1
|
Go LOP, Abdellatif MM, Makino R, Shimoyama D, Higashi S, Hirano H, Nomura K. Synthesis of Network Biobased Aliphatic Polyesters Exhibiting Better Tensile Properties than the Linear Polymers by ADMET Polymerization in the Presence of Glycerol Tris(undec-10-enoate). Polymers (Basel) 2024; 16:468. [PMID: 38399846 PMCID: PMC10891964 DOI: 10.3390/polym16040468] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
Development of biobased aliphatic polyesters with better mechanical (tensile) properties in film has attracted considerable attention. This report presents the synthesis of soluble network biobased aliphatic polyesters by acyclic diene metathesis (ADMET) polymerization of bis(undec-10-enyl)isosorbide diester [M1, dianhydro-D-glucityl bis(undec-10-enoate)] in the presence of a tri-arm crosslinker [CL, glycerol tris(undec-10-enoate)] using a ruthenium-carbene catalyst, and subsequent olefin hydrogenation using RhCl(PPh3)3. The resultant polymers, after hydrogenation (expressed as HCP1) and prepared in the presence of 1.0 mol% CL, showed better tensile properties than the linear polymer (HP1) with similar molecular weight [tensile strength (elongation at break): 20.8 MPa (282%) in HP1 vs. 35.4 MPa (572%) in HCP1]. It turned out that the polymer films prepared by the addition of CL during the polymerization (expressed as a 2-step approach) showed better tensile properties. The resultant polymer film also shows better tensile properties than the conventional polyolefins such as linear high density polyethylene, polypropylene, and low density polyethylene.
Collapse
Affiliation(s)
- Lance O’Hari P. Go
- Department of Chemistry, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan; (L.O.P.G.); (M.M.A.)
| | - Mohamed Mehawed Abdellatif
- Department of Chemistry, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan; (L.O.P.G.); (M.M.A.)
| | - Ryoji Makino
- Department of Chemistry, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan; (L.O.P.G.); (M.M.A.)
| | - Daisuke Shimoyama
- Department of Chemistry, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan; (L.O.P.G.); (M.M.A.)
| | - Seiji Higashi
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan; (S.H.)
| | - Hiroshi Hirano
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan; (S.H.)
| | - Kotohiro Nomura
- Department of Chemistry, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan; (L.O.P.G.); (M.M.A.)
| |
Collapse
|
2
|
Kojima M, Wang X, Go LO, Makino R, Matsumoto Y, Shimoyama D, Abdellatif MM, Kadota J, Higashi S, Hirano H, Nomura K. Synthesis of High Molecular Weight Biobased Aliphatic Polyesters Exhibiting Tensile Properties Beyond Polyethylene. ACS Macro Lett 2023; 12:1403-1408. [PMID: 37793171 PMCID: PMC10586459 DOI: 10.1021/acsmacrolett.3c00481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/13/2023] [Indexed: 10/06/2023]
Abstract
Synthesis of high molecular weight polyesters prepared by acyclic diene metathesis (ADMET) polymerization of bis(undec-10-enoate) with isosorbide (M1), isomannide (M2), and 1,3-propanediol (M3) and the subsequent hydrogenation have been achieved by using a molybdenum-alkylidene catalyst. The resultant polymers (P1) prepared by the ADMET polymerization of M1 (in toluene at 25 °C) possessed high Mn values (Mn = 44400-49400 g/mol), and no significant differences in the Mn values and the PDI (Mw/Mn) values were observed in the samples after the hydrogenation. Both the tensile strength and the elongation at break in the hydrogenated polymers from M1 (HP1) increased upon increasing the molar mass, and the sample with an Mn value of 48200 exhibited better tensile properties (tensile strength of 39.7 MPa, elongation at break of 436%) than conventional polyethylene, polypropylene, as well as polyester containing C18 alkyl chains. The tensile properties were affected by the diol segment employed, whereas HP2 showed a similar property to HP1.
Collapse
Affiliation(s)
- Mika Kojima
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Xiuxiu Wang
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Lance O’Hari
P. Go
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Ryoji Makino
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Yuichi Matsumoto
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Daisuke Shimoyama
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Mohamed Mehawed Abdellatif
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Joji Kadota
- Osaka
Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Seiji Higashi
- Osaka
Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Hiroshi Hirano
- Osaka
Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Kotohiro Nomura
- Department
of Chemistry, Tokyo Metropolitan University, 1-1 minami Osawa, Hachioji, Tokyo 192-0397, Japan
| |
Collapse
|
3
|
Okimura A, Hirano H, Ito Y, Kajiwara N, Nakatsugawa M. Primary Lung Adenocarcinoma With ALK Gene Rearrangement Mostly Occupied by the Signet-Ring Cell Carcinoma Component: A Case Report. Cureus 2023; 15:e45068. [PMID: 37842503 PMCID: PMC10568040 DOI: 10.7759/cureus.45068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
Primary lung carcinoma tumors possessing a signet-ring cell carcinoma (SRCC) component at varying proportions are rare, while those primarily composed of an SRCC component are much rarer. Reported here is a case of primary lung adenocarcinoma primarily composed of an SRCC component with a scant acinar component that developed in an 81-year-old male. Approximately 95% of the adenocarcinoma was occupied by an SRCC component that was shown to be diastase-resistant based on positive periodic acid-Schiff staining. Immunostaining for ALK and fluorescence in situ hybridization analysis (break-apart assay) showed the presence of an ALK gene rearrangement. Findings in this case indicated a primary lung adenocarcinoma with ALK gene rearrangement, in which an SRCC component accounted for approximately 95% of the tumor.
Collapse
Affiliation(s)
- Akira Okimura
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, JPN
| | - Hiroshi Hirano
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, JPN
| | - Yumika Ito
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, JPN
| | - Naohiro Kajiwara
- Thoracic Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, JPN
| | - Munehide Nakatsugawa
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, JPN
| |
Collapse
|
4
|
Amaya K, Okimura A, Hirano H, Wakiya M, Ito Y, Yamada K, Nakatsugawa M. Myxofibrosarcoma of the Breast: A Case Report. Cureus 2023; 15:e39046. [PMID: 37378143 PMCID: PMC10292088 DOI: 10.7759/cureus.39046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/29/2023] Open
Abstract
Development of a myxofibrosarcoma in the breast tissue is extremely rare. Reported here is a case of myxofibrosarcoma found in the left breast tissue of a male in his late fifties. The patient first underwent tumor resection, followed by a left mastectomy with the reconstruction of the vastus lateralis valve. The tumor comprised atypical spindle-shaped cells in a myxoid matrix with elongated blood vessels. Myxofibrosarcoma was diagnosed based on histology and immunohistochemical examination results performed for differential diagnosis. At two years and two months after the mastectomy, no local occurrence or metastasis had occurred.
Collapse
Affiliation(s)
- Keigo Amaya
- Breast Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Akira Okimura
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Hiroshi Hirano
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Midori Wakiya
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Yumika Ito
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Kimito Yamada
- Breast Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| | - Munehide Nakatsugawa
- Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, JPN
| |
Collapse
|
5
|
Shui Y, Hu X, Hirano H, Tsukamoto H, Guo WZ, Hasumi K, Ijima F, Fujino M, Li XK. Combined phospholipids adjuvant augments anti-tumor immune responses through activated tumor-associated dendritic cells. Neoplasia 2023; 39:100893. [PMID: 36893559 PMCID: PMC10018555 DOI: 10.1016/j.neo.2023.100893] [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: 11/24/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023]
Abstract
Dendritic cells (DCs) can initiate both naïve and memory T cell activation, as the most potent antigen-presenting cells. For efficient anti-tumor immunity, it is essential to enhance the anti-tumoral activity of tumor-associated DCs (TADCs) or to potently restrain TADCs so that they remain immuno-stimulating cells. Combined phospholipids (cPLs) adjuvant may act through the activation of DCs. This study demonstrated the potential mechanism of tumor growth inhibition of cPLs adjuvant, and confirmed that cPLs adjuvant could induce the maturation and activation (upregulation of MHC-II, CD80, CD40, IL-1β, IL-12, IL-6 expression) of BMDCs in vitro. Then we isolated tumor infiltrating lymphocytes (TILs) from solid tumor and analyzed the phenotype and cytokines of TILs. The examination of the TILs revealed that cPLs adjuvant upregulated the expression of co-stimulatory molecules (MHC-II, CD86), phosphatidylserine (PS) receptor (TIM-4) on TADCs and enhanced the cytotoxic effect (CD107a), as well as pro-inflammatory cytokine production (IFN-γ, TNF-α, IL-2) by the tumor-resident T cells. Taken together, cPLs adjuvant may be an immune-potentiating adjuvant for cancer immunotherapy. This reagent may lead to the development of new approaches in DC-targeted cancer immunotherapy.
Collapse
Affiliation(s)
- Yifang Shui
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Xin Hu
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiroshi Hirano
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hirotake Tsukamoto
- Department of Immunology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Division of Clinical Immunology and Cancer Immunotherapy, Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Japan
| | - Wen-Zhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | | | - Masayuki Fujino
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Management Department of Biosafety, Laboratory Animal, and Pathogen Bank, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Xiao-Kang Li
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
| |
Collapse
|
6
|
Hu X, Shui Y, Hirano H, Kusano K, Guo WZ, Fujino M, Li XK. PD-L1 antibody enhanced β-glucan antitumor effects via blockade of the immune checkpoints in a melanoma model. Cancer Immunol Immunother 2023; 72:719-731. [PMID: 36053290 DOI: 10.1007/s00262-022-03276-4] [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: 06/19/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
Abstract
In the tumor microenvironment (TME), one of the major functions of tumor-recruited CD11b+ cells are the suppression of the T-cell-mediated anti-tumor immune response. β-glucan could convert the phenotype of tumor-recruited CD11b+ cells from the suppressive to the promotive, and enhanced their anti-tumor effects. However, β-glucan could enhance the PD-1/PD-L1 expression on CD11b+ cells, while PD-1 could inhibit macrophage phagocytosis and PD-L1 could induce a co-inhibitory signal in T-cells and lead to T-cell apoptosis and anergy. These protumor effects may be reversed by PD-1/PD-L1 block therapy. In the present study, we focused on the efficacy of β-glucan anti-tumor therapy combined with anti-PD-L1 mAb treatment, and the mechanism of their synergistic effects could be fully verified. We verified the effect of β-glucan (i.e., inflammatory cytokine secretion of TNF-α, IL-12, IL-6, IL-1β and the expression of immune checkpoint PD-1/PD-L1) in naïve mouse peritoneal exudate CD11b+ cells. In our mouse melanoma model, treatment with a PD-L1 blocking antibody with β-glucan synergized tumor regression. After treatment with β-glucan and anti-PD-L1 mAb antibody, tumor infiltrating leukocyte (TILs) not only showed a competent T-cell function (CD107a, perforin, IL-2, IFN-γ and Ki67) and CTL population, but also showed enhanced tumor-recruited CD11b+ cell activity (IL-12, IL-6, IL-1β and PD-1). This effect was also verified in the peritoneal exudate CD11b+ cells of tumor-bearing mice. PD-1/PD-L1 blockade therapy enhanced the β-glucan antitumor effects via the blockade of tumor-recruited CD11b+ cell immune checkpoints in the melanoma model.
Collapse
Affiliation(s)
- Xin Hu
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yifang Shui
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hiroshi Hirano
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | | | - Wen-Zhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Masayuki Fujino
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Laboratory Animal, and Pathogen Bank, Management Department of Biosafety, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
| | - Xiao-Kang Li
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| |
Collapse
|
7
|
Tao K, Yamada K, Higashi S, Kago K, Kuwashiro S, Hirano H, Takeshita H, Tokumitsu K. Effect of molding history on molecular orientation relaxation during physical aging of polystyrene injection moldings. INT POLYM PROC 2023. [DOI: 10.1515/ipp-2022-4264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Abstract
This work examined the effect of changing molding conditions on the physical aging of polystyrene injection moldings. First, we investigated the relationship between the molecular orientation and the molding conditions. The molecular orientation near the surface changed with changing injection rate, so we hypothesized that this molecular orientation might form during the filling stage. Because this molecular orientation did not relax under heat treatment below the glass transition temperature (T
g), the oriented molecules near the surface were thought to be elongated owing to the high strain rate during the filling stage. On the other hand, the molecular orientation in the core layer changed with changing holding pressure and relaxed under heat treatment below T
g. Thus, the molecules in the core layer might become oriented during the holding stage and not be elongated owing to the slow strain rate. Furthermore, the molecular orientation in the core layer decreased with increasing mold temperature, and the physical heat resistance improved with increasing mold temperature. Meanwhile, the excess enthalpy did not change with changing molding conditions. Therefore, the improvement in physical heat resistance with increasing mold temperature was likely caused by the decrease in the molecular orientation in the core layer. Analyzing the relaxation behavior of the molecular orientation suggested that increasing mold temperature reduced the number of oriented molecules with large deformation in the core layer.
Collapse
Affiliation(s)
- Kousaku Tao
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
- Department of Material Science , School of Engineering, University of Shiga Prefecture , Hikone-city , Japan
| | - Koji Yamada
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
| | - Seiji Higashi
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
| | - Keitaro Kago
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
| | - Shiho Kuwashiro
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
| | - Hiroshi Hirano
- Osaka Research Institute of Industrial Science and Technology , Osaka-city , Japan
| | - Hiroki Takeshita
- Department of Material Science , School of Engineering, University of Shiga Prefecture , Hikone-city , Japan
| | - Katsuhisa Tokumitsu
- Department of Material Science , School of Engineering, University of Shiga Prefecture , Hikone-city , Japan
| |
Collapse
|
8
|
Guo L, Makino R, Shimoyama D, Kadota J, Hirano H, Nomura K. Synthesis of Ethylene/Isoprene Copolymers Containing Cyclopentane/Cyclohexane Units as Unique Elastomers by Half-Titanocene Catalysts. Macromolecules 2023. [DOI: 10.1021/acs.macromol.2c02399] [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: 01/20/2023]
Affiliation(s)
- Lijuan Guo
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Ryoji Makino
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Daisuke Shimoyama
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Joji Kadota
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Hiroshi Hirano
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Kotohiro Nomura
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| |
Collapse
|
9
|
Kasahara K, Katsumata K, Saito A, Ishizaki T, Enomoto M, Mazaki J, Tago T, Nagakawa Y, Matsubayashi J, Nagao T, Hirano H, Kuroda M, Tsuchida A. Artificial intelligence predicts lymph node metastasis or risk of lymph node metastasis in T1 colorectal cancer. Int J Clin Oncol 2022; 27:1570-1579. [PMID: 35908272 DOI: 10.1007/s10147-022-02209-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The treatment strategies for colorectal cancer (CRC) must ensure a radical cure of cancer and prevent over/under treatment. Biopsy specimens used for the definitive diagnosis of T1 CRC were analyzed using artificial intelligence (AI) to construct a risk index for lymph node metastasis. METHODS A total of 146 T1 CRC cases were analyzed. The specimens for analysis were mainly biopsy specimens, and in the absence of biopsy specimens, the mucosal layer of the surgical specimens was analyzed. The pathology slides for each case were digitally imaged, and the morphological features of cancer cell nuclei were extracted from the tissue images. First, statistical methods were used to analyze how well these features could predict lymph node metastasis risk. A lymph node metastasis risk model using AI was created based on these morphological features, and accuracy in test cases was verified. RESULTS Each developed model could predict lymph node metastasis risk with a > 90% accuracy in each region of interest of the training cases. Lymph node metastasis risk was predicted with 81.8-86.3% accuracy for randomly validated cases, using a learning model with biopsy data. Moreover, no case with lymph node metastasis or lymph node risk was judged to have no risk using the same model. CONCLUSIONS AI models suggest an association between biopsy specimens and lymph node metastases in T1 CRC and may contribute to increased accuracy of preoperative diagnosis.
Collapse
Affiliation(s)
- Kenta Kasahara
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Kenji Katsumata
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akira Saito
- Department of AI Applied Quantitative Clinical Science, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tetsuo Ishizaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Masanobu Enomoto
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Junichi Mazaki
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Tomoya Tago
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yuichi Nagakawa
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Jun Matsubayashi
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroshi Hirano
- Diagnostic Pathology Division, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, 193-0998, Tokyo, Japan
| | - Masahiko Kuroda
- Department of Molecular Pathology, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Akihiko Tsuchida
- Department of Digestive and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishi Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
10
|
Amari Y, Morimoto S, Teranishi T, Ohata M, Takeshita A, Hirano H, Kobayashi H. Case report of a Japanese patient with chronic renal failure who developed
SARS‐CoV
‐2 in a hospital cluster during treatment for acute respiratory failure: An autopsy report. Clin Case Rep 2022; 10:e6024. [PMID: 35846939 PMCID: PMC9272203 DOI: 10.1002/ccr3.6024] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Yoshifumi Amari
- Department of Nephrology Moriguchi Keijinkai Hospital Osaka Japan
| | - Satoshi Morimoto
- Department of Endocrinology and Hypertension Tokyo Women's Medical University Tokyo Japan
| | - Takashi Teranishi
- Department of General Medicine Moriguchi Keijinkai Hospital Osaka Japan
| | - Mai Ohata
- Department of Pathology and Laboratory Medicine Moriguchi Keijinkai Hospital Osaka Japan
| | - Atsushi Takeshita
- Department of Pathology and Laboratory Medicine Moriguchi Keijinkai Hospital Osaka Japan
| | - Hiroshi Hirano
- Department of Pathology and Laboratory Medicine Nozaki Tokushukai Hospital Osaka Japan
| | - Hitoshi Kobayashi
- Department of General Medicine Moriguchi Keijinkai Hospital Osaka Japan
| |
Collapse
|
11
|
Nishiuchi Y, Tateishi Y, Hirano H, Ozeki Y, Yamaguchi T, Miki M, Kitada S, Maruyama F, Matsumoto S. Direct Attachment with Erythrocytes Augments Extracellular Growth of Pathogenic Mycobacteria. Microbiol Spectr 2022; 10:e0245421. [PMID: 35293805 PMCID: PMC9045221 DOI: 10.1128/spectrum.02454-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/14/2022] [Indexed: 11/20/2022] Open
Abstract
Pathogenic intracellular mycobacteria, such as Mycobacterium tuberculosis and Mycobacterium avium, which cause lung diseases, can grow in macrophages. Extracellular mycobacteria have been reported in the lungs, blood, and sputum of patients, indicating the involvement of these pathogens in disease progression. Erythrocytes are involved in the symptoms associated with pulmonary mycobacterial diseases, such as bloody sputum and hemoptysis; however, little attention has been paid to the role of erythrocytes in mycobacterial diseases. Herein, we found that Mycobacterium avium subsp. hominissuis (MAH) and Mycobacterium intracellulare colocalized with erythrocytes at the sites of lung infection, inside capillaries and necrotic areas of granulomas, using histopathological examinations. Electron microscopy showed that MAH adhered and entered human erythrocytes when they were cocultured in vitro. MAH adhered to erythrocytes through complement receptor 1 and cell-surface sialo-glycoproteins. Importantly, MAH grew vigorously without causing any pronounced damage to erythrocytes. This erythrocyte-mediated enhancement of MAH growth occurred extracellularly depending on its direct attachment to erythrocytes. In contrast, MAH failed to multiply inside erythrocytes. Similarly, erythrocytes augmented the growth of other pathogenic mycobacteria, such as M. intracellulare and M. tuberculosis. THP-1 cell-derived human macrophages preferentially phagocytosed erythrocytes that were attached to mycobacteria (compared to bacteria alone), suggesting that erythrocyte-attached mycobacteria are an efficient infectious source for macrophages. Our findings provide new insights into the pathogenesis of mycobacterial diseases and offer an alternative and useful strategy for treating mycobacterial disease. IMPORTANCE Pathogenic mycobacteria, such as Mycobacterium tuberculosis, Mycobacterium avium subsp. hominissuis (MAH), and Mycobacterium intracellulare, cause pulmonary infections as intracellular parasites of lung macrophages and epithelial cells. Here, using histopathological examinations we found that MAH and M. intracellulare colocalized with erythrocytes in lung infection sites. Subsequent studies demonstrated that direct interaction with erythrocytes enhances the extracellular proliferation of mycobacteria based on the following results: 1. MAH adhered and invaded human erythrocytes upon coculture in vitro; 2. MAH adhered to erythrocytes through complement receptor 1 and cell-surface sialo-glycoproteins; 3. MAH rapidly proliferated when directly attached to erythrocytes but not within them; 4. other mycobacteria, such as M. intracellulare and M. tuberculosis, also proliferated in the same way as MAH. The finding that pathogenic mycobacteria grow extracellularly in an erythrocyte-dependent manner is of considerable clinical importance for understanding disease progression and latent infection.
Collapse
Affiliation(s)
- Yukiko Nishiuchi
- Toneyama Institute for Tuberculosis Research, Osaka City University Graduate School of Medicine, Toyonaka, Japan
- Office of Industry-Academia-Government and Community Collaboration, Hiroshima University, Higashi-Hiroshima, Japan
| | - Yoshitaka Tateishi
- Department of Bacteriology, Niigata University Graduate School of Medicine, Niigata, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yuriko Ozeki
- Department of Bacteriology, Niigata University Graduate School of Medicine, Niigata, Japan
| | - Takehiro Yamaguchi
- Department of Pharmacology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mari Miki
- National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Seigo Kitada
- National Hospital Organization, Osaka Toneyama Medical Center, Toyonaka, Japan
| | - Fumito Maruyama
- Office of Industry-Academia-Government and Community Collaboration, Hiroshima University, Higashi-Hiroshima, Japan
| | - Sohkichi Matsumoto
- Department of Bacteriology, Niigata University Graduate School of Medicine, Niigata, Japan
- Laboratory of Tuberculosis, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| |
Collapse
|
12
|
Kitphaitun S, Chaimongkolkunasin S, Manit J, Makino R, Kadota J, Hirano H, Nomura K. Ethylene/Myrcene Copolymers as New Bio-Based Elastomers Prepared by Coordination Polymerization Using Titanium Catalysts. Macromolecules 2021. [DOI: 10.1021/acs.macromol.1c01878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Suphitchaya Kitphaitun
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Sapanna Chaimongkolkunasin
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Jeeranun Manit
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Ryoji Makino
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| | - Joji Kadota
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Hiroshi Hirano
- Osaka Research Institute of Industrial Science and Technology (ORIST), 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan
| | - Kotohiro Nomura
- Department of Chemistry, Graduate School of Science, Tokyo Metropolitan University, 1-1 Minami Osawa, Hachioji, Tokyo 192-0397, Japan
| |
Collapse
|
13
|
Shui Y, Hu X, Hirano H, Kusano K, Tsukamoto H, Li M, Hasumi K, Guo WZ, Li XK. β-glucan from Aureobasidium pullulans augments the anti-tumor immune responses through activated tumor-associated dendritic cells. Int Immunopharmacol 2021; 101:108265. [PMID: 34715491 DOI: 10.1016/j.intimp.2021.108265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/25/2022]
Abstract
Dendritic cells (DCs) are recognized as the most potent antigen-presenting cells, capable of priming both naïve and memory T cells. Thus, tumor-resident DCs (tumor-associated DCs: TADCs) play a crucial role in the immune response against tumors. However, TADCs are also well known as a "double-edged sword" because an immunosuppressive environment, such as a tumor microenvironment, maintains the immature and tolerogenic properties of TADCs, resulting in the deterioration of the tumor. Therefore, it is essential to maintain and enhance the anti-tumoral activity of TADCs to aid tumor elimination. This study demonstrated the potential for tumor growth inhibition of Aureobasidium pullulan-derived β-glucan (AP-BG). Administration of AP-BG dramatically limited the development of different types of tumor cell lines transplanted into mice. Examination of the tumor-infiltrating leukocytes revealed that AP-BG caused high expression of co-stimulatory molecules on TADCs and enhanced the production of cytolytic granules as well as pro-inflammatory cytokines by the tumor-resident T cells. Furthermore, the syngeneic mixed lymphoid reaction assay and popliteal lymph node assay showed the significant ability of AP-BG to improve DCs' antigen-specific priming of T cells in vitro and in vivo. Taken together, β-glucan might be an immune-potentiating adjuvant for cancer treatment. This highly widely-used reagent will initiate a new way to activate DC-targeted cancer immune therapy.
Collapse
Affiliation(s)
- Yifang Shui
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Hu
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiroshi Hirano
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan; Hasumi International Research Foundation, Tokyo, Japan
| | | | - Hirotake Tsukamoto
- Department of Immunology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan; Division of Clinical Immunology and Cancer Immunotherapy, Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Japan
| | - Mengquan Li
- Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Wen-Zhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Xiao-Kang Li
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
| |
Collapse
|
14
|
Nagai M, Uchida T, Yamada M, Komatsu S, Ota K, Mukae M, Iwamoto H, Hirano H, Karube M, Kaname S, Oda T. TAFRO Syndrome in a Kidney Transplant Recipient That Was Diagnosed on Autopsy: A Case Report. Front Med (Lausanne) 2021; 8:747678. [PMID: 34671626 PMCID: PMC8520974 DOI: 10.3389/fmed.2021.747678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 01/09/2023] Open
Abstract
A 57-year-old man who received a kidney transplant 4 years previously owing to unknown underlying disease presented with thrombocytopenia and fever. Hepatosplenomegaly and lymphadenopathy were observed, and development of prominent anasarca and worsening of renal function yielded the diagnosis of TAFRO syndrome. He was treated with high-dose steroids and plasmapheresis, and a thrombopoietin receptor agonist was administered for refractory thrombocytopenia. However, his general condition worsened, and he died on day 92. Histopathological analysis of a kidney autopsy specimen showed thrombotic microangiopathy characterized by glomerular endothelial swelling, mesangiolysis, and double contours of the glomerular capillary walls. His bone marrow showed megakaryocytic hyperplasia with mild reticulin fibrosis. Interestingly, these clinical and pathological features were remarkably similar to those the patient demonstrated before the kidney transplant, suggesting the recurrence of TAFRO syndrome. TAFRO syndrome is a rare systemic disorder whose concept has recently been established, but information on its long-term outcome is scarce. To our knowledge, this is the first case of TAFRO syndrome developing in a kidney transplant recipient, which suggests that disease recurrence occurs many years after the kidney transplant.
Collapse
Affiliation(s)
- Marie Nagai
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Takahiro Uchida
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Muneharu Yamada
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Shuuhei Komatsu
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Kohei Ota
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Mitsuya Mukae
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Hitoshi Iwamoto
- Department of Kidney Transplantation Surgery, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Hiroshi Hirano
- Departmet of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| | - Miho Karube
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Takashi Oda
- Department of Nephrology and Blood Purification, Kidney Disease Center, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan
| |
Collapse
|
15
|
Kuroki N, Abe D, Hasegawa K, Nagatomo R, Okochi M, Kato T, Aoyama T, Hirano H, Ohashi K, Takayama A, Hattori A, Kimata A, Hamabe Y, Suzuki K, Ueda T. Habitual exercise provides better prognosis for cardiac arrest with coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although regular physical activity has beneficial cardiovascular effects, exercise can trigger sudden cardiac arrest (SCA). Coronary artery disease (CAD) was identified as the most common cause of an exercise-related out-of-hospital cardiac arrest (OHCA). Regular exercise has been reported to reduce the risk of plaque rupture in animal studies and basic research. Therefore, we compared the coronary artery findings in CAD-OHCA patients with and without habitual exercise.
There have been few reports on whether regular exercise changes the prognosis in OHCA due to CAD (CAD-OHCA). We investigated the association between the better clinical outcome and the regular exercise in patients with CAD-OHCA.
Methods
This is a single-center retrospective analysis from 2006 to 2019. The consecutive 397 patients with OHCA due to myocardial ischemia underwent coronary angiography (CAG). After excluding 73 patients with vasospastic angina, the remaining 324 patients with CAD were enrolled in this study. We divided these patients into two groups according to whether they were habitually exercising (Exercise group: N=37) or not/unknown (Non-Exercise group: N=287).
Clinical outcome was a 30-day survival with minimal neurologic impairment represented by a Glasgow-Pittsburgh Cerebral Performance Categories Scale value 1 or 2.
Results
The patients in the Exercise Group were significantly younger (exercise vs. non-exercise, 57±12 vs. 64±12 years; P<0.01) than those in the non-exercise group. The Exercise group had a lower incidence of diabetes mellitus (22% vs. 42%; P=0.02) and a higher incidence of dyslipidemia (81% vs. 62%; P=0.02) than the non-exercise group. The time from collapse to cardiopulmonary resuscitation (1.4±4.0 vs. 3.0±4.8min) and from collapse to return of spontaneous circulation (11.9±10.0 vs. 28.0±25.3min) were shorter in Exercise group (all p<0.05). The ST-segment elevation was recorded on electrocardiography in fewer of the Exercise group (22% vs. 63%; P<0.01). The finding of culprit lesion in the coronary arteries on arrival resulted significant differences between the 2groups (good collateral and/or TIMI3 flow: 62% vs. 25%, the plaque rupture and/or thrombus: 22% vs. 73%) (all p<0.01) (Figure 1). Kaplan-Meier curve showed Exercise group has better neurological outcome at 30days compared than Non-Exercise (95% vs 51%; P<0.001, log-rank test) (Figure 2). Multivariable Cox proportional hazards models revealed that a habitual exercise was one of the predictors of a good neurological outcome (HR 0.21, 95% CI 0.05–0.92; P=0.039).
Conclusions
The patients with habitual exercise had less plaque rupture, less coronary thrombosis than non-exercise. The patients with regular exercise had better clinical outcomes than non-exercise after CAD-OHCA.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Tokyo Metropolitan Goverment Figure 1. Findings of the culprit lesion in coronar arteriesFigure 2. Kaplan-Meier analysis
Collapse
Affiliation(s)
- N Kuroki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - D Abe
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Hasegawa
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - R Nagatomo
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - M Okochi
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Kato
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Aoyama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Ohashi
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Takayama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Hattori
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Kimata
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Hamabe
- Tokyo Metropolitan Bokutoh Hospital, Emergency and Intensive Care Center, Tokyo, Japan
| | - K Suzuki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Ueda
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| |
Collapse
|
16
|
Nakajima E, Takahashi H, Kajiwara N, Furukawa K, Ishizumi T, Kataba H, Okubo M, Hirano H, Ikeda N. Intrathoracic lipoma in the horizontal fissure of the right lung: a case report. J Surg Case Rep 2021; 2021:rjab385. [PMID: 34522322 PMCID: PMC8432412 DOI: 10.1093/jscr/rjab385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 11/14/2022] Open
Abstract
Lipomas are benign tumors that originate from mesenchymal tissue, such as subcutaneous tissue. Intrathoracic lipomas are rare, and they can occur in the chest wall, mediastinum and bronchi. In the present case, the patient had an intrathoracic lipoma that was located in the horizontal fissure of the right lung. Retrospective review of chest radiographs taken at a previous health checkup confirmed that the tumor was growing. The patient had no symptoms, and computed tomography and magnetic resonance imaging suggested that the tumor was a hamartoma. The tumor was resected by video-assisted thoracic surgery, and was diagnosed by pathological analysis as an intrathoracic lipoma consisting of no atypical fats.
Collapse
Affiliation(s)
- Eiji Nakajima
- Department of Thoracic Surgery, Toda Chuo General Hospital, Saitama, Japan
| | - Hidenobu Takahashi
- Department of General Thoracic Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Naohiro Kajiwara
- Department of General Thoracic Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kinya Furukawa
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Taichiro Ishizumi
- Department of Thoracic Surgery, Toda Chuo General Hospital, Saitama, Japan
| | - Hiroaki Kataba
- Department of Thoracic Surgery, Toda Chuo General Hospital, Saitama, Japan
| | - Mitsuru Okubo
- Department of Radiology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Norihiko Ikeda
- Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
17
|
Hu X, Que W, Hirano H, Wang Z, Nozawa N, Ishii T, Ishizuka M, Ito H, Takahashi K, Nakajima M, Tanaka T, Zhu P, Guo WZ, Li XK. 5-Aminolevulinic acid/sodium ferrous citrate enhanced the antitumor effects of programmed cell death-ligand 1 blockade by regulation of exhausted T cell metabolism in a melanoma model. Cancer Sci 2021; 112:2652-2663. [PMID: 33934440 PMCID: PMC8253271 DOI: 10.1111/cas.14930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
Mitochondria are key cytoplasmic organelles. Their activation is critical for the generation of T cell proliferation and cytotoxicity. Exhausted tumor‐infiltrating T cells show a decreased mitochondrial function and mass. 5‐Aminolevulinic acid (5‐ALA), a natural amino acid that is only produced in the mitochondria, has been shown to influence metabolic functions. We hypothesized that 5‐ALA with sodium ferrous citrate (SFC) might provide metabolic support for tumor‐infiltrating T cells. In a mouse melanoma model, we found that 5‐ALA/SFC with a programmed cell death‐ligand 1 (PD‐L1) blocking Ab synergized tumor regression. After treatment with 5‐ALA/SFC and anti‐PD‐L1 Ab, tumor infiltrating lymphocytes (TILs) were not only competent for the production of cytolytic particles and cytokines (granzyme B, interleukin‐2, and γ‐interferon) but also showed enhanced Ki‐67 activity (a proliferation marker). The number of activated T cells (PD‐1+Tim‐3−) was also significantly increased. Furthermore, we found that 5‐ALA/SFC activated the mitochondrial functions, including the oxygen consumption rate, ATP level, and complex V expression. The mRNA levels of Nrf‐2, HO‐1, Sirt‐1, and PGC‐1α and the protein levels of Sirt‐1 were upregulated by treatment with 5‐ALA/SFC. Taken together, our findings revealed that 5‐ALA/SFC could be a key metabolic regulator in exhausted T cell metabolism and suggested that 5‐ALA/SFC might synergize with anti‐PD‐1/PD‐L1 therapy to boost the intratumoral efficacy of tumor‐specific T cells. Our study not only revealed a new aspect of immune metabolism, but also paved the way to develop a strategy for combined anti‐PD‐1/PD‐L1 cancer immunotherapy.
Collapse
Affiliation(s)
- Xin Hu
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Weitao Que
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiroshi Hirano
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.,Hasumi International Research Foundation, Tokyo, Japan
| | - Zhidan Wang
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan
| | | | | | | | | | | | | | | | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wen-Zhi Guo
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao-Kang Li
- Division of Transplantation Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
18
|
Hirano H. [Practice of New Academic Style]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:I. [PMID: 34011800 DOI: 10.6009/jjrt.2021_jsrt_77.5.i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
19
|
Kondo T, Kawachi S, Nakatsugawa M, Takeda A, Kikawada N, Aihara Y, Okimura A, Hirano H, Ogawa Y, Tsukahara K. Nivolumab for recurrent/metastatic hypopharyngeal squamous cell carcinoma in a liver transplant recipient. Auris Nasus Larynx 2021; 49:721-726. [PMID: 33612350 DOI: 10.1016/j.anl.2021.02.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 01/20/2023]
Abstract
Nivolumab administration to patients with organ transplantation history requires careful management. Herein, we report the case of a living-donor liver-transplant recipient, a 52-year-old man, with recurrent and metastatic hypopharyngeal cancer treated with nivolumab. He was diagnosed with T2N2bM0 stage IVA hypopharyngeal squamous cell carcinoma. While using oral immunosuppressants (cyclosporine and mycophenolate mofetil), the patient underwent right neck dissection followed by radiotherapy as an initial treatment. Three months after radiotherapy, positron emission tomography scans revealed multiple bone metastases. We administered two courses of the EXTREME regimen, comprising cisplatin, 5-fluorouracil, and cetuximab, as the first-line treatment for distal metastasis, but the patient presented with progressive disease. The patient was administered nivolumab as the second-line treatment. The programmed death-ligand 1 (PD-L1) expression level in a biopsy specimen of the primary hypopharyngeal tumor and resected specimen of the cervical lymph node metastasis was 40% and 10%, respectively. PD-L1 expression was not detected in hepatocytes of the liver biopsy sample obtained before nivolumab introduction. The patient received four courses of nivolumab 240 mg. Although liver dysfunction was alleviated by adjusting the dose of the hepatoprotective agent and cyclosporine, the progressive disease status persisted after completing nivolumab courses. The patient died of hypopharyngeal cancer progression.
Collapse
Affiliation(s)
- Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan.
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Munehide Nakatsugawa
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Atsuo Takeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Naiue Kikawada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yusuke Aihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Akira Okimura
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yasuo Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| |
Collapse
|
20
|
Yamada K, Nishimura T, Wakiya M, Satoh E, Fukuda T, Amaya K, Bando Y, Hirano H, Ishikawa T. Protein co-expression networks identified from HOT lesions of ER+HER2-Ki-67high luminal breast carcinomas. Sci Rep 2021; 11:1705. [PMID: 33462336 PMCID: PMC7814020 DOI: 10.1038/s41598-021-81509-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/05/2021] [Indexed: 01/20/2023] Open
Abstract
Patients with estrogen receptor-positive/human epidermal growth factor receptor 2-negative/Ki-67-high (ER+HER2-Ki-67high) luminal breast cancer have a worse prognosis and do not respond to hormonal treatment and chemotherapy. This study sought to identify disease-related protein networks significantly associated with this subtype, by assessing in-depth proteomes of 10 lesions of high and low Ki-67 values (HOT, five; COLD, five) microdissected from the five tumors. Weighted correlation network analysis screened by over-representative analysis identified the five modules significantly associated with the HOT lesions. Pathway enrichment analysis, together with causal network analysis, revealed pathways of ribosome-associated quality controls, heat shock response by oxidative stress and hypoxia, angiogenesis, and oxidative phosphorylation. A semi-quantitative correlation of key-protein expressions, protein co-regulation analysis, and multivariate correlation analysis suggested co-regulations via network-network interaction among the four HOT-characteristic modules. Predicted highly activated master and upstream regulators were most characteristic to ER-positive breast cancer and associated with oncogenic transformation, as well as resistance to chemotherapy and endocrine therapy. Interestingly, inhibited intervention causal networks of numerous chemical inhibitors were predicted within the top 10 lists for the WM2 and WM5 modules, suggesting involvement of potential therapeutic targets in those data-driven networks. Our findings may help develop therapeutic strategies to benefit patients.
Collapse
Affiliation(s)
- Kimito Yamada
- Department of Breast Surgery, Tokyo Medical University Hachioji Medical Centre, Tokyo, 193-0998, Japan
- Department of Breast Surgery, Tokyo Medical University Hospital, Tokyo, 160-0023, Japan
| | - Toshihide Nishimura
- Department of Translational Medicine Informatics, St. Marianna University School of Medicine, Kanagawa, 216-8511, Japan.
| | - Midori Wakiya
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Centre, Tokyo, 193-0998, Japan
| | - Eiichi Satoh
- Department of Pathology, Institute of Medical Science, Tokyo Medical University, Tokyo, 160-0023, Japan
| | - Tetsuya Fukuda
- Research and Development, Biosys Technologies Inc, Tokyo, 152-0031, Japan
| | - Keigo Amaya
- Department of Breast Surgery, Tokyo Medical University Hachioji Medical Centre, Tokyo, 193-0998, Japan
| | - Yasuhiko Bando
- Research and Development, Biosys Technologies Inc, Tokyo, 152-0031, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Centre, Tokyo, 193-0998, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery, Tokyo Medical University Hospital, Tokyo, 160-0023, Japan
| |
Collapse
|
21
|
Hoshino D, Hirano H, Edahiro A, Motokawa K, Shirobe M, Watanabe Y, Motohashi Y, Ohara Y, Iwasaki M, Maruoka Y, Yokoyama Y, Narita M, Taniguchi Y, Shinkai S, Kitamura A. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. J Nutr Health Aging 2021; 25:361-368. [PMID: 33575729 DOI: 10.1007/s12603-020-1538-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS A total of 769 community-dwelling older persons aged 65 and over. INTERVENTIONS We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants. MEASUREMENTS OF was defined by 1-2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0-2), medium score (3-5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS. RESULTS The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219-2.335, OF; adjusted OR = 2.857, 95% CI = 1.489-5.484). CONCLUSION The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.
Collapse
Affiliation(s)
- D Hoshino
- Daichi Hoshino, Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan, Phone: +81 337 87 1151, Fax: +81 337 85 6403,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Nogami K, Kanaji Y, Sugiyama T, Hoshino M, Yamaguchi M, Hada M, Sumino Y, Misawa T, Hirano H, Ueno H, Kakuta T. Prognostic value of unrecognized myocardial infarction and hyperemic coronary sinus flow in patients undergoing elective percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiac magnetic resonance (CMR) imaging is a useful instrument for the assessment of pathological and functional conditions without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Both unrecognized myocardial infarction (UMI) and impaired global myocardial blood flow (g-MBF) have been reported to be strongly associated with worse outcome in patients with cardiovascular disease. However, their combined efficacy remains undetermined.
Purpose
We sought to assess the prognostic value of the presence of UMI and pre-procedural hyperemic g-MBF evaluated by phase-contrast cine magnetic resonance imaging (PC-CMR) in patients with chronic coronary syndrome who underwent elective percutaneous coronary intervention (PCI).
Methods
A total of 177 patients with de novo functionally significant stenosis who underwent pre-PCI CMR and PCI between September, 2016 and March, 2019 were retrospectively studied. UMI was defined as a scar detected by late gadolinium enhancement (LGE) without previously diagnosed MI. g-MBF was assessed by quantifying coronary sinus flow using PC-CMR at rest and hyperemic state. The predictors of major adverse cardiac events (MACE; cardiac death, nonfatal myocardial infarction, clinically driven unplanned revascularization, or hospitalization for congestive heart failure) during follow-up were investigated.
Results
UMI was detected in 40 (27.7%) patients and rest and maximal hyperemic g-MBF evaluated by the coronary sinus flow obtained by PC-CMR were 0.95 ml/min/g and 2.26 ml/min/g, respectively. During the median follow-up of 26 months, cardiovascular death occurred in 1 patient (0.6%), nonfatal myocardial infarction occurred in 4 patients (2.3%), and clinically driven revascularization and hospitalization due to congestive heart failure occurred in 25 patients (14.1%) and 3 patients (1.7%) patients, respectively. In patients with MACE, hyperemic g-MBF was significantly lower and the prevalence of UMI were significantly higher compared with those without MACE (1.94 ml/min/g vs 2.36 ml/min/g P=0.014; 48.3% vs 23.6%, P=0.011). Cox proportional hazards model indicated that impaired hyperemic g-MBF (<2.00 ml/min/g) and the presence of UMI were significant predictors of MACE (HR 2.22, 95% CI 1.060–4.640, P=0.034; HR 2.660, 95% CI 1.290–5.470, P=0.008). During follow-up, cardiac event-free survival was significantly worse in patients with impaired hyperemic g-MBF (<2.00 ml/min/g) and UMI (log-rank χ2=11.0, P=0.010).
Conclusion
In patients with chronic coronary syndrome undergoing elective PCI, the combined assessment of UMI and hyperemic g-MBF obtained by preprocedural noninvasive CMR may provide significant prognostic information.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
23
|
Kawachi S, Chiba N, Nakagawa M, Kobayashi T, Hikita K, Sano T, Tomita K, Hirano H, Abe Y, Obara H, Shimazu M. Living donor liver transplantation for idiopathic portal hypertension with extrahepatic portal vein stenosis and splenic artery aneurysms: a case report and review of the literature. BMC Surg 2020; 20:257. [PMID: 33121468 PMCID: PMC7597044 DOI: 10.1186/s12893-020-00921-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023] Open
Abstract
Background Idiopathic portal hypertension (IPH) generally has a good prognosis and rarely results in liver transplantation. Furthermore, there are few reports of living donor liver transplantation (LDLT) for IPH with extrahepatic portal vein stenosis. Case presentation We report the case of a 51-year-old female patient diagnosed with IPH more than 20 years ago. She suffered severe jaundice, massive ascites, and encephalopathy at the time of her visit to our hospital. The patient’s extrahepatic portal vein showed a scar-like stenosis, and the portal flow was completely hepatofugal. Collateral circulation such as the splenorenal shunt was well developed, and multiple splenic artery aneurysms up to 2 cm were observed in the splenic hilum. Her Model for End-Stage Liver Disease score increased to over 40 because of renal dysfunction, requiring temporary dialysis. We performed LDLT using her husband’s right lobe graft and splenectomy. The extrahepatic stenotic portal vein was completely resected, and the superficial femoral vein (SFV) graft collected from the recipient’s right leg was used for portal reconstruction as an interposition graft. Although the clinical course after LDLT had many complications, the patient was discharged on postoperative day 113 and has been fine for 2 years after LDLT. Histopathologically, the explanted liver had obliterative portal venopathy, nodular regenerative hyperplasia, and incomplete septal cirrhosis. Conclusion This case showed that severe IPH is occasionally associated with extrahepatic portal vein stenosis and can be treated with LDLT with portal vein reconstruction using an interposition graft. It was also suggested that the SFV is a useful choice for the interposition graft.
Collapse
Affiliation(s)
- Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan.
| | - Naokazu Chiba
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Masashi Nakagawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Toshimichi Kobayashi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Kosuke Hikita
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Toru Sano
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Koichi Tomita
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Hiroshi Hirano
- Departmet of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 1608582, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 1608582, Japan
| | - Motohide Shimazu
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo, 1930998, Japan
| |
Collapse
|
24
|
Kondo T, Nakatsugawa M, Hirai Y, Takeda A, Kikawada N, Aihara Y, Chiba Y, Okimura A, Hirano H, Ogawa Y, Tsukahara K. Minocycline-induced black thyroid with black pigmentation of the thyroid cartilage, cricoid cartilage, and trachea found during reconstructive surgery for hypopharyngeal cancer. Auris Nasus Larynx 2020; 49:299-303. [PMID: 32912766 DOI: 10.1016/j.anl.2020.08.028] [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: 07/14/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
Black thyroid is characterized by a rare pigment change observed almost exclusively in patients taking minocycline. We present the case of a 72-year-old man diagnosed with T3N3bM0 stage IVB hypopharyngeal squamous cell carcinoma who had been taking minocycline for approximately 18 months as a treatment for prurigo chronica multiformis. Initial treatment consisted of total pharyngolaryngoesophagectomy, bilateral neck dissection, total thyroidectomy, pharyngeal reconstruction using a free jejunal autograft, and creation of a permanent tracheostoma. During surgery, black discoloration of the thyroid and trachea was observed. Postoperative histological findings confirmed the black discoloration, with deposits of dark-brown, melanin-like granules observed in the thyroid, trachea, thyroid cartilage, and cricoid cartilage. Therefore, the black discoloration of the thyroid associated with the use of minocycline can extend to the thyroid cartilage, cricoid cartilage, and trachea. This information is important for surgeons to recognize in order to prevent unnecessary resection due to misdiagnosis.
Collapse
Affiliation(s)
- Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan.
| | - Munehide Nakatsugawa
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yuji Hirai
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Atsuo Takeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Naiue Kikawada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yusuke Aihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yuujin Chiba
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Akira Okimura
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Yasuo Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji-shi, Tokyo 193-0998, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| |
Collapse
|
25
|
Tsuchihashi K, Nakatsugawa M, Kobayashi JI, Sasaya T, Morita R, Kubo T, Kanaseki T, Tsukahara T, Asanuma H, Hasegawa T, Hirano H, Miyazaki A, Hirohashi Y, Torigoe T. Borderline Microenvironment Fibrosis Is a Novel Poor Prognostic Marker of Oral Squamous Cell Carcinoma. Anticancer Res 2020; 40:4319-4326. [PMID: 32727759 DOI: 10.21873/anticanres.14434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/04/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The tumor microenvironment (TME) balances tumor growth and suppression through humoral factors and cell-cell interactions. In oral squamous cell carcinoma (OSCC), TMEs have been associated with prognosis of cancer patients and are evaluated by microscopy; however, these methods of evaluation vary among studies. MATERIALS AND METHODS To evaluate the TME, borderline microenvironment fibrosis (bMF) was evaluated histologically in 236 OSCC cases and used to determine the clinicopathological status. RESULTS bMF was observed in 47% (110 in 236 cases) of OSCC cases and associated with higher T category, N category, stage, histological grade and mode of invasion. bMF-positive was related to overall survival (OS) and progression-free survival (PFS). Multivariate analysis revealed that bMF-positive was an independent factor for OS in all cases [n=226; HR=1.683 (1.018-2.781); p=0.042], especially in T1+T2 cases [n=186; HR=1.926 (1.079-3.440); p=0.024], and PFS in all cases [n=226; HR=2.254 (1.397-3.637); p=0.001]. CONCLUSION bMF may act as a novel biomarker for OSCC.
Collapse
Affiliation(s)
- Kei Tsuchihashi
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan.,Department of Oral Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Munehide Nakatsugawa
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan .,Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Jun-Ichi Kobayashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Takashi Sasaya
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan.,Department of Oral Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Rena Morita
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Terufumi Kubo
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Takayuki Kanaseki
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Tomohide Tsukahara
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Hiroko Asanuma
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Akihiro Miyazaki
- Department of Oral Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Yoshihiko Hirohashi
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Toshihiko Torigoe
- Department of Pathology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| |
Collapse
|
26
|
Inamoto T, Komura K, Uehara H, Ibuki N, Ichihashi A, Minami K, Taniguchi S, Hirano H, Nomi H, Azuma H. Bladder preserving tetra-modal therapy for octogenarian with localized muscle invasive bladder cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
27
|
Koganezawa I, Tomita K, Nakagawa M, Ozawa Y, Kobayashi T, Sano T, Tsutsui R, Chiba N, Okimura A, Nakatsugawa M, Hirano H, Kawachi S. Right trisectionectomy for liver metastasis of granulosa cell tumor: a case report and literature review. Surg Case Rep 2020; 6:125. [PMID: 32494954 PMCID: PMC7270424 DOI: 10.1186/s40792-020-00880-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Granulosa cell tumor (GCT) is a type of ovarian sex cord-stromal tumor with low-grade malignancy, which can recur long after primary resection. All reports on GCTs in the liver describe cases of metastases, while there are no previous reports of primary GCTs originating from the liver. We report a case of GCT, with recurrence of liver metastasis long after ovariectomy, which was subsequently resected by a right trisectionectomy. CASE PRESENTATION A 76-year-old woman presented with a history of surgical resection of an ovarian tumor performed 30 years previously; no details of the tumor were available. When she was 68 years old, an abdominal ultrasound revealed a small liver mass, which was diagnosed as a hepatic hemangioma with slow growth. Outpatient follow-up was discontinued for 5 years, and the patient was not examined again until the age of 76 years. At this point, the tumor had substantially increased in size, and surgical resection was required owing to suspicion of malignancy. The patient was then referred to our hospital. Contrast-enhanced computed tomography (CT) showed a large tumor, approximately 18 cm in size, occupying the right lobe and medial section of the liver. After percutaneous transhepatic portal vein embolization, a right trisectionectomy was performed. The histopathological findings of the resected specimen showed that the tumor cells had "coffee bean-like" nuclear grooves, which are characteristic of a GCT. Acidophilic non-structural Call-Exner bodies were also observed. Inhibin-α, CD99, and CD56 markers of sex cord-stromal tumors were detected on immunohistological examination; all pathology suggested a GCT. We considered the tumor to be a liver metastasis of a previous ovarian GCT that was resected 30 years prior by ovariectomy. There was no recurrence for > 15 months after the hepatectomy. CONCLUSIONS We report a case of a GCT in the liver, which was identified to be a liver metastasis. Right trisectionectomy was subsequently performed for tumor resection. Clinicians should be aware that ovarian GCTs may recur in the liver, and that GCT recurrence may occur long after ovariectomy of the primary ovarian GCT.
Collapse
Affiliation(s)
- Itsuki Koganezawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Koichi Tomita
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Masashi Nakagawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Yosuke Ozawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Toshimichi Kobayashi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Toru Sano
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Rina Tsutsui
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Naokazu Chiba
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Akira Okimura
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Munehide Nakatsugawa
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachiojishi, Tokyo, 193-0998, Japan.
| |
Collapse
|
28
|
Hirano H, Fujisaki H, Tokeshi Y, Fujiwara Y, Matsunaga T, Uehara H, Nomi H, Komura K, Ibuki N. Promoting a medical system for renal transplantation in the remote island in Japan. Transplantation Reports 2020. [DOI: 10.1016/j.tpr.2020.100043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
29
|
Tsunoda S, Kobayashi Y, Hirano H, Kitamura R, Nakamori S, Matoba S. Isolated pulmonary valvular stenosis with equilateral triangle orifice. J Cardiol Cases 2020; 21:145-148. [DOI: 10.1016/j.jccase.2019.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/08/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022] Open
|
30
|
Yamashita G, Kondo T, Okimura A, Nakatsugawa M, Hirano H, Takeda A, Kikawada N, Aihara Y, Chiba Y, Ogawa Y, Tsukahara K. Occult Papillary Thyroid Carcinoma without Detection of the Primary Tumor on Preoperative Ultrasonography or Postoperative Pathological Examination: A Case Report. Case Rep Oncol 2020; 13:105-112. [PMID: 32231531 DOI: 10.1159/000505831] [Citation(s) in RCA: 4] [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: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 12/26/2022] Open
Abstract
Herein, we report a case of an occult thyroid cancer that was not detected as a primary tumor on preoperative ultrasonography or postoperative pathological examination, although a diagnosis of papillary thyroid carcinoma metastasis was made owing to the presence of a mass in the right upper neck. Needle biopsy of the mass in the right upper neck revealed positive results for thyroglobulin and TTF-1 on immunostaining, and a papillary thyroid carcinoma was observed with papillary and follicular patterns. We suspected papillary thyroid carcinoma (T0N1bM0) or ectopic papillary thyroid carcinoma. Accordingly, we performed total thyroidectomy, central lymph node dissection, right lateral neck dissection, and resection of the superficial lobe of the right parotid. A postoperative pathological examination of 5-mm slices of the specimen revealed no primary tumor in the thyroid. However, a hyalinized image of the thyroid indicated that a micropapillary thyroid carcinoma might have spontaneously disappeared. As there was no normal thyroid tissue in the metastasis to the superior internal jugular lymph node, the tumor was unlikely to be an ectopic papillary thyroid carcinoma. Therefore, we made a diagnosis of a papillary thyroid carcinoma (pT0N1bM0). After surgery, we determined that the tumor belonged to a high-risk group of papillary thyroid carcinomas and a poor-prognosis group of symptomatic papillary thyroid microcarcinomas; accordingly, ablation was performed with 30 mCi iodine-131. There was no recurrence or metastasis 24 months after the first surgery.
Collapse
Affiliation(s)
- Gai Yamashita
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takahito Kondo
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Akira Okimura
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Munehide Nakatsugawa
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Atsuo Takeda
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Naiue Kikawada
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yusuke Aihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yuujin Chiba
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yasuo Ogawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
31
|
Hikita K, Chiba N, Nakagawa M, Koganezawa I, Yokozuka K, Kobayashi T, Sano T, Tomita K, Tsutsui R, Hirano H, Kawachi S. Efficacy of Peak Hounsfield Units of the Visceral Fat Area in Predicting Postoperative Complications after Pancreaticoduodenectomy. Dig Surg 2020; 37:331-339. [PMID: 31972560 DOI: 10.1159/000505060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 11/26/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Morbidity following pancreaticoduodenectomy (PD) has been reported to remain high. This study sought to measure the peak Hounsfield units (HUs) of visceral attenuation in patients undergoing PD and to assess the quality of adipocytes by comparing these measurements with perioperative factors. METHODS Patients undergoing PD were retrospectively identified (n = 108). Abdominal perimeter, subcutaneous fat area (SFA), visceral fat area (VFA), and peak HU of the VFA were measured. Logistic regression analysis was used to identify independent predictors of postoperative pancreatic fistula (POPF) or complications. Histopathological examination was performed for qualitative diagnosis of the stromal tissue. RESULTS The overall rate of POPF was 16%, and severe complications occurred in 23% of the cases. A criterion for peak HU of the VFA only independently predicted POPF (p = 0.007) in the multivariate analysis. A criterion for peak HU of the VFA (p = 0.015) was associated with an increased rate of postoperative severe complications in the univariate analysis. The peak HU of the VFA was significantly correlated with abdominal perimeter (p < 0.001) and VFA (p < 0.001). The peak HU of the VFA was significantly correlated with adipocyte diameter (p < 0.001) and the ratio of stromal connective tissue area around the adipocytes (p < 0.001). CONCLUSION The peak HU of the VFA was an independent factor contributing to severe complications, including POPF after PD. It reflects the amount of stromal connective tissue around the adipocytes.
Collapse
Affiliation(s)
- Kosuke Hikita
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Naokazu Chiba
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan,
| | - Masashi Nakagawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Itsuki Koganezawa
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kei Yokozuka
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Toshimichi Kobayashi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Toru Sano
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Koichi Tomita
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Rina Tsutsui
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| |
Collapse
|
32
|
Yamamoto K, Motokawa K, Yoshizaki T, Yano T, Hirano H, Ohara Y, Shirobe M, Inagaki H, Awata S, Shinkai S, Watanabe Y. Association of Dietary Variety and Appetite with Sleep Quality in Urban-Dwelling Older Japanese Adults. J Nutr Health Aging 2020; 24:152-159. [PMID: 32003404 DOI: 10.1007/s12603-019-1297-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Although it has been shown that specific foods and nutrients are associated with sleep quality, few studies have examined the association of dietary variety and appetite with sleep quality in older adults. DESIGN AND SETTING A cross-sectional study was conducted that examined the association of dietary variety and appetite with sleep quality in Japanese adults aged ≥70 years who resided in the metropolitan area of Tokyo, Japan. PARTICIPANTS Data were collected in two steps: a mailed interview survey and an on-site survey. Those who responded to the surveys and met the inclusion criteria were included. MEASUREMENTS Dietary variety, appetite, and sleep quality were assessed using a Dietary Variety Score (DVS), Council on Nutrition Appetite Questionnaire (CNAQ) score, and sleep efficiency, respectively. The sleep efficiency is the ratio of sleep duration to total time in bed (retiring time-awakening time). We defined the individuals with a sleep efficiency less than 75% as having poor sleep quality. RESULTS Mean DVS and CNAQ score were 3.8 and 29.6 points, respectively. The rate of individuals with poor sleep quality was 11.7%. In the fully adjusted model, the odds ratios (OR) for low sleep efficiency in the middle and highest group categories of the DVS were 0.83 (95% confidence interval [CI], 0.54-1.29) and 0.50 (95% CI, 0.28-0.90), respectively, in reference to the lowest group category (p for trend = 0.023). The OR for low sleep efficiency in the middle and highest group categories of the CNAQ score were 0.73 (95% CI, 0.47-1.14) and 0.54 (95% CI, 0.30-0.96), respectively, in reference to the lowest group category (p for trend = 0.031). CONCLUSIONS The higher DVS and CNAQ scores were significantly associated with higher sleep efficiency. Thus, dietary variety and good appetite might help maintain good sleep quality in urban-dwelling older Japanese adults.
Collapse
Affiliation(s)
- K Yamamoto
- Keiko Motokawa, Tokyo Metropolitan Institute of Gerontology, 35-2, Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan; Tel: +81-3-3964-1141 (ext. 4213); Fax: +81-3-3964-2316; E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Katayanagi S, Yokoyama T, Makuuchi Y, Osakabe H, Iwamoto H, Sumi T, Hirano H, Katsumata K, Tsuchida A, Hirota S, Kawachi S. Long-Term Survival After Multidisciplinary Treatment Including Surgery for Metachronous Metastases of Small Intestinal Gastrointestinal Stromal Tumors after Curative Resection: A Case Report. Am J Case Rep 2019; 20:1942-1948. [PMID: 31875847 PMCID: PMC6944036 DOI: 10.12659/ajcr.918606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patient: Male, 56-year-old Final Diagnosis: Metachronous metastases of small intestinal gastrointestinal stromal tumors Symptoms: Abdominal and/or epigastric pain Medication: — Clinical Procedure: Operation • chemotharapy Specialty: Gastroenterology and Hepatology
Collapse
Affiliation(s)
- So Katayanagi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takayoshi Yokoyama
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yousuke Makuuchi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroaki Osakabe
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hitoshi Iwamoto
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Tetsuo Sumi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| |
Collapse
|
34
|
Nakaguro M, Urano M, Ogawa I, Hirai H, Yamamoto Y, Yamaguchi H, Tanigawa M, Matsubayashi J, Hirano H, Shibahara J, Tada Y, Tsuzuki T, Okada Y, Sato Y, Ikeda K, Sukeda A, Honda Y, Mikami Y, Nagao T. Histopathological evaluation of minor salivary gland papillary–cystic tumours: focus on genetic alterations in sialadenoma papilliferum and intraductal papillary mucinous neoplasm. Histopathology 2019; 76:411-422. [DOI: 10.1111/his.13990] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Masato Nakaguro
- Department of Pathology and Laboratory Medicine Nagoya University Hospital Nagoya Japan
| | - Makoto Urano
- Department of Diagnostic Pathology School of Medicine Fujita Health University Toyoake Japan
| | - Ikuko Ogawa
- Centre of Oral Clinical Examination Hiroshima University Hospital Hiroshima Japan
| | - Hideaki Hirai
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| | | | - Hiroshi Yamaguchi
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| | - Maki Tanigawa
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| | - Jun Matsubayashi
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| | - Hiroshi Hirano
- Department of Pathology Tokyo Medical University Hachioji Medical Centre Tokyo Japan
| | | | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery International University of Health and Welfare Mita Hospital Tokyo Japan
| | | | - Yasuo Okada
- Department of Pathology The Nippon Dental University School of Life Dentistry at Niigata Niigata Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery Niigata Cancer Centre Hospital Niigata Japan
| | | | - Aoi Sukeda
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| | - Yumi Honda
- Department of Diagnostic Pathology Kumamoto University Hospital Kumamoto Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology Kumamoto University Hospital Kumamoto Japan
| | - Toshitaka Nagao
- Department of Anatomical Pathology Tokyo Medical University Tokyo Japan
| |
Collapse
|
35
|
Sugiyama T, Kanno Y, Hamaya R, Hoshino M, Usui E, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Yuki H, Horie T, Yonetsu T, Kakuta T. P3578Determinants of visual-functional mismatches as assessed by coronary angiography and 3-D angiography-based quantitative flow ratio. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Quantitative flow ratio (QFR) is a novel three-dimensional quantitative coronary angiography (QCA)-based computational index that can estimate fractional flow reserve (FFR) without pharmacologically induced hyperemia or the use of a pressure wire.
Purpose
We aimed to evaluate the determinants of visual-functional mismatches between conventional two-dimensional QCA and QFR.
Methods
A total of 504 de novo intermediate-to-severe lesions from 504 patients with stable angina who underwent angiographical and physiological assessments were analyzed. All lesions were divided into four groups based on the significance of visual (QCA-diameter stenosis [DS] >50% and ≤50%) and functional (QFR <0.80 and ≥0.80) stenosis severity. Patient characteristics, angiographic findings, QFR computations, and physiological indices were compared among the four groups.
Results
Among 504 lesions, 153 lesions (30.4%) showed concordantly negative (DS ≤50% and QFR >0.80) and 170 lesions (33.7%) showed concordantly positive (DS >50% and QFR ≤0.80) visual and functional assessments. Among 181 lesions (35.9%) with discordant results, 75 lesions (14.9%) showed a mismatch (DS >50% and QFR >0.80) and 106 lesions (21.0%) showed a reverse mismatch (DS ≤50% and QFR ≤0.80), respectively. Reverse mismatch was associated with smaller reference diameter (odds ratio [OR] 0.561; P=0.036), greater DS (OR 1.039, P=0.013), lower coronary flow reserve (CFR) (OR 0.571, P<0.001, non-diabetes mellitus (OR 2.141, P=0.013) and lower ejection fraction (OR 0.961, P=0.011). Mismatch was associated with smaller DS (OR 0.914, P<0.001), shorter lesion length (OR 0.894, P=0.001), higher CFR (OR 1,633, P<0.001), and lower estimated glomerular filtration rate (OR, 0.968, P=0.001). Lesion location and the index of microcirculatory resistance was not associated with the prevalence of reverse mismatch or mismatch.
Conclusions
There was a high prevalence of visual-functional mismatches between QCA-DS and QFR, and CFR was an important functional factor of mismatches. Our results suggested the difference between predictors of reported visual-functional mismatches of QCA/FFR and those of QCA/QFR.
Collapse
Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - R Hamaya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - E Usui
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
36
|
Kanno Y, Hoshio M, Sugiyama T, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Horie T, Yuki H, Yonetsu T, Kakuta T. P2705Hybrid QFR-FFR decision making strategy for revascularization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Measurement of the fractional flow reserve (FFR) has become a standard practice for revascularization decision-making in evaluating the functional significance of angiographically intermediate epicardial coronary stenosis. The quantitative flow ratio (QFR) is a novel method for rapid computational estimation of FFR without pressure wire and vasodilator drugs.
Purpose
Nevertheless, the evidence was shown the clinical better outcome of coronary revascularization stratified by FFR, the adoption of FFR remains low. We hypothesized that combined QFR and FFR hybrid strategy could improve the physiological assessment without pressure wire and drugs.
Methods and results
We performed a post-hocanalysis of 549 vessels with angiographically intermediate stenosis in 549 patients who underwent measurement of FFR. The median FFR and QFR values were 0.81 (0.73–0.87) and 0.79 (0.74–0.87), respectively.The ischemic threshold was defined as 0.80 for both QFR and FFR measures. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the QFR for predicting an FFR of ≤0.80 were 86.2%, 71.9%, 78.9%, 74.5%, and 84.5%, respectively. The area under the receiver operating characteristic curve using the cut-off threshold of ≤0.80 for the FFR was 0.85 (95% confidence interval [CI], 0.81–0.88) for the QFR.In total, 433 (78.9%) and 116 (21.1%) lesions showed concordant and discordant FFR and QFR functional classifications, respectively. A hybrid QFR-FFR strategy was developed, by allowing deferral when QFR values providing negative predictive value greater than 90% and treat others when QFR values greater than that showing 90% positive predictive value, with adenosine being given only to patients with QFR in between those values. For the FFR cut-off (0.8), an QFR of <0.73 could be used to confirm treatment (PPV of 90.7%), while an QFR value of >0.83 could be used to defer revascularization (NPV of 90.0%). When QFR values fall between 0.73 and 0.84, adenosine is given for hyperemic induction and the FFR cut-off of 0.8 is used to guide revascularization. This hybrid QFR-FFR approach has a 95% agreement with an FFR-only decision making, and 285 lesions (51.9%) would have obviated the need of a pressure wire and adenosine.
Hybrid QFR-FFR strategy
Conclusions
A hybrid QFR-FFR strategy for coronary revascularization could reduce the need of a pressure wire and vasodilator drugs, which may increase the penetration of functional assessment of coronary lesions.
Collapse
Affiliation(s)
- Y Kanno
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hoshio
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| |
Collapse
|
37
|
Hoshino M, Kanaji Y, Sugiyama T, Yamaguchi M, Ohya H, Sumino Y, Hada M, Kanno Y, Hirano H, Horie T, Yonetsu T, Kakuta T. P5619Comparison of different resting physiological indices: are diastolic pressure ratio and resting full-cycle ratio equal? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous reports showed all diastolic resting indexes tested were virtually identical to the instantaneous wave-free ratio (iFR). Although RFR has been also reported to be diagnostically equivalent to iFR, no comparisons have been reported about the prevalence and characteristics of discordance in diagnosis between diastolic pressure ratio (dPR) and resting full-cycle ratio (RFR).
Purpose
This study sought to determine the coronary pressure characteristics of lesions classified as discordant between dPR and RFR in angiographically intermediate stenoses.
Methods
We recruited 532 patients with 668 intermediate (angiographically stenosis between 30% to 70% severity) coronary lesions undergoing FFR assessment and analyzed DICOM pressure tracings of resting state (dPR and RFR) using a fully automated off-line software algorithm in a blind fashion. Diagnostic performance of dPR and RFR was evaluated using FFR as a reference. Furthermore, we investigated similarity and difference between dPR and RFR.
Results
Median FFR was 0.81 with an interquartile range of 0.74 to 0.87. RFR was highly correlated to dPR (R2=0.94, p<0.001), with a mean bias of 0.012 (95% limits of agreement −0.008 to 0.031). The diagnostic performance of RFR versus dPR was diagnostic accuracy 95.4%, sensitivity 100.0%, specificity 91.6%, positive predictive value 90.6%, negative predictive value 100.0%). Using the binary cut-off of dPR ≤0.89 as a cut-off value, RFR showed near identical agreement according to ROC curve analysis (AUC: 0.996, 95% CI: 0.994–0.999, p<0.001). Although dPR and RFR demonstrated equivalent performance against FFR ≤0.8 (79.5% vs. 79.3% accuracy; p=0.960; area under the receiver-operating characteristic curve: 0.869 vs. 0.870; p=0.528), RFR disagreed with dPR in 4.6% (31 of 668). When all lesions (668 vessels) were divided into groups according to the concordance and discordance between dPR and RFR: RFR+/dPR+ (298 vessels, n=240), RFR+/dPR– (31 vessels, n=31 patients), RFR-/dPR- (339 vessels, n=259). There was no lesion showing RFR-/dPR+. The prevalence of ischemia was tended to be higher in lesions evaluated by RFR (49.3% vs 44.6%, P=0.100) when using FFR ≤0.80 as a reference standard. An overall significant difference in the prevalence of FFR ≤0.80 and the FFR values were detected among these 3 groups. Furthermore, pairwise comparison also revealed the prevalence of FFR >0.80 and the FFR values were significantly lower in RFR+/dPR– than in RFR-/dPR-, and significantly higher in RFR+/dPR– than in RFR+/dPR+. (P<0.001 and P<0.001, respectively)
Conclusion
Significant difference in FFR values was observed according to dPR/RFR agreement and disagreement. Revascularization decision making might defer according to the resting index used. Compared with RFR, lesions might be more frequently deferred when dPR was used to assess physiological significance.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
38
|
Hirano H, Kanaji Y, Horie T, Yuki H, Kanno Y, Ohya H, Hada M, Sumino Y, Yamaguchi M, Hoshino M, Sugiyama T, Yonetsu T, Kakuta T. P2704The association between global coronary flow reserve and coronary inflammation assessed by attenuation index on computed tomography in patients with stable angina pectoris. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Impaired global coronary flow reserve (G-CFR) is known to predict worse outcomes in patients with coronary artery disease. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying coronary sinus flow (CSF) and G-CFR without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Although G-CFR impairment is previously reported to be linked with endothelium dysfunction and progression of atherosclerosis, the association of perivascular adipose tissue inflammation with myocardial coronary flow remains to be determined.
Purpose
We evaluated the association between G-CFR by quantifying CSF using PC-CMR and the extent of coronary inflammation evaluated by perivascular adipose tissue inflammatory status using CT to assess if coronary inflammation is linked with G-CFR in patients with stable angina pectoris (SAP) treated with elective percutaneous coronary intervention (PCI).
Methods
The study enrolled 74 SAP patients with single denovo lesion who underwent coronary CT angiography and PC-CMR within 90 days before coronary intervention. Proximal 40-mm segments of all three major epicardial coronary vessels were traced and examined. Coronary inflammation was assessed by the CT fat attenuation index of perivascular adipose tissue (FAI-PVAT) defined as the mean attenuation of the perivascular adipose tissue (−190 to −30 Hounsfield units (HU)) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel. CMR images were also acquired to assess absolute CSF at rest and during maximum hyperemia before elective PCI. The patients were divided into 4 groups according to the number of inflamed vessels as defined by showing FAI ≥−70.1 HU.
Results
In the final analysis of 69 patients (mean age 67, Male 45 (65.2%)), 18, 19, 20, 12 patients exhibited none, 1, 2, 3 inflamed vessels with FAI ≥−70.1 HU, respectively. Rest and maximal hyperemic CSF and corrected G-CFR were 1.28 [0.76,1.55] vs 1.47 [1.11, 1.81] vs 1.30 [0.94, 1.64] vs 1.27 [1.11, 2.00] ml/min/g; P=0.49, 3.50 [2.84, 5.25] vs 3.28 [2.62, 4.31] vs 3.11 [2.16, 3.63] vs 2.37 [1.40, 2.98] ml/min/g; P=0.049, 3.57 [2.17, 4.54] vs 2.25 [1.73, 3.49] vs 2.26 [1.64, 3.38] vs 1.89 [0.89, 2.32]; P=0.023, respectively. G-CFR and hyperemic CSF were both significantly lower in the group with larger number of inflamed vessels.
Conclusions
In SAP patients with significant coronary artery stenosis, G-CFR obtained by PC-CMR significantly associated with the prevalence of inflamed vessels detected by coronary CT. The extent of coronary inflammation may influence global coronary endothelium dysfunction, resulting in decreased G-CFR.
Collapse
Affiliation(s)
- H Hirano
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | | | - M Hoshino
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Tsuchiura, Japan
| |
Collapse
|
39
|
Horie T, Hoshino M, Hirano H, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. P5617Repeatability of instantaneous wave-free ratio in comparison with fractional flow reserve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Instantaneous wave-free ratio (iFR) has been recently introduced as an adenosine free alternative for fractional flow reserve (FFR) to assess the functional significance of epicardial coronary stenosis. Little is known, however, regarding the repeatability and stability of iFR in comparison with FFR.
Purpose
The aim of this study was to evaluate the repeatability of iFR and compare it to that of FFR.
Methods
Patients with stable coronary artery disease who underwent physiological assessment twice within 90 days were enrolled. Repeated measurements were performed at diagnostic and therapeutic catheterization in about 70% of studied population. The remaining patients were measured twice for non-culprit lesion assessment at primary PCI and subsequent non-culprit and ischemia-documented lesion PCI. The calculation of iFRmatlab from DICOM pressure tracing data of resting state was performed using a fully automated off-line software algorithm in a blind fashion. FFR values were also measured by a fully automated algorithm in the same core laboratory by using hyperemic pressure tracing data. The repeatability of the two indices were evaluated and compared. The inter-rater agreement between iFRmatlab and FFR values of two measurements was assessed by κ coefficient. The pressure rate product during each assessment was also documented and evaluated.
Results
Ninety-three lesions from 92 patients were included in the study. The time interval between the two assessments was 38.4±19.0 days. iFRmatlab and FFR both showed significant correlation within the two assessments (iFRmatlab: r=0.75, 95% confidence interval, 0.64 to 0.83; mean difference, −0.006 [−0.18 to −0.01], FFR: r=0.86, 95% confidence interval, 0.79 to 0.90; mean difference, 0.004 [−0.07 to 0.03]). The inter-rater agreement of functional ischemia for iFRmatlab and FFR were κ=0.449 and κ=0.732, respectively. Although the prevalence of functional ischemia during the first and second assessment were consistent for both indices (iFRmatlab: 70.0%/67.7%, FFR: 86.0%/ 86.0%), significant difference was observed in the prevalence of clinical disagreement on the diagnosis of functional ischemia (FFR=0.80, iFR=0.89 used as cut-off values, respectively) between the first and second assessment among the two indices (iFRmatlab: 6.5%, FFR: 23.7%, p=0.002). iFRmatlab was significantly associated with pressure rate product during the examination compared to FFR (iFRmatlab: r= −0.25, 95% confidence interval, −0.43 to −0.04, P=0.018, FFR: r=−0.08, 95% confidence interval, −0.28 to −0.13, p=0.467).
Conclusion
Our results suggested that iFRmatlab showed lower repeatability and reliability for decision making compared to FFR. The instability of iFRmatlab potentially derives at least in part from its association with heart rate and blood pressure product.
Collapse
Affiliation(s)
- T Horie
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiology, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Ibaraki, Japan
| |
Collapse
|
40
|
Kanno Y, Hoshino M, Sugiyama T, Kanaji Y, Yamaguchi M, Hada M, Ohya H, Sumino Y, Hirano H, Horie T, Yonetsu T, Kakuta T. P2703Impact of subtended myocardial mass on the assessment of functional ischemia as evaluated by FFR and QFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The fractional flow reserve (FFR) becomes a standard practice for revascularization decision-making in evaluating the functional significance of angiographically intermediate epicardial coronary stenosis. The quantitative flow ratio (QFR) is a novel method for rapid computational estimation of FFR without pressure wire and hyperemic induction. FFR has been reported to be associated with not only epicardial stenosis but also subtended myocardial mass (Vsub). In contrast, the relationship between QFR and Vsub has not been clarified.
Purpose
We sought to examine if subtended myocardial mass (Vsub) assessed by coronary computed tomography showed a significant relationship with QFR in comparison with FFR.
Methods and results
We performed a post-hoc analysis of 152 territories (LAD 116, RCA 25 and LCX 11 lesions) with angiographically intermediate-to-severe stenosis in 152 patients who underwent FFR assessment. The median FFR and QFR values were 0.76 (0.64–0.84) and 0.76 (0.72–0.83), respectively. The median diameter stenosis (%DS) and minimum lumen diameter (MLD) were 54.5 (43.9–64.2) and 1.2 (0.9–1.6), respectively. In total, 123 (80.9%) and 29 (19.1%) lesions showed concordant and discordant FFR and QFR functional classifications, respectively. The ability of Vsub/MLD2 to discriminate lesions with FFR≤0.80 and QFR≤0.80 was assessed compared with QCA data. FFR values were associated with Vsub (R=0.37, P<0.001). In contrast, a trend albeit no significant linear relationshipwas detected between QFR and Vsub (R=0.15, P=0.060). The area under the curve (AUC) of Vsub/MLD2 predicting FFR≤0.80 (0.88: 95% confidence interval [CI], 0.83–0.94)was significantly better than that of MLD (0.80: 95% [CI], 0.72–0.88) (P<0.001). On the other hand, the AUC of Vsub/MLD2 predicting QFR≤0.80 (0.82: 95% [CI], 0.75–0.90) was similar to that of MLD (0.80: 95% [CI], 0.72–0.87) (P=0.276). Multivariate analysis showed that the value of Vsub/MLD2 was an independent predictor of FFR≤0.80 (odds ratio [OR]: 1.09, 95% [CI]: 1.03–1.15, P=0.002), whereas it was not an independent predictor of QFR≤0.80.
Conclusions
Subtended cardiac mass volume derived from CT segmentation improved the diagnostic performance of angiography-derived parameters to identify ischemia-producing lesions when FFR used as a reference standard, whereas QFR showed non-significant relationship with subtended cardiac mass.
Collapse
Affiliation(s)
- Y Kanno
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Cardiology, Tsuchiura, Japan
| |
Collapse
|
41
|
Hoshino M, Yonetsu T, Kanaji Y, Sugiyama T, Yamaguchi M, Hada M, Ohya H, Sumino Y, Kanno Y, Hirano H, Horie T, Murai T, Koo BK, Escaned J, Kakuta T. 6113Gender differences in long-term outcomes in patients with deferred revascularization following fractional flow reserve assessment: international collaboration registry of physiologic evaluation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Studies of sex differences in fractional flow reserve (FFR) measurements have shown that in comparison with men, angiographic lesions of similar visual severity are less likely to be ischemia producing in women. Gender specific differences may influence revascularization decision making and prognosis after deferred revascularization following FFR measurement.
Purpose
This study sought to investigate the gender difference in long-term prognosis of patients of deferred revascularization following FFR assessment.
Methods
A total of 879 patients (879 vessels) with deferred revascularization with FFR >0.75 who underwent FFR and CFR measurements were enrolled from 3 countries (Korea, Japan, and Spain). Long-term outcomes were assessed in 649 men and 230 women by the patient-oriented composite outcome (POCO, a composite of any death, any myocardial infarction [MI], and any revascularization). We applied inverse-probability weighting (IPW) based on propensity scores to account for differences at baseline between women and men (age, hypertension, hyperlipidemia, diabetes mellitus, lesion location, clinical status, FFR, Reference diameter, Diameter stenosis, lesion length). The median follow-up duration was 1855 days (745–1855 days).
Results
Median FFR values were 0.88 (0.83–0.93) in men and 0.89 (0.85–0.94) in women, respectively. The occurrences of POCO were significantly high in men compared with that in women (10.5% vs 4.2%, P=0.007). Kaplan–Meier analysis revealed that women had a significantly lower risk of POCO (χ2=7.2, P=0.007). Multivariate COX regression analysis revealed that age, male, diabetes mellitus, diameter stenosis, lesion length, and coronary flow reserve were independent predictors of POCO. After applying IPW, the hazard ratio of male for POCO was 2.20 (95% confidence interval: 1.12 to 4.33, P=0.023).
Conclusion
This large multinational study reveals that long-term outcome differs between women and men in favour of women after FFR-guided revascularization deferral.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Murai
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - B K Koo
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
42
|
Yuba T, Kimura Y, Mukaida T, Aoyama T, Hirano H, Gen S, Ohashi K, Hattori A, Takayama A, Yui Y, Kuroki N, Abe D, Suzuki K. P3708Prognostic significance of electrocardiographic changes after subarachnoid hemorrhage. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
Many reports have examined electrocardiographic (ECG) changes after subarachnoid hemorrhage from long ago; however, there are few reports on the prognosis of patients who have an ECG abnormality. Therefore, in this study, the prognoses of patients with subarachnoid hemorrhage showing abnormal ECG findings were retrospectively analyzed.
Methods
Over 30 months from January 2014 to June 2016, 199 patients (mean age, 61.1±17.0 years; 46.7% male) admitted with a subarachnoid hemorrhage (SAH) were enrolled. To assess the mechanism underlying abnormal ECG in the SAH, predictor variables, such as demographics (age, sex, and body surface area), hemodynamics (heart rate and systolic blood pressure), blood biochemical results, neurological assessments (Glasgow Coma Scale), and computed tomography (CT) severity classification (World Federation of Neurosurgical Societies classification) were recorded. The subarachnoid hemorrhage was classified into either the cerebral aneurysm rupture group (N=132) or traumatic subarachnoid hemorrhage group (N=67) and analyzed.
Results
In the cerebral aneurysm rupture group, the QT prolongation was significantly increased compared with the traumatic subarachnoid hemorrhage group (424.8±87.7 ms vs. 400.5±95.8 ms, P<0.05). There was a correlation between consciousness level (Glasgow Coma Scale) on admission and QT prolongation, and significant QT prolongation was observed in critical patients (Pearson's correlation coefficient test P=0.04). ST changes correlated with CT classification severity (WFNS classification), and the most severe group (WFNS Grade 5) showed significant ST changes. On admission, the cerebral aneurysm rupture group and 97.0% in the traumatic subarachnoid hemorrhage group.
Conclusions
Significantly prolonged QT and ST changes are noted in patients with severe aneurysmal subarachnoid hemorrhage. The cause of the ECG abnormality in subarachnoid hemorrhage patients is not yet understood. A small number of experimental animal models have shown that electrocardiogram abnormalities associated with subarachnoid hemorrhage develop in the brain stem, and an autonomic nerve abnormality may also be involved.
A D-dimer is positively correlated with both aneurysm trauma and traumatic subarachnoid hemorrhage and may be used for auxiliary diagnosis of a subarachnoid hemorrhage.
Collapse
Affiliation(s)
- T Yuba
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Kimura
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Mukaida
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - T Aoyama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - S Gen
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Ohashi
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Hattori
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - A Takayama
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - Y Yui
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - N Kuroki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - D Abe
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| | - K Suzuki
- Tokyo Metropolitan Bokutoh Hospital, Department of Cardiology, Tokyo, Japan
| |
Collapse
|
43
|
Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Horie T, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yuki H, Yonetsu T, Kakuta T. P2239The association between global coronary flow reserve and coronary inflammation assessed by fat attenuation index on computed tomography in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Impaired global coronary flow reserve (G-CFR) is known to predict worse outcomes in patients with coronary artery disease. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying coronary sinus flow (CSF) and global coronary flow reserve (G-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Although G-CFR impairment has been previously reported to be linked with endothelium dysfunction and subsequent atherosclerosis, the relationship between coronary inflammation and absolute coronary blood flow volume or coronary flow reserve remains elusive.
Purpose
We evaluated the association between G-CFR by quantifying CSF using PC-CMR and the extent of coronary inflammation in patients with ACS treated with emergent percutaneous coronary intervention (PCI).
Methods
The study enrolled 107 ACS patients who underwent uncomplicated emergent PCI within 48 hours of symptom onset and coronary CT angiography were performed before PCI. Proximal 40-mm segments of all three major epicardial coronary vessels were examined. Coronary inflammation was assessed by the CT fat attenuation index of perivascular adipose tissue (FAI−PVAT) defined as the mean attenuation of the perivascular adipose tissue (−190 to −30 Hounsfield units (HU)) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel, as previously reported. CMR images were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after emergent PCI and revascularization of non-culprit significant lesions. The patients were divided into 4 groups according to the number of inflamed vessels (defined as 0, 1, 2, 3 vessels with FAI ≥−70.1 HU).
Results
In the final analysis of 102 patients (mean age 64, Male 65 (63.7%)) including 77 patients with non-ST-segment elevation myocardial infarction (NSTEMI) (75.5%) and 25 patients with unstable angina pectoris (UAP), 25, 30, 26, 21 patients exhibited none, 1, 2, 3 inflamed vessels with FAI ≥−70.1 HU, respectively. Rest and maximal hyperemic CSF and corrected G-CFR were 1.17 [0.63, 1.71] vs 1.36 [1.05, 1.67] vs 1.21 [0.83, 1.94] vs 1.35 [0.96, 1.67] ml/min/g; P=0.61, 3.26 [2.62, 2.99] vs 3.50 [2.60, 4.03] vs 3.34 [1.78, 4.20] vs 2.48 [1.54, 3.43]; P=0.061, 2.95 [2.05, 4.30] vs 2.63 [1.80, 3.56] vs 2.15 [1.37, 2.91] vs 2.18 [1.46, 2.42]; P=0.018, respectively. G-CFR was significantly lower in group with increased number of inflamed vessels.
Conclusions
In ACS patients successfully revascularized within 48 hours of onset, G-CFR obtained by noninvasive PC-CMR significantly associated with the prevalence of inflamed vessels detected by coronary CT. Further large population study is warranted to test the hypothesis that the extent of coronary inflammation before coronary revascularization in patients with ACS might provide prognostic information.
Collapse
Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
44
|
Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Yuki H, Horie T, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yonetsu T, Kakuta T. P5251Prognostic value of unrecognized myocardial infarction detected by cardiac magnetic resonance imaging in patients presenting with first acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Unrecognized myocardial infarction (UMI) has been reported to be strongly associated with worse outcome in patients with cardiovascular disease. Cardiac magnetic resonance (CMR) imaging is a useful instrument for the assessment of pathological and functional conditions.
Purpose
This study sought to evaluate the prognostic value of the presence of unrecognized non-infarct-related late gadolinium enhancement (non-IR LGE) evaluated by cardiac magnetic resonance imaging in patients presenting with a first acute myocardial infarction (AMI).
Methods
We studied 311 AMI patients including 213 STEMI and 98 NSTEMI patients without the history of prior MI who underwent uncomplicated primary or emergent PCI within 48 hours of symptom onset between October, 2012 and June, 2017. CMR images were acquired at 28 [21, 32] days after primary/emergent PCI. UMI was defined as having LGE separately in the different and remote area from the perfused territory by infarct-related artery. In case of multiple LGE areas of infarction, the coronary angiography findings were used to support identification of the area corresponding to the culprit artery of AMI. The association of CMR variables and other clinical characteristics with major adverse cardiac events (cardiac death, nonfatal myocardial infarction, nonfatal stroke) were investigated.
Results
Forty-six patients (14.8%) showed UMI defined by the presence of non-IR LGE (27 STEMI and 19 NSTEMI). During the follow up for 830 [385, 1309] days, cardiovascular death occurred in 7 patients (2.3%), and non-fatal MI and non-fatal stroke occurred in 10 and 1 patients, respectively (3.2%, 0.3%, respectively). There was no significant difference in the prevalence of UMI and incidence of MACE between the patients with STEMI and NSTEMI (p=0.13, p=0.11, respectively). Event-free survival was significantly worse in patients with UMI (log-rank χ2=16.3, P=0.001) in a total cohort. Cox proportional hazards analysis showed that UMI was independent predictors of adverse cardiac events during follow-up in patients with first MI (hazard ratio, 7.60, 95% confidence interval, 2.78–20.8, p=0.0001).
Conclusions
In first AMI patients, UMI defined by non-IR LGE obtained by noninvasive CMR provides significant prognostic information. Early detection of UMI by CMR may help risk stratification of patients with AMI and support adjunctive aggressive patient management such as strong statin therapy and life style intervention.
Collapse
Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
45
|
Sugiyama T, Hoshino M, Kanaji Y, Horie T, Yuki H, Hirano H, Kanno Y, Hada M, Ohya H, Sumino Y, Yamaguchi M, Yonetsu T, Kakuta T. P6393Differences in coronary inflammation between the culprit and non-culprit vessels assessed by fat attenuation index on computed tomography in patients with acute coronary syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Inflammation is linked with progression of coronary atherosclerosis. Recent studies have reported the association between elevated perivascular fat attenuation index (FAI) on computed tomography (CT) and worse cardiac outcomes in patients with coronary artery disease.
Purpose
We aimed to investigate the differences in FAI-defined peri-coronary inflammation status between the culprit and non-culprit vessels in patients with acute coronary syndromes (ACS).
Methods
A total of 78 ACS patients with left anterior descending coronary arteries (LAD) as a culprit vessel who underwent coronary CT angiography and invasive coronary angiography were studied. Proximal 40-mm segments of the LAD and the right coronary artery (RCA) were traced. Coronary inflammation was assessed by the FAI defined as the mean CT attenuation value of perivascular adipose tissue (−190 to −30 Hounsfield units [HU]) in a layer of tissue within a radial distance from the outer coronary artery wall equal to the diameter of the vessel. All patients were divided into two groups according to the values of FAI in the LAD: high FAI group (FAI-LAD > median; n=39) and low FAI group (FAI-LAD ≤ median; n=39). Patient characteristics, angiographic and CT findings were compared between the two groups.
Results
In a total of 78 patients, median FAI in the LAD was −70.20 (interquartile range, −74.81 to −64.58) HU. High FAI group was associated with male sex and lower left ventricular ejection fraction compared with Low FAI group. Minimal lumen diameter, reference diameter, diameter stenosis, and lesion length on quantitative coronary angiography analysis and coronary artery calcium score on CT was not different between the groups. FAI in the RCA was also higher in High FAI group than that in Low FAI group (−67.64±8.31 vs. −76.47±6.25 HU, P<0.001). Paired t-test comparison demonstrated that culprit vessel showed higher FAI than the non-culprit vessel (−69.85±7.74 vs. −72.11±8.54 HU, P=0.013).
Conclusions
In ACS patients with culprit LAD lesions, FAI-defined peri-coronary inflammation status is higher in the culprit vessel than in the non-culprit vessel.
Collapse
Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
46
|
Kanaji Y, Sugiyama T, Hoshino M, Hirano H, Horie T, Yuki H, Kanno Y, Ohya H, Sumino Y, Hada M, Yamaguchi M, Yonetsu T, Kakuta T. P3585Prognostic value of the assessment of coronary sinus flow by phase contrast cine-magnetic resonance imaging in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying global coronary sinus flow (CSF) and global coronary flow reserve (G-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization.
Purpose
We evaluated the prognostic value of G-CFR by quantifying CSF using PC-CMR in patients with ACS treated with primary or emergent percutaneous coronary intervention (PCI).
Methods
The study prospectively enrolled 387 ACS patients who underwent uncomplicated primary or emergent PCI within 48 hours of symptom onset. Breath-hold PC-CMR images of CS were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after primary PCI and revascularization of functionally significant non-culprit lesions of ACS. The association of G-CFR and baseline clinical characteristics with major adverse cardiac events (cardiac death, nonfatal myocardial infarction, late revascularization, or hospitalization for congestive heart failure) was investigated.
Results
In the final analysis of 366 patients (Male 294 (80.3%), mean age 65) including 233 patients (63.7%) with ST-segment elevation myocardial infarction (STEMI) and 133 patients (36.3%) with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), rest and maximal hyperemic CSF and corrected G-CFR were 1.24 [0.83, 1.71] ml/min/g, 2.56 [1.87, 3.66] ml/min/g, and 2.20 [1.53, 3.17], respectively. During a median follow-up of 16 months, MACE occurred in 84 patients (cardiac death: 9, nonfatal myocardial infarction: 11, late revascularization: 59, hospitalization for congestive heart failure: 5). Cardiac event-free survival was significantly worse in patients with a corrected G-CFR <2.00 (log-rank χ2=20.2, P<0.001). Cox proportional hazards analysis showed that corrected G-CFR were independent predictors of adverse cardiac events during follow-up in patients with STEMI (hazard ratio, 0.66, 95% confidence interval, 0.51–0.85, p=0.001) and NSTE-ACS (hazard ratio, 0.64, 95% confidence interval, 0.43–0.95, p=0.026), respectively.
Conclusions
In ACS patients successfully revascularized within 48 hours of onset, G-CFR obtained by noninvasive PC-CMR provided significant prognostic information independent of infarction size and conventional risk scores.
Collapse
Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Horie
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Yuki
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ohya
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| |
Collapse
|
47
|
Tsuji S, Matsuzaki H, Iseki M, Nagasu A, Hirano H, Ishihara K, Ueda N, Honda Y, Horiuchi T, Nishikomori R, Morita Y, Mukai T. Functional analysis of a novel G87V TNFRSF1A mutation in patients with TNF receptor-associated periodic syndrome. Clin Exp Immunol 2019; 198:416-429. [PMID: 31429073 DOI: 10.1111/cei.13365] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2019] [Indexed: 12/17/2022] Open
Abstract
Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is an autoinflammatory disease that is caused by heterozygous mutations in the TNFRSF1A gene. Although more than 150 TNFRSF1A mutations have been reported to be associated with TRAPS phenotypes only a few, such as p.Thr79Met (T79M) and cysteine mutations, have been functionally analyzed. We identified two TRAPS patients in one family harboring a novel p.Gly87Val (G87V) mutation in addition to a p.Thr90Ile (T90I) mutation in TNFRSF1A. In this study, we examined the functional features of this novel G87V mutation. In-vitro analyses using mutant TNF receptor 1 (TNF-R1)-over-expressing cells demonstrated that this mutation alters the expression and function of TNF-R1 similar to that with the previously identified pathogenic T79M mutation. Specifically, cell surface expression of the mutant TNF-R1 in transfected cells was inhibited with both G87V and T79M mutations, whereas the T90I mutation did not affect this. Moreover, peripheral blood mononuclear cells (PBMCs) from TRAPS patients harboring the G87V and T90I mutations showed increased mitochondrial reactive oxygen species (ROS). Furthermore, the effect of various Toll-like receptor (TLR) ligands on inflammatory responses was explored, revealing that PBMCs from TRAPS patients are hyper-responsive to TLR-2 and TLR-4 ligands and that interleukin (IL)-8 and granulocyte-macrophage colony-stimulating factor (GM-CSF) are likely to be involved in the pathogenesis of TRAPS. These findings suggest that the newly identified G87V mutation is one of the causative mutations of TRAPS. Our findings based on unique TRAPS-associated mutations provide novel insight for clearer understanding of inflammatory responses, which would be basic findings of developing a new therapeutic and prophylactic approach to TRAPS.
Collapse
Affiliation(s)
- S Tsuji
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - H Matsuzaki
- Department of Life Sciences, Faculty of Life and Environmental Sciences, Prefectural University of Hiroshima, Shobara, Hiroshima, Japan
| | - M Iseki
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - A Nagasu
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - H Hirano
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - K Ishihara
- Department of Immunology and Molecular Genetics, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - N Ueda
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Y Honda
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, Japan
| | - R Nishikomori
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Y Morita
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - T Mukai
- Department of Rheumatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| |
Collapse
|
48
|
Matsumoto Y, Harada K, Maeda T, Egusa C, Hirano H, Okubo Y, Tsuboi R. Molecular detection of fungal and bacterial DNA from pustules in patients with palmoplantar pustulosis: special focus on Malassezia species. Clin Exp Dermatol 2019; 45:36-40. [PMID: 31220362 DOI: 10.1111/ced.14026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Palmoplantar pustulosis (PPP) is a distinct, chronic skin disorder characterized by intraepidermal pustules on the palms and soles. It is hypothesized that microorganisms on the skin might induce the symptoms of PPP via inflammatory cell activation. However, the microbiota has not been studied in detail because of the assumption that the pustules in PPP are sterile. AIM To elucidate the role of microorganisms in pathogenesis of PPP. METHODS PCR analysis was performed of microbial DNA fragments in the pustules of patients with PPP. The sequence of the D1/D2 LSU 26s rRNA gene and that of the 16S rRNA gene was used for fungal and bacterial DNA detection, respectively. RESULTS In total, 71 samples were carefully collected from the pustules of patients with PPP. Fungal DNA bands were detected in 68 samples, and fungi including Malassezia spp. were identified in 30 of 71 samples (42.3%). Malassezia restricta was the most frequently encountered fungus (14/71; 19.7%). However, bacterial DNA was not detected by the methods used. Furthermore, identical fungal DNA was not detected in the outer lid of the pustules, suggesting that the fungi detected within the pustule did not derive from contamination via the skin surface. CONCLUSIONS In the present study, we demonstrated for the first time that certain pustules in patients with PPP contain fungal DNA fragments, especially those of Malassezia spp. Our findings provide new insights on the role of skin microbiota in the pathogenesis of PPP.
Collapse
Affiliation(s)
- Y Matsumoto
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - K Harada
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - T Maeda
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - C Egusa
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - H Hirano
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - Y Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | - R Tsuboi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
49
|
Nakajima E, Takashi H, Taira O, Fukuda K, Furukawa K, Hirano H, Ikeda N. Glomus Tumor in a Segmental Bronchus: A Case Report. Ann Thorac Cardiovasc Surg 2019; 27:407-409. [PMID: 31189773 PMCID: PMC8684842 DOI: 10.5761/atcs.cr.19-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glomus tumors originate from a neuroarterial structure called the glomus body, and grow mostly in soft tissue. It is rare for glomus tumors to develop in the respiratory system. The patient of the present case had an abnormal shadow in the right lung on chest X-ray, and computed tomography (CT) findings displayed a lung tumor in the right S6. Bronchoscopy was performed for the diagnosis of the lung tumor, and a polypoid bronchial tumor was unexpectedly found to occupy the right B3. The bronchial tumor was diagnosed as a glomus tumor, and the lung tumor was diagnosed as an adenocarcinoma. The bronchial glomus tumor was cauterized by argon plasma coagulation (APC). Three weeks after the cauterization by APC, the right lower lobectomy was performed for the treatment of the lung adenocarcinoma. The patient has remained disease free for 2 years.
Collapse
Affiliation(s)
- Eiji Nakajima
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
| | - Hidenobu Takashi
- Department of Thoracic Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Osamu Taira
- Department of Surgery, Migita Hospital, Hachioji, Tokyo, Japan
| | - Kentarou Fukuda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kinya Furukawa
- Department of Thoracic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-machi, Ibaraki, Japan
| | - Hiroshi Hirano
- Department of Diagnostic Pathology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
50
|
Abstract
INTRODUCTION Meningioma is mostly a benign tumor, but sometimes it is malignant, and there have been reports of distant metastases. PATIENT CONCERNS The patient, a woman in her 40s, was under follow-up after resection of an ectopic malignant meningioma originating in the left axilla. She was referred to our department because of a nodule shadow in the right lung on chest computed tomography (CT) 3 years and 5 months postoperatively. DIAGNOSIS Chest CT showed a 1.0 cm nodule shadow in the right S4, which was positive on positron emission tomography-CT; no abnormality was found in any other organ. Therefore, it was considered to be a metastatic lung tumor. INTERVENTIONS Right middle lobe partial resection was performed using thoracoscopic surgery, and a diagnosis of pulmonary metastasis of ectopic malignant meningioma was made by histopathology and immunohistochemistry. OUTCOMES In this case, complete resection was possible. CONCLUSION Meningioma occurs mainly in the cranium, and occurrence in the soft tissue of the extremities is extremely rare. To our knowledge, ours is the first report of a histologically malignant ectopic meningioma with metastasis to the thoracic cavity.
Collapse
Affiliation(s)
| | | | | | | | - Hiroshi Hirano
- Department of Pathology, Hachioji Medical Center, Tokyo Medical University
| | - Norihiko Kawate
- Department of Health Science and Social Welfare, Waseda University School of Human Sciences
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|