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Yotsukura M, Nakagawa K, Yoshida Y, Watanabe H, Kusumoto M, Yatabe Y, Watanabe S. FP06.01 Unexpected Aggressive Histological Component in Subsolid Lung Adenocarcinoma: Priority for Resection Without Delay. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yasuda M, Tachi T, Osawa T, Watanabe H, Inoue S, Makino T, Nagaya K, Morita M, Tanaka K, Aoyama S, Kasahara S, Teramachi H, Mizui T. Risk factors for thrombocytopenia and analysis of time to platelet transfusion after azacitidine treatment. DIE PHARMAZIE 2021; 76:444-449. [PMID: 34481536 DOI: 10.1691/ph.2021.1566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The use of azacitidine (AZA) has been known to lead to a high incidence of hematotoxic adverse events. The aims of this study were to identify the risk factors for thrombocytopenia after the administration of AZA and to analyze time to the initial platelet transfusion. Sixty-two patients with myelodysplastic syndrome (MDS), who were treated with AZA in Gifu Municipal Hospital between March 2012 and June 2020, were included in this study. The risk factors for thrombocytopenia were identified using univariate analysis of patient characteristics, disease type, and laboratory values immediately before the start of treatment. Variables with p<0.2 identified in the univariate analysis were used as independent variables in the multivariate analysis. This analysis identified "creatinine clearance (CCr) <60 mL/min" as a significant factor (odds ratio, 4.790; 95% confidence interval [CI], 1.380-16.70; p=0.014). Subsequently, time in days to the initial platelet transfusion after the initial administration of AZA was analyzed using the log-rank test. The overall median time in days to platelet transfusion was 370 days. The log-rank test was used to determine the influence of patient characteristics, disease type, and laboratory values immediately before the start of treatment. The subsequent Cox proportional hazard regression analysis using variables with p<0.2 as independent variables identified "hemoglobin (Hb) <8.0 g/dL" as a significant factor (hazard ratio, 2.143; 95% CI, 1.001-4.573; p=0.048). The results of this study led to the following clinical implications: first, patients with CCr of <60 mL/min at the start of treatment should be treated with caution due to the risk of thrombocytopenia. Second, patients with Hb of <8.0 g/dL at the start of treatment may require platelet transfusion in the early stage of treatment.
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Nakamura I, Yamaguchi T, Miura Y, Watanabe H. Transmission of extended-spectrum β-lactamase-producing Klebsiella pneumoniae associated with sinks in a surgical hospital ward, confirmed by single-nucleotide polymorphism analysis. J Hosp Infect 2021; 118:1-6. [PMID: 34437982 DOI: 10.1016/j.jhin.2021.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/19/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although sink- and drain-related carbapenemase-producing Enterobacterales transmission has been reported previously, there is limited research regarding the transmission of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales. AIM To investigate nosocomial ESBL-producing Klebsiella pneumoniae transmission via patient sinks and drains on a general surgical hospital ward. METHODS ESBL-producing K. pneumoniae transmission on a surgical ward at Tokyo Medical University Hospital (built in July 2019) from July 2019 to February 2020 was investigated. Information regarding the relatedness of the isolates from the patients and the environment was provided by whole-genome sequence analysis. FINDINGS Four clinical isolates of K. pneumoniae (TUM19831, TUM19832, TUM19833 and TUM19834) were detected during the study. TUM19831 was identified prior to moving to the new building and was detected again in the new building. TUM19832 and TUM19833 were detected in July 2019, and TUM19834 was detected in December 2019. TUM19835 and TUM19836 were detected in two different sinks and drains in July 2019, while a further two sinks and drains tested positive for TUM19837 and TUM19838 in February 2020. Whole-genome analysis revealed that all strains were ST307 and CTXM15 sequence types, and the isolates were indistinguishable by genetic analysis. Due to inadequate removal of the slime biofilm coating, the sinks needed to be cleaned again before TUM19837 and TUM19838 could be detected. CONCLUSIONS This study demonstrated the transmission of indistinguishable ESBL-producing K. pneumoniae strains from sinks and drains in the patient area of a general surgical hospital ward. There is a need to recognize this risk and develop optimal management strategies for plumbing systems in hospitals and other healthcare settings.
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Takeda S, Fukunaga N, Sanami S, Tsuzuki Y, Kitasaka H, Takeda S, Watanabe H, Kida Y, Kondou F, Asada Y. P–156 Automatic pronuclear detection based on deep learning technology has clinical utility. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does the performance of an automatic pronuclear detection system based on deep learning technology have clinical utility?
Summary answer
Output results for 2PN detection using the automatic system powered by deep learning technology has clinical utility.
What is known already
In order to establish a more objective embryo evaluation system, we have been developing an automatic pronuclear detection system that utilizes deep learning technology based on Time- Lapse (TL) images. We have previously reported that the accuracy of pronuclei detection was improved by introducing an analysis method using 11 slices in the Z axis. In this study, we evaluated the potential clinical practicality of the automatic pronuclear detection system.
Study design, size, duration
Embryos clinically evaluated between May 2018 and December 2019 by embryologists were chosen for this study. We prepared for analysis TL videos of 995 embryos that had been evaluated as having 0, 1, 2, and 3PN.
Participants/materials, setting, methods
Part1:We compared the outputs of the automatic pronuclear detection system with these embryologists(three junior embryologists (1a), three intermediate embryologists (1b),and three senior embryologists (1c)) who had judged the pronuclei number from TL videos from 40 embryos each having 0,1,2,and 3PN.
Part2:The automatic pronuclear detection system determined the pronuclei number from the TL videos of 955 embryos scored as either 1,2,and 3PN,(different from those used in Part1),and the detection rate for 2PN was calculated.
Main results and the role of chance
Part1: The sensitivities for embryologist groups 1a),1b),1c) and the automatic pronuclear detection system were 80.0%,100%,100%,100% for 2PN, 60.0%,83.3%,86.7%,100% for 0PN, 46.7%,80.0%,86.7%,10.0% for 1PN, and 73.3%,96.7%,96.7%,10.0% for 3PN.
Part2: The precision for 2PN by the automatic pronuclear detection system was 99%.
Limitations, reasons for caution
In order to further improve the performance of the automatic pronuclear detection system, further adjustment of the algorithm and more training images will be utilised.
Wider implications of the findings: The detection of 2PN by the automatic pronuclear detection system was highly reliable, and the performance of the system was comparable to that of embryologists. These first results are reassuring and support the clinical use of the system as a further aid for embryologists, in routine laboratory practice.
Trial registration number
‘not applicable’
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Mizumoto S, Watanabe H, Nagao Y, Tanaka K, Murakami M, Montag M, Kuramoto T. P–221 Prospective randomized sibling study on gamete preparation, insemination and subsequent culture of human oocytes in a time-lapse system using media systems with and without antioxidants. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does the addition of antioxidants for gamete preparation, insemination and embryo culture lead to differences in embryo development and clinical outcome
Summary answer
Using an antioxidant-containing media system for sperm preparation, insemination and embryo culture imparts significantly higher good-quality blastocyst rates and improved clinical outcome in elderly patients.
What is known already
A previous study showed that adding combined antioxidants for sequential embryo culture in conventional incubators (interrupted culture) improves embryo viability and clinical outcome, especially for elderly patients. Here we investigated the combined effect of three antioxidants Acetyl-L-Carnitine (10 µM), N-Acetyl-L-Cysteine (10 µM), and α-Lipoic Acid (5 µM) during sperm preparation, insemination, and time-lapse culture in a single step medium on human embryo development and clinical outcome.
Study design, size, duration
Prospective randomized single center study including 143 couples for IVF/ICSI between August 2018 and December 2019. Inclusion required at least eight cumulus-oocyte-complexes (COCs) after retrieval. Cycles involving PGT, split IVF/ICSI, and surgically retrieved sperm were excluded. Immediately after retrieval oocytes were randomly distributed to a study or control media system with or without antioxidants (Vitrolife). Similarly, ejaculates were split and prepared with and without antioxidants.
Participants/materials, setting, methods
Sibling oocytes were inseminated in the respective group with accordingly prepared sperm. Single step embryo culture was conducted in medium with (Gx-TL) and without (G-TL) antioxidants in the EmbryoScope+. Embryo quality and clinical outcome were assessed in relation to maternal age (<35/>35 years). Good-quality embryos on day 3 were defined as 8- to 10-cells with even cells and low fragmentation; good-quality blastocysts as > 3BB. Clinical outcome was assessed after single vitrified blastocyst transfer (SVBT).
Main results and the role of chance
From 143 participants (female age, 34.7±3.2 years), a total of 2424 COCs were collected; 1180 COCs/916 metaphase-II (MII) oocytes were allocated to Gx-TL media and 1244 COCs/981 MII oocytes to G-TL media. Age-related analysis in Gx-TL compared with G-TL in relation to allocated MII oocytes revealed a trend for higher fertilization rates in Gx-TL for both age groups (<35: 72.1% vs. 66.9%; >35: 70.7% vs. 64.9%, P < 0.1). Good-quality day 3 embryo development/MII oocytes was higher, albeit not significant, in the elderly patients in Gx-TL (<35: 35.9% vs. 34.4%; >35: 31.1% vs. 27.9%). Overall day 5/6 blastocyst rate was similar for both media (<35: 48.2% vs. 49.9%; >35: 42.3% vs. 39.5%). Day 5/6 GQB rate was comparable for younger patients (<35: 23.8% for Gx-TL vs. 26.0% for G-TL) but significantly higher in Gx-TL in elderly patients (>35: 20.7% vs. 14.4%; P < 0.05). A total of 200 SVBT were performed; 99 in the Gx-TL- and 101 in the G-TL-arm. We noted almost similar implantation and ongoing pregnancy rates between Gx-TL vs G-TL in the younger (<35) age group (50.0% vs. 55.4%; 50.0% vs. 55.6%) but higher albeit not significant rates for Gx-TL in older (>35) patients (44.1% vs. 33.3%; 44.1% vs. 33.3%).
Limitations, reasons for caution
In almost 95% of the cycles, oocytes were inseminated by ICSI; thus results may not equally apply for cycles with IVF. The use of a closed time-lapse system may have prevented from some environmental oxidative stress. Therefore results may come out different with a similar study using standard incubation.
Wider implications of the findings: Supplementation of antioxidants to media for gamete isolation and preparation, as well as subsequent single step time-lapse culture may improve GQE/B rates and clinical outcomes in certain age groups, plausibly through the reduction of oxidative stress. Further studies in selected sub-groups (severe OAT syndrome / testicular cases) may be indicated.
Trial registration number
UMIN000034482
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Kobayashi Y, Yozu A, Watanabe H, Taga G. Multiple patterns of infant rolling in limb coordination and ground contact pressure. Exp Brain Res 2021; 239:2887-2904. [PMID: 34302513 DOI: 10.1007/s00221-021-06174-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
Infants acquire the ability to roll over from the supine to the prone position, which requires body coordination of multiple degrees of freedom under dynamic interactions with the ground. Although previous studies on infant rolling observed kinematic characteristics, little is known about the kinetic characteristics of body segments in contact with the surface. We measured the ground contact pressure under the arms, legs, head, and proximal body segments using a pressure mat and their displacements using a three-dimensional motion capture system. The data obtained from 17 infants aged 9-10 months indicated that most of them showed 2-4 of 6 highly observed movement patterns, including 1 axial rolling, 2 spinal flexion, and 3 shoulder girdle leading patterns. The arms and legs had small contributions to the ground contact pressure in the axial rolling and spinal flexion patterns. The ipsilateral leg in relation to the rolling direction was involved in supporting the body weight in only 1 shoulder girdle leading pattern. The contralateral leg showed large peak pressure to push on the floor before rolling in 3 shoulder girdle leading patterns. The results indicate that infants can produce multiple rolling-over patterns with different strategies to coordinate their body segments and interact with the floor. The results of the analysis of the movement patterns further suggest that few patterns correspond to those reported in adults. This implies that infants generate unique motor patterns by taking into account their own biomechanical constraints.
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Jurado CA, Tsujimoto A, Watanabe H, Fischer NG, Hasslen JA, Tomeh H, Baruth AG, Barkmeier WW, Garcia-Godoy F. Evaluation of Polishing Systems for CAD/CAM Polymer-Infiltrated Ceramic-Network Restorations. Oper Dent 2021; 46:219-225. [PMID: 34192321 DOI: 10.2341/20-006-l] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness of five different polishing systems on a computer-aided design and computer-aided manufacturing (CAD/CAM) polymer-infiltrated ceramic-network restoration with nanoscale assessment using atomic force microscopy (AFM) and visual assessment performed by dental school senior students and faculty members. METHOD Forty-eight full coverage crowns were milled out of polymer-infiltrated ceramic-network CAD/CAM blocks (Vita Enamic) for polishing with one company proprietary, two ceramic and two composite polishing systems. The prepared crowns were divided into six groups: (1) no polishing (control); (2) polishing with Vita Enamic Polishing Kit (VEna); (3) polishing with Shofu Porcelain Laminate Polishing Kit (SCer); (4) polishing with Brasseler Dialite Feather lite All- Ceramic Adjusting & Polishing System (BCer); (5) polishing with Shofu Composite Polishing Kit (SCom); and (6) polishing with Brasseler Composite Polishing Kit (BCom). The polished crown surface topography was observed, and surface roughness and area were measured with AFM. In addition, polished crowns were visually assessed by 15 senior dental students and 15 dental school faculty members. RESULTS All polishing treatments significantly reduced the surface roughness and area of the crown compared with the control. SCom and BCom showed significantly higher surface area than VEna, and the SCer and BCer groups were intermediate, showing no significant difference from either VEna or SCom and BCom. There were no significant differences in surface roughness between any of the systems. Dental students and faculty members classified the groups polished with VEna, SCer, and BCer groups as clinically acceptable, and they selected BCer group as the best polished restorations and the control group as the least polished restorations. CONCLUSIONS Ceramic and composite polishing systems produced similar polishing results as that observed using a company proprietary polishing system. However, effectiveness for polishing using a company proprietary and ceramic polishing system tends to be higher than composite polishing systems.
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Tanaka S, Uchida S, Hakamata A, Miyakawa S, Odagiri K, Inui N, Watanabe H, Namiki N. Simultaneous LC-MS analysis of plasma concentrations of sildenafil, tadalafil, bosentan, ambrisentan, and macitentan in patients with pulmonary arterial hypertension. DIE PHARMAZIE 2021; 75:236-239. [PMID: 32539916 DOI: 10.1691/ph.2020.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Phosphodiesterase-5 (PDE-5) inhibitors and endothelin receptor antagonists (ERAs) are standard therapies for pulmonary arterial hypertension (PAH). The inter-individual variability of these pharmacokinetics is reported remarkably large, and therapeutic drug monitoring (TDM) can be useful to improve the likelihood of the desired therapeutic and safety outcomes. This study aimed to develop a LC-MS method to determine the concentrations of five PAH drugs (PDE-5 inhibitors: sildenafil and tadalafil, ERAs: bosentan, macitentan, and ambrisentan) from plasma samples using a simple process followed by a single mass spectrometric run, and to validate this approach through pharmacokinetic analyses in patients. A solid extraction method was used for sample preparation of the drugs from human plasma. The total run time for a single injection was within 10 min. The calibration curves for all drugs were linear, and the lower limits of quantitation were 1 (sildenafil), 2 (tadalafil), 5 (ambrisentan), and 10 ng/mL (bosentan, macitentan). The accuracy and precision values suggested that the assay had high accuracy and reliability. To prove the utility of this method, the plasma concentrations of the five PAH drugs were determined after their oral administration to nine PAH patients.
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Ahn JK, Beckford B, Campbell M, Chen SH, Comfort J, Dona K, Farrington MS, Hanai K, Hara N, Haraguchi H, Hsiung YB, Hutcheson M, Inagaki T, Isoe M, Kamiji I, Kato T, Kim EJ, Kim JL, Kim HM, Komatsubara TK, Kotera K, Lee SK, Lee JW, Lim GY, Lin QS, Lin C, Luo Y, Mari T, Masuda T, Matsumura T, Mcfarland D, McNeal N, Miyazaki K, Murayama R, Nakagiri K, Nanjo H, Nishimiya H, Noichi Y, Nomura T, Nunes T, Ohsugi M, Okuno H, Redeker JC, Sanchez J, Sasaki M, Sasao N, Sato T, Sato K, Sato Y, Shimizu N, Shimogawa T, Shinkawa T, Shinohara S, Shiomi K, Shiraishi R, Su S, Sugiyama Y, Suzuki S, Tajima Y, Taylor M, Tecchio M, Togawa M, Toyoda T, Tung YC, Vuong QH, Wah YW, Watanabe H, Yamanaka T, Yoshida HY, Zaidenberg L. Study of the K_{L}→π^{0}νν[over ¯] Decay at the J-PARC KOTO Experiment. PHYSICAL REVIEW LETTERS 2021; 126:121801. [PMID: 33834796 DOI: 10.1103/physrevlett.126.121801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
The rare decay K_{L}→π^{0}νν[over ¯] was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of (7.20±0.05_{stat}±0.66_{syst})×10^{-10}, three candidate events were observed in the signal region. After unveiling them, contaminations from K^{±} and scattered K_{L} decays were studied, and the total number of background events was estimated to be 1.22±0.26. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of 4.9×10^{-9} on the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level.
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Patel A, Kong R, Sato T, Yoo S, Sinha A, Powell C, Zhu J, Watanabe H. FP12.11 Single-Cell RNA Sequencing Analyses Distinguishes Transcriptional Activity of c-Myc and L-Myc in Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Walker PM, Hirayama Y, Lane GJ, Watanabe H, Dracoulis GD, Ahmed M, Brunet M, Hashimoto T, Ishizawa S, Kondev FG, Litvinov YA, Miyatake H, Moon JY, Mukai M, Niwase T, Park JH, Podolyák Z, Rosenbusch M, Schury P, Wada M, Watanabe XY, Liang WY, Xu FR. Properties of ^{187}Ta Revealed through Isomeric Decay. PHYSICAL REVIEW LETTERS 2020; 125:192505. [PMID: 33216598 DOI: 10.1103/physrevlett.125.192505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Mass-separated ^{187}Ta_{114} in a high-spin isomeric state has been produced for the first time by multinucleon transfer reactions, employing an argon gas-stopping cell and laser ionization. Internal γ rays revealed a T_{1/2}=7.3±0.9 s isomer at 1778±1 keV, which decays through a rotational band with perturbations associated with the approach to a prolate-oblate shape transition. Model calculations show less influence from triaxiality compared to heavier elements in the same mass region. The isomer-decay reduced E2 hindrance factor f_{ν}=27±1 supports the interpretation that axial symmetry is approximately conserved.
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Sato W, Kobayashi Y, Otaka M, Unuma M, Yamanaka T, Suto Y, Sato T, Iino T, Seki K, Suzuki T, Terata K, Iino K, Watanabe H. Validity of ultrasound arterial wall vascularization for assessment of vascular inflammation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vascular inflammation plays a fundamental role in most vascular diseases including atherosclerosis and vasculitis syndrome, in which arterial wall vascularization (AWV) frequently develops. Visualization of AWV is informative in detecting the vascular inflammation but is challenging. A new ultrasound technique (superb micro-vascular imaging [SMI]) allows the detection of extremely low-velocity flows. We examined an availability of SMI for assessment of the instability of atherosclerotic plaques and the activity of Takayasu arteritis (TA).
Methods and results
The study consists of two independent and consecutive parts A and B, examined in carotid stenosis (A) and TA (B), respectively. In part A, 12 patients with symptomatic severe carotid stenosis (CS group) scheduled for carotid endarterectomy were enrolled. In six of 12 patients, preoperative ultrasonography with SMI showed intraplaque neovascularization at the plaque shoulder. Postoperatively, histopathology confirmed the neovessels at the corresponding sites of visualized AWV. SMI had a sensitivity of 67%, specificity of 90% for detection of AWV in CS group. In SMI analysis, false positive findings were caused by motion artifact and arterial wall calcification, and a false negative finding is attributed by intraplaque hemorrhage. In part B, 10 patients with TA were enrolled. All patients underwent 18F-FDG-PET/CT, and its vascular uptake were compared with AWV detected by SMI. Bilateral common carotid arteries (CCA), internal carotid arteries and common iliac arteries were examined by SMI. Active vascular 18F-FDG uptake (max SUV >2.1) were found at five sites in three patients, which were not significantly correlated with the prevalence of macaroni sign, increase in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Of note, SMI revealed AWV at five sites corresponding to uptake of 18F-FDG, with a sensitivity/specificity of 100% and 98%, positive predictive value 71%, and a negative predictive value 100%.
Conclusion
SMI enables visualization of AWV at vulnerable plaque in CS patients and at 18F-FDG positive sites in TA patients. SMI has potential as a modality to detect the vascular inflammation.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research, Japan
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Watanabe H, Koike A, Kato H, Wu L, Hayashi K, Kubota H, Konno H, Nishi I, Kawamoto H, Sato A, Matsumura A, Aonuma K, Sankai Y, Ieda M. Efficacy of cardiac rehabilitation with motion assistance from wearable cyborg hybrid assistive limb in patients with chronic heart failure: a randomized controlled trial. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recent Cochrane Systematic Review suggested that the participation in cardiac rehabilitation is associated with approximately 20% lower cardiovascular mortality and morbidity. Exercise therapy is the key component of cardiac rehabilitation programs. In recent years, innovative technologies have been introduced into the field of rehabilitation, and a typical example is the wearable cyborg Hybrid Assistive Limb (HAL). The wearable cyborg HAL provides motion assistance based on detection of bioelectrical signals on the skin surface when muscle forces are generated. The lumbar-type HAL is expected to expand the therapeutic options for severe cardiac patients who have difficulty in performing usual cardiac rehabilitation programs, such as bicycle pedaling or walking.
Purpose
We aim to compare the efficacy of exercise therapy performed with motion assistance from a lumbar-type HAL versus conventional training (sit-to-stand exercise without HAL) in patients with chronic heart failure.
Methods
This clinical trial is a randomized, non-blinded, and controlled study. Twenty-eight heart failure patients (73.1±13.8 years) who have difficulty in walking at the usual walking speed of healthy subjects were randomly assigned to 2 groups (HAL group or control group) with a 1:1 allocation ratio and performed sit-to stand exercise either with HAL or without HAL for 5 to 30 minutes once a day, and 6 to 10 days during the study period. The brain natriuretic peptide (BNP), isometric knee extensor strength, standing ability (30-seconds chair-stand test: CS-30), short physical performance battery (SPPB) and 6-minute walking distance (6MWD) were measured before and after the completion of cardiac rehabilitation. Cardiac events such as death, re-hospitalization, myocardial infarction and worsening of angina pectoris and heart failure during 1 year after discharge were evaluated.
Results
There was no significant difference in the number of days of exercise therapy between the two groups. BNP, SPPB and 6MWD were improved in both groups. In the HAL group, the isometric knee extensor strength (0.29±0.11 vs 0.35±0.11 kgf/kg, p=0.003) significantly improved and CS-30 (5.5±5.1 vs 8.2±5.3, p=0.054) tended to improve. However, in the control group, either the isometric knee extensor strength (0.35±0.11 vs 0.36±0.14 kgf/kg, p=0.424) or CS-30 (6.0±4.3 vs 9.2±6.2, p=0.075) did not significantly change. HAL group showed significantly more improvement in the isometric knee extensor strength than control group (p=0.045). Cardiac events occurred in 20% in the HAL group and 43% in the control group.
Conclusion
The improvement in isometric knee extensor strength with the assistance from lumbar-type HAL suggests that exercise therapy using this device may be useful in chronic heart failure patients with flail or sarcopenia, a strong poor prognostic factor in these patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): This work was supported in part by a grant-in-aid for Scientific Research from the Ministry of Education, Science, and Culture of Japan (JSPS KAKENHI grant number JP17K09485) and funded by the ImPACT Program of the Council for Science, Technology and Innovation (Cabinet Office, Government of Japan) (grant number 2017-PM05-03-01).
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Suto Y, Sato W, Kobayashi Y, Otaka M, Unuma M, Yamanka T, Sato T, Seki K, Iino T, Suzuki T, Terata K, Iino K, Watanabe H. Utility of superb microvascular imaging for assessment of foot perfusion in patients with critical limb ischemia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, an increasing attention has been paid to foot microcirculation in critical limb ischemia (CLI). Although skin perfusion pressure (SPP) is the most frequently used marker of microcirculation, SPP is often unmeasurable at the most ischemic site in the foot. A new ultrasound technique (superb micro-vascular imaging [SMI]) allows the detection of extremely low velocity flows and enables the quantitative verification as vascular index (VI). We examined the diagnostic value of SMI-based VI in assessing foot perfusion when planning endovascular treatment (EVT).
Methods
Consecutive 50 patients with CLI were enrolled. All cases underwent EVT for superficial femoral arteries. SMI-based VI of plantar, dorsal, medial heel, lateral heel and toe's area were obtained before and after EVT, and those were compared with SPP (plantar and dorsal) or ankle-brachial index (ABI) representing macrocirculation.
Results
Based on the six angiosomes concept, SMI enabled to visualize microcirculation in all subjects, but SPP was not feasible in 13% of all subjects at the most ischemic site. After EVT, ABIs were significantly increased from 0.64±0.19 to 0.85±0.27 (P=0.0003). Plantar SPP also increased from 39.6±20.4 mmHg to 58.5±27.1 mmHg (p=0.002). SMI-based VI significantly increased in each sites based on the six angiosomes concept. Of note, plantar SMI-based VI significantly increased from 5.1±3.2% to 10.6±6.6% (p<0.0001), suggesting improvement of foot perfusion. Plantar SMI-based VI was well correlated with plantar-SPP both before and after EVT (p=0.002, r=0.663). Plantar VI was also informative in showing a rapid improvement of foot perfusion during EVT.
Conclusion
SMI enabled to visualize the foot microcirculation on the basis of angiosomes concept. SMI has potential as an alternative to SPP.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in -Aid for Scientific Reseach, Japan
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Ishii K, Yoshikawa Y, Hyodo E, Seo Y, Ishizu T, Kihara H, Daimon M, Tanaka A, Watanabe H, Akasaka T, Ito H, Yoshikawa J. Diagnostic accuracy of left ventricular diastolic transverse strain imaging by speckle tracking echocardiography for diagnosing chest pain in diabetic patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Two-dimensional speckle tracking echocardiography (2D-STE) has been reported to be useful for the diagnosis of myocardial ischemia by detecting delayed relaxation (diastolic stunning) after an episode of angina. 2D-longitudinal strain is not specific besides ischemia such as diastolic dysfunction, and diabetes have been associated with abnormal longitudinal fibers. The aim is to evaluate the diagnostic accuracy of Left ventricular (LV) diastolic transverse strain imaging by STE to detect the presence of acute coronary syndrome (ACS) in diabetic patients with acute chest pain.
Methods
385 consecutive patients with acute chest pain and without wall motion abnormality, who were admitted to an emergency department (ED) at 1 of 12 clinical sites in Japan, were enrolled and underwent 2D-STE at ED. Left ventricular (LV) transverse strain values at aortic valve closure (A) and one-third of diastole duration (B) were measured. The strain imaging diastolic index (SI-DI) was value was determined as: (A − B)/A × 100% to assess the LV diastolic strain imaging and was used to identify the regional LV delayed relaxation. All patients underwent coronary CT or coronary angiography to establish the diagnosis of ACS. Clinicians were blinded to the 2D-STE results.
Results
Out of 385 patients, 2D-STE analysis was possible in 365 patients (94%). 76 patients were diabetic (DM+), and 289 patients were non-diabetic (DM-). With assessment of coronary CT or coronary angiography, ACS was diagnosed in 125 patients (34%). 2D-STE was obtained at a mean of 5.3 hours after chest pain episode. Transverse SI-DI of ischemic segments were significantly lower than those of non-ischemic segments (p value <0.001) in both diabetic and non-diabetic patients, and transverse SI-DI of both diabetic and non-diabetic patients demonstrated high area under curve (AUC) for detection of myocardial ischemia (Figure: RCA; right coronary artery, LAD; left anterior descending artery, LCX; left circumferencial artery). In diabetic patients, sensitivity, specificity, and negative predictive value for ACS of transverse SI-DI are 100%, 95%, 100% in RCA (a cut-off value of 36.2), and 86.4%, 95%, 93% in LAD (a cut-off value of 50.2), and 75%, 85%, 94% in LCX (a cut-off value of 52), respectively.
Conclusion
LV diastolic transverse strain imaging by 2D-STE at ED increase the sensitivity, specificity and accuracy to predict the presence of ACS in diabetic patients with chest pain, as well as non-diabetic patients. (UMIN000013859).
Figure 1. Transverse Strain (SI-DI): AUC (95% CI)
Funding Acknowledgement
Type of funding source: None
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Fujikawa H, Yamada T, Koumori K, Watanabe H, Kano K, Takahashi K, Rino Y, Masuda M, Ogata T, Oshima T. 135P Significance of lymphatic invasion in the indication for additional gastrectomy after endoscopic treatment. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yamada T, Hayashi T, Fujikawa H, Kumazu Y, Nagasawa S, Nakazono M, Kano K, Hara K, Watanabe H, Komori K, Shimoda Y, Takahashi K, Ogata T, Oshima T, Yoshikawa T. 1439P Phase II study to evaluate feasibility and safety of oral nutritional supplementation with high density liquid diet after total gastrectomy for patients with gastric cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Matsushita Y, Watanabe H, Tamura K, Motoyama D, Miyake H. Prognostic significance of time to castration resistance in patients with metastatic castration-sensitive prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Motoyama D, Matsushita Y, Watanabe H, Tamura K, Ito T, Sugiyama T, Otsuka A, Miyake H. Significant impact of three-dimensional volumetry of perinephric fat on the console time during robot-assisted partial nephrectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33084-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Nakamura I, Watanabe H, Itoi T. Protective barrier box to mitigate exposure to airborne virus particles with minimum personal protective equipment when obtaining nasal PCR samples. J Hosp Infect 2020; 106:397-398. [PMID: 32621843 PMCID: PMC7328607 DOI: 10.1016/j.jhin.2020.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 01/25/2023]
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Sada KE, Hayashi K, Asano Y, Katayama Y, Hiramatsu Asano S, Ohashi K, Morishita M, Watanabe H, Narazaki M, Matsumoto Y, Yajima N, Yoshimi R, Shimojima Y, Ono S, Kajiyama H, Ichinose K, Sato S, Fujiwara M, Wada J. AB0387 TREATMENT STATUS FOR OSTEOPOROSIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: CROSS-SECTIONAL ANALYSIS FROM A LUPUS REGISTRY OF NATIONWIDE INSTITUTIONS (LUNA). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Osteoporosis is one of the most important adverse effects of glucocorticoids in patients with systemic lupus erythematosus (SLE). Because osteoporosis is accelerated by chronic kidney disease (CKD), more attention should be paid to the treatment for osteoporosis in SLE patients with CKD. Many treatment options for osteoporosis have emerged recently, but treatment status in patients with SLE is not elucidated.Objectives:The purpose of this study is to elucidate the treatment status for osteoporosis in patients with SLE among the CKD stages.Methods:Using data from lupus registry of nationwide institutions (LUNA), a cross-sectional analysis was performed. We firstly described treatment status for osteoporosis in all enrolled patients. Secondary, treatment status for osteoporosis was compared among CKD stages. Finally, bone damage in Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) was compared among CKD stages.Results:The median age (interquartile range [IQR]) of enrolled 917 patients was 44 (34- 57) years and 809 patients (88%) were female. CKD stages were follows: CKD stage 1, 234 (26%); CKD stage 2, 465 (51%); CKD stage 3, 189 (21%); CKD stage 4, 9 (1%); CKD stage 5, 16 (2%). Median (IQR) age, female sex, and median (IQR) previous maximum dose of prednisolone in patients with and without CKD (≥CKD stage 3) were 56 (46.5-66) and 41 (32-50), 191 (89%) and 615 (88%), and 40 (30-60) and 40 (30-55) mg/day, respectively. Bisphosphonate was administered in 388 (42%) patients, vitamin D supplements in 448 (49%), Ca supplements in 36 (4%), denosumab in 20 (2%) and teriparatide in 14 (2%), respectively. Of enrolled patients, any treatment for osteoporosis was not administered in 226 (25%) patients. In spite of more frequent bone damage in patients with CKD compared to those without CKD (15% vs 10%, p=0.036), treatment status did not differ between patients with and without CKD (bisphosphonate: 41% vs 46%, p=0.29; vitamin D supplements: 50% vs 44%, p=0.14).Conclusion:About a quarter of patients with SLE did not take any treatment for osteoporosis. Treatment for osteoporosis might be strengthened to prevent bone damage in SLE patients with CKD.Disclosure of Interests:KEN-EI SADA Speakers bureau: I received speaker’s fee from GSK and Astra Zeneca K.K., Keigo Hayashi: None declared, Yosuke ASANO: None declared, Yu Katayama: None declared, Sumie Hiramatsu Asano: None declared, Keiji Ohashi: None declared, Michiko Morishita: None declared, Haruki Watanabe: None declared, Mariko Narazaki: None declared, Yoshinori Matsumoto: None declared, Nobuyuki Yajima: None declared, Ryusuke Yoshimi: None declared, Yasuhiro Shimojima: None declared, Shigeru Ono: None declared, Hiroshi Kajiyama: None declared, Kunihiro Ichinose: None declared, Shuzo Sato: None declared, Michio Fujiwara: None declared, Jun Wada: None declared
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Sugimoto T, Hirata S, Kohno H, Watanabe H, Yoshida Y, Mokuda S, Sugiyama E. AB0612 SHORT-TERM REVERSIBLE IMPROVEMENT IN EARLY-PHASE ELEMENTS OF NAILFOLD CAPILLARY ABNORMALITIES IN PATIENTS WITH SYSTEMIC SCLEROSIS BY INTRAVENOUS CYCLOPHOSPHAMIDE (IVCY). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Nailfold capillary abnormalities are one of representative signs in systemic sclerosis (SSc). However, previous reports about changes in nailfold capillary by immunosuppressive therapy have been limited. Especially, there have been no reports about short-term changes in nailfold capillary abnormalities.Objectives:To clarify whether intravenous cyclophosphamide (IVCY) treatment for SSc patients can improve nailfold capillary abnormalities in half a year.Methods:Among patients diagnosed as having SSc according to the 2013 ACR/EULAR classification criteria at our hospital from May 2018 to December 2019, those who treated with IVCY for interstitial lung disease (ILD) were consecutively registered. All patients received IVCY six times. Nailfold capillary abnormalities on eight fingers including both second to the fifth fingers were observed with a nailfold videocapillaroscopy (NVC). Each finger was evaluated for enlarged capillary, giant capillaries, hemorrhage, loss of capillary, disorganization of the vascular array, and capillary ramification. Quantitative scoring was performed on a scale of 0 to 3 in accordance with the ratio of each of them. NVC tests were evaluated before IVCY treatment intervention and after IVCY. In all cases, the evaluation of NVC after IVCY treatment was performed 6 months after the administration day. Skin changes were evaluated by modified Rodnan’s total skin thickness score (mRSS) at performing NVC. Anti-centromere antibodies, anti-Scl-70 antibodies, anti-RNA polymerase III, and anti-RNP antibodies were measured. Pulmonary function tests (PFTs) including forced vital capacity (FVC) and diffusing capacity of the lung carbon monoxide (DLCO) were performed before and after IVCY. The statistical significance of the differences between means of two groups was evaluated by paired t-test. A p level of 0.05 or less was considered statistically significant.Results:Five patients were included. The mean age was 59 years and 4 patients were female (80%). High dose corticosteroids were used in 2 patients (40%). Anti-RNA polymerase III was positive in 2 patients (40%), anti-Scl-70 antibody was positive in 1 (20%), and negative test for any specific antibodies was in 2 (40%). Changes in NVC scores, which were total scores of 8 fingers, were as follows: Enlarged; 13.2±4.8 to 6.4±5.9 (p=0.018), Giant; 7.0±5.7 to 1.6±1.1 (p=0.0314), Hemorrhage; 8.4±6.2 to 3.2±2.3 (p=0.0274), Loss; 4.0±2.5 to 0.6±1.3 (p=0.0288), Disorganization; 0.6±0.9 to 1.0±1.0 (p=0.7065), Ramification; 0.6±0.9 to 0.8±1.8 (p=0.5730). (Table) After IVCY treatment, mRSS reduced in 4 cases (80%). Changes in mRSS scores were as follows: 18.8±8.3 to 12.4±13.3 (p=0.0677). The cases with improved mRSS and those with improved NVC findings were consistent. The mean FVC before and after IVCY was 2077 ml and 2062 ml, respectively. The mean DLCObefore and after IVCY was 9.88 mL/min/mmHg and 9.58 mL/min/mmHg, respectively.Conclusion:Nailfold capillary abnormalities in patients with SSc could be improved in half a year with IVCY. Especially, early phase elements including enlargement, giant, and hemorrhage were specifically reversible.Table.No.(E)(G)(H)(L)(D)(R)mRSS121→1416→319→70→00→20→014→9212→34→26→14→02→11→015→1314→118→26→27→00→00→410→5410→46→18→34→30→22→025→1259→01→03→35→01→00→030→35mean ± SD13.2±4.87.0±5.78.4±6.24.0±2.50.6±0.90.6±0.918.8±8.36.4±5.91.6±1.13.2±2.30.6±1.31.0±1.00.8±1.812.4±13.3p-value0.0180.03140.02740.02880.70650.57300.0677E: enlarged, G: giant, H: hemorrhage, L: loss, D: disorganization, R: ramification.The table shows the total of eight points for each finding in the NVC test. The previously described values are before treatment and the later values are after treatment.Disclosure of Interests:Tomohiro Sugimoto: None declared, Shintaro Hirata Grant/research support from: Eli Lilly, Consultant of: Bristol-Myers Squibb, UCB, Paid instructor for: AbbVie, Eisai, Tanabe-Mitsubishi, Speakers bureau: AbbVie, Eisai, Tanabe-Mitsubishi, Astellas, Ayumi, Bristol-Myers Squibb, UCB, Chugai, Eli Lilly, Janssen, Kissei, Sanofi, Takeda, Hiroki Kohno: None declared, Hirofumi Watanabe: None declared, Yusuke Yoshida Grant/research support from: Astellas, Paid instructor for: Astellas, Tanabe Mitsubishi, Sanofi, Novartis, GlaxoSmithKline, Eli Lilly, Bristol-Myers Squibb, Chugai, Asahikasei, Eisai, Janssen, Speakers bureau: Astellas, Tanabe Mitsubishi, Sanofi, Novartis, GlaxoSmithKline, Eli Lilly, Bristol-Myers Squibb, Chugai, Asahikasei, Sho Mokuda: None declared, Eiji Sugiyama Grant/research support from: AbbVie, Astellas, Ayumi, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Speakers bureau: AbbVie, Astellas, Ayumi, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Actelion
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Yoshida Y, Sugimoto T, Kohno H, Watanabe H, Mokuda S, Hirata S, Sugiyama E. AB0452 PREDICTIVE FACTORS FOR INSUFFICIENT RESPONSE TO INITIAL TREATMENT OR RECURRENCE IN PATIENTS WITH LUPUS ENTERITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Lupus enteritis (LE) is a rare but well-known complication of systemic lupus erythematosus (SLE). However, little knowledge about risk factors for insufficient response to initial treatment or recurrence have been reported.Objectives:To identify prognostic factors associated with poor response in patients with LE.Methods:Patients diagnosed as having LE at our hospital were consecutively registered from January 2009 to October 2019. The diagnosis of LE was made according to the criteria of BILAG 2004 which is defined as either vasculitis or inflammation of small or large bowel with supportive imaging and/or biopsy findings. Poor response was defined as insufficient response to initial therapy or relapse. We retrospectively compared clinical characteristics collected from medical records of the patients with good vs. poor response, using a non-parametric Wilcoxon signed-rank test for numerical variables and Fisher’s exact test for categorical variables.Results:A total of 12 patients (16 episodes) diagnosed with LE were reviewed. The median age was 44.5 years and 11 were females. Six patients had a history of SLE (median disease duration; 3.0 years), of which 4 had a history of LE prior to the study period. And in the remaining 6 patients, LE was the primary symptom (Table 1). The comorbidities were 4 lupus cystitis, 1 biopsy-proven lupus nephritis, 1 pseudo-obstruction and 1 protein-losing enteropathy. Computed Tomography (CT) imaging of all 16 episodes showed small bowel wall thickening. Dilatation of intestine was observed in 81.3%, ascites in 81.3%, comb sign in 80.0% and target sign in 62.5%. When comparing clinical characteristics between the groups revealed that CT findings were similar in both groups, however serum CH50 levels (median (interquartile ranges (IQR)) 37.2 (25.3-46.9) U/mL vs 17.6 (7.1-21.4) U/mL, p=0.0095) were significantly lower in poor response group. Furthermore, patients who initiated glucocorticoids (GCs) at a lower dose (less than or equal to 0.6mg/kg prednisolone equivalent dose (PEQ)) was significantly more frequent in poor response group (Table 2).Table 1.Baseline demographics and outcomes of LE patientsVariablesN=12DemographicsFemale (%)91.7Age (yrs), median (IQR)44.5 (34.0-47.5)SLE duration (yrs), median (IQR)3.0 (0-9.0)Baseline therapyPrednisolone (mg), median (IQR)7.0 (0-10.5)Cyclosporine (%)16.7Azathioprine (%)8.3Mycophenolate mofetil (%)8.3Tacrolimus (%)8.3OutcomesFollow-up period (yrs), median (IQR)4.0 (1.9-5.0)Poor response to initial therapy (%)33.3Recurrence (%)33.3Need for surgical intervention (%)8.3Death (%)0Table 2.Comparison of baseline characteristics and initial treatment between LE patients with good vs. poor responseVariablesGood response(N=10)Poor response(N=6)p valueComorbiditiesLupus cystitis (%)30.033.31.0Lupus nephritis (%)016.70.38CT findingsMaximum external diameterof small intestine (mm), median (IQR)30.8 (22.2-37.9)25.3 (19.4-29.0)0.083Colon involvement (%)30.066.70.30Dilatation of intestine (%)90.066.70.52Ascites (%)90.066.70.52Comb sign (%)90.066.70.52Target sign (%)70.050.00.61Laboratoryfindingsanti-dsDNA Ab (IU/mL), median (IQR)5.4 (1.6-12.6)10.1 (3.8-111.5)0.17CH50 (U/mL), median (IQR)37.2 (25.3-46.9)17.6 (7.1-21.4)0.0095C4 (mg/dL), median (IQR)16.0 (10.5-27.3)10.0 (10.0-13.8)0.11C3 (mg/dL), median (IQR)66.0 (56.8-79.8)46.5 (33.0-58.3)0.10Initial treatmentLess than or equal to 0.6mg/kg PEQ (%)10.066.70.036Intravenous cyclophosphamide10.016.71.0Conclusion:Lower level of CH50 and initial treatment with GCs at a lower dose were identified as prognostic factors associated with poor response to initial therapy or recurrence in LE.Disclosure of Interests: :Yusuke Yoshida Grant/research support from: Astellas, Paid instructor for: Astellas, Tanabe Mitsubishi, Sanofi, Novartis, GlaxoSmithKline, Eli Lilly, Bristol-Myers Squibb, Chugai, Asahikasei, Eisai, Janssen, Speakers bureau: Astellas, Tanabe Mitsubishi, Sanofi, Novartis, GlaxoSmithKline, Eli Lilly, Bristol-Myers Squibb, Chugai, Asahikasei, Tomohiro Sugimoto: None declared, Hiroki Kohno: None declared, Hirofumi Watanabe: None declared, Sho Mokuda: None declared, Shintaro Hirata Grant/research support from: Eli Lilly, Consultant of: Bristol-Myers Squibb, UCB, Paid instructor for: AbbVie, Eisai, Tanabe-Mitsubishi, Speakers bureau: AbbVie, Eisai, Tanabe-Mitsubishi, Astellas, Ayumi, Bristol-Myers Squibb, UCB, Chugai, Eli Lilly, Janssen, Kissei, Sanofi, Takeda, Eiji Sugiyama Grant/research support from: AbbVie, Astellas, Ayumi, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Speakers bureau: AbbVie, Astellas, Ayumi, Kissei, Pfizer, Sanofi, Takeda, Tanabe-Mitsubishi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Actelion
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Tanaka M, Ono T, Takeda T, Watanabe H, Muso E, Sasayama S. A Case of Candida Peritonitis Followed by Mediastinitis after Esophageal Perforation in a Peritoneal Dialysis Patient. Perit Dial Int 2020. [DOI: 10.1177/089686080102100315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fujii S, Watanabe H, Taga G. Wearable strain sensor suit for infants to measure limb movements under interaction with caregiver. Infant Behav Dev 2020; 58:101418. [PMID: 31935592 DOI: 10.1016/j.infbeh.2019.101418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/25/2019] [Accepted: 12/27/2019] [Indexed: 11/28/2022]
Abstract
Development of motion capture technology has enabled the measurement of body movements over long periods of time in daily life. Although accelerometers have been used as primary sensors, problems arise when they are used to measure the movements of infants. Because infants and caregivers interact frequently, accelerometer data from infants may be significantly distorted by a caregiver's movement. To overcome this problem, a strain sensor suit was developed for infants to measure flexion and extension movements of the limbs. A case study was performed to analyze the strain sensor data of an infant in relation to the accelerometer data of the infant's and a caregiver's body under various types of infant-caregiver interaction. The results demonstrated that the strain sensor data had low correlation with the accelerometer data of the infant and caregiver while the accelerometer data between infant and caregiver had higher correlation. This suggests that the strain sensor is suitable to detect limbs' angular displacements mostly independent from the translational body movements exerted by a caregiver.
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