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Hishiki T, Honda S, Takama Y, Inomata Y, Okajima H, Hoshino K, Suzuki T, Souzaki R, Wada M, Kasahara M, Mizuta K, Oue T, Yokoi A, Kazama T, Komatsu S, Saeki I, Miyazaki O, Takimoto T, Ida K, Watanabe K, Hiyama E. Feasibility of Real-Time Central Surgical Review for Patients with Advanced-Stage Hepatoblastoma in the JPLT3 Trial. Children (Basel) 2022; 9:children9020234. [PMID: 35204954 PMCID: PMC8870682 DOI: 10.3390/children9020234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/01/2022] [Accepted: 02/05/2022] [Indexed: 12/16/2022]
Abstract
In the JPLT3 study, a real-time central surgical reviewing (CSR) system was employed aimed at facilitating early referral of candidates for liver transplantation (LTx) to centers with pediatric LTx services. The expected consequence was surgery, including LTx, conducted at the appropriate time in all cases. This study aimed to review the effect of CSR on institutional surgical decisions in cases enrolled in the JPLT3 study. Real-time CSR was performed in cases in which complex surgeries were expected, using images obtained after two courses of preoperative chemotherapy. Using the cloud-based remote image viewing system, an expert panel consisting of pediatric and transplant surgeons reviewed the images and commented on the expected surgical strategy or the necessity of transferring the patient to a transplant unit. The results were summarized and reported to the treating institutions. A total of 41 reviews were conducted for 35 patients, and 16 cases were evaluated as possible candidates for LTx, with the treating institutions being advised to consult a transplant center. Most of the reviewed cases promptly underwent definitive liver surgeries, including LTx per protocol.
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Affiliation(s)
- Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Chiba, Japan;
- Correspondence:
| | - Shohei Honda
- Department of Gastroenterological Surgery I, Hokkaido University Hospital, Sapporo 060-8648, Hokkaido, Japan;
| | - Yuichi Takama
- Department of Pediatric Surgery, Osaka City General Hospital, Osaka 534-0021, Osaka, Japan;
| | | | - Hideaki Okajima
- Department of Pediatric Surgery, Kanazawa Medical University, Kanazawa 920-0293, Ishikawa, Japan;
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio School of Medicine, Keio University, Tokyo 108-8345, Tokyo, Japan;
| | - Tatsuya Suzuki
- Department of Pediatric Surgery, Fujita Health University Hospital, Toyoake 470-1192, Aichi, Japan;
| | - Ryota Souzaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Fukuoka, Japan;
| | - Motoshi Wada
- Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai 980-8574, Miyagi, Japan; (M.W.); (T.K.)
| | - Mureo Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo 157-8535, Tokyo, Japan;
| | - Koichi Mizuta
- Transplant Center, Saitama Children’s Medical Center, Saitama 330-8777, Saitama, Japan;
| | - Takaharu Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, Japan;
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe 650-0047, Hyogo, Japan;
| | - Takuro Kazama
- Department of Pediatric Surgery, Tohoku University School of Medicine, Sendai 980-8574, Miyagi, Japan; (M.W.); (T.K.)
| | - Shugo Komatsu
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Chiba, Japan;
| | - Isamu Saeki
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan; (I.S.); (E.H.)
| | - Osamu Miyazaki
- Department of Diagnostic Radiology, National Center for Child Health and Development, Tokyo 157-8535, Tokyo, Japan;
| | - Tetsuya Takimoto
- Department of Childhood Cancer Data Management, National Center for Child Health and Development, Tokyo 157-8535, Tokyo, Japan;
| | - Kohmei Ida
- Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawasaki 213-8507, Kanagawa, Japan;
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka 420-8660, Shizuoka, Japan;
| | - Eiso Hiyama
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Hiroshima, Japan; (I.S.); (E.H.)
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima 734-8551, Hiroshima, Japan
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Watanabe K, Mori M, Hishiki T, Yokoi A, Ida K, Yano M, Fujimura J, Nogami Y, Iehara T, Hoshino K, Inoue T, Tanaka Y, Miyazaki O, Takimoto T, Yoshimura K, Hiyama E. Feasibility of dose-dense cisplatin-based chemotherapy in Japanese children with high-risk hepatoblastoma: Analysis of the JPLT3-H pilot study. Pediatr Blood Cancer 2022; 69:e29389. [PMID: 34606680 DOI: 10.1002/pbc.29389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 08/29/2021] [Accepted: 09/14/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The SIOPEL-4 study has demonstrated that dose-dense cisplatin-based chemotherapy dramatically improves outcome in children with high-risk hepatoblastoma in western countries. However, the feasibility and safety of this regimen have not been clarified in Japanese patients. METHODS A pilot study, JPLT3-H, was designed to evaluate the safety profile of the SIOPEL-4 regimen in Japanese children with newly diagnosed hepatoblastoma with either metastatic disease or low alpha-fetoprotein. RESULTS A total of 15 patients (three female) were enrolled. Median age was 2 years (range, 0-14). Three patients were PRETEXT II (where PRETEXT is PRETreatment EXTent of disease), six PRETEXT III, and six PRETEXT IV. All patients had lung metastasis, none had low alpha-fetoprotein. Eight patients completed the prescribed treatment, and seven patients discontinued therapy prematurely, four due to progressive disease and three due to causes other than severe toxicity. Grade 4 neutropenia was documented in most patients in preoperative cycles A1-3 (11/15 in A1, 9/11 in A2, and 7/11 in A3) and in all considering all cycles. Grade 3-4 thrombocytopenia and grade 3 anemia were also frequently observed. Patients experienced several episodes of grade 3 febrile neutropenia, but none had grade 4 febrile neutropenia or severe infections. One patient had grade 3 heart failure only in the first cycle. Other grade 3 or 4 toxicities were hypomagnesemia, anorexia, nausea, mucositis, liver enzyme elevation, fever, infection, and fatigue. There were no unexpected severe toxicities. CONCLUSION The toxicity profile of JPLT3-H was comparable to that of SIOPEL-4. Dose-dense cisplatin-based chemotherapy may be feasible among Japanese patients with high-risk hepatoblastoma.
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Affiliation(s)
- Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Makiko Mori
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan
| | - Kohmei Ida
- Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawanagawa, Japan
| | - Michihiro Yano
- Department of Pediatrics, Akita University Hospital, Akita, Japan
| | - Junya Fujimura
- Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuki Nogami
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio School of Medicine, Keio University, Tokyo, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Tetsuya Takimoto
- Department of Childhood Cancer Data Management, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Yoshimura
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Eiso Hiyama
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan.,Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan
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Fujimura T, Yamada Y, Umeyama T, Kudo Y, Kanamori H, Mori T, Shimizu T, Kato M, Kawaida M, Hosoe N, Hasegawa Y, Matsubara K, Shimojima N, Shinoda M, Obara H, Naganuma M, Kitagawa Y, Hoshino K, Kuroda T. Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report. World J Clin Cases 2021; 9:5270-5279. [PMID: 34307578 PMCID: PMC8283613 DOI: 10.12998/wjcc.v9.i19.5270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/18/2021] [Accepted: 05/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence has been published on the successful applications of the anti-tumor necrosis factor alpha antibody infliximab, such as induction therapy, salvage treatment for acute cellular rejection, and treatment for chronic ulcerative inflammation, in intestinal transplant recipients. However, the optimal protocol for the effective use of infliximab remains largely undetermined due to scarcity of available clinical data. We report a continuative application of infliximab as maintenance therapy for recurrent chronic ulcerative ileitis in a recipient of isolated intestinal transplantation (ITx).
CASE SUMMARY The patient was a 11-year-old boy with intestinal motility disorder classified as a hypogenic type of intestinal dysganglionosis. The patient underwent living-donor related intestinal transplant. His immunosuppression regimen consisted of daclizumab, tacrolimus, and steroids. Although he did not show rejection while on tacrolimus monotherapy, routine screening endoscopy showed several ulcerative lesions in the distal end of the graft 2 years after the intestinal transplant. Endoscopic work up to evaluate the progression of anemia revealed stenosis with ulcerative inflammatory changes and multiple longitudinal ulcers in the graft. Since the endoscopic findings suggested ulcerative lesions in Crohn’s disease, infliximab treatment was considered. Treatment with infliximab and a small dose of oral prednisolone afforded successful withdrawal of total parenteral nutrition and maintenance of a well-functioning graft without infectious complications for 5 years since the administration of the first dose of infliximab.
CONCLUSION Infliximab is effective as maintenance therapy for recurrent chronic ulcerative ileitis in an isolated ITx patient.
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Affiliation(s)
- Takumi Fujimura
- Department of Pediatric Surgery, National Saitama Hospital, Wako Shi, Saitama 351-0102, Japan
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoshige Umeyama
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yumi Kudo
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroki Kanamori
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Teizaburo Mori
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takahiro Shimizu
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mototoshi Kato
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yasushi Hasegawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Naoki Shimojima
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
- Digestive Diseases Center, International University of Health and Welfare, Mita Hospital, Tokyo 108-8329, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Makoto Naganuma
- Department of Gastroenterology and Hepatology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
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Asakura N, Hoshino K, Homma Y, Sakamoto Y. Simulation studies of divertor detachment and critical power exhaust parameters for Japanese DEMO design. Nuclear Materials and Energy 2021. [DOI: 10.1016/j.nme.2020.100864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hayakawa SH, Agari K, Ahn JK, Akaishi T, Akazawa Y, Ashikaga S, Bassalleck B, Bleser S, Ekawa H, Endo Y, Fujikawa Y, Fujioka N, Fujita M, Goto R, Han Y, Hasegawa S, Hashimoto T, Hayakawa T, Hayata E, Hicks K, Hirose E, Hirose M, Honda R, Hoshino K, Hoshino S, Hosomi K, Hwang SH, Ichikawa Y, Ichikawa M, Imai K, Inaba K, Ishikawa Y, Ito H, Ito K, Jung WS, Kanatsuki S, Kanauchi H, Kasagi A, Kawai T, Kim MH, Kim SH, Kinbara S, Kiuchi R, Kobayashi H, Kobayashi K, Koike T, Koshikawa A, Lee JY, Ma TL, Matsumoto SY, Minakawa M, Miwa K, Moe AT, Moon TJ, Moritsu M, Nagase Y, Nakada Y, Nakagawa M, Nakashima D, Nakazawa K, Nanamura T, Naruki M, Nyaw ANL, Ogura Y, Ohashi M, Oue K, Ozawa S, Pochodzalla J, Ryu SY, Sako H, Sato S, Sato Y, Schupp F, Shirotori K, Soe MM, Soe MK, Sohn JY, Sugimura H, Suzuki KN, Takahashi H, Takahashi T, Takeda T, Tamura H, Tanida K, Theint AMM, Tint KT, Toyama Y, Ukai M, Umezaki E, Watabe T, Watanabe K, Yamamoto TO, Yang SB, Yoon CS, Yoshida J, Yoshimoto M, Zhang DH, Zhang Z. Observation of Coulomb-Assisted Nuclear Bound State of Ξ^{-}-^{14}N System. Phys Rev Lett 2021; 126:062501. [PMID: 33635678 DOI: 10.1103/physrevlett.126.062501] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/19/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
In an emulsion-counter hybrid experiment performed at J-PARC, a Ξ^{-} absorption event was observed which decayed into twin single-Λ hypernuclei. Kinematic calculations enabled a unique identification of the reaction process as Ξ^{-}+^{14}N→_{Λ}^{10}Be+_{Λ}^{5}He. For the binding energy of the Ξ^{-} hyperon in the Ξ^{-}-^{14}N system a value of 1.27±0.21 MeV was deduced. The energy level of Ξ^{-} is likely a nuclear 1p state which indicates a weak ΞN-ΛΛ coupling.
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Affiliation(s)
- S H Hayakawa
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - K Agari
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Korea
| | - T Akaishi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - Y Akazawa
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - S Ashikaga
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - B Bassalleck
- Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - S Bleser
- Helmholtz Institute Mainz, 55099 Mainz, Germany
| | - H Ekawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - Y Endo
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - Y Fujikawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - N Fujioka
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Fujita
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - R Goto
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - Y Han
- Institute of Nuclear Energy Safety Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China
| | - S Hasegawa
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - T Hashimoto
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - T Hayakawa
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - E Hayata
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - K Hicks
- Department of Physics & Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - E Hirose
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - M Hirose
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - R Honda
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - K Hoshino
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - S Hoshino
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - K Hosomi
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - S H Hwang
- Korea Research Institute of Standards and Science, Daejeon 34113, Korea
| | - Y Ichikawa
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - M Ichikawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Meson Science Laboratory, RIKEN, Wako 351-0198, Japan
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - K Inaba
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - Y Ishikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Ito
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - K Ito
- Department of Physics, Nagoya University, Nagoya 464-8601, Japan
| | - W S Jung
- Department of Physics, Korea University, Seoul 02841, Korea
| | - S Kanatsuki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Kanauchi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - A Kasagi
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - T Kawai
- Center for Advanced Photonics, RIKEN, Wako 351-0198, Japan
| | - M H Kim
- Department of Physics, Korea University, Seoul 02841, Korea
| | - S H Kim
- Department of Physics, Korea University, Seoul 02841, Korea
| | - S Kinbara
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - R Kiuchi
- Institute of High Energy Physics, Beijing 100049, China
| | - H Kobayashi
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - K Kobayashi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Koike
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - A Koshikawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - J Y Lee
- Department of Physics, Seoul National University, Seoul 08826, Korea
| | - T L Ma
- Institute of Modern Physics, Shanxi Normal University, Linfen 041004, China
| | - S Y Matsumoto
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Meson Science Laboratory, RIKEN, Wako 351-0198, Japan
| | - M Minakawa
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - K Miwa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - A T Moe
- Department of Physics, Lashio University, Lashio 06301, Myanmar
| | - T J Moon
- Department of Physics, Seoul National University, Seoul 08826, Korea
| | - M Moritsu
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - Y Nagase
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - Y Nakada
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - M Nakagawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - D Nakashima
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - K Nakazawa
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - T Nanamura
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Naruki
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - A N L Nyaw
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - Y Ogura
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Ohashi
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - K Oue
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - S Ozawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - J Pochodzalla
- Helmholtz Institute Mainz, 55099 Mainz, Germany
- Institut fur Kernphysik, Johannes Gutenberg-Universitat, 55099 Mainz, Germany
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - H Sako
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - S Sato
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - Y Sato
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - F Schupp
- Helmholtz Institute Mainz, 55099 Mainz, Germany
| | - K Shirotori
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - M M Soe
- Department of Physics, University of Yangon, Yangon 11041, Myanmar
| | - M K Soe
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - J Y Sohn
- Research Institute of Natural Science, Gyeongsang National University, Jinju 52828, Korea
| | - H Sugimura
- Accelerator Laboratory, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - K N Suzuki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Takahashi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Takahashi
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Takeda
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Tamura
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - A M M Theint
- Graduate School of Engineering, Gifu University, Gifu 501-1193, Japan
| | - K T Tint
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - Y Toyama
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Ukai
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - E Umezaki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - T Watabe
- Department of Physics, Nagoya University, Nagoya 464-8601, Japan
| | - K Watanabe
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - T O Yamamoto
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - S B Yang
- Department of Physics, Korea University, Seoul 02841, Korea
| | - C S Yoon
- Research Institute of Natural Science, Gyeongsang National University, Jinju 52828, Korea
| | - J Yoshida
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Yoshimoto
- Faculty of Education, Gifu University, Gifu 501-1193, Japan
| | - D H Zhang
- Institute of Modern Physics, Shanxi Normal University, Linfen 041004, China
| | - Z Zhang
- Institute of Modern Physics, Shanxi Normal University, Linfen 041004, China
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Oka S, Kai T, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. A comparison of rate control and rhythm control in tachycardia induced cardiomyopathy patients with persistent atrial flutter. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
Tachycardia induced cardiomyopathy (TIC) is a potentially reversible dysfunction of the left ventricle (LV) caused by tachyarrhythmias. Early recognition of TIC and treatment of the culprit arrhythmia using pharmacological therapy or catheter ablation results in the recovery of LV function. For atrial flutter (AFL)-induced TIC, rhythm control strategy, such as catheter ablation has been recommended. On the other hand, the efficacy of rate control strategy has remained unclear due to the difficulty of control with arrhythmic medications. However, not all patients can take rhythm control treatments due to their backgrounds.
Purpose
The aim of this cohort study was to establish whether rate control strategy using β-blocker is as effective as invasive rhythm control strategy for the recovery of LV function in patients with TIC due to AFL.
Methods
We prospectively assessed 47 symptomatic non-ischaemic heart failure (HF) patients with left ventricular ejection fraction (LVEF) below 50% and suspected TIC induced by persistent AFL. Patients were divided into rhythm control strategy group (n=22, treatment: catheter ablation, electrical cardioversion) and rate control strategy group (n=25, treatment: bisoprolol). As a sub-group study, the rate control strategy group was divided into the strict rate control group (n=12, average heart rate below 80 bpm) and lenient rate control group (n=13, average heart rate below 110 bpm). The primary outcome was the recovery of LV function, defined as an increase of LVEF over 20% or to a value of 55% or greater after 6 months.
Results
There were no significant differences in baseline AFL heart rate, New York Heart Association class, LVEF, estimated glomerular filtration rate, and brain natriuretic peptide between the two groups. A greater proportion of patients who showed the recovery of LVEF after 6 months belonged to the rhythm control strategy group (90.9% vs. 52.0%, p=0.004). The cumulative incidence of HF re-hospitalization was significantly higher in the rate control strategy group than in the rhythm control strategy group (hazard ratio: 4.90, 95% CI: 1.06–22.69). As a result of sub-group study, LVEF recovery was greater in the strict rate control group compared to the lenient rate control group (75.0% vs. 30.8%, p=0.027)
Conclusion
Rate control strategy was significantly inferior to rhythm control strategy for the recovery of LVEF in TIC patients with persistent AFL. Rhythm control should be the first choice in the management of TIC with AFL, and strict rate control should be an alternative if rhythm control is not available.
Primary outcomes
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Oka
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - T Kai
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - K Hoshino
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - K Watanabe
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - J Nakamura
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - M Abe
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - A Watanabe
- Fujieda Municipal General Hospital, Fujieda, Japan
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7
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Hiyama E, Hishiki T, Watanabe K, Ida K, Ueda Y, Kurihara S, Yano M, Hoshino K, Yokoi A, Takama Y, Nogami Y, Taguchi T, Mori M, Kihira K, Miyazaki O, Fuji H, Honda S, Iehara T, Kazama T, Fujimura J, Tanaka Y, Inoue T, Tajiri T, Kondo S, Oue T, Yoshimura K. Outcome and Late Complications of Hepatoblastomas Treated Using the Japanese Study Group for Pediatric Liver Tumor 2 Protocol. J Clin Oncol 2020; 38:2488-2498. [PMID: 32421442 DOI: 10.1200/jco.19.01067] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We report here the outcomes and late effects of the Japanese Study Group for Pediatric Liver Tumors (JPLT)-2 protocol, on the basis of cisplatin-tetrahydropyranyl-adriamycin (CITA) with risk stratification according to the pretreatment extent of disease (PRETEXT) classification for hepatoblastoma (HB). PATIENTS AND METHODS From 1999 to 2012, 361 patients with untreated HB were enrolled. PRETEXT I/II patients were treated with up-front resection, followed by low-dose CITA (stratum 1) or received low-dose CITA, followed by surgery and postoperative chemotherapy (stratum 2). In the remaining patients, after 2 cycles of CITA, responders received the CITA regimen before resection (stratum 3), and nonresponders were switched to ifosfamide, pirarubicin, etoposide, and carboplatin (ITEC; stratum 4). Intensified chemotherapeutic regimens with autologous hematopoietic stem-cell transplantation (SCT) after resection were an optional treatment for patients with refractory/metastatic disease. RESULTS The 5-year event-free and overall survival rates of HB patients were 74.2% and 89.9%, respectively, for stratum 1, 84.8% and 90.8%%, respectively, for stratum 2, 71.6% and 85.9%%, respectively, for stratum 3, and 59.1% and 67.3%%, respectively, for stratum 4. The outcomes for CITA responders were significantly better than those for nonresponders, whose outcomes remained poor despite salvage therapy with a second-line ITEC regimen or SCT. The late effects, ototoxicity, cardiotoxicity, and delayed growth, occurred in 61, 18, and 47 patients, respectively. Thirteen secondary malignant neoplasms (SMNs), including 10 leukemia, occurred, correlating with higher exposure to pirarubicin and younger age at diagnosis. CONCLUSION The JPLT-2 protocol achieved up-front resectability in PRETEXT I/II patients with no annotation factors, and satisfactory survival in patients who were CITA responders in the remaining patients. However, outcomes for CITA nonresponders were unsatisfactory, despite therapy intensification with ITEC regimens and SCT. JPLT-2 had a relatively low incidence of cardiotoxicity but high rates of SMNs.
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Affiliation(s)
- Eiso Hiyama
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan.,Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoro Hishiki
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.,National Cancer Center Hospital, Tokyo, Japan
| | | | - Kohmei Ida
- Department of Pediatrics, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan
| | - Yuka Ueda
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Sho Kurihara
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Michihiro Yano
- Department of Pediatrics, Akita University School of Medicine, Akita, Japan
| | - Ken Hoshino
- School of Medicine, Keio University, Tokyo, Japan
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Yuichi Takama
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuki Nogami
- National Cancer Center Hospital, Tokyo, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Makiko Mori
- Departments of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Kentaro Kihira
- Department of Pediatrics, Mie University Graduate School of Medicine, Mie, Japan
| | - Osamu Miyazaki
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroshi Fuji
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shohei Honda
- Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Takuro Kazama
- Department of Pediatric Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Junya Fujimura
- Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Satoshi Kondo
- Division of Pediatric Surgery and Transplant Surgery, Nagoya City University Medical School, Nagoya, Japan
| | - Takaharu Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Kenichi Yoshimura
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan
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8
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Wakabayashi T, Obara H, Seki M, Shinoda M, Kitago M, Yagi H, Abe Y, Matsubara K, Yamada Y, Oshima G, Oki K, Nagoshi N, Watanabe K, Hibi T, Itano O, Hoshino K, Suzuki N, Kuroda T, Kitagawa Y. Myelopathy due to human T-cell leukemia virus type-1 from the donor after ABO-incompatible liver transplantation. Ann Hepatol 2020; 18:397-401. [PMID: 31029562 DOI: 10.1016/j.aohep.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/19/2018] [Accepted: 06/19/2018] [Indexed: 02/04/2023]
Abstract
We report the case of a 53-year-old-man who developed human T-cell leukemia virus type-1-associated myelopathy (HAM) after ABO-incompatible liver transplantation for alcoholic liver cirrhosis. The living donor was seropositive for human T-cell leukemia virus type-1 (HTLV-1) and the recipient was seronegative for HTLV-1 before transplantation. After transplantation, the recipient developed steroid-resistant acute cellular rejection, which was successfully treated using anti-thymocyte globulin, and he was eventually discharged. He underwent spinal surgery twice after the transplantation for the treatment of cervical spondylosis that had been present for a period of 9 months before the transplantation. The surgery improved his gait impairment temporarily. However, his gait impairment progressed, and magnetic resonance imaging revealed multiple sites of myelopathy. He was diagnosed with HAM 16 months after the transplantation. Pulse steroid therapy (1000mg) was administered over a period of 3 days, and his limb paresis improved. Presently, steroid therapy is being continued, with a plan to eventually taper the dose, and he is being carefully followed up at our institution. Our case suggests that liver transplantation involving an HTLV-1-positive living donor carries the risk of virus transmission and short-term development of HAM after transplantation.
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Affiliation(s)
- Taiga Wakabayashi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Go Oshima
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Oki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of Transplantation and Pediatric Surgery, Kumamoto University, Kumamoto, Japan
| | - Osamu Itano
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Norihiro Suzuki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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9
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Shimura K, Shibata H, Mizuno Y, Amano N, Hoshino K, Kuroda T, Kameyama K, Matsuse M, Mitsutake N, Sugino K, Yoshimura Noh J, Hasegawa T, Ishii T. Rapid Growth and Early Metastasis of Papillary Thyroid Carcinoma in an Adolescent Girl with Graves' Disease. Horm Res Paediatr 2019; 91:210-215. [PMID: 30092570 DOI: 10.1159/000491102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/20/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The risk factors for rapid growth and early metastasis of papillary thyroid carcinoma (PTC) and the role of coexisting Graves' disease in the clinical course of PTC remain uncertain in children. CASE DESCRIPTION We report on a Japanese girl, whose PTC rapidly grew and metastasized within 4 years. Graves' disease was diagnosed by the presence of serum TSH receptor antibodies at 8 years of age when thyroid ultrasonography detected no nodules. After 4 years of effective treatment with thiamazole, multifocal nodules - up to 47 mm in diameter - were detected on thyroid ultrasonography. Chest CT scan revealed multiple metastatic lesions in the lung. After total thyroidectomy, PTC was pathologically diagnosed. The patient underwent two courses of radioactive iodine (RAI) treatment, but the pulmonary metastatic lesions did not take up the RAI. Molecular analyses of the PTC tissue identified a TFG/NTRK1 chimeric gene and disclosed the preserved expression of TSHR and the reduced expression of SLC5A5 compared with non-tumor thyroid tissue. CONCLUSIONS Rapid growth and early metastasis of PTC with coexisting Graves' disease in this patient can be related to a combination of multiple factors including preserved TSHR expression, reduced SLC5A5 expression, and TFG/NTRK1 rearrangement.
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Affiliation(s)
- Kazuhiro Shimura
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Hironori Shibata
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Mizuno
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Naoko Amano
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Kameyama
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Michiko Matsuse
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Norisato Mitsutake
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | | | | | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tomohiro Ishii
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan,
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10
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Takemura Y, Hibi T, Shinoda M, Obara H, Minagawa T, Kitago M, Yagi H, Abe Y, Matsubara K, Oshima G, Hori S, Hoshino K, Yamada Y, Itano O, Takano Y, Kuroda T, Hasegawa N, Kitagawa Y. Methicillin-resistant Staphylococcus aureus carriers are vulnerable to bloodstream infection after living donor liver transplantation. Clin Transplant 2019; 33:e13753. [PMID: 31692105 DOI: 10.1111/ctr.13753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/03/2019] [Accepted: 10/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bloodstream infection (BSI) is a life-threatening complication after living donor liver transplantation (LDLT). We aimed to explore the incidence and predisposing factors of BSI at our institution. METHODS We conducted a retrospective cohort analysis on all consecutive adults with BSI within 6 months after LDLT performed between 2005 and 2016. For antimicrobial prophylaxis, ampicillin/sulbactam, cefotaxime, and micafungin were administered. From 2011, methicillin-resistant Staphylococcus aureus (MRSA) carriers were decolonized using mupirocin ointment and chlorhexidine gluconate soap. Risk factors for BSI were identified by uni- and multivariate logistic regression. RESULTS Of a total of 106 LDLTs, 42 recipients (40%) suffered BSI. The BSI group demonstrated significantly higher in-hospital mortality rates compared with the non-BSI group (24% vs. 7%, P = .01). We identified MRSA carrier (odds ratio [OR], 19.1; P < .001), ABO incompatibility (OR, 2.9; P = .03), and estimated glomerular filtration rate <30 mL/min/1.73m2 (OR, 15.8; P = .02) as independent risk factors for BSI. Decolonization treatment for MRSA carriers did not reduce the incidence of all-cause BSI but reduced the frequency of BSI caused by MRSA. CONCLUSION To our knowledge, for the first time, MRSA carriers were revealed to be highly vulnerable to BSI after LDLT.
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Affiliation(s)
- Yusuke Takemura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takuya Minagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Surgery, Saitama City Hospital, Saitama, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Go Oshima
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shutaro Hori
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Osamu Itano
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Yaoko Takano
- Center for Infectious Disease and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Hasegawa
- Center for Infectious Disease and Infection Control, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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11
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.
Methods
We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.
Results
We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).
Figure 1
Conclusion
IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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12
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P2659Difference of prognostic impact of Killip classification in ACS patients with or without hemodialysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular deaths are more frequently in hemodialysis (HD) patients compared to general population. However, difference of prognosis of acute coronary syndrome (ACS) patients with or without HD were not well evaluated.
Purpose
The purpose of this study was to evaluate the clinical and prognostic characteristics of ACS patients with HD compared to that of ACS patients without HD.
Methods
We investigated 3427 ACS patients including 63 HD and 3364 non-HD patients between 2013 and 2017 using date from Mie ACS registry, a retrospective and multicenter registry. The primary outcome was defined as all-cause mortality.
Results
HD patients showed significantly higher prevalence of diabetes mellitus, past treatment of coronary artery disease, history of myocardial infarction and Killip ≥2 compared to non-HD patients (p<0.05, respectively). During the follow-up periods (median 719 days), 425 (12.4%) patients experienced all-cause death. HD patients demonstrated the higher all-cause mortality rate compared to that of non-HD patients during the follow-up (11.9% versus 38.1%, p<0.001, chi square). Kaplan Meier survival curves demonstrated that HD and non-HD patients with Killip 1 showed similar 30-day mortality, and Killip ≥2 patients also showed similar prognosis (Left side of figure). On the other hand, all cause mortality at 2 years were higher in Killip 1 HD patients compared to Killip 1 non-HD patients and similar between Killip 1 HD patients and Killip ≥2 non-HD patients in the 30 days landmark analysis (Right side of figure). In addition, cox regression analyses for all cause mortality demonstrated that HD was a strongest independent prognostic factor not of 30-day mortality but of after 30-day mortality with hazard ratio of 4.09 (95% confidential interval: 2.32–7.21, p<0.001).
Figure 1
Conclusion
Careful management are required in chronic phase for ACS patients with HD even in Killip 1 classification.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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13
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Yamada Y, Ohno M, Fujino A, Kanamori Y, Irie R, Yoshioka T, Miyazaki O, Uchida H, Fukuda A, Sakamoto S, Kasahara M, Matsumoto K, Fuchimoto Y, Hoshino K, Kuroda T, Hishiki T. Fluorescence-Guided Surgery for Hepatoblastoma with Indocyanine Green. Cancers (Basel) 2019; 11:cancers11081215. [PMID: 31434361 PMCID: PMC6721588 DOI: 10.3390/cancers11081215] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 01/06/2023] Open
Abstract
Fluorescence-guided surgery with indocyanine green (ICG) for malignant hepatic tumors has been gaining more attention with technical advancements. Since hepatoblastomas (HBs) possess similar features to hepatocellular carcinoma, fluorescence-guided surgery can be used for HBs, as aggressive surgical resection, even for distant metastases of HBs, often contributes positively to R0 (complete) resection and subsequent patient survival. Despite a few caveats, fluorescence-guided surgery allows for the more sensitive identification of lesions that may go undetected by conventional imaging or be invisible macroscopically. This leads to precise resection of distant metastatic tumors as well as primary liver tumors.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan.
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Michinobu Ohno
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Yutaka Kanamori
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Rie Irie
- Department of Pathology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Hajime Uchida
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Akinari Fukuda
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Seisuke Sakamoto
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Mureo Kasahara
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Kimikazu Matsumoto
- Children Cancer Center, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, International University of Health and Welfare, Chiba 286-0048, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoro Hishiki
- Division of Surgical Oncology, National Center for Child Health and Development, Tokyo 157-0074, Japan
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14
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Takahashi N, Yamada Y, Hoshino K, Kawaida M, Mori T, Abe K, Fujimura T, Matsubara K, Hibi T, Shinoda M, Obara H, Isshiki K, Shima H, Shimada H, Kameyama K, Fuchimoto Y, Kitagawa Y, Kuroda T. Living Donor Liver Re-Transplantation for Recurrent Hepatoblastoma in the Liver Graft following Complete Eradication of Peritoneal Metastases under Indocyanine Green Fluorescence Imaging. Cancers (Basel) 2019; 11:cancers11050730. [PMID: 31130716 PMCID: PMC6562613 DOI: 10.3390/cancers11050730] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 04/11/2019] [Revised: 05/16/2019] [Accepted: 05/25/2019] [Indexed: 12/18/2022] Open
Abstract
The curability of chemotherapy-resistant hepatoblastoma (HB) largely depends on the achievement of radical surgical resection. Navigation techniques utilizing indocyanine green (ICG) are a powerful tool for detecting small metastatic lesions. We herein report a patient who underwent a second living donor liver transplantation (LDLTx) for multiple recurrent HBs in the liver graft following metastasectomy for peritoneal dissemination with ICG navigation. The patient initially presented with ruptured HB at 6 years of age and underwent 3 liver resections followed by the first LDLTx with multiple sessions of chemotherapy at 11 years of age. His alpha-fetoprotein (AFP) level increased above the normal limit, and metastases were noted in the transplanted liver and peritoneum four years after the first LDLTx. The patient underwent metastasectomy of the peritoneally disseminated HBs with ICG navigation followed by the second LDLTx for multiple metastases in the transplanted liver. The patient has been recurrence-free with a normal AFP for 30 months since the second LDLTx. To our knowledge, this report is the first successful case of re-LDLTx for recurrent HBs. Re-LDLTx for recurrent HB can be performed in highly select patients, and ICG navigation is a powerful surgical tool for achieving tumor clearance.
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Affiliation(s)
- Nobuhiro Takahashi
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan.
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Teizaburo Mori
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Kiyotomo Abe
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Takumi Fujimura
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Taizo Hibi
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto 860-0862, Japan.
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Kyohei Isshiki
- Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan.
- Children's Cancer Center, National Center for Child Health and Development, Tokyo 157-0074, Japan.
| | - Haruko Shima
- Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Hiroyuki Shimada
- Department of Pediatrics, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Kaori Kameyama
- Department of Pathology, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
- Department of Pediatric Surgery, International University of Health and Welfare, Chiba 286-0048, Japan.
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
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15
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Yokose T, Obara H, Shinoda M, Nakano Y, Kitago M, Yagi H, Abe Y, Yamada Y, Matsubara K, Oshima G, Hori S, Ibuki S, Higashi H, Masuda Y, Hayashi M, Mori T, Kawaida M, Fujimura T, Hoshino K, Kameyama K, Kuroda T, Kitagawa Y. Colon perforation due to antigenemia-negative cytomegalovirus gastroenteritis after liver transplantation: A case report and review of literature. World J Gastroenterol 2019; 25:1899-1906. [PMID: 31057303 PMCID: PMC6478612 DOI: 10.3748/wjg.v25.i15.1899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/03/2019] [Accepted: 03/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) remains a critical complication after solid-organ transplantation. The CMV antigenemia (AG) test is useful for monitoring CMV infection. Although the AG-positivity rate in CMV gastroenteritis is known to be low at onset, almost all cases become positive during the disease course. We treated a patient with transverse colon perforation due to AG-negative CMV gastroenteritis, following a living donor liver transplantation (LDLT).
CASE SUMMARY The patient was a 52-year-old woman with decompensated liver cirrhosis as a result of autoimmune hepatitis who underwent a blood-type compatible LDLT with her second son as the donor. On day 20 after surgery, upper and lower gastrointestinal endoscopy (GE) revealed multiple gastric ulcers and transverse colon ulcers. The biopsy tissue immunostaining confirmed a diagnosis of CMV gastroenteritis. On day 28 after surgery, an abdominal computed tomography revealed transverse colon perforation, and simple lavage and drainage were performed along with an urgent ileostomy. Although the repeated remission and aggravation of CMV gastroenteritis and acute cellular rejection made the control of immunosuppression difficult, the upper GE eventually revealed an improvement in the gastric ulcers, and the biopsy samples were negative for CMV. The CMV-AG test remained negative, therefore, we had to evaluate the status of the CMV infection on the basis of the clinical symptoms and GE.
CONCLUSION This case report suggests a monitoring method that could be useful for AG-negative CMV gastroenteritis after a solid-organ transplantation.
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Affiliation(s)
- Takahiro Yokose
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Yutaka Nakano
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Yohei Yamada
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Go Oshima
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Shutaro Hori
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Sho Ibuki
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Hisanobu Higashi
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Yuki Masuda
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Masanori Hayashi
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Takumi Fujimura
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Ken Hoshino
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Kaori Kameyama
- Department of Pathology, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Tatsuo Kuroda
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo 1608582, Japan
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16
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Mori T, Yamada Y, Abe K, Takahashi N, Kano M, Fujimura T, Watanabe T, Nakatsuka S, Hoshino K, Kuroda T. Laparoscopic Partial Closure for Congenital Portosystemic Shunt-Indications, Postoperative Management, and Subsequent Complete Closure. J Laparoendosc Adv Surg Tech A 2019; 29:573-578. [PMID: 30614751 DOI: 10.1089/lap.2018.0581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Extrahepatic congenital portosystemic shunts (CPSSs) can be occluded by surgical or endovascular approaches. However, when the estimated portal vein (PV) pressure after the closure is high enough to induce symptoms associated with portal hypertension, partial closure is recommended to avoid life-threatening events. In this study, we attempted laparoscopic partial closure of a CPSS in two patients. Along with intraoperative real-time measuring of the PV pressure and angiography, laparoscopic partial closure was performed to achieve a PV pressure of ≤25 mmHg. Subsequently, the intrahepatic portal system grew in both patients. The partially ligated CPSS closed spontaneously in the first patient. In the second patient, laparoscopic complete closure was performed for the residual CPSS 6 months after the first operation. To our knowledge, this is the first report of laparoscopic partial closure for CPSS. Minimally invasive laparoscopic partial ligation of CPSS is technically feasible and useful when the estimated PV pressure is too high to tolerate one-step complete closure.
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Affiliation(s)
- Teizaburo Mori
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Yamada
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kiyotomo Abe
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Nobuhiro Takahashi
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Motohiro Kano
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takumi Fujimura
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Toshihiko Watanabe
- 2 Department of Pediatric Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Seishi Nakatsuka
- 3 Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- 1 Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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17
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Ueno T, Wada M, Hoshino K, Matsuura T, Okajima H, Okuyama H. Impact of Donor Age on Outcome of Intestinal Transplantation in Japan. Transplant Proc 2018; 50:2775-2778. [PMID: 30401396 DOI: 10.1016/j.transproceed.2018.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/25/2018] [Accepted: 04/09/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Donor age for intestinal transplantation (ITx) is somewhat younger than that for other solid organs. Clear criteria for adequate donors have not been established. There is a donor scarcity for ITx in Japan due to the shortage of young donors. METHODS We reviewed outcomes associated with ITx in Japan based on donor age for cadaveric and living donation. RESULTS Standardized report forms were sent to all known ITx programs, asking for information on ITxs performed between 1996 and 2016. All programs responded. Patient and graft survival estimates were obtained using the Kaplan-Meier method. Five institutions provided data on 27 grafts in 24 patients. There were 14 cadaveric and 13 living donor transplants. Median donor age for ITxs was 40 (range, 17-60) years. Graft survival at 5 years was 66% for patients >40 years old (n = 18) and 47% for those <40 years old (n = 9), not a statistically significant difference (P = .49). Graft survival at 5 years was 60% in those >50 years old (n = 5) and 57% for those <50 years old (n = 22), again not a significant difference (P = .27). CONCLUSION There is no difference in survival between for those with donor age <40 vs >40 years. Donor age for ITx can be extended from >40 to up to 50 years, which may help to mitigate the donor shortage. It will be necessary to clarify the donor criteria for ITx through accumulation of further data on ITx.
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Affiliation(s)
- T Ueno
- Department of Pediatric Surgery, Osaka University, Osaka, Japan.
| | - M Wada
- Department of Pediatric Surgery, Tohoku University, Miyagi, Japan
| | - K Hoshino
- Department of Pediatric Surgery, Keio University, Tokyo, Japan
| | - T Matsuura
- Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan
| | - H Okajima
- HBP Surgery/Transplantation, Kyoto University, Kyoto, Japan
| | - H Okuyama
- Department of Pediatric Surgery, Osaka University, Osaka, Japan
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18
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Ueno T, Wada M, Hoshino K, Matsuura T, Ida S, Okuyama H. Three-Year Prospective Follow-up of Potential Pediatric Candidate for Intestinal Transplantation. Transplant Proc 2018; 50:2779-2782. [DOI: 10.1016/j.transproceed.2018.03.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/06/2018] [Indexed: 11/16/2022]
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19
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Hoshino K, Sugiyama M, Date T, Maruwaka S, Arakaki S, Shibata D, Maeshiro T, Hokama A, Sakugawa H, Kanto T, Fujita J, Mizokami M. Phylogenetic and phylodynamic analyses of hepatitis C virus subtype 1a in Okinawa, Japan. J Viral Hepat 2018; 25:976-985. [PMID: 29577516 DOI: 10.1111/jvh.12898] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 02/02/2018] [Indexed: 12/28/2022]
Abstract
Okinawa Island, located in Southern Japan, has a higher prevalence rate of hepatitis C virus subtype 1a (HCV-1a) infection than that in mainland Japan. Okinawa has a history of US military occupation after World War II. To elucidate the transmission history of HCV-1a in Okinawa, 26 whole-genome sequences were obtained from 29 patients during 2011-2016. Phylogenetic trees were reconstructed to identify the origin and characteristics of HCV-1a in Okinawa with epidemiological information. A phylogenetic tree based on whole-genome sequencing revealed that all of the samples were located below the US branches. Additionally, we identified one cluster comprised of 17 strains (Okinawa, n = 16; United States, n = 1). The majority of the patients in this cluster were people who inject drugs (PWID), indicating the presence of a people who inject drugs (PWID) cluster. Subsequently, Bayesian analyses were employed to reveal viral population dynamics. Intriguingly, a phylodynamic analysis uncovered a substantial increase in effective population size of HCV-1a from 1965 to 1980 and a slight increase in mid-2000, which were associated with an increase in illicit drug use in Okinawa. The estimated divergence time of the PWID cluster was 1967.6 (1964.2-1971.1). These findings suggest that HCV-1a was introduced into Okinawa from the United States in the late 1960s, coincident with the Vietnam War. Subsequently, HCV-1a might have spread among the Japanese population with the spread of injecting drug use. Our study provides an understanding of HCV transmission dynamics in Okinawa, as well as the key role of PWID in HCV transmission.
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Affiliation(s)
- K Hoshino
- Genome Medical Science Project, National Center for Global Health and Medicine, Chiba, Japan.,Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - M Sugiyama
- Genome Medical Science Project, National Center for Global Health and Medicine, Chiba, Japan
| | - T Date
- Genome Medical Science Project, National Center for Global Health and Medicine, Chiba, Japan
| | - S Maruwaka
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - S Arakaki
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - D Shibata
- Digestive Division, Heart Life Hospital, Okinawa, Japan
| | - T Maeshiro
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - A Hokama
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - H Sakugawa
- Digestive Division, Heart Life Hospital, Okinawa, Japan
| | - T Kanto
- Department of Liver Diseases, National Center for Global Health and Medicine, Chiba, Japan
| | - J Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - M Mizokami
- Genome Medical Science Project, National Center for Global Health and Medicine, Chiba, Japan
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20
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Ito H, Masuda J, Takasaki A, Ichikawa K, Sato Y, Takeuchi T, Kakuta K, Matsuda A, Nakajima H, Omura T, Sawai T, Hoshino K, Seko T, Kitamura T, Ito M. P6043Prognostic impact of a chronic total occlusion in a non-infarct-related artery and left ventricular ejection fraction in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Ito
- Ise Red Cross Hospital, cardiology, Ise, Japan
| | | | | | | | - Y Sato
- Mie CCU Network, Tsu, Japan
| | | | | | | | | | | | | | | | - T Seko
- Mie CCU Network, Tsu, Japan
| | | | - M Ito
- Mie CCU Network, Tsu, Japan
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21
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Fukuoka S, Kurita T, Dohi K, Takasaki A, Nakata T, Fujimoto N, Masuda J, Hoshino K, Tanigawa T, Fujii E, Koyabu S, Ito M. P3660Clinical usefulness of instantaneous wave-free ratio for evaluation of coronary artery lesion with prior myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3660] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Fukuoka
- Mie University Hospital, Cardiology, Tsu, Japan
| | - T Kurita
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Dohi
- Mie University Hospital, Cardiology, Tsu, Japan
| | - A Takasaki
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - T Nakata
- Mie Prefecture General Medical Center, Cardiology, Yokkaichi, Japan
| | - N Fujimoto
- Mie University Hospital, Cardiology, Tsu, Japan
| | - J Masuda
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - E Fujii
- Mie University Hospital, Cardiology, Tsu, Japan
| | - S Koyabu
- Owase General Hospital, Cardiology, Owase, Japan
| | - M Ito
- Mie University Hospital, Cardiology, Tsu, Japan
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22
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Yamada Y, Hoshino K, Mori T, Kawaida M, Abe K, Takahashi N, Fujimura T, Kameyama K, Kuroda T. Metastasectomy of Hepatoblastoma Utilizing a Novel Overlay Fluorescence Imaging System. J Laparoendosc Adv Surg Tech A 2018; 28:1152-1155. [PMID: 29906233 DOI: 10.1089/lap.2017.0735] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The curability of hepatoblastoma (HB) largely depends on the achievement of radical surgical resection, even for metastatic tumors. However, the extension of the metastatic tumor when viewed through an endoscope with the conventional white-light mode is often unclear. Advancements in imaging technology utilizing indocyanine green (ICG) have facilitated precise resection of metastatic HBs, owing to the longer retention of ICG in such lesions than in other normal tissues. CASE We utilized an endoscope loaded with the PINPOINT system (NOVADAQ Technologies, Inc., Ontario, Canada), which allows for real-time overlay visualization with the same focal range between the white-light mode and near-infrared mode. Metastatic HBs that have taken up ICG are visualized as an area of green color superimposed on a high-definition white-light image. A 19-year-old female who underwent liver transplantation for an unresectable HB 2 years earlier was noted to have metastases on the diaphragm and the pleura. Preoperative magnetic resonance imaging showed metastatic HBs on the right pleura extending from the ribs and the diaphragm. The margin of the metastatic tumor was more sharply demarcated by the PINPOINT system than that detected in the normal white-light mode. The tumor was successfully resected en bloc with real-time guidance utilizing the overlay image. The alphafetoprotein levels were normalized and have remained within normal limits in the 12 months since the operation. CONCLUSION Novel overlay imaging technology with ICG makes it possible to achieve real-time precise resection of metastatic HBs.
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Affiliation(s)
- Yohei Yamada
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Ken Hoshino
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Teisaburo Mori
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Miho Kawaida
- 2 Department of Pathology, Keio University School of Medicine , Tokyo, Japan
| | - Kiyotomo Abe
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Nobuhiro Takahashi
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Takumi Fujimura
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
| | - Kaori Kameyama
- 2 Department of Pathology, Keio University School of Medicine , Tokyo, Japan
| | - Tatsuo Kuroda
- 1 Department of Pediatric Surgery, Keio University School of Medicine , Tokyo, Japan
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23
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Hiyama E, Kurihara S, Ueda Y, Hishiki T, Ida K, Watanabe K, Yano M, Tanaka Y, Hoshino K, Hiyama K. Survival and delayed effects of risk-stratified hepatoblastoma patients treated in the JPLT-2 trial. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.10524] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Yuka Ueda
- Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoro Hishiki
- Japanese Study Group for Pediatric Liver Tumor, Hiroshima, Japan
| | - Kohmei Ida
- Japanese Study Group for Pediatric Liver Tumor, Hiroshima, Japan
| | | | | | - Yukichi Tanaka
- Japanese Study Group for Pediatric Liver Tumor, Yokohama, Japan
| | - Ken Hoshino
- Japanese Study Group for Pediatric Liver Tumor, Tokyo, Japan
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24
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Ilham SJ, Chen L, Guo T, Emadi S, Hoshino K, Feng B. In vitro single-unit recordings reveal increased peripheral nerve conduction velocity by focused pulsed ultrasound. Biomed Phys Eng Express 2018; 4. [PMID: 30410792 DOI: 10.1088/2057-1976/aabef1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ultrasound that is widely used in medical diagnosis has drawn growing interests as a noninvasive means of neuromodulation. Focused pulsed ultrasound (FPUS) effectively modulates neural encoding and transmission in the peripheral nervous system (PNS) with unclear mechanism of action, which is further confounded by contradictory experimental outcomes from recordings of compound action potentials (CAP). To address that, we developed a novel in vitro set up to achieve simultaneous single-unit recordings from individual mouse sciatic nerve axon and systematically studied the neuromodulation effects of FPUS on individual axon. Unlike previous CAP recordings, our single-unit recordings afford superior spatial and temporal resolution to reveal the subtle but consistent effects of ultrasonic neuromodulation. Our results indicate that, 1) FPUS did not evoke action potentials directly in mouse sciatic nerve at all the tested intensities (spatial peak temporal average intensity, ISPTA of 0.91 to 28.2 W/cm2); 2) FPUS increases the nerve conduction velocity (CV) in both fast-conducting A- and slow-conducting C- type axons with effects more pronounced at increased stimulus duration and intensity; and 3) effects of increased CV is reversible and cannot be attributed to the change of local temperature. Our results support existing theories of non-thermal mechanisms underlying ultrasonic neuromodulation with low-intensity FPUS, including NICE, flexoelectricity, and solition models. This work also provides a solid experimental basis to further advance our mechanistic understandings of ultrasonic neuromodulation in the PNS.
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Affiliation(s)
- S J Ilham
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - L Chen
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - T Guo
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - S Emadi
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - K Hoshino
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - B Feng
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA
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25
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Yamada Y, Hoshino K, Oyanagi T, Gatayama R, Maeda J, Katori N, Fuchimoto Y, Hibi T, Shinoda M, Matsubara K, Obara H, Aeba R, Kitagawa Y, Yamagishi H, Kuroda T. Successful management of living donor liver transplantation for biliary atresia with single ventricle physiology-from peri-transplant through total cavopulmonary connection: A case report. Pediatr Transplant 2018; 22:e13118. [PMID: 29457852 DOI: 10.1111/petr.13118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 01/05/2023]
Abstract
Children with single ventricle physiology have complete mixing of the pulmonary and systemic circulations, requiring staged procedures to achieve a separation of these circulations, or Fontan circulation. The single ventricle physiology significantly increases the risk of mortality in children undergoing non-cardiac surgery. As liver transplantation for patients with single ventricle physiology is particularly challenging, only a few reports have been published. We herein report a case of successful LDLTx for an 8-month-old pediatric patient with biliary atresia, heterotaxy, and complex heart disease of single ventricle physiology. The cardiac anomalies included total anomalous pulmonary venous return type IIb, intermediate atrioventricular septal defect, tricuspid regurgitation grade III, coarctation of aorta, interrupted inferior vena cava, bilateral superior vena cava, and polysplenia syndrome. Following LDLTx, the patient sequentially underwent total cavopulmonary shunt + Damus-Kaye-Stansel at 3 years of age and extracardiac total cavopulmonary connection (EC-TCPC) completion at 5 years of age; 7 years have now passed since LDLTx (2 years post-EC-TCPC). We describe the details of the management of LTx in the presence of cardiac anomalies and report the long-term cardiac and liver function, from peri-LDLTx through EC-TCPC completion.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Oyanagi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Ryohei Gatayama
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Jun Maeda
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Nobuyuki Katori
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Aeba
- Department of Cardiac Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Yamagishi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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Kawasaki A, Mizushima Y, Matsui S, Hoshino K, Yano S, Kitagawa M. A Case of T-Cell Lymphoma Accompanying Marked Eosinophilia, Chronic Eosinophilic Pneumonia and Eosinophilic Pleural Effusion. A Case Report. Tumori 2018; 77:527-30. [PMID: 1803719 DOI: 10.1177/030089169107700616] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 57-year-old woman was admitted to our hospital for lumbago, weight loss and weakness of her right lower extremity. Leukocytosis was evident with marked eosinophilia (65.5 % = 46,000/mm3), and the chest roentgenogram showed diffuse reticular shadows throughout both lung fields and a left pleural effusion. The pleural effusion contained 22.4 % eosinophils with no immature cells. Biopsy of a thumb-sized mass on the chest wall revealed a T-cell lymphoma of pleomorphic type. The diffuse pulmonary shadow was diagnosed as chronic eosinophilic pneumonia by autopsy. This was a relatively rare case of T-cell lymphoma, in which an eosinophilic pneumonia and eosinophilic pleural effusion were observed.
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Affiliation(s)
- A Kawasaki
- First Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan
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Yamada Y, Hoshino K, Mori T, Kawaida M, Abe K, Ishihama H, Shimizu T, Takahashi N, Matsubara K, Hibi T, Abe Y, Yagi H, Shimojima N, Shinoda M, Kitago M, Obara H, Fuchimoto Y, Kameyama K, Kitagawa Y, Kuroda T. Successful living donor liver retransplantation for graft failure within 7 days due to acute de novo donor-specific anti-human leukocyte antigen antibody-mediated rejection. Hepatol Res 2018. [PMID: 28626871 DOI: 10.1111/hepr.12924] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Growing evidence suggests a relationship between antibody-mediated rejection (AMR) and early graft failure due to a previously unknown etiology in liver transplantation (LTx). We herein report a 3-year-old boy who developed rapid graft failure due to de novo donor-specific antibody (DSA)-driven AMR a week after living donor LTx, requiring a second transplant on the 10th day after the first LTx. The pathology of the first graft showed massive necrosis in zone 3 along with positive C4d and inflammatory cell infiltrates in portal areas. The mean fluorescence intensity against human leukocyte antigen (HLA)-DR15, which was possessed by both the first and the second donor, peaked at 12 945 on the day before the second LTx. Antithymocyte globulin, plasma exchange along with i.v. immunoglobulin, rituximab, and the local infusion of prostaglandin E1, steroids, and Mesilate gabexate through a portal catheter were provided to save the second graft. To our knowledge, this is the first report to show a clear association between de novo DSA and acute AMR within 7 days of a LTx. Furthermore, we successfully rescued the recipient with a second graft despite possessing the same targeted HLA. The rapid decision to carry out retransplantation and specific strategies overcoming AMR were crucial to achieving success in this case of immunologically high-risk LTx.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Teisaburo Mori
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Miho Kawaida
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Kiyotomo Abe
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideo Ishihama
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takahiro Shimizu
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Nobuhiro Takahashi
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Matsubara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Shimojima
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kaori Kameyama
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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28
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Hishiki T, Watanabe K, Ida K, Hoshino K, Iehara T, Aoki Y, Kazama T, Kihira K, Takama Y, Taguchi T, Fujimura J, Honda S, Matsumoto K, Mori M, Yano M, Yokoi A, Tanaka Y, Fuji H, Miyazaki O, Yoshimura K, Takimoto T, Hiyama E. The role of pulmonary metastasectomy for hepatoblastoma in children with metastasis at diagnosis: Results from the JPLT-2 study. J Pediatr Surg 2017; 52:2051-2055. [PMID: 28927977 DOI: 10.1016/j.jpedsurg.2017.08.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 08/16/2017] [Accepted: 08/28/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND/PURPOSE The purpose of this study was to clarify the role of pulmonary metastasectomy in hepatoblastomas with lung metastasis at diagnosis. We reviewed cases enrolled in the JPLT-2 study. METHODS A total of 360 cases with hepatoblastoma were enrolled. The clinical courses and outcome of 60 cases with pulmonary metastasis at diagnosis were reviewed, focusing on metastasectomy. RESULTS Induction chemotherapy resulted in eradication of nodules in 26, residual nodules in 33, and early treatment-related death in one. Of the 33 cases with residual nodules, 11 underwent complete resection of the lung lesions, and among these, progression was reported in five. Complete resection of the liver tumor was not achieved in two of these. Three underwent incomplete resection of lung nodules, eventually leading to progression. Twelve cases with incomplete or no liver tumor resection progressed regardless of the status of lung lesions. Contrarily, among patients who underwent complete resection of the liver tumor, half were cured without metastasectomy. CONCLUSIONS Metastasectomy for residual pulmonary nodules after induction chemotherapy is effective provided that the liver tumor could be completely resected. TYPE OF STUDY Prospective Cohort Study. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Tomoro Hishiki
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT).
| | | | - Kohmei Ida
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Ken Hoshino
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Tomoko Iehara
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Yuki Aoki
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Takuro Kazama
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Kentaro Kihira
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Yuichi Takama
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Tomoaki Taguchi
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Junya Fujimura
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Shohei Honda
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | | | - Makiko Mori
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Michihiro Yano
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Akiko Yokoi
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Yukichi Tanaka
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Hiroshi Fuji
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Osamu Miyazaki
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | | | - Tetsuya Takimoto
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
| | - Eiso Hiyama
- Japan Children's Cancer Group (JCCG) liver tumor committee (JPLT)
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29
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Yoshizaki A, Aoi Y, Yamamoto T, Murata E, Okada S, Matsuzawa S, Hoshino K, Kato-Nishimura K, Miyata R, Tachibana M, Mohri I, Taniike M. Development of an interactive smartphone application for the improvement of Japanese infants' sleep habits. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.1056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Hoshino K, Irie Y, Mizunuma M, Kawano K, Kitamura T, Ishikura H. Incidence of elevated procalcitonin and presepsin levels after severe trauma: a pilot cohort study. Anaesth Intensive Care 2017; 45:600-604. [PMID: 28911289 DOI: 10.1177/0310057x1704500510] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses. In this study, 75 patients were included. PCT levels on days 0 and 1 were 0.1±0.4 and 1.8±6.3 ng/ml, respectively (P=0.02). PSEP levels on days 0 and 1 were 221±261 and 222±207 pg/ml, respectively (P=0.98). As per multivariate logistic regression analyses, packed red blood cell (PRBC) transfusion was the only independent risk factor for higher PCT levels on day 1 (P=0.04). Using PCT to diagnose sepsis in trauma patients on day 1 requires caution. PRBC transfusion was found to be a risk factor for increasing PCT levels. On the other hand, PSEP levels were not affected by trauma during the early phases.
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31
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Kobayashi T, Isayama A, Sawahata M, Suzuki S, Terakado M, Hiranai S, Wada K, Sato Y, Hinata J, Yokokura K, Hoshino K, Kajiwara K, Sakamoto K, Moriyama S. Dual Frequency ECRF System Development for JT-60SA. Fusion Science and Technology 2017. [DOI: 10.13182/fst13-a16895] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Kobayashi
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - A. Isayama
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - M. Sawahata
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - S. Suzuki
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - M. Terakado
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - S. Hiranai
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - K. Wada
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - Y. Sato
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - J. Hinata
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - K. Yokokura
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - K. Hoshino
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - K. Kajiwara
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - K. Sakamoto
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
| | - S. Moriyama
- Japan Atomic Energy Agency: Mukoyama 801-1, Naka, Ibaraki, 311-0193 Japan
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32
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Hida S, Chikamori T, Igarashi Y, Saitoh T, Hirose K, Yamashita J, Murata N, Hoshino K, Hatano T, Tanaka H, Yamashina A. P2969Comparison of diagnostic performance of cadmium-zinc-telluride camera system between 201Tl and 99mTc-radiotracers as assessed by fractional flow reserve. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2969] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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33
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Shimazu M, Kato Y, Kawachi S, Tanabe M, Hoshino K, Wakabayashi G, Kitagawa Y, Kitajima M. Impact of Portal Hemodynamic Changes in Partial Liver Grafts on Short-Term Graft Regeneration in Living Donor Liver Transplantation. Transplant Proc 2017; 48:2747-2755. [PMID: 27788812 DOI: 10.1016/j.transproceed.2016.06.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/20/2016] [Accepted: 06/22/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Regeneration of partial liver grafts is critical for successful living donor liver transplantation (LDLT), especially in adult recipients. The purpose of this study was to investigate the intraoperative hemodynamic changes in partial liver grafts and characterize their potential impact on post-transplant liver regeneration in LDLT. METHODS We examined the portal venous flow (PVF) and hepatic arterial flow (HAF) to partial liver grafts by means of ultrasonic transit time flowmeter of donors immediately before graft retrieval and of the corresponding recipients after vascular reconstruction in 48 LDLT cases. We evaluated post-transplant liver regeneration according to the changes in graft liver volume between the time of transplantation and the 7th post-transplant day. RESULTS There was a significant increase in PVF to the partial liver grafts in recipients (rPVF) compared with that in donors. In contrast, graft HAF in recipients significantly decreased compared with that in donors. The rPVF inversely correlated with graft weight (GW)-recipient body weight ratio (GRWR), whereas HAF volume showed no significant correlation. The rPVF/GW positively correlated with the rate of liver regeneration (GRR), which inversely correlated with GRWR. The rPVF/GW was significantly higher, and GRR tended to be larger in the small graft group than in the non-small graft group. CONCLUSIONS Intraoperative portal hemodynamic changes in partial liver grafts strongly affect their post-transplant regeneration. In particular, in small liver grafts, an immediate and remarkable increase in graft PVF may contribute to rapid liver regeneration after LDLT if the increased PVF remains within a safe range.
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Affiliation(s)
- M Shimazu
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan; Department of Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
| | - Y Kato
- Department of Surgery, Fujita Health University, Aichi, Japan
| | - S Kawachi
- Department of Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - M Tanabe
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Hoshino
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - G Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Saitama, Japan
| | - Y Kitagawa
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - M Kitajima
- International University of Health and Welfare, Tokyo, Japan
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34
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Kasai S, Kamiya K, Shinohara K, Kawashima H, Ogawa H, Uehara K, Miura Y, Okano F, Suzuki S, Hoshino K, Tsuzuki K, Sato M, Oasa K, Kusama Y, Yamauchi T, Nagashima Y, Ida K, Hidekuma S, Ido T, Hamada Y, Nishizawa A, Kawasumi Y, Uesugi Y, Okajima S, Kawahata K, Ejiri A, Amemiya H, Sadamoto Y. Plasma Diagnostics in JFT-2M. Fusion Science and Technology 2017. [DOI: 10.13182/fst06-a1097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Kasai
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Kamiya
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Shinohara
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - H. Kawashima
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - H. Ogawa
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Uehara
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - Y. Miura
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - F. Okano
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - S. Suzuki
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Hoshino
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Tsuzuki
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - M. Sato
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - K. Oasa
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - Y. Kusama
- Japan Atomic Energy Research Institute, Naka Fusion Research Establishment, Naka-shi, Ibaraki-ken 311-0193, Japan
| | - T. Yamauchi
- Japan Atomic Energy Research Institute, Kansai Research Establishment, Tokai-mura, Naka-gun Ibaraki-ken 319-1195, Japan
| | - Y. Nagashima
- Kyushu University, Research Institute for Applied Mechanics, Kasuga-shi, Fukuoka-ken 816-8580, Japan
| | - K. Ida
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Hidekuma
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Ido
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Hamada
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Nishizawa
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Kawasumi
- National Institute for Fusion Science, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Uesugi
- Kanazawa University, Kanazawa-shi, Ishikawa-ken 920-8667, Japan
| | - S. Okajima
- Chubu University, College of Engineering, Kasugai-shi, Aichi-ken 487-8501, Japan
| | - K. Kawahata
- Kanazawa University, Kanazawa-shi, Ishikawa-ken 920-8667, Japan
| | - A. Ejiri
- The University of Tokyo, Graduate School of Frontier Sciences, Kashiwa-shi, Chiba-ken 277-8561, Japan
| | - H. Amemiya
- Chuo University, The Faculty of Science and Engineering, Bunkyo-ku, Tokyo-to 112-8551, Japan
| | - Y. Sadamoto
- Joetsu University of Education, Joetsu-shi, Niigata-ken 943-8512, Japan
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35
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Tsuzuki K, Kimura H, Kusama Y, Sato M, Kawashima H, Kamiya K, Shinohara K, Ogawa H, Uehara K, Kurita G, Kasai S, Hoshino K, Isei N, Miura Y, Yamamoto M, Kikuchi K, Shibata T, Bakhtiari M, Hino T, Hirohata Y, Yamauchi Y, Yamaguchi K, Tsutsui H, Shimada R, Amemiya H, Nagashima Y, Ido T, Hamada Y. Characteristics of Plasma Operation with the Ferritic inside Wall and Its Compatibility with High-Performance Plasmas in JFT-2M. Fusion Science and Technology 2017. [DOI: 10.13182/fst06-a1095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. Tsuzuki
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - H. Kimura
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - Y. Kusama
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - M. Sato
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - H. Kawashima
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - K. Kamiya
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - K. Shinohara
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - H. Ogawa
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - K. Uehara
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - G. Kurita
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - S. Kasai
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - K. Hoshino
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - N. Isei
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - Y. Miura
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - M. Yamamoto
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - K. Kikuchi
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - T. Shibata
- Japan Atomic Energy Research Institute Naka Fusion Research Establishment, Naka-shi, Inaraki 319-0193, Japan
| | - M. Bakhtiari
- University of Wisconsin, Madison, Wisconsin 53706
| | - T. Hino
- Hokkaido University Sapporo, Hokkaido 060-8628, Japan
| | - Y. Hirohata
- Hokkaido University Sapporo, Hokkaido 060-8628, Japan
| | - Y. Yamauchi
- Hokkaido University Sapporo, Hokkaido 060-8628, Japan
| | - K. Yamaguchi
- Hokkaido University Sapporo, Hokkaido 060-8628, Japan
| | - H. Tsutsui
- Tokyo Institute of Technology, Meguro-ku Tokyo 152-8550, Japan
| | - R. Shimada
- Tokyo Institute of Technology, Meguro-ku Tokyo 152-8550, Japan
| | - H. Amemiya
- The Institute of Physical and Chemical Research, Wako, Saitama 351-0198, Japan
| | - Y. Nagashima
- National Institute for Fusion Science, Toki-shi 509-5292, Japan
| | - T. Ido
- National Institute for Fusion Science, Toki-shi 509-5292, Japan
| | - Y. Hamada
- National Institute for Fusion Science, Toki-shi 509-5292, Japan
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36
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Kazama K, Hoshino K, Kodama T, Okada M, Yamawaki H. Adipocytokine, progranulin, augments acetylcholine-induced nitric oxide-mediated relaxation through the increases of cGMP production in rat isolated mesenteric artery. Acta Physiol (Oxf) 2017; 219:781-789. [PMID: 27332749 DOI: 10.1111/apha.12739] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 03/31/2016] [Revised: 04/18/2016] [Accepted: 06/17/2016] [Indexed: 01/28/2023]
Abstract
AIM Progranulin (PGRN) is a novel adipocytokine with anti-inflammatory effects in vascular cells. The aim of this study was to clarify the effects of PGRN on reactivity of isolated blood vessel. METHODS Isometric contraction of rat isolated superior mesenteric artery was measured. RESULTS Pre-treatment with PGRN (10-100 ng mL-1 , 30 min) had no effect on noradrenaline- or 5-hydroxytriptamine-induced contraction. On the other hand, pre-treatment with PGRN (100 ng mL-1 ) augmented acetylcholine (ACh; 30 nm)-induced endothelium-dependent relaxation. Pre-treatment with PGRN (100 ng mL-1 ) augmented ACh (10 μm)-induced nitric oxide (NO)-mediated relaxation in the presence of indomethacin (10 μm), a cyclooxygenase inhibitor, and tetraethyl ammonium (10 mm), a non-selective potassium channel blocker. In contrast, pre-treatment with PGRN (100 ng mL-1 ) had no effect on ACh-induced endothelium-derived hyperpolarizing factor-mediated relaxation. Pre-treatment with PGRN (100 ng mL-1 ) had no effect on ACh (10 μm, 1 min)-induced endothelial NO synthase phosphorylation (at Ser1177) as determined by Western blotting. Pre-treatment with PGRN (100 ng mL-1 ) augmented an NO donor, sodium nitroprusside (SNP; 30 nm-1 μm)- but not a membrane-permeable cGMP analogue, 8-bromo-cGMP-induced relaxation. In the presence of 3-isobutyl-1-methylxanthine (100 μm), a phosphodiesterase inhibitor, pre-treatment with PGRN (100 ng mL-1 ) increased SNP (30 nm, 5 min)-induced cGMP production as determined by enzyme immunoassay. CONCLUSION We for the first time demonstrate that PGRN augments ACh-induced NO-mediated relaxation through the increases of cGMP production in smooth muscle. These results indicate PGRN as a possible pharmacotherapeutic target against cardiovascular diseases including obesity-related hypertension.
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Affiliation(s)
- K. Kazama
- Laboratory of Veterinary Pharmacology; School of Veterinary Medicine; Kitasato University; Towada Aomori Japan
| | - K. Hoshino
- Laboratory of Veterinary Pharmacology; School of Veterinary Medicine; Kitasato University; Towada Aomori Japan
| | - T. Kodama
- Laboratory of Veterinary Pharmacology; School of Veterinary Medicine; Kitasato University; Towada Aomori Japan
| | - M. Okada
- Laboratory of Veterinary Pharmacology; School of Veterinary Medicine; Kitasato University; Towada Aomori Japan
| | - H. Yamawaki
- Laboratory of Veterinary Pharmacology; School of Veterinary Medicine; Kitasato University; Towada Aomori Japan
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Hoshino K, Suzuki T, Isayama A, Ide S, Takenaga H, Kubo H, Fujita T, Kamada Y, Fujii T, Tsuda T, Ida K, Inagaki S. Electron Cyclotron Heating Applied to the JT-60U Tokamak. Fusion Science and Technology 2017. [DOI: 10.13182/fst08-a1659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. Hoshino
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - T. Suzuki
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - A. Isayama
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - S. Ide
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - H. Takenaga
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - H. Kubo
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - T. Fujita
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - Y. Kamada
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - T. Fujii
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - T. Tsuda
- Japan Atomic Energy Agency, Mukouyama 801-1, Naka, Ibaraki 311-0193, Japan
| | - K. Ida
- National Institute for Fusion Science Oroshicho 322-6, Gifu 509-5292, Japan
| | - S. Inagaki
- National Institute for Fusion Science Oroshicho 322-6, Gifu 509-5292, Japan
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38
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Higashi H, Obara H, Miyakoshi K, Shinoda M, Kitago M, Shimojima N, Abe Y, Hibi T, Yagi H, Matsubara K, Yamada Y, Itano O, Hoshino K, Kuroda T, Kitagawa Y. First successful perinatal management of pregnancy after ABO-incompatible liver transplantation. World J Gastroenterol 2017; 23:547-550. [PMID: 28210092 PMCID: PMC5291861 DOI: 10.3748/wjg.v23.i3.547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/07/2016] [Accepted: 11/13/2016] [Indexed: 02/06/2023] Open
Abstract
Many papers have reported on pregnancy and delivery after liver transplantation, but there have been no reports on pregnancy after ABO-incompatible liver transplantation. This paper reports the first successful pregnancy and delivery of a newborn after ABO-incompatible liver transplantation for fulminant hepatic failure. The patient was a 39-year-old female. She had an ABO-incompatible liver transplantation, donated from her husband, due to subacute fulminant hepatitis of unknown etiology. She was taking tacrolimus, methylprednisolone, and mizoribine orally for the maintenance of immunosuppression at the time of discharge. She was discharged uneventfully on postoperative day 38 without any rejection episodes. At 1 year and 6 mo after transplantation, she indicated a wish to become pregnant. Therefore, treatment with mycophenolate mofetil was interrupted at that time. After two miscarriages, she finally became pregnant and delivered transvaginally 3 years after the transplantation. All of the pregnancies were conceived naturally. The newborn was female with a birth weight of 3146 g; the Apgar scores were 9 and 10. Delivery was performed smoothly, and the newborn exhibited no malformations. The mother and the newborn were discharged uneventfully. We suggest that pregnancy is possible for recipients after ABO-incompatible liver transplantation.
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Soeda E, Hoshino K, Izawa Y, Takaoka C, Isobe C, Takahashi A, Takahashi N, Yamada Y, Shimojima N, Fujino A, Shinoda M, Kitagawa Y, Tanabe M, Nakamaru S, Taki N, Sekiguchi A, Nakazawa Y, Turukawa T, Kuroda T. A Report on the Positive Response to an Outdoor Nature Challenge of a Snow Camp for Young Liver Transplant Patients. Transplant Proc 2017; 49:115-120. [PMID: 28104117 DOI: 10.1016/j.transproceed.2016.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES More than two decades have passed since the first living donor liver transplantation was performed in Japan in 1989. There are many reports about problems in adherence to taking medication and medical follow-ups in children who received liver transplants, because there is no transition strategy for those children and parents or guardians. The objective of this study is to measure the effect of nature and outdoor activity to improve children's medical adherence. METHODS We recruited participants from 9-year-old children who are attending the outpatient liver transplant clinic in a stable condition (no event such as rejection or surgical procedure within 6 months). We took participants to a snow camp and measured its effect by using the IKIRU CHIKARA (IKR) tool, which contain 28 items divided into 3 categories: psychosocial ability, moral fitness, and physical ability. Children were tested on three occasions, before, just after, and 1 month after the camp. RESULTS Eight patients participated in the snow camp and 7 patients were eligible for the study. The average age was 12.6 with a range 10 to 17 years. There were 3 girls and 4 boys. The average IKR scores before, just after, and 1 month after the camp were 127.9, 131.5, and 126.6, respectively. CONCLUSION An outdoor activity such as a snow camp can be safely conducted, and it is an acceptable option to incorporate within a pediatric liver transplant program. There were no significant changes in IKR scores during this short observation. Longer observation is needed to measure the effect of nature and outdoor activities.
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Affiliation(s)
- E Soeda
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.
| | - K Hoshino
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Izawa
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - C Takaoka
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - C Isobe
- School of Nursing, Shibuya Medical Association, Tokyo, Japan
| | | | - N Takahashi
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Yamada
- School of Medicine, Keio University, Tokyo, Japan
| | - N Shimojima
- School of Medicine, Keio University, Tokyo, Japan
| | - A Fujino
- School of Medicine, Keio University, Tokyo, Japan
| | - M Shinoda
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Kitagawa
- School of Medicine, Keio University, Tokyo, Japan
| | - M Tanabe
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Nakamaru
- Faculty of Health and Sports Science, Juntendo University, Chiba, Japan
| | - N Taki
- Faculty of Educatoin, Shinshu University, Nagano, Japan
| | - A Sekiguchi
- Japanese Center for Research on Women in Sports, Juntendo University, Tokyo, Japan
| | | | | | - T Kuroda
- School of Medicine, Keio University, Tokyo, Japan
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Hiyama E, Hishiki T, Watanabe K, Ida K, Yano M, Oue T, Iehara T, Hoshino K, Koh K, Tanaka Y, Kurihara S, Ueda Y, Onitake Y. Resectability and tumor response after preoperative chemotherapy in hepatoblastoma treated by the Japanese Study Group for Pediatric Liver Tumor (JPLT)-2 protocol. J Pediatr Surg 2016; 51:2053-2057. [PMID: 27712887 DOI: 10.1016/j.jpedsurg.2016.09.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 08/17/2016] [Accepted: 09/12/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND/PURPOSE We aimed to clarify whether surgical resectability and tumor response after preoperative chemotherapy (preCTx) represented prognostic factors for patients with hepatoblastoma (HBL) in the JPLT-2 study (1999-2012). METHODS Patients (N=342) with HBL who underwent preCTx were eligible. PRETEXT, CHIC risk stratification (standard [SR], intermediate [IR] and high risk [HR]) at diagnosis, POST-TEXT, and tumor resectability were evaluated by imaging. Tumor response was classified into responders (CR or PR) and nonresponders (NC or PD) according to RECIST criteria. RESULTS There were 7 PRETEXT I, 106 II, 143 III, and 86 IV, including 71 metastatic HBLs. In POST-TEXT, 12 PRETEXT II, 42 III, and 58 IV were down-staged. The 5-year EFS/OS rates of 198 SR, 73 IR, and 71 HR-HBLs were 82/94%, 49/64%, and 28/34%, respectively. In 198 SR, 154 of 160 responders and 24 of 38 nonresponders survived event-free (P<0.01). In 73 IR, 12 of 24 whose tumors remained unresectable experienced recurrence, 9 of whom were nonresponders (P<0.01). In 71 HR, chemoresponders and tumor resectability after preCTx correlated with favorable outcomes (P<0.05). CONCLUSIONS Evaluation of response and tumor resectability after preCTx is useful for predicting prognosis in HBLs. To improve outcomes, we should reconsider surgical procedures according to resectability and chemoresponsiveness. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Eiso Hiyama
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, 734-8551, Japan; Japanese Study Group for Pediatric Liver Tumor.
| | | | | | - Kohmei Ida
- Japanese Study Group for Pediatric Liver Tumor
| | | | | | | | - Ken Hoshino
- Japanese Study Group for Pediatric Liver Tumor
| | | | | | - Sho Kurihara
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Yuka Ueda
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Yoshiyuki Onitake
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
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Kobayashi T, Itoh K, Ido T, Kamiya K, Itoh SI, Miura Y, Nagashima Y, Fujisawa A, Inagaki S, Ida K, Hoshino K. Experimental Identification of Electric Field Excitation Mechanisms in a Structural Transition of Tokamak Plasmas. Sci Rep 2016; 6:30720. [PMID: 27489128 PMCID: PMC4973265 DOI: 10.1038/srep30720] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 07/06/2016] [Indexed: 11/09/2022] Open
Abstract
Self-regulation between structure and turbulence, which is a fundamental process in the complex system, has been widely regarded as one of the central issues in modern physics. A typical example of that in magnetically confined plasmas is the Low confinement mode to High confinement mode (L-H) transition, which is intensely studied for more than thirty years since it provides a confinement improvement necessary for the realization of the fusion reactor. An essential issue in the L-H transition physics is the mechanism of the abrupt "radial" electric field generation in toroidal plasmas. To date, several models for the L-H transition have been proposed but the systematic experimental validation is still challenging. Here we report the systematic and quantitative model validations of the radial electric field excitation mechanism for the first time, using a data set of the turbulence and the radial electric field having a high spatiotemporal resolution. Examining time derivative of Poisson's equation, the sum of the loss-cone loss current and the neoclassical bulk viscosity current is found to behave as the experimentally observed radial current that excites the radial electric field within a few factors of magnitude.
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Affiliation(s)
- T. Kobayashi
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Itoh
- National Institute for Fusion Science, Toki 509-5292, Japan
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
| | - T. Ido
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Kamiya
- National Institutes for Quantum and Radiological Science and Technology, Naka 311-0193, Japan
| | - S.-I. Itoh
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - Y. Miura
- Japan Atomic Energy Agency, Tokai 319-1184, Japan
| | - Y. Nagashima
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - A. Fujisawa
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - S. Inagaki
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - K. Ida
- National Institute for Fusion Science, Toki 509-5292, Japan
- Research Center for Plasma Turbulence, Kyushu University, Kasuga 816-8580, Japan
| | - K. Hoshino
- National Institutes for Quantum and Radiological Science and Technology, Naka 311-0193, Japan
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Yamada Y, Hoshino K, Irie R, Tomita H, Kato M, Shimojima N, Fujino A, Hibi T, Shinoda M, Obara H, Itano O, Kawachi S, Tanabe M, Sakamoto M, Kitagawa Y, Kuroda T. The optimal immunosuppressive protocol for the portal vein infusion of PGE1 and methylprednisolone in pediatric liver transplantation for fulminant hepatic failure of unknown etiology. Pediatr Transplant 2016; 20:640-6. [PMID: 27090203 DOI: 10.1111/petr.12711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 01/01/2023]
Abstract
The outcome of LTx in pediatric patients with FHF of unknown etiology remains inferior to that of LTx in pediatric patients with cholestatic diseases. A higher incidence of steroid-resistant severe rejection has been increasingly recognized among the responsible factors. We assessed the efficacy of the administration of steroids and PGE1 via PVI in the management of LTx for FHF in pediatric patients. In our early cohort (1995-2007), seven patients who underwent LTx for FHF of unknown etiology were treated with conventional immunosuppressive therapy (calcineurin inhibitor and a steroid). Seven of eight grafts (one patient underwent re-LTx) sustained CV and/or CPV associated with ACR, and four patients died of a graft failure or infectious complications that were associated with the treatment for rejection. Of note, the pathological incidence of CV/CPV was significantly higher in recipients with FHF of unknown etiology than in recipients with biliary cholestatic disease during the same study period (87.5% vs. 13.7%, p < 0.00001). From 2008, three patients underwent LTx for cryptogenic FHF with PVI and conventional IS. PVI was well tolerated, and no relevant severe complications were observed. More strikingly, the patients who received PVI overcame biopsy-proven immunological events and are all currently doing well with excellent graft function after more than five yr. We conclude that PVI is technically safe and effective for preventing severe rejection in pediatric patients who undergo LTx for FHF of unknown etiology and that it does not increase the risk of fatal infectious complications.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Rie Irie
- Department of Pathology, Kawasaki Municipal Hospital, Kanagawa, Japan
| | - Hirofumi Tomita
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Mototoshi Kato
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Shimojima
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Taizo Hibi
- Department of General Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Shinoda
- Department of General Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Obara
- Department of General Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Osamu Itano
- Department of General Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of General Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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Daniels NJ, Hyde E, Ghosh S, Seo K, Price KM, Hoshino K, Kaisho T, Okada T, Ronchese F. Antigen-specific cytotoxic T lymphocytes target airway CD103+ and CD11b+ dendritic cells to suppress allergic inflammation. Mucosal Immunol 2016; 9:229-39. [PMID: 26104914 DOI: 10.1038/mi.2015.55] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/19/2015] [Indexed: 02/04/2023]
Abstract
Allergic airway inflammation is driven by the recognition of inhaled allergen by T helper type 2 (Th2) cells in the airway and lung. Allergen-specific cytotoxic T lymphocytes (CTLs) can strongly reduce airway inflammation, however, the mechanism of their inhibitory activity is not fully defined. We used mouse models to show that allergen-specific CTLs reduced early cytokine production by Th2 cells in lung, and their subsequent accumulation and production of interleukin (IL)-4 and IL-13. In addition, treatment with specific CTLs also increased the proportion of caspase(+) dendritic cells (DCs) in mediastinal lymph node (MLN), and decreased the numbers of CD103(+) and CD11b(+) DCs in the lung. This decrease required expression of the cytotoxic mediator perforin in CTLs and of the appropriate MHC-antigen ligand on DCs, suggesting that direct CTL-DC contact was necessary. Lastly, lung imaging experiments revealed that in airway-challenged mice XCR1-GFP(+) DCs, corresponding to the CD103(+) DC subset, and XCR1-GFP(-) CD11c(+) cells, which include CD11b(+) DCs and alveolar macrophages, both clustered in the areas surrounding the small airways and were closely associated with allergen-specific CTLs. Thus, allergen-specific CTLs reduce allergic airway inflammation by depleting CD103(+) and CD11b(+) DC populations in the lung, and may constitute a mechanism through which allergic immune responses are regulated.
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Affiliation(s)
- N J Daniels
- Malaghan Institute of Medical Research, Wellington, New Zealand.,University of Otago, Wellington, New Zealand
| | - E Hyde
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - S Ghosh
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - K Seo
- Lab for Tissue Dynamics, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan
| | - K M Price
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - K Hoshino
- Laboratory for Inflammatory Regulation, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan.,Department of Immunology, Faculty of Medicine, Kagawa University, Kita-gun, Japan
| | - T Kaisho
- Laboratory for Inflammatory Regulation, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan.,Laboratory for Immune Regulation, World Premier International Immunology Frontier Research Center, Osaka University Suita, Osaka, Japan.,Department of Immunology, Institute of Advanced Medicine, Wakayama Medical University, Wakayama, Japan
| | - T Okada
- Lab for Tissue Dynamics, RIKEN Center for Integrative Medical Sciences (IMS-RCAI), Yokohama, Japan.,PRESTO, Japan Science and Technology Agency, Saitama, Japan.,Graduate School of Medical Life Science, Yokohama City University, Yokohama, Japan
| | - F Ronchese
- Malaghan Institute of Medical Research, Wellington, New Zealand
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Hibi T, Shinoda M, Itano O, Obara H, Kitago M, Abe Y, Yagi H, Tanaka M, Hoshino K, Fujino A, Kuroda T, Kawachi S, Tanabe M, Shimazu M, Kitagawa Y. Steroid minimization immunosuppression protocol using basiliximab in adult living donor liver transplantation for hepatitis C virus-related cirrhosis. Hepatol Res 2015; 45:1178-84. [PMID: 25594837 DOI: 10.1111/hepr.12486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 01/05/2015] [Accepted: 01/10/2015] [Indexed: 12/24/2022]
Abstract
AIM Recent randomized trials have failed to prove the benefit of steroid-free immunosuppression in liver transplantation for hepatitis C virus (HCV)-related cirrhosis. Furthermore, there is a lack of data on the use of basiliximab in living donor liver transplantation (LDLT). This pilot study evaluated the safety and efficacy of a steroid minimization protocol using basiliximab compared with standard immunosuppression. METHODS A single center, prospective cohort analysis was conducted to compare two immunosuppression regimens in adult recipients who underwent LDLT for HCV since 2004: calcineurin inhibitor/mizoribine/basiliximab (the St- group) and calcineurin inhibitor/mizoribine/steroid (the St+ group). Study end-points were rejection rates, recurrent HCV, patient survival and other adverse events up to 2 years after transplantation. RESULTS A total of 27 consecutive patients were enrolled. Transplantation characteristics were similar between the two groups (14 St- and 13 St+) except ABO incompatible cases being more common in the St+ group. Rejection rates, recurrent HCV, patient survival, fibrosis stage and new-onset diabetes mellitus at 2 years were comparable between the two groups. ABO incompatibility did not affect short- and long-term outcomes. Nine St- and seven St+ recipients underwent interferon and ribavirin therapy for recurrent HCV, with a sustained virological response rate of 33% and 29%, respectively. CONCLUSION A steroid minimization protocol with basiliximab in adult LDLT for HCV is safe and affords equivalent rejection rates compared with standard immunosuppression. However, no significant differences are observed with respect to recurrent HCV, patient survival and metabolic complications.
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Affiliation(s)
- Taizo Hibi
- Department of Surgery, Keio University School of Medicine
| | | | - Osamu Itano
- Department of Surgery, Keio University School of Medicine
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine
| | - Yuta Abe
- Department of Surgery, Keio University School of Medicine
| | - Hiroshi Yagi
- Department of Surgery, Keio University School of Medicine
| | | | - Ken Hoshino
- Department of Surgery, Keio University School of Medicine
| | - Akihiro Fujino
- Department of Surgery, Keio University School of Medicine
| | - Tatsuo Kuroda
- Department of Surgery, Keio University School of Medicine
| | - Shigeyuki Kawachi
- Division of Digestive Surgery and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohide Shimazu
- Division of Digestive Surgery and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine
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Tomita H, Fuchimoto Y, Fujino A, Hoshino K, Yamada Y, Masugi Y, Sakamoto M, Kasahara M, Kanamori Y, Nakazawa A, Yoshida F, Akatsuka S, Nakano M, Kuroda T. Development and Validation of a Novel Fibrosis Marker in Biliary Atresia during Infancy. Clin Transl Gastroenterol 2015; 6:e127. [PMID: 26583502 PMCID: PMC4816091 DOI: 10.1038/ctg.2015.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/12/2015] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Most biliary atresia (BA) patients suffer from liver fibrosis and often require liver transplantation. The aim of this study was to develop and validate a novel fibrosis marker for BA patients aged <1 year-the infant BA liver fibrosis (iBALF) score-subsequent to the previously reported fibrosis marker for BA patients aged ≥1 year. METHODS From three institutions for pediatric surgery, BA patients and their native liver histology examinations performed at the age of <1 year were retrospectively identified and assigned to a development cohort (58 patients and 73 examinations) or validation cohort (92 patients and 117 examinations) according to their institutions. Histological fibrosis stages (F0-F4), blood test results, and clinical information at the time of liver histology examination were reviewed. The iBALF score was determined using multivariate ordered logistic regression analysis and was assessed for its associations with histological fibrosis stages. RESULTS The iBALF score equation was composed of natural logarithms, including serum total bilirubin level, blood platelet counts, and days of age. The score revealed a strong correlation with fibrosis stage (r=0.80 and 0.73 in the development and validation cohorts, respectively; P<0.001). The areas under the receiver-operating characteristic curves for diagnosing each fibrosis stage were 0.86-0.94 in the development cohort and 0.86-0.90 in the validation cohort (P<0.001), indicating good diagnostic power. In addition, no patient with an iBALF score >6 (equivalent to F4) at the initial surgery survived with their native liver at 1 year of age (n=9). CONCLUSIONS The iBALF score that was developed was a good noninvasive marker of native liver fibrosis for BA patients aged <1 year.
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Affiliation(s)
- Hirofumi Tomita
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Yasushi Fuchimoto
- Department of Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Masugi
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Mureo Kasahara
- Department of Transplant Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Yutaka Kanamori
- Department of Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Pathology, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Fumiko Yoshida
- Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Seiya Akatsuka
- Department of Pathology, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Miwako Nakano
- Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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Mori T, Kato J, Sakurai M, Hashimoto N, Kohashi S, Hashida R, Saburi M, Kikuchi T, Yamane Y, Hoshino K, Okamoto S. New-onset food allergy following cord blood transplantation in adult patients. Bone Marrow Transplant 2015; 51:295-6. [PMID: 26457912 DOI: 10.1038/bmt.2015.243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- T Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - J Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - M Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - N Hashimoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - S Kohashi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - R Hashida
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - M Saburi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - T Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Y Yamane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - K Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - S Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Shinoda M, Itano O, Obara H, Kitagoo M, Hibi T, Abe Y, Yagi H, Matsubara K, Yamada Y, Fujino A, Hoshino K, Kuroda T, Kitagawa Y. P-136 De novo malignancy after living donor liver transplantation. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hiyama E, Kurihara S, Ueda Y, Hishiki T, Ida K, Iehara T, Oue T, Yano M, Watanabe K, Hoshino K, Ko K, Tanaka Y. Survival and late effects in the risk-stratified hepatoblastoma patients treated by JPLT-2 protocol. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10021] [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: 11/20/2022] Open
Affiliation(s)
| | | | - Yuka Ueda
- Hiroshima University Hospital, Hiroshima, Japan
| | - Tomoro Hishiki
- Japanese Study Group for Pediatric Liver Tumor, Hiroshima, Japan
| | - Kohmei Ida
- Japanese Study Group for Pediatric Liver Tumor, Hiroshima, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takaharu Oue
- Japanese Study Group for Pediatric Liver Tumor, Osaka, Japan
| | - Michihiro Yano
- Japanese Study Group for Pediatric Liver Tumor, Hiroshima, Japan
| | | | - Ken Hoshino
- Japanese Study Group for Pediatric Liver Tumor, Tokyo, Japan
| | - Katsuyoshi Ko
- Japanese Study Group for Pediatric Liver Tumor, Saitama, Japan
| | - Yukichi Tanaka
- Japanese Study Group for Pediatric Liver Tumor, Yokohama, Japan
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Tomita H, Fuchimoto Y, Ohkuma K, Hoshino K, Fujino A, Kato M, Fujimura T, Ishihama H, Takahashi N, Tanami Y, Nakatsuka S, Ebinuma H, Saito H, Shinoda M, Kitagawa Y, Kuroda T. Spleen stiffness measurements by acoustic radiation force impulse imaging after living donor liver transplantation in children: a potential quantitative index for venous complications. Pediatr Radiol 2015; 45:658-66. [PMID: 25501257 DOI: 10.1007/s00247-014-3215-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/18/2014] [Accepted: 10/20/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Living donor liver transplantation in children often results in venous complications, leading to portal hypertension. Spleen stiffness measurements have been recently proposed as a new, noninvasive parameter for portal hypertension in cirrhotic patients. OBJECTIVE To evaluate the diagnostic value of spleen stiffness measurements by acoustic radiation force impulse (ARFI) imaging in diagnosing venous complications after pediatric living donor liver transplantation. MATERIALS AND METHODS We prospectively enrolled 69 patients after pediatric living donor liver transplantation using a left-side liver allograft. Around the time of the protocol liver biopsy examination, spleen stiffness measurements by ARFI imaging were performed via the left intercostal space at the center of the spleen parenchyma and repeated five times. Imaging examinations around the time of the spleen stiffness measurements were retrospectively reviewed. Regarding venous complications, significant portal and hepatic venous stenosis was defined as >50% stenosis on multiphasic computed tomography. RESULTS After post hoc exclusion, 62 patients were studied. Portal and hepatic venous stenosis was identified in three and two patients, respectively. The median spleen stiffness values were 2.70 and 4.00 m/s in patients without and with venous complications, respectively (P < 0.001). Spleen stiffness measurements showed good diagnostic power for venous complications, and the cutoff value was determined as 2.93 m/s, with 100% sensitivity and 78.9% specificity. Spleen stiffness measurements decreased with the relief of venous stenosis resulting from an interventional radiology procedure. CONCLUSION Spleen stiffness measurements by ARFI imaging might provide a useful quantitative index for venous complications after pediatric living donor liver transplantation.
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Affiliation(s)
- Hirofumi Tomita
- Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Hotta R, Fujimura T, Shimojima N, Nakahara T, Fuchimoto Y, Hoshino K, Morikawa Y, Matsufuji H, Kuroda T. Application of nuclear medicine to achieve less invasive surgery for malignant solid tumors in children. Pediatr Int 2014; 56:896-901. [PMID: 24773623 DOI: 10.1111/ped.12368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 03/11/2014] [Accepted: 04/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of nuclear medicine for the management of malignant tumor, such as radioguided surgery and sentinel lymph node biopsy (SLNB), has been widely accepted in the adult practice. However, there are very few studies to apply those techniques for pediatric diseases. The aim of this study was to investigate the feasibility of application of nuclear medicine in surgery for neuroblastoma (NB) or rhabdomyosarcoma (RMS) in children. METHODS Radioguided surgery using (123) I-metaiodobenzylguanidine was performed on six children with NB. SLNB using technetium-labeled tin or sulfur colloid was performed on two children with perineal RMS. Histological evaluation of resected specimens was performed to determine the accuracy of intraoperative detection and SLNB. All patients were evaluated for overall survival and complications. RESULTS Intraoperative tumor localization using hand-held gamma probe was helpful in 85.7% of NB patients. Sensitivity and specificity of this technique were 81.8% and 93.3%, respectively. There were no postoperative complications, and four out of five patients with high-risk NB experienced disease-free survival (median follow up, 57 months). Sentinel lymph nodes were easily detected in patients with perineal RMS, and histological assessment revealed complete consistency with regional lymph node status. CONCLUSIONS Nuclear medicine may have a potential application in the use of less invasive surgery for advanced NB or perineal RMS, the two most challenging pediatric malignancies.
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Affiliation(s)
- Ryo Hotta
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takumi Fujimura
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoki Shimojima
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tadaki Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasushi Fuchimoto
- Department of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasuhide Morikawa
- Department of Pediatric Surgery, International University of Health & Welfare, Tochigi, Japan
| | - Hiroshi Matsufuji
- Department of Pediatric Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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