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Shimokaze T, Toyoshima K, Saito T, Katsumata K, Kemmotsu T, Ishikawa H, Kurosawa K. Death of children with Down syndrome by gestational age and cause. Pediatr Res 2024; 95:1325-1330. [PMID: 37898703 DOI: 10.1038/s41390-023-02870-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/16/2023] [Accepted: 10/12/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND We often encounter preterm infants with Down syndrome (DS) who die in the neonatal intensive care unit (NICU). In this study, we examined survival until NICU discharge and assessed the developmental prognosis of preterm infants with DS. METHODS We retrospectively reviewed 416 infants with DS hospitalized during the past 27 years at our NICU. RESULTS Death occurred in 8/20 (40%) infants at <32 weeks' gestation, 11/23 (48%) at 32-33 weeks, 9/99 (9%) at 34-36 weeks, and 9/274 (3%) at >36 weeks. In total, 84% of infants who died and 25% of those who survived had a non-reassuring fetal status (p < 0.001). Sex, small-for-gestational-age status, and postnatal transport were not associated with death. The main causes of death were bronchopulmonary dysplasia in 4/8 (50%) infants at <32 weeks' gestation, transient abnormal myelopoiesis in 11/20 (55%) and lymphatic dysplasia in 6/20 (30%) at 32-36 weeks, and varied causes at >36 weeks. Among survivors born at <34 weeks' gestation, 6/19 (32%) aged >2 years had moderate or severe cerebral palsy. CONCLUSIONS These data on the high mortality and morbidity of preterm infants with DS may be useful for patient treatment and parent counseling in NICUs treating critically ill infants. IMPACT Most infants with Down syndrome born at <34 weeks' gestation are born by cesarean section because of the non-reassuring fetal status. The mortality rate before discharge for infants with Down syndrome born at <34 weeks' gestation was 40%, and 30% of survivors developed moderate or severe cerebral palsy. The risk of death due to bronchopulmonary dysplasia and pulmonary hypertension was high in very preterm infants with Down syndrome despite the absence of chorioamnionitis. Infants with Down syndrome were born 1-2 weeks earlier than unaffected controls.
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Affiliation(s)
- Tomoyuki Shimokaze
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
| | - Katsuaki Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Tomoko Saito
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Kaoru Katsumata
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Takahiro Kemmotsu
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
| | - Kenji Kurosawa
- Department of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan
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Khreish M, Schuman JS, Lee T, Ghassabi Z, Zambrano R, Hu J, Ishikawa H, Wollstein G, Lavinsky F. Peripapillary Atrophy Area as an Indicator of Glaucomatous Structural and Functional Progression. Transl Vis Sci Technol 2024; 13:1. [PMID: 38427349 PMCID: PMC10913935 DOI: 10.1167/tvst.13.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
Purpose To determine whether peripapillary atrophy (PPA) area is an indicator of glaucomatous structural and functional damage and progression. Methods In this retrospective longitudinal analysis from ongoing prospective study we qualified 71 eyes (50 subjects) with glaucoma. All subjects had a comprehensive ophthalmic examination, visual field (VF), and spectral-domain optical coherence tomography (OCT) testing in at least three visits. PPA was manually delineated on en face OCT optic nerve head scans, while observing the corresponding cross-sectional images, as the hyper-reflective area contiguous with the optic disc. Results The mean follow-up duration was 4.4 ± 1.4 years with an average of 6.8 ± 2.2 visits. At baseline, PPA area was significantly associated only with VF's mean deviation (MD; P = 0.041), visual field index (VFI; P = 0.041), superior ganglion cell inner plexiform layer (GCIPL; P = 0.011), and disc area (P = 0.011). Longitudinally, PPA area was negatively and significantly associated with MD (P = 0.015), VFI (P = 0.035), GCIPL (P = 0.009), superior GCIPL (P = 0.034), and disc area (P = 0.007, positive association). Conclusions Longitudinal change in PPA area is an indicator of glaucomatous structural and functional progression but PPA area at baseline cannot predict future progression. Translational Relevance Longitudinal changes in peripapillary atrophy area measured by OCT can be an indicator of structural and functional glaucoma progression.
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Affiliation(s)
- Maroun Khreish
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Neuroscience and Physiology, NYU Langone Health, New York, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
| | - TingFang Lee
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Zeinab Ghassabi
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Ronald Zambrano
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
| | - Jiyuan Hu
- Department of Population Health, NYU Langone Health, New York, NY, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
| | - Fabio Lavinsky
- Universidade do Vale do Rio dos Sinos Medical School, Sao Leopoldo, Brazil
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Yamamoto M, Aoki S, Shinoda S, Ishikawa H, Miyagi E. Impact of interpregnancy weight changes and perinatal outcomes: A retrospective study in Japan. PLoS One 2024; 19:e0299794. [PMID: 38421997 PMCID: PMC10903892 DOI: 10.1371/journal.pone.0299794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 02/01/2024] [Indexed: 03/02/2024] Open
Abstract
Previous studies have shown that interpregnancy weight fluctuations impact perinatal outcomes. In order to examine this in Japanese women, we analyzed the data of 2,861 women in their first and second pregnancies who delivered singletons between 2000 and 2022. We compared the second pregnancy perinatal outcomes of women whose interpregnancy body mass index (BMI) change was -1 to 1 unit with those of women whose BMI change was < -1 or ≥ 1 unit. An interpregnancy BMI change ≥ 1 unit was associated with an increased risk of developing gestational diabetes mellitus (adjusted odds ratio [aOR], 1.51; 95% confidence interval [CI], 1.18-1.95) and delivering a large for gestational age neonate (aOR, 1.67; 95% CI, 1.15-2.42) but a decreased risk of preterm birth (aOR, 0.66; 95% CI, 0.46-0.95). An interpregnancy BMI change < -1 unit was associated with a decreased risk of developing gestational diabetes mellitus (aOR, 0.51; 95% CI, 0.31-0.85). In a subgroup analysis of three groups divided according to prepregnancy BMI, interpregnancy BMI changes ≥ 1 unit in women with a BMI of < 18.5 kg/m2 before their first pregnancy were associated with a remarkable risk reduction of developing preterm birth (aOR, 0.30; 95% CI, 0.11-0.81). Interpregnancy BMI changes < -1 unit in women with a BMI of ≥ 25 kg/m2 before their first pregnancy were associated with a remarkable risk reduction of developing gestational diabetes mellitus (aOR, 0.33; 95% CI, 0.12-0.88). Weight gain during interpregnancy period was related to an increased risk of gestational diabetes mellitus and delivery of a large-for-gestational-age neonate, whereas weight loss was related to a decreased risk of developing gestational diabetes mellitus. These results indicate the importance of interpregnancy weight control as part of preconception care; therefore, women considering additional pregnancies should be educated on the importance of maintaining a healthy weight.
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Affiliation(s)
- Masafumi Yamamoto
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shigeru Aoki
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Satoru Shinoda
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Obstetrics and Gynecology, Kanagawa Children’s Medical Center, Yokohama, Kanagawa, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Ishikawa S, Ishikawa H, Sato M, Nagasawa A, Suzuki Y, Okayama J, Nakada E, Omoto A, Shozu M, Koga K. Postpartum acute adrenal insufficiency of early-onset Sheehan syndrome: A case series study in a single center. J Obstet Gynaecol Res 2024; 50:205-211. [PMID: 37986644 DOI: 10.1111/jog.15838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
AIM To identify the symptoms and relevant factors associated with acute adrenal insufficiency of early-onset Sheehan syndrome. METHODS We retrospectively reviewed the charts of 125 women admitted to our intensive care unit because of postpartum hemorrhage between January 2011 and December 2021. Three women developed acute adrenal insufficiency. We investigated the total blood loss, shock status, consciousness level upon arrival, and intensive care provided to the women. We also analyzed the symptoms and laboratory data that led to the diagnosis of acute adrenal insufficiency. Continuous variables were presented by median (minimum-maximum). RESULTS The medians and ranges of age, total blood loss, and shock index [heart rate/systolic blood pressure] on admission were 33.1 (17.2-45.3) years, 3351 (595-20 260) g, and 0.94 (0.55-2.94), respectively. Seven women were older than 40 years, 28 experienced >5000 g blood loss, 17 had shock index >1.5, 27 had impaired consciousness upon arrival, and 15 underwent hysterectomy. Women who developed acute adrenal insufficiency were <40 years old and had a bleeding volume of over 5000 g, impaired consciousness upon arrival, and had undergone hysterectomy. They had experienced lactation failure, presented with hyponatremia-related symptoms on postpartum days 8-9, experienced general malaise, headache, and impaired consciousness, and showed severe hyponatremia. CONCLUSIONS Massive postpartum hemorrhage over 5000 g, impaired consciousness upon arrival, and hysterectomy as a hemostatic measure were relevant factors associated with acute adrenal insufficiency of early-onset Sheehan syndrome. Hyponatremia-related symptoms occurring after lactation failure are indicative of the onset of acute adrenal insufficiency.
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Affiliation(s)
- Shota Ishikawa
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mika Sato
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
| | - Akiko Nagasawa
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
| | - Yoshiya Suzuki
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
| | - Jun Okayama
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
| | - Emiri Nakada
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akiko Omoto
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makio Shozu
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Evolution and Reproductive Biology, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, Japan
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Ishikawa H, Yoshino O, Taniguchi F, Harada T, Momoeda M, Osuga Y, Hikake T, Hattori Y, Hanawa M, Inaba Y, Hanaoka H, Koga K. Efficacy and safety of a novel pain management device, AT-04, for endometriosis-related pain: study protocol for a phase III randomized controlled trial. Reprod Health 2024; 21:12. [PMID: 38279180 PMCID: PMC10811886 DOI: 10.1186/s12978-024-01739-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Endometriosis-related pain encompassing dysmenorrhea, dyspareunia, and chronic pelvic pain, reduces the quality of life in premenopausal women. Although treatment options for endometriosis alleviate this pain, approximately one-third of women still experience pain even after receiving treatment, indicating the need for novel approaches to pain relief in those women. The Angel Touch device (AT-04) is a portable magnetic fields irradiation device that incorporates a combination of mixed alternative magnetic fields at 2 kHz and 83.3 MHz. A phase III trial confirmed the efficacy and safety of AT-02, a prototype of AT-04, for pain relief in patients with fibromyalgia. METHODS This is a phase III, multicenter, prospective, randomized, sham device-controlled, double-blind, parallel study. The participants will be premenopausal women aged > 18 years who have endometriosis-related pain with at least moderate severity. Considering dropouts, 50 participants have been deemed appropriate. Eligible women will be centrally registered, and the data center will randomly allocate them in a 1:1 ratio to the intervention and control groups. Women in the intervention group will receive electromagnetic wave irradiation generated by AT-04 and those who in the control group will wear a sham device for 16 weeks, and both groups will wear AT-04 for another 4 weeks. The primary outcome measure is the change in the Numeric Rating Scale score at 16 weeks compared with the baseline. Secondary outcome measures are efficacy for pelvic pain including dysmenorrhea and non-menstrual pain, and chronic pelvic pain not related to menstruation, dysmenorrhea, and dyspareunia, and improvement of quality of life during the study period. Safety will be evaluated by device defects and the frequency of adverse events. The study protocol has been approved by the Clinical Study Review Board of Chiba University Hospital, Chiba, Japan, and will be conducted in accordance with the principles of the Declaration of Helsinki and the Japanese Clinical Trials Act and relevant notifications. DISCUSSION This study aims to develop a novel method of managing endometriosis-related pain. The AT-04 is an ultralow-invasive device that can be used without inhibiting ovulation, suggesting potential benefits to women of reproductive-age. Trial registration number Japan Registry of Clinical Trials (jRCTs032230278).
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Affiliation(s)
- Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-Ku, Chiba, 260-8670, Japan.
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, 260-8677, Japan.
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi Graduate School of Medicine, Yamanashi, 409-3898, Japan
| | - Fuminori Taniguchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tottori University, Tottori, 683-8504, Japan
| | - Tasuku Harada
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tottori University, Tottori, 683-8504, Japan
| | - Mikio Momoeda
- Department of Obstetrics and Gynecology, Aiiku Hospital, Tokyo, 105-8321, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, The University of Tokyo Graduate School of Medicine, Tokyo, 113-8655, Japan
| | - Tamiki Hikake
- Chiba University Clinical Research Center, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Youko Hattori
- Data Center, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Michiko Hanawa
- Chiba University Clinical Research Center, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Yosuke Inaba
- Chiba University Clinical Research Center, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Hideki Hanaoka
- Chiba University Clinical Research Center, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-Ku, Chiba, 260-8670, Japan
- Department of Obstetrics and Gynecology, Chiba University Hospital, Chiba, 260-8677, Japan
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Kikuchi-Hayakawa H, Ishikawa H, Suda K, Gondo Y, Hirasawa G, Nakamura H, Takada M, Kawai M, Matsuda K. Effects of Lacticaseibacillus paracasei Strain Shirota on Daytime Performance in Healthy Office Workers: A Double-Blind, Randomized, Crossover, Placebo-Controlled Trial. Nutrients 2023; 15:5119. [PMID: 38140378 PMCID: PMC10745872 DOI: 10.3390/nu15245119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Lacticaseibacillus paracasei strain Shirota (LcS) modulates psychological homeostasis via the gut-brain axis. To explore the possible efficacy of LcS for improving daytime performance, we conducted a double-blind, randomized, crossover, placebo-controlled study of 12 healthy office workers with sleep complaints. The participants received fermented milk containing viable LcS (daily intake of 1 × 1011 colony-forming units) and non-fermented placebo milk, each for a 4-week period. In the last week of each period, the participants underwent assessments of their subjective mood and measurements of physiological state indicators via an electroencephalogram (EEG) and heart rate variability in the morning and afternoon. The attention score in the afternoon as assessed by the visual analog scale was higher in the LcS intake period than in the placebo intake period (p = 0.041). Theta power on EEG measured at rest or during an auditory oddball task in the afternoon was significantly lower in the LcS period than in the placebo period (p = 0.025 and 0.009, respectively). The change rate of theta power was associated with the change in attention score. Treatment-associated changes were also observed in heart rate and the sympathetic nerve activity index. These results indicate that LcS has possible efficacy for improving daytime performance, supported by observations of the related physiological state indicators.
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Affiliation(s)
| | - Hiroshi Ishikawa
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Kazunori Suda
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
- Yakult Honsha European Research Center for Microbiology VOF, Technologiepark 94 bus 3, 9052 Ghent, Belgium
| | - Yusuke Gondo
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Genki Hirasawa
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Hayato Nakamura
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Mai Takada
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Mitsuhisa Kawai
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Kazunori Matsuda
- Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
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Omoto A, Ishikawa H, Inoue M, Morimoto S, Koga K, Shozu M. Metroplasty increases the take-home baby rate by reducing pregnancy loss without changing the chance of conception in women with septate uterus: a retrospective, single-center, observational study. BMC Pregnancy Childbirth 2023; 23:860. [PMID: 38098016 PMCID: PMC10720111 DOI: 10.1186/s12884-023-06191-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Although abdominal or hysteroscopic metroplasty for septate uterus is considered to reduce pregnancy loss and increase the take-home baby (THB) rate in women with a history of recurrent pregnancy loss, there exists an inherent risk of impaired fertility. This study aimed to clarify the reproductive outcomes of women with septate uterus who underwent abdominal and hysteroscopic metroplasty in a single center. METHODS This retrospective observational study enrolled 27 women who underwent metroplasty between 2007 and 2019. The analysis included women with septate uterus [European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) type U2)] or septate-bicornuate uterus (ESHRE/ESGE type U3b) who underwent either abdominal or hysteroscopic metroplasty. Women who did not have an immediate desire to conceive were excluded from the analysis. As a rule, we recommended pregnancy without surgery for women who had not experienced repeated pregnancy loss. Abdominal metroplasty (ABM) was performed using the modified Tompkins' method and hysteroscopic metroplasty was performed using hysteroscopic transcervical resection of the septum [transcervical metroplasty (TCM)]. The conception ratio was calculated as the number of women who achieved ≥ 1 conception/total number of women, the pregnancy loss ratio was calculated as the number of women who experienced ≥ 1 pregnancy loss/the number of women who conceived, and the THB ratio was calculated as the number of women who achieved ≥ 1 THB/total number of women. RESULTS Seventeen women underwent ABM and 10 women underwent TCM. Thirty-three conceptions and 26 babies were taken home after surgery. ABM did not change the ≥ 1 conception ratio (76% vs. 83% before and after surgery, respectively; RR = 1.08, p = 0.80). Meanwhile, ABM decreased the ≥ 1 pregnancy loss ratio (100% vs. 36%, RR = 0.36, p < 0.001) and increased the ≥ 1 THB ratio (12% vs. 71%, RR = 6.00, p < 0.01). Similarly, TCM did not change the ≥ 1 conception ratio, decreased the ≥ 1 pregnancy loss ratio, and increased the ≥ 1 THB ratio. CONCLUSIONS Both abdominal and hysteroscopic metroplasty for septate uterus increased the THB rate by preventing pregnancy loss without affecting the chance of pregnancy. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Akiko Omoto
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan.
| | - Mariko Inoue
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
- Department of Obstetrics and Gynecology, Chiba Kaihin Municipal Hospital, Chiba, 261- 0012, Japan
| | - Sachi Morimoto
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
- Department of Obstetrics and Gynecology, Matsudo City General Hospital, Matsudo, 270- 2296, Japan
| | - Kaori Koga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Makio Shozu
- Department of Obstetrics and Gynecology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan
- Evolution and Reproductive Biology, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
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Tochio T, Kawano K, Iyori K, Makida R, Kadota Y, Fujii T, Ishikawa H, Yasutake T, Watanabe A, Funasaka K, Hirooka Y, Nishifuji K. Topical erythritol combined with L-ascorbyl-2-phosphate inhibits staphylococcal growth and alleviates staphylococcal overgrowth in skin lesions of canine superficial pyoderma. Pol J Vet Sci 2023; 26:647-655. [PMID: 38088308 DOI: 10.24425/pjvs.2023.148284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/18/2023]
Abstract
Erythritol (ERT) and L-ascorbyl-2-phosphate (APS) are bacteriostatic, but their effects on staphylococcal skin infections remain unknown. We aimed to determine whether ERT combined with APS inhibits the growth of staphylococci that are commonly isolated from pyoderma skin lesions in dogs. We investigated the individual and combined effects of ERT and APS on the growth of Staphylococcus pseudintermedius, S. schleiferi, and S. aureus using turbidity assays in vitro. Skin lesions from 10 dogs with superficial pyoderma were topically treated with 5% ERT and 0.1% APS for 28 days, and swabbed skin samples were then analyzed using 16S rRNA amplicon sequencing and quantitative real-time PCR (qPCR). Results showed that ERT inhibited S. pseudintermedius growth regardless of harboring the mecA gene, and APS increased the inhibitory effects of ERT against S. pseudintermedius, S. schleiferi, and S. aureus in vitro. Moreover, combined ERT and APS decreased the prevalence of staphylococci on canine skin lesions at the genus level. The combination slightly increased the α-diversity but did not affect the β-diversity of the microbiota. The qPCR results revealed that the combination significantly decreased S. pseudintermedius and S. schleiferi in skin lesions. Topical administration of EPS combined with APS can prevent staphylococcal colonization on the surface of mammalian skin. The results of this study may provide an alternative to systemic antibiotics for treating superficial pyoderma on mammalian skin surfaces.
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Affiliation(s)
- T Tochio
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Kawano
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
- Tokyo Animal Allergy Center, 4-23-15, Kurihara, Adachi-ku, Tokyo 123-0842, Japan
| | - K Iyori
- Vet Derm Tokyo, Dermatological and Laboratory Service for Animals, 910 Shoubusawa, Fujisawa, Kanagawa 252-0823, Japan
| | - R Makida
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - Y Kadota
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - T Fujii
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - H Ishikawa
- Healthcare Systems Co., Ltd., Nagoya Aichi, 466-0058, Japan
| | - T Yasutake
- Healthcare Systems Co., Ltd., Nagoya Aichi, 466-0058, Japan
| | - A Watanabe
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Funasaka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - Y Hirooka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Nishifuji
- Division of Animal Life Science, Institute of Agriculture, Graduate School, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
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9
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Ishikawa H, Saito Y, Koga K, Shozu M. Reproductive outcomes following abdominal repair for cesarean scar defect in women who desire subsequent pregnancies: A single-center retrospective study. Eur J Obstet Gynecol Reprod Biol 2023; 291:141-147. [PMID: 37871351 DOI: 10.1016/j.ejogrb.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/22/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE To clarify the reproductive outcomes of women who underwent abdominal repair surgery for cesarean scar defect (CSD). STUDY DESIGN This is a retrospective observational study performed in a tertiary center. We retrospectively reviewed 20 women who underwent abdominal repair between 2007 and 2021. The indication for the repair was a minimal residual myometrial thickness (RMT) of ≦3.0 mm. We investigated surgical complications, changes in minimal RMT before and three-months after the repair, and reproductive outcomes. RESULTS The median age at the time of repair was 36 years (27-40), with a median body mass index of 21.0 (17.7-28.7) and a median of 1 prior cesarean section (1-5). Twelve women reported secondary infertility, while eight women were concerned about the potential risk of uterine rupture in future pregnancies due to thin RMT. Additionally, one woman had a co-existing vesicouterine fistula, two had abscess and hematoma formation at the precedent cesarean section, and three showed remarkable dehiscence of the defect. The median minimal RMT significantly increased to 5.05 mm (range; 2.5-14.2 mm) after the repair. Seven women had a total of eight live births, with a median duration from the repair to a live-birth pregnancy of 11.5 months (range; 4-20 months). No surgical complications occurred during the repair, and there were no instances of uterine rupture in subsequent pregnancies. However, one woman who became pregnant with twins following double blastocyst transfer required a cesarean section at 25 weeks of pregnancy due to bulging towards the bladder side of the repaired CSD. CONCLUSION Abdominal repair for CSD is feasible in women with thin RMT who experience secondary infertility. Twin pregnancies can promote thinning of the CSD repair site, potentially increasing the risk of uterine rupture.
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Affiliation(s)
- Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Yoshiko Saito
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kaori Koga
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makio Shozu
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan; Evolution and Reproductive Biology, Medical Mycology Research Center, Chiba University, Chiba, Japan
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10
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Ishikawa H, Kobayashi T, Kaneko M, Saito Y, Shozu M, Koga K. RISING STARS: Role of MED12 mutation in the pathogenesis of uterine fibroids. J Mol Endocrinol 2023; 71:e230039. [PMID: 37668348 DOI: 10.1530/jme-23-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/05/2023] [Indexed: 09/06/2023]
Abstract
Abstract Uterine fibroids (UFs) are benign tumors arising from the uterus, characterized by accumulation of abundant extracellular matrix (ECM) and sex steroid-dependent growth. Women with symptomatic UFs have reduced quality of life and decreased labor productivity. Among the driver gene mutations identified in UFs, mutations in MED12, a component of the cyclin-dependent kinase (CDK) Mediator module, are the most common and observed in 50-80% of UFs. They are gain-of-function mutations and are more frequently observed in Black women and commonly observed even in small UFs. MED12 mutation-positive UFs (MED12-UFs) often develop multiple rather than solitary and have distinct gene expression profiles, DNA methylomes, transcriptomes, and proteomes. Gene expressions related to ECM organization and collagen-rich ECM components are upregulated, and impaired Mediator kinase activity and dysregulation of Wnt/β-catenin signaling are identified in MED12-UFs. Clinically, the UF shrinking effect of gonadotropin-releasing hormone agonists and ulipristal acetate is dependent on the MED12 mutation status. Understanding of characteristics of MED12-UFs and functions of MED12 mutations for UF tumorigenesis may elucidate the pathophysiology of UFs, leading to the development of new therapeutic options in women with symptomatic UFs.
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Affiliation(s)
- Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Tatsuya Kobayashi
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Evolution and Reproductive Medicine, Medical Mycology Research Center, Chiba University, Chiba, Japan
- Fujita Medical Innovation Center Tokyo, Reproduction Center, Tokyo, Japan
| | - Meika Kaneko
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiko Saito
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makio Shozu
- Evolution and Reproductive Medicine, Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Kaori Koga
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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11
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Stüdle C, Nishihara H, Wischnewski S, Kulsvehagen L, Perriot S, Ishikawa H, Schroten H, Frank S, Deigendesch N, Du Pasquier R, Schirmer L, Pröbstel AK, Engelhardt B. SARS-CoV-2 infects epithelial cells of the blood-cerebrospinal fluid barrier rather than endothelial cells or pericytes of the blood-brain barrier. Fluids Barriers CNS 2023; 20:76. [PMID: 37875964 PMCID: PMC10598911 DOI: 10.1186/s12987-023-00479-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND As a consequence of SARS-CoV-2 infection various neurocognitive and neuropsychiatric symptoms can appear, which may persist for several months post infection. However, cell type-specific routes of brain infection and underlying mechanisms resulting in neuroglial dysfunction are not well understood. METHODS Here, we investigated the susceptibility of cells constituting the blood-brain barrier (BBB) and the blood-cerebrospinal fluid barrier (BCSFB) of the choroid plexus (ChP) to SARS-CoV-2 infection using human induced pluripotent stem cell (hiPSC)-derived cellular models and a ChP papilloma-derived epithelial cell line as well as ChP tissue from COVID-19 patients, respectively. RESULTS We noted a differential infectibility of hiPSC-derived brain microvascular endothelial cells (BMECs) depending on the differentiation method. Extended endothelial culture method (EECM)-BMECs characterized by a complete set of endothelial markers, good barrier properties and a mature immune phenotype were refractory to SARS-CoV-2 infection and did not exhibit an activated phenotype after prolonged SARS-CoV-2 inoculation. In contrast, defined medium method (DMM)-BMECs, characterized by a mixed endothelial and epithelial phenotype and excellent barrier properties were productively infected by SARS-CoV-2 in an ACE2-dependent manner. hiPSC-derived brain pericyte-like cells (BPLCs) lacking ACE2 expression were not susceptible to SARS-CoV-2 infection. Furthermore, the human choroid plexus papilloma-derived epithelial cell line HIBCPP, modeling the BCSFB was productively infected by SARS-CoV-2 preferentially from the basolateral side, facing the blood compartment. Assessment of ChP tissue from COVID-19 patients by RNA in situ hybridization revealed SARS-CoV-2 transcripts in ChP epithelial and ChP stromal cells. CONCLUSIONS Our study shows that the BCSFB of the ChP rather than the BBB is susceptible to direct SARS-CoV-2 infection. Thus, neuropsychiatric symptoms because of COVID-19 may rather be associated with dysfunction of the BCSFB than the BBB. Future studies should consider a role of the ChP in underlying neuropsychiatric symptoms following SARS-CoV-2 infection.
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Affiliation(s)
- Chiara Stüdle
- Theodor Kocher Institute, University of Bern, Bern, Switzerland.
| | - Hideaki Nishihara
- Theodor Kocher Institute, University of Bern, Bern, Switzerland
- Department of Neurotherapeutics, Yamaguchi University, Yamaguchi, Japan
| | - Sven Wischnewski
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Laila Kulsvehagen
- Departments of Neurology, Biomedicine and Clinical Research, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Sylvain Perriot
- Laboratory of Neuroimmunology, Neuroscience Research Centre, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, University of Tsukuba, Tsukuba, 305-8575, Ibaraki, Japan
| | - Horst Schroten
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephan Frank
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nikolaus Deigendesch
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Renaud Du Pasquier
- Laboratory of Neuroimmunology, Neuroscience Research Centre, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Lucas Schirmer
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Center for Translational Neuroscience and Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Interdisciplinary Center for Neurosciences, Heidelberg University, Heidelberg, Germany
| | - Anne-Katrin Pröbstel
- Departments of Neurology, Biomedicine and Clinical Research, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
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12
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Harada H, Suefuji H, Mori K, Ishikawa H, Nakamura M, Tokumaru S, Murakami M, Ogino T, Iwata H, Tatebe H, Kubo N, Waki T, Yoshida D, Nakamura M, Aoyama H, Araya M, Nakajima M, Nakayama H, Satouchi M, Shioyama Y. Proton and Carbon Ion Radiotherapy for Operable Early-Stage Lung Cancer: 3-Year Results of a Prospective Nationwide Registry. Int J Radiat Oncol Biol Phys 2023; 117:e23. [PMID: 37784924 DOI: 10.1016/j.ijrobp.2023.06.698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this analysis was to report subset analysis as to progression-free survival (PFS) and overall survival (OS) of particle-beam radiation therapy for operable early-stage lung cancer. MATERIALS/METHODS Patients of early-stage lung cancer (T1-T2aN0) who were eligible for radical surgery but did not wish to undergo surgery were treated by proton-ion (PT) or carbon-ion (CT) radiation therapy and enrolled in Japanese prospective registry. In this analysis, PFS and OS by clinical stage, tumor location, pathological confirmation and particle-ion type were evaluated. RESULTS A total of 274 patients were enrolled and included in efficacy and safety analyses. Most tumors were adenocarcinoma (44%), and 105 (38%) were not histologically confirmed and diagnosed clinically. 250 (91%) of 274 patients had tumors that were peripherally situated. 138 (50%) and 136 (50%) patients were treated by PT and CT, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7 - 49.0). No grade 3 or severe treatment-related toxicity was observed. 3-year PFS was 81% (95% CI;76-86) and OS was 93% (95% CI;89-96), respectively. As to particle-ion type, 3-year PFS were 79.0% and 81.9% in PT and CT (p = 0.19), and 3-year OS were 93.9% and 91.1% in PT and CT (P = 0.72), respectively. For PFS, pathological confirmation, clinical stage was significant factors but there were no significant differences by tumor location or particle-ion type; for OS, clinical stage was significant factor but there was no significant difference on pathological confirmation, tumor location or particle-ion type (Table1). Table 1. 3-year PFS and OS CONCLUSION: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS on each subset.
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Affiliation(s)
- H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - H Suefuji
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
| | - K Mori
- Shizuoka Cancer Center, Nagaizumi, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - M Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Koriyama, Japan
| | - T Ogino
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - H Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Japan
| | - H Tatebe
- Fukui Prefectural Hospital Proton Therapy Center, Fukui, Japan
| | - N Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Waki
- Tsuyama Chuo Hospital, Tsuyama, Japan
| | - D Yoshida
- Kanagawa Cancer Center, Yokohama, Japan
| | - M Nakamura
- University of Tsukuba, Tsukuba City 305-8575, Japan
| | - H Aoyama
- Department of Radiation oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Japan
| | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Nakayama
- Kanagawa Prefectural Hospital Organization, Yokohama, Japan
| | | | - Y Shioyama
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
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13
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Wakatsuki M, Makishima H, Mori Y, Kaneko T, Yasuda S, Okada N, Nakajima M, Murata K, Okonogi N, Aoki S, Ishikawa H, Yamada S. Clinical Outcomes of Carbon-Ion Radiotherapy for Large-Sized (≥4cm) Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e348. [PMID: 37785207 DOI: 10.1016/j.ijrobp.2023.06.2418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radical treatment options for bulky unresectable locally advanced hepatocellular carcinoma (HCC) are limited. The purpose of this study is to evaluate the safety and efficacy of carbon-ion radiotherapy (C-ion RT) for bulky (≥4cm) locally advanced HCC. MATERIALS/METHODS We performed a retrospective cohort study of patients with bulky (≥4cm) locally advanced HCC treated by C-ion RT between April 2000 and March 2020 in our institution. The eligibility criteria for this study were: (1) the treatment protocols of 45.0-48.0 Gy/2 fractions or 52.8-60.0 Gy/4 fractions, which proven the safety and efficacy in the past clinical trials; (2) Tumors within 3 intrahepatic lesions and with a maximum tumor diameter of 4 cm or greater; (3) N0M0 status; (4) an Eastern Cooperative Oncology Group performance status of 0 to 2; (5) controllable ascites; (6) Child-Pugh grade was A or B. Overall survival (OS), progression-free survival (PFS), and local control rate (LC) were calculated by the Kaplan-Meier method, and Cox regression analysis was used for multivariate analysis. Adverse events were evaluated by CTCAE ver. 5.0. JMP® 12 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. We defined p < 0.05 as statistically significant. RESULTS A total of 187 patients met the criteria and were evaluated. The median patient age was 73 years (range, 37-90), and 139 of 187 patients were male. Child-Pugh grade was A in 163 patients and B in 24. Modified albumin-bilirubin (mALBI) grade was 1 in 96 patients, 2a in 50, and 2b in 41. The number of HCV-related HCC cases was in 80, HBV in 32 and non-B and non-C in 75. In 51 patients, identification of vascular invasion to the first-order branch of the portal vein and/or major hepatic vein was confirmed. The median maximum tumor diameter was 5.1 cm (4.0-13.5 cm). In 76 patients, C-ion RT were treated for recurrence. With a median follow-up period of 25.9 months (range, 1.1-215.1), 2-year overall survival, progression-free survival and local control rates were 68.3% (95% confidence interval [CI], 64.7-72.0%), 39.0% (95% CI, 35.2 - 42.8%) and 86.7% (95% CI, 84.7 - 89.7%), respectively. Late adverse events were observed in 3 patients (1.6%) with Grade 3 liver dysfunction and in 3 patients (1.6%) with Grade 3 skin disorders, but there were no cases of Grade 4 or higher. Multivariate analysis of prognostic factors for overall survival revealed that mALBI grade in 2b(HR:3.13, 1.97-4.78, p<0.0001), tumor status in recurrent treatment (HR:1.50, 1.02-2.21, p = 0.039), the number of tumors in 2 or more (HR:2.16, 1.01-2.17, p = 0.045), and maximum tumor diameter in larger than 6 cm (HR:2.34, 1.50-3.61, p = 0.0001) were the predominant prognostic factors, while age, presence of vascular invasion, AFP and DCP were not. CONCLUSION The safety and efficacy of C-ion RT for bulky (≥4cm) locally advanced HCC was demonstrated. These results suggested that C-ion RT may be a new treatment option for locally advanced bulky HCC with no curative treatment options.
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Affiliation(s)
- M Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Makishima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan; Departement of Radiation Oncology and Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Mori
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - T Kaneko
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - S Yasuda
- Department of Radiation Oncology, Chiba Rosai Hospital, Chiba, Japan
| | | | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Murata
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Okonogi
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Aoki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
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14
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Mori Y, Wakatsuki M, Makishima H, Takashi K, Ishikawa H, Yasuda S, Okada N, Nakajima M, Murata K, Okonogi N, Aoki S, Yamada S. Long-Term Clinical Outcome of Carbon Ion Radio Therapy for Hepatocellular Carcinoma in the Caudate Lobe. Int J Radiat Oncol Biol Phys 2023; 117:e326-e327. [PMID: 37785158 DOI: 10.1016/j.ijrobp.2023.06.2373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Surgical resection is the first-line treatment for hepatocellular carcinoma in the caudate lobe (caudate HCC), but it is often difficult due to the tumor's location. In addition, radiofrequency ablation and transcatheter arterial chemoembolization are also difficult for the same reason. This study aimed to evaluate the safety and efficacy of carbon-ion radiation therapy (C-ion RT) for caudate HCC. MATERIALS/METHODS We performed a retrospective cohort study of patients with hepatocellular carcinoma treated by C-ion RT between April 2000 and March 2020 in our institution. The eligibility criteria for this study were: (1) located mainly in the caudate lobe (2) the treatment protocols of 45.0-48.0 Gy/2 fractions or 52.8-60.0 Gy/4 fractions, which proved the safety and efficacy in the past clinical trials; (3) N0M0 status; (4) an Eastern Cooperative Oncology Group performance status (PS) of 0 to 2; (5) controllable ascites. The prescribed dose (Gy) used in this study is relative biological effectiveness (RBE) weighted dose. Overall survival (OS), progression-free survival (PFS), and local control rate (LC) were calculated by the Kaplan-Meier method. Adverse events were evaluated by NCI-CTCAE ver. 5.0. SPSS software version 27.0 (IBM Inc.) was used for all analyses. We defined p-value < 0.05 as statistically significant. RESULTS A total of 25 patients met the criteria and were evaluated. The median patient age was 73 years (range 58-89), and 21 of 25 patients were male. The number of patients with PS 0 was 22, PS 1 was 1, and PS 2 was 2. The number of HBV-related HCC cases was in 8, HCV-related HCC cases was in 11, and non-B and non-C cases was in 6. The median maximum tumor diameter was 3.0 cm (1.1-4.8 cm). In 6 patients, identification of vascular invasion to the main trunk of the portal vein and/or major hepatic vein was confirmed. The Child-Pugh (CP) grade was A in 21 patients and B in 4. The modified albumin-bilirubin (mALBI) grade 1 is in 17 patients, 2a in 4, 2b in 4. Prescribed doses were 45 Gy / 2 fr in 3 cases, 48 Gy / 2 fr in 12 cases, 52.8 Gy / 4 fr in 7 cases, and 60 Gy / 4 fr in 3 cases. With a median follow-up period of 43.6 months (range 0.3-85.0), 3-year OS, PFS, and LC were 74% (95% confidence interval [CI], 54.8-93.8%), 32% (95% CI, 11.8-51.4%), and 93% (95% CI, 79.4-106%), respectively. All patients had no Grade 2 or higher adverse events during the observation period. CONCLUSION The safety and efficacy of C-ion RT for caudate HCC were demonstrated. These results suggested that C-ion RT may be a promising treatment option for patients with caudate HCC.
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Affiliation(s)
- Y Mori
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Makishima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Takashi
- Yamagata university hospital, Yamagata, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yasuda
- Department of Radiation Oncology, Chiba Rosai Hospital, Chiba, Japan
| | | | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Murata
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Okonogi
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Aoki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
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15
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Hirata K, Marushima A, Nagasaki Y, Ishikawa H, Matsumura H, Mujagić A, Hirayama A, Toyomura J, Ohyama A, Takaoka S, Bukawa H, Matsumura A, Ishikawa E, Matsumaru Y. Efficacy of redox nanoparticles for improving survival of transplanted cells in a mouse model of ischemic stroke. Hum Cell 2023; 36:1703-1715. [PMID: 37418231 DOI: 10.1007/s13577-023-00940-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
The success of cell transplantation therapy for ischemic stroke is hindered by the low cell survival rate in poststroke brain, due in part to high free radical production and ensuing oxidative stress. We have developed redox nanoparticles to eliminate reactive oxygen species. In this study, we tested the protective efficacy of these redox nanoparticles in cell culture and a mouse model of ischemic stroke. Induced human dental pulp stem cells were subjected to oxygen-glucose deprivation and reoxygenation to recapitulate ischemia and reperfusion in the penumbra surrounding a cerebral infarct. Cell viability using WST-8 assay, apoptosis using TUNEL, free radicals using MitoSOX, and inflammatory cytokines using ELISA kit were measured in the presence and absence of redox nanoparticles after oxygen-glucose deprivation and reoxygenation. The scavenging activity of redox nanoparticles against reactive oxygen species was detected by electron spin resonance. Moreover, induced cells were transplanted intracerebrally into to the distal middle cerebral artery occlusion model with and without redox nanoparticles, and the survival rate measured. Cell viability was enhanced, while apoptosis, free radical generation, and inflammatory cytokine expression levels were reduced in cultures with redox nanoparticles. Further, reduced redox nanoparticles were detected in the cytoplasm, indicating free radical scavenging. Addition of redox nanoparticles also improved the survival rate of transplanted cells after 6 weeks in vivo. These redox nanoparticles may increase the applicability and success of induced stem cell therapy for ischemic stroke patents by promoting long-term survival.
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Affiliation(s)
- Koji Hirata
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Aiki Marushima
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan.
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan.
| | - Yukio Nagasaki
- Department of Materials Science, Faculty of Pure and Applied Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Hiroshi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Hideaki Matsumura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Arnela Mujagić
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Aki Hirayama
- Center for Integrative Medicine, Tsukuba University of Technology, Kasuga 4-12-7, Tsukuba, Ibaraki, Japan
| | - Junko Toyomura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Akihiro Ohyama
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Shohei Takaoka
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Hiroki Bukawa
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Akira Matsumura
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
| | - Yuji Matsumaru
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan
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Fujimoto S, Kokame GT, Ryan EH, Johnson MW, Hirakata A, Shirriff A, Ishikawa H, Adams OE, Bommakanti N. Macular Retinoschisis from Optic Disc without a Visible Optic Pit or Advanced Glaucomatous Cupping (No Optic Pit Retinoschisis [NOPIR]). Ophthalmol Retina 2023; 7:811-818. [PMID: 37271192 DOI: 10.1016/j.oret.2023.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/18/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To review eyes with peripapillary and macular retinoschisis without a visible optic pit or advanced glaucomatous optic atrophy, or No Optic Pit Retinoschisis (NOPIR). DESIGN Retrospective multicenter case series. SUBJECTS The study included 11 eyes of 11 patients. METHODS Retrospective study of eyes with macular retinoschisis without a visible optic pit, advanced optic nerve head cupping, or macular leakage on fluorescein angiography. MAIN OUTCOME MEASURES Visual acuity (VA), retinoschisis resolution, months to resolution, and recurrence of retinoschisis RESULTS: The mean age was 68.1 ± 17.6 years, mean intraocular pressure was 17.4 ± 3.8 mmHg, and the mean spherical equivalent refractive error was -3.1 ± 2.9 diopters. No subject had pathologic myopia. Seven subjects were treated for glaucoma, and 9 subjects had nerve fiber layer defects on OCT. All eyes had retinoschisis in the outer nuclear layer (ONL) in the nasal macula and extending to the edge of the optic disc, and 8 subjects had fovea-involving retinoschisis. Three nonfoveal and 4 fovea-involved eyes were observed, and 4 fovea-involved eyes with vision loss underwent surgery. Surgery involved preoperative juxtapapillary laser followed by vitrectomy and membrane and internal limiting membrane peeling with intraocular gas and face-down position. The mean baseline VA was significantly worse in the surgery group than that in the observation group (P = 0.020). Retinoschisis resolved and vision improved in all surgical cases. The mean resolution time for the surgery group was 2.75 ± 0.96 months, which was shorter than that for the observation group (28.0 ± 21.2 months; P = 0.014). No eye developed recurrence of the retinoschisis after surgery. CONCLUSIONS Peripapillary and macular retinoschisis can develop in eyes without a visible optic pit or advanced glaucomatous cupping. Eyes without foveal involvement and those with foveal involvement but only mild decrease in vision can be observed for spontaneous resolution. If there is persistent foveal involvement with vision loss, surgery can improve vision by resolving the macular retinoschisis. Surgery for fovea-involved macular retinoschisis without a visible optic pit resulted in faster anatomic resolution and better vision recovery. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
| | - Gregg T Kokame
- Hawaii Macula and Retina Institute, Aiea, Hawaii; University of Hawaii John A Burns School of Medicine, Honolulu, Hawaii.
| | | | - Mark W Johnson
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Akito Hirakata
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Ashley Shirriff
- University of Hawaii John A Burns School of Medicine, Honolulu, Hawaii
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon
| | | | - Nikhil Bommakanti
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
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Herold R, Denzer L, Muranyi W, Stump-Guthier C, Ishikawa H, Schroten H, Schwerk C. Corrigendum: The phosphoproteome of choroid plexus epithelial cells following infection with Neisseria meningitidis. Front Cell Infect Microbiol 2023; 13:1249940. [PMID: 37637459 PMCID: PMC10456996 DOI: 10.3389/fcimb.2023.1249940] [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: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/29/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fcimb.2023.1113528.].
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Affiliation(s)
- Rosanna Herold
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Denzer
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Walter Muranyi
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carolin Stump-Guthier
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Horst Schroten
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schwerk
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Abbasi A, Antony BJ, Gowrisankaran S, Wollstein G, Schuman JS, Ishikawa H. Can Glaucoma Suspect Data Help to Improve the Performance of Glaucoma Diagnosis? Transl Vis Sci Technol 2023; 12:6. [PMID: 37555737 PMCID: PMC10424152 DOI: 10.1167/tvst.12.8.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/15/2023] [Indexed: 08/10/2023] Open
Abstract
Purpose The presence of imbalanced datasets in medical applications can negatively affect deep learning methods. This study aims to investigate how the performance of convolutional neural networks (CNNs) for glaucoma diagnosis can be improved by addressing imbalanced learning issues through utilizing glaucoma suspect samples, which are often excluded from studies because they are a mixture of healthy and preperimetric glaucomatous eyes, in a semi-supervised learning approach. Methods A baseline 3D CNN was developed and trained on a real-world glaucoma dataset, which is naturally imbalanced (like many other real-world medical datasets). Then, three methods, including reweighting samples, data resampling to form balanced batches, and semi-supervised learning on glaucoma suspect data were applied to practically assess their impacts on the performances of the trained methods. Results The proposed method achieved a mean accuracy of 95.24%, an F1 score of 97.42%, and an area under the curve of receiver operating characteristic (AUC ROC) of 95.64%, whereas the corresponding results for the traditional supervised training using weighted cross-entropy loss were 92.88%, 96.12%, and 92.72%, respectively. The obtained results show statistically significant improvements in all metrics. Conclusions Exploiting glaucoma suspect eyes in a semi-supervised learning method coupled with resampling can improve glaucoma diagnosis performance by mitigating imbalanced learning issues. Translational Relevance Clinical imbalanced datasets may negatively affect medical applications of deep learning. Utilizing data with uncertain diagnosis, such as glaucoma suspects, through a combination of semi-supervised learning and class-imbalanced learning strategies can partially address the problems of having limited data and learning on imbalanced datasets.
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Affiliation(s)
- Ashkan Abbasi
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Bhavna Josephine Antony
- Electrical and Computer System Engineering, Faculty of Engineering, Monash University, Clayton, Victoria, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne, Victoria, Australia
| | - Sowjanya Gowrisankaran
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Electrical & Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
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Lazarevic I, Soldati S, Mapunda JA, Rudolph H, Rosito M, de Oliveira AC, Enzmann G, Nishihara H, Ishikawa H, Tenenbaum T, Schroten H, Engelhardt B. Correction to: The choroid plexus acts as an immune cell reservoir and brain entry site in experimental autoimmune encephalomyelitis. Fluids Barriers CNS 2023; 20:55. [PMID: 37452369 PMCID: PMC10349419 DOI: 10.1186/s12987-023-00457-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Affiliation(s)
- Ivana Lazarevic
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Sasha Soldati
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Josephine A Mapunda
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Henriette Rudolph
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- Clinic for Pediatrics and Adolescent Medicine, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Maria Rosito
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
- Department of Physiology and Pharmacology, Sapienza University, Rome, 00185, Italy
| | | | - Gaby Enzmann
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Hideaki Nishihara
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
- Department of Neurotherapeutics, Yamaguchi University, Yamaguchi, 755-8505, Japan
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, University of Tsukuba, Tsukuba, 305-8575, Ibaraki, Japan
| | - Tobias Tenenbaum
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- Clinic for Pediatrics and Adolescent Medicine, Sana Clinic Lichtenberg, Charité, Berlin, Germany
| | - Horst Schroten
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Britta Engelhardt
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland.
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Duncan JL, Cheng P, Maguire MG, Ayala AA, Birch DG, Cheetham JK, Durham TA, Fahim AT, Hoyng CB, Ishikawa H, Michaelides M, Pennesi ME, Sahel JA, Stingl K, Weng CY. Static Perimetry in the Rate of Progression in USH2A-related Retinal Degeneration (RUSH2A) Study: Assessment Through 2 Years. Am J Ophthalmol 2023; 250:103-110. [PMID: 36764426 DOI: 10.1016/j.ajo.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/01/2022] [Accepted: 02/02/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To evaluate disease progression using static perimetry (SP) in patients with USH2A-related retinal degeneration, including Usher syndrome type 2 (USH2) and nonsyndromic autosomal recessive retinitis pigmentosa. DESIGN Prospective, observational cohort study. METHODS A total of 102 patients with biallelic disease-causing sequence variants in USH2A with baseline best-corrected visual acuity (BCVA) letter score ≥54 were recruited from 16 clinical sites in Europe and North America. SP, BCVA, full-field stimulus thresholds, spectral domain optical coherence tomography macular scans, and fundus-guided mesopic microperimetry were performed at baseline and annually. The main outcome measures were total hill of vision (VTOT), hill of vision in the central 30° (V30), VTOT minus V30 (VPERIPH), and mean sensitivity. RESULTS The average decline (95% CI) was 2.05 (1.40, 2.70) decibel-steradian (dB-sr)/y for VTOT, 0.48 (0.32, 0.65) dB-sr/y for V30, 1.53 (0.97, 2.08) dB-sr/y for VPERIPH, and 0.55 (0.40, 0.71) dB/y for mean sensitivity. Average percentage decline per year was 8.3 (5.5, 11.1) for VTOT, 5.2 (3.0, 7.4) for V30, 16.0 (9.5, 22.0) for VPERIPH, and 5.1 (3.5, 6.7) for mean sensitivity. Changes from baseline to year 2 in all SP measures were highly correlated (r's ranging from 0.52 [V30 vs VPERIPH] to 0.98 [VTOT vs VPERIPH]). CONCLUSIONS Quantitative measures of SP declined significantly over 2 years in USH2A-related retinal degeneration. The annual percentage rate of change was greatest for VTOT and VPERIPH, whereas V30 and mean sensitivity changed least, reflecting earlier and more severe peripheral degeneration compared with central loss.
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Affiliation(s)
- Jacque L Duncan
- From the University of California, San Francisco (J.L.D.), San Francisco, California, USA
| | - Peiyao Cheng
- Jaeb Center for Health Research (P.C., M.G.M., A.A.A.), Tampa, Florida, USA
| | - Maureen G Maguire
- Jaeb Center for Health Research (P.C., M.G.M., A.A.A.), Tampa, Florida, USA
| | - Allison A Ayala
- Jaeb Center for Health Research (P.C., M.G.M., A.A.A.), Tampa, Florida, USA.
| | - David G Birch
- Retina Foundation of the Southwest (D.G.B.), Dallas, Texas, USA
| | - Janet K Cheetham
- Foundation Fighting Blindness (J.K.C., T.A.D.), Columbia, Maryland, USA
| | - Todd A Durham
- Foundation Fighting Blindness (J.K.C., T.A.D.), Columbia, Maryland, USA
| | - Abigail T Fahim
- Kellogg Eye Center, University of Michigan (A.T.F.), Ann Arbor, Michigan, USA
| | - Carel B Hoyng
- Radboud University Medical Center (C.B.H.), Nijmegen, the Netherlands
| | - Hiroshi Ishikawa
- Casey Eye Institute, Oregon Health & Science University (H.I., M.E.P.), Portland, Oregon, USA
| | - Michel Michaelides
- Moorfields Eye Hospital and UCL Institute of Ophthalmology (M.M.), London, United Kingdom
| | - Mark E Pennesi
- Casey Eye Institute, Oregon Health & Science University (H.I., M.E.P.), Portland, Oregon, USA
| | - José-Alain Sahel
- Institut de la Vision, Sorbonne Université, INSERM, CNRS (J.A.-S.), Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DGOS CIC1423 (J.A.-S.), Paris, France; Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Katarina Stingl
- University Eye Hospital, Center for Ophthalmology, University of Tübingen (K.S.), Tübingen, Germany; Center for Rare Eye Diseases, University of Tübingen, Tübingen (K.S.), Germany
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Chen Z, Shemuelian E, Wollstein G, Wang Y, Ishikawa H, Schuman JS. Segmentation-Free OCT-Volume-Based Deep Learning Model Improves Pointwise Visual Field Sensitivity Estimation. Transl Vis Sci Technol 2023; 12:28. [PMID: 37382575 PMCID: PMC10318595 DOI: 10.1167/tvst.12.6.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/18/2023] [Indexed: 06/30/2023] Open
Abstract
Purpose The structural changes measured by optical coherence tomography (OCT) are related to functional changes in visual fields (VFs). This study aims to accurately assess the structure-function relationship and overcome the challenges brought by the minimal measurable level (floor effect) of segmentation-dependent OCT measurements commonly used in prior studies. Methods We developed a deep learning model to estimate the functional performance directly from three-dimensional (3D) OCT volumes and compared it to the model trained with segmentation-dependent two-dimensional (2D) OCT thickness maps. Moreover, we proposed a gradient loss to utilize the spatial information of VFs. Results Our 3D model was significantly better than the 2D model both globally and pointwise regarding both mean absolute error (MAE = 3.11 + 3.54 vs. 3.47 ± 3.75 dB, P < 0.001) and Pearson's correlation coefficient (0.80 vs. 0.75, P < 0.001). On a subset of test data with floor effects, the 3D model showed less influence from floor effects than the 2D model (MAE = 5.24 ± 3.99 vs. 6.34 ± 4.58 dB, P < 0.001, and correlation 0.83 vs. 0.74, P < 0.001). The gradient loss improved the estimation error for low-sensitivity values. Furthermore, our 3D model outperformed all prior studies. Conclusions By providing a better quantitative model to encapsulate the structure-function relationship more accurately, our method may help deriving VF test surrogates. Translational Relevance DL-based VF surrogates not only benefit patients by reducing the testing time of VFs but also allow clinicians to make clinical judgments without the inherent limitations of VFs.
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Affiliation(s)
- Zhiqi Chen
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Eitan Shemuelian
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
| | - Yao Wang
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Hiroshi Ishikawa
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
| | - Joel S. Schuman
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
- Center for Neural Science, NYU College of Arts and Sciences, New York, NY, USA
- Wills Eye Hospital, Philadelphia, PA, USA
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Lazarevic I, Soldati S, Mapunda JA, Rudolph H, Rosito M, de Oliveira AC, Enzmann G, Nishihara H, Ishikawa H, Tenenbaum T, Schroten H, Engelhardt B. The choroid plexus acts as an immune cell reservoir and brain entry site in experimental autoimmune encephalomyelitis. Fluids Barriers CNS 2023; 20:39. [PMID: 37264368 DOI: 10.1186/s12987-023-00441-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 02/13/2023] [Accepted: 05/15/2023] [Indexed: 06/03/2023] Open
Abstract
The choroid plexus (ChP) has been suggested as an alternative central nervous system (CNS) entry site for CCR6+ Th17 cells during the initiation of experimental autoimmune encephalomyelitis (EAE), an animal model for multiple sclerosis (MS). To advance our understanding of the importance of the ChP in orchestrating CNS immune cell entry during neuroinflammation, we here directly compared the accumulation of CD45+ immune cell subsets in the ChP, the brain and spinal cord at different stages of EAE by flow cytometry. We found that the ChP harbors high numbers of CD45int resident innate but also of CD45hi adaptive immune cell subsets including CCR6+ Th17 cells. With the exception to tissue-resident myeloid cells and B cells, numbers of CD45+ immune cells and specifically of CD4+ T cells increased in the ChP prior to EAE onset and remained elevated while declining in brain and spinal cord during chronic disease. Increased numbers of ChP immune cells preceded their increase in the cerebrospinal fluid (CSF). Th17 but also other CD4+ effector T-cell subsets could migrate from the basolateral to the apical side of the blood-cerebrospinal fluid barrier (BCSFB) in vitro, however, diapedesis of effector Th cells including that of Th17 cells did not require interaction of CCR6 with BCSFB derived CCL20. Our data underscore the important role of the ChP as CNS immune cell entry site in the context of autoimmune neuroinflammation.
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Affiliation(s)
- Ivana Lazarevic
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Sasha Soldati
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Josephine A Mapunda
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Henriette Rudolph
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- Present address: Clinic for Pediatrics and Adolescent Medicine, Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Maria Rosito
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
- Present address: Department of Physiology and Pharmacology, Sapienza University, Rome, 00185, Italy
| | | | - Gaby Enzmann
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
| | - Hideaki Nishihara
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland
- Present address: Department of Neurotherapeutics, Yamaguchi University, Yamaguchi, 755-8505, Japan
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tobias Tenenbaum
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- Present address: Clinic for Pediatrics and Adolescent Medicine, Sana Clinic Lichtenberg, Charité, Berlin, Germany
| | - Horst Schroten
- Klinik für Kinder - und Jugendmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Britta Engelhardt
- Theodor Kocher Institute, University of Bern, Freiestrasse 1, Bern, CH-3012, Switzerland.
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Rubinoff I, Kuranov RV, Fang R, Ghassabi Z, Wang Y, Beckmann L, Miller DA, Wollstein G, Ishikawa H, Schuman JS, Zhang HF. Adaptive spectroscopic visible-light optical coherence tomography for clinical retinal oximetry. Commun Med (Lond) 2023; 3:57. [PMID: 37095177 PMCID: PMC10126115 DOI: 10.1038/s43856-023-00288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Retinal oxygen saturation (sO2) provides essential information about the eye's response to pathological changes that can result in vision loss. Visible-light optical coherence tomography (vis-OCT) is a noninvasive tool that has the potential to measure retinal sO2 in a clinical setting. However, its reliability is currently limited by unwanted signals referred to as spectral contaminants (SCs), and a comprehensive strategy to isolate true oxygen-dependent signals from SCs in vis-OCT is lacking. METHODS We develop an adaptive spectroscopic vis-OCT (ADS-vis-OCT) technique that can adaptively remove SCs and accurately measure sO2 under the unique conditions of each vessel. We also validate the accuracy of ADS-vis-OCT using ex vivo blood phantoms and assess its repeatability in the retina of healthy volunteers. RESULTS In ex vivo blood phantoms, ADS-vis-OCT agrees with a blood gas machine with only a 1% bias in samples with sO2 ranging from 0% to 100%. In the human retina, the root mean squared error between sO2 values in major arteries measured by ADS-vis-OCT and a pulse oximeter is 2.1% across 18 research participants. Additionally, the standard deviations of repeated ADS-vis-OCT measurements of sO2 values in smaller arteries and veins are 2.5% and 2.3%, respectively. Non-adaptive methods do not achieve comparable repeatabilities from healthy volunteers. CONCLUSIONS ADS-vis-OCT effectively removes SCs from human images, yielding accurate and repeatable sO2 measurements in retinal arteries and veins with varying diameters. This work could have important implications for the clinical use of vis-OCT to manage eye diseases.
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Affiliation(s)
- Ian Rubinoff
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Roman V Kuranov
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Opticent Inc., Evanston, IL, 60201, USA
| | - Raymond Fang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Zeinab Ghassabi
- Department of Ophthalmology, New York University, New York, NY, 10017, USA
| | - Yuanbo Wang
- Currently with Department of Ophthalmology, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Lisa Beckmann
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - David A Miller
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Gadi Wollstein
- Department of Ophthalmology, New York University, New York, NY, 10017, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, New York University, New York, NY, 10017, USA
- Currently with Department of Ophthalmology, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Joel S Schuman
- Department of Ophthalmology, New York University, New York, NY, 10017, USA
| | - Hao F Zhang
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA.
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24
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Kanetani H, Obuchi T, Ishikawa H, Shozu M. Acute vulvar ulcer as a possible adverse event of gene-based COVID-19 vaccines: A review of 14 cases. J Obstet Gynaecol Res 2023. [PMID: 37069805 DOI: 10.1111/jog.15647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/17/2023] [Indexed: 04/19/2023]
Abstract
AIM To evaluate whether an acute vulvar ulcer that developed after the COVID-19 vaccine administration is an adverse effect of the vaccine. METHODS This is a descriptive study of two cases that we observed in addition to cases that have been reported in the literature. We searched for case reports in the PubMed. The consistency of clinical manifestations among cases and the association between ulceration and vaccination were assessed. RESULTS Fourteen female patients were identified, including 12 patients from 8 literatures published in 2021 and 2022 and 2 patients from our cases. Of the 14 patients, 11 had received the BNT162b2 vaccine, 2 had received the ChAdOx1 nCoV-19 vaccine, and one had received the mRNA-1273 vaccine. The patient's ages were 16.9 ± 5.0 (mean ± SD) years. Postvaccination, the disease progressed in the following sequence (time interval from vaccination): fever and other systemic inflammatory reactions (0.9 ± 0.4 days), development of vulvar ulcers (2.4 ± 1.2 days), and resolution of the ulcer (16.9 ± 7.4 days). The ulcers eventually healed in all cases, except one where the prognosis was not noted. For two-dose vaccine recipients, more patients developed the ulcer after the full vaccination (the second or third doses) compared with after the first dose: n = 10 and n = 2, respectively. CONCLUSION The acute vulvar ulcer was closely associated with COVID-19 vaccination in terms of temporality and vaccine doses, supporting the notion that a vulvar ulcer is an adverse event of the COVID-19 vaccines.
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Affiliation(s)
- Hiromi Kanetani
- Department of Obstetrics and Gynecology, Chiba Aoba Municipal Hospital
| | - Tomoka Obuchi
- Department of Obstetrics and Gynecology, Chiba Aoba Municipal Hospital
| | - Hiroshi Ishikawa
- Reproductive Medicine, Chiba University Hospital, Chiba University, Chiba, Japan
| | - Makio Shozu
- Reproductive Medicine, Chiba University Hospital, Chiba University, Chiba, Japan
- Evolution and Reproductive Medicine, Medical Mycology Research Center, Chiba University, Chiba, Japan
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25
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Alexopoulos P, Glidai Y, Ghassabi Z, Wang B, Tayebi B, Vellappally A, Wu M, Liu M, Lucy-Jones K, Zambrano R, Ishikawa H, Schuman JS, Wollstein G. Under Pressure: Lamina Cribrosa Pore Path Tortuosity in Response to Acute Pressure Modulation. Transl Vis Sci Technol 2023; 12:4. [PMID: 37017959 PMCID: PMC10082387 DOI: 10.1167/tvst.12.4.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
Purpose Lamina cribrosa (LC) deformation is hypothesized to play a major role in glaucoma pathogenesis. The purpose of this study was to determine in vivo how varying intraocular pressure (IOP) under fixed intracranial pressure (ICP), and vice versa, deforms the pore paths throughout the LC volume. Methods Spectral-domain optical coherence tomography scans of the optic nerve head were acquired from healthy adult rhesus monkeys under different pressures. IOP and ICP were controlled with gravity-based perfusion systems into the anterior chamber and lateral ventricle, respectively. IOP and ICP were modulated from baseline to high (19-30 mmHg) and highest (35-50 mmHg) levels while maintaining a fixed ICP of 8 to 12 mmHg and IOP of 15 mmHg, respectively. After three-dimensional registration and segmentation, the paths of pores visible in all settings were tracked based on their geometric centroids. Pore path tortuosity was defined as the measured distance divided by the minimal distance between the most anterior and posterior centroids. Results The median pore tortuosity at baseline varied among the eyes (range, 1.16-1.68). For the IOP effect under fixed ICP (six eyes, five animals), two eyes showed statistically significant increased tortuosity and one showed a decrease (P < 0.05, mixed-effects model). No significant change was detected in three eyes. When modulating ICP under fixed IOP (five eyes, four animals), a similar response pattern was detected. Conclusions Baseline pore tortuosity and the response to acute pressure increase vary substantially across eyes. Translational Relevance LC pore path tortuosity could be associated with glaucoma susceptibility.
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Affiliation(s)
| | - Yoav Glidai
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Zeinab Ghassabi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Bo Wang
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Behnam Tayebi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Anse Vellappally
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Mengfei Wu
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
- Division of Biostatistics, Departments of Population Health and Environmental Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Mengling Liu
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
- Division of Biostatistics, Departments of Population Health and Environmental Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Katie Lucy-Jones
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Ronald Zambrano
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, New York University, New York, NY, USA
- Department of Neuroscience and Physiology, NYU Langone Health, New York, NY, USA
- Center for Neural Science, New York University College of Arts and Sciences, New York, NY, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York University, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, New York University, New York, NY, USA
- Center for Neural Science, New York University College of Arts and Sciences, New York, NY, USA
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26
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Furtado A, Esgalhado AJ, Duarte AC, Costa AR, Costa-Brito AR, Carro E, Ishikawa H, Schroten H, Schwerk C, Gonçalves I, Arosa FA, Santos CRA, Quintela T. Circadian rhythmicity of amyloid-beta-related molecules is disrupted in the choroid plexus of a female Alzheimer's disease mouse model. J Neurosci Res 2023; 101:524-540. [PMID: 36583371 DOI: 10.1002/jnr.25164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/20/2022] [Accepted: 12/18/2022] [Indexed: 12/31/2022]
Abstract
The choroid plexus (CP) is part of the blood-cerebrospinal fluid barrier (BCSFB) and was recently described as an important component of the circadian clock system. It is the principal source of cerebrospinal fluid (CSF) and responsible for the synthesis and secretion of various neuroprotective peptides including those involved in amyloid-β (Aβ) transport/degradation, contributing to Aβ homeostasis. Inadequate Aβ metabolic clearance and transport across the BCSFB have been associated with circadian dysfunctions in Alzheimer's disease (AD) patients. To investigate whether AD pathology influences Aβ scavengers circadian expression, we collected CP at different time points from an AD mouse model (APP/PS1) (female and male animals, aged 6- and 12-months-old) and analyzed their mRNA expression by Real-time RT-PCR. Only angiotensin-converting enzyme (Ace) expression in 6-month-old female wild-type mice and transthyretin (Ttr) expression in 12-month-old female wild-type mice presented significant rhythmicity. The circadian rhythmicity of Ace and Ttr, prompt us to analyze the involvement of circadian rhythm in Aβ uptake. A human CP papilloma (HIBCPP) cell line was incubated with Aβ-488 and uptake was evaluated at different time points using flow cytometry. Aβ uptake displayed circadian rhythmicity. Our results suggest that AD might affect Aβ scavengers rhythmicity and that Aβ clearance is a rhythmic process possibly regulated by the rhythmic expression of Aβ scavengers.
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Affiliation(s)
- André Furtado
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - André J Esgalhado
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Ana C Duarte
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,UDI-IPG- Unidade de Investigação para o Desenvolvimento do Interior, Instituto Politécnico da Guarda, Guarda, Portugal
| | - Ana R Costa
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Ana R Costa-Brito
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Eva Carro
- Networked Biomedical Research Center in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Group of Neurodegenerative Diseases, Hospital 12 de Octubre Research Institute (imas12), Madrid, Spain
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Horst Schroten
- Mannheim Medical Faculty, University of Heidelberg, Childrens Hospital, Mannheim, Germany
| | - Christian Schwerk
- Mannheim Medical Faculty, University of Heidelberg, Childrens Hospital, Mannheim, Germany
| | - Isabel Gonçalves
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Fernando A Arosa
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Cecília R A Santos
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Telma Quintela
- CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,UDI-IPG- Unidade de Investigação para o Desenvolvimento do Interior, Instituto Politécnico da Guarda, Guarda, Portugal
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27
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Herold R, Denzer L, Muranyi W, Stump-Guthier C, Ishikawa H, Schroten H, Schwerk C. The phosphoproteome of choroid plexus epithelial cells following infection with Neisseria meningitidis. Front Cell Infect Microbiol 2023; 13:1113528. [PMID: 37065199 PMCID: PMC10102474 DOI: 10.3389/fcimb.2023.1113528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/03/2023] [Indexed: 04/03/2023] Open
Abstract
The Gram-negative bacterium Neisseria meningitidis, which causes meningitis in humans, has been demonstrated to manipulate or alter host signalling pathways during infection of the central nervous system (CNS). However, these complex signalling networks are not completely understood. We investigate the phosphoproteome of an in vitro model of the blood-cerebrospinal fluid barrier (BCSFB) based on human epithelial choroid plexus (CP) papilloma (HIBCPP) cells during infection with the N. meningitidis serogroup B strain MC58 in presence and absence of the bacterial capsule. Interestingly, our data demonstrates a stronger impact on the phosphoproteome of the cells by the capsule-deficient mutant of MC58. Using enrichment analyses, potential pathways, molecular processes, biological processes, cellular components and kinases were determined to be regulated as a consequence of N. meningitidis infection of the BCSFB. Our data highlight a variety of protein regulations that are altered during infection of CP epithelial cells with N. meningitidis, with the regulation of several pathways and molecular events only being detected after infection with the capsule-deficient mutant. Mass spectrometry proteomics data are available via ProteomeXchange with identifier PXD038560.
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Affiliation(s)
- Rosanna Herold
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Denzer
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Walter Muranyi
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carolin Stump-Guthier
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Horst Schroten
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Schwerk
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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28
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Aoki H, Kawataki M, Kim K, Saito T, Inagaki Y, Shimokaze T, Ishikawa H, Toyoshima K. Reopening of ductus arteriosus in idiopathic premature constriction or closure of ductus arteriosus: A case series. J Neonatal Perinatal Med 2023; 16:75-80. [PMID: 36872790 DOI: 10.3233/npm-221013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND There is no consensus on managing pregnancy when the fetus is diagnosed with idiopathic premature constriction or closure of the ductus arteriosus (PCDA). Knowing whether the ductus reopens is valuable information for managing idiopathic PCDA. We conducted a case-series study to investigate the natural perinatal course of idiopathic PCDA and examined factors associated with ductal reopening. METHODS We retrospectively collected information about the perinatal course and echocardiographic findings at our institution, which, on principle, does not determine delivery timing based on fetal echocardiographic results. We also examined perinatal factors related to the reopening of the ductus arteriosus. RESULTS Thirteen cases of idiopathic PCDA were included in the analysis. The ductus reopened in 38% of cases. Among cases diagnosed in < 37 weeks of gestation, 71% reopened, which was confirmed seven days after diagnosis (interquartile range 4-7). Diagnosis earlier in gestation was associated with ductal reopening (p = 0.006). Two cases (15%) developed persistent pulmonary hypertension. No fetal hydrops or death occurred. CONCLUSIONS The ductus is likely to reopen when prenatally diagnosed before 37 weeks gestation. There were no complications due to our pregnancy management policy. In idiopathic PCDA, especially if the prenatal diagnosis is made before 37 weeks of gestational age, continuing the pregnancy with careful monitoring of the fetus's well-being is recommended.
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Affiliation(s)
- H Aoki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - M Kawataki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Kim
- Department of Cardiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - T Saito
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Y Inagaki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - T Shimokaze
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - H Ishikawa
- Department of Obstetrics and Gynecology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
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Abbasi A, Monadjemi A, Fang L, Rabbani H, Antony BJ, Ishikawa H. Mixed multiscale BM4D for three-dimensional optical coherence tomography denoising. Comput Biol Med 2023; 155:106658. [PMID: 36827787 PMCID: PMC10739784 DOI: 10.1016/j.compbiomed.2023.106658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
A multiscale extension for the well-known block matching and 4D filtering (BM4D) method is proposed by analyzing and extending the wavelet subbands denoising method in such a way that the proposed method avoids directly denoising detail subbands, which considerably simplifies the computations and makes the multiscale processing feasible in 3D. To this end, we first derive the multiscale construction method in 2D and propose multiscale extensions for three 2D natural image denoising methods. Then, the derivation is extended to 3D by proposing mixed multiscale BM4D (mmBM4D) for optical coherence tomography (OCT) image denoising. We tested mmBM4D on three public OCT datasets captured by various imaging devices. The experiments revealed that mmBM4D significantly outperforms its original counterpart and performs on par with the state-of-the-art OCT denoising methods. In terms of peak-signal-to-noise-ratio (PSNR), mmBM4D surpasses the original BM4D by more than 0.68 decibels over the first dataset. In the second and third datasets, significant improvements in the mean to standard deviation ratio, contrast to noise ratio, and equivalent number of looks were achieved. Furthermore, on the downstream task of retinal layer segmentation, the layer quality preservation of the compared OCT denoising methods is evaluated.
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Affiliation(s)
- Ashkan Abbasi
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, USA
| | - Amirhassan Monadjemi
- School of Continuing and Lifelong Education, National University of Singapore, Singapore
| | - Leyuan Fang
- College of Electrical and Information Engineering, Hunan University, China
| | - Hossein Rabbani
- Department of Biomedical Engineering, Medical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Iran
| | - Bhavna Josephine Antony
- Electrical and Computer System Engineering, Faculty of Engineering, Monash University, Australia; Department of Infectious Diseases, Alfred Health, Australia
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, USA; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, USA.
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30
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Ishikawa H, Shozu M. Early peritoneal pregnancy in the pouch of Douglas identified by transvaginal ultrasound. Int J Gynaecol Obstet 2023; 160:1050-1052. [PMID: 36200653 DOI: 10.1002/ijgo.14494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/07/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makio Shozu
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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31
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Zhu Z, Waxman S, Wang B, Wallace J, Schmitt SE, Tyler-Kabara E, Ishikawa H, Schuman JS, Smith MA, Wollstein G, Sigal IA. In vivo Modulation of Intraocular and Intracranial Pressures Causes Nonlinear and Non-monotonic Deformations of the Lamina Cribrosa and Scleral Canal. bioRxiv 2023:2023.01.29.526113. [PMID: 36778255 PMCID: PMC9915473 DOI: 10.1101/2023.01.29.526113] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose To evaluate changes in monkey optic nerve head (ONH) morphology under acutely controlled intraocular pressure (IOP) and intracranial pressure (ICP). Methods Seven ONHs from six monkeys were imaged via optical coherence tomography while IOP and ICP were maintained at one of 16 conditions. These conditions were defined by 4 levels for each pressure: low, baseline, high and very high. Images were processed to determine scleral canal area, aspect ratio, and planarity and anterior lamina cribrosa (ALC) shape index and curvature. Linear mixed effect models were utilized to investigate the effects of IOP, ICP and their interactions on ONH morphological features. The IOP-ICP interaction model was compared with one based on translaminar pressure difference (TLPD). Results We observed complex, eye-specific, non-linear patterns of ONH morphological changes with changes in IOP and ICP. For all ONH morphological features, linear mixed effects models demonstrated significant interactions between IOP and ICP that were unaccounted for by TLPD. Interactions indicate that the effects of IOP and ICP depend on the other pressure. The IOP-ICP interaction model was a higher quality predictor of ONH features than a TLPD model. Conclusions In vivo modulation of IOP and ICP causes nonlinear and non-monotonic changes in monkey ONH morphology that depend on both pressures and is not accounted for by a simplistic TLPD. These results support and extend prior findings. Translational Relevance A better understanding of ICP's influence on the effects of IOP can help inform the highly variable presentations of glaucoma and effective treatment strategies.
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Affiliation(s)
- Ziyi Zhu
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susannah Waxman
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bo Wang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob Wallace
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Samantha E. Schmitt
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Elizabeth Tyler-Kabara
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Neurosurgery, University of Texas-Austin, Austin, TX, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
- Department of Medical Informatics and Clinical Epidemiology (DMICE), Oregon Health & Science University, Portland, OR, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU School of Medicine, New York, NY, USA
| | - Matthew A. Smith
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU School of Medicine, New York, NY, USA
| | - Ian A. Sigal
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
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Toyoshima K, Saito T, Shimokaze T, Katsumata K, Ohmura J, Kimura S, Aoki H, Takahashi M, Shibasaki J, Kawataki M, Kim KS, Shinkai M, Ishikawa H, Saito N, Masutani S. Right to left ventricular volume ratio is associated with mortality in congenital diaphragmatic hernia. Pediatr Res 2023:10.1038/s41390-022-02430-z. [PMID: 36624284 DOI: 10.1038/s41390-022-02430-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Congenital diaphragmatic hernia (CDH) is associated with high neonatal mortality. We performed this study to test the hypothesis that left ventricular (LV) and right ventricular (RV) volumes assessed by three-dimensional echocardiography may be associated with mortality in CDH. METHODS This study was a single-center retrospective cohort study involving 35 infants with CDH. RV and LV end-diastolic volume (RVEDV and LVEDV, respectively) were measured by three-dimensional echocardiography and were corrected by birth body weight (BBW) on day 1. RVEDV/BBW, LVEDV/BBW, and LVEDV/RVEDV were compared between CDH survivors and non-survivors. Receiver-operating characteristic curve analysis was performed to assess the predictive ability for mortality of the echocardiographic parameters. RESULTS Comparing CDH non-survivors (n = 6) with survivors (n = 29), respectively, RVEDV/BBW was significantly larger (2.54 ± 0.33 vs 1.86 ± 0.35 ml/kg; P < 0.01), LVEDV/BBW was significantly smaller (0.86 ± 0.21 vs 1.22 ± 0.33 ml/kg; P < 0.001), and LVEDV/RVEDV was significantly lower (0.34 ± 0.06 vs 0.66 ± 0.18; P < 0.001). The area under the curve for LVEDV/RVEDV was the largest (0.98). CONCLUSIONS Three-dimensional echocardiographic volume imbalance between the RV and LV was remarkable in CDH non-survivors. The LVEDV/RVEDV ratio may be associated with mortality in CDH. IMPACT Mortality with congenital diaphragmatic hernia (CDH) is high, and evaluating left and right ventricular structures and functions may be helpful in assessing the prognosis. Three-dimensional (3D) echocardiography indicated that the left ventricular end-diastolic volume/right ventricular end-diastolic volume ratio within 24 h after birth was associated with mortality in CDH infants. The usefulness of this ratio should be validated in prospective multicenter studies involving larger numbers of patients.
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Affiliation(s)
- Katsuaki Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan.
| | - Tomoko Saito
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomoyuki Shimokaze
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kaoru Katsumata
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Junya Ohmura
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Sasagu Kimura
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hirosato Aoki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Megumi Takahashi
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Motoyoshi Kawataki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Ki-Sung Kim
- Department of Cardiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masato Shinkai
- Department of Surgery, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroshi Ishikawa
- Department of Obstetrics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Naka Saito
- Department of Clinical Laboratory, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Satoshi Masutani
- Department of Pediatrics, Saitama Medical University, Kawagoe, Japan
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Kitahara Y, Hiraike O, Ishikawa H, Kugu K, Takai Y, Yoshino O, Ono M, Maekawa R, Ota I, Iwase A. National survey of abnormal uterine bleeding according to the FIGO classification in Japan. J Obstet Gynaecol Res 2023; 49:321-330. [PMID: 36258286 DOI: 10.1111/jog.15464] [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: 05/06/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 01/19/2023]
Abstract
AIM To investigate the status of abnormal uterine bleeding (AUB) in Japan using the International Federation of Gynecology and Obstetrics (FIGO) classification (AUB system 1 and 2; PALM-COEIN) and to clarify the relationship between AUB symptoms and the diseases causing AUB. METHODS In a nationwide study, we enrolled first-time patients who visited target facilities during two consecutive weeks from December 1, 2019 to January 31, 2020. The FIGO classification was used to investigate patients with symptoms and causative diseases of AUB. Based on the proportion of patients in the nationwide study, 373 cases were included in the detailed survey. Survey items included symptoms of AUB according to AUB system 1, examination details, and causative diseases according to the PALM-COEIN classification. RESULTS Within the study period, we encountered 61 740 first-time patients, of which 8081 (13.1%) were diagnosed with AUB. Among them, 39.9% had abnormal menstrual cycles and 56.9% had abnormal menstrual bleeding. In the survey, PALM had the highest percentage of AUB-L and COEIN had the highest percentage of AUB-O. Correspondence analysis showed that COEIN was strongly associated with abnormal menstrual cycles and PALM with abnormal menstrual bleeding. CONCLUSION We conducted the first nationwide survey of AUB in Japan. The FIGO classification was a useful tool for the diagnosis of AUB, with a strong correlation between symptoms of AUB by AUB system 1 and the causative disease of AUB by PALM-COEIN. Conversely, a high percentage of AUB-N and AUB-E suggests that AUB system 1 and PALM-COEIN are ambiguous as diagnostic tools.
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Affiliation(s)
- Yoshikazu Kitahara
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Osamu Hiraike
- Department of Obstetrics and Gynecology, Faculty of Medicine University Hospital, University of Tokyo, Tokyo, Japan
| | - Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Koji Kugu
- Department of Obstetrics and Gynecology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi Hospital, Tokyo, Japan
| | - Masanori Ono
- Department of Obstetrics and Gynecology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Ryo Maekawa
- Department of Obstetrics and Gynecology, Yamaguchi University Hospital, Ube, Japan
| | - Ikuko Ota
- Department of Gynecology, Kurashiki Heisei Hospital, Kurashiki, Japan
| | - Akira Iwase
- Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Maebashi, Japan
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Ishikawa H, Satoh H, Hizawa N. Tracheobronchial adenoid cystic carcinoma mimicking bronchial asthma. J Postgrad Med 2023; 69:56-58. [PMID: 36571332 PMCID: PMC9997610 DOI: 10.4103/jpgm.jpgm_201_22] [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: 12/27/2022] Open
Affiliation(s)
- H Ishikawa
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - H Satoh
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - N Hizawa
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
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Wei J, Hua Y, Yang B, Wang B, Schmitt SE, Wang B, Lucy KA, Ishikawa H, Schuman JS, Smith MA, Wollstein G, Sigal IA. Comparing Acute IOP-Induced Lamina Cribrosa Deformations Premortem and Postmortem. Transl Vis Sci Technol 2022; 11:1. [DOI: 10.1167/tvst.11.12.1] [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: 12/05/2022] Open
Affiliation(s)
- Junchao Wei
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yi Hua
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bin Yang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Engineering, Duquesne University, Pittsburgh, PA, USA
| | - Bo Wang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Samantha E. Schmitt
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Bingrui Wang
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Katie A. Lucy
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
- Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
- Department of Biomedical Engineering and Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
- Neuroscience Institute, NYU Langone Health, New York, NY, USA
| | - Matthew A. Smith
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Ian A. Sigal
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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Kenney R, Liu M, Hasanaj L, Joseph B, Al-Hassan AA, Balk L, Behbehani R, Brandt AU, Calabresi PA, Frohman EM, Frohman T, Havla J, Hemmer B, Jiang H, Knier B, Korn T, Leocani L, Martínez-Lapiscina EH, Papadopoulou A, Paul F, Petzold A, Pisa M, Villoslada P, Zimmermann H, Ishikawa H, Schuman JS, Wollstein G, Chen Y, Saidha S, Thorpe LE, Galetta SL, Balcer LJ. Normative Data and Conversion Equation for Spectral-Domain Optical Coherence Tomography in an International Healthy Control Cohort. J Neuroophthalmol 2022; 42:442-453. [PMID: 36049213 PMCID: PMC10350791 DOI: 10.1097/wno.0000000000001717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Spectral-domain (SD-) optical coherence tomography (OCT) can reliably measure axonal (peripapillary retinal nerve fiber layer [pRNFL]) and neuronal (macular ganglion cell + inner plexiform layer [GCIPL]) thinning in the retina. Measurements from 2 commonly used SD-OCT devices are often pooled together in multiple sclerosis (MS) studies and clinical trials despite software and segmentation algorithm differences; however, individual pRNFL and GCIPL thickness measurements are not interchangeable between devices. In some circumstances, such as in the absence of a consistent OCT segmentation algorithm across platforms, a conversion equation to transform measurements between devices may be useful to facilitate pooling of data. The availability of normative data for SD-OCT measurements is limited by the lack of a large representative world-wide sample across various ages and ethnicities. Larger international studies that evaluate the effects of age, sex, and race/ethnicity on SD-OCT measurements in healthy control participants are needed to provide normative values that reflect these demographic subgroups to provide comparisons to MS retinal degeneration. METHODS Participants were part of an 11-site collaboration within the International Multiple Sclerosis Visual System (IMSVISUAL) consortium. SD-OCT was performed by a trained technician for healthy control subjects using Spectralis or Cirrus SD-OCT devices. Peripapillary pRNFL and GCIPL thicknesses were measured on one or both devices. Automated segmentation protocols, in conjunction with manual inspection and correction of lines delineating retinal layers, were used. A conversion equation was developed using structural equation modeling, accounting for clustering, with healthy control data from one site where participants were scanned on both devices on the same day. Normative values were evaluated, with the entire cohort, for pRNFL and GCIPL thicknesses for each decade of age, by sex, and across racial groups using generalized estimating equation (GEE) models, accounting for clustering and adjusting for within-patient, intereye correlations. Change-point analyses were performed to determine at what age pRNFL and GCIPL thicknesses exhibit accelerated rates of decline. RESULTS The healthy control cohort (n = 546) was 54% male and had a wide distribution of ages, ranging from 18 to 87 years, with a mean (SD) age of 39.3 (14.6) years. Based on 346 control participants at a single site, the conversion equation for pRNFL was Cirrus = -5.0 + (1.0 × Spectralis global value). Based on 228 controls, the equation for GCIPL was Cirrus = -4.5 + (0.9 × Spectralis global value). Standard error was 0.02 for both equations. After the age of 40 years, there was a decline of -2.4 μm per decade in pRNFL thickness ( P < 0.001, GEE models adjusting for sex, race, and country) and -1.4 μm per decade in GCIPL thickness ( P < 0.001). There was a small difference in pRNFL thickness based on sex, with female participants having slightly higher thickness (2.6 μm, P = 0.003). There was no association between GCIPL thickness and sex. Likewise, there was no association between race/ethnicity and pRNFL or GCIPL thicknesses. CONCLUSIONS A conversion factor may be required when using data that are derived between different SD-OCT platforms in clinical trials and observational studies; this is particularly true for smaller cross-sectional studies or when a consistent segmentation algorithm is not available. The above conversion equations can be used when pooling data from Spectralis and Cirrus SD-OCT devices for pRNFL and GCIPL thicknesses. A faster decline in retinal thickness may occur after the age of 40 years, even in the absence of significant differences across racial groups.
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Affiliation(s)
- Rachel Kenney
- Departments of Neurology (RK, LH, BJ, SLG, LJB) and Population Health (RK, ML, YC, LET, LJB), New York University Grossman School of Medicine, New York, New York; Al-Bahar Ophthalmology Center (AAA-H, RB), Ibn Sina Hospital, Kuwait City, Kuwait; Centre for Research on Sports in Society (LB), Mulier Institute, Utrecht, Netherlands; Experimental and Clinical Research Center (AUB, AP, FP, HZ), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology (AUB), University of California, Irvine, California; Department of Neurology (PAC, SS), Johns Hopkins University, Baltimore, Maryland; Laboratory of Neuroimmunology (EMF, TF), Stanford University School of Medicine, Palo Alto, California; Institute of Clinical Neuroimmunology (JH), LMU Hospital, Ludwig Maximilians Universität München, Munich, Germany; Data Integration for Future Medicine consortium (DIFUTURE) (JH), Ludwig-Maximilians University, Munich, Germany; Department of Neurology (BH, BK, TK), Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) (BH, TK), Munich, Germany; Department of Neurology (HJ), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Vita-Salute University & Hospital San Raffaele (LL, MP), Milano, Italy; Center of Neuroimmunology and Department of Neurology (EHM-L, PV), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Neurologic Clinic and Policlinic (AP), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland; NeuroCure Clinical Research Center (FP, HZ), Charité-Universitätsmedizin Berlin, Berlin, Germany; Moorfields Eye Hospital (AP), London, United Kingdom ; The National Hospital for Neurology and Neurosurgery (AP), Queen Square, UCL Institute of Neurology, London, United Kingdom; Dutch Neuro-Ophthalmology Expertise Centre (AP), Amsterdam UMC, Amsterdam, the Netherlands; Oregon Health and Science University (HI), Portland, Oregon; Department of Ophthalmology (JSS, GW, SLG, LJB), New York University Grossman School of Medicine, New York, New York; Departments of Biomedical Engineering and Electrical and Computer Engineering (JSS), Tandon School of Engineering, New York University, Brooklyn, New York; Center for Neural Science (JSS), NYU, New York, New York; and Neuroscience Institute (JSS), NYU Langone Health, New York, New York
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Herold R, Borkowski J, Schwerk C, Stump-Guthier C, Lampe M, Ishikawa H, Muranyi W, Schroten H. Protocol for the setup and use of a human choroid plexus endothelial-epithelial two-cell-type in vitro model. STAR Protoc 2022; 3:101816. [DOI: 10.1016/j.xpro.2022.101816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Hulme L, Hochstetler A, Schwerk C, Schroten H, Ishikawa H, Tung CY, Perrin B, Blazer-Yost B. Characterization of TRPV4-mediated signaling pathways in an optimized human choroid plexus epithelial cell line. Am J Physiol Cell Physiol 2022; 323:C1823-C1842. [PMID: 35938676 PMCID: PMC9744646 DOI: 10.1152/ajpcell.00193.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022]
Abstract
The objectives of these studies were twofold: 1) to characterize the human choroid plexus papilloma (HIBCPP) cell line as a model of the blood-cerebrospinal fluid barrier (BCSFB) via morphology, tightness, and polarization of transporters in choroid plexus epithelia (CPe), and 2) to utilize Ussing-style electrophysiology to elucidate signaling pathways associated with the activation of the transient receptor potential vanilloid 4 (TRPV4) channel involved in cerebrospinal fluid (CSF) secretion. RT-PCR was implemented to determine gene expression of cell fate markers, junctional complex proteins, and transporters of interest. Scanning electron microscopy and confocal three-dimensional renderings of cultures grown on permeable supports were utilized to delineate the morphology of the brush border, junctional complexes, and polarization of key transporters. Electrophysiology was used to understand and explore TRPV4-mediated signaling in the HIBCPP cell line, considering both short-circuit current (Isc) and conductance responses. HIBCPP cells grown under optimized culture conditions exhibited minimal multilayering, developed an intermediate resistance monolayer, retained differentiation properties, and expressed, and correctly localized, junctional proteins and native transporters. We found that activation of TRPV4 resulted in a robust, multiphasic change in electrogenic ion flux and increase in conductance accompanied by substantial fluid secretion. This response appears to be modulated by a number of different effectors, implicating phospholipase C (PLC), protein kinase C (PKC), and phosphoinositide 3-kinase (PI3K) in TRPV4-mediated ion flux. The HIBCPP cell line is a representative model of the human BCSFB, which can be utilized for studies of transporter function, intracellular signaling, and regulation of CSF production.
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Affiliation(s)
- Louise Hulme
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
| | - Alexandra Hochstetler
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
| | - Christian Schwerk
- Department of Pediatrics, Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Horst Schroten
- Department of Pediatrics, Pediatric Infectious Diseases, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Department of Neurosurgery, Laboratory of Clinical Regenerative Medicine, University of Tsukuba, Ibaraki, Japan
| | - Chun-Yu Tung
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
| | - Benjamin Perrin
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
| | - Bonnie Blazer-Yost
- Department of Biology, Indiana University Purdue University Indianapolis, Indianapolis, Indiana
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Kuyama S, Yoshioka H, Kaneda H, Kataoka Y, Miura S, Katakami N, Yamanaka Y, Tamiya A, Yamada T, Yokoyama T, Hara S, Tanaka H, Fujisaka Y, Nakamura A, Azuma K, Namba M, Hata A, Sawa K, Ishikawa H, Kurata T. 330P A real-world multi-center prospective observational study of atezolizumab (Atezo) + bevacizumab (Bev) + carboplatin (CBDCA) + paclitaxel (PTX) (ABCP) in patients (pts) with advanced EGFR-mutated (EGFRm) NSCLC after EGFR-TKIs failure. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Murofushi K, Murofushi W, Komazawa M, Ohnishi K, Shimizuguchi T, Ito K, Hayakawa S, Ishikawa H. Preliminary Study on Establishing a Heart Rate Variability–Based Method for Objectively Evaluating Bone Metastasis Pain. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tanaka R, Ishikawa H, Sato J, Aoyama T, Shikamura Y, Shino M. Prevention of Acne-Like Eruption Caused by Panitumumab Treatment through Oral Administration of Non-steroidal Anti-inflammatory Drugs. Biol Pharm Bull 2022; 45:1531-1536. [PMID: 36184512 DOI: 10.1248/bpb.b22-00404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Acne-like eruption caused by anti-epidermal growth factor receptor (EGFR) antibodies such as panitumumab reduces treatment adherence and patient QOL; an alternative therapy is desired. Meanwhile, the usefulness of oral Non-steroidal Anti-inflammatory Drugs (NSAIDs) for acne-like eruptions caused by low-molecular-weight EGFR inhibitors such as erlotinib has been reported in the treatment of lung cancer. This study aimed to investigate whether the combined use of oral NSAIDs and panitumumab for colorectal cancer patients helps prevent acne-like eruption. We retrospectively investigated 167 colorectal cancer patients who had been treated with panitumumab for three cycles or more. The observation period was set from the start of panitumumab treatment to the end of three cycles. Within this period, the incidence and severity of acne-like eruptions were compared. A total of 59 and 108 patients were in the NSAIDs use and non-use groups, respectively, showing differences in the incidence of acne-like eruption rates (78.0 vs. 90.7%, respectively; p = 0.033). In the use group, eruption severity grades 0, 1, 2, and 3 were observed in 13, 33, 13, and 0 patients, respectively; the corresponding values in the non-use group were 10, 60, 36, and 2, respectively (p = 0.007). Oral NSAIDs may help prevent acne-like eruptions caused by panitumumab.
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Affiliation(s)
- Rei Tanaka
- Department of Pharmacy, Shizuoka Cancer Center.,Faculty of Pharmaceutical Sciences, Tokyo University of Science
| | | | - Junya Sato
- Department of Pharmacy, Shizuoka Cancer Center.,Department of Pharmacy, International University of Health and Welfare Hospital.,School of Pharmacy, International University of Health and Welfare
| | - Takao Aoyama
- Faculty of Pharmaceutical Sciences, Tokyo University of Science
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Kenney RC, Liu M, Hasanaj L, Joseph B, Abu Al-Hassan A, Balk LJ, Behbehani R, Brandt A, Calabresi PA, Frohman E, Frohman TC, Havla J, Hemmer B, Jiang H, Knier B, Korn T, Leocani L, Martinez-Lapiscina EH, Papadopoulou A, Paul F, Petzold A, Pisa M, Villoslada P, Zimmermann H, Thorpe LE, Ishikawa H, Schuman JS, Wollstein G, Chen Y, Saidha S, Galetta S, Balcer LJ. The Role of Optical Coherence Tomography Criteria and Machine Learning in Multiple Sclerosis and Optic Neuritis Diagnosis. Neurology 2022; 99:e1100-e1112. [PMID: 35764402 PMCID: PMC9536738 DOI: 10.1212/wnl.0000000000200883] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent studies have suggested that intereye differences (IEDs) in peripapillary retinal nerve fiber layer (pRNFL) or ganglion cell + inner plexiform (GCIPL) thickness by spectral domain optical coherence tomography (SD-OCT) may identify people with a history of unilateral optic neuritis (ON). However, this requires further validation. Machine learning classification may be useful for validating thresholds for OCT IEDs and for examining added utility for visual function tests, such as low-contrast letter acuity (LCLA), in the diagnosis of people with multiple sclerosis (PwMS) and for unilateral ON history. METHODS Participants were from 11 sites within the International Multiple Sclerosis Visual System consortium. pRNFL and GCIPL thicknesses were measured using SD-OCT. A composite score combining OCT and visual measures was compared individual measurements to determine the best model to distinguish PwMS from controls. These methods were also used to distinguish those with a history of ON among PwMS. Receiver operating characteristic (ROC) curve analysis was performed on a training data set (2/3 of cohort) and then applied to a testing data set (1/3 of cohort). Support vector machine (SVM) analysis was used to assess whether machine learning models improved diagnostic capability of OCT. RESULTS Among 1,568 PwMS and 552 controls, variable selection models identified GCIPL IED, average GCIPL thickness (both eyes), and binocular 2.5% LCLA as most important for classifying PwMS vs controls. This composite score performed best, with area under the curve (AUC) = 0.89 (95% CI 0.85-0.93), sensitivity = 81%, and specificity = 80%. The composite score ROC curve performed better than any of the individual measures from the model (p < 0.0001). GCIPL IED remained the best single discriminator of unilateral ON history among PwMS (AUC = 0.77, 95% CI 0.71-0.83, sensitivity = 68%, specificity = 77%). SVM analysis performed comparably with standard logistic regression models. DISCUSSION A composite score combining visual structure and function improved the capacity of SD-OCT to distinguish PwMS from controls. GCIPL IED best distinguished those with a history of unilateral ON. SVM performed as well as standard statistical models for these classifications. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that SD-OCT accurately distinguishes multiple sclerosis from normal controls as compared with clinical criteria.
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Affiliation(s)
- Rachel C Kenney
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Mengling Liu
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lisena Hasanaj
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Binu Joseph
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Abdullah Abu Al-Hassan
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lisanne J Balk
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Raed Behbehani
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Alexander Brandt
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Peter A Calabresi
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Elliot Frohman
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Teresa C Frohman
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Joachim Havla
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Bernhard Hemmer
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Hong Jiang
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Benjamin Knier
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Thomas Korn
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Letizia Leocani
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Elena Hernandez Martinez-Lapiscina
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Athina Papadopoulou
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Friedemann Paul
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Axel Petzold
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Marco Pisa
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Pablo Villoslada
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Hanna Zimmermann
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lorna E Thorpe
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Hiroshi Ishikawa
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Joel S Schuman
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Gadi Wollstein
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Yu Chen
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Shiv Saidha
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Steven Galetta
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Laura J Balcer
- From the Departments of Neurology (R.C.K., L.H., B.J., S.G., L.J. Balcer) and Population Health (R.C.K., M.L., L.E.T., Y.C., L.J. Balcer), New York University Grossman School of Medicine; Al-Bahar Ophthalmology Center (A.A.A.-H., R.B.), Ibn Sina Hospital, Kuwait City, Kuwait; Mulier Institute (L.J. Balk), Centre for Research on Sports in Society, Utrecht, the Netherlands; Experimental and Clinical Research Center (A.B., A. Papadopoulou, F.P., H.Z.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (P.A.C., S.S.), Johns Hopkins University, Baltimore, MD; Laboratory of Neuroimmunology (E.F., T.C.F.), of Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig Maximilians Universität München; Data Integration for Future Medicine Consortium (DIFUTURE) (J.H.), Ludwig-Maximilians University, Munich; Department of Neurology (B.H., B.K., T.K.), Klinikum rechts der Isar, School of Medicine, Technical University of Munich; Munich Cluster for Systems Neurology (SyNergy) (B.H., T.K.), Germany; Bascom Palmer Eye Institute (H.J.), Department of Neurology, University of Miami Miller School of Medicine, FL; Vita-Salute University & Hospital San Raffaele (L.L., M.P.), Milano, Italy; Center of Neuroimmunology and Department of Neurology (E.H.M.-L., P.V.), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Spain; Neurologic Clinic and Policlinic (A. Papadopoulou), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Switzerland; NeuroCure Clinical Research Center (F.P., H.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Moorfields Eye Hospital (Axel Petzold), London; The National Hospital for Neurology and Neurosurgery (A. Petzold), Queen Square, UCL Institute of Neurology, United Kingdom; Dutch Neuro-ophthalmology Expertise Centre, Amsterdam UMC, the Netherlands; Oregon Health and Science University (H.I.), Portland; Department of Ophthalmology (J.S.S., G.W., S.G., Laura J. Balcer), New York University Grossman School of Medicine; Departments of Biomedical Engineering and Electrical and Computer Engineering (J.S.S.), New York University Tandon School of Engineering, Brooklyn; Center for Neural Science (J.S.S.), New York University; and Neuroscience Institute (J.S.S.), NYU Langone Health. Dr. Kenney is currently at the Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN.
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Herrmann A, Schnedermann CS, Ishikawa H, Schwerk C, Schroten H, Mogk S. Protocol to analyze the transmigration efficiency of T. brucei using an in vitro model of the blood-cerebrospinal fluid barrier. STAR Protoc 2022; 3:101676. [PMID: 36103307 PMCID: PMC9483630 DOI: 10.1016/j.xpro.2022.101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/09/2022] [Accepted: 08/05/2022] [Indexed: 01/25/2023] Open
Abstract
At present, the only approach to investigate the transmigration of Trypanosoma brucei, the causative agent of human African trypanosomiasis, from blood to cerebrospinal fluid is through animal experiments. This protocol details how to analyze the transmigration efficiency using an in vitro model of the blood-cerebrospinal fluid (blood-CSF) barrier. We describe how to grow human choroid plexus epithelial cells on cell culture filter inserts to form the barrier, followed by isolating and quantifying genomic DNA of transmigrated parasites by qPCR. For complete details on the use and execution of this protocol, please refer to Speidel et al. (2022).
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Affiliation(s)
- Alexander Herrmann
- Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany
| | | | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Christian Schwerk
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Horst Schroten
- Pediatric Infectious Diseases, Department of Pediatrics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan Mogk
- Interfaculty Institute of Biochemistry, University of Tübingen, Tübingen, Germany,Corresponding author
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Nagumo Y, Kimura T, Ishikawa H, Sekino Y, Maruo K, Mathis B, Takemura M, Kageyama Y, Ushijima H, Kawai T, Yamashita H, Azuma H, Naiki T, Kobayashi Y, Inokuchi J, Osawa T, Kita Y, Tsuzuki T, Hashimoto K, Nishiyama H. 1740P Bladder preservation therapy in combination with atezolizumab and radiation therapy for invasive bladder cancer (BPT-ART): An open-label, single-arm, multicenter, phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Hermans D, Houben E, Baeten P, Slaets H, Janssens K, Hoeks C, Hosseinkhani B, Duran G, Bormans S, Gowing E, Hoornaert C, Beckers L, Fung WK, Schroten H, Ishikawa H, Fraussen J, Thoelen R, de Vries HE, Kooij G, Zandee S, Prat A, Hellings N, Broux B. Oncostatin M triggers brain inflammation by compromising blood-brain barrier integrity. Acta Neuropathol 2022; 144:259-281. [PMID: 35666306 DOI: 10.1007/s00401-022-02445-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/01/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
Oncostatin M (OSM) is an IL-6 family member which exerts neuroprotective and remyelination-promoting effects after damage to the central nervous system (CNS). However, the role of OSM in neuro-inflammation is poorly understood. Here, we investigated OSM's role in pathological events important for the neuro-inflammatory disorder multiple sclerosis (MS). We show that OSM receptor (OSMRβ) expression is increased on circulating lymphocytes of MS patients, indicating their elevated responsiveness to OSM signalling. In addition, OSM production by activated myeloid cells and astrocytes is increased in MS brain lesions. In experimental autoimmune encephalomyelitis (EAE), a preclinical model of MS, OSMRβ-deficient mice exhibit milder clinical symptoms, accompanied by diminished T helper 17 (Th17) cell infiltration into the CNS and reduced BBB leakage. In vitro, OSM reduces BBB integrity by downregulating the junctional molecules claudin-5 and VE-cadherin, while promoting secretion of the Th17-attracting chemokine CCL20 by inflamed BBB-endothelial cells and reactive astrocytes. Using flow cytometric fluorescence resonance energy transfer (FRET) quantification, we found that OSM-induced endothelial CCL20 promotes activation of lymphocyte function-associated antigen 1 (LFA-1) on Th17 cells. Moreover, CCL20 enhances Th17 cell adhesion to OSM-treated inflamed endothelial cells, which is at least in part ICAM-1 mediated. Together, these data identify an OSM-CCL20 axis, in which OSM contributes significantly to BBB impairment during neuro-inflammation by inducing permeability while recruiting Th17 cells via enhanced endothelial CCL20 secretion and integrin activation. Therefore, care should be taken when considering OSM as a therapeutic agent for treatment of neuro-inflammatory diseases such as MS.
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Affiliation(s)
- Doryssa Hermans
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Evelien Houben
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Paulien Baeten
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Helena Slaets
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Kris Janssens
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Cindy Hoeks
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Baharak Hosseinkhani
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Gayel Duran
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Seppe Bormans
- Institute for Materials Research (IMO), UHasselt, Diepenbeek, Belgium
| | - Elizabeth Gowing
- Centre de Recherche du CHUM (CRCHUM), Neuroimmunology Unit, Montreal, QC, Canada
| | - Chloé Hoornaert
- Centre de Recherche du CHUM (CRCHUM), Neuroimmunology Unit, Montreal, QC, Canada
| | - Lien Beckers
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Wing Ka Fung
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Horst Schroten
- Pediatric Infectious Diseases, Medical Faculty Mannheim, University Children's Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Hiroshi Ishikawa
- Laboratory of Clinical Regenerative Medicine, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Judith Fraussen
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Ronald Thoelen
- Institute for Materials Research (IMO), UHasselt, Diepenbeek, Belgium
| | - Helga E de Vries
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Gijs Kooij
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Stephanie Zandee
- Centre de Recherche du CHUM (CRCHUM), Neuroimmunology Unit, Montreal, QC, Canada
| | - Alexandre Prat
- Centre de Recherche du CHUM (CRCHUM), Neuroimmunology Unit, Montreal, QC, Canada
| | - Niels Hellings
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium.,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium
| | - Bieke Broux
- University MS Center, Campus Diepenbeek, Diepenbeek, Belgium. .,Neuro-Immune Connections and Repair Lab, Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Diepenbeek, Belgium. .,Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands.
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Ishikawa H, Shozu M. Modified Leak-Proof Puncture Technique for the Aspiration of Giant Ovarian Cysts by Instantly Mounting a Plastic Wrap and Gauze with Cyanoacrylates: A Retrospective Observational Study. Front Surg 2022; 9:948073. [PMID: 35865035 PMCID: PMC9295911 DOI: 10.3389/fsurg.2022.948073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveWe developed a leak-proof puncture technique for giant ovarian cysts by instantly mounting a plastic wrap to the cysts using cyanoacrylates and aspirating cyst fluid over the wrap. Here, we modified it by inserting a gauze between the wrap and cyst to strengthen the mounting. This study aimed to clarify the feasibility of the modified procedure.MethodA retrospective observational study was conducted in a single center. Surgical outcomes of 35 women who underwent the modified procedure from December 2013 to July 2020 were compared with those of 51 women who underwent the original procedure.ResultsMean long-axis diameters of the cysts were 233.1 mm and 229.8 mm in the modified and original procedures, respectively. The median of surgical time, blood loss, and aspirated fluid volume were 109 min, 50 ml, and 3,050 ml, in the modified procedure, all of which were not significantly different from those of the original procedure. One case of mounting disruption and two (5.7%) cases of intraperitoneal spillage of the cyst fluid were observed in the modified procedure, whereas four (7.8%) cases of mounting disruption and five (9.8%) cases of intraperitoneal spillage occurred in the original procedure. These events were caused by aspiration difficulty of the high viscosity fluid and/or multilocular cysts. Laparotomy conversion was observed in five (14.3%) cases in the modified procedure.ConclusionOur modified procedure is feasible in select cases. The high viscosity of the cyst fluid and multilocular cyst may cause mounting disruption and intraperitoneal spillage of the cyst fluid.
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Fukuda H, Ishikawa H, Ito S, Haga T. Nitidotellina hachiensis n. sp. (Bivalvia: Tellinidae) from the Seto Inland Sea, between Honshū and Shikoku, western Japan. Molluscan Research 2022. [DOI: 10.1080/13235818.2022.2068112] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hiroshi Fukuda
- Conservation of Aquatic Biodiversity, Faculty of Agriculture, Okayama University, Okayama, Japan
| | | | - Soma Ito
- Department of Biological Sciences, Faculty of Science and Technology, Kochi University, Kochi, Japan
| | - Takuma Haga
- Department of Geology and Paleontology, National Museum of Nature and Science, Tsukuba, Japan
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Ando T, Nakashima K, Yoshita H, Sakumura M, Nomura M, Muto M, Fujii H, Horie Y, Takeda H, Yoshii T, Tahara Y, Katada C, Yoshimura K, Ishikawa H, Hosokawa A. P-108 A phase II study of weekly paclitaxel in patients with advanced or recurrent esophageal cancer who had previously received docetaxel-containing chemotherapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.198] [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: 11/26/2022] Open
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Glidai Y, Lucy KA, Schuman JS, Alexopoulos P, Wang B, Wu M, Liu M, Vande Geest JP, Kollech HG, Lee T, Ishikawa H, Wollstein G. Microstructural Deformations Within the Depth of the Lamina Cribrosa in Response to Acute In Vivo Intraocular Pressure Modulation. Invest Ophthalmol Vis Sci 2022; 63:25. [PMID: 35604666 PMCID: PMC9150833 DOI: 10.1167/iovs.63.5.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose The lamina cribrosa (LC) is a leading target for initial glaucomatous damage. We investigated the in vivo microstructural deformation within the LC volume in response to acute IOP modulation while maintaining fixed intracranial pressure (ICP). Methods In vivo optic nerve head (ONH) spectral-domain optical coherence tomography (OCT) scans (Leica, Chicago, IL, USA) were obtained from eight eyes of healthy adult rhesus macaques (7 animals; ages = 7.9-14.4 years) in different IOP settings and fixed ICP (8-12 mm Hg). IOP and ICP were controlled by cannulation of the anterior chamber and the lateral ventricle of the brain, respectively, connected to a gravity-controlled reservoir. ONH images were acquired at baseline IOP, 30 mm Hg (H1-IOP), and 40 to 50 mm Hg (H2-IOP). Scans were registered in 3D, and LC microstructure measurements were obtained from shared regions and depths. Results Only half of the eyes exhibited LC beam-to-pore ratio (BPR) and microstructure deformations. The maximal BPR change location within the LC volume varied between eyes. BPR deformer eyes had a significantly higher baseline connective tissue volume fraction (CTVF) and lower pore aspect ratio (P = 0.03 and P = 0.04, respectively) compared to BPR non-deformer. In all eyes, the magnitude of BPR changes in the anterior surface was significantly different (either larger or smaller) from the maximal change within the LC (H1-IOP: P = 0.02 and H2-IOP: P = 0.004). Conclusions The LC deforms unevenly throughout its depth in response to IOP modulation at fixed ICP. Therefore, analysis of merely the anterior LC surface microstructure will not fully capture the microstructure deformations within the LC. BPR deformer eyes have higher CTVF than BPR non-deformer eyes.
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Affiliation(s)
- Yoav Glidai
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States
| | - Katie A. Lucy
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States,Department of Biomedical Engineering, NYU Tandon School of Engineering, New York, New York, United States,Center for Neural Science, NYU, New York, New York, United States
| | | | - Bo Wang
- UPMC Eye Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Mengfei Wu
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States,Division of Biostatistics, Departments of Population Health and Environmental Medicine, NYU Langone Health, New York, New York, United States
| | - Mengling Liu
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States,Division of Biostatistics, Departments of Population Health and Environmental Medicine, NYU Langone Health, New York, New York, United States
| | - Jonathan P. Vande Geest
- UPMC Eye Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Hirut G. Kollech
- Computational Modeling and Simulation Program, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - TingFang Lee
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States,Division of Biostatistics, Departments of Population Health and Environmental Medicine, NYU Langone Health, New York, New York, United States
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York, New York, United States,Center for Neural Science, NYU, New York, New York, United States
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Hulme L, Hochstetler A, Schwerk C, Schroten H, Ishikawa H, Blazer‐Yost B. Functional Characterization of a Human Choroid Plexus Cell Line and TRPV4 Stimulated Transepithelial Ion Flux. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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