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Nagata H, Kanou T, Fukui E, Kimura T, Ose N, Funaki S, Shintani Y. Native lung surgery after single lung transplantation: clinical characteristics and outcomes. Surg Today 2024:10.1007/s00595-024-02828-8. [PMID: 38662116 DOI: 10.1007/s00595-024-02828-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Single lung transplantation (SLT) is a viable option for patients with end-stage pulmonary parenchymal and vascular diseases. However, various diseases can occur in native lungs after SLT. METHODS Between January 2000 and December 2021, 35 patients underwent cadaveric SLT and survived for more than 30 days in our hospital. Among these 35 patients, 10 required surgery for diseases that developed in their native lungs. The clinical characteristics of these 10 patients and the outcomes of native lung surgery (NLS) were investigated. RESULTS Among these ten patients, the indications for lung transplantation were chronic obstructive pulmonary disease and idiopathic interstitial pneumonia in three patients each, and lymphangioleiomyomatosis and collagen vascular disease-related interstitial pneumoniain two patients each. The causes of NLS included pneumothorax (n = 4), primary lung cancer (n = 2), native lung hyperinflation (n = 2), and pulmonary aspergilloma (n = 2). The surgical procedures were pneumonectomy (n = 7), lobectomy (n = 2), and alveolar-pleural fistula repair (n = 1). Only one postoperative complication, empyema, was treated with antibiotics. The 5-year overall survival rates after transplantation with and without NLS were 70.0% and 80.0%, respectively, and did not differ to a statistically extent (p = 0.56). CONCLUSION NLS is an effective treatment option for diseases that develop in the native lungs after SLT.
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Affiliation(s)
- Hideki Nagata
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Kanzaki R, Nagoya A, Taniguchi S, Ishida H, Kimura K, Fukui E, Kimura T, Kanou T, Ose N, Funaki S, Minami M, Morii E, Shintani Y. Surgery for pulmonary lesions in patients with a history of urinary tract transitional cell carcinoma. J Cardiothorac Surg 2024; 19:117. [PMID: 38475921 DOI: 10.1186/s13019-024-02607-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND There has been little information on the actual diagnosis of pulmonary lesions in patients with a history of urinary tract transitional cell carcinoma (TCC) and short- and long- outcomes of pulmonary resection for these patients. METHODS In the present study, the data of 37 consecutive patients with a history of TCC who underwent pulmonary resection for solitary pulmonary lesions were reviewed, and the clinical factors and short- and long-term outcomes were analyzed. RESULTS The study population included 35 male patients, and 2 female patients. The mean age was 72.5 years. Twenty patients (80%) were smokers and showed a high incidence of chronic obstructive pulmonary disease. Pulmonary lesions and primary TCC were detected simultaneously in 5 patients and metachronously in 32 patients. The median interval between treatment for primary TCC and the detection of pulmonary lesion was 43 months. The mean tumor diameter was 23 mm. The types of resection included lobectomy (n = 19), segmentectomy (n = 8), and partial resection (n = 10). Twelve of 37 patients (32%) developed postoperative complications. The pathological diagnoses included primary lung cancer (n = 28), pulmonary metastasis from TCC (n = 7), and others (n = 2). The 5-year overall survival rate for all patients was 72%. The 5-year overall survival rate of patients with primary lung cancer was 74%, while that of patients with pulmonary metastasis from TCC was 57%. CONCLUSIONS Surgery can be proactively considered for treating pulmonary lesions in patients with a previous history of TCC, as it provides favorable long-term outcomes.
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Affiliation(s)
- Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan.
| | - Akihiro Nagoya
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Seiji Taniguchi
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Hiroto Ishida
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-City, Osaka, 565-0871, Japan
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3
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Miyashita Y, Kanou T, Fukui E, Matsui T, Kimura T, Ose N, Funaki S, Shintani Y. A Novel Peroxisome Proliferator-Activated Receptor Gamma/Nuclear Factor-Kappa B Activation Pathway is Involved in the Protective Effect of Adipose-Derived Mesenchymal Stem Cells Against Ischemia-Reperfusion Lung Injury. Transplant Proc 2024; 56:369-379. [PMID: 38320873 DOI: 10.1016/j.transproceed.2024.01.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/04/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Adipose-derived stem cells (ADSCs) are well-recognized for their remarkable ability to suppress ischemia-reperfusion lung injury (IRLI). The primary objective of this investigation was to elucidate the underlying mechanism through which ADSCs exert protective effects against IRLI. METHODS A warm hilar occlusion model in C57BL6J mice was used. Hilar occlusion was achieved for 1 hour (ischemic), and after 1 hour the occlusion was released (reperfusion) to recover for 3 hours. RNA sequencing, the physiological function, pathway activation, and expression of inflammatory cytokines were evaluated. RESULTS Lung gas exchange and pulmonary edema were significantly improved in the IRLI/ADSCs group compared with the IRLI group. RNA sequencing results suggested that the peroxisome proliferator-activated receptor gamma (PPARγ)/nuclear factor-kappa B (NF-κB) pathway was involved in the effect of the ADSCs. Administration of a PPARγ antagonist in the IRLI/ADSC group resulted in the deterioration of the physiological function. Furthermore, the PPARγ protein expression level decreased, the NF-κB protein expression level increased, and inflammatory cytokine parameters from lung tissue and blood sample worsened in the PPARγ antagonist-administered group. CONCLUSION Administration of ADSCs exerted a significant protective effect against IRLI in mice, and the effect is attributed to the activation of the PPARγ/NF-κB pathway.
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Affiliation(s)
- Yudai Miyashita
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takahiro Matsui
- Department of Pathology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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Watabe T, David IR, Kimura T, Hiroshima T, Tatsumi M, Naka S, Kamiya T, Fukui E, Kanou T, Ose N, Funaki S, Mori Y, Cardinale J, Kato H, Morii E, Shintani Y, Giesel FL. Epithelioid granuloma mimicking lung cancer showed intense uptake on [ 18F]FAPI-74 PET. Eur J Nucl Med Mol Imaging 2024; 51:930-931. [PMID: 37891330 PMCID: PMC10796733 DOI: 10.1007/s00259-023-06478-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023]
Affiliation(s)
- Tadashi Watabe
- Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
- Institute for Radiation Sciences, Osaka University, Toyonaka, Japan.
| | - Ivan Ray David
- Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Department of Nuclear Medicine, Jose R. Reyes Memorial Medical Center, Manila, Philippines
| | - Toru Kimura
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takashi Hiroshima
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Mitsuaki Tatsumi
- Institute for Radiation Sciences, Osaka University, Toyonaka, Japan
- Department of Radiology, Osaka University Hospital, Suita, Japan
| | - Sadahiro Naka
- Department of Pharmacy, Osaka University Hospital, Suita, Japan
| | - Takashi Kamiya
- Department of Radiology, Osaka University Hospital, Suita, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yuriko Mori
- Department of Nuclear Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Jens Cardinale
- Department of Nuclear Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Institute for Radiation Sciences, Osaka University, Toyonaka, Japan
| | - Eiichi Morii
- Department of Pathology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Frederik L Giesel
- Institute for Radiation Sciences, Osaka University, Toyonaka, Japan
- Department of Nuclear Medicine, University Hospital Duesseldorf, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
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Matsui Y, Kanou T, Fukui E, Kimura T, Ose N, Funaki S, Shintani Y. Association of the psoas muscle index with the survival of patients on a waiting list for lung transplantation: a Japanese single-institution study. Surg Today 2023:10.1007/s00595-023-02765-y. [PMID: 37982871 DOI: 10.1007/s00595-023-02765-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/24/2023] [Indexed: 11/21/2023]
Abstract
PURPOSES Some predictive markers of death have been reported for patients on the waiting list for lung transplantation (LTx). We assessed whether or not the preoperative psoas muscle index (PMI) correlates with waitlist mortality. METHODS In 81 patients with end-stage lung disease on the waiting list for LTx between 2011 and 2020 at Osaka University Hospital, we examined the association between baseline characteristics, including the diagnosis, respiratory function test results, blood collection items, steroid use, and psoas muscle mass on computed tomography, and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models. RESULTS Thirty-three patients (41%) died during follow-up. Univariate and multivariate analyses showed that patients with a low PMI had a higher rate of death during follow-up than those with a high PMI (p < 0.0001 and 0.0002, respectively). In addition, a diagnosis of interstitial pneumonia (hazard ratio 3.30, 95% confidence interval 1.52-7.17, p = 0.0025) and low albumin level (hazard ratio 2.21, 95% confidence interval 1.02-4.80, p = 0.0449) were also significant predictors of survival. CONCLUSION A low PMI at registration is associated with a decreased survival time among LTx candidates and it may be a predictive factor of mortality in patients waiting for LTx.
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Affiliation(s)
- Yuuki Matsui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan.
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-Shi, Osaka, 565-0871, Japan
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Watabe T, Ose N, Naka S, Fukui E, Kimura T, Kanou T, Funaki S, Sasaki H, Kamiya T, Kurimoto K, Isohashi K, Tatsumi M, Shimosegawa E, Kato H, Ohgaki R, Kanai Y, Shintani Y. Evaluation of LAT1 Expression in Patients With Lung Cancer and Mediastinal Tumors: 18F-FBPA PET Study With Immunohistological Comparison. Clin Nucl Med 2023; 48:853-860. [PMID: 37682600 DOI: 10.1097/rlu.0000000000004816] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
PURPOSE OF THE REPORT L-type amino acid transporter-1 (LAT1) is a tumor-specific transporter expressed in various tumor types, with minimal expression in normal organs. We previously demonstrated 18F-fluoro-borono-phenylalanine (18F-FBPA) as a selective PET probe for LAT1 in a preclinical study. Herein, we evaluated LAT1 expression in preoperative patients with lung or mediastinal tumors using 18F-FBPA PET and immunofluorescence staining. PATIENTS AND METHODS The study population included patients with histopathological diagnosis (n = 55): primary lung cancers (n = 21), lung metastases (n = 6), mediastinal tumors (n = 15), and benign lesion (n = 13). PET scanning was performed 1 hour after the injection of 18F-FBPA (232 ± 32 MBq). Immunofluorescence staining was performed on the resected tumor sections using LAT1 antibody. LAT1 staining was graded on a 4-grade scale and compared with the SUVmax on 18F-FBPA PET. RESULTS A positive correlation was observed between the SUVmax of 18F-FBPA PET and LAT1 expression by immunofluorescence staining (r = 0.611, P < 0.001). The SUVmax of 18F-FBPA was 3.92 ± 1.46 in grade 3, 3.21 ± 1.82 in grade 2, 2.33 ± 0.93 in grade 1, and 1.50 ± 0.39 in grade 0 of LAT1 expression. Although 18F-FBPA PET showed variable uptake in lung cancers and mediastinal tumors, benign lesions showed significantly lower SUVmax than those in malignant lesions (P < 0.01). CONCLUSIONS Uptake on 18F-FBPA PET reflected the expression level of LAT1 in lung and mediastinal tumors. It was suggested that 18F-FBPA PET can be used for the precise characterization of the tumor in pretreatment evaluation.
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Affiliation(s)
| | - Naoko Ose
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
| | | | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
| | - Toru Kimura
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
| | - Takashi Kanou
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
| | | | | | | | | | | | | | | | - Ryuichi Ohgaki
- Bio-system Pharmacology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshikatsu Kanai
- Bio-system Pharmacology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University
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Shintani Y, Funaki S, Kanou T, Ose N, Kimura T, Fukui E, Minami M, Miyagawa S. Integrated cardiothoracic team approach for complex lung transplantation procedures in Japan-current status and future direction. J Thorac Dis 2023; 15:5195-5203. [PMID: 37868882 PMCID: PMC10586956 DOI: 10.21037/jtd-22-1720] [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: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 10/24/2023]
Abstract
The first lung transplant procedure in the world was performed in 1983, while in Japan that was first accomplished in 1998. Over the following 25 years, lung transplantation has become a viable treatment option for Japanese patients with a variety of end-stage lung diseases. Seventy cadaveric-donor lung (41 single, 29 bilateral), 11 bilateral living-donor lobar lung, and three heart-lung transplants have been performed with use of an integrated cardiothoracic team approach at medical facilities associated with Osaka University. Extremely advanced clinical and surgical skill sets are required to complete a lung transplant procedure, including surgical knowledge and techniques, as well as management of cardiovascular surgery, especially in regard to mechanical circulatory support (MCS), vascular anastomosis in difficult cases, and concomitant cardiac surgery. We have found that a collaborative effort by general thoracic and cardiac surgeons is an important key for success with lung transplantation. Complex lung transplant surgery and management in Japan are performed by use of an integrated cardiothoracic team approach, which has led to a synergistic impact on successful lung transplantation cases by capitalizing greatly on the experiences, techniques, and expertise of cardiac and thoracic experts. The present review is focused on the role of cardiac surgeons from the viewpoint of our experience with these cases.
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Affiliation(s)
- Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Kobayashi M, Funaki S, Fukui E, Morii E, Shintani Y. A case of alpha-fetoprotein-positive thymic small cell carcinoma: a case report. Surg Case Rep 2023; 9:165. [PMID: 37721573 PMCID: PMC10506963 DOI: 10.1186/s40792-023-01750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND An alpha-fetoprotein (AFP)-positive neuroendocrine tumor of the thymus is a rare thoracic malignancy. Few cases of AFP-positive thymic large cell neuroendocrine carcinoma have been reported, with no known previous report of an AFP-positive thymic small cell carcinoma. We encountered a patient with an AFP-positive small cell carcinoma and report here the clinical course. CASE PRESENTATION A 40-year-old man was transferred to our hospital for a large anterior mediastinal tumor and showed an elevated serum AFP level. Computed tomography-guided biopsy results led to diagnosis of small cell carcinoma. Induction chemoradiotherapy was performed before surgery because of pulmonary artery invasion. The response to Induction chemoradiotherapy varied among sites, with the main tumor showing shrinkage and the metastasis site growth. This discrepancy suggested a histologic type unresponsive to or cancer cells potentially resistant to chemotherapy, thus a surgical re-biopsy was performed and histological findings revealed AFP-positive small cell carcinoma. Additional chemotherapy was performed, though could not control cancer progression, and the patient died 8 months after the first medical examination. CONCLUSIONS Our present clinical experience indicates the importance of histological examination for determining AFP-positive anterior mediastinal tumor treatment. Although AFP-positive neuroendocrine tumor of the thymus is relatively rarer than germ cell carcinoma, differential diagnosis with use of a histological examination should be considered because of the potentially poorer prognosis. The present clinical findings for an AFP-positive neuroendocrine tumor of the thymus case are considered useful for establishing an optimal treatment strategy in the future.
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Affiliation(s)
- Masao Kobayashi
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 L5, Suita city, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 L5, Suita city, Osaka, 565-0871, Japan.
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 L5, Suita city, Osaka, 565-0871, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, 2-2, Suita city, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 L5, Suita city, Osaka, 565-0871, Japan
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9
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Matsui Y, Kanou T, Matsui T, Fukui E, Kimura T, Ose N, Funaki S, Shintani Y. Protective Effect of Calpain Inhibition During Cold Ischemia on Ischemia-reperfusion Injury After Lung Transplantation. Transplantation 2023; 107:1945-1954. [PMID: 36648297 DOI: 10.1097/tp.0000000000004515] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Necroptosis, one of the types of regulated necrosis, causes ischemia-reperfusion (IR) lung injury. N-acetyl-leucyl-leucyl-norleucinal (ALLN), a calpain inhibitor, is known to attenuate necroptosis and apoptosis, and the purpose of this study was to evaluate the protective effect of ALLN during cold ischemia against IR injury in a rat lung transplant model. METHODS Male Lewis rats (250-350 g) were divided into 3 groups: sham group (n = 4), nontransplantation; control group (n = 8), transplantation with IR lung injury; and ALLN group (n = 8), transplantation with IR lung injury/ALLN. Rats in the sham group underwent a simple thoracotomy, and the remaining 2 groups of rats underwent an orthotopic left lung transplant. Cold ischemic time was 15 h. After 2 h of reperfusion, physiological function, inflammatory cytokine expression, pathway activation, and the degrees of necroptosis and apoptosis were evaluated. RESULTS Lung gas exchange (PaO 2 /FiO 2 ) was significantly better, and pulmonary edema was significantly improved in the ALLN group compared with the control group ( P = 0.0009, P = 0.0014). Plasma expression of interleukin-1β was significantly lower in the ALLN group than in the control group ( P = 0.0313). The proportion of necroptotic and apoptotic cells was significantly lower in the ALLN group than in the control group ( P = 0.0009), whereas the proportion of apoptotic cells remained unchanged ( P = 0.372); therefore, the calpain inhibitor was thought to suppress necroptosis. CONCLUSIONS The administration of ALLN during cold ischemia appears to improve IR lung injury in a lung transplant animal model via the inhibition of necroptosis.
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Affiliation(s)
- Yuuki Matsui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takahiro Matsui
- Department of Pathology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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Uchino T, Fukui E, Takubo Y, Iwai M, Katagiri N, Tsujino N, Imamura H, Fujii C, Tanaka K, Shimizu T, Nemoto T. Perceptions and attitudes of users and non-users of mental health services concerning mental illness and services in Japan. Front Psychiatry 2023; 14:1138866. [PMID: 37588026 PMCID: PMC10425963 DOI: 10.3389/fpsyt.2023.1138866] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/22/2023] [Indexed: 08/18/2023] Open
Abstract
Objectives There is a global movement to develop and implement community-based integrated mental health systems. The present study attempted to clarify the perceptions and attitudes of users and non-users of mental health services concerning mental illness and services in Japan. Methods A new questionnaire was developed for this internet survey. Data from 500 outpatients with depression and 500 healthy subjects were sampled according to the demographics of the Japanese population. Results Over 90% of healthy subjects and over 70% of patients were unaware of the common age of onset or lifetime prevalence of mental illness. Over 90% of the healthy subjects and about 70% of the patients could not describe any services where they would feel comfortable discussing mental health problems. In both groups, "adolescents and young adults" were ranked first as a target population for mental health and illness policies. The top requirement for the integrated care systems was the promotion and awareness of correct knowledge of mental illness in both the healthy subjects and patients. Conclusion Societal requirements could include disseminating correct knowledge, awareness-raising actions for society, and implementing services where people, especially young people, can easily consult and receive support in the community.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Tokyo, Japan
- Tokyo Adachi Hospital, Tokyo, Japan
- SODA Youth Mental Health Council, Tokyo, Japan
| | - Eriko Fukui
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- SODA Youth Mental Health Council, Tokyo, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Momoko Iwai
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- SODA Youth Mental Health Council, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- SODA Youth Mental Health Council, Tokyo, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Haruhiko Imamura
- Graduate School of Health and Nutrition Sciences, The University of Nagano, Nagano, Japan
| | - Chiyo Fujii
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kuniaki Tanaka
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- Tokyo Adachi Hospital, Tokyo, Japan
| | - Tetsuo Shimizu
- Akita Prefectural Mental Health and Welfare Center, Akita, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
- Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Tokyo, Japan
- SODA Youth Mental Health Council, Tokyo, Japan
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11
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Isono T, Iwahori K, Yanagawa M, Yamamoto Y, Tone M, Haruna M, Hirata M, Fukui E, Kimura T, Kanou T, Ose N, Funaki S, Takeda Y, Morii E, Kumanogoh A, Shintani Y, Wada H. T cell immunity in interstitial lung disease with non-small cell lung cancer patients. Lung Cancer 2023; 182:107278. [PMID: 37321075 DOI: 10.1016/j.lungcan.2023.107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/01/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Limited treatment options are available for non-small cell lung cancer (NSCLC) patients with interstitial lung disease (ILD). The rationale for immunotherapy and its adverse events for NSCLC with ILD remains unclear. In this study, we examined T cell profiles and functions in the lung tissues of NSCLC patients with or without ILD to provide evidence for the potential mechanism of immune checkpoint inhibitor (ICI)-related pneumonitis in NSCLC patients with ILD. MATERIAL AND METHODS We investigated T cell immunity in the lung tissues of NSCLC patients with ILD to support the application of immunotherapy for these patients. We analyzed T cell profiles and functions in surgically resected lung tissues from NSCLC patients with and without ILD. The T cell profiles of infiltrating cells in lung tissues were analyzed by flow cytometry. T cell functions were measured based on cytokine production by T cells stimulated with phorbol 12-myristate 13-acetate and ionomycin. RESULTS The percentages of CD4+ T cells expressing immune checkpoint molecules (Tim-3, ICOS, and 4-1BB), CD103+CD8+ T cells, and regulatory T (Treg) cells were higher in NSCLC patients with than in those without ILD. A functional analysis of T cells in lung tissues indicated that CD103+CD8+ T cells positively correlated with IFNγ production, whereas Treg cells negatively correlated with IFNγ and TNFα production. Cytokine production by CD4+ and CD8+ T cells did not significantly differ between NSCLC patients with and without ILD, except for TNFα production by CD4+ T cells being lower in the former than in the latter. CONCLUSION In NSCLC patients with ILD stable for surgery, T cells were active participants and balanced in part by Treg cells in lung tissues, suggesting the potential development of ICI-related pneumonitis in NSCLC patients with ILD.
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Affiliation(s)
- Tomomi Isono
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kota Iwahori
- Department of Clinical Research in Tumor Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan.
| | - Masahiro Yanagawa
- Department of Radiology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoko Yamamoto
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mari Tone
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Miya Haruna
- Department of Clinical Research in Tumor Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan; Biopharmaceutical Research Division, Shionogi & Co., Ltd., Osaka, Japan
| | - Michinari Hirata
- Department of Clinical Research in Tumor Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan; Biopharmaceutical Research Division, Shionogi & Co., Ltd., Osaka, Japan
| | - Eriko Fukui
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Toru Kimura
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Takashi Kanou
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoko Ose
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Soichiro Funaki
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yoshito Takeda
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Immunopathology, World Premier International Research Center Initiative (WPI), Immunology Frontier Research Center (IFReC), Osaka University, Osaka, Japan; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Osaka, Japan; Center for Infectious Diseases for Education and Research (CiDER), Osaka University, Osaka, Japan; Japan Agency for Medical Research and Development - Core Research for Evolutional Science and Technology (AMED-CREST), Osaka University, Osaka, Japan; Center for Advanced Modalities and DDS (CAMaD), Osaka University, Osaka, Japan
| | - Yasushi Shintani
- Department of Thoracic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hisashi Wada
- Department of Clinical Research in Tumor Immunology, Graduate School of Medicine, Osaka University, Osaka, Japan
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12
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Ose N, Funaki S, Kanou T, Kimura T, Fukui E, Morii E, Shintani Y. Significance of the Surgical Treatment with Lymph Node Dissection for Neuroendocrine Tumors of Thymus. Cancers (Basel) 2023; 15:cancers15082370. [PMID: 37190298 DOI: 10.3390/cancers15082370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/01/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Neuroendocrine tumors of a thymus (NETTs) are rare, accounting for approximately 2-5% of all thymic epithelial tumors, and have a poor prognosis due to frequent lymph nodes or distant metastasis. METHODS We retrospectively reviewed the clinicopathological background and outcomes of 40 patients who underwent resection or surgical biopsy with histologically diagnosed NETTs from 1986 to 2022. RESULTS The most common pathological type was atypical carcinoid. Surgical resection was performed in 35 patients, with lymph node dissection in 33 and surgical biopsy in five. The overall survival (OS) rate for all patients was 81.4% and 52.3% at 5 and 10 years, respectively. The 2-year survival rate was 20% for the biopsy group, which was significantly worse than that of the resected group (p < 0.001). The relapse-free survival rates were 61.7% and 37.6% at 5 and 10 years, respectively, in 34 patients with complete resection. The univariate analysis revealed better the OS rate in the resected cases but with no significant differences between histological grade, lymph node metastasis, tumor size, or Ki67 index. CONCLUSIONS Surgical complete resection is considered to improve prognosis regardless of histologic type. NETTs frequently develop lymph node metastasis, thus, lymph node dissection seems necessary for complete resection.
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Affiliation(s)
- Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan
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13
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Fukushima K, Matsumoto Y, Matsuki T, Saito H, Motooka D, Komukai S, Fukui E, Yamuchi J, Nitta T, Niitsu T, Abe Y, Nabeshima H, Nagahama Y, Nii T, Tsujino K, Miki K, Kitada S, Kumanogoh A, Akira S, Nakamura S, Kida H. MGIT-seq for the Identification of Nontuberculous Mycobacteria and Drug Resistance: a Prospective Study. J Clin Microbiol 2023; 61:e0162622. [PMID: 36946719 PMCID: PMC10117113 DOI: 10.1128/jcm.01626-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Because nontuberculous mycobacterial pulmonary disease is a considerable health burden, a simple and clinically applicable analytical protocol enabling the identification of subspecies and drug-resistant disease is required to determine the treatment strategy. We aimed to develop a simplified workflow consisting only of direct sequencing of mycobacterial growth indicator tube cultures (MGIT-seq). In total, 138 patients were prospectively enrolled between April 2021 and May 2022, and culture-positive MGIT broths were subjected to sequencing using MinION, a portable next-generation sequencer. Sequence analysis was conducted to identify species using core genome multilocus sequence typing and to predict macrolide and amikacin (AMK) resistance based on previously reported mutations in rrl, rrs, and erm(41). The results were compared to clinical tests for species identification and drug susceptibility. A total of 116 patients with positive MGIT cultures were included in the analysis. MGIT-seq yielded 99.1% accuracy in species-level identification and identified 98 isolates (84.5%) at the subspecies level. Macrolide and AMK resistance were detected in 19.4% and 1.9% of Mycobacterium avium complex (MAC) and Mycobacterium abscessus isolates. The predicted macrolide and AMK resistance was consistent with the results of conventional drug susceptibility tests, with specificities of 97.6% and 100.0%, respectively. Direct MGIT-seq has achieved comprehensive identification and drug resistance detection of nontuberculous mycobacteria, which could be applicable to determine the treatment strategy by a single test in clinical practice.
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Affiliation(s)
- Kiyoharu Fukushima
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Host Defense, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
- Laboratory of Host Defense, World Premier Institute Immunology Frontier Research Center (WPI-IFReC), Osaka University, Osaka, Japan
- Global Center for Medical Engineering and Informatics, Suita, Osaka, Japan
| | - Yuki Matsumoto
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases (RIMD), Osaka University, Suita, Osaka, Japan
| | - Takanori Matsuki
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
| | - Haruko Saito
- Department of Clinical Laboratory, National Hospital Organization, Osaka Toneyama Medical Centre, Toyonaka, Osaka, Japan
| | - Daisuke Motooka
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases (RIMD), Osaka University, Suita, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
| | - Sho Komukai
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
- Department of Biomedical Statistics, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - June Yamuchi
- Department of Clinical Laboratory, National Hospital Organization, Osaka Toneyama Medical Centre, Toyonaka, Osaka, Japan
| | - Tadayoshi Nitta
- Department of Clinical Laboratory, National Hospital Organization, Osaka Toneyama Medical Centre, Toyonaka, Osaka, Japan
| | - Takayuki Niitsu
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yuko Abe
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroshi Nabeshima
- Laboratory of Host Defense, World Premier Institute Immunology Frontier Research Center (WPI-IFReC), Osaka University, Osaka, Japan
| | - Yasuharu Nagahama
- Laboratory of Host Defense, World Premier Institute Immunology Frontier Research Center (WPI-IFReC), Osaka University, Osaka, Japan
| | - Takuro Nii
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
| | - Kazuyuki Tsujino
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
| | - Keisuke Miki
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
| | | | - Atsushi Kumanogoh
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
- Center for Infectious Disease Education and Research, Japan for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
| | - Shizuo Akira
- Department of Host Defense, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
- Laboratory of Host Defense, World Premier Institute Immunology Frontier Research Center (WPI-IFReC), Osaka University, Osaka, Japan
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases (RIMD), Osaka University, Suita, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan
- Center for Infectious Disease Education and Research, Japan for Infectious Disease Education and Research, Osaka University, Suita, Osaka, Japan
| | - Hiroshi Kida
- Department of Respiratory Medicine, National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Osaka, Japan
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14
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Ose N, Funaki S, Fukui E, Kanou T, Kimura T, Shintani Y. Experiences of broncho-pleural fistula after pulmonary resection in minimally invasive approach and open thoracotomy. Video-assist Thorac Surg 2023. [DOI: 10.21037/vats-22-43] [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: 03/29/2023]
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15
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Ose N, Funaki S, Kanou T, Kimura T, Fukui E, Shintani Y. [Ingenuities of Segmentectomy for Small Lung Cancer in Uniportal Video-assisted Thoracic Surgery]. Kyobu Geka 2023; 76:65-69. [PMID: 36731836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Our department has been performing uniportal thoracoscopic lobectomy since April 2019 and now also performs segmentectomy for small malignant tumors. A skin incision of approximately 4 cm is created between the anterior fifth intercostal space on the left and right sides. Based on our experience, uniportal segmentectomy does not follow the learning curve unique to segmentectomy. For dissection of segmental surface, an automatic suture is used to prevent pulmonary fistulas. If the cutting line between the segments is straight, dissection can be performed easily even in uniportal surgery, in which the automatic suturing device is inserted from one direction. For inter-area identification, we use an air-containing collapsed line with normal ventilation, after which thoracoscopic indocyanine green( ICG) imaging is introduced. However, there have been cases in which a difference in inter-area identification occurred between ICG identification and the air-containing collapsed line. As such, it is better to utilize both methods in cases with masses close to the inter-areas.
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Affiliation(s)
- Naoko Ose
- Department of General Thoracic Surgery, Osaka University, Suita, Japan
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16
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Funaki S, Ose N, Kimura T, Kanou T, Fukui E, Shintani Y. Clinicopathological analysis of a superior sulcus tumor treated by salvage surgery after concurrent definitive chemoradiotherapy followed by durvalumab: A case report. Thorac Cancer 2022; 13:3229-3232. [PMID: 36193676 PMCID: PMC9663671 DOI: 10.1111/1759-7714.14681] [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: 08/29/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023] Open
Abstract
Surgical treatment of superior sulcus tumors (SSTs) is clinically challenging. Definitive chemoradiotherapy (CRT) is a standard treatment for SST. In operable cases, multimodal therapy (CRT followed by surgery) is another option, at least for experienced institutions. Immune checkpoint inhibitors (ICIs) have recently been developed, and several clinical trials have investigated definitive CRT followed by ICIs for consolidation or maintenance therapy of unresectable local advanced non-small cell lung cancer (NSCLC), including SSTs. Clinical studies of salvage surgery after CRT followed by ICIs are also ongoing. However, the clinical outcomes of salvage surgery after multimodal therapies and histopathological analyses of surgical specimens after such treatments remain unclear. Here, we report the case of a patient with SST comprising squamous cell carcinoma with invasion of the second to third rib and vertebrae who underwent salvage surgery after concurrent definitive CRT followed by the ICI durvalumab, and show the results of clinicopathological analyses of the resected specimen.
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Affiliation(s)
- Soichiro Funaki
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Naoko Ose
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Toru Kimura
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Takashi Kanou
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Eriko Fukui
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
| | - Yasushi Shintani
- Department of General Thoracic SurgeryOsaka University Graduate School of MedicineOsakaJapan
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17
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Funaki S, Ose N, Kanou T, Fukui E, Kimura K, Minami M, Okumura M, Shintani Y. Prognostic Impact of Number of Organ Invasions in Patients with Surgically Resected Thymoma. Ann Surg Oncol 2022; 29:4900-4907. [PMID: 35397738 DOI: 10.1245/s10434-022-11698-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/02/2022] [Indexed: 11/19/2023]
Abstract
PURPOSE This study aimed to explore the clinical implications and prognostic value of the number of organ/structure invasions (NOI) in patients with thymoma after curative surgical resection. METHODS We retrospectively analyzed 306 consecutive Japanese patients with thymoma who underwent curative surgical resection. Tumor invasions of pericardium, mediastinal pleura, phrenic nerve, lung, and venous structures were examined histopathologically. Cases were classified into four subgroups according to NOI: group 0, no tumor invasion; group 1, tumor invasion into single organ/structure; group 2, tumor invasion of two organs/structures; group 3, invasion of three or more organs/structures. Associations with NOI and several clinical characteristics and their prognostic significance were analyzed. RESULTS Pleural invasion was found in 100 cases (32.7%), lung invasion in 48 cases (15.7%), pericardial invasion in 46 cases (15%), phrenic nerve invasion in 29 (9.5%), and venous invasion in 22 cases (7.2%). NOI was classed as group 0 in 201 cases (65.0%), group 1 in 42 cases (13.7%), group 2 in 20 cases (6.5%), and group 3 in 43 cases (14.1%). Cases with higher NOI showed significantly worse relapse-free survival (RFS) and overall survival (OS). Cox's proportional hazard model analysis also identified NOI as a prognostic factor affecting RFS and OS. CONCLUSIONS Cases with higher NOI of thymoma after radical surgical resection showed significantly worse recurrence rates and survival.
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Affiliation(s)
- Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Meinoshin Okumura
- General Thoracic Surgery, Osaka Toneyama Medical Center, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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18
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Nagoya A, Kanzaki R, Kimura K, Fukui E, Kanou T, Ose N, Funaki S, Minami M, Fujii M, Shintani Y. Utility of the surgical Apgar score for predicting the short- and long-term outcomes in non-small-cell lung cancer patients who undergo surgery. Interact Cardiovasc Thorac Surg 2022; 35:6595029. [PMID: 35640534 PMCID: PMC9297508 DOI: 10.1093/icvts/ivac150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/22/2022] [Revised: 04/14/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Akihiro Nagoya
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
| | - Makoto Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine , Suita, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine , Suita, Japan
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19
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Kanou T, Funaki S, Minami M, Ose N, Kimura T, Fukui E, Watabe T, Shintani Y. Usefulness of positron-emission tomography for predicting the World Health Organization grade of thymic epithelial tumors. Thorac Cancer 2022; 13:1651-1656. [PMID: 35460177 PMCID: PMC9161332 DOI: 10.1111/1759-7714.14434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background It is often difficult to distinguish between thymoma and thymic carcinoma by preoperative radiological tests. While there have been some reports that the maximum standardized uptake value (SUVmax) in positron emission tomography‐computed tomography (PET‐CT) is useful to this end, no large‐scale analysis has been performed. We therefore analyzed the usefulness of the SUVmax and tumor size (TS) for differentiating thymic epithelial tumors. Methods From 2011 to 2019, 129 patients with thymic epithelial tumor who underwent PET‐CT before surgical treatment were enrolled. The relevance of the SUVmax to the World Health Organization (WHO) histological type was assessed. To reduce the impact of the TS, the ratio of the SUVmax to the TS was also investigated. Results A total of 99 thymoma cases and 30 thymic carcinoma cases were enrolled into the study. The SUVmax and SUVmax/TS of thymic carcinoma were significantly higher than those of thymoma (SUVmax: 7.7 ± 3.4 vs. 3.3 ± 1.3, p < 0.01; SUVmax/TS: 1.5 ± 0.7 vs. 0.6 ± 0.4, p < 0.01). Focusing on the patients with a moderate SUVmax of ≤5 (84 thymoma and 4 thymic carcinoma), the SUVmax/TS values of thymic carcinoma were still significantly higher than those of thymoma (1.6 ± 0.8 vs. 0.6 ± 0.4, p < 0.01). Conclusions PET‐CT might provide significant information for differentiating images of thymoma and thymic carcinoma. We experienced several cases of thymic carcinoma with a moderate SUVmax of ≤5, and SUVmax/TS was considered a useful parameter for differentiating such cases.
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Affiliation(s)
- Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Watabe
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Funaki S, Ose N, Kanou T, Fukui E, Kimura K, Minami M, Okumura M, Shintani Y. ASO Visual Abstract: Prognostic Impact of the Number of Organ Invasions in Patients with Surgically Resected Thymoma. Ann Surg Oncol 2022. [PMID: 35416557 DOI: 10.1245/s10434-022-11708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Meinoshin Okumura
- General Thoracic Surgery, Osaka Toneyama Medical Center, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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21
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Kanou T, Minami M, Funaki S, Fukui E, Oose N, Shintani Y. [Surveillance Bronchoscopy after Lung Transplantation]. Kyobu Geka 2022; 75:273-277. [PMID: 35342157] [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: 06/14/2023]
Abstract
Acute cellular rejection( ACR) is one of the major complications of the acute phase after lung transplantation. In addition, ACR is considered to be a major cause of chronic lung allograft dysfunction (CLAD). Therefore, the diagnosis and treatment for ACR are major issues at transplantation facilities. Surveillance bronchoscopy( SB) is performed at many institutions as the golden standard for ACR diagnosis, and our hospital also implements long-term post-transplant monitoring of ACR as a preventive measure for CLAD. However, the suitability of SB may be questioned due to the risk of complications such as bleeding and pneumothorax. Here, we would like to report the results of SB in our department and discuss future diagnosis and treatment policy for ACR.
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Affiliation(s)
- Takashi Kanou
- Department of Thoracic Surgery, Osaka University, Suita, Japan
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Miyashita Y, Kanou T, Ishida H, Fukui E, Ose N, Funaki S, Minami M, Sato Y, Yanagawa M, Shintani Y. Prognostic impact of tumor volume in patients with complete resection of thymoma. Thorac Cancer 2022; 13:1021-1026. [PMID: 35166441 PMCID: PMC8977177 DOI: 10.1111/1759-7714.14353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
Background The impact of tumor volume on prognosis is unclear. We therefore investigated the correlation between tumor volume and prognosis in patients with complete resection of thymoma. Methods A total of 177 patients who underwent curative surgical resection for thymoma were retrospectively collected and reviewed. We performed a volumetric analysis of each case using the modified version of “Watchin GGO” and evaluated the relationship between tumor volume and recurrence. Results The median tumor size was 5.0 (range 0.5–15) cm, and the median tumor volume was 35.1 (range 0.265–881.0) cm3. The Pearson product–moment correlation coefficient was 0.658, suggesting a moderately strong connection between tumor volume and tumor size. To determine the impact of tumor volume on tumor recurrence, receiver operating characteristic curves of the recurrence and tumor volume were calculated. The area under the curve was 0.65 (95% confidence interval [CI]: 0.51–0.80), and the optimal cutoff level of the tumor volume for recurrence was 82.6 cm3, with a sensitivity and specificity of 0.64 (11/17) and 0.74 (119/160), respectively. Patients with tumors ≥82.6 cm3 had a significantly worse recurrence‐free survival than those with smaller tumors (p = 0.0122, hazard ratio: 2.99), with 5‐year recurrence rates of 74.9% (95% CI: 58.6%–86.3%) versus 88.9% (95% CI: 79.0%–94.4%). Conclusion The volume of completely resectable thymoma may be a useful prognostic indicator.
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Affiliation(s)
- Yudai Miyashita
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroto Ishida
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukihisa Sato
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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Yamato H, Kimura K, Fukui E, Kanou T, Ose N, Funaki S, Minami M, Shintani Y. Periostin secreted by activated fibroblasts in idiopathic pulmonary fibrosis promotes tumorigenesis of non-small cell lung cancer. Sci Rep 2021; 11:21114. [PMID: 34702952 PMCID: PMC8548404 DOI: 10.1038/s41598-021-00717-5] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/12/2021] [Indexed: 12/20/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) patients with idiopathic pulmonary fibrosis (IPF) show poor prognosis. Periostin is an extracellular matrix protein highly expressed in the lung tissues of IPF. This study aimed to investigate the possibility that periostin secreted by fibroblasts derived from IPF lung might affect proliferation of NSCLC cells. Periostin was more highly expressed and secreted by fibroblasts from diseased human lung with IPF (DIPF) than by normal human lung fibroblasts (NHLF). Cocultivation of NSCLC cells with conditioned media (CM) from DIPF increased proliferation of NSCLC cells through pErk signaling, with this proliferation attenuated by periostin-neutralizing antibodies. Knockdown of integrin β3, a subunit of the periostin receptor, in NSCLC cells suppressed proliferation of NSCLC cells promoted by recombinant human periostin and CM of DIPF. On in vivo examination, DIPF promoted tumor progression more than NHLF, and knockdown of integrin β3 in NSCLC cells suppressed tumor progression promoted by DIPF. Fibroblasts derived from surgical specimens from IPF patients also increased secretion of periostin compared to those from non-IPF patients. Periostin secreted from IPF-activated fibroblasts plays critical roles in the proliferation of NSCLC cells. The present study provides a solid basis for considering periostin-targeted therapy for NSCLC patients with IPF.
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Affiliation(s)
- Hiroyuki Yamato
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Ose N, Kawagishi S, Funaki S, Kanou T, Fukui E, Kimura K, Minami M, Shintani Y. Thymic Lymphoepithelial Carcinoma Associated with Epstein-Barr Virus: Experiences and Literature Review. Cancers (Basel) 2021; 13:4794. [PMID: 34638279 PMCID: PMC8507618 DOI: 10.3390/cancers13194794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/07/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
Thymic lymphoepithelial carcinoma (TLEC) is a primary thymic carcinoma that accounts for about 14% of all thymic epithelial tumors and is classified into 14 types. The histological morphology is similar to lymphoepithelioma, a type of undifferentiated nasopharyngeal carcinoma. It has been reported that squamous carcinoma accounts for approximately 80% of thymic carcinoma, followed by TLEC, which accounts for 6%. TLEC has been reported to be associated with Epstein-Barr virus (EBV), with EBV infection in TLEC tumor cells first noted by Lyvraz et al. in 1985. Tumors shown to be EBV-positive are classified as TLEC if lymphoplasmacytic infiltration is lacking. However, only about 50% of the cases are positive for EBV, which is lower compared to nasopharyngeal lymphoepithelioma. Instances of EBV infection in other types of thymic epithelial tumor have been reported at lower rates, which suggests that EBV infection may have an important influence on the carcinogenesis of TLEC, though the etiology is unknown. TLEC is a highly malignant tumor with poor prognosis, as affected patients have a median survival time of 22 months, according to 58 cases from the literature, while the 5-year survival rate is 34.4%. Presently, prognosis is not considered to be affected by the presence or absence of EBV positivity.
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Affiliation(s)
- Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Sachi Kawagishi
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka-shi 541-8567, Osaka, Japan;
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan; (S.F.); (T.K.); (E.F.); (K.K.); (M.M.); (Y.S.)
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25
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Kuno H, Akagi T, Fukui E, Yamato H, Akashi M, Shintani Y. Three-Dimensional Idiopathic Pulmonary Fibrosis Model Using a Layer-by-Layer Cell Coating Technique. Tissue Eng Part C Methods 2021; 27:378-390. [PMID: 34074128 DOI: 10.1089/ten.tec.2020.0365] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a severe health problem characterized by progressive fibroblast proliferation and aberrant vascular remodeling. However, the lack of a suitable in vitro model that replicates cell-specific changes in IPF tissue is a crucial issue. Three-dimensional (3D) cell cultures allow the mimicking of cell-specific functions, facilitating development of novel antifibrosis drugs. We have established a layer-by-layer (LbL) cell coating technique that enables the construction of 3D tissue and also vascularized 3D tissue. This study evaluated whether this technique is beneficial for constructing an in vitro IPF-3D model using human lung fibroblasts and microvascular endothelial cells. We fabricated an in vitro IPF-3D model to provide IPF-derived fibroblasts-specific function and aberrant microvascular structure using the LbL cell coating technique. We also found that this in vitro IPF-3D model showed drug responsiveness to two antifibrosis drugs that have recently been approved worldwide. This in vitro IPF-3D model constructed by a LbL cell coating technique would help in the understanding of fibroblast function and the microvascular environment in IPF and could also be used to predict the efficacy of novel antifibrosis drugs. Impact statement We established a novel in vitro model mimicking idiopathic pulmonary fibrosis. Three-dimensional culture was constructed by layer-by-layer cell coating technique. This novel model provides a visualization of fibroblast-specific function. This assay allows for the assessment of pulmonary microvascular environment. Our model may be useful for predicting the efficacy of novel antifibrosis drugs.
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Affiliation(s)
- Hidenori Kuno
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takami Akagi
- Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hiroyuki Yamato
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Mitsuru Akashi
- Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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Kanou T, Minami M, Funaki S, Ose N, Fukui E, Kimura K, Shintani Y. Importance of the preoperative prognostic nutritional index score as a predictor of chronic lung allograft dysfunction after lung transplantation: a Japanese single-institution study. Surg Today 2021; 51:1946-1952. [PMID: 33839934 DOI: 10.1007/s00595-021-02285-7] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/21/2021] [Indexed: 11/29/2022]
Abstract
PURPOSES Numerous indicators have been discussed as predictive markers for the incidence of chronic allograft dysfunction (CLAD) after lung transplantation (LTX). The aim of this study was to evaluate whether or not the preoperative prognostic nutrition index (PNI) correlated with the development of CLAD. METHOD This study is a single-center and retrospective cohort study. Forty-six patients underwent cadaveric lung transplantation between 2000 and 2016 at our institution. The primary endpoint of this study was the CLAD-free survival of the patients. RESULT CLAD was diagnosed in 11 patients (23%) during the follow-up period. Potential risk factors included recipient factors, donor factors, number of HLA mismatches, operation-related factors, and preoperative blood test results, including the preoperative PNI. The patients with a higher PNI showed a longer CLAD-free survival after LTX than those with lower values according to univariate and multivariate analyses (p = 0.01, 0.04, respectively). The 5-year CLAD-free survival rates in the higher-PNI patients and lower-PNI patients were 94% and 62%, respectively. CONCLUSION We found that a lower preoperative PNI of the recipient was significantly associated with a higher incidence rate of CLAD. The preoperative PNI may, therefore, be useful as a predictor of the development of CLAD.
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Affiliation(s)
- Takashi Kanou
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan.
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University, Osaka, 565-0871, Japan
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Kanzaki R, Fukui E, Kanou T, Ose N, Funaki S, Minami M, Shintani Y, Okumura M. Preoperative evaluation and indications for pulmonary metastasectomy. J Thorac Dis 2021; 13:2590-2602. [PMID: 34012607 PMCID: PMC8107542 DOI: 10.21037/jtd-19-3791] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM.
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Affiliation(s)
- Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Meinoshin Okumura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Japan
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Shintani Y, Funaki S, Miyashita Y, Ose N, Kanou T, Fukui E, Minami M. Role of tumor reduction surgery in multimodality therapy for advanced thymoma—case series. J Vis Surg 2021. [DOI: 10.21037/jovs-21-59] [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: 11/06/2022]
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Abstract
A thymoma is a common anterior thymus mediastinal tumor composed of atypical epithelial tumor cells, though the morbidity rate is lower as compared to other types of thoracic malignancy such as lung cancer and lung metastasis from another primary cancer. As a result, clinical data regarding thymomas have not been well discussed as compared to those of other carcinomas. Also, because of the low morbidity rate and insufficient clinical experience, oncological characteristics and clinical treatment options are poorly understood. Surgical complete resection is the most reliable option for clinical treatment of a thymoma. This tumor can easily develop adjacent to several different structures and nearby organs, such as the pericardium, lungs, and great vessels, which are easily invaded when the size is large, and a combined resection is then needed. When en bloc resection is considered to be difficult based on evaluation with preoperative modalities, induction chemotherapy followed by surgery is recommended. Moreover, when pleural dissemination is revealed during pre- or peri-operative procedures, volume reduction surgery has been reported by several groups to extend prognosis. On the other hand, in cases with a small-sized tumor, a minimally invasive surgical procedure, such as video-assisted thoracic surgery (VATS) or robotic-assisted thoracic surgery (RATS), is usually selected. Because of the wide variety of cases with thymoma, a deliberate strategy and skillful techniques are necessary for effectual surgical treatment. In this review, we discuss strategies that have been shown to be effective for treating patients with early and advanced thymoma, including those with involved adjacent organs.
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Affiliation(s)
- Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Meinoshin Okumura
- General Thoracic Surgery, Osaka Toneyama Medical Center, Osaka, Japan
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Kanou T, Minami M, Wada N, Funaki S, Ose N, Fukui E, Shintani Y. Usefulness of a preoperative inflammatory marker as a predictor of asymptomatic acute rejection after lung transplantation: a Japanese single-institution study. J Thorac Dis 2020; 12:4754-4761. [PMID: 33145048 PMCID: PMC7578460 DOI: 10.21037/jtd-20-1325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background Surveillance bronchoscopy (SB) is performed as routine follow-up after lung transplantation (LTx), primarily for the early detection of clinically asymptomatic acute rejection (AR). To identify appropriate candidates for SB over a long period, we explored risk factors of asymptomatic AR after LTx. Method This study is a single-center and retrospective cohort study. Forty-five patients underwent cadaveric LTx between 2000 and 2016 in our institution. All enrolled patients had at least three months of follow-up. SB is scheduled at 1, 2, 3, 6, and 12 months after LTx routinely and annually thereafter until 5 years after LTx. A histological assessment for AR was performed according to the International Society for Heart and Lung Transplantation (ISHLT) criteria. The analysis of potential risk factors for AR was performed using a chi-square test and logistic regression analysis. Results The median period of follow-up after LTx for the entire cohort was 64 months. Asymptomatic AR (grade A1-A3) was detected in 22 patients, 14 of whom showed severe AR (worse than grade A2). The percentage of patients with AR was 5–24% at each time point, and 15% of patients still showed severe AR (A2 and A3) at 24 months after LTx. Potential risk factors included recipient factors (diagnosis, age, gender, BMI), donor factors (age, gender, smoking history, cause of brain death), HLA mismatch, operation-related factors, neutrophil-to-leucocyte ratio (NLR), platelet-to-leucocyte ratio (PLR), and other scores. Patients with a higher NLR showed a higher incidence of AR after LTx than others during follow-up (P=0.01). Conclusions An increased perioperative NLR was significantly associated with a higher odds ratio of AR during follow-up. Patients with a high NLR seem to be good candidates for long-term SB.
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Affiliation(s)
- Takashi Kanou
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
| | - Naoki Wada
- Department of Diagnostic Pathology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University, Osaka, Japan
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31
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Fujiwara A, Funaki S, Fukui E, Kimura K, Kanou T, Ose N, Minami M, Shintani Y. Effects of pirfenidone targeting the tumor microenvironment and tumor-stroma interaction as a novel treatment for non-small cell lung cancer. Sci Rep 2020; 10:10900. [PMID: 32616870 PMCID: PMC7331721 DOI: 10.1038/s41598-020-67904-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 07/29/2019] [Accepted: 06/17/2020] [Indexed: 02/06/2023] Open
Abstract
Targeting cancer-associated fibroblasts (CAFs), as well as the crosstalk between stroma and cancer cells, could be of value in managing cancers. Pirfenidone (PFD) is an anti-fibrotic agent for idiopathic pulmonary fibrosis. This study aimed to investigate the possibility that PFD might exert an anti-tumor effect through inhibition of fibroblast activation and the tumor-stroma interaction in non-small cell lung cancer (NSCLC) cell lines in vitro and in vivo. PFD significantly inhibited myofibroblast differentiation and activation of both primary cultured normal human lung fibroblasts and CAFs. Cocultivation of NSCLC cells with conditioned media (CM) of fibroblasts changed the morphology or epithelial to mesenchymal transition (EMT) status, and PFD suppressed these changes. Cocultivation of CAFs with CM of NSCLC cells also induced activation of CAFs, and these changes were suppressed by PFD. On in vivo examination, CAFs promoted tumor progression, and PFD suppressed tumor progression with an inhibitory effect on tumor-stroma crosstalk. PFD might inhibit not only fibroblast activity, but also the crosstalk between cancer cells and fibroblasts. PFD may have great potential as a novel treatment for NSCLC from multiple perspectives.
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Affiliation(s)
- Ayako Fujiwara
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kenji Kimura
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Momozane T, Fukui E, Funaki S, Fujii M, Kinehara Y, Ito E, Miyagawa S, Ohno Y, Sawa Y, Okumura M, Shintani Y. Efficient Differentiation of Mouse Induced Pluripotent Stem Cells into Alveolar Epithelium Type II with a BRD4 Inhibitor. Stem Cells Int 2019; 2019:1271682. [PMID: 31949433 PMCID: PMC6948319 DOI: 10.1155/2019/1271682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 04/01/2019] [Revised: 11/05/2019] [Accepted: 11/19/2019] [Indexed: 01/10/2023] Open
Abstract
Regenerative medicine has continued to progress for lung biology and lung diseases. Efforts have focused on a variety of different applications for pluripotent stem cells. Several groups have reported successful methods for inducing differentiation of induced pluripotent stem cells (iPSCs) into the airway epithelium such as alveolar epithelium type II (ATII). However, differentiation efficiency varies among reports and improvements are needed. In the present paper, we propose a novel method for elimination of residual undifferentiated murine iPSCs using JQ1, a potent inhibitor of bromodomain (BRD) and extraterminal domain (BET) family proteins, for efficient differentiation into ATII. First, the murine iPSC line 20D-17 was induced to differentiate into ATII over a period of 26 days (days 0-26) using previously reported embryoid body seeding and stepwise differentiation methods. mRNA expressions of differentiation markers including surfactant protein C (Sftpc) were confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) results, and 17% of the cells were shown positive for prosurfactant protein C (proSPC) in flow cytometry analysis. Next, those cells were cultured three-dimensionally in Matrigel for an additional 14 days (days 26-40), during which JQ1 was added for 4 days (days 28-32) to remove residual undifferentiated iPSCs. As a result, on day 40, the mRNA expression level of Sftpc in the three-dimensional culture was maintained at the same level as on day 26 and shown to be further increased by the addition of JQ1, with 39% of the cells found to express proSPC, showing that differentiation efficiency could be further increased. Three-dimensional culture with BRD4 inhibition by JQ1 improved the differentiation induction efficiency to ATII by removing residual undifferentiated murine iPSCs during the differentiation induction process.
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Affiliation(s)
- Toru Momozane
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makoto Fujii
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuhei Kinehara
- Department of Respiratory Medicine and Clinical Immunology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Emiko Ito
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuko Ohno
- Department of Mathematical Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiki Sawa
- Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Meinoshin Okumura
- Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Shintani Y, Funaki S, Ose N, Kanou T, Fukui E, Minami M. Preoperative variables for predicting prolonged air leak following pulmonary resection. J Thorac Dis 2019; 11:S1891-S1893. [PMID: 31632777 DOI: 10.21037/jtd.2019.08.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan
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Ose N, Minami M, Funaki S, Kanou T, Fukui E, Morii E, Shintani Y. Late-Onset Central Nervous System Posttransplant Lymphoproliferative Disorder After Lung Transplantation:A Case Report. Transplant Proc 2019; 51:3163-3166. [PMID: 31619339 DOI: 10.1016/j.transproceed.2019.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 07/28/2019] [Indexed: 11/26/2022]
Abstract
Posttransplant lymphoproliferative disorder (PTLD) is caused by uncontrolled proliferation of lymphoid cells after a hematopoietic stem cell or solid organ transplant procedure related to the Epstein-Barr virus (EBV) infection. A primary central nervous system (CNS) PTLD (CNS-PTLD) is rare and important to distinguish from an intracranial lesion after transplantation. A 66-year-old man with pulmonary arterial hypertension who underwent living-donor lung transplantation 9 years prior noticed disorientation regarding route and dates. Brain magnetic resonance imaging revealed multiple white matter lesions and fluorodeoxyglucose (FDG) positron emission tomography showed FDG uptake in the brain and skin. CNS-PTLD was diagnosed by craniotomy biopsy and EBV-encoded RNA was positive in in situ hybridization findings and elevated in brain tissue. The treatment was started with immunosuppressant reduction and whole brain radiotherapy. But the condition progressed rapidly over 2 months after the first symptom and the patient was passed away 25 days after hospitalization. CNS-PTLD can occur several years after transplantation and it is necessary to keep in mind to distinguish brain disease because early diagnosis and treatment are important.
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Affiliation(s)
- Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiichi Morii
- Department of Pathology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Hasegawa S, Yamamoto H, Hashimoto M, Fukui E, Suzuki K, Sato Y, Endo S, Chida M. IBS06.03 Japanese Data. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Shintani Y, Funaki S, Ose N, Kanou T, Fukui E, Kimura K. P1.15-07 Combined Aortic Arch Resection for Thymic Cancer Using Total Rerouting of Supra-Arch Vessels. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Affiliation(s)
- Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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Funaki S, Shintani Y, Fukui E, Yamamoto Y, Kanzaki R, Ose N, Kanou T, Minami M, Mori E, Okumura M. The prognostic impact of programmed cell death 1 and its ligand and the correlation with epithelial-mesenchymal transition in thymic carcinoma. Cancer Med 2019; 8:216-226. [PMID: 30600651 PMCID: PMC6346217 DOI: 10.1002/cam4.1943] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 09/07/2018] [Revised: 11/18/2018] [Accepted: 12/03/2018] [Indexed: 12/14/2022] Open
Abstract
Background The significance of epithelial‐mesenchymal transition (EMT) and immune checkpoint proteins in thymic carcinoma remains unknown. We examined the clinical significance of EMT, tumor‐infiltrating lymphocytes expressing the immune checkpoint protein, programmed cell death 1 (PD‐1 + TILs), and the expression of PD‐1 ligand 1 (PD‐L1) in thymic carcinoma (TC). We also investigated the relationships between these immune checkpoint proteins and the EMT status and examined the impact of induction chemotherapy on patients with tumors that express these proteins. Methods The relationship between PD‐1 + TILs/PD‐L1 and clinicopathological findings including EMT was investigated by immunohistochemistry (IHC) of surgically resected samples from 43 patients with TC. In 15 patients receiving induction therapy (IT), those factors were compared before and after IT. Results With IHC, 26 cases (60.5%) were positive for PD‐L1, and 19 cases were positive for PD‐1 + TILs (44.2%). The disease‐free survival rate in patients showing EMT and who were PD‐1/PD‐L1 positive was significantly worse compared to negative cases (EMT; P = 0.0095, PD‐1; P = 0.001, PD‐L1; P = 0.0037). We found a significant relationship between PD‐L1 and EMT status (P = 0.01). In patients who received IT, PD‐L1 increased, and the change was strongly correlated with EMT status (P = 0.01). Conclusion Epithelial‐mesenchymal transition, PD‐L1, and PD‐1 + TILs have prognostic impact, and PD‐L1 is correlated with EMT status. PD‐L1 expression after IT was significantly higher compared to before IT and was correlated with the EMT change. Thus, PD‐L1 may be upregulated during EMT, and anti‐PD‐1/PD‐L1 immunotherapy may provide reliable treatment of TC in combination with chemotherapy.
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Affiliation(s)
- Soichiro Funaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Yoko Yamamoto
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Takashi Kanou
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Masato Minami
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Eiichi Mori
- Department of Pathology, Osaka University Graduate School of Medicine, Suita-city, Japan
| | - Meinoshin Okumura
- General Thoracic Surgery, Toneyama National Hospital, Toneyama, Japan
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Fujiwara A, Shintani Y, Funaki S, Kawamura T, Kanzaki R, Fukui E, Minami M, Okumura M. P1.02-068 Effects of Pirfenidone Targeting EMT and Tumor-Stroma Interaction as Novel Treatment for Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Funaki S, Shintani Y, Fukui E, Kawamura T, Kimura T, Kanzaki R, Minami M, Okumura M. The regulation of PD-L1 in non small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw362.17] [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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Kadota Y, Fukui E, Kitahara N, Okura E, Ohta M. Total pleural covering technique for intractable pneumothorax in patient with Ehlers-Danlos syndrome. Gen Thorac Cardiovasc Surg 2014; 64:425-8. [PMID: 25512090 DOI: 10.1007/s11748-014-0504-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 10/15/2014] [Accepted: 12/02/2014] [Indexed: 11/26/2022]
Abstract
We report a patient with vascular-type Ehlers-Danlos syndrome (vEDS) who developed pneumothorax and was treated with a total pleural covering technique (TPC). A 24-year-old man developed repeat pneumothorax with intermittent hemo-sputum. Based on unusual radiological manifestations of lung lesions and physical findings, EDS was suspected as an underlying cause of the pneumothorax. Surgical treatment was performed using a mediastinal fat pad and TPC, and no relapse was seen up to 2 years after surgery. TPC is a less invasive surgical approach for selected patients with vEDS. Accurate underlying diagnosis of vEDS and systemic evaluation of vascular complications are necessary before planning surgery.
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Affiliation(s)
- Yoshihisa Kadota
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino, Osaka, Japan.
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino, Osaka, Japan
| | - Naoto Kitahara
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino, Osaka, Japan
| | - Eiji Okura
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino, Osaka, Japan
| | - Mitsunori Ohta
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino, Osaka, Japan
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Ohta M, Okura E, Fukui E, Kitahara N, Kadota Y. Simple technique for reconstruction of superior vena cava and brachiocephalic vein after removal for thoracic malignancies. Ann Thorac Surg 2014; 97:2171-3. [PMID: 24882297 DOI: 10.1016/j.athoracsur.2013.07.082] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 06/30/2013] [Accepted: 07/09/2013] [Indexed: 11/18/2022]
Abstract
A ringed polytetrafluoroethylene graft was applied to reduce clamping time for a patent major vein. In case 1, after suturing the ringed graft to the right appendage, the other end was inserted in the distal direction of the left brachiocephalic vein and secured by ligation. In case 2, to repair an extensive superior vena cava defect, the graft was wrapped with the remnant venous wall and fixed with a continuous suture. Only 5 minutes were required to reconstruct the left brachiocephalic vein and 20 minutes for the superior vena cava. Long-term graft patency was obtained without thrombosis.
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Affiliation(s)
- Mitsunori Ohta
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan.
| | - Eiji Okura
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | - Eriko Fukui
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | - Naoto Kitahara
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
| | - Yoshihisa Kadota
- Department of General Thoracic Surgery, Osaka Prefectural Medical Center for Respiratory and Allergic Disease, Osaka, Japan
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Hatano S, Yamashita T, Hayami N, Fukui E, Murakawa Y, Omata M, Nakazawa K, Nobuoka S, Miyake F, Murayama M. Time- and subunit-dependent differential mRNA expression of L-type Ca2+ channel during progression of right ventricular hypertrophy. Jpn Heart J 2001; 42:617-25. [PMID: 11804303 DOI: 10.1536/jhj.42.617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To clarify the molecular basis for changes in L-type calcium channel (VLCC) density in ventricular hypertrophy, we analyzed the mRNA expression of all the subunits including the main subunit alpha1c and auxiliary subunits (alpha2delta, beta2 and beta3) composing VLCC in rat right ventricular hypertrophy (RVH) induced by monocrotaline injection. To test the hypothesis that the expression of each subunit might change differently during progression of RVH, leading to an altered electrophysiologic outcome for VLCC, we investigated the ratio of the mRNA level of each auxiliary subunit to the main subunit. After monocrotaline injection, alpha1c mRNA showed a transient decrease on the 14th day and thereafter significantly increased to reach approximately 1.8 fold that of the control level on the 21st day. The auxiliary subunit alpha2delta mRNA showed a pattern similar to that of alpha1c. The beta3 mRNA increased rapidly after monocrotaline injection and increased approximately 4.1 fold. On the other hand, beta2 mRNA showed no significant changes. Accordingly, only the mRNA ratio of beta3 to alpha1c showed a significant increase among the auxiliary subunits after the monocrotaline injection. The ratio increased to a maximum of approximately 5.7 fold on the 14th day and thereafter decreased. These results suggest that VLCC density may be modified not only by alpha1c but also by its auxiliary subunit expression in ventricular hypertrophy, and provide a clue for understanding the controversial electrophysiologic results on VLCC density in hypertrophied hearts.
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Affiliation(s)
- S Hatano
- Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Fukui E, Miyamura N, Yoneyama T, Kobayashi M. Drug release from and mechanical properties of press-coated tablets with hydroxypropylmethylcellulose acetate succinate and plasticizers in the outer shell. Int J Pharm 2001; 217:33-43. [PMID: 11292540 DOI: 10.1016/s0378-5173(01)00578-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dissolution profiles of diltiazem hydrochloride (DIL) contained in core tablets from press-coated (PC) tablets with hydroxypropylmethylcellulose acetate succinate (HPMCAS) and plasticizers-adsorbent in the outer shell were investigated. Although, on the addition of triethyl citrate (TEC), triacetin (TA), and acetyltriethy citrate (ATEC) as plasticizers, DIL release was suppressed completely in first fluid (pH 1.2) for 10 h, it was not suppressed in HPMCAS on the addition of dibutyl sebacate (DBS) and acetylated monoglyceride. On the other hand, DIL in second fluid (pH 6.8) was released rapidly after a lag time in all the PC tablets. Water-soluble plasticizers such as TEC, TA, and ATEC showed greater compatibility to HPMCAS, and the results were consistent with suppression of DIL release in first fluid. Furthermore, as to PC tablets with HPMCAS and TEC-adsorbent, the DIL release in second fluid did not change after pretreatment in first fluid by the paddle-beads methods. To evaluate the resistance of the outer shell against such a mechanical impact, tablets with HPMCAS, HPMCAS and TEC- or DBS-adsorbent (H, HT, or HD tablets, respectively) were prepared. In compressive load-strain curves after immersion in first fluid, wet crushing strength was lower in the order of HT > H > HD tablets. Also, the curves of HT tablets at 3 and 21 h after immersion were quite different from those of other tablets, and it was hard to find crushing points. These results suggested that the resistance of the outer shell was due to plastic deformation properties involving some interaction between HPMCAS and TEC.
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Affiliation(s)
- E Fukui
- Product & Technology Development Laboratory, Tanabe Seiyaku Co., Ltd., 16-89 Kashima-3-chome, Yodogawa-ku, 532-0085, Osaka, Japan.
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Fukui E, Miyamura N, Kobayashi M. Effect of magnesium stearate or calcium stearate as additives on dissolution profiles of diltiazem hydrochloride from press-coated tablets with hydroxypropylmethylcellulose acetate succinate in the outer shell. Int J Pharm 2001; 216:137-46. [PMID: 11274815 DOI: 10.1016/s0378-5173(01)00580-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Effect of magnesium stearate (MgSt) or calcium stearate (CaSt) on the dissolution profiles of diltiazem hydrochloride in the core of press-coated (PC) tablets with an outer shell composed of hydroxypropylmethylcellulose acetate succinate (HPMCAS) was evaluated by porosity and changes in IR spectra of tablets. In JP first fluid (pH 1.2), the lag time increased with decreasing porosity and was greatest by the addition of MgSt to HPMCAS. While, in JP second fluid (pH 6.8), it increased with decreasing porosity by the addition of CaSt, but hardly changed by the addition of MgSt. Thus, using tablets prepared with the same composition as the outer shell, the changes in IR spectra and uptake amount of the dissolution media after immersion in first fluid and second fluid were determined. The results suggested that some physicochemical interaction occur between MgSt and HPMCAS in tablets with HPMCAS and MgSt and the uptake increased markedly in each dissolution medium. These phenomena seem to cause a prolongation of lag time in first fluid but a shortening of it in second fluid in PC tablets with HPMCAS and MgSt. In contrast, CaSt and HPMCAS did not show such interactions and increased the hydrophobic properties of the outer shell. Consequently, the lag time was only slightly prolonged in first fluid, however, markedly prolonged in second fluid due to suppression of second fluid penetration into micro pores in the outer shell and HPMCAS gel formation on the surface in PC tablets with HPMCAS and CaSt.
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Affiliation(s)
- E Fukui
- Product & Technology Development Laboratory, Tanabe Seiyaku Co., Ltd., 16-89 Kashima-3-chome, Yodogawa-ku, Osaka 532-0085, Japan.
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Fukui E, Miyamura N, Kobayashi M. An in vitro investigation of the suitability of press-coated tablets with hydroxypropylmethylcellulose acetate succinate (HPMCAS) and hydrophobic additives in the outer shell for colon targeting. J Control Release 2001; 70:97-107. [PMID: 11166411 DOI: 10.1016/s0168-3659(00)00332-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To develop a new colon targeting formulation, which can suppress drug release completely during 12 h in the stomach and release the drug rapidly after a lag time of 3+/-1 h in the small intestine, the use of press-coated tablets with hydroxypropylmethylcellulose acetate succinate (HPMCAS) in the outer shell was investigated. The release of diltiazem hydrochloride (DIL) as a model drug contained in the core tablets in the 1st fluid (pH 1.2) was suppressed by preparing with higher compression force, but the lag time in the 2nd fluid (pH 6.8) could not exceed 1.5 h. Therefore, to improve the dissolution characteristics, the effects of addition of various hydrophobic additives to HPMCAS were examined. All of the additives examined suppressed the release rate in the 1st fluid, and prolonged the lag time in the 2nd fluid compared to HPMCAS alone. However, although none of the additives examined fulfilled all of the desired criteria, magnesium stearate (MgSt) and calcium stearate (CaSt) showed interesting effects; the former suppressed drug release completely in 1st fluid, while the latter markedly prolonged the lag time in 2nd fluid. To integrate the merits of each additive, press-coated tablets with a powder mixture of HPMCAS, MgSt and CaSt in the outer shell (HMC tablets) were prepared and in vitro tests were performed. The results indicated that HMC tablets with a mixing ratio of 80% HPMCAS, 5-15% MgSt and 15-5% CaSt in the outer shell met the desired criteria and the lag time in 2nd fluid could also be controlled from 2 to 9 h. At a mixing ratio of 80% HPMCAS, 10% MgSt and 10% CaSt, the dissolution profiles of DIL in 1st fluid and 2nd fluid were not remarkably affected by agitation intensity, and addition of bile salts, pretreatment time or anticipated higher pH except for pH 6.0, respectively. These results indicated the usefulness of HMC tablets with the desirable functions for colon-targeting formulations.
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Affiliation(s)
- E Fukui
- Product & Technology Development Laboratory, Tanabe Seiyaku Co. Ltd., 16-89 Kashima-3-chome, Yodogawa-ku, Osaka 532-0085, Japan.
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Fukui E, Yamashita T, Sezaki K, Ajiki K, Inoue M, Hayami N, Kasaoka Y, Omata M, Murakawa Y, Nagai R. Overdrive suppression of antegrade conduction over the accessory pathway. Jpn Heart J 2000; 41:767-72. [PMID: 11232994 DOI: 10.1536/jhj.41.767] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In a patient with Wolff-Parkinson-White syndrome whose accessory pathway was primarily capable of bidirectional conduction, antegrade conduction over the accessory pathway was transiently inhibited after rapid atrial or ventricular pacing or after spontaneous termination of atrioventricular reentrant tachycardia. Pacing rate and duration of tachycardia were related to the duration of the suppression of preexcitation, while the coupling interval of the first sinus beat to the last driven or tachycardia beat was irrelevant to the phenomenon. Thus, overdrive suppression of conduction may be the most likely mechanism of this phenomenon.
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Affiliation(s)
- E Fukui
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Japan
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Murakawa Y, Yamashita T, Ajiki K, Suzuki J, Hayami N, Fukui E, Kasaoka Y, Omata M, Nagai R. Is the QT interval an indicator of autonomic state? Jpn Heart J 2000; 41:713-21. [PMID: 11232988 DOI: 10.1536/jhj.41.713] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Prolonged QT interval is suggested to indicate an increased risk of sudden cardiac death in certain clinical conditions such as diabetes mellitus. We investigated whether the individual QT interval is an indicator of an autonomic state. An ambulatory 24-hour ECG was recorded in 53 subjects from different clinical backgrounds. Power spectral components of heart rate variability (HRV) and the QT interval were regressively obtained at a heart rate of 60, 70, 80, 90, or 100 beats per minutes (bpm). Log values of the high-frequency component of HRV (HF: 0.15-0.50 Hz, a scale of cardiac parasympathetic tone) failed to show a relationship with the QT interval. In contrast, the QT interval at a heart rate of 90 bpm and 100 bpm showed a significant correlation with the log values of the low-frequency component (LF: 0.04-0.15 Hz) and the log[LF/HF], i.e., a putative scale of sympathetic tone (100 bpm: QT vs logLF: r = 0.414, p < 0.005, QT vs log[LF/HF]: 0.416, p < 0.002). Also, attenuated rate-dependent QT shortening was associated with greater logLF and log[LF / HF] values at a heart rate of 80, 90, or 100 bpm. These results suggest that the QT interval at a moderate heart rate (approximately 90-100 / min) and the degree of rate-dependent QT shortening are related to individual sympathetic tone.
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Affiliation(s)
- Y Murakawa
- Department of Cardiovascular Medicine, University of Tokyo, Japan
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