maki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
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Sugai K, Sekine Y, Kawamura T, Yanagihara T, Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y. Sphericity of lymph nodes using 3D-CT predicts metastasis in lung cancer patients. Cancer Imaging 2023; 23:124. [PMID: 38105231 PMCID: PMC10726577 DOI: 10.1186/s40644-023-00635-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The presence of mediastinal lymph node metastasis is important because it is related to the treatment and prognosis of lung cancer. Although prevalently used, evaluation of lymph nodes is not always reliable. We introduced sphericity as a criterion for evaluating morphologic differences between metastatic and nonmetastatic nodes. METHODS We reviewed the cases of 66 patients with N2 disease and of 68 patients with N0-1 disease who underwent lobectomy with mediastinal dissection between January 2012 and December 2021. The sphericity of the dissected station lymph nodes, which represents how close the node is to being a true sphere, was evaluated along with the diameter and volume. Each parameter was obtained and evaluated for ability to predict metastasis. RESULTS Metastatic lymph nodes had a larger short-axis diameter (average: 8.2 mm vs. 5.4 mm, p < 0.001) and sphericity (average: 0.72 vs. 0.60, p < 0.001) than those of nonmetastatic lymph nodes. Short-axis diameter ≥ 6 mm and sphericity ≥ 0.60 identified metastasis with 76.2% sensitivity and 70.2% specificity (AUC = 0.78, p < 0.001) and 92.1% sensitivity and 53.9% specificity (AUC = 0.78, p < 0.001), respectively. For lymph nodes with a short-axis diameter ≥ 5 mm, sphericity ≥ 0.60 identified metastasis with 84.1% sensitivity and 89.3% specificity. CONCLUSION By using 3D-CT analysis to examine sphericity, we showed that metastatic lymph nodes became spherical. Our method for predicting lymph node metastasis based on sphericity of lymph nodes with a short-axis diameter ≥ 5 mm could do so with higher sensitivity than the conventional method, and with acceptable specificity.
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Affiliation(s)
- Kazuto Sugai
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Yasuharu Sekine
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
- Ibaraki Prefectural Hospital, 6528, Koibuchi, Kasama, 309-1793, Ibaraki, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
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Saeki Y, Moriyama Y, Araki Y, Oda A, Nakaoka K, Inagaki M. Gas Gangrene after Thoracic Drainage for Empyema with Tension Pneumothorax. Am J Respir Crit Care Med 2023; 208:814-815. [PMID: 37339519 DOI: 10.1164/rccm.202207-1322im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 06/20/2023] [Indexed: 06/22/2023] Open
Affiliation(s)
- Yusuke Saeki
- Department of Thoracic Surgery
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | | | - Yuichi Araki
- Department of Emergency Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan, and
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Saeki Y, Okamura J, Ueda S, Sato Y. Middle lobe pulmonary artery branch running ventral to the upper lobe pulmonary vein. Eur J Cardiothorac Surg 2023; 64:ezad250. [PMID: 37458493 DOI: 10.1093/ejcts/ezad250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/19/2023] [Indexed: 07/21/2023] Open
Affiliation(s)
- Yusuke Saeki
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Junko Okamura
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Sho Ueda
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan
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Saeki Y, Nakaoka K, Inagaki M. Identification of the Separation Range of an Incomplete Interlobar Fissure in Segmentectomy Using Near Infrared. Cureus 2023; 15:e38009. [PMID: 37228543 PMCID: PMC10207970 DOI: 10.7759/cureus.38009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
In segmentectomy for patients with incomplete interlobar fissures, insufficient dissection of the interlobar parenchyma may result in incomplete segmentectomy, while excessive dissection may lead to excessive bleeding and air leaks. Here, we report a case of left apicoposterior (S1+2) segmentectomy with incomplete interlobar fissure in which near-infrared thoracoscopy with indocyanine green was used to identify the separation range of interlobar fissure by dissecting the relevant vessels beforehand.
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Affiliation(s)
- Yusuke Saeki
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, JPN
- Department of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, JPN
| | - Kojiro Nakaoka
- Department of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, JPN
| | - Masaharu Inagaki
- Department of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, JPN
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Okuda R, Osaki M, Saeki Y, Okano T, Tsuda K, Nakamura T, Morio Y, Nagashima H, Hagino H. Effect of coordinator-based osteoporosis intervention on quality of life in patients with fragility fractures: a prospective randomized trial. Osteoporos Int 2022; 33:1445-1455. [PMID: 35195752 DOI: 10.1007/s00198-021-06279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED We examined the effects of the coordinator-based intervention on quality of life (QOL) in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL. The coordinator-based interventions mitigated the decrease in QOL. Secondary fracture after primary fracture, however, was a significant predictor of lower QOL. PURPOSE This study aimed to determine the effects of the coordinator-based intervention on QOL in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL, in an Asian population. METHODS Patients with new fractures in the intervention group received the coordinator-based intervention by a designated nurse certified as a coordinator, within 3 months of injury. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) scale before the fracture (through patient recollections) and at 0.5, 1, and 2 years after the primary fracture. RESULTS Data for 141 patients were analyzed: 70 in the liaison intervention (LI) group and 71 in the non-LI group. Significant intervention effects on QOL were observed at 6 months after the fracture; the QOL score was 0.079 points higher in the LI group than in the non-LI group (p=0.019). Further, the LI group reported significantly less pain/discomfort at 2 years after the fracture, compared to the non-LI group (p=0.037). In addition, secondary fractures were found to significantly prevent improvement and maintenance of QOL during the recovery period (p=0.015). CONCLUSION Short-term intervention effects were observable 6 months after the primary fracture, with the LI group mitigated the decrease in QOL. Few patients in the LI group reported pain/discomfort 2 years after the fracture, but there is uncertainty regarding its clinical significance. Secondary fracture after initial injury was a significant predictor of lower QOL after a fracture.
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Affiliation(s)
- R Okuda
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan.
| | - M Osaki
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
| | - Y Saeki
- Orthopedic Surgery Hospital Ward, Tottori University Hospital, Yonago, Tottori, Japan
| | - T Okano
- Department of Orthopedic Surgery, San-in Rosai Hospital, Yonago, Tottori, Japan
| | - K Tsuda
- Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Sakaiminato, Tottori, Japan
| | - T Nakamura
- Department of Orthopedic Surgery, Hakuai Hospital, Yonago, Tottori, Japan
| | - Y Morio
- Department of Orthopedic Surgery, Misasa Onsen Hospital, Misasa, Tottori, Japan
| | - H Nagashima
- Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
| | - H Hagino
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
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10
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Yanagihara T, Kobayashi N, Saeki Y, Kikuchi S, Goto Y, Sato Y. Left thoracoscopic sympathectomy for refractory ventricular arrhythmias. Gen Thorac Cardiovasc Surg 2022; 70:920-923. [DOI: 10.1007/s11748-022-01835-1] [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] [Received: 02/22/2022] [Accepted: 05/19/2022] [Indexed: 11/04/2022]
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Maki N, Sakamoto H, Takata Y, Taniguchi K, Wijesinghe A, Okamura J, Kawamura T, Yanagihara T, Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y, Yanagi H. Effect of pulmonary training for community‐dwelling frail older adults with chronic stroke: A randomized controlled pilot trial. J Gen Fam Med 2021; 23:140-148. [PMID: 35509345 PMCID: PMC9062559 DOI: 10.1002/jgf2.511] [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: 05/23/2021] [Revised: 10/16/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Decreased pulmonary function and poor deglutition are a major risk factor for poststroke aspiration pneumonia. We analyzed the benefits of pulmonary training on pulmonary function, deglutition, and quality of life (QOL) in community‐dwelling, frail elderly people with chronic stroke. Method This study was designed as an open, randomized, controlled pilot trial. The participants, who were frail older adults with a history of stroke, were randomized to 2 rehabilitation groups: intervention group (n = 15) and control (n = 15). All participants (65–94 years) attended twelve 20‐min sessions twice a week for 6 weeks of either standard rehabilitation (control group) or standard rehabilitation with pulmonary training including home pulmonary exercise (intervention group). The main outcome measures were pulmonary function (%MIP), deglutition (DRACE), and QOL (SF8・PCS), while secondary outcomes were muscle strength (grip and abdominal), thorax flexibility, 6‐min walk distance, and activities in daily living. All outcomes were measured both prior to training and after the 12 sessions. Results The intervention group showed significant improvement in %MIP (95% CI, 2.9–31.6; p < 0.01), DRACE (95% CI, −4.1–0.1; p < 0.01), and SF8・PCS (95% CI, 2.5–7.2; p < 0.01) compared with controls. There were no cognitive function decline and higher brain dysfunction. Conclusions These results suggest that the addition of pulmonary training including home pulmonary exercise to a standard rehabilitation program could improve pulmonary function, deglutition, and QOL in frail elderly people with chronic stroke.
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Affiliation(s)
- Naoki Maki
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | | | - Yu Takata
- AHR Medical and Welfare College School Tsuchiura Japan
| | | | - Ashoka Wijesinghe
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Junko Okamura
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yukio Sato
- Department of Thoracic Surgery Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Hisako Yanagi
- Department of Medical Science and Welfare Faculty of Medicine University of Tsukuba Tsukuba Japan
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12
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Shimokawa A, Kobayashi A, Saeki Y, Uchio E. A case of fungal conjunctivitis with giant papillae treated surgically. Taiwan J Ophthalmol 2021; 11:417-420. [PMID: 35070676 PMCID: PMC8757520 DOI: 10.4103/tjo.tjo_46_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/11/2020] [Indexed: 12/03/2022] Open
Abstract
Fungal conjunctivitis is a rare disorder, with low incidence and difficulty in diagnosis due to a lack of specific clinical findings. We report a case of fungal conjunctivitis which exhibited a specific clinical feature of giant papilla formation, and its diagnosis was a complex process. A 19-year-old woman with a history of atopic dermatitis and hard contact lens use was referred to us with a 3-month history of giant papillary conjunctivitis of the right eye in spite of treatment with antiallergic and corticosteroid eye drops, complicated by intraocular pressure elevation. The left eye showed no symptom of ocular surface disorder throughout the clinical course. The right eye did not respond to oral corticosteroid. Polymerase chain reaction of conjunctival scrapings against Chlamydia trachomatis was negative, and she was treated surgically by total papilla resection. Conjunctival giant papilla recurrence was not observed after surgery. Although the primary histopathological diagnosis was chronic inflammation due to atopic keratoconjunctivitis, repeated histopathological survey of excised conjunctival tissue including immunohistochemical staining revealed histiocytes, yeast type spores and hyphae, and phagocytosed spores and hyphae in macrophages. The causative organism was identified morphologically as a Candida species. Later, histopathological examination of a cervical swab revealed the presence of Candida sp. This rare case indicates that a fungal organism may underlie refractory conjunctivitis with specific giant papillary hypertrophy mimicking vernal keratoconjunctivitis.
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Affiliation(s)
- Asami Shimokawa
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Ayaka Kobayashi
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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13
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Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Saeki Y, Sato Y. Comparison of Postoperative Quality of Life and Pain with and without a Metal Rib Spreader in Patients Undergoing Lobectomy through Axillary Mini-Thoracotomy for Stage I Lung Cancer. Ann Thorac Cardiovasc Surg 2021; 28:129-137. [PMID: 34556613 PMCID: PMC9081463 DOI: 10.5761/atcs.oa.21-00148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: To evaluate postoperative patient-reported quality of life (QOL) and pain with and without a metal rib spreader (MRS) in patients with stage I lung cancer who underwent lobectomy through axillary mini-thoracotomy (AMT). Methods: This single-institution prospective observational study enrolled patients between January 2015 and April 2018. Their QOL and pain were evaluated using the EQ-5D and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire 30 items (QLQ-C30). The EQ-5D was completed preoperatively (Pre) and on days 1/3/5/7 (D1/3/5/7), at 1 month (M1), and at 1 year postoperatively (Y1). The EORTC QLQ-C30 was completed at Pre, M1, and Y1. Results: The data of 140 patients were analyzed (video-assisted without MRS: VA/noMRS: 67, AMT with MRS: AMT/MRS: 73). Although the AMT/MRS group had more preoperative comorbidities, longer operative times, and more blood loss than the VA/noMRS group, the EQ-5D visual analog scale scores were not significantly different at any assessment point (Pre/D1/D3/D5/D7/M1/Y1) (VA/noMRS: 82/48/60/67/73/77/85, AMT/MRS: 80/46/60/66/73/76/85). Postoperative pain in the EQ-5D descriptive system and the EORTC QLQ-C30 was comparable between the groups. Conclusion: VA/noMRS and AMT/MRS showed similar postoperative QOL and pain scores, indicating that MRS negligibly impacts the postoperative QOL and pain.
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Affiliation(s)
- Hideo Ichimura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.,Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Thoracic Surgery, Hitachi Medical Education and Research Center, Faculty of Medicine, University of Tsukuba, Hitachi, Ibaraki, Japan
| | - Keisuke Kobayashi
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kojiro Nakaoka
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
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14
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Kitazawa S, Wijesinghe AI, Maki N, Yanagihara T, Saeki Y, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y. Predicting Respiratory Complications Following Lobectomy Using Quantitative CT Measures of Emphysema. Int J Chron Obstruct Pulmon Dis 2021; 16:2523-2531. [PMID: 34511897 PMCID: PMC8428273 DOI: 10.2147/copd.s321541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/02/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose In performing surgery for lung cancer, emphysema is a risk factor related to postoperative respiratory complications (PRC). However, few studies have addressed the risk of radiological emphysematous volume affecting PRC. The aim of this study was to investigate the relationship between emphysematous volume as measured on 3-dimensional computed tomography and PRC. Patients and Methods We reviewed 342 lung cancer patients undergoing lobectomy between 2013 and 2018. The percentage of low attenuation area (LAA%) was defined as the percentage of the lung area showing attenuation of −950 Hounsfield units or lower. Preoperative factors including age, sex, body mass index, smoking index, respiratory function, tumour histology, and LAA% were evaluated. PRC included pneumonia, atelectasis, prolonged air leakage, empyema, hypoxia, ischemic bronchitis, bronchopleural fistula, and exacerbation of interstitial pneumonia. Uni- and multivariable analyses were performed to investigate the relationship between independent clinical variables and postoperative adverse events. Results Median LAA% was 5.0% (range, 0–40%) and PRC was observed in 50 patients (14.6%). Patients who presented with PRC showed significantly high LAA% compared to those without complications (median: 8.1% vs 3.8%; p < 0.001). Based on univariable analysis, age, sex, smoking index, percentage of forced expiratory volume in 1 s (FEV1.0%), histology, and LAA% were significant predictors for PRC. Multivariable analysis revealed higher LAA% as a significant risk factor for PRC (odds ratio = 1.040; 95% confidence interval, 1.001–1.080; p = 0.046). Conclusion In addition to respiratory function with spirometry, LAA% can be used as a predictor of PRC.
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Affiliation(s)
- Shinsuke Kitazawa
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Ashoka Indranatha Wijesinghe
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoki Maki
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takahiro Yanagihara
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yusuke Saeki
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naohiro Kobayashi
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shinji Kikuchi
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukinobu Goto
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hideo Ichimura
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Sato
- Department of General Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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15
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Kobayashi N, Kawamura T, Yanagihara T, Saeki Y, Kikuchi S, Goto Y, Sato Y. [Influence of Pleural Adhesions on Thoracoscopic Surgeries for Malignant Lung Tumors]. Kyobu Geka 2021; 74:509-513. [PMID: 34193785] [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
In the present study, influences of pleural adhesions on thoracoscopic lung surgeries were investigated. A total of 666 consecutive patients who had undergone thoracoscopic surgeries for lung malignant tumors were retrospectively analyzed. Pleural adhesions were present intraoperatively in 289 cases, of which 6 required conversion to thoracotomy due to the adhesions. The influences of pleural adhesions on the perioperative period were comparatively large under following conditions (level-A); the adhesion-type was tight which meant lung and pleural wall sticked closely even if lung collapse was encouraged, the strength was middle( required sharp-dissection) or strong( hard to dissect between visceral and parietal pleura), and the range was more than 10% of total pleural surface. Significant influences of the level-A of pleural adhesions were as follows;prolonged operation time in all procedures, frequent intraoperative lung fistula and prolonged pleural drainage period in wedge resections, and increased blood loss, intraoperative and postoperative lung fistula with prolonged pleural drainage time and postoperative hospitalization period in lobectomy. Other postoperative complications (pneumonia, empyema, exacerbation of interstitial pneumonitis, and arrhythmias) were not associated with pleural adhesions. Careful dissection procedure for pleural adhesions that minimize damage of visceral pleura would be the most important.
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16
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Kumagai K, Yagi S, Yamaguchi T, Nagashima K, Nomura T, Watanabe M, Makuuchi R, Kawakami K, Otsuka S, Matsushima T, Kadowaki S, Haruta S, Cho H, Yamada T, Kakihara N, Imai Y, Fukunaga H, Saeki Y, Kanaji S, Boku N, Goto M. P-83 The efficacy of chemotherapy for gastric cancer with early recurrence during or after adjuvant S-1. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.138] [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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17
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Yanagihara T, Maki N, Wijesinghe AI, Sato S, Saeki Y, Kitazawa S, Yamaoka M, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Watnabe S, Taguchi T, Sato Y. Efficacy of Alaska pollock gelatin sealant for pulmonary air leakage in porcine models. Ann Thorac Surg 2021; 113:1641-1647. [PMID: 34102175 DOI: 10.1016/j.athoracsur.2021.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Postoperative prolonged air leakage is a frequent complication following lung resection. We have developed a new sealant based on a hydrophobically modified Alaska pollock-derived gelatin (ApGltn) sealant. The purpose of this study was to evaluate the adhesive strength of the ApGltn sealant in comparison with a fibrin sealant using a new spray system in ex vivo and in vivo models. METHODS Pleural defects in ex vivo and in vivo porcine models were created, to which the ApGltn sealant or the fibrin sealant was applied. The pressure resistance was assessed with a stepwise increase in airway pressure to confirm air leakage from the sealing site. Tissue samples covered with each sealant were obtained for histologic assessment. RESULTS In the ex vivo experiment, the leak pressures of the ApGltn sealant were significantly greater than those of the fibrin sealant (102.94 ± 15.6 cmH2O and 28.37 ± 5.1 cmH2O, respectively) (p < 0.01). In the in vivo experiment, the leak pressures of the ApGltn sealant were also significantly greater than those of the fibrin sealant (68.82 ± 18.04 cmH2O and 43.33 ± 7.13 cmH2O, respectively) (p = 0.043). The histologic examination confirmed that the ApGltn sealant adhered tightly to both the pleura and the surface of the pleural defect. CONCLUSIONS The ApGltn sealant has sufficiently high adhesive quality in ex vivo and in vivo porcine lungs, which could be considered suitable and effective for use in the prevention of air leakage from the lungs.
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Affiliation(s)
- Takahiro Yanagihara
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Naoki Maki
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - A I Wijesinghe
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Shoko Sato
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Yusuke Saeki
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Shinsuke Kitazawa
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Masatoshi Yamaoka
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Naohiro Kobayashi
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Shinji Kikuchi
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Yukinobu Goto
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Hideo Ichimura
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Shiharu Watnabe
- National Institute for Materials Science, Research Center for Functional Materials, Polymer-Bio Field, 1-1 Namiki, Tsukuba, Ibaraki, Japan
| | - Tetsushi Taguchi
- National Institute for Materials Science, Research Center for Functional Materials, Polymer-Bio Field, 1-1 Namiki, Tsukuba, Ibaraki, Japan
| | - Yukio Sato
- University of Tsukuba, Faculty of Medicine, Department of Thoracic Surgery, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
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18
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Yanagihara T, Sekine Y, Sugai K, Kawamura T, Maki N, Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y. Risk factors of middle lobe bronchus kinking following right upper lobectomy. J Thorac Dis 2021; 13:3010-3020. [PMID: 34164192 PMCID: PMC8182536 DOI: 10.21037/jtd-21-105] [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: 11/06/2022]
Abstract
Background The incidence rate of kinking of the middle lobe bronchus following right upper lobectomy is higher compared to that with residual lung bronchus following other lobectomies. Bronchial kinking was presumed to be caused by the displacement of the residual lung lobes, but its etiology is unclear. Moreover, prevention methods and effective treatments have not yet been established. The purpose of this study was to investigate the risk factors and etiology of middle lobe bronchus kinking and discuss prevention methods. Methods Patients who underwent right upper lobectomy in our hospital were retrospectively evaluated. Patient clinical characteristics, lung function, and lung lobe volume, surgical procedure were analyzed in association with the incidence of middle lobe bronchus kinking. The association between the displacement of residual lung lobes after operation and the incidence of middle lobe bronchus kinking was analyzed to assess the etiology. Results A total of 175 patients were enrolled in the risk analysis. Middle lobe bronchus kinking was observed in 5 patients (2.9%). The low percentage of forced expiratory volume percentage in 1 second (P=0.021), the low volume ratio of the right middle lobe (RML) to the right thoracic cavity (RTC) (P=0.016), and the low volume ratio of RML to right upper lobe (RML/RUL) (P=0.006) were significant risk factors of middle lobe bronchus kinking. In the patients who underwent CT at 6 months after surgery, the degree of the cranial displacement of RML was associated with the incidence of middle lobe bronchus kinking (P=0.025). Conclusions The risk of middle lobe bronchus kinking could be assessed preoperatively by calculating the volume ratio of RML/RTC and RML/RUL. The displacement of RML could be associated with the incidence of middle lobe bronchus kinking.
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Affiliation(s)
- Takahiro Yanagihara
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasuharu Sekine
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuto Sugai
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naoki Maki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Osaki M, Okuda R, Saeki Y, Okano T, Tsuda K, Nakamura T, Morio Y, Nagashima H, Hagino H. Efficiency of coordinator-based osteoporosis intervention in fragility fracture patients: a prospective randomized trial. Osteoporos Int 2021; 32:495-503. [PMID: 33483796 PMCID: PMC7929967 DOI: 10.1007/s00198-021-05825-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 10/11/2020] [Accepted: 01/04/2021] [Indexed: 11/26/2022]
Abstract
UNLABELLED We examined the effectiveness of coordinators' interventions to prevent secondary fractures in patients with fragility fractures. These coordinator-based interventions improved bone density assessment implementation and treatment rates, and enhanced treatment persistence rates in the early stages following fractures. INTRODUCTION This study aimed to determine the efficiency of coordinator-based osteoporosis intervention in fragility fracture patients during a 2-year period. METHODS A prospective intervention randomized control study was conducted at seven medical facilities from January 2015 to March 2017. Postmenopausal women and men over 50 years old with fragility fractures were randomly divided into the coordinator intervention (LI; 70 patients) and without intervention (non-LI; 71 patients) groups. The osteoporosis treatment rate, osteoporosis treatment persistence rate, fall rate, fracture incidence rate, and bone density measurement rate 3 months, 6 months, 1 year, and 2 years after registration were compared between the two groups. Non-parametric tests were used to analyze data at each inspection period. RESULTS The osteoporosis treatment initiation rate was significantly higher in the LI group than in the non-LI group (85.7% vs. 71.8%; p = 0.04). The LI group had significantly higher bone density assessment implementation rates than the non-LI group at the time of registration (90.0% vs. 69.0%; p = 0.00) and 6 months after registration (50.0% vs. 29.6%; p = 0.01), but not 1 or 2 years after registration. In addition, no significant differences in fall or fracture incidence rates were found between the two groups. CONCLUSION The coordinator-based interventions for fragility fractures improved bone density assessment implementation and treatment rates and enhanced treatment persistence rates in the early stages following bone fractures. The findings suggest that liaison intervention may help both fracture and osteoporosis physicians for the evaluation of osteoporosis and initiation and continuation of osteoporosis medication.
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Affiliation(s)
- M Osaki
- Rehabilitation Division, Tottori University Hospital, Tottori, 683-8504, Japan.
| | - R Okuda
- School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Y Saeki
- Orthopedic Surgery Hospital Ward, Tottori University Hospital, Tottori, Japan
| | - T Okano
- Department of Orthopedic Surgery, San-in Rosai Hospital, Tottori, Japan
| | - K Tsuda
- Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - T Nakamura
- Department of Orthopedic Surgery, Hakuai Hospital, Tottori, Japan
| | - Y Morio
- Department of Orthopedic Surgery, Misasa Onsen Hospital, Tottori, Japan
| | - H Nagashima
- Department of Orthopedic Surgery, Tottori University, Tottori, Japan
| | - H Hagino
- Rehabilitation Division, Tottori University Hospital, Tottori, 683-8504, Japan
- School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
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20
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Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Ueda S, Saeki Y, Araki K, Kawamura T, Sato Y. Trajectory and profile of quality of life in patients undergoing lung resection for lung cancer during hospitalization according to the EQ-5D. Gen Thorac Cardiovasc Surg 2021; 69:1204-1213. [PMID: 33608836 DOI: 10.1007/s11748-021-01607-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/24/2020] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To clarify the trajectory and profile of quality of life (QOL) in lung cancer patients undergoing surgery during hospitalization. METHODS Among prospectively enrolled 279 patients between 2015 and 2018, we used the EQ-5D-5 levels (EQ-5D-5L), which consist of a descriptive system of five dimensions and a visual analog scale (VAS) (from 0 to 100). The five dimensions are mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, which are rated according to a 5-grade evaluation. QOL assessments were performed preoperatively (Pre) and on postoperative day 1/3/5/7 (D1/D3/D5/D7). To observe the trajectory of QOL, the EQ-5D VAS was used. To define the profile of QOL, we applied univariate linear regression analysis to predict EQ-5D VAS based on the five dimensions of EQ-5D as explanatory variables and to determine the rank of absolute values of the standardized coefficient of each dimension that represented strength of the effect on the EQ-5D VAS. RESULTS The means of VAS scores were as follows: Pre/D1/D3/D5/D7 = 79/45/58/64/71. Younger age, fewer comorbidities, and surgical indications decreased the VAS at D1. More comorbidities, advanced cancer stage, postoperative adverse events, and chest tube placements hampered restoration of the VAS. Regarding QOL profiles, anxiety/depression was the highest rank preoperatively while usual activity, but not pain/discomfort, was the highest postoperatively. CONCLUSIONS This is the first study to visualize the trajectory of QOL in surgical patients with lung cancer during hospitalization. This information may help improve perioperative patient care.
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Affiliation(s)
- Hideo Ichimura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan. .,Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan. .,Department of Thoracic Surgery, Faculty of Medicine, Hitachi Medical Education and Research Center, University of Tsukuba, 2-1-1 Jyounan, Hitachi, Ibaraki, 317-0077, Japan.
| | - Keisuke Kobayashi
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kojiro Nakaoka
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Sho Ueda
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Kentaro Araki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Ibaraki, 317-0077, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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Saeki Y, Kitazawa S, Yanagihara T, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y. Consolidation volume and integration of computed tomography values on three-dimensional computed tomography may predict pathological invasiveness in early lung adenocarcinoma. Surg Today 2021; 51:1320-1327. [PMID: 33547958 DOI: 10.1007/s00595-021-02231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/10/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the relationship between three-dimensional computed tomography (3D-CT) findings and pathological invasiveness in lung adenocarcinoma. METHODS We retrospectively evaluated 95 patients who underwent surgical resection of lung adenocarcinoma of ≤ 20 mm. The diameters, volumes, and CT values of tumor consolidation were analyzed. We defined the modified CT value by setting air as 0 and water as 1000 and assumed a correlation with pathological invasiveness. Pre-invasive lesions and minimally invasive adenocarcinomas were classified as non-invasive adenocarcinoma. We compared the clinico-radiological features with pathological invasiveness. Receiver operator characteristic (ROC) curves and recurrence-free survival curves were constructed. RESULTS Twenty-six non-invasive adenocarcinomas and 69 invasive adenocarcinomas were evaluated. The multivariate analysis revealed that the consolidation volume and the integration of modified CT values were the most important predictors of pathological invasion. The area under the ROC curve and the cut-off values of the consolidation volume were 0.868 and 75 mm3, respectively. The area under the ROC curve and the cut-off values of the integration of modified CT values were 0.871 and 80,000, respectively. There was no recurrence in cases with values below the cut-off across all parameters. CONCLUSION The consolidation volume and integration of modified CT values were shown to be highly predictive of pathological invasiveness.
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Affiliation(s)
- Yusuke Saeki
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shinsuke Kitazawa
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takahiro Yanagihara
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naohiro Kobayashi
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shinji Kikuchi
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukinobu Goto
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hideo Ichimura
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Sato
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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22
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Ichimura H, Kobayashi K, Gosho M, Nakaoka K, Yanagihara T, Ueda S, Saeki Y, Maki N, Kobayashi N, Kikuchi S, Suzuki H, Goto Y, Sato Y. Preoperative predictors of restoration in quality of life after surgery for lung cancer. Thorac Cancer 2021; 12:835-844. [PMID: 33508893 PMCID: PMC7952797 DOI: 10.1111/1759-7714.13819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background The preoperative predictors of quality of life (QOL) in patients who undergo lung resection for lung cancer are poorly known. Here, we investigated these predictors in such patients using two QOL measures. Methods In this single‐institutional prospective cohort study, we administered the EQ‐5D‐5 levels (EQ‐5D‐5L) from January 2015, and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire with 30 items from April 2015 to April 2018 preoperatively (Pre) and at one month postoperatively (M1), and one year postoperatively (Y1). General health status was measured by the EQ‐5D visual analogue scale (VAS) and EORTC global health status/QOL (GHS) scores. Multivariable linear regression analyses were used to explore the preoperative predictors of QOL at Y1. Results A total of 223 patients were included in the study. The EQ‐5D VAS and EORTC GHS scores, at Pre, M1, and Y1, were 80 ± 15, 77 ± 15, and 84 ± 11; and 74 ± 19, 65 ± 20, and 78 ± 17, respectively. In the multivariable analyses, the albumin level, preoperative VAS score, and preoperative pain/discomfort and anxiety/depression were identified as predictors by the EQ‐5D VAS score. The preoperative EORTC GHS score, absence of diabetes mellitus, preoperative cognitive function score, and preoperative symptom score of pain were identified as predictors by the EORTC GHS score. Conclusions The EQ‐5D VAS and EORTC GHS scores traced similar trajectories of QOL. In both QOL measures, preoperative pain was found as a common predictor. These predictors may help improve patient/survivor care in the future.
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Affiliation(s)
- Hideo Ichimura
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan.,Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan.,Department of Thoracic Surgery, Hitachi Medical Education and Research Center, Faculty of Medicine, University of Tsukuba, Hitachi, Japan
| | - Keisuke Kobayashi
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kojiro Nakaoka
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | | | - Sho Ueda
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Naoki Maki
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Hisashi Suzuki
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, Tsukuba, Japan
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23
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Maki N, Sakamoto H, Takata Y, Mutsukura Y, Ashoka W, Yanagihara T, Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y, Yanagi H. Factors related to physical and mental components of quality of life in the community-dwelling frail older persons. J Phys Ther Sci 2020; 32:557-562. [PMID: 32982049 PMCID: PMC7509155 DOI: 10.1589/jpts.32.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/03/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to investigate factors associated with changes in both the physical and mental components of quality of life (QOL) in of community-dwelling frail older persons in long-term care and to clarify which aspects are important to maintaining physical and mental components of QOL. [Participants and Methods] In this 1 year follow-up cohort study, participants were older persons from a single day care rehabilitation center in Japan. The Medical Outcome Study 8-Item Short-Form Health Survey (MOS-SF8), which gives both physical component summary (PCS) and mental component summary (MCS) scores, was used as the main QOL assessment. Participants were divided according to their level of QOL maintenance according to changes in PCS and MCS scores over the study period, and the variables were compared between the groups. [Results] PCS domain was significantly associated with forced vital capacity and the MCS domain was significantly associated with the Geriatric Depression Scale and Dysphagia Risk Assessment for the Community-Dwelling Elderly Test. [Conclusion] Depression, reduced pulmonary function, and reduced deglutition ability were independently related to low QOL. Assessment of these factors could be beneficial for maintaining the physical and mental components of QOL in community-dwelling frail older persons in long-term care.
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Affiliation(s)
- Naoki Maki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Harumi Sakamoto
- AHR Medical and Welfare College School, Japan.,Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yu Takata
- AHR Medical and Welfare College School, Japan
| | | | - Wijesinghe Ashoka
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Takahiro Yanagihara
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Hideo Ichimura
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Hisako Yanagi
- Department of Medical Science and Welfare, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
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24
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Takahashi R, Okamura K, Tsukahara-Kawamura T, Harada K, Saeki Y, Ozaki H, Uchio E. Finite Element Analysis of Changes in Tensile Strain by Airsoft Gun Impact on Eye and Deformation Rate in Eyes of Various Axial Lengths. Clin Ophthalmol 2020; 14:1445-1450. [PMID: 32546952 PMCID: PMC7266397 DOI: 10.2147/opth.s249483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose We have carried out three-dimensional finite element analysis (FEA) to determine the physical and mechanical response in several ocular injuries. We applied this FEA model to evaluate an airsoft gun impact on an eye and the deformation rate of eyes of various axial lengths at various velocities. Methods This study was carried out on a human eye model using an FEA program created by Nihon, ESI Group. The airsoft gun pellet was set to impact the eye at initial velocities of 45, 60 and 75 m/s with the addition of variation in axial length of 20 mm (hyperopia), 22 mm (emmetropia), 24 mm (myopia) and 26 mm (high myopia). Deformation of the eye was calculated as the decrease rate of the volume of the eyeball and the decrease rate of the axial length. Results In all emmetropic cases, the cornea reached its strain threshold during the impact, and scleral strain showed a patchy strength distribution in the simulation. The deformation was most evident in the anterior segment, while deformation of the posterior segment was less. The decrease rate of the volume of the eyeball and decrease rate of the axial length were highest in the hyperopic eye, followed by the emmetropic eye and myopic eye, and the high myopic eye showed the lowest decrease rates among the four axial lengths in all impact velocity simulations. Conclusion These results suggest that hyperopic eyes are most susceptible to deformation by an airsoft gun impact compared with other axial length eye models in this simulation. The considerable deformation by an airsoft gun impact shown in this study might indicate the necessity of ocular protection to avoid permanent eye injury. FEA using a human eyeball model might be a useful method to analyze and predict the mechanical features of ocular injury by an airsoft gun.
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Affiliation(s)
- Rie Takahashi
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Kanno Okamura
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | | | - Kazuhiro Harada
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroaki Ozaki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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25
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Matsuoka H, Kabata D, Taura A, Matsui T, Takahi K, Hirano F, Katayama M, Okamoto A, Suenaga Y, Suematsu E, Yoshizawa S, Ohmura K, Ito S, Takaoka H, Oguro E, Kuzuya K, Okita Y, Udagawa C, Yoshimura M, Teshigawara S, Harada Y, Isoda K, Yoshida Y, Ohshima S, Tohma S, Saeki Y. Lack of association between a disease-susceptible single-nucleotide polymorphism, rs2230926 of TNFAIP3, and tumour necrosis factor inhibitor therapeutic failure in Japanese patients with rheumatoid arthritis. Scand J Rheumatol 2020; 49:253-255. [PMID: 32406335 DOI: 10.1080/03009742.2020.1716992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H Matsuoka
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - D Kabata
- Department of Medical Statics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Taura
- Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - T Matsui
- Department of Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Japan
| | - K Takahi
- Department of Orthopedics and Rheumatology, NHO Osaka Toneyama Medical Center, Toyonaka, Japan
| | - F Hirano
- Department of Internal Medicine, NHO Asahikawa Medical Center, Asahikawa, Japan
| | - M Katayama
- Department of Rheumatology, NHO Nagoya Medical Center, Nagoya, Japan
| | - A Okamoto
- Department of Rheumatology, NHO Himeji Medical Center, Himeji, Japan
| | - Y Suenaga
- Department of Rheumatology, NHO Beppu Medical Center, Beppu, Japan
| | - E Suematsu
- Department of Rheumatology, NHO Kyushu Medical Center, Fukuoka, Japan
| | - S Yoshizawa
- Department of Rheumatology, NHO Fukuoka National Hospital, Fukuoka, Japan
| | - K Ohmura
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - S Ito
- Department of Rheumatology, Niigata Rheumatic Center, Niigata, Japan
| | - H Takaoka
- Section of Internal Medicine and Rheumatology, Kumamoto Shinto General Hospital, Kumamoto, Japan
| | - E Oguro
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - K Kuzuya
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Okita
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - C Udagawa
- Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Molecular Chemistry, Faculty of Pharmacy, Osaka Ohtani University, Tondabayashi, Osaka, Japan
| | - M Yoshimura
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Teshigawara
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Harada
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - K Isoda
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - Y Yoshida
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Ohshima
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan
| | - S Tohma
- Department of Rheumatology, NHO Tokyo National Hospital, Tokyo, Japan
| | - Y Saeki
- Department of Rheumatology and Allergology, NHO Osaka Minami Medical Center, Kawachinagano, Japan.,Department of Clinical Research, NHO Osaka Minami Medical Center, Kawachinagano, Japan
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26
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Takajo I, Iwao C, Aratake M, Nakayama Y, Yamada A, Takeda N, Saeki Y, Umeki K, Toyama T, Hirabara Y, Fukuda M, Okayama A. Pseudo-outbreak of Mycobacterium paragordonae in a hospital: possible role of the aerator/rectifier connected to the faucet of the water supply system. J Hosp Infect 2020; 104:545-551. [DOI: 10.1016/j.jhin.2019.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
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Okamura K, Shimokawa A, Takahashi R, Saeki Y, Ozaki H, Uchio E. Finite Element Analysis of Air Gun Impact on Post-Keratoplasty Eye. Clin Ophthalmol 2020; 14:179-186. [PMID: 32021083 PMCID: PMC6982457 DOI: 10.2147/opth.s236825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/13/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Due to the mechanical vulnerability of eyes that have undergone penetrating keratoplasty (PKP), it is clinically important to evaluate the possibility of corneal wound dehiscence by blunt impact. We have previously developed a simulation model resembling a human eye based on information obtained from cadaver eyes and applied three-dimensional finite element analysis (FEA) to determine the physical and mechanical response to an air gun impact at various velocities on the post-PKP eye. Methods Simulations in a human eye model were performed with a computer using a FEA program created by Nihon, ESI Group. The air gun pellet was set to impact the eye at three-different velocities in straight or 12° up-gaze positions with the addition of variation in keratoplasty suture strength of 30%, 50% and 100% of normal corneal strength. Results Furthermore to little damage in the case of 100% strength, in cases of lower strength in a straight-gaze position, wound rupture seemed to occur in the early phase (0.04-0.06 ms) of impact at low velocities, while regional break was observed at 0.14 ms after an impact at high velocity (75 m/s). In contrast, wound damage was observed in the lower quadrant of the suture zone and sclera in 12° up-gaze cases. Wound damage was observed 0.08 ms after an impact threatening corneoscleral laceration, and the involved area being larger in middle impact velocity (60 m/s) simulations than in lower impact velocity simulations, and larger damaged area was observed in high impact velocity cases and leading to corneoscleral laceration. Conclusion These results suggest that the eye is most susceptible to corneal damage around the suture area especially with a straight-gaze impact by an air gun, and that special precautionary measures should be considered in patients who undergo PKP. FEA using a human eyeball model might be a useful method to analyze and predict the mechanical features of eyes that undergo keratoplasty.
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Affiliation(s)
- Kanno Okamura
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Asami Shimokawa
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Rie Takahashi
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Hiroaki Ozaki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Sato Y. Prediction of invasiveness in lung adenocarcinoma using machine learning algorithm based on 3D-CT imaging. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz435.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Kitazawa S, Saeki Y, Kobayashi N, Kikuchi S, Goto Y, Sato Y. Three-dimensional mean CT attenuation value of pure and part-solid ground-glass lung nodules may predict invasiveness in early adenocarcinoma. Clin Radiol 2019; 74:944-949. [PMID: 31630766 DOI: 10.1016/j.crad.2019.09.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 09/12/2019] [Indexed: 10/25/2022]
Abstract
AIM This study evaluated the relationship between three-dimensional (3D) mean computed tomography (CT) attenuation values of ground-glass nodules (GGN) and pathological invasiveness in early lung adenocarcinoma. The diagnostic accuracy of 3D CT attenuation values was compared with that of two-dimensional (2D) CT attenuation values and standardised uptake value on positron-emission tomography (PET). MATERIALS AND METHODS Surgical and radiological data from 96 pure or part-solid GGNs of <20 mm were analysed retrospectively. Mean 2D and 3D CT attenuation values of the tumours were obtained with semi-automated volumetric software. Pathological invasiveness was diagnosed according to the International Association for the Study of Lung Cancer (IASLC))/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification. Pre-invasive lesions and minimally invasive adenocarcinomas were classified as non-invasive adenocarcinoma. Univariate and multivariate analyses determined relationships between pathological invasiveness and clinical/radiological findings. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off value for detecting invasive adenocarcinoma. RESULTS A total of 66 non-invasive and 30 invasive adenocarcinoma cases between 2010 and 2016 were analysed. Univariate analysis revealed four tumour invasiveness-associated predictors: maximum diameter, SUVmax, mean 2D CT attenuation value, and mean 3D CT attenuation value (p<0.05). Multivariate analysis revealed that the maximum diameter, SUVmax, and mean 3D CT attenuation value were significant predictors of pathological invasiveness (p=0.023, 0.022, 0.004). The area under the ROC curve to predict invasive adenocarcinoma for mean 3D CT attenuation value was 0.838 and the cut-off value was -489 HU. CONCLUSION The mean 3D CT attenuation value could distinguish pre-invasive lesions and minimally invasive adenocarcinoma from invasive adenocarcinoma.
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Affiliation(s)
- S Kitazawa
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Y Saeki
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - N Kobayashi
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - S Kikuchi
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Y Goto
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Y Sato
- Department of General Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan.
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Fujibayashi K, Oda M, Wakasa M, Takano S, Kuzume Y, Saeki Y, Sawaguchi J, Fujita W, Saito R, Kawai Y, Kajinami K. P3648Plasma glutamate are increased in non-smoker patients with vasospastic angina pectoris and associated with plasma cystine and antioxidant capacity. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0505] [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
Endothelial dysfunction of the coronary arteries caused by oxidative stress plays an important role in the pathogenesis of vasospastic angina pectoris (VSAP). Glutamate, a non-essential amino acid, exerts endothelial dysfunction by oxidative stress production through N-methyl-D-aspartate receptor activation. Besides oxidative stress, decrease of antioxidant may be responsible for endothelial dysfunction. Glutathione (GSH), an important antioxidant, is synthesized from imported cystine through the cystine/glutamate antiporter system (XC-) in association with the export of glutamate. Glutamate also competitively inhibits cystine import into the endothelial cells through the XC-leading to GSH depletion. Thus the extracellular glutamate and cystine are crucial for the intracellular redox status. However, it remains unclear whether glutamate and/or cystine are implicated in the pathogenesis of VSAP. As smoking induces powerful oxidant stresses in the whole body, we investigated plasma glutamate, cystine, oxidative stress markers and antioxidant capacity in non-smoker patients with VSAP.
Methods and results
Sixty-two consecutive non-smoker patients suspected having VSAP were performed coronary angiograms (CAG). Forty-nine patients who did not show any significant coronary stenosis (<50%) were performed the intracoronary acetylcholine provocation test. Patients were categorized into the VSAP-positive group (n=27) and the VSAP-negative group (n=22) on the basis of test results. Blood samples were collected from the femoral sheath before the CAG. Plasma glutamate, cystine, nitrotyrosine (NT), reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) were measured. The levels of plasma glutamate and cystine in the VSAP-positive group were significantly higher than those in the VSAP-negative group (59.8±25.7 vs 43.5±18.7 nmol/L, p=0.0054, and 35.3±14.2 nmol/L vs 25.2±9.1 nmol/L, p=0.0018, respectively). The levels of plasma glutamate showed significant and positive association with the levels of plasma cystine (r=0.40, p=0.005). There were no significant differences in the levels of NT and d-ROMs as oxidative stress markers, and BAP as an antioxidant capacity between the two groups, respectively. However, the levels of plasma glutamate showed significant and negative association with BAP values (r=−0.3, p=0.038).
Conclusions
Plasma levels of glutamate were increased in non-smoker patients with VSAP and positively associated with plasma cystine levels and negatively associated with antioxidant capacity, suggesting that plasma glutamate modulate plasma cystine levels and antioxidant capacity through the XC- inhibition, and could be a novel risk factor of VSAP.
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Affiliation(s)
| | - M Oda
- Kanazawa Medical University, Uchinada, Japan
| | - M Wakasa
- Kanazawa Medical University, Uchinada, Japan
| | - S Takano
- Kanazawa Medical University, Uchinada, Japan
| | - Y Kuzume
- Kanazawa Medical University, Uchinada, Japan
| | - Y Saeki
- Kanazawa Medical University, Uchinada, Japan
| | - J Sawaguchi
- Kanazawa Medical University, Uchinada, Japan
| | - W Fujita
- Kanazawa Medical University, Uchinada, Japan
| | - R Saito
- Kanazawa Medical University, Uchinada, Japan
| | - Y Kawai
- Kanazawa Medical University, Uchinada, Japan
| | - K Kajinami
- Kanazawa Medical University, Uchinada, Japan
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Kikuchi S, Sekine Y, Sugai K, Kawamura T, Yanagihara T, Saeki Y, Kitazawa S, Kobayashi N, Goto Y, Onizuka M, Ichimura H, Sato Y. P2.05-17 Preoperative Identification of the Left Common Pulmonary Vein for Safe Video-Assisted Lobectomy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Uchio E, Saeki Y, Tsukahara-Kawamura T, Kadonosono K, Ozaki H. Clinical outcome after air-assisted manual deep anterior lamellar keratoplasty for fungal keratitis poorly responsive to medical treatment. Clin Ophthalmol 2019; 13:1913-1919. [PMID: 31576108 PMCID: PMC6769053 DOI: 10.2147/opth.s211099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/15/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose Fungal keratitis remains an important disorder because of difficulty in its diagnosis, and some patients do not respond to medical treatment using antifungal local and systemic agents. This study was carried out to determine the therapeutic value of air-assisted manual therapeutic deep anterior lamellar keratoplasty (TDALK) in the treatment of fungal keratitis not curable by antifungal chemotherapy. Methods Seventeen patients (18 eyes) who were referred to Fukuoka University Hospital and treated surgically from January 2006 to April 2018, in whom a diagnosis of fungal keratitis was confirmed by typical clinical findings and microbiological or histological analysis of corneal specimens, and who were poorly responsive to topical and systemic antifungal medication, whereas the lesion had not resulted in corneal perforation, were enrolled in this study and were treated by air-assisted manual TDALK. Clinical outcomes including treatment course, therapeutic success rate, visual acuity outcomes and graft clarity rate were analyzed. Results The most common pathogen was Fusarium, followed by Candida and Aspergillus. Beneficial therapeutic results (a clear or translucent graft) were achieved in 15 of 18 eyes (83%). There was no recurrence of infection and resulting visual acuity ≤0.15 logarithm of minimal angle of resolution unit was achieved in 15 eyes (83%). Intraoperative microperforation of Descemet’s membrane (DM) was not observed in any patients. Conclusion Air-assisted manual TDALK can be effective for treating severe fungal keratitis. In addition, air-assisted manual TDALK might be an alternative procedure to big-bubble DALK, because it can provide ambulatory vision and can preserve potentiality of vision with less risk of intraoperative perforation of DM.
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Affiliation(s)
- Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | | | - Kazuaki Kadonosono
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroaki Ozaki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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Migita H, Ueno T, Tsukahara-Kawamura T, Saeki Y, Hanaoka N, Fujimoto T, Uchio E. Evaluation of adenovirus amplified detection of immunochromatographic test using tears including conjunctival exudate in patients with adenoviral keratoconjunctivitis. Graefes Arch Clin Exp Ophthalmol 2019; 257:815-820. [PMID: 30826875 DOI: 10.1007/s00417-019-04281-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/15/2019] [Accepted: 02/19/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We evaluated a novel silver amplification immunochromatography test for rapid detection of adenovirus (AdV) antigen equipped with an automated reader system using tears including conjunctival exudate in patients with adenoviral keratoconjunctivitis. METHODS Two kinds of immunochromatographic (IC) kits, a conventional IC kit for conjunctival scrapings (control kit) and an IC kit using tears including conjunctival exudate collected by pressing a filter paper strip on the conjunctiva (test kit), were tested on 90 patients who attended Migita Eye Clinic with suspected adenoviral conjunctivitis. The results of the test kits were automatically obtained by a specific reader, which was based on silver amplification immunochromatography system, in 15 min. The detection of AdV was confirmed by real-time polymerase chain reaction (PCR) method, and typing was performed by direct sequencing. Comparative dilution assay was carried out with the two kits, using AdV type 3 and type 54 strains. RESULTS The sensitivity of the control kit and test kit was 89.8% and 98.3%, respectively. The specificity of both kits was 100%. A significant difference in the sensitivities of the two IC kits against PCR positivity was observed (P < 0.01). A significant correlation was found between AdV DNA copy numbers on a logarithmic scale obtained with the two tests (P < 0.01). The sensitivity of the test kit was 32-64-fold higher than that of the control kit without silver amplification for both AdV types. CONCLUSIONS These results suggest that this novel amplified AdV detection kit using tears including conjunctival exudate is useful, because it decreases patients' discomfort from specimen collection and its sensitivity is significantly higher than that of the conventional IC kit.
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Affiliation(s)
- Hironori Migita
- Migita Eye Clinic, 2-15-13 Harisuri-Chuo, Chikushino, 818-0083, Japan
| | - Tomohiro Ueno
- Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Tomoko Tsukahara-Kawamura
- Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Nozomu Hanaoka
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Tsuguto Fujimoto
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
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Matsuura K, Terasaka Y, Uchio E, Saeki Y, Fujimoto T, Hanaoka N, Miyazaki D, Inoue Y. Human adenoviral type 54 keratoconjunctivitis accompanied by stellate keratitis and keratic precipitates: two cases. BMC Ophthalmol 2019; 19:7. [PMID: 30616635 PMCID: PMC6323660 DOI: 10.1186/s12886-018-1025-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Of the 10 patients with adenoviral type 54 keratoconjunctivitis examined at Nojima Hospital, 2 developed stellate keratitis and mutton-fat keratic precipitates (KPs) following acute symptoms. CASE PRESENTATION We encountered 10 cases of epidemic keratoconjunctivitis from August to October 2017. All patients were adults with a mean age of 60.9 ± 10.0 years. The species D human adenovirus (HAdV)-54 was detected in the conjunctival scrapings of these patients. Fluorometholone instillation was administered during the first week for acute symptomatic relief. Case 1: A 64-year-old female was prescribed with fluorometholone instillation, which was discontinued after 1 week when her symptoms alleviated. One week after discontinuation of the instillation, she presented with blurred vision in her left eye with KPs and multiple stellate keratitis. The anterior chamber had no apparent cells. Her symptoms disappeared after 1 week of betamethasone instillation. Case 2: A 66-year-old female was prescribed with 0.1% fluorometholone instillation, which was discontinued within10 days. Three months after the appearance of initial symptoms, multiple subepithelial corneal infiltrates (MSI) appeared in her eyes. Stellate keratitis and dark-brown pigmentation were observed in the centres of MSI, with several cells in the anterior chamber. Betamethasone was prescribed, and MSI and stellate keratitis improved within 1 week. However, KPs were observed in the left eye. The instillation was continued for 3 more weeks until symptoms improved. CONCLUSIONS MSI is an immune reaction that occurs after the disappearance of acute symptoms. Here, corneal findings and KPs were observed after improvement in eye redness and discontinuation of steroids. These symptoms were presumed to be secondary inflammation due to immune response to the adenoviral antigen. The clinical features of HAdV-54 keratoconjunctivitis on the ocular surface are initially moderate, but become active in the subacute to chronic phases. This may develop atypical findings, including stellate keratitis with KPs. Although early steroid administration can relieve acute symptoms, it may facilitate chronic corneal immunological reaction.
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Affiliation(s)
- Kazuki Matsuura
- Department of Ophthalmology, Nojima Hospital, 2714-1 Sesaki-machi Kurayoshi City, Tottori, 682-0863, Japan.
| | - Yuki Terasaka
- Department of Ophthalmology, Nojima Hospital, 2714-1 Sesaki-machi Kurayoshi City, Tottori, 682-0863, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University, 45-1 7 chome Nanakuma Jonan-ku, Fukuoka City, Fukuoka, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University, 45-1 7 chome Nanakuma Jonan-ku, Fukuoka City, Fukuoka, Japan
| | - Tsuguto Fujimoto
- Infectious Diseases Surveillance Centre, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Nozomu Hanaoka
- Infectious Diseases Surveillance Centre, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Dai Miyazaki
- Department of Ophthalmology, Faculty of Medicine, Tottori University, 36-1 Nishicho Yonago City, Tottori, Japan
| | - Yoshitsugu Inoue
- Department of Ophthalmology, Faculty of Medicine, Tottori University, 36-1 Nishicho Yonago City, Tottori, Japan
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Tsukahara-Kawamura T, Fujimoto T, Gonzalez G, Hanaoka N, Konagaya M, Arashiro T, Saeki Y, Uchio E. Epidemic Keratoconjunctivitis Cases Resulting from Adenovirus Types 8 and 54 Detected at Fukuoka University Hospital between 2014 and 2015. Jpn J Infect Dis 2018; 71:322-324. [PMID: 29709978 DOI: 10.7883/yoken.jjid.2017.349] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Tsuguto Fujimoto
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Gabriel Gonzalez
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University
| | - Nozomu Hanaoka
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Masami Konagaya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Takeshi Arashiro
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University, School of Medicine
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University, School of Medicine
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Uemura T, Migita H, Ueno T, Tsukahara-Kawamura T, Saeki Y, Fujimoto T, Uchio E. Clinical and virological analysis of epidemic keratoconjunctivitis caused by adenovirus type 54 in a regional ophthalmic clinic in Kyushu, Japan. Clin Ophthalmol 2018; 12:511-517. [PMID: 29593376 PMCID: PMC5863712 DOI: 10.2147/opth.s148264] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Human adenovirus type 54 (HAdV-54) is a novel type of adenovirus that belongs to species D and has thus far been detected only in Japan in patients with epidemic keratoconjunctivitis (EKC). There was a large nationwide outbreak of HAdV-54 EKC from 2015 to 2016 in Japan. The clinical characteristics of an outbreak of HAdV-54 conjunctivitis treated in a regional ophthalmic clinic in Fukuoka, Japan, in 2016 were analyzed. Patients and methods A consecutive series of 55 cases diagnosed clinically as EKC confirmed by HAdV-54 detection from conjunctival scrapings by polymerase chain reaction (PCR) method between 17 June 2016 and 29 August 2016 were enrolled. Viral DNA copies were counted by real-time PCR method. The clinical findings were recorded at the first visit to the clinic and evaluated. Results In the analysis of the relationship between mean clinical score groups and several factors, such as days after onset, sex, HAdV DNA number on a logarithmic scale, and age, most factors did not show a significant difference in clinical score between groups. However, mean clinical score of cases aged <23 years was significantly higher than that of cases aged ≥23 years (P<0.01). The correlation coefficient between DNA copies on a logarithmic scale and clinical score was 0.280, and a significant correlation was observed (P<0.05). Multiple subepithelial corneal infiltrates (MSI) were observed in 24 out of 31 cases (77%). Conclusion These results suggested that the clinical features in the early phase of HAdV-54 keratoconjunctivitis were milder but the rate of MSI observed in the late phase was higher than those in previous epidemics of several HAdV types. The significant difference in clinical severity between age groups might be a virological characteristic of HAdV-54.
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Affiliation(s)
- Takashi Uemura
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | | | - Tomohiro Ueno
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Tomoko Tsukahara-Kawamura
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan.,Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Tsuguto Fujimoto
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan
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Kitazawa S, Saeki Y, Kobayashi N, Kikuchi S, Goto Y, Sato Y. F-036THREE-DIMENSIONAL MEAN COMPUTED TOMOGRAPHY VALUE OF PURE OR PART-SOLID GROUND-GLASS NODULE CAN PREDICT TUMOUR INVASIVENESS OF SMALL LUNG ADENOCARCINOMA. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Saeki Y, Sato Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y. P-208THE CONSOLIDATION VOLUME ANALYSIS USING THREE DIMENSIONAL COMPUTED TOMOGRAPHY PREDICTS INVASIVENESS IN LUNG ADENOCARCINOMA ≦20 MM. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Suzuki S, Kawamura T, Saeki Y, Okubo M, Konagaya M, Hanaoka N, Arashiro T, Fujimoto T, Uchio E. A Case of Type 54 Human Mastadenovirus Keratoconjunctivitis Causing Severe Broad Epithelial Defect Ten Years after LASIK Surgery. Jpn J Infect Dis 2017; 70:597-598. [PMID: 28674318 DOI: 10.7883/yoken.jjid.2017.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Shuji Suzuki
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University
| | - Tomoko Kawamura
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University
| | - Yusuke Saeki
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University
| | - Mika Okubo
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University
| | - Masami Konagaya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Nozomu Hanaoka
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Takeshi Arashiro
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Tsuguto Fujimoto
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Eiichi Uchio
- Department of Ophthalmology, Faculty of Medicine, Fukuoka University
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Kobayashi K, Saeki Y, Kitazawa S, Kobayashi N, Kikuchi S, Goto Y, Sakai M, Sato Y. Three-dimensional computed tomographic volumetry precisely predicts the postoperative pulmonary function. Surg Today 2017; 47:1303-1311. [PMID: 28378062 DOI: 10.1007/s00595-017-1505-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/30/2016] [Accepted: 02/20/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE It is important to accurately predict the patient's postoperative pulmonary function. The aim of this study was to compare the accuracy of predictions of the postoperative residual pulmonary function obtained with three-dimensional computed tomographic (3D-CT) volumetry with that of predictions obtained with the conventional segment-counting method. METHODS Fifty-three patients scheduled to undergo lung cancer resection, pulmonary function tests, and computed tomography were enrolled in this study. The postoperative residual pulmonary function was predicted based on the segment-counting and 3D-CT volumetry methods. The predicted postoperative values were compared with the results of postoperative pulmonary function tests. RESULTS Regarding the linear correlation coefficients between the predicted postoperative values and the measured values, those obtained using the 3D-CT volumetry method tended to be higher than those acquired using the segment-counting method. In addition, the variations between the predicted and measured values were smaller with the 3D-CT volumetry method than with the segment-counting method. These results were more obvious in COPD patients than in non-COPD patients. CONCLUSIONS Our findings suggested that the 3D-CT volumetry was able to predict the residual pulmonary function more accurately than the segment-counting method, especially in patients with COPD. This method might lead to the selection of appropriate candidates for surgery among patients with a marginal pulmonary function.
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Affiliation(s)
- Keisuke Kobayashi
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yusuke Saeki
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shinsuke Kitazawa
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naohiro Kobayashi
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shinji Kikuchi
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukinobu Goto
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Mitsuaki Sakai
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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Abstract
PURPOSE The disease concept of sick building syndrome (SBS) is still unclear. Ocular mucous membrane irritation is one of the major symptoms of SBS. However, the immunological aspects of the ocular complications of SBS are not yet clarified. The clinical and allergological aspects of SBS cases with ocular disorders with special reference to allergic conjunctival diseases (ACD) were analyzed, especially with respect to local immunological features. METHODS Twelve cases of SBS with ocular findings and 49 cases of ACD (allergic conjunctivitis [AC], atopic keratoconjunctivitis [AKC], and vernal keratoconjunctivitis [VKC]) for comparison were evaluated. The clinical findings in SBS and ACD were scored, and tear film breakup time (BUT) was measured. Cytokine (interferon-γ [IFN-γ], interleukin [IL]-2, IL-4, IL-5, IL-6, IL-8, and IL-13) concentrations in tears were analyzed by cytometric bead arrays. Eosinophil count in peripheral blood, total IgE in serum, and multiple allergen simultaneous test (MAST) for antigen-specific IgE were also measured. RESULTS In SBS, conjunctival lesions were observed in all cases, and corneal abnormalities were found in two-thirds of the cases. Limbal lesions were observed in 2 pediatric cases. Mean serum total IgE level in SBS was significantly higher than that in AC; however, it was significantly lower than that in AKC and VKC. Eosinophil count in peripheral blood and number of positive allergens in MAST were significantly lower in SBS than in AKC and VKC. Significant elevation of tear IL-4 was observed in SBS and ACD. However, in contrast to ACD, elevation of other cytokines in tears was not observed in SBS. Mean tear BUT in SBS was in the normal range. CONCLUSION From these results, SBS is thought to be partially induced by an allergic response. However, clinical dissociation of the ocular clinical findings and local immunological features in tear cytokines may suggest that SBS belongs to a different entity from ACD.
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Affiliation(s)
- Yusuke Saeki
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka
| | - Kazuaki Kadonosono
- Department of Ophthalmology, Yokohama City University Medical Center, Yokohama, Japan
| | - Eiichi Uchio
- Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka
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Tanimine N, Tanaka Y, Abe T, Piao J, Ishiyama K, Kobayashi T, Ide K, Ohira M, Tahara H, Shimizu S, Saeki Y, Sakai H, Yano T, Ohdan H. MELD and Child-Pugh Scores Are Related to Immune Status of Intrahepatic Natural Killer Cells in Liver Transplant Candidates. Transplant Proc 2017; 49:98-101. [PMID: 28104168 DOI: 10.1016/j.transproceed.2016.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The role and phenotypic alterations of intrahepatic natural killer (NK) cells in liver disease were investigated. Although intrahepatic NK cells reportedly functionally deteriorate in the fibrotic liver, it remains unclear how the clinical severity of liver disease affects intrahepatic NK cells in patients with advanced liver failure. METHODS We analyzed the phenotypic properties of intrahepatic NK cells by using mononuclear cells extracted from ex vivo liver perfusate effluents from patients who underwent liver transplantation. The relationship between the clinical severity of liver disease and the phenotype of intrahepatic NK cells in these patients was also evaluated. To estimate the immunological responsiveness of intrahepatic NK cells, phenotypic enhancement after interleukin-2 stimulation was analyzed. RESULTS Intrahepatic NK cells from patients with advanced liver failure exhibited down-regulated monomodal expression of NKp46, a major activating molecule. Notably, the expression level of NKp46 decreased depending on the severity of liver disease, Model for End-Stage Liver Disease score, and Child-Pugh score rather than the etiology. After in vitro recombinant interleukin-2 stimulation, the enhancement of expression of cytotoxic molecules, NKp44, and tumor necrosis factor-related apoptosis-inducing ligand was significantly impaired in intrahepatic NK cells from patients with liver failure, concurrently with decreased expression of CD122 and interleukin-2 receptor beta. CONCLUSIONS Our results suggest that terminal deterioration of liver environments by chronic liver disease impairs the potential of local NK cells, depending on the severity of the deterioration. These influences of advanced liver failure on intrahepatic NK cells may be attributed to multicentric carcinogenesis in patients with liver failure.
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Affiliation(s)
- N Tanimine
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Tanaka
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Abe
- Department of Surgery, Onomichi General Hospital, Hiroshima, Japan
| | - J Piao
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ishiyama
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Kobayashi
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ide
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Ohira
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Tahara
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Shimizu
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Saeki
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Sakai
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Yano
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Ohdan
- Gastroenterological and Transplant Surgery, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
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Saeki Y, Ishiyama K, Ishida N, Tanaka Y, Ohdan H. Role of Natural Killer Cells in the Innate Immune System After Intraportal Islet Transplantation in Mice. Transplant Proc 2017; 49:139-144. [DOI: 10.1016/j.transproceed.2016.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
The periodontal ligament (PDL) works as a suspensory ligament when external mechanical stress is placed on the teeth. PDL fibroblasts, the principal cells in the PDL, are responsible for many PDL functions. We hypothesized that mechanosensitive ion channels are present in human PDL fibroblasts, which are capable of responding to mechanical stress during normal function of the tissue. Using patch-clamp techniques, we detected mechanosensitive TREK-1 K+ channels (a member of the two-pore-domain K+ channel family), whose single-channel conductance was 104 pS in symmetrical K+-rich solutions. The open probability of the channel was low in the quiescent state, but it was strongly increased by the induction of membrane stretch. Arachidonic acid also enhanced the channel activity. RT-PCR and immunocytochemical observations showed the expression of TREK-1 K+ channels in PDL fibroblasts. The results suggest that the activation of TREK-1 K+ channels by masticatory stress contributes to the hyperpolarization of PDL fibroblasts.
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Affiliation(s)
- A Ohara
- Department of Bioscience, Shiga University of Medical Science, Seta, Ohtsu, Shiga 520-2192, Japan.
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45
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Ohashi A, Saeki Y, Harada T, Naito M, Takahashi T, Aizawa S, Hasegawa H. Tetrahydrobiopterin Supplementation: Elevation of Tissue Biopterin Levels Accompanied by a Relative Increase in Dihydrobiopterin in the Blood and the Role of Probenecid-Sensitive Uptake in Scavenging Dihydrobiopterin in the Liver and Kidney of Rats. PLoS One 2016; 11:e0164305. [PMID: 27711248 PMCID: PMC5053593 DOI: 10.1371/journal.pone.0164305] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/22/2016] [Indexed: 12/21/2022] Open
Abstract
Tetrahydrobiopterin (BH4) is an essential cofactor of nitric oxide synthase (NOS) and aromatic amino acid hydroxylases. BH4 and 7,8-dihydrobiopterin (BH2) are metabolically interchangeable at the expense of NADPH. Exogenously administered BH4 can be metabolized by the body, similar to vitamins. At present, synthetic BH4 is used as an orphan drug for patients with inherited diseases requiring BH4 supplementation. BH4 supplementation has also drawn attention as a means of treating certain cardiovascular symptoms, however, its application in human patients remains limited. Here, we tracked biopterin (BP) distribution in blood, bile, urine, liver, kidney and brain after BH4 administration (5 mg/kg rat, i.v.) with or without prior treatment with probenecid, a potent inhibitor of uptake transporters particularly including organic anion transporter families such as OTA1 and OAT3. The rapid excretion of BP in urine was driven by elevated blood concentrations and its elimination reached about 90% within 120 min. In the very early period, BP was taken up by the liver and kidney and gradually released back to the blood. BH4 administration caused a considerable decrease in the BH4% in blood BP as an inevitable compensatory process. Probenecid treatment slowed down the decrease in blood BP and simultaneously inhibited its initial rapid excretion in the kidney. At the same time, the BH4% was further lowered, suggesting that the probenecid-sensitive BP uptake played a crucial role in BH2 scavenging in vivo. This suggested that the overproduced BH2 was taken up by organs by means of the probenecid-sensitive process, and was then scavenged by counter-conversion to BH4 via the BH4 salvage pathway. Taken together, BH4 administration was effective at raising BP levels in organs over the course of hours but with extremely low efficiency. Since a high BH2 relative to BH4 causes NOS dysfunction, the lowering of the BH4% must be avoided in practice, otherwise the desired effect of the supplementation in ameliorating NOS dysfunction would be spoiled.
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Affiliation(s)
- Akiko Ohashi
- Department of Anatomy, Nihon University School of Dentistry, Chiyoda, Tokyo, Japan
| | - Yusuke Saeki
- Department of Biosciences, Teikyo University of Science and TechnologyUenohara, Yamanashi, Japan
| | - Tomonori Harada
- Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Masako Naito
- Department of Anatomy, Nihon University School of Dentistry, Chiyoda, Tokyo, Japan
| | - Tomihisa Takahashi
- Department of Anatomy, Nihon University School of Dentistry, Chiyoda, Tokyo, Japan
| | - Shin Aizawa
- Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
| | - Hiroyuki Hasegawa
- Department of Anatomy, Nihon University School of Dentistry, Chiyoda, Tokyo, Japan
- Division of Anatomical Science, Department of Functional Morphology, Nihon University School of Medicine, Itabashi, Tokyo, Japan
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46
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Matsushita M, Okada M, Kobayashi T, Yoshie H, Kuzuya K, Matsuoka H, Shimizu T, Nii T, Teshigawara S, Tanaka E, Tsuji S, Ohshima S, Hashimoto J, Saeki Y. AB0282 Predicting The Responses To Biological Therapy by Two Kinds of Antibodies Titers against Porphyromonas Gingivalis in RA Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2626] [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: 11/03/2022]
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47
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Iwase S, Tani S, Saeki Y, Tuda M, Haran J, Skuhrovec J, Takagi M. Dynamics of infection with Wolbachia in Hypera postica (Coleoptera: Curculionidae) during invasion and establishment. Biol Invasions 2015. [DOI: 10.1007/s10530-015-0985-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Okatsu K, Koyano F, Kimura M, Kosako H, Saeki Y, Tanaka K, Matsuda N. Phosphorylated ubiquitin chain is the genuine Parkin receptor. J Exp Med 2015. [DOI: 10.1084/jem.2124oia14] [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: 11/04/2022] Open
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49
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Kikuchi-Taura A, Yura A, Tsuji S, Ohshima S, Kitatoube A, Shimizu T, Nii T, Katayama M, Teshigawara S, Yoshimura M, Kudo-Tanaka E, Harada Y, Matsushita M, Hashimoto J, Saeki Y. Monocyte CD64 expression as a novel biomarker for the disease activity of systemic lupus erythematosus. Lupus 2015; 24:1076-80. [DOI: 10.1177/0961203315579093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/02/2015] [Indexed: 12/19/2022]
Abstract
Objective Interferon alpha (IFN-α) is a key cytokine associated with systemic lupus erythematosus (SLE). IFN-α induces the expression of CD64 on monocytes (mCD64). Although enhanced mCD64 expression has been reported in patients with SLE, it has never been assessed quantitatively. The aim of this study was to investigate whether or not mCD64 expression correlates with SLE disease activity. Methods The mCD64 expression levels were assessed quantitatively in 40 patients with active or inactive SLE by using flow cytometry. The mCD64 expression levels were subsequently compared with the SLE disease activity index (SLEDAI) and levels of existing SLE activity biomarkers, such as anti-DNA antibody, complements, and so on. Results The mCD64 expression was significantly higher in active disease than in inactive disease SLE (median molecules/cell, interquartile range: 34,648, 8174–24,932 and 20,865, 6357–21,503, respectively; p < 0.001). The levels of mCD64 expression strongly correlated with SLEDAI ( r = 0.68, p < 0.001). Conclusion The mCD64 expression is a simple and useful biomarker for evaluating disease activity in patients with SLE.
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Affiliation(s)
- A Kikuchi-Taura
- Department of Clinical Research, Osaka-Minami Medical Center, Osaka, Japan
| | - A Yura
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - S Tsuji
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - S Ohshima
- Department of Clinical Research, Osaka-Minami Medical Center, Osaka, Japan
| | - A Kitatoube
- Department of Clinical Research, Osaka-Minami Medical Center, Osaka, Japan
| | - T Shimizu
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - T Nii
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - M Katayama
- Department of Rheumatology and Allergology, Osaka University, Graduate School of Medicine, Osaka, Japan
| | - S Teshigawara
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - M Yoshimura
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - E Kudo-Tanaka
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - Y Harada
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - M Matsushita
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - J Hashimoto
- Department of Rheumatology and Allergology, Osaka-Minami Medical Center, Osaka, Japan
| | - Y Saeki
- Department of Clinical Research, Osaka-Minami Medical Center, Osaka, Japan
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50
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Morimoto H, Ishiyama K, Ishifuro M, Ohira M, Ide K, Tanaka Y, Tahara H, Teraoka Y, Yamashita M, Abe T, Hashimoto S, Hirata F, Tanimine N, Saeki Y, Shimizu S, Sakai H, Yano T, Tashiro H, Ohdan H. Clinical efficacy of simultaneous splenectomy in liver transplant recipients with hepatitis C virus. Transplant Proc 2015; 46:770-3. [PMID: 24767345 DOI: 10.1016/j.transproceed.2013.12.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 11/30/2013] [Accepted: 12/11/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Interferon (IFN) therapy is a well-established antiviral treatment for hepatitis C virus (HCV) - infected patients. However, susceptibility to thrombocytopenia is a major obstacle in its initiation or continuation, particularly in patients with HCV who underwent liver transplantation (LT). We previously showed that the coexistence of splenomegaly and thrombocytopenia could result in persistent thrombocytopenia after LT. Here we retrospectively evaluated the validity of this criterion for simultaneous splenectomy in recipients with HCV. PATIENTS AND METHODS Subjects included 36 recipients with HCV who received LT between January 2006 and February 2012 at Hiroshima University. We analyzed the spleen volume, body surface area, platelet (PLT) count, and rate of completion or continuation with IFN therapy in these recipients. RESULT Of these recipients, 30 did not require simultaneous splenectomy according to the criterion, and 24 actually did not receive simultaneous splenectomy. In this group, 21 (87.5%) started IFN therapy. Fifteen (71.4%) of these recipients completed or continued IFN therapy, whereas 13 (61.9%) achieved either a sustained virological response (SVR) or an end-of-treatment response. The PLT count increased to >100,000/mm(3) 1 month after LT in 16 (66.7%) recipients from this group. CONCLUSION Our criterion detected the PLT count outcome after LT in recipients with HCV and achieved a better SVR result after IFN therapy.
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Affiliation(s)
- H Morimoto
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ishiyama
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - M Ishifuro
- Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Hiroshima University, Hiroshima, Japan
| | - M Ohira
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Ide
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Tanaka
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Tahara
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Teraoka
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Yamashita
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Abe
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Hashimoto
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - F Hirata
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - N Tanimine
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Saeki
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Shimizu
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Sakai
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Yano
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Tashiro
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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