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Awaya T, Endo J, Iijima R, Shimoda M, Moroi M. siRNA therapy improves multimodality imaging in hereditary transthyretin cardiac amyloidosis: a case report. QJM 2024; 117:304-306. [PMID: 38229248 DOI: 10.1093/qjmed/hcae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- T Awaya
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - J Endo
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - R Iijima
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - M Shimoda
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - M Moroi
- Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
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Miyamoto R, Shiihara M, Shimoda M, Suzuki S. Laparoscopic Distal Pancreatectomy Using Three-Dimensional Computer Graphics for Surgical Navigation With a Deep Learning Algorithm: A Case Report. Cureus 2024; 16:e55907. [PMID: 38601417 PMCID: PMC11004505 DOI: 10.7759/cureus.55907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/12/2024] Open
Abstract
We have demonstrated the utility of SYNAPSE VINCENT® (version 6.6; Fujifilm Medical Co., Ltd., Tokyo, Japan), a 3D image analysis system, in semi-automated simulations of the peripancreatic vessels, pancreatic ducts, pancreatic parenchyma, and peripancreatic organs using an artificial intelligence (AI) engine developed with deep learning algorithms. Furthermore, we investigated the usefulness of this AI engine for patients with pancreatic cancer. Here, we present a case of laparoscopic distal pancreatectomy with an extended surgical procedure performed using surgical simulation and navigation via an AI engine. An 80-year-old woman presented with abdominal pain. Enhanced abdominal computed tomography (CT) revealed main pancreatic duct dilatation with a maximum diameter of 40 mm. Furthermore, there was a 17 mm cystic lesion between the pancreatic head and the pancreatic body and a 14 mm mural nodule in the pancreatic tail. Thus, the lesion was preoperatively diagnosed as an intraductal papillary carcinoma (IPMC) of the pancreatic tail and classified as T1N0M0 stage IA according to the 8th edition of the Union for International Cancer Control guidelines. The present patient had laparoscopic distal pancreatectomy and regional lymphadenectomy. In particular, since it was necessary to include the cystic lesion in the pancreatic neck, pancreatic resection was performed at the right edge of the portal vein, which is closer to the head of the pancreas than usual. We routinely employed three-dimensional computer graphics (3DCG) surgical simulation and navigation, which allowed us to recognize the surgical anatomy, including the location of pancreatic resection. In addition to displaying the detailed 3DCG of the surgical anatomy, this technology allowed surgical staff to share the situation, and it has been reported that this approach improves the safety of surgery. Furthermore, the remnant pancreatic volume (47.6%), pancreatic resection surface area (161 mm2), and thickness of the pancreatic parenchyma (12 mm) at the resection location were investigated using 3DCG imaging. Intraoperative frozen biopsy confirmed that the resection margin was negative. Histologically, an intraductal papillary mucinous neoplasm with low-grade dysplasia was observed in the pancreatic tail. No malignant findings, including those related to the resection margin, were observed in the specimen. At the 12-month postoperative follow-up examination, the patient's condition was unremarkable. We conclude that the SYNAPSE VINCENT® AI engine is a useful surgical support for the extraction of the surrounding vessels, surrounding organs, and pancreatic parenchyma including the location of the pancreatic resection even in the case of extended surgical procedures.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, JPN
| | - Masahiro Shiihara
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, JPN
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, JPN
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, JPN
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Iseki M, Mizuma M, Unno M, Maruyama H, Akagi S, Shimoda M, Uemura K, Inoue T, Shiomi H, Watanabe M, Kobayashi M, Matsuda A, Mizuuchi Y, Aoki T, Shinkawa H, Takahata R, Makino K, Arai H, Yokoyama Y, Takeda S, Yaguchi Y, Kitagawa Y. Prognostic impact of postoperative infection after resection of biliary malignancy: A multicenter retrospective cohort study. Surgery 2023; 174:1145-1152. [PMID: 37599194 DOI: 10.1016/j.surg.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND The aim of this study was to investigate the prognostic impact of postoperative infections in patients who underwent resection for biliary malignancy, including intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma, gallbladder carcinoma, and carcinoma of the ampulla of Vater. METHODS This study was conducted in an 11-center retrospective cohort study. Patients with biliary tract cancer who underwent curative resection between April 2013 and March 2015 at 11 institutions in Japan were enrolled. We analyzed the prevalence of postoperative infection, infection-related factors, and prognostic factors. RESULTS Of the total 290 cases, 33 were intrahepatic cholangiocarcinoma, 60 were perihilar cholangiocarcinoma, 120 were distal cholangiocarcinoma, 55 were gallbladder carcinoma, and 22 were carcinoma of the ampulla of Vater. Postoperative infectious complications, including remote infection, were observed in 146 patients (50.3%), and Clavien-Dindo ≥III in 115 patients (39.7%). Postoperative infections occurred more commonly in the patients who received pancreaticoduodenectomy and bile duct resection. Patients with infectious complications had a significantly poorer prognosis than those without (median overall survival 38 months vs 62 months, P = .046). In a diagnosis-specific analysis, although there was no correlation between infectious complications and overall survival in intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma, and carcinoma of the ampulla of Vater, infectious complications were a significantly poor prognostic factor in gallbladder carcinoma (P = .031). CONCLUSION Postoperative infection after surgery for biliary tract cancer commonly occurred, especially in patients who underwent pancreaticoduodenectomy and bile duct resection. Postoperative infection is relatively associated with the prognosis of patients with biliary malignancy, especially gallbladder carcinoma.
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Affiliation(s)
- Masahiro Iseki
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Masamichi Mizuma
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Maruyama
- Department of Surgery, Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan; Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan
| | - Shinji Akagi
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Mazda Hospital, Hiroshima, Japan
| | - Mitsugi Shimoda
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Kenichiro Uemura
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Toru Inoue
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Gastrointestinal Surgery, Osaka City General Hospital, Japan
| | - Hisanori Shiomi
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Nagahama Red Cross Hospital, Shiga, Japan
| | - Manabu Watanabe
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Minako Kobayashi
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Infection Control and Prevention, Nippon Medical School, Musashikosugi Hospital, Kanagawa, Japan
| | - Akihisa Matsuda
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
| | - Yusuke Mizuuchi
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taku Aoki
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Hepato-Biliary-Pancreatic Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hiroji Shinkawa
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - Risa Takahata
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Medical Risk Management and Infection Control, National Defense Medical Collage, Saitama, Japan
| | - Kenta Makino
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Graduate School of Medicine, Kyoto University, Japan
| | - Hiroki Arai
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Nippon Medical School Chiba Hokusoh Hospital, Japan
| | - Yasuyuki Yokoyama
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Digestive Surgery, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Shigeru Takeda
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Gastroenterological, Breast, and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Japan
| | - Yoshihisa Yaguchi
- Clinical Research Support Committee, Japan Society for Surgical Infection, Tokyo, Japan; Department of Surgery, Sassa General Hospital, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan; The Japan Society of Surgical Infection, Tokyo, Japan
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Shimoda M, Kuboyama Y, Suzuki S. Continuous suture closure using a LapraTy® suture clips is an effective method for reconstruction of cystic duct stump after laparoscopic subtotal cholecystectomy. Heliyon 2023; 9:e20043. [PMID: 37809889 PMCID: PMC10559765 DOI: 10.1016/j.heliyon.2023.e20043] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Objective Recently, number of laparoscopic subtotal cholecystectomy (LSC) has been increasing. Summary background data LSC is suitable as a treatment as it can avoid intraoperative bile duct injury and bleeding for difficult laparoscopic cholecystectomy. On the other hand, improper handling of remnant of GB can lead to postoperative bile leakage. Methods Here, we report our positive experience utilizing new technique of continuous suture closure and omental covering using Lapra Ty® suture clips on the remnant of GB. Results From January 2016 to July 2021, we experienced 30 cases of LSC for LC patients who had difficulty securing critical view of safety (CVS). In six of the 30 cases, we repaired remnant of GB using continuous suture closure and omental covering with Lapra Ty® suture clips. The median operating time was 136 min (range 112-199 ml), and amount of bleeding was 1 ml (range 1-100). There were no cases of postoperative bile leakage (postope. BL), remnant cystic duct stone, and abscess formation in abdomen. Conclusion we recommend this new suturing technique for closure of remnant of GB as it was very effective in preventing postope. BL after LSC.
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Affiliation(s)
- Mitsugi Shimoda
- Tokyo Medical University, Ibaraki Medical Center, Department of Gastroenterological Surgery, Japan
| | - Yu Kuboyama
- Tokyo Medical University, Ibaraki Medical Center, Department of Gastroenterological Surgery, Japan
| | - Shuji Suzuki
- Tokyo Medical University, Ibaraki Medical Center, Department of Gastroenterological Surgery, Japan
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Shimoda M, Kuboyama Y, Suzuki S. Laparoscopic bailout surgery effective procedure for patients with difficult laparoscopic cholecystectomy. Updates Surg 2022; 74:1611-1616. [PMID: 35266106 DOI: 10.1007/s13304-022-01266-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/28/2022] [Indexed: 12/07/2022]
Abstract
TG18 recommends bailout surgery (BOS) for difficult laparoscopic cholecystectomy. However, there is not a clear criterion on the decision process on whether to continue laparoscopic BOS or open BOS, and optimal procedure for treatment for the remnant cystic bile duct also awaits discussion. We comparted with open BOS and laparoscopic BOS, and compared with suture close and clipping or ligating of remnant cystic duct. We have accrued 57 patients underwent BOS during study period. Seventeen cases underwent laparoscopic BOS, and 38 cases underwent open BOS. There were 22 patients were accrued in suture closing and 35 patients were accrued in clipping or ligating. Open BOS experienced high levels of CRP, WBC, NLR, and CAR, and was associated with significantly longer hospitalization, operating time, and amount of bleeding. Suture close was higher in patients with preoperative endoscopic lithotripsy (EL). BOS can be sufficiently performed under laparoscopy. Patients underwent preoperative EL tended to be higher necessity to suture close of cystic duct.
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Affiliation(s)
- Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1, Ami, Chuo, Ibaraki, 300-0395, Japan.
| | - Yu Kuboyama
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1, Ami, Chuo, Ibaraki, 300-0395, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, 3-20-1, Ami, Chuo, Ibaraki, 300-0395, Japan
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Tago T, Shimoda M, Imazato R, Udou R, Katsumata K, Tsuchida A, Suzuki S. Possibility for avoidance of urgent nighttime operations for acute appendicitis in a regional core university hospital. Asian J Endosc Surg 2022; 15:22-28. [PMID: 34008336 DOI: 10.1111/ases.12953] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In recent years, a shortage of surgeons and anesthesiologists, particularly in regional hospitals, has become a social issue in Japan. In such hospitals, urgent surgery at night has been performed with difficulty. Therefore, we retrospectively assessed the outcomes of appendectomies for the patients visited at nighttime in our hospital categorized as a local university hospital. METHODS A retrospective review was conducted on 82 patients of acute appendicitis presented to our hospital between 5:30 p.m. to 8:30 a.m., between January 2014 and April 2019. We compared patients who underwent urgent nighttime appendectomy (group A) and patients who underwent appendectomy during the daytime, or so-called short interval appendectomy (group B). The evaluated factors were preoperative characteristics (age, sex, body mass index, cardiopulmonary complications, laboratory data, body temperature, presence of the Blumberg sign, and CT findings), operation characteristics, and postoperative characteristics (surgical-site infection [SSI], complications, and length of hospital stay). RESULTS Patients in group A were significantly younger than patients in group B. Patients in group A were significant more likely to experience an SSI. DISCUSSION Patients diagnosed with acute appendicitis during the nighttime can undergo short interval appendectomy, which leads to a decreased risk of SSI, has no effect on length of hospital stay after surgery, and lessens medical staff burden.
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Affiliation(s)
- Tomoya Tago
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.,Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Mitsugi Shimoda
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Ryosuke Imazato
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Ryutaro Udou
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.,Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Shuji Suzuki
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
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Suzuki S, Shimoda M, Shimazaki J, Oshiro Y, Nishda K, Orimoto N, Nagakawa Y, Tsuchida A. Carbohydrate Antigen 19-9 Is an Invasive Malignancy Preoperative Prognostic Factor for Intraductal Papillary Mucinous Neoplasms. Eur Surg Res 2021; 62:262-270. [PMID: 34344012 DOI: 10.1159/000517558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/31/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION This study aimed to determine the preoperative clinicophysiological and postoperative clinicopathological predictors of malignancy in patients with intraductal papillary mucinous neoplasm (IPMN). METHODS This was a retrospective observational study. We included 121 patients (73 men and 48 women; mean age: 68.7 years) who had undergone pancreatic resection for IPMN between 2007 and 2018. These patients were grouped into invasive carcinoma (IPMN-INV, N = 21) and low/high-grade IPMN (IPMN-LG/HG, N = 100) groups. Univariate and multivariate analyses of clinicophysiological parameters were carried out. These parameters were also compared between the IPMN-INV/HG (N = 53) and IPMN-LG (N = 68) groups. Survival analyses according to macroscopic type and IPMN subtypes were performed. RESULTS On univariate analysis, age (p = 0.038), carbohydrate antigen (CA) 19-9 (p < 0.001), IPMN macroscopic type (p = 0.001), IPMN subtype (p < 0.001), pancreatic duct diameter (p < 0.001), and mural nodule (p = 0.042), between IPMN-INV and IPMN-LG/HG were found to be significant prognostic factors of malignancy. CA 19-9 was found to be an independent prognostic factor of IPMN malignancy on multivariate analysis (p = 0.035). The 1-, 3-, and 5-year overall survival (OS) rates of the IPMN-INV and IPMN-LG/HG groups were 94.4/100%, 94.4/100%, and 67.2/100%, respectively. The OS rate in the IPMN-LG/HG group was significantly higher than that in the IPMN-INV group (p < 0.001). On univariate analysis, platelet (p = 0.043), CA 19-9 (p = 0.039), prognostic nutritional index (p = 0.034), platelet/lymphocyte ratio (p = 0.01), IPMN macroscopic type (p < 0.001), IPMN subtype (p < 0.001), pancreatic duct diameter (p = 0.036), and mural nodule (p = 0.032) between IPMN-INV/HG and IPMN-LG were found to be significant prognostic factors of malignancy. On multivariate analysis, CA 19-9 was found to be an independent prognostic factor (p = 0.042) between IPMN-INV/HG and IPMN-LG of malignancy. The 1-, 3-, and 5-year OS rates of the IPMN-INV/HG and IPMN-LG groups were 97.9/100%, 97.9/100%, and 82.6/100%, respectively. The OS rate was significantly higher in the IPMN-LG group than in the IPMN-INV/HG group (p = 0.03). No significant differences in survival were observed in patients with macroscopic tumors (p= 0.544). CONCLUSION CA 19-9 is an independent invasive malignancy predictor of IPMN.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Kiyotaka Nishda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Naoki Orimoto
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
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Oshiro Y, Harada H, Hasegawa K, Akutsu N, Yoshizumi T, Kawagishi N, Nanmoku K, Ichimaru N, Okamura K, Ohira M, Itabashi Y, Fujiyama N, Ide K, Okajima H, Ogawa K, Takagi K, Eguchi H, Shinoda M, Nishida K, Shimazaki J, Shimoda M, Takahashi M, Okamoto H, Suzuki S. Loss of antibodies to hepatitis E virus in organ transplant patients with hepatitis E. Hepatol Res 2021; 51:538-547. [PMID: 33749100 DOI: 10.1111/hepr.13637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 02/10/2021] [Accepted: 03/14/2021] [Indexed: 02/08/2023]
Abstract
AIM Studies regarding changes in antibodies to hepatitis E virus (HEV) after HEV infection in organ transplant patients are limited. This study aimed to clarify HEV infection trends in organ transplant patients who contracted HEV using data from a previous Japanese nationwide survey. METHODS This study was undertaken from 2012 to 2019. Among 4518 liver, heart, and kidney transplant patients, anti-HEV immunoglobulin G (IgG) antibodies were positive in 164; data were collected from 106 of these patients, who consented to participate in the study. In total, 32 liver transplant patients, seven heart transplant patients, and 67 kidney transplant patients from 16 institutions in Japan were examined for IgG, IgM, and IgM antibodies to HEV and the presence of HEV RNA in the serum. The χ2 -test was used to determine the relationship between the early and late postinfection groups in patients with anti-HEV IgG positive-to-negative conversion rates. The Mann-Whitney U-test was used to compare clinical factors. RESULTS Anti-HEV IgG positive-to-negative conversion occurred in 25 (23.6%) of 106 organ transplant patients. Of eight patients with hepatitis E who tested positive for HEV RNA, one (14.0%) had anti-HEV IgG positive-to-negative conversion. Twenty-four (24.5%) of 98 patients negative for HEV RNA had anti-HEV IgG positive-to-negative conversion. CONCLUSIONS This study revealed, for the first time, the changes in HEV antibodies in organ transplant patients. Loss of anti-HEV IgG could often occur unexpectedly in organ transplant patients with previous HEV infection.
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Affiliation(s)
- Yukio Oshiro
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
| | - Hiroshi Harada
- Kidney Transplant Surgery, Sapporo City General Hospital, Sapporo, Japan
| | - Kiyoshi Hasegawa
- Hepato-Biliary-Pancreatic Surgery Division, Artificial Organs and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naotake Akutsu
- Department of Surgery, National Hospital Organization Chibahigashi National Hospital, Chiba, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Koji Nanmoku
- Department of Renal Surgery and Transplantation, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Naotsugu Ichimaru
- Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenichi Okamura
- Department of Cardiovascular Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiro Ohira
- Department of Gastroenterology and Metabolism, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
| | - Yoshihiro Itabashi
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Nobuhiro Fujiyama
- Center for Kidney Disease and Transplantation, Akita University Hospital, Akita, Japan
| | - Kentaro Ide
- Department of Gastroenterology and Metabolism, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
| | - Hideaki Okajima
- Department of Paediatric Surgery, Kanazawa Medical University, Kahoku, Japan
| | - Kohei Ogawa
- Department of HPB and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kosei Takagi
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahiro Shinoda
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
| | - Masaharu Takahashi
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Japan
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Suzuki S, Shimoda M, Shimazaki J, Oshiro Y, Nishida K, Shiihara M, Izumo W, Yamamoto M. Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy. World J Surg 2021; 45:1921-1928. [PMID: 33721069 DOI: 10.1007/s00268-021-06038-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pancreaticoduodenectomy (PD) has recently been improved due to its increased safety. However, postoperative pancreatic fistula (POPF) remains a lethal complication of PD. Identifying novel clinicophysiological risk factors for POPF during the early post-PD period would help improve patient morbidity and mortality. Therefore, this retrospective study aimed to evaluate possible risk factors during the early postoperative period after pancreaticoduodenectomy (PD). METHODS Data from 349 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into 2 groups: group A, patients without fistulae or biochemical leaks (288 patients), and group B, those with grade B or C POPF (61 patients). Data on various clinicophysiological parameters, including serum and drain laboratory data, were collected. Univariate and multivariate analyses were performed to evaluate POPF predictors. A predictive nomogram was established for these results. RESULTS Univariate analysis showed that various serum and drain-related factors, such as white blood cell count, C-reactive protein levels, drain amylase (DAMY) levels, and drain lipase (DLIP) levels, were possible POPF risk factors. Multivariate analysis confirmed that postoperative day (POD) 1 DLIP levels (hazard ratio, 15.393; p = 0.037) and decreased rate (POD3/1) of DAMY levels (hazard ratio, 4.415; p = 0.028) were independent risk factors. Further, POD1 DLIP levels and decreased rate of DAMY levels were significantly lower in group A than in group B. The accuracy of nomogram was 0.810. CONCLUSIONS POD1 DLIP levels (> 245 U/mL) and decreased rate of DAMY levels (> 0.44) were POPF risk factors, making them possible biomarkers for POPF.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, 300-0395, Japan.
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, 300-0395, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, 300-0395, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, 300-0395, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, 300-0395, Japan
| | - Masahiro Shiihara
- Department of Gastroenterological Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Wataru Izumo
- Department of Gastroenterological Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Masakazu Yamamoto
- Department of Gastroenterological Surgery, Tokyo Women's Medical University, Tokyo, Japan
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10
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Riess J, Schalper K, Kelly K, Shimoda M, Luxardi G, Merleev A, Monjazeb A, Danenberg K, Maverakis E, Gandara D. P15.04 A Phase I/IB Trial of Pembrolizumab and Trametinib Focused on Advanced KRAS Mutant Non-Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.541] [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: 10/21/2022]
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11
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Maruyama T, Shimoda M, Hakoda H, Sako A, Ueda K, Suzuki S. Preoperative prognostic nutritional index predicts risk of recurrence after curative resection for stage IIA colon cancer. Am J Surg 2020; 222:179-185. [PMID: 33138968 DOI: 10.1016/j.amjsurg.2020.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Preoperative nutritional and inflammatory indices have been reported to be associated with the prognosis of patients with malignancy. We evaluated clinicopathological factors, including nutritional and inflammatory indices, and recurrence prognosis in patients with stage IIA colon cancer (CC) who underwent curative surgery. METHODS This retrospective study included 197 patients with stage IIA CC who had undergone curative resection. We evaluated the association between prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with clinicopathological factors and prognosis for recurrence. For the recurrence-free survival (RFS) analysis, receiver operating characteristic (ROC) curves were used to determine appropriate cutoff values for PNI, NLR, and PLR. RESULTS Univariate analyses showed that PNI<44.8 (P = 0.028) was significantly associated with worse RFS in patients with stage IIA CC patients. In the multivariate analyses, PNI<44.8 (hazard ratio [HR] 2.082; 95% confidence interval [CI] 1.005-4.317; P = 0.049) independently and significantly predicted RFS. CONCLUSION PNI is a useful marker for predicting recurrence prognosis in post-resection patients with stage IIA CC.
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Affiliation(s)
- Tsunehiko Maruyama
- Department of Surgery, Mito Saiseikai General Hospital, Japan; Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Japan.
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Japan
| | | | - Akihiro Sako
- Department of Surgery, Hitachi General Hospital, Japan
| | - Kazumitsu Ueda
- Department of Gastroenterological Surgery, Tsukuba Memorial Hospital, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Japan
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12
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Tago T, Suzuki S, Kuroda J, Udou R, Nishida K, Oshiro Y, Shimazaki J, Kou K, Morishita Y, Shimoda M. Leiomyosarcoma of the transverse colon with lymph node metastasis and malignant transformation: a case report. Surg Case Rep 2020; 6:256. [PMID: 33006746 PMCID: PMC7532233 DOI: 10.1186/s40792-020-00998-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/18/2020] [Indexed: 11/30/2022] Open
Abstract
Background The concept of GIST was established in 1998, clearly differentiating between gastrointestinal leiomyosarcoma and GISTs among gastrointestinal mesenchymal tumors. Lymph node metastasis is extremely rare in true gastrointestinal leiomyosarcoma, and there are no reports of malignant transformation from leiomyoma. Case presentation The patient was an old woman who had undergone endoscopic mucosal resection for an Is polyp on the left side of the transverse colon at the age of 73. She was diagnosed with leiomyoma with positive surgical margins. Subsequently, she presented to our institution with a sensation of pressure in the upper abdominal region as a chief complaint at the age of 76 years. Abdominal computed tomography and colorectal endoscopy showed a tumor lesion with invagination of the intestines in the transverse colon, the same site as that of the previously resected leiomyoma. A biopsy suggested a smooth muscle tumor, and we performed partial left transverse colectomy and lymph node dissection under a diagnosis of recurrence and enlargement of the previously incompletely resected leiomyoma. Histopathological examination revealed spindle-shaped tumor cells, and the mitotic activity was 30–40/10 high-power field. Tumor cells were immunohistologically positive for α-smooth muscle actin and h-caldesmon; partially positive for desmin; negative for c-kit, CD34, DOG-1, and the S-100 protein; and showed a Ki-67 labeling index of 70–80%. She was diagnosed with leiomyosarcoma malignantly transformed from leiomyoma. Metastasis was found in 1 of the 14 resected lymph nodes. The patient did not undergo adjuvant chemotherapy, but has survived with no recurrence at 2 years after the surgery. Conclusions We have reported a case of leiomyosarcoma of the transverse colon with lymph node metastasis that was malignantly transformed from a leiomyoma.
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Affiliation(s)
- Tomoya Tago
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan.
| | - Shuji Suzuki
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Jun Kuroda
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Ryutaro Udou
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Kiyotaka Nishida
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Yukio Oshiro
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Jirou Shimazaki
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Keni Kou
- Department of Pathology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Yukio Morishita
- Department of Pathology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
| | - Mitsugi Shimoda
- Department of Gastrointestinal Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, AmimachiIbaraki, Inashiki-gun, 300-0395, Japan
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13
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Maruyama T, Shimoda M, Sako A, Ueda K, Hakoda H, Sakata A, Suzuki S. Predictive Effectiveness of the Glasgow Prognostic Score for Gastrointestinal Stromal Tumors. Nutr Cancer 2020; 73:1333-1339. [PMID: 32748650 DOI: 10.1080/01635581.2020.1800763] [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: 10/23/2022]
Abstract
The aim of this study was to evaluate the significance of the Glasgow prognostic score (GPS) in patients with resected gastrointestinal stromal tumors (GISTs). Forty-six GIST patients who underwent radical resection between January 2004 and December 2011 were enrolled in this retrospective study. The clinicopathological parameters examined included predictors of recurrence-free survival (RFS). Univariate and multivariate analysis of prognostic factors related to RFS were calculated using Cox proportional hazards model. The GPS classification system revealed 37 (80.4%), 6 (13.1%), and 3 (6.5%) patients with a GPS of 0, 1, and 2, respectively. Patients with GPS 1/2 had a significantly shorter RFS compared to those with GPS 0 (P = 0.01). The 3- and 5-year RFS rates for patients with GPS 0 were 94.0% and 90.9%, respectively, compared to 66.7% and 53.3%, respectively, for patients with GPS 1/2. Univariate analyses indicated that tumor size (P < 0.01), mitotic rate (P < 0.01), higher GPS (P < 0.01), and platelet count (P = 0.04) were prognostic factors for RFS; tumor size (P = 0.01) and GPS (P = 0.04) were independent prognostic factors in multivariate analysis. Preoperative high GPS were predictors of long-term prognosis in patients with resected GISTs.
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Affiliation(s)
- Tsunehiko Maruyama
- Department of Surgery, Mito Saiseikai General Hospital, Mito, Japan.,Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Akihiro Sako
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Kazumitsu Ueda
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Hiroyuki Hakoda
- Department of Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Akiko Sakata
- Department of Pathology, Hitachi General Hospital, Hitachi, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Tokyo, Japan
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14
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Miyoshi K, Shimoda M, Udo R, Oshiro Y, Suzuki S. Urinary titin N-terminal fragment concentration is an indicator of preoperative sarcopenia and nutritional status in patients with gastrointestinal tract and hepatobiliary pancreatic malignancies. Nutrition 2020; 79-80:110957. [PMID: 32866763 DOI: 10.1016/j.nut.2020.110957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/29/2020] [Accepted: 06/26/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Recent reports indicate that preoperative patients with gastrointestinal malignancies often have sarcopenia. The diagnosis of sarcopenia is generally done by evaluation of walking speed, grip strength, and skeletal muscle volume of the limbs on computed tomography (CT). However, these parameters are objective indices, and new indicators for diagnosis, such as molecular biomarkers, have been anticipated. The aim of this study was to investigate whether titin, a muscular contractile protein present in sarcomeres, is an indicator of sarcopenia. METHODS We analyzed 39 patients with gastrointestinal tract and hepatobiliary pancreatic malignancies who underwent surgery. We compared urinary titin n-terminal fragment concentration (UTF) with clinical factors, subcutaneous fat volume, and skeletal muscle volume index, and also compared UTF levels between patients with and without sarcopenia. RESULTS The patients comprised 24 men and 15 women, with a mean age of 72 y (range: 35-85 y). Cancer locations were the pancreas (n = 17), liver (n = 9), stomach (n = 5), colorectum (n = 5), and esophagus (n = 3). UTF was significantly higher in patients with sarcopenia (P = 0.04), and showed statistically significant negative correlations with albumin (r = -2.61, P = 0.001), pre-albumin (r = -2.14, P = 0.02), body mass index (r = -0.49, P = 0.007), cholinesterase (r = -0.02, P = 0.01, skeletal muscle volume index (r = -0.16, P = 0.04), and subcutaneous fat volume (r = -0.03, P = 0.007). CONCLUSION UTF may be a new index for preoperative nutritional assessment in patients with gastrointestinal malignancies.
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Affiliation(s)
- Kenta Miyoshi
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan.
| | - Ryutaro Udo
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan
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15
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Oshiro Y, Nishida K, Shimazaki J, Shimoda M, Suzuki S. Investigation of morphological and functional changes in the liver and pancreas during bevacizumab treatment. Scand J Gastroenterol 2020; 55:712-717. [PMID: 32432961 DOI: 10.1080/00365521.2020.1766556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: Recently, there have been reports regarding the atrophy of various organs caused by molecular targeted drugs. We investigated morphological and clinical changes in the liver and pancreas caused by treatment with bevacizumab.Methods: We investigated 30 patients with colorectal cancer who received bevacizumab-containing chemotherapy (study group) and 11 patients with colorectal cancer who received chemotherapy without bevacizumab (control group) from 2010 to 2014. We obtained computed tomography data of the liver and pancreas and performed three-dimensional image analysis and volumetry. Laboratory data before and after chemotherapy were analyzed.Results: There was no significant difference in liver volume before and after bevacizumab-containing chemotherapy, but the pancreatic volume was found to be significantly reduced after bevacizumab-containing chemotherapy (57.9 ± 16 mL versus 47.4 ± 15.3 mL; p = .005). The liver and pancreatic volume did not change statistically in the control group. With regard to complete blood cell counts and laboratory data, no significant differences were observed in the leukocyte count and hemoglobin, hemoglobin A1c, triglyceride, albumin, and C-reactive protein levels. In contrast, there was a significant decrease in the platelet count, total cholesterol level and a significant increase in the amylase level. A chemotherapy regimen that included bevacizumab reduced pancreatic volume and significantly altered the morphology of the pancreas.Conclusions: Although bevacizumab caused atrophy of the pancreas and reduced pancreatic volume, pancreatic endocrine function showed no change. Future studies should investigate the survival rate and functional changes caused by bevacizumab treatment.
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Affiliation(s)
- Yukio Oshiro
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University
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16
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Shimoda M, Udo R, Imasato R, Oshiro Y, Suzuki S. What are the risk factors of conversion from total cholecystectomy to bailout surgery? Surg Endosc 2020; 35:2206-2210. [DOI: 10.1007/s00464-020-07626-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/04/2020] [Indexed: 12/24/2022]
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17
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Johnson T, Aguilera D, Al-Basheer A, Berrong Z, Castellino R, Eaton B, Esiashvili N, Foreman N, Heger I, Kennedy E, Vahanian N, Martin W, Pacholczyk R, Ring E, Sadek R, Smith A, Shimoda M, Macdonald T, Munn D. Results of the NLG2105 Phase I Trial Using the IDO Pathway Inhibitor Indoximod, in Combination with Radiation and Chemotherapy, for Children with Newly Diagnosed DIPG. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz451.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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18
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Toussi A, Merleev A, Barton VR, Le ST, Marusina A, Luxardi G, Kirma J, Xing X, Adamopoulos IE, Fung MA, Raychaudhuri SP, Shimoda M, Gudjonsson JE, Maverakis E. Transcriptome mining and B cell depletion support a role for B cells in psoriasis pathophysiology. J Dermatol Sci 2019; 96:181-184. [PMID: 31780313 DOI: 10.1016/j.jdermsci.2019.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
Affiliation(s)
- A Toussi
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States; University of California, School of Medicine, Davis, Sacramento, CA, United States
| | - A Merleev
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - V R Barton
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - S T Le
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - A Marusina
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - G Luxardi
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - J Kirma
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - X Xing
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - I E Adamopoulos
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Sacramento, CA, United States
| | - M A Fung
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States; Department of Pathology, University of California, Davis, Sacramento, CA, United States
| | - S P Raychaudhuri
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States; Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Sacramento, CA, United States
| | - M Shimoda
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States
| | - J E Gudjonsson
- Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - E Maverakis
- Department of Dermatology, University of California, Davis, Sacramento, CA, United States.
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19
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Shimoda M, Hariyama M, Oshiro Y, Suzuki S. Development of new software enabling automatic identification of the optimal anatomical liver resectable region, incorporating preoperative liver function. Oncol Lett 2019; 18:6639-6647. [PMID: 31788120 PMCID: PMC6865544 DOI: 10.3892/ol.2019.11006] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022] Open
Abstract
Determining the resectable region and volume of the liver prior to anatomical resection is important. The synapse Vincent (SV) system is the current method for surgical liver resection that relies on the surgeon's individual experience and skill. Additionally, in cases involving abnormal liver function, the resectable region is limited due to deteriorating liver function, thus making the determination of the hepatectomy region challenging. The current study outlines a novel 3D Hariyama-Shimoda Soft (HSS) simulation software that can be used to automatically simulate the optimal hepatectomy region under a limited resectable liver volume. The current study recruited patients with hepatic malignant tumors that were scheduled for anatomical resection. The influence of the tumor on each portal vein point was quantified in accordance with the tumor domination ratio (TDR). The resectable region was subsequently determined so that the sum of the TDR was the maximum estimated resectable liver volume (ERLV). The maximum ERLV settings utilized were within Makuuchi's criteria. ERLV was compared with the actual resected liver volume (ARLV) using SV and HSS. A total of 15 patients were included in the present study. The median ERLV was not significantly different between the two groups (P=0.15). However, the correlation between ERLV and ARLV, for SV and HSS, was statistically significant [SV ERLV (ml) = 1.139 × HSS ERLV (ml) + 30.779 (P=0.001)]. In conclusion, HSS may be an effective 3D simulation system. TDR and ERLV were indicated to be novel factors that may be incorporated into simulation software for use in anatomical resection surgery.
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Affiliation(s)
- Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan
| | - Masanori Hariyama
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan.,Graduate School of Information Sciences, Tohoku University, Sendai 980-8579, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki 300-0395, Japan
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20
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Nakano Y, Onishi T, Niwa T, Takashima H, Shimoda M, Ohashi H, Ando H, Waseda K, Amano T. P3638Triglyceride deposite cardiomyovasculopathy latency in population with coronary artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0495] [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
Triglyceride deposit cardiomyovasculopathy (TGCV) is a novel clinical concept found among Japanese cardiac transplant recipients in 2008 that the abnormal intracellular triglyceride (TG) metabolism results in the ectopic accumulation of TG in vascular smooth muscle cells and cardiomyocytes, leading to diffuse narrowing coronary artery disease (CAD) and heart failure. TGCV is estimated to affect almost forty to fifty-thousand people in Japan, but there is no real-world date about the prevalence or latency.
Purpose
To evaluate TGCV latency in population with CAD, especially requiring urgent coronary angiography as Study 1, and chronic hemodialysis as Study 2.
Methods
This is multicenter retrospective estimation consisting of two studies.
Study 1) From 2012 to 2017, consecutive 400 patients of unstable angina or acute myocardial infarction who underwent urgent coronary angiography (CAG) and following iodine-123-β-methyliodophenyl-pentadecanoic acid (BMIPP) scintigraphy, a tracer for the diagnosis of TGCV, were enrolled.
Study 2) From 2011 to 2017, 88 chronic hemodialysis patients who underwent planed CAG and BMIPP scintigraphy for detection of ischemic heart disease were enrolled.
TGCV was diagnosed based on the latest diagnostic criteria for TGCV. The criteria include two major items (2 points each: BMIPP scintigraphy Wash-Out Rare <10%, Diffuse narrowing coronary arteries) and two minor items (1 point each: Jordans' anomaly in peripheral blood smear, Diabetes). Four points or more and three points indicated definite and probable TGCV, respectively. Only Items other than Jordans' anomaly were available for the diagnosis of TGCV because of retrospective nature. We evaluated the latent rate of definite and probable TGCV.
Results
Study 1) Figure (left) demonstrates the result of Study 1. Definitive TGCV patients were 14 patients, accounting for 3.5% of total 400 patients, and probable TGCV patients were 39 patients, accounting for 9.8% of all. Total 53 definitive and probable TGCV patients accounted for 13.3% of all. Annual average latency were 3.6±1.7% as definitive, 10.0±5.5% as probable and 13.6±6.6% as definitive and probable TGCV, respectively.
Study 2) Figure (right) demonstrates the result of Study 2. Definitive TGCV patients were 17 patients, accounting for 19.3% of total 88 hemodialysis patients, and probable TGCV patients were 22 patients, accounting for 25.0% of all. Total 39 definitive and probable TGCV patients accounted for 44.3% of all. Annual average latency of definitive TGCV was 19.3±13.4%. Of the 17 definitive TGCV patients, 9 patients were hemodialysis patients with diabetes.
Figure 1
Conclusions
TGCV might be latent with a probability of 3.6±1.7% per year in patients with unstable angina or acute myocardial infarction, and with a probability of 19.3±13.4% per year in chronic hemodialysis patients suspected of ischemic heart disease.
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Affiliation(s)
- Y Nakano
- Aichi Medical University, Nagakute, Japan
| | - T Onishi
- Narita Memorial Hospital, Cardiology, Toyohashi, Japan
| | - T Niwa
- Narita Memorial Hospital, Cardiology, Toyohashi, Japan
| | | | - M Shimoda
- Aichi Medical University, Nagakute, Japan
| | - H Ohashi
- Aichi Medical University, Nagakute, Japan
| | - H Ando
- Aichi Medical University, Nagakute, Japan
| | - K Waseda
- Aichi Medical University, Nagakute, Japan
| | - T Amano
- Aichi Medical University, Nagakute, Japan
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21
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Nakano Y, Suzuki M, Waseda K, Niwa T, Ando H, Sakurai S, Shimoda M, Ohashi H, Takashima H, Amano T. P2688A novel risk factor of stent restenosis after drug-eluting stent implantation; Involvement of triglyceride deposit cardiomyovasculopathy, coronary atherosclerosis with triglyceride deposition. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1006] [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
Triglyceride deposit cardiomyovasculopathy (TGCV) is a novel disease concept characterized by the excessive accumulation of triglyceride in cardiomyocytes and vascular smooth muscle cells, leading to coronary artery disease (CAD), heart failure, and arrhythmia. However, it is rarely known whether TGCV contributes to the increased risk of vascular failure after drug eluting stent (DES) implantation.
Purpose
The aim of this study was to evaluate vascular failure after 2nd generation DES implantation in patients with TGCV.
Methods
Among 637 consecutive patients suspected of having CAD who underwent both coronary angiography and iodine-123-β-methyliodophenyl-pentadecanoic acid (BMIPP) scintigraphy between 2010 and 2018, we analyzed the data from 92 patients who met the inclusion criteria (shown in Table and Figure). Ninety-two patients were allocated to the presence (TGCV group, 11 patients) or absence (control group, 81 patients) of TGCV. All of 92 patients were implanted 2nd generation DES and underwent planned follow up coronary angiography. Control patients were diagnosed of diabetes mellitus. Binary restenosis (ISR), defined as angiographic luminal diameter ≥50% by quantitative coronary angiography, target lesion revascularization (TLR), In-stent late loss and restenosis morphology were assessed in 23 stents of TGCV group and 120 stents of control group.
Results
There were no significant differences in baseline characteristics between the two groups except for the prevalence of hypertension. In-stent late loss was greater in TGCV than in control (0.45 (−0.04 to 3.33) vs. 0.15 (−0.18 to 2.75), p=0.ehz748.10067), resulting in greater incidence of ISR and TLR in TGCV than in control (34.8% vs. 10.0%, p=0.0017; 21.7% vs. 6.7%, p=0.021, respectively). On multivariable logistic regression analysis, TGCV was found to be a significant and independent predictor for ISR after 2nd generation DES implantation. Regarding restenosis morphology, diffuse and occlusive pattern of ISR, were more frequently observed in TGCV than control (87.5% and 33.3%, Fisher's exact test p=0.028).
Table 1.The 4th edition diagnostic criteria for TGCV Items Clinical findings 2 points I) BMIPP scintigraphy Wash-Out Rare <10% II) Diffuse narrowng coronary arteries 1 point III) Jordans anomaly in peripheral blood smear IV) Diabetes Decision 4 points or more → Definite TGCV
Figure 1
Conclusion
Patients with TGCV showed the greater incidence of vascular failure even after 2nd generation DES implantation, contributing to the novel risk factor for coronary intervention even in the 2nd DES era.
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Affiliation(s)
- Y Nakano
- Aichi Medical University, Nagakute, Japan
| | - M Suzuki
- Aichi Medical University, Nagakute, Japan
| | - K Waseda
- Aichi Medical University, Nagakute, Japan
| | - T Niwa
- Narita Memorial Hospital, Cardiology, Toyohashi, Japan
| | - H Ando
- Aichi Medical University, Nagakute, Japan
| | - S Sakurai
- Aichi Medical University, Nagakute, Japan
| | - M Shimoda
- Aichi Medical University, Nagakute, Japan
| | - H Ohashi
- Aichi Medical University, Nagakute, Japan
| | | | - T Amano
- Aichi Medical University, Nagakute, Japan
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Shimoda M, Ando H, Takashima H, Waseda K, Sakurai S, Suzuki A, Sawada H, Fujimoto M, Ohashi H, Amano T. P5628Resolution of incomplete stent apposition in the early phase after stent implantation: serial optical coherence tomography analyses at 2-week and 4-month. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previous optical coherence tomography (OCT) study demonstrated that the incomplete stent apposition (ISA) distance <355 μm immediately after an index procedure was the corresponding cut-off point for predicting the resolution of ISA at 8–12 months follow-up in the second-generation DES. However, the natural course of acute ISA in the earlier phase remains unknown. The aim of the present study is to evaluate the natural course of acute ISA in the early phase after second-generation everolimus-eluting stent (EES) using serial OCT analyses at 2-week and 4-month.
Methods
From the population of the ACS-OCT trial, we identified a total of 45 patients who successfully underwent serial OCT examinations at post-stenting, 2-week follow-up, and 4-month follow-up. The presence of ISA was assessed in the OCT images, and ISA distance was measured within the stented segment. The target site for OCT analysis was the cross-section at the proximal edge of implanted stent. Serial OCT images at post-stenting, 2-week follow-up and 4-month follow-up were reviewed side by side on the screen, and maximum ISA distance and cross-sectional ISA area were measured.
Results
Incomplete stent apposition was observed in all EES at post-stenting, and it was persistent in 37.8% at 2-week follow-up and 11.1% at 4-month follow-up. Maximum ISA distance was significantly decreased over time (post-stenting, 144±150mm; 2-week follow-up, 88±146mm; 4-month follow-up, 34±111mm). Receiver-operating curve analysis identified that the best cut-off value of OCT-estimated ISA distance at post-stenting for predicting persistent ISA at 2-week follow-up and 4-month follow-up was >140μm and >215μm, respectively.
ROC curve analysis
Conclusion
ISA distance at post-stenting is an useful predictor for the resolution of ISA in the early phase after EES implantation.
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Affiliation(s)
- M Shimoda
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - H Ando
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - H Takashima
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - K Waseda
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - S Sakurai
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - A Suzuki
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - H Sawada
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - M Fujimoto
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - H Ohashi
- Aichi Medical University, Cardiology, Nagakute, Japan
| | - T Amano
- Aichi Medical University, Cardiology, Nagakute, Japan
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Inoue K, Kishimoto S, Akimoto K, Sakuma M, Toyoda S, Inoue T, Yoshida K, Shimoda M, Suzuki S. Cancer-associated fibroblasts show heterogeneous gene expression and induce vascular endothelial growth factor A ( VEGFA) in response to environmental stimuli. Ann Gastroenterol Surg 2019; 3:416-425. [PMID: 31346581 PMCID: PMC6635680 DOI: 10.1002/ags3.12249] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/05/2019] [Accepted: 03/15/2019] [Indexed: 02/02/2023] Open
Abstract
AIM Cancer-associated fibroblasts (CAF) play a crucial role in angiogenesis in the complex tumor microenvironment. However, fibroblasts show extensive heterogeneity and their dynamic functions against stressors remain largely unknown. METHODS We collected patient-derived CAF and carried out perturbation-based monitoring of the dynamic functions. Clinically relevant experimental stimuli were defined as follows: hypoxia, cisplatin, fluorouracil, coculture with cancer spheroids (interaction through paracrine signals). We selected 18 marker genes that encode components for fibroblast activation, intracellular communication, and extracellular matrix remodeling. Quantitative reverse transcription polymerase chain reaction was carried out for data collection and statistical analyses were carried out using SPSS software. RESULTS Kruskal-Wallis multivariate analysis of variance showed that variations in expression of 11 marker genes were explained, in part, by a difference in tissue of origin. Friedman and two-sided Wilcoxon signed rank tests detected significant perturbations in expression of marker genes. Paracrine signal from cancer spheroids induced vascular endothelial growth factor A (VEGFA) in CAF but not in fetal lung fibroblasts. CONCLUSION We have established perturbation-based monitoring of patients' CAF. Further data collection and individual patient follow up is ongoing to identify critical determinants of disease outcome.
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Affiliation(s)
- Ken‐ichi Inoue
- Center for Research SupportDokkyo Medical UniversityMibuJapan
- Center for Regenerative MedicineDokkyo Medical University HospitalMibuJapan
| | | | - Kazumi Akimoto
- Center for Research SupportDokkyo Medical UniversityMibuJapan
| | - Masashi Sakuma
- Department for Cardiovascular MedicineDokkyo Medical UniversityMibuJapan
| | - Shigeru Toyoda
- Department for Cardiovascular MedicineDokkyo Medical UniversityMibuJapan
| | - Teruo Inoue
- Center for Research SupportDokkyo Medical UniversityMibuJapan
- Center for Regenerative MedicineDokkyo Medical University HospitalMibuJapan
- Department for Cardiovascular MedicineDokkyo Medical UniversityMibuJapan
| | - Ken‐ichiro Yoshida
- Center for Regenerative MedicineDokkyo Medical University HospitalMibuJapan
| | - Mitsugi Shimoda
- Department of Gastroenterological SurgeryIbaraki Medical CenterTokyo Medical UniversityTokyoJapan
| | - Shuji Suzuki
- Department of Gastroenterological SurgeryIbaraki Medical CenterTokyo Medical UniversityTokyoJapan
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Suzuki S, Shimoda M, Shimazaki J, Maruyama T, Oshiro Y, Nishida K, Kuroda J, Miyoshi K, Koike N, Harada N. Number of positive lymph nodes and lymphatic invasion are significant prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma. Clin Exp Gastroenterol 2019; 12:255-262. [PMID: 31239748 PMCID: PMC6559140 DOI: 10.2147/ceg.s207333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 05/02/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Early recurrence of distal cholangiocarcinoma (DCC) may result in a poorer prognosis. This study aimed to evaluate the clinicopathological factors that predict survival and recurrence in patients with DCC. Methods: Fifty-five patients with DCC who underwent pancreaticoduodenectomy between 2005 and 2015 were studied retrospectively. The following clinicopathological parameters were analyzed as predictors of disease-free survival (DFS) and overall survival (OS): sex, age, body mass index, presence of biliary tract decompression, macroscopic type, histological type, tumor size, TNM classification, lymph node metastasis ratio, number of positive lymph nodes (PLNs), lymphatic invasion, venous invasion, perineural invasion, proximal bile duct margin, dissected margin, portal system invasion, arterial system invasion, stage, and residual tumor. Results: Univariate analysis showed that contiguous extension of the primary tumor, PLN, lymphatic invasion, venous invasion, perineural invasion, and stage were significant prognostic factors for DFS and OS. Multivariate analysis revealed that PLN and lymphatic invasion were prognostic for DFS and OS (P<0.001). Significant differences in OS and DFS were found in analyses stratified by PLN (0, 1, 2 vs ≥3) and lymphatic invasion (0 vs 1, 2, 3). Conclusion: Among the clinicopathological parameters analyzed, PLN and lymphatic invasion were confirmed as prognostic factors for DCC.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Tsunehiko Maruyama
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Yukio Oshiro
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Jun Kuroda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Kenta Miyoshi
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki 300-0395, Japan
| | - Nobusada Koike
- Department of Surgery, Hachioji Digestive Disease Hospital, Tokyo 192-0903, Japan
| | - Nobuhiko Harada
- Department of Surgery, Hachioji Digestive Disease Hospital, Tokyo 192-0903, Japan
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Shimoda M, Maruyama T, Nishida K, Suzuki K, Tago T, Shimazaki J, Suzuki S. Preoperative high C-reactive protein level is associated with an increased likelihood for conversion from laparoscopic to open appendectomy in patients with acute appendicitis. Clin Exp Gastroenterol 2019; 12:141-147. [PMID: 31114285 PMCID: PMC6497831 DOI: 10.2147/ceg.s196471] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/01/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Laparoscopic appendectomy (LA) has been increasingly adopted for its advantages over the open appendectomy, but there are possibilities of conversion from laparoscopic to open appendectomy (CA) if the patients had complicated appendicitis concurrently, or when the extent of inflammation prohibits successful procedure. In this retrospective study, we aimed to clarify the preoperative predictors for CA. Patients and methods: From January 2010 to April 2016, medical records of 93 consecutive patients who underwent LA for suspected appendicitis were reviewed retrospectively. Factors evaluated were age, gender, body mass index, C-reactive protein (CRP), white cell count, albumin, Neutrophil count, lymphocyte count, Neutrophil/lymphocyte ratio, preoperative CT imaging (abscess formation: yes/no, appendicolith: yes/no), operative factors (time to operation, amount of bleeding), length of hospital stay, period until oral intake after surgery, and period from initial symptoms to surgery. Results: CA occurred in nine patients (9.7%). The reason for conversion was severe dense adhesion in two cases, inadequate exposure of appendix in two cases, uncompleted appendectomy in two cases, perforated appendicitis in one case, gangrenous appendicitis in one case, and abscess formation in one case. Based on 93 patients evaluated by preoperative CT scan, significant factors in the final multivariate analysis associated with CA was CRP [odds ratio=1.13, 95% CI:1.00–1.28, p=0.04]. Conclusion: Identifying the potential factors for conversion preoperatively may assist the surgeons in making decisions concerning the management of patients with appendicitis and in the judicious use of LA.
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Affiliation(s)
- Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Tsunehiko Maruyama
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Kazuomi Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Tomoya Tago
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan
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Shigenobu T, Ohtsuka T, Shimoda M. Pioglitazone Induces Infiltrations of Regulatory T Cells in the Tracheal Graft and Attenuates Allograft Rejection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.623] [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] Open
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27
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Suzuki S, Shimoda M, Shimazaki J, Maruyama T, Oshiro Y, Nishida K, Sahara Y, Nagakawa Y, Tsuchida A. Predictive Early Recurrence Factors of Preoperative Clinicophysiological Findings in Pancreatic Cancer. Eur Surg Res 2018; 59:329-338. [DOI: 10.1159/000494382] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/04/2018] [Indexed: 11/19/2022]
Abstract
Background: We aimed to evaluate the use of preoperative clinicophysiological parameters as predictive risk factors for early recurrence of pancreatic ductal adenocarcinoma (PDAC) after curative resection. Methods: A total of 260 patients who underwent pancreatic resection for PDAC between 2007 and 2015 were examined retrospectively. We divided the patients into those with early recurrence (within 6 months; group A, n = 52) and those with relapse within ≥6 months or without recurrence (group B, n = 208). Data regarding clinicophysiological parameters were analyzed as predictors of disease-free survival (DFS). These factors were analyzed by χ2 tests on univariate analysis and Cox proportional hazard models on multivariate analyses. Kaplan-Meier survival curves were generated using log-rank tests. Results: Groups A and B had significantly different preoperative carbohydrate antigen 19-9 (CA19-9) levels, carcinoembryonic antigen (CEA) levels, and curability. Univariate and multivariate analysis showed that CA19-9 and CEA were independent prognostic factors for early recurrence. Patients with CA19-9 levels > 124.65 U/mL had significantly shorter DFS than those with lower levels, as did patients with CEA levels > 4.45 ng/mL. Conclusions: Our results show that elevated CA19-9 (> 124.65 U/mL) and CEA (> 4.45 ng/mL) were independent predictors of early recurrence after pancreatic resection in PDAC patients.
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Nakano Y, Suzuki M, Niwa T, Suzuki A, Shimoda M, Satake A, Ando H, Takashima H, Waseda K, Amano T. P1662Impact of triglyceride deposit cardiomyovasculopathy, a novel type atherosclerosis with triglyceride deposition in coronary arteries, on neointimal proliferation after coronary stent-implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1662] [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)
- Y Nakano
- Aichi Medical University, Nagakute, Japan
| | - M Suzuki
- Aichi Medical University, Nagakute, Japan
| | - T Niwa
- Aichi Medical University, Nagakute, Japan
| | - A Suzuki
- Aichi Medical University, Nagakute, Japan
| | - M Shimoda
- Aichi Medical University, Nagakute, Japan
| | - A Satake
- Aichi Medical University, Nagakute, Japan
| | - H Ando
- Aichi Medical University, Nagakute, Japan
| | | | - K Waseda
- Aichi Medical University, Nagakute, Japan
| | - T Amano
- Aichi Medical University, Nagakute, Japan
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29
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Shimoda M, Maruyama T, Nishida K, Suzuki K, Tago T, Shimazaki J, Suzuki S. Comparison of clinical outcome of laparoscopic versus open appendectomy, single center experience. Heliyon 2018; 4:e00635. [PMID: 29872767 PMCID: PMC5986549 DOI: 10.1016/j.heliyon.2018.e00635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/26/2018] [Accepted: 05/22/2018] [Indexed: 12/15/2022] Open
Abstract
Introduction Laparoscopic appendectomy (LA) is now a treatment of choice in patients with appendicitis. This study compares the treatment outcomes of LA and open appendectomies (OA) in our department. Patients and Methods From January 2006 to April 2016 a total of 185 patients underwent appendectomy at our institution. We divided the patients into two groups; LA group (LAG) and OA group (OAG). Following parameters were analyzed: age, gender, preoperative clinicolaboratory characteristics, operative factors, interval appendectomy, length of hospital stay (LHS), and surgical site infections (SSI). Results There were 93 patients in LA G and 92 in OAG. According to the Univariate analysis, there were statistically significant differences among age (p = 0.037), LHS (p = 0.0001), duration till resuming oral intake (p = 0.016), blood loss (p = 0.038), SSI ratio (p = 0.044) and CRP level (p = 0.038) between the LAG and the OAG. According to the Multivariate analysis, blood loss (p = 0.038) and LHS (p = 0.023) were significantly different between both groups. Conclusion LA was decreasing blood loss and LHS.
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Affiliation(s)
- Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Tsunehiko Maruyama
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Kazuomi Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Tomoya Tago
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Japan
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30
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Kimura T, Obata A, Shimoda M, Hirukawa H, Kanda-Kimura Y, Nogami Y, Kohara K, Nakanishi S, Mune T, Kaku K, Kaneto H. Durability of protective effect of dulaglutide on pancreatic β-cells in diabetic mice: GLP-1 receptor expression is not reduced despite long-term dulaglutide exposure. Diabetes & Metabolism 2018. [DOI: 10.1016/j.diabet.2017.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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31
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Suzuki S, Shimoda M, Shimazaki J, Maruyama T, Nishida K. Clinical Outcome of Resected Remnant Pancreatic Cancer After Resection of the Primary Pancreatic Cancer. J INVEST SURG 2018; 32:670-678. [PMID: 29589962 DOI: 10.1080/08941939.2018.1452995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Purpose: Pancreatic cancer (PC) has high morbidity and mortality rates, with a poor prognosis and frequent recurrence. The postresection survival rate has increased but remains low, and remnant PC is becoming more common. This review evaluates the current literature pertaining to the clinical outcomes of patients with resected remnant PC. Material and Methods: We reviewed publications on remnant PC that included repeated and completion pancreatectomy. Clinicophysiological data were analyzed, and survival rates were calculated using the Kaplan-Meier method. Remnant PC was defined by negative margins at the initial operation, a cancer-free interval >1 year, and presence in the remnant pancreas. Results: Forty-nine cases of remnant PC selected from the literature were examined. Primary and remnant PCs had the same histopathological features in 29 of 45 patients (64.4%). The median disease-free interval was 44.3 months (12-143 months). The 1- and 3-year survival rates after repeat pancreatectomy were 81.5% and 50%, respectively, and the median survival time was 32 months. The age of the patient at the time of the first operation independently predicted survival in a multivariate analysis. Conclusion: In long-term survivors after curative resection for PC, resectable remnant PCs should be aggressively removed to improve prognosis.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan
| | - Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan
| | - Tsunehiko Maruyama
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University , Ibaraki , Japan
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32
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Abstract
A clear correlation between electronic structure and CO2 selectivity for steam reforming of methanol (SRM) was obtained with PdZn, PtZn, NiZn, and PdCd intermetallics on the basis of experiments and calculations. In order to rule out the effects of oxide supports, the intermetallic powders were simply prepared by alloying in an arc furnace followed by crushing in a mortar. PdZn and PdCd exhibit valence electronic densities of states similar to that of Cu and significant chemical shifts (larger than 1 eV) of Pd 3d states with respect to pure Pd, as verified by high-resolution hard X-ray photoelectron spectroscopy (HXPS) measurements and density functional theory (DFT) calculations. Consequently, they show the similar high selectivity of CO2 for the SRM reaction. However, this is not the case for PtZn and NiZn because of the slight differences in their valence electronic structures from that of PdZn. The interval between the Fermi level and the top of the d band is closely related to the selectivity of CO2 for the SRM: the larger the interval is, the higher is the selectivity of CO2. According to DFT calculations for bulk PdZn performed by Chen et al. ( Phys. Rev. B 2003 , 68 , 075417 ), the (111) and (100) surfaces exposing Zn and Pd in an equimolar ratio are more stable than the (001) or (110) surfaces terminated by alternative Zn or Pd layers. First-principles slab calculations for PdZn, PtZn, and NiZn show that bond breaking on the surface leads to a reduction in the d bandwidth but that the d band for stable (111) or (100) surfaces remains essentially unchanged from that of the bulk. It is intriguing that PdZn and PdCd do not contain Cu but show similar valence electronic structure and catalytic selectivity, and hence, a concept is proposed where PdZn and PdCd are regarded as pseudoelements of Cu. The basis of this concept is like electronic structure, like catalysis, which has been demonstrated by experiments and calculations. This is a logical way to enable us to look for new catalysts in which precious metals are partially or completely replaced by base metals. We do not expect that this concept can be applied to all catalytic reactions, but this approach is one of most promising ways to derive a better understanding of the origin of catalytic mechanisms and eventually allow us to design useful catalysts intentionally in the future. This Account reviews the authors' published works on this topic.
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Affiliation(s)
- A. P. Tsai
- Institute
of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980-8577, Japan
- National Institute for Materials Science, Tsukuba 305-0047, Japan
| | - S. Kameoka
- Institute
of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980-8577, Japan
| | - K. Nozawa
- Department
of Physics and Astronomy, Kagoshima University, Kagoshima 890-0065, Japan
| | - M. Shimoda
- National Institute for Materials Science, Tsukuba 305-0047, Japan
| | - Y. Ishii
- Department
of Physics, Chuo University, Tokyo 112-8551, Japan
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Shimoda M, Tago K, Shiraki T, Mori S, Kato M, Aoki T, Kubota K. Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection. World J Surg 2017; 40:2466-71. [PMID: 27138886 DOI: 10.1007/s00268-016-3529-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Hepatic resection is established as the treatment for HCC. However, patients sometimes experience early recurrence of HCC (ER HCC) after curative resection. METHODS A retrospective analysis was conducted for 193 patients with single HCC who underwent curative liver resection in our medical center between April 2000 and March 2013. We divided the cohort into two groups; early recurrence group (ER G) which experienced recurrence within 6 months after resection, and non-early recurrence group (NER G). Risk factors for ER HCC were analyzed. RESULTS Thirty-nine out of 193 (20.2 %) patients had ER HCC. Univariate analysis showed Glasgow prognostic score (GPS, p = 0.036), neutrophil to lymphocyte ratio (NLR, p = 0.001), level of PIVKA-II (p = 0.0001), level of AFP (p = 0.0001), amounts of blood loss (p = 0.001), operating time (p = 0.002), tumor size (p = 0.0001), stage III and IV (p = 0.0001), and microvascular invasions (portal vein: p = 0.0001 and hepatic vein: p = 0.001) to be associated with ER HCC. By multivariate analysis, there were significant differences in high NLR (p = 0.029) and high AFP (p = 0.0001) in patients with ER HCC. CONCLUSIONS Preoperative high AFP (more than 250 ng/ml) and high NLR (more than 1.829) were independent risk factors for ER HCC.
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Affiliation(s)
- Mitsugi Shimoda
- Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1, Ami, Ibaraki, 300-0395, Japan.
| | - Kazuma Tago
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Takayuki Shiraki
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Shozo Mori
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Masato Kato
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Taku Aoki
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Keiichi Kubota
- Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
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Nogawa S, Abe T, Shigematsu H, Chin Y, Nakayama T, Imai M, Tokuoka K, Oda S, Shimoda M. DWI-aspects and NIHSS at baseline predict good responsiveness to endovascular thrombectomy following thrombolysis in large cerebral vessel occlusion. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1788] [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: 11/25/2022]
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Shimoda M, Ando H, Sawada H, Naitou K, Saka Y, Suzuki A, Sakurai S, Kurita A, Waseda K, Takashima H, Amano T. P3318Acute phase vascular healing after stent implantation for patients with acute coronary syndrome: comparison of stent coverage between SYNERGY and XIENCE at 2 weeks and 4 months after implantation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3318] [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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Takashima H, Kurita A, Ando H, Sakurai S, Suzuki A, Saka Y, Sawada H, Shimoda M, Amano T. P2346Releationship between coronary plaque composition and functional lesion severity in patients with stable angina pectoris. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2346] [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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Kamei S, Kaneto H, Tanabe A, Kinoshita T, Obata A, Kimura T, Hirukawa H, Tatsumi F, Shimoda M, Kohara K, Anno T, Nakanishi S, Mune T, Kaku K. Increase in cortisol/ACTH ratio after chronic treatment with liraglutide in patients with type 2 diabetes. Diabetes Metab 2017; 43:398-399. [PMID: 28283288 DOI: 10.1016/j.diabet.2017.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
Affiliation(s)
- S Kamei
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan.
| | - H Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - A Tanabe
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - T Kinoshita
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - A Obata
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - T Kimura
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - H Hirukawa
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - F Tatsumi
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - M Shimoda
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - K Kohara
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - Takatoshi Anno
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - S Nakanishi
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - T Mune
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
| | - K Kaku
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192 Kurashiki, Japan
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Suzuki S, Kajiyama H, Shimoda M, Shimazaki J, Koike N, Harada N. Prognostic Factors Associated with Preoperative Clinicophysiological Outcomes of Distal Cholangiocarcinoma. Dig Surg 2017; 34:476-482. [PMID: 28166534 DOI: 10.1159/000456082] [Citation(s) in RCA: 7] [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] [Received: 07/11/2016] [Accepted: 01/10/2017] [Indexed: 12/10/2022]
Abstract
BACKGROUND/AIMS Although biliary tract cancer is generally associated with a high mortality rate, patients with distal cholangiocarcinoma have better prognoses, compared to those with periampullary cancer. This study aimed to determine the preoperative clinicophysiological factors predictive of survival and recurrence in patients with distal cholangiocarcinoma. METHODS Forty-five patients (34 men) with distal cholangiocarcinoma who underwent pancreaticoduodenectomy between 2005 and 2013 were examined retrospectively at our center and associated hospitals. Clinicophysiological parameters included predictors of overall survival (OS). Kaplan-Meier survival curves were generated and compared using log-rank tests, and Cox proportional hazard multivariate analyses were performed. RESULTS The mean patient age was 68.8 years (range 54-81 years). Patients had a median OS duration of 43 months, and 1-, 3-, and 5-year OS rates of 91.1, 61.1, and 40.4%, respectively. Univariate analyses indicated that the body mass index, C-reactive protein (CRP) level, and carcinoembryonic antigen level were independent prognostic factors for OS; however, only the CRP level remained an independent prognostic factor in a multivariate analysis. CONCLUSIONS A CRP level <0.3 mg/dL was predictive of a better outcome among patients with distal cholangiocarcinoma.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
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Shimoda M, Tago K, Kato M, Aoki T, Kubota K. Prognostic Factors after Curative Resection for Single-Lesion Hepatocellular Carcinoma in Patients with Normal Liver Function: A Historical Cohort Study. Dig Surg 2017; 34:281-288. [PMID: 28099960 DOI: 10.1159/000451066] [Citation(s) in RCA: 3] [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: 06/18/2016] [Accepted: 09/20/2016] [Indexed: 12/10/2022]
Abstract
BACKGROUND Hepatic resection for hepatocellular carcinoma (HCC) is now established as the treatment most likely to yield the best outcome. We aimed to clarify the risk factors for HCC recurrence after curative resection of single HCC in patients with normal liver function (NLF). METHODS The clinical records of 105 patients with NFL and a single HCC less than 5 cm in diameter who had undergone curative liver resection between April 2000 and January 2013 were investigated. We analyzed risk factors for recurrence of HCC. RESULTS Forty of the 105 patients suffered recurrence of HCC, and median recurrence-free survival (RFS) was 22.0 (5.1-148.5) months after surgery, and the liver was the most frequent site of recurrence. Univariate analysis showed that limited resection (LR; p = 0.002), the indocyanine green retention rate at 15 min (p = 0.023), C-reactive protein value (p = 0.001), bilirubin value (p = 0.042), neutrophil to lymphocyte ratio (p = 0.042), operation time (p = 0.018), and amount of bleeding (p = 0.011) were associated with RFS. Multivariate analysis showed that LR (p = 0.007) was a significant risk factor associated with RFS. CONCLUSION LR is a risk factor for HCC recurrence in patients with single-lesion HCC and NLF.
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Affiliation(s)
- Mitsugi Shimoda
- Department of Gastroenterological Surgery, Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan
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Shimazaki J, Takemura A, Nishida K, Kajiyama H, Shimoda M, Suzuki S. Heterotopic Ossification in Rectal Carcinoma: Report of a Case and Review of the Literature. Case Rep Oncol 2016; 9:698-704. [PMID: 27920705 PMCID: PMC5126607 DOI: 10.1159/000452297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 12/11/2022] Open
Abstract
Heterotopic ossification in colorectal carcinoma is extremely rare. This report presents the case of a 57-year-old male who had undergone a low anterior resection following a diagnosis of rectal carcinoma. Histological examination showed heterotopic ossification in the tumor. The patient was referred to Ibaraki Medical Center, Tokyo Medical University, with a diagnosis of rectal carcinoma by a local physician. Abdominal computed tomography revealed thickening of the rectal wall with calcified deposits, and virtual colonoscopy showed stenosis with a mass in the rectum. The patient underwent a low anterior resection and diverting ileostomy in May 2014. Histological examination of the excised tumor showed moderately differentiated adenocarcinoma and an infiltration of spindle cells with numerous foci of osteoid and ossification, with osteoblastic rimming in the stroma. Immunohistochemical analysis of these spindle cells and osteoblasts revealed negative staining for AE1/AE3, suggesting a reactive change. There was metastasis in 1 of the 12 lymph nodes, and the tumor was diagnosed as stage IIIB (T4a, N1a, M0) rectal carcinoma. The patient had an uneventful recovery and was followed up at our outpatient clinic. In conclusion, the malignant potential of heterotopic ossification in rectal carcinoma has not been determined. However, heterotopic ossification is induced by tumor progression in a microenvironment, suggesting a high tumor malignity. The patient should be carefully monitored after surgery in terms of improved patient outcome.
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Affiliation(s)
- Jiro Shimazaki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
| | - Akira Takemura
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
| | - Kiyotaka Nishida
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
| | - Hideki Kajiyama
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
| | - Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Japan
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Ishizuka M, Shibuya N, Shimoda M, Kato M, Aoki T, Kubota K. Preoperative hypoalbuminemia is an independent risk factor for conversion from laparoscopic to open cholecystectomy in patients with cholecystolithiasis. Asian J Endosc Surg 2016; 9:275-280. [PMID: 27283337 DOI: 10.1111/ases.12301] [Citation(s) in RCA: 2] [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: 01/24/2016] [Revised: 04/20/2016] [Accepted: 05/05/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Laparoscopic cholecystectomy (LC) is regarded as the first choice for patients with cholecystolithiasis, but some patients require conversion to open cholecystectomy (OC) because of inflammation-related incidents. Therefore, the aim of this study is to explore the risk factors for conversion to OC in patients undergoing elective LC for cholecystolithiasis. METHODS This study included 461 patients who underwent elective LC for cholecystolithiasis were between April 2000 and September 2010. Receiver-operator curve (ROC) analysis was used to define the ideal cut-off values of clinicolaboratory characteristics, and the area under the ROC for conversion was also measured. Univariate and multivariate analyses using preoperative clinicolaboratory characteristics were performed to investigate the most significant risk factors for conversion to OC in patients with cholecystolithiasis. RESULTS Multivariate analysis using nine parameters selected by univariate analyses demonstrated that γ-glutamyltransferase (<20/>20 IU/L) (odds ratio, 8.777; 95% confidence interval, 1.132-68.06; P = 0.038), albumin (<3.8/>3.8 g/dL) (odds ratio, 0.329; 95% confidence interval, 0.127-0.850; P = 0.022), and platelet count (<27/>27 × 104 /mm3 ) (odds ratio, 2.573; 95% confidence interval, 1.048-6.319; P = 0.039) were associated with conversion. Among these three parameters, ROC curve analysis disclosed that albumin (0.705) had the largest area under the ROC (γ-glutamyltransferase, 0.622, platelet count, 0.536) for conversion. CONCLUSIONS Preoperative hypoalbuminemia is the most important risk factor for conversion to OC in patients undergoing elective LC for cholecystolithiasis.
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Affiliation(s)
- Mitsuru Ishizuka
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
| | - Norisuke Shibuya
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Masato Kato
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Taku Aoki
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Keiichi Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
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Suzuki S, Kajiyama H, Takemura A, Shimazaki J, Nishida K, Shimoda M. The Clinical Outcomes after Total Pancreatectomy. Dig Surg 2016; 34:142-150. [PMID: 27701159 DOI: 10.1159/000449234] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 02/18/2016] [Accepted: 08/17/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Total pancreatectomy (TP) is not more beneficial than less aggressive resection techniques for the treatment of pancreatic neoplasms and is associated with high morbidity and mortality. However, with advances in surgical techniques and glycemic monitoring, and the development of synthetic insulin and pancreatic enzymes for postoperative treatment, TP has been increasingly indicated. This is a review of the recent literature reporting the clinical outcomes after TP. METHODS We reviewed the publications reporting the use of TP starting 2007. The clinicophysiological and survival data were analyzed. RESULTS Few studies evaluated the differences in clinical outcomes between TP and pancreaticoduodenectomy (PD) with inconsistent results. It was reported that while the perioperative morbidity did not decrease, the mortality decreased compared to previous literature. All patients who underwent TP required insulin and high dose of pancreatic enzyme supplements. The 5-year survival rates after TP and PD for pancreatic cancer were similar. CONCLUSION The perioperative mortality decreased in patients who underwent TP with advances in the operative procedures and perioperative care. The long-term survival rates were similar for TP and PD. Therefore, treating pancreatic neoplasms using TP is feasible. Patients undergoing TP should receive adequate treatment with synthetic insulin and pancreatic enzyme supplements.
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Affiliation(s)
- Shuji Suzuki
- Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan
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Matsumoto T, Kubota K, Aoki T, Iso Y, Kato M, Shimoda M. Clinical Impact of Anatomical Liver Resection for Hepatocellular Carcinoma with Pathologically Proven Portal Vein Invasion. World J Surg 2016; 40:402-11. [PMID: 26306893 DOI: 10.1007/s00268-015-3231-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Portal vein invasion (PVI) is known to be a poor prognostic factor for hepatocellular carcinoma (HCC) patients. Anatomical liver resection (ALR) is a preferable procedure for treating HCC. However, the effect of ALR for HCC with PVI has not been fully evaluated. The aim of this study is to investigate the survival benefit of ALR for HCC patients with or without pathologically proven portal vein invasion (pPVI). METHODS Curative hepatic resection was performed for a single HCC in 313 patients. The patients were divided into two groups according to the absence or presence of pPVI (absence: n = 216, presence: n = 97). These groups were then subclassified by the surgical procedures employed (ALR or non-ALR), and the clinical characteristics and stratified prognoses were compared according to the surgical procedure between the subgroups. Uni- and multivariate analyses were performed to explore the significant prognostic factors. RESULTS Among the patients without pPVI, there was no significant difference in postoperative survival between the groups. However, among the patients with pPVI, both the 5-year overall and recurrence-free survival rates in the ALR group were significantly higher than those in the non-ALR group (46.1 % vs. 16.3 %; p = 0.0019 and 33.8 % vs. 0 %; p = 0.0010). Multivariate analyses revealed that tumor differentiation and intraoperative blood loss (IOB) were associated with postoperative survival in patients without pPVI. On the other hand, in patients with pPVI, ALR, serum AFP level, and IOB were associated with postoperative survival. CONCLUSION ALR confers a survival benefit for HCC patients with pPVI.
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Affiliation(s)
- Takatsugu Matsumoto
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
| | - Keiichi Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Taku Aoki
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Yukihiro Iso
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Masato Kato
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
| | - Mitsugi Shimoda
- Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
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Ishizuka M, Kubota K, Nemoto T, Shimoda M, Kato M, Iso Y, Tago K. Administration of adjuvant oral tegafur/uracil chemotherapy post hepatocellular carcinoma resection: A randomized controlled trial. Asian J Surg 2016; 39:149-54. [DOI: 10.1016/j.asjsur.2015.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 03/16/2015] [Accepted: 04/01/2015] [Indexed: 12/15/2022] Open
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Shimoda M, Oda S, Hirayama A, Imai M, Komatsu F, Hoshikawa K, Shigematsu H, Nishiyama J, Osada T. Centripetal Propagation of Vasoconstriction at the Time of Headache Resolution in Patients with Reversible Cerebral Vasoconstriction Syndrome. AJNR Am J Neuroradiol 2016; 37:1594-8. [PMID: 27079368 DOI: 10.3174/ajnr.a4768] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/05/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reversible cerebral vasoconstriction syndrome is characterized by thunderclap headache and diffuse segmental vasoconstriction that resolves spontaneously within 3 months. Previous reports have proposed that vasoconstriction first involves small distal arteries and then progresses toward major vessels at the time of thunderclap headache remission. The purpose of this study was to confirm centripetal propagation of vasoconstriction on MRA at the time of thunderclap headache remission compared with MRA at the time of reversible cerebral vasoconstriction syndrome onset. MATERIALS AND METHODS Of the 39 patients diagnosed with reversible cerebral vasoconstriction syndrome at our hospital during the study period, participants comprised the 16 patients who underwent MR imaging, including MRA, within 72 hours of reversible cerebral vasoconstriction syndrome onset (initial MRA) and within 48 hours of thunderclap headache remission. RESULTS In 14 of the 16 patients (87.5%), centripetal propagation of vasoconstriction occurred from the initial MRA to remission of thunderclap headache, with typical segmental vasoconstriction of major vessels. These mainly involved the M1 portion of the MCA (10 cases), P1 portion of the posterior cerebral artery (10 cases), and A1 portion of the anterior cerebral artery (5 cases). CONCLUSIONS This study found evidence of centripetal propagation of vasoconstriction on MRA obtained at the time of thunderclap headache remission, compared with MRA obtained at the time of reversible cerebral vasoconstriction syndrome onset. If clinicians remain unsure of the diagnosis during early-stage reversible cerebral vasoconstriction syndrome, this time point represents the best opportunity to diagnose reversible cerebral vasoconstriction syndrome with confidence.
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Affiliation(s)
- M Shimoda
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - S Oda
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - A Hirayama
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - M Imai
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - F Komatsu
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - K Hoshikawa
- From the Department of Neurosurgery (M.S., S.O., A.H., M.I., F.K., K.H.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - H Shigematsu
- Department of Neurosurgery (H.S., J.N., T.O.), Tokai University School of Medicine, Kanagawa, Japan
| | - J Nishiyama
- Department of Neurosurgery (H.S., J.N., T.O.), Tokai University School of Medicine, Kanagawa, Japan
| | - T Osada
- Department of Neurosurgery (H.S., J.N., T.O.), Tokai University School of Medicine, Kanagawa, Japan
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Shimoda M, Nishimukai A, Shibata N, Kikuchi W, Hutawatari H, Ishihara H, Miyoshi Y, Noguchi S. Abstract P2-08-27: Prediction of bone metastases of breast cancer using combined markers of bone metabolism and inflammation. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-08-27] [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: 11/16/2022]
Abstract
Abstract
Introduction
Luminal breast cancer patients show a relatively favorable prognosis when treated with adjuvant hormonal therapy alone. However, some of these patients develop recurrence and they might derive benefit from adjuvant chemotherapy. Although several genomic profilings successfully developed to decide whether to administer adjuvant chemotherapy, clinically practical prediction methods of recurrence sites do not exist. Our previous study showed a possible prediction of bone metastases by using two serum markers; TRACP-5b as a marker of bone metabolism; likelihood of bone metastases, and CRP as a marker of inflammation; likelihood of distant recurrence. The incidence of bone metastases was significantly higher in high risk patients(+/+) than in the others(odds ratio: 10.9, P=0.040). In this study, we examined the potential of the two-marker prediction in the newly enrolled luminal patients.
Patients and methods
One hundred sixty luminal patients who underwent surgery were enrolled in this study. Their serum levels of TRACP-5b and CRP were measured in a blinded manner at the R & D laboratory of Nittobo Medical Co., Ltd. In the preliminary study, we identified that the median value of TRACP-5b in the premenopausal patients was lower than in the postmenopausal patients. We adjusted the value of TRACP-5b in the premenopausal patients and the cutoff value of TRACP-5b from 334 to 396mU/dL. The cutoff value of CRP was same as previous study(0.016 mg/dL). The odds ratio between +/+ and the others were calculated using MedCalc statistical software.
Results
One hundred sixty patients stratified into four classes according to the value of TRACP-5b and CRP: +/+ (n=43), +/- (n=38), -/+ (n=42) and -/- (n=37). Six of the 160 patients developed bone metastases as the initial site of replase within five years from surgery. The Incidence of bone metastases was 9.3%(4/43) in the +/+ patients and 1.7%(2/117) in the others. The incidence was significantly higher in the +/+ patients than in the others(odds ratio: 5.9, 95% CI 1.31 to 33.46, p= 0.045). When the other relapses than bone metastases were included in the analysis, no significant difference was observed between the two groups (odds ratio: 0.4, 95% CI 0.02 to 7.43, P=0.521). TRACP-5b concentration alone could not classify the patients into two groups according to significantly different incidences of bone metastases(odds ratio: 13.7, 95% CI 0.76 to 247.22, P=0.076).
Conclusion
The results in here show that the prediction of bone metastases by the combination of TRACP-5b and CRP concentrations is clinically relevant in the luminal patients. Reliable prediction of bone metastases would be realized by combination of our prediction method and one of genomic profilings. We plan to increase the number of patients to provide sufficient statistical power to confirm this diagnostic potential.
Citation Format: Shimoda M, Nishimukai A, Shibata N, Kikuchi W, Hutawatari H, Ishihara H, Miyoshi Y, Noguchi S. Prediction of bone metastases of breast cancer using combined markers of bone metabolism and inflammation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-27.
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Affiliation(s)
- M Shimoda
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - A Nishimukai
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - N Shibata
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - W Kikuchi
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - H Hutawatari
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - H Ishihara
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - Y Miyoshi
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
| | - S Noguchi
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; Nittobo Medical Co., Ltd, Koriyama, Fukushima, Japan
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Shimoda M, Chihara Y, Kagara N, Naoi Y, Shimomura A, Shimazu K, Kim SJ, Noguchi S. Abstract P3-06-05: Importance of TGFβ-SMAD3 axis in resistance to anti-HER2 drugs. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-06-05] [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: 11/16/2022]
Abstract
Abstract
Aim: The aim of this study was to elucidate the role of transforming growth factor β (TGFβ) in the resistance of HER2-positive breast cancer cells to anti-HER2 drugs including trastuzumab and lapatinib.
Methods: A HER2-positive breast cancer cell line, SKBR3, was cultured in the presence or absence of TGFβ for 14 days. Subsequently, TGFβ-treated cells were cultured for seven days with or without the anti-HER2 drugs. Sensitivity to trastuzumab and lapatinib was estimated by the WST-8 cell viability assay or absolute cell counts using In Cell Analyzer (GE Healthcare). Proportion of CD44+ CD24– breast cancer stem cells was estimated by flow cytometry of cells immunostained with anti-CD44 and anti-CD24 antibodies. For clinical study, 33 patients with HER2-positive breast cancer receiving neoadjuvant paclitaxel plus trastuzumab in our institution were analyzed. Among the cases, 27 biopsy samples obtained before any treatment from 27 patients who completed 12 cycles of weekly paclitaxel and trastuzumab were subjected to CD24 immunohistochemistry.
Results: SKBR3 cells cultured with TGFβ for 14 days exhibited decreased sensitivity to both trastuzumab and lapatinib. Time course study revealed that continuous stimulation for 14 days with TGFβ was required for the resistance to anti-HER2 drugs. Activation of SMAD3, a downstream target molecule of TGFβ, was enhanced over time, judged by the increase in phosphorylation and in nuclear translocation. During 14 day culture with TGFβ, proportion of CD44+ CD24– cells were dramatically increased, and mammosphere formation, another marker of breast cancer stem cells, was significantly enhanced compared to cells treated without TGFβ. Among four HER2-positive breast cancer cell lines, only SKBR3 cells showed increased proportion of CD44+ CD24– cells and resistance to the anti-HER2 drugs, while other two cell lines exhibited epithelial-mesenchymal transition (EMT) in response to TGFβ. To explore the possibility of targeting TGFβ-SMAD3 axis to overcome resistance to anti-HER2 therapy, we used SIS3, a specific inhibitor of SMAD3. Importantly, SIS3 completely restored the sensitivity to both trastuzumab and lapatinib of TGFβ-treated SKBR3 cells, with the decrease in the proportion of CD44+ CD24– cells. These in vitro results suggest that CD24 downregulation can be a surrogate marker of resistance to anti-HER2 therapy. To establish this, we evaluated the CD24 expression in tumor samples of breast cancer patients who received paclitaxel plus trastuzumab in the neoadjuvant setting. Weak CD24 expression in tumor cells in biopsy samples obtained before any treatment was significantly correlated with poorer response to the drugs.
Conclusion: These data clearly indicate the importance of TGFβ-SMAD3 axis in the acquired resistance to anti-HER2 drugs. Moreover, resistance to anti-HER2 therapy is associated with the property of breast cancer stem cells rather than EMT. Targeting TGFβ-SMAD3 axis warrants further investigation for overcoming resistance to anti-HER2 therapeutics.
Citation Format: Shimoda M, Chihara Y, Kagara N, Naoi Y, Shimomura A, Shimazu K, Kim SJ, Noguchi S. Importance of TGFβ-SMAD3 axis in resistance to anti-HER2 drugs. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-06-05.
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Affiliation(s)
- M Shimoda
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Y Chihara
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - N Kagara
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Y Naoi
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - A Shimomura
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - K Shimazu
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - SJ Kim
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - S Noguchi
- Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Oda S, Shimoda M, Hirayama A, Imai M, Komatsu F, Shigematsu H, Nishiyama J, Matsumae M. Reply: To PMID 25977479. AJNR Am J Neuroradiol 2015; 36:E64. [PMID: 26185327 DOI: 10.3174/ajnr.a4480] [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: 11/07/2022]
Affiliation(s)
- S Oda
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - M Shimoda
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - A Hirayama
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - M Imai
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - F Komatsu
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - H Shigematsu
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - J Nishiyama
- Department of Neurosurgery Tokai University Hachioji Hospital Tokyo, Japan
| | - M Matsumae
- Department of Neurosurgery Tokai University School of Medicine Kanagawa, Japan
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Hamamoto S, Kaneto H, Kamei S, Shimoda M, Tawaramoto K, Kanda-Kimura Y, Kawasaki F, Hashiramoto M, Matsuki M, Mune T, Kaku K. Low bilirubin levels are an independent risk factor for diabetic retinopathy and nephropathy in Japanese patients with type 2 diabetes. Diabetes Metab 2015; 41:429-31. [PMID: 26054296 DOI: 10.1016/j.diabet.2015.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 05/07/2015] [Accepted: 05/10/2015] [Indexed: 11/17/2022]
Affiliation(s)
- S Hamamoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - H Kaneto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
| | - S Kamei
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Shimoda
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - K Tawaramoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - Y Kanda-Kimura
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - F Kawasaki
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Hashiramoto
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - M Matsuki
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - T Mune
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
| | - K Kaku
- Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan
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Oda S, Shimoda M, Hirayama A, Imai M, Komatsu F, Shigematsu H, Nishiyama J, Matsumae M. Neuroradiologic Diagnosis of Minor Leak prior to Major SAH: Diagnosis by T1-FLAIR Mismatch. AJNR Am J Neuroradiol 2015; 36:1616-22. [PMID: 25977479 DOI: 10.3174/ajnr.a4325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 02/09/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In major SAH, the only method to diagnose a preceding minor leak is to ascertain the presence of a warning headache by interview; however, poor clinical condition and recall bias can cause inaccuracy. We devised a neuroradiologic method to diagnose previous minor leak in patients with SAH and attempted to determine whether warning (sentinel) headaches were associated with minor leaks before major SAH. MATERIALS AND METHODS We retrospectively evaluated 127 patients who were admitted with SAH within 48 hours of ictus. Previous minor leak before major SAH was defined as T1WI-detected clearly bright hyperintense subarachnoid blood accompanied by SAH blood on FLAIR images that was distributed over a larger area than bright hyperintense subarachnoid blood on T1WI (T1-FLAIR mismatch). RESULTS The incidence of warning headache before SAH was 11.0% (14 of 127 patients, determined by interview). The incidence of T1-FLAIR mismatch (neuroradiologic diagnosis of minor leak before major SAH) was 33.9% (43 of 127 patients). Of the 14 patients with warning headache, 13 had a minor leak diagnosed by T1-FLAIR mismatch at the time of admission. Variables identified by multivariate analysis as significantly associated with minor leak diagnosed by T1-FLAIR mismatch included 80 years of age or older, rebleeding after admission, intracerebral hemorrhage on CT, and mRS scores of 3-6. CONCLUSIONS We conclude that warning headaches diagnosed by interview are not a product of recall bias but are the result of actual leaks from aneurysms.
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Affiliation(s)
- S Oda
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - M Shimoda
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - A Hirayama
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - M Imai
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - F Komatsu
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - H Shigematsu
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - J Nishiyama
- From the Department of Neurosurgery (S.O., M.S., A.H., M.I., F.K., H.S., J.N.), Tokai University Hachioji Hospital, Tokyo, Japan
| | - M Matsumae
- Department of Neurosurgery (M.M.), Tokai University School of Medicine, Kanagawa, Japan
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