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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Kobayashi F, Watanabe J, Koizumi M, Sata N. Efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernia: a systematic review and meta-analysis. Hernia 2023; 27:1415-1427. [PMID: 37955811 DOI: 10.1007/s10029-023-02919-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/22/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To examine updated evidence on the efficacy and safety of mesh non-fixation in patients undergoing laparo-endoscopic repair of groin hernias. METHODS We searched MEDLINE, Cochrane Central Library, Embase, ClinicalTrials. gov, and ICTRP databases to identify randomized controlled trials. The primary outcomes were recurrence, chronic pain, and return to daily life. The certainty of evidence (CoE) was assessed by grading recommendations, assessments, developments, and evaluations. We performed a subgroup analysis based on the surgical type. This study was registered with PROSPERO (CRD 42022368929). RESULTS We included 25 trials with 3,668 patients (4,038 hernias) were included. Mesh non-fixation resulted in little to no difference in hernia recurrence (relative risk [RR]:1.40, 95% confidence interval [CI]:0.59-3.31; I2 = 0%; moderate CoE) and chronic pain (RR:0.48, 95% CI:0.13-1.78; I2 = 77%; moderate CoE), but reduced return to daily life (mean difference [MD]: - 1.79 days, 95% CI: - 2.79 to -0.80; I2 = 96%; low CoE). In subgroup analyses, the transabdominal preperitoneal approach (TAPP) (MD: - 2.97 days, 95% CI: - 4.87 to - 1.08; I2 = 97%) reduced return to daily life than total extraperitoneal inguinal approach (MD: - 0.24 days, 95% CI - 0.71 to 0.24; I2 = 61%) (p = 0.006). CONCLUSIONS Mesh nonfixation improves the return to daily life without increasing the risk of hernia recurrence or chronic pain. Surgeons and patients may discuss mesh nonfixation options to accommodate a patient's desired return to daily life. Further trials focusing on TAPP are required to confirm these findings.
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Affiliation(s)
- F Kobayashi
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
| | - J Watanabe
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan.
- Division of Community and Family Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke city, Tochigi, 329-0498, Japan.
| | - M Koizumi
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
| | - N Sata
- Department of Surgery, Division of Gastroenterological, General, and Transplant Surgery, Jichi Medical University, Shimotsuke city, Tochigi, Japan
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Inui S, Tomita N, Takaoka T, Ueda Y, Ohira S, Tsuchiya T, Miyazaki M, Nishio T, Koizumi M, Konishi K. Dosimetric Comparison of Automated Non-Coplanar Volumetric-Modulated Arc Therapy and Intensity-Modulated Proton Therapy in Angiosarcoma of the Scalp. Int J Radiat Oncol Biol Phys 2023; 117:e675. [PMID: 37785989 DOI: 10.1016/j.ijrobp.2023.06.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Angiosarcoma of the scalp (AS) is a rare tumor and has often been treated by total scalp irradiation (TSI). TSI is a challenging technique because of the target close to the organs at risks (OARs), located in the skin surface, and helmet-shape of the target. We performed the dosimetric comparison of automated non-coplanar volumetric-modulated arc therapy (HA) and intensity-modulated proton therapy (IMPT) in TSI for AS. MATERIALS/METHODS A planning study was performed on 20 patients with AS. The clinical target volume (CTV) 1 and CTV2 were defined as gross tumor volume with margin and entire scalp, respectively. For HA, planning target volume (PTV) 1 and PTV2 were defined as CTV1 and CTV2 with 5-mm margins, respectively. For IMPT, robust optimization was utilized which accounted for a 5-mm setup and a 3.5% range uncertainty and dose was prescribed to CTV1 robust and CTV2 robust. The prescription doses were 70 Gy and 56 Gy in 35 fractions to PTV1 (CTV1 robust) and PTV2 (CTV2 robust), respectively, using the simultaneous integrated boost technique. The HA plan was performed using a 6-MV photon beam machine and a 1-cm thick virtual bolus. The HA plan included three half non-coplanar and one full coplanar arc fields. The HA plan used collimator angles of 15°, 60°, 15°, and 120° in the beam with couch rotations of 0°, 45°, 90°, and 315°, respectively. The IMPT plan was performed using a compact proton beam machine dedicated to pencil beam scanning. The IMPT plan used gantry angles of 70°, 150°, 70°, 150°, and 30° in the beam with couch rotations of 0°, 0°, 180°, 180°, and 270°, respectively. The IMPT plan was optimized assuming a relative biological effectiveness of 1.1. The dose distribution and dosimetric parameters for each plan were evaluated. RESULTS All plans met the goals within the acceptable range in target volume coverage, conformity, and homogeneity. Table shows the dosimetric parameters of OARs in HA and IMPT plans. The doses receiving 0.1 cc of the volume for hippocampus, optic passway, eye, and lens in the IMPT plan were significantly lower than those in the HA plan. The IMPT plan showed a significant reduction in the percentage of brain volume receiving at least 5 Gy (V5 Gy) compared to the HA plan, while the HA plan showed a significant reduction of V10 Gy - V60 Gy and mean brain dose compared to the IMPT plan. The HA plan provided a shorter beam-on time (184 ± 9 s) than did the IMPT plan (446 ± 49 s). CONCLUSION The HA and IMPT plans demonstrated different strengths with respect to OARs sparing.
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Affiliation(s)
- S Inui
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan; Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - N Tomita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - T Takaoka
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Y Ueda
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - S Ohira
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Tsuchiya
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - M Miyazaki
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - M Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - K Konishi
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
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Saito T, Shikama N, Takahashi T, Nakamura N, Aoyama H, Nakajima K, Koizumi M, Sekii S, Ebara T, Kiyohara H, Higuchi K, Yorozu A, Nishimura T, Ejima Y, Harada H, Araki N, Miwa M, Yamada K, Kawamoto T, Onishi H, Imano N. Quality of Palliative Radiation Therapy Assessed Using Quality Indicators: A Multicenter Survey. Int J Radiat Oncol Biol Phys 2023; 117:e111. [PMID: 37784649 DOI: 10.1016/j.ijrobp.2023.06.890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Clinical practice is not always performed in accordance with guideline recommendations. Quality indicators (QIs) are valuable tools for evaluating the quality of healthcare systems. We sought to identify potential gaps between clinical practice and evidence using QIs previously developed using a modified Delphi method. MATERIALS/METHODS We used seven QIs (Table 1) to assess the quality of radiation therapy for bone (BoM) and brain metastases (BrM) at 29 centers; 13 (45%) were academic (12 university hospitals and 1 cancer center) and 16 (55%) were nonacademic hospitals. Compliance rate was calculated as the percentage of patients for whom recommended medical care was conducted. Random effects models were used to estimate pooled compliance rates. Mixed effects models with a Q test were used to compare compliance rates between academic and nonacademic centers. RESULTS The estimates of the compliance rates with 95% confidence intervals are presented in Table 1. For BoM-1, the compliance rate was higher in academic hospitals (100% [100-100%]) than in non-academic hospitals (96% [89-100%]) (P = 0.021). For BrM-3, the compliance rate was lower in academic hospitals (92% [81-99%]) than in nonacademic hospitals (100% [98-100%]) (P = 0.016). CONCLUSION A quality assessment based on these seven QIs is feasible. Overall, compliance rates were high; however, for BoM-3, the practice remains to be improved in some centers. Based on BoM-4 compliance rates, steroids are infrequently used concurrently with radiation therapy for malignant spinal cord compression. Extended fractionation for BoM was less frequently performed in academic than in nonacademic centers. The initiation of radiation therapy for brain metastases was more frequently delayed in academic than in nonacademic centers.
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Affiliation(s)
- T Saito
- Department of Radiation Oncology, Arao Municipal Hospital, Kumamoto, Japan
| | - N Shikama
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - T Takahashi
- Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - N Nakamura
- Department of Radiation Oncology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - H Aoyama
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - K Nakajima
- Asahikawa Medical College, Asahikawa, Japan
| | - M Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - S Sekii
- Kita-Harima Medical Center, Hyogo, Japan
| | - T Ebara
- Department of Radiation Oncology, Kyorin University, Mitaka, Tokyo, Japan
| | - H Kiyohara
- Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, Gunma, Japan
| | - K Higuchi
- Department of Radiation Oncology, Isesaki Municipal Hospital, Gunma, Japan
| | - A Yorozu
- Department of Radiation Oncology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - T Nishimura
- Department of Radiology, Fukuchiyama City Hospital, Kyoto, Japan
| | - Y Ejima
- Department of Radiology, Dokkyo Medical University, Koshigaya, Japan
| | - H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - N Araki
- Department of Radiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - M Miwa
- Department of Radiation Oncology, Sendai Kousei Hospital, Sendai, Japan
| | - K Yamada
- Department of Radiation Oncology, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - T Kawamoto
- Division of Radiation Oncology, Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - H Onishi
- University of Yamanashi, Chuo, Japan
| | - N Imano
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, Hiroshima, Japan
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Tai T, Igarashi H, Takesige Y, Nakamura Y, Hattori H, Nakajo Y, Aono N, Kasajima M, Yoshinaga K, Koizumi M, Hashimoto T, Toya M, Kumagai J, Kyono K. A rare case of spinal and bulbar muscular atrophy (SMBA) diagnosed by hypertestosteronemia during infertility treatment. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kuzume K, Koizumi M, Kagata Y, Nishimura K, Kuwabara Y, Okamoto M, Asami T, Murakami Y, Yagi Y, Midoro-Horiuti T. A056 HOW TO DRINK MILK - ASSESSMENT OF AN INTERMITTENT ORAL IMMUNOTHERAPY FOR SEVERE MILK ALLERGY. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koizumi M, Saito Y, Kojima M. Syntactic development in children with intellectual disabilities - using structured assessment of syntax. J Intellect Disabil Res 2019; 63:1428-1440. [PMID: 31496031 DOI: 10.1111/jir.12684] [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] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/02/2019] [Accepted: 08/03/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Children with intellectual disabilities (IDs) have a severe delay in syntactic development compared with other language abilities. This study investigated conditions of syntactic development in native Japanese-speaking children with ID. METHODS Children with ID [N = 51; 18 autism spectrum disorders (ASD), 18 Down syndrome (DS) and 15 ID without ASD and DS] were compared with typically developing children (N = 78) with the same mental age (MA). The development of syntax in spoken language was examined by receptive and production tasks. RESULTS The development of syntax in children with ID was significantly delayed than in typically developing children with the same MA. However, when reaching the MA of 7-9, syntax abilities started to develop remarkably. Moreover, children with ASD had significant difficulties in acquiring passive voice, whereas children with DS showed a significant delay in syntactic development. CONCLUSIONS The development of syntax in children with ID might be affected by MA and the type of disability. Moreover, it is necessary to exceed an MA of 7-9 years for children with ID to develop syntax abilities.
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Affiliation(s)
- M Koizumi
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Y Saito
- Child Development Center PALETTE, Social Welfare Organization SUZURAN NO KAI, Sagamihara, Japan
| | - M Kojima
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Japan
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Yoshida Y, Yamada T, Matsuoka H, Hirata K, Kuramochi H, Kosugi C, Takahashi M, Fukazawa A, Sonoda H, Matsuda A, Watanabe T, Koizumi M, Aisu N, Hasegawa S, Yoshida H, Sakamoto K, Ishida H, Koda K. Biweekly TAS-102 and bevacizumab as a third-line chemotherapy for metastatic colorectal cancer: A phase II multicenter clinical trial (TAS-CC4 study). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Amano H, Noike R, Saito D, Yabe T, Watanabe I, Koizumi M, Okubo R, Toda M, Ikeda T. P5623Plaque characteristics, slow flow during percutaneous coronary intervention, and clinical outcomes of irregular protrusion by optical coherence tomography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In pathological studies, penetration of the lipid core into the stent strut is associated with neointimal growth and stent thrombosis. Irregular protrusion on optical coherence tomography (OCT) is associated with clinical events and target lesion revascularization. However, there are few reports about the relationship among irregular protrusion, plaque characteristics, and slow flow during percutaneous coronary intervention. We investigated clinical and procedure characteristics, plaque characteristics, slow flow after stent implantation, and clinical outcomes with irregular protrusion by using OCT.
Methods
Eighty-four lesions in 76 patients undergoing OCT before percutaneous coronary intervention were evaluated. Irregular protrusion was defined as protrusion of material with an irregular surface into the lumen between stent struts with a maximum height of ≥100 μm. Major adverse clinical outcomes were defined as death, acute myocardial infarction, acute coronary syndrome, or target lesion revascularization.
Results
Lesions with irregular protrusion were found in 56% (47/84). Compared with lesions without irregular protrusion, those with irregular protrusion had significantly higher low-density lipoprotein cholesterol (LDL-C) levels (108±31 mg/dL vs. 95±25 mg/dL, P=0.044); a tendency toward decreased use of statins (44% [19/43] vs. 67% [22/33], P=0.065); significantly larger reference vessel diameter (3.12±0.53 mm vs. 2.74±0.63 mm, P=0.004); significantly larger stent diameter (3.23±0.43 mm vs. 3.00±0.49 mm, P=0.025); a tendency toward longer total stent length (29.3±14.2 mm vs. 23.7±11.4 mm, P=0.056); significantly larger maximum balloon diameter (3.56±0.55 mm vs. 3.22±0.63 mm, P=0.010); significantly higher incidence of slow flow after stent implantation (38% [18/47] vs. 11% [4/37], P=0.006); significantly higher ΔTIMI flow from pre-stenting to post-stenting (0.4±0.6 vs. 0.1±0.3, P=0.009); significantly higher incidence of lipid-rich plaque (70% [33/47] vs. 35% [13/37], P=0.002); thin-cap fibroatheromas (TCFAs: 49% [23/47] vs. 5% [2/37], P<0.001); plaque rupture (40% [19/47] vs. 16% [6/37], P=0.018); macrophage accumulation (51% [24/47] vs. 24% [9/37], P=0.015); internal running vasa vasorum (51% [24/47] vs. 11% [4/37], P<0.001); thrombus (32% [15/47] vs. 3% [1/37], P<0.001); and a tendency higher incidence of one-year adverse clinical outcomes (12% [5/43] vs. 0% [0/33], P=0.075: log rank). The multivariable analysis showed that TCFA was an independent predictor of irregular protrusion (odds ratio 9.00, 95% CI 1.32–61.36, P=0.025).
Conclusions
Irregular protrusion on OCT was associated with high plaque vulnerability, higher LDL-C, less frequent use of statin, larger vessel diameter, longer total stent length, slow flow after stent implantation, and one-year adverse clinical outcomes.
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Affiliation(s)
- H Amano
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - R Noike
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - D Saito
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Yabe
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - I Watanabe
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Koizumi
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - R Okubo
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Toda
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Ikeda
- Toho University Faculty of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
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Hara K, Yamada T, Koizumi M, Shinji S, Yokoyama Y, Takahashi G, Hotta M, Iwai T, Takeda K, Yoshida H. Adjuvant chemotherapy for colorectal cancer using oxaliplatin induced irreversible sinusoidal obstruction syndrome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yamada T, Takahashi G, Iwai T, Takeda K, Furuki H, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Hotta M, Hara K, Yoshida H. Emergence of KRAS mutation may play a major role in the secondary resistance to EGFR blockade. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kuzume K, Koizumi M, Okamoto M, Nishimura K, Asami T. P329 Utility and safety of the intermittent oral immunotherapy, step-up method, for severe food allergy patients. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.08.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kyono K, Hashimoto T, Toya M, Koizumi M, Sasaki C, Shibasaki S, Aono N, Nakamura Y, Obata R, Okuyama N, Ogura Y, Igarashi H. A transportation network for human ovarian tissue is indispensable to success for fertility preservation. J Assist Reprod Genet 2017; 34:1469-1474. [PMID: 28866830 PMCID: PMC5699996 DOI: 10.1007/s10815-017-1022-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/11/2017] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the efficacy of an ovarian tissue transportation network for fertility preservation (FP) for cancer patients in Japan. METHODS PubMed was searched for papers on transportation of human ovarian tissue for FP. We analyzed population, area, number of cancer patients for ovarian tissue cryopreservation (OTC), quality control/assessment and safety, cost of a cryopreservation center for the building for 30 years, and medical fees of cancer patients (operation, cryopreservation, and storage of ovarian tissue). RESULTS More than twenty babies have been born in Denmark and Germany through a transportation system. Up to 400 new patients a year need OTC. The fees for removal, cryopreservation, and storage for 5 years, and transplantation of ovarian tissue are around €5,000, €4,000, and €5,000, respectively. It costs more than €5 million to establish and maintain one cryopreservation center for 30 years. If we have a few cryopreservation centers in Japan, we can cryopreserve 400 patients' ovarian tissue per year by safer slow freezing and maintain quality control/assessment. We need to lighten the patients' burden for easy to use FP by a government subsidy and medical insurance coverage. CONCLUSIONS This model has been termed the Danish model ("the woman stays - the tissue moves"). This is truly patient-centered medicine. We can have maximum effects with the minimum burden. A transportation network like those of Denmark and Germany is the best strategy for FP in Japan. It may be the best system for cancer patients, medical staff, and the Ministry of Health, Labor, and Welfare.
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Affiliation(s)
- K Kyono
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan.
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan.
| | - T Hashimoto
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - M Toya
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - M Koizumi
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - C Sasaki
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - S Shibasaki
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - N Aono
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Y Nakamura
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - R Obata
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - N Okuyama
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - Y Ogura
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
| | - H Igarashi
- Kyono ART Clinic Takanawa, Takanawa Court 5F, 3-13-1 Takanawa, Minatoku, Tokyo, 108-0074, Japan
- Kyono ART Clinic, 1-1-1-3F, Honcho, Aobaku, Sendai, Miyagi, 980-0014, Japan
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Takaishi K, Kakuta M, Ito K, Kanda A, Takakusa H, Miida H, Masuda T, Nakamura A, Onishi Y, Onoda T, Kazuki Y, Oshimura M, Takeshima Y, Matsuo M, Koizumi M. Stunning pharmacological properties of DS-5141b, an antisense oligonucleotide consisting of 2'-O,4'-C-ethylene-bridged nucleic acids and 2'-O-methyl RNA, on dystrophin mRNA exon skipping. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sasaki C, Aono N, Nakajo Y, Hattori H, Tanaka Y, Inoue H, Koizumi M, Toya M, Hashimoto T, Igarashi H, Kyono K. Effect of cancer treatment on female reproductive outcomes. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Amano H, Saito D, Yabe T, Watanabe I, Koizumi M, Okubo R, Toda M, Ikeda T. P2332Association between internal running vasa vasorum in optical coherence tomography and slow flow during percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2332] [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: 11/14/2022] Open
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Iwai T, Yamada T, Takahashi G, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Hara K, Takeda K, Nakayama M, Kitano S, Ohta K, Uchida E. Circulating cell-free DNA can predict relapse after resection of metastatic liver tumors from colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yamada T, Takahashi G, Iwai T, Takeda K, Koizumi M, Shinji S, Yokoyama Y, Hara K, Hotta M, Matsuda A, Matsumoto S, Ohta K, Uchida E. Tracking emerging KRAS and BRAF mutations through ccfDNA in colorectal cancers treated with EGFR blockade. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Isohashi F, Mabuchi S, Yoshioka Y, Tamari K, Suzuki O, Koizumi M, Kawashima A, Okubo H, Kimura T, Ogawa K. Postoperative Whole-Pelvic Intensity Modulated Radiation Therapy in Surgically Treated Cervical Cancer Patients With Adverse Risk Factors. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Agatsuma T, Furukawa H, Hotoda H, Koizumi M, Koga R, Kaneko M. Anti-Human Immunodeficiency Virus Type 1 Activity of R-95288, a Phosphodiester Hexadeoxyribonucleotide Modified by Dibenzyloxybenzyl and Hydroxyethyl Residues at the 5′- and 3′-Ends. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029700800505] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The phosphodiester hexadeoxyribonucleotide R-95288 is a potent anti-human immunodeficiency virus type 1 (HIV-1) agent in vitro which consists or a TGGGAG nucleoside sequence with dibenzyloxybenzyl and hydroxyethyl substituents at the 5′- and 3′-ends, respectively. In this study, the antiviral activity of R-95288 against various strains of HIV-1 in vitro was assessed and its mechanism of action was analysed. R-95288 inhibited replication of all strains of HIV-1 used including laboratory strains with the syncytium-inducing (SI) phenotype and clinical isolates with both SI and non-SI (NSI) phenotypes. The 50% inhibitory concentrations (IC50s) were 0.62–18 μg mL−1 (0.21–6.2 μM). R-95288 inhibited the binding and fusion of HIV-1-infected T cells with CD4+ cells. In addition, R-95288 specifically blocked the binding of monoclonal antibodies, recognizing the anti-V3 loop or the CD4-binding site of the virus envelope glycoprotein gp120. Furthermore, the target site of R-95288 within the V3 loop was found in the putative heparin-binding region by binding inhibition assays using various anti-V3 loop antibodies. These results suggest that R-95288 can inhibit various strains of HIV-1, possibly by specific interaction with gp120.
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Affiliation(s)
- T Agatsuma
- Biological Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
| | - H Furukawa
- Biological Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
| | - H Hotoda
- New Leads Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
| | - M Koizumi
- New Leads Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
| | - R Koga
- New Leads Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
| | - M Kaneko
- New Leads Research Laboratories, Sankyo Company, 2-58 Hiromachi 1-chome, Shinagawa-ku, Tokyo 140, Japan
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Takahashi G, Yamada T, Kan H, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Iwai T, Masuda Y, Watanabe A, Uchida E. 153P Novel, highly sensitive molecular biomarkers for metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Wakita S, Yamaguchi H, Ueki T, Usuki K, Kurosawa S, Kobayashi Y, Kawata E, Tajika K, Gomi S, Koizumi M, Fujiwara Y, Yui S, Fukunaga K, Ryotokuji T, Hirakawa T, Arai K, Kitano T, Kosaka F, Tamai H, Nakayama K, Fukuda T, Inokuchi K. Complex molecular genetic abnormalities involving three or more genetic mutations are important prognostic factors for acute myeloid leukemia. Leukemia 2015; 30:545-54. [DOI: 10.1038/leu.2015.288] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 10/04/2015] [Accepted: 10/07/2015] [Indexed: 01/07/2023]
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Takahashi G, Yamada T, Kan H, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Iwai T, Watanabe A, Nakayama M, Kitano S, Uchida E. 2028 Self-expandable colonic stent increases plasma level of circulating cell free DNA significantly in patients with obstructive colorectal cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Iwai T, Yamada T, Kan H, Matumoto S, Koizumi M, Shinji S, Matuda A, Yokoyama Y, Takahashi G, Watanabe A, Nakayama M, Shiro K, Uchida E. 434 Follow-up after resection of metastatic liver tumor from colorectal cancer using circulating cell-free DNA. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Hashimoto M, Oohira S, Ueda Y, Miyazaki M, Isono M, Masaoka A, Takashina M, Koizumi M, Teshima T. SU-E-T-437: Four-Dimensional Treatment Planning for Lung VMAT-SBRT. Med Phys 2015. [DOI: 10.1118/1.4924798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Anetai Y, Takegawa H, Inoue T, Mizuno H, Sumida I, Koizumi M, Ogawa K, van't Veld A, Korevaar E. SU-E-T-527: Is CTV-Based Robust Optimized IMPT in Non-Small-Cell Lung Cancer Robust Against Respiratory Motion? Med Phys 2015. [DOI: 10.1118/1.4924889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yamanaka M, Takashina M, Kurosu K, Moskvin V, Das I, Koizumi M. SU-E-T-132: Assess the Shielding of Secondary Neutrons From Patient Collimator in Proton Therapy Considering Secondary Photons Generated in the Shielding Process with Monte Carlo Simulation. Med Phys 2015. [DOI: 10.1118/1.4924493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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29
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Mizuno H, Mizuno H, Sumida I, Otani Y, Yagi M, Takashina M, Suzuki O, Yoshioka Y, Koizumi M, Ogawa K. SU-E-T-767: Treatment Planning Study of Prostate Cancer by CyberKnife with Respect to the Urethral Dose. Med Phys 2015. [DOI: 10.1118/1.4925131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Otani Y, Sumida I, Yagi M, Mizuno H, Takashina M, Koizumi M, Ogawa K. SU-E-T-260: Development of a System to Verify for Connection Consistency in a Brachytherapy. Med Phys 2015. [DOI: 10.1118/1.4924622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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31
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Oohira S, Ueda Y, Nishiyama K, Miyazaki M, Isono M, Katsutomo T, Takashina M, Koizumi M, Kawanabe K, Teruki T. Couch-Height Based Patient Setup for Abdominal Radiation Therapy. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yamada T, Kan H, Matsumoto S, Koizumi M, Matsuda A, Shinji S, Yokoyama Y, Yamagishi A, Iwai T, Kitano S, Nakayama M, Watanabe A, Uchida E. Liquid Biopsy Detection of Kras and Braf Mutations May Be Useful As a Prognostic or Predictive Marker. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yada T, Damdindorj B, Rita RS, Kurashina T, Ando A, Taguchi M, Koizumi M, Sone H, Nakata M, Kakei M, Dezaki K. Ghrelin signalling in β-cells regulates insulin secretion and blood glucose. Diabetes Obes Metab 2014; 16 Suppl 1:111-7. [PMID: 25200304 DOI: 10.1111/dom.12344] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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: 03/23/2014] [Accepted: 04/20/2014] [Indexed: 12/13/2022]
Abstract
Insulin secretion from pancreatic islet β-cells is stimulated by glucose. Glucose-induced insulin release is potentiated or suppressed by hormones and neural substances. Ghrelin, an acylated 28-amino acid peptide, was isolated from the stomach in 1999 as the endogenous ligand for the growth hormone (GH) secretagogue-receptor (GHS-R). Circulating ghrelin is produced predominantly in the stomach and to a lesser extent in the intestine, pancreas and brain. Ghrelin, initially identified as a potent stimulator of GH release and feeding, has been shown to suppress glucose-induced insulin release. This insulinostatic action is mediated by Gα(i2) subtype of GTP-binding proteins and delayed outward K⁺ (Kv) channels. Interestingly, ghrelin is produced in pancreatic islets. The ghrelin originating from islets restricts insulin release and thereby upwardly regulates the systemic glucose level. Furthermore, blockade or elimination of ghrelin enhances insulin release, which can ameliorate glucose intolerance in high-fat diet fed mice and ob/ob mice. This review focuses on the insulinostatic action of ghrelin, its signal transduction mechanisms in islet β-cells, ghrelin's status as an islet hormone, physiological roles of ghrelin in regulating systemic insulin levels and glycaemia, and therapeutic potential of the ghrelin-GHS-R system as the target to treat type 2 diabetes.
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Affiliation(s)
- T Yada
- Division of Integrative Physiology, Department of Physiology, Jichi Medical University School of Medicine, Tochigi, Japan
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Kurosu K, Takashina M, Koizumi M, Das I, Moskvin V. SU-E-T-254: Optimization of GATE and PHITS Monte Carlo Code Parameters for Uniform Scanning Proton Beam Based On Simulation with FLUKA General-Purpose Code. Med Phys 2014. [DOI: 10.1118/1.4888585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Koizumi M, Sata N, Kaneda Y, Endo K, Sasanuma H, Sakuma Y, Ota M, Lefor AT, Yasuda Y. Optimal timeline for emergency surgery in patients with strangulated groin hernias. Hernia 2014; 18:845-8. [PMID: 24435318 DOI: 10.1007/s10029-014-1219-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 01/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This retrospective study evaluates the clinical course and outcomes of patients who underwent surgery for strangulated hernias. METHODS Among 520 groin hernias from 2001 to 2012, 51 inguinal and 42 femoral hernias were strangulated and operated emergently at a tertiary referral center. Perioperative factors, patient profiles, and time interval to surgery (T total = time from onset to surgery, T 1 = time from onset to initial evaluation, T 2 = time from the first hospital to the tertiary center, T 3 = time from admission at the tertiary center to surgery, T total = T 1 + T 2 + T 3) were analyzed in patients with strangulation, then compared between two groups, the bowel resection (BR) group and the non-bowel resection (NBR) group. RESULTS T 1, T 2 and T total in the bowel resection group were significantly longer than those in the non-bowel resection group (P < 0.05). Patients who presented initially to the tertiary center (T 2 = 0) had a significantly lower resection rate than patients transported from other hospitals (24 vs. 44 %, P = 0.048). There was no significant difference in morbidity between the BR and NBR groups (35 vs. 24 %, P = 0.231). CONCLUSIONS The elapsed time from onset to surgery, especially T 1 and T 2, is the most important prognostic factor in patients with strangulated groin hernias. Early diagnosis and transportation are essential for good outcomes.
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Affiliation(s)
- M Koizumi
- Department of Surgery, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke, Tochigi, 329-0498, Japan,
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Okada Y, Shimodaira H, Yamauchi J, Kondo N, Funada A, Sato A, Narita H, Kubota E, Koizumi M, Tochikubo M. Total Cancer Care in Community Medicine by Medical Oncologists. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Seo Y, Isohashi F, Tamari K, Hayashi K, Koizumi M, Ogawa K. Association Between Linear-Quadratic Model Parameters and Basal Gene Expression Profiles in the NCI-60 Cancer Cell Line Panel. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ueyama S, Takegawa H, Korevaar E, Wauben D, Takashina M, Koizumi M, van' t Veld A, Teshima T. SU-E-T-522: Modeling the Agility MLC for Monte Carlo IMRT and VMAT Calculations. Med Phys 2013. [DOI: 10.1118/1.4814952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wakai N, Zhang H, Zhou P, Das I, Takashina M, Koizumi M, Ogawa K, Teshima T, Matsuura N. SU-E-T-319: Verification of Dose Perturbations Due to High-Z Materials Inside Tissue. Med Phys 2013. [DOI: 10.1118/1.4814753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tan CW, Lee YH, Choolani M, Tan HH, Griffith L, Chan J, Chuang PC, Wu MH, Lin YJ, Tsai SJ, Rahmati M, Petitbarat M, Dubanchet S, Bensussan A, Chaouat G, Ledee N, Bissonnette L, Haouzi D, Monzo C, Traver S, Bringer S, Faidherbe J, Perrochia H, Ait-Ahmed O, Dechaud H, Hamamah S, Ibrahim MG, de Arellano MLB, Sachtleben M, Chiantera V, Frangini S, Younes S, Schneider A, Plendl J, Mechsner S, Ono M, Hamai H, Chikawa A, Teramura S, Takata R, Sugimoto T, Iwahashi K, Ohhama N, Nakahira R, Shigeta M, Park IH, Lee KH, Sun HG, Kim SG, Lee JH, Kim YY, Kim HJ, Jeon GH, Kim CM, Bocca S, Wang H, Anderson S, Yu L, Horcajadas J, Oehninger S, Bastu E, Mutlu MF, Celik C, Yasa C, Dural O, Buyru F, Quintana F, Cobo A, Remohi J, Ferrando M, Matorras R, Bermejo A, Iglesias C, Cerrillo M, Ruiz M, Blesa D, Simon C, Garcia-Velasco JA, Chamie L, Ribeiro DMF, Riboldi M, Pereira R, Rosa MB, Gomes C, de Mello PH, Fettback P, Domingues T, Cambiaghi A, Soares ACP, Kimati C, Motta ELA, Serafini P, Hapangama DK, Valentijn AJ, Al-Lamee H, Palial K, Drury JA, von Zglinicki T, Saretzki G, Gargett CE, Liao CY, Lee KH, Sung YJ, Li HY, Morotti M, Remorgida V, Venturini PL, Ferrero S, Nabeta M, Iki A, Hashimoto H, Koizumi M, Matsubara Y, Hamada K, Fujioka T, Matsubara K, Kusanagi Y, Nawa A, Zanatta A, Riboldi M, da Rocha AM, Guerra JL, Cogliati B, Pereira R, Motta ELA, Serafini P, Bianchi PDM, Zanatta A, Riboldi M, da Rocha AM, Cogliati B, Guerra JL, Pereira R, Motta ELA, Serafini P, Prieto B, Exposito A, Mendoza R, Rabanal A, Matorras R, Bedaiwy M, Yi L, Dahoud W, Liu J, Hurd W, Falcone T, Biscotti C, Mesiano S, Sugiyama R, Nakagawa K, Nishi Y, Kuribayashi Y, Akira S, Germeyer A, Rosner S, Jauckus J, Strowitzki T, von Wolff M, Khan KN, Kitajima M, Fujishita A, Nakashima M, Masuzaki H, Kajihara T, Ishihara O, Brosens J, Ledee N, Petitbarat M, Rahmati M, Vezmar K, Savournin V, Dubanchet S, Chaouat G, Balet R, Bensussan A, Chaouat G, Lee YH, Loh SF, Tannenbaum SR, Chan JKY, Scarella A, Chamy V, Devoto L, Abrao M, Sovino H, Krasnopolskaya K, Popov A, Kabanova D, Beketova A, Ivakhnenko V, Shohayeb A, Wahba A, Abousetta A, al-inany H, Wahba A, El Daly A, Zayed M, Kvaskoff M, Han J, Missmer SA, Navarro P, Meola J, Ribas CP, Paz CP, Ferriani RA, Donabela FC, Tafi E, Maggiore ULR, Scala C, Remorgida V, Venturini PL, Ferrero S, Hackl J, Strehl J, Wachter D, Dittrich R, Cupisti S, Hildebrandt T, Lotz L, Attig M, Hoffmann I, Renner S, Hartmann A, Beckmann MW, Urquiza F, Ferrer C, Incera E, Azpiroz A, Junovich G, Pappalardo C, Guerrero G, Pasqualini S, Gutierrez G, Corti L, Sanchez AM, Bordignon PP, Santambrogio P, Levi S, Persico P, Vigano P, Papaleo E, Ferrari S, Candiani M, van der Houwen LEE, Schreurs AMF, Lambalk CB, Schats R, Hompes PGA, Mijatovic V, Xu SY, Li J, Chen XY, Chen SQ, Guo LY, Mathew D, Nunes Q, Lane B, Fernig D, Hapangama D, Lind T, Hammarstrom M, Golmann D, Rodriguez-Wallberg K, Hestiantoro A, Cakra A, Aulia A, Al-Inany H, Houston B, Farquhar C, Abousetta A, Tagliaferri V, Gagliano D, Immediata V, Tartaglia C, Zumpano A, Campagna G, Lanzone A, Guido M, Matsuzaki S, Darcha C, Botchorishvili R, Pouly JL, Mage G, Canis M, Shivhare SB, Bulmer JN, Innes BA, Hapangama DK, Lash GE, de Graaff AA, Zandstra H, Smits LJ, Van Beek JJ, Dunselman GAJ, Bozdag G, Calis PT, Demiralp DO, Ayhan B, Igci N, Yarali H, Acar N, Er H, Ozmen A, Ustunel I, Korgun ET, Kuroda K, Kuroda M, Arakawa A, Kitade M, Brosens AI, Brosens JJ, Takeda S, Yao T. Endometriosis, endometrium, implantation and fallopian tube. Hum Reprod 2013. [DOI: 10.1093/humrep/det211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Morimoto M, Yoshioka Y, Konishi K, Isohashi F, Takahashi Y, Koizumi M, Teshima T, Bijl H, Langendijk J, Ogawa K. Comparison of Acute Genitourinary and Gastrointestinal Adverse Events of Localized Prostate Cancer Treated With Monotherapy Using Intensity Modulated Radiation Therapy or 3-dimensional Conformal Radiation Therapy or Permanent Implant Brachytherapy (I-125) or High-dose-rate Brachytherapy (Ir-192). Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shibamoto Y, Sumi M, Onodera S, Matsushita H, Sugie C, Tamaki Y, Onishi H, Abe E, Koizumi M, Miyawaki D. Primary Central Nervous System Lymphoma (PCNSL) Treated by Radiation Therapy: A Nationwide Survey of 2005-2009 Patients and Comparison With 1985-2004 Data. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yagi M, Oxley D, Dendooven P, Brandenburg S, Koizumi M, Teshima T. SU-E-T-294: Maximizing the Availability of Positron Emitting Nuclei for Proton Therapy Verification Using Different Beam Irradiation Sequences. Med Phys 2012; 39:3771. [DOI: 10.1118/1.4735364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Azemoto N, Kumagi T, Yokota T, Kuroda T, Koizumi M, Yamanishi H, Soga Y, Furukawa S, Abe M, Ikeda Y, Hiasa Y, Matsuura B, Watanabe J, Kushihata F, Onji M. An unusual case of subclinical diffuse glucagonoma coexisting with two nodules in the pancreas: characteristic features on computed tomography. Clin Res Hepatol Gastroenterol 2012; 36:e43-7. [PMID: 22239827 DOI: 10.1016/j.clinre.2011.12.003] [Citation(s) in RCA: 4] [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] [Received: 06/14/2011] [Revised: 12/02/2011] [Accepted: 12/05/2011] [Indexed: 02/04/2023]
Abstract
A lesion was discovered in the tail of the pancreas by ultrasonography performed during a health checkup for a 59-year-old Japanese man. Abdominal contrast-enhanced computed tomography (CE-CT) revealed strong enhancement in a 4-cm tumor in the pancreatic tail and in a 1-cm tumor in the pancreatic body. Serum glucagon levels were elevated to 54,405 pg/mL and a preoperative diagnosis of glucagonoma was made. The pancreatic tail and spleen were resected en bloc, along with a protruding tumor in the pancreatic body. However, histopathological evaluation revealed diffuse glucagonoma throughout the pancreas. When we retrospectively reviewed abdominal CE-CT after the operation, the entire pancreas was seen to be enlarged and diffusely enhanced by strong spots. Immunohistochemical examination using anti-CD31 demonstrated rich microvessels in two solid glucagonomas as well as microglucagonoma throughout the entire pancreas, indicating hypervascularity. Enlarged pancreas and diffuse enhancement of the pancreas by strong spots may be characteristic features of diffuse glucagonoma on abdominal CE-CT.
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Affiliation(s)
- N Azemoto
- Endoscopy Center, Ehime University Hospital, Shitsukawa, Toon, Ehime, Japan
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Hyodo M, Sata N, Koizumi M, Sakuma Y, Kurihara K, Lefor AT, Ohki J, Nagai H, Yasuda Y. Laparoscopic splenectomy using pneumoperitoneum or gasless abdominal wall lifting: a 15-year single institution experience. Asian J Endosc Surg 2012; 5:63-8. [PMID: 22776366 DOI: 10.1111/j.1758-5910.2011.00124.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 10/03/2011] [Accepted: 11/11/2011] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Laparoscopic splenectomy using pneumoperitoneum has been performed since 1992. The gasless abdominal wall-lifting method for laparoscopic splenectomy was introduced as an alternative. This retrospective study was undertaken to compare results using the two techniques. METHODS Between 1995 and 2010, 54 patients underwent laparoscopic splenectomy at a single institution; 30 underwent the procedure using the gasless technique and 24 using pneumoperitoneum. There were no significant differences between the two groups regarding age, sex or BMI, but more patients underwent concurrent operations in the pneumoperitoneum group. The abdominal wall-lift system with subcutaneous K-wires was used for the gasless method. RESULTS Intraoperative blood loss was similar in the two groups (193.0 ± 196.7 mL gasless, 217.3 ± 296.6 mL pneumoperitoneum; P > 0.05), but operative time (182.1 ± 92.1 min, 135.1 ± 46.1 min; P < 0.05), and resected spleen weight (306.1 ± 297.7 g, 138 ± 81.0 g; P < 0.05) were significantly different. In the gasless group, additional procedures included conversion (n = 1), mini-laparotomy (n = 2), and CO(2) insufflation (n = 2). Excluding the concurrent living-related kidney donor patients, hospital stay was similar (6.9 ± 2.5 days, 6.3 ± 2.0 days, P > 0.05). CONCLUSION Although gasless laparoscopic splenectomy is feasible, there are disadvantages, particularly the restricted operative working space in some patients. These results suggest that either technique may be used on an individual basis in patients undergoing laparoscopic splenectomy.
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Affiliation(s)
- M Hyodo
- Department of Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.
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Akiyama H, Yoshida K, Shimizutani K, Yamazaki H, Koizumi M, Yoshioka Y, Kakimoto N, Murakami S, Furukawa S, Ogawa K. PO-369 COMPARISON OF 60 GY AND 54 GY IN HIGH-DOSE-RATE INTERSTITIAL BRACHYTHERAPY FOR EARLY ORAL TONGUE CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72335-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Konishi K, Yoshioka Y, Takahashi Y, Ogata T, Isohashi F, Koizumi M, Ogawa K. PO-179 THREE YEAR RESULTS OF HDR-BRACHYTHERAPY FOR PROSTATE CANCER TREATED WITH NEW REGIMEN OF 45.5 GY IN SEVEN FRACTIONS. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72145-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Raut V, Takaori K, Kawaguchi Y, Mizumoto M, Kawaguchi M, Koizumi M, Kodama S, Kida A, Uemoto S. Laparoscopic common hepatic artery ligation and staging followed by distal pancreatectomy with en bloc resection of celiac artery for advanced pancreatic cancer. Asian J Endosc Surg 2011; 4:199-202. [PMID: 22776310 DOI: 10.1111/j.1758-5910.2011.00105.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [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: 11/28/2022]
Abstract
INTRODUCTION Adeno-carcinomas of pancreatic body are usually asymptomatic and progress to advanced stage with involvement of major arteries. Resection of advanced cancer along with en bloc resection of a common hepatic artery and celiac trunk enables a "curative" resections and only possible treatment. However, the celiac axis resection always has a risk of compromising blood supply to liver, resulting in the hepatic insufficiency. We evaluated practicability of a two-stage procedure for the advanced pancreases body cancer, laparoscopic clamping of a common hepatic artery followed by open distal pancreatectomy with en bloc celiac arterial resection to prevent the hepatic insufficiency. MATERIALS AND SURGICAL TECHNIQUE Seventy-five-year-old woman diagnosed with a 50-mm pancreatic body mass, invading splenic artery, common hepatic artery, splenic vein, and portal vein at the confluence. STAGE-1: At laparoscopy, after confirming absence of the peritoneal, superficial liver metastases and negative peritoneal cytology; we approached the common hepatic artery through the lesser sac and ligated. STAGE-2: Her liver function tests were normal after 2 weeks, and CT angiography showed complete blockage of the common hepatic artery with sufficient collateral circulation to the liver through inferior pancreatico-duodenal artery and gastro-duodenal artery. We performed an open distal pancreatectomy with en bloc resection of celiac artery. Histopathology examination confirmed R0 resection. DISCUSSION The celiac axis resection with distal pancreatectomy improves the chance of R0 resection and potentially, survival of the patient. Preoperative laparoscopic ligation of the common hepatic artery is a safe, effective, and in-expensive technique to prevent postoperative hepatic insufficiency and improves the safety of en bloc celiac artery resection with a distal pancreatectomy. Also these patients have high risk of peritoneal dissemination. Diagnostic laparoscopy is useful to detect occult metastasis, which are missed by per-operative CT scan.
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Affiliation(s)
- V Raut
- Department of Hepatobiliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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