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Tomosugi N, Koshino Y, Ogawa C, Maeda K, Shimada N, Tomita K, Daimon S, Shikano T, Ryu K, Takatani T, Sakamoto K, Ueyama S, Nagasaku D, Nakamura M, Ra S, Nishimura M, Takagi C, Ishii Y, Kudo N, Takechi S, Ishizu T, Yanagawa T, Fukuda M, Nitta Y, Yamaoka T, Saito T, Imayoshi S, Omata M, Oshima J, Onozaki A, Ichihashi H, Matsushima Y, Takae H, Nakazawa R, Ikeda K, Tsuboi M, Konishi K, Kato S, Ooura M, Koyama M, Naganuma T, Ogi M, Katayama S, Okumura T, Kameda S, Shirai S. Oral Iron Absorption of Ferric Citrate Hydrate and Hepcidin-25 in Hemodialysis Patients: A Prospective, Multicenter, Observational Riona-Oral Iron Absorption Trial. Int J Mol Sci 2023; 24:13779. [PMID: 37762085 PMCID: PMC10531220 DOI: 10.3390/ijms241813779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/27/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
Oral ferric citrate hydrate (FCH) is effective for iron deficiencies in hemodialysis patients; however, how iron balance in the body affects iron absorption in the intestinal tract remains unclear. This prospective observational study (Riona-Oral Iron Absorption Trial, R-OIAT, UMIN 000031406) was conducted at 42 hemodialysis centers in Japan, wherein 268 hemodialysis patients without inflammation were enrolled and treated with a fixed amount of FCH for 6 months. We assessed the predictive value of hepcidin-25 for iron absorption and iron shift between ferritin (FTN) and red blood cells (RBCs) following FCH therapy. Serum iron changes at 2 h (ΔFe2h) after FCH ingestion were evaluated as iron absorption. The primary outcome was the quantitative delineation of iron variables with respect to ΔFe2h, and the secondary outcome was the description of the predictors of the body's iron balance. Generalized estimating equations (GEEs) were used to identify the determinants of iron absorption during each phase of FCH treatment. ΔFe2h increased when hepcidin-25 and TSAT decreased (-0.459, -0.643 to -0.276, p = 0.000; -0.648, -1.099 to -0.197, p = 0.005, respectively) in GEEs. FTN increased when RBCs decreased (-1.392, -1.749 to -1.035, p = 0.000) and hepcidin-25 increased (0.297, 0.239 to 0.355, p = 0.000). Limiting erythropoiesis to maintain hemoglobin levels induces RBC reduction in hemodialysis patients, resulting in increased hepcidin-25 and FTN levels. Hepcidin-25 production may prompt an iron shift from RBC iron to FTN iron, inhibiting iron absorption even with continued FCH intake.
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Affiliation(s)
- Naohisa Tomosugi
- Division of Systems Bioscience for Drug Discovery, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku 920-0293, Ishikawa, Japan
| | | | - Chie Ogawa
- Maeda Institute of Renal Research Musashikosugi, Kawasaki 211-0063, Kanagawa, Japan;
| | - Kunimi Maeda
- Maeda Institute of Renal Research Shakujii, Nerima 177-0041, Tokyo, Japan;
| | | | - Kimio Tomita
- The Chronic Kidney Disease Research Center, Tomei Atsugi General Hospital, Atsugi 243-8571, Kanagawa, Japan;
| | - Shoichiro Daimon
- Department of Nephrology, Daimon Clinic for Internal Medicine, Nonoichi 921-8802, Ishikawa, Japan;
| | - Tsutomu Shikano
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Kazuyuki Ryu
- Kyoto Okamoto Memorial Hospital, Kuze 613-0034, Kyoto, Japan; (T.S.); (K.R.)
| | - Toru Takatani
- Nephrology Division, Tojinkai Hospital, Fushimi 612-8026, Kyoto, Japan;
| | - Kazuya Sakamoto
- Department of Urology, Tomakomai Nisshou Hospital, Tomakomai 053-0803, Hokkaido, Japan;
| | - Satonori Ueyama
- Jinaikai Ueyama Hospital, Kagoshima 890-0073, Kagoshima, Japan;
| | | | | | - Shibun Ra
- Noheji Clinic, Noheji 039-3152, Aomori, Japan;
| | | | | | - Yoji Ishii
- Nozatomon Clinic, Himeji 670-0011, Hyogo, Japan;
| | | | | | - Takashi Ishizu
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | - Takamoto Yanagawa
- Department of Nephrology, Tsukuba Central Hospital, Ushiku 300-1211, Ibaraki, Japan; (T.I.); (T.Y.)
| | | | - Yutaka Nitta
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Takayuki Yamaoka
- The Department of Nephrology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan; (Y.N.); (T.Y.)
| | - Taku Saito
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Suzuko Imayoshi
- Saito Memorial Hospital, Kawaguchi 332-0034, Saitama, Japan; (T.S.); (S.I.)
| | - Momoyo Omata
- Department of Internal Medicine, Hachioji Azumacho Clinic, Hachioji-shi 192-0082, Tokyo, Japan;
| | - Joji Oshima
- Kubojima Clinic, Kumagaya 360-0831, Saitama, Japan;
| | - Akira Onozaki
- Tokatsu-Clinic Hospital, Matsudo 271-0067, Chiba, Japan;
| | | | | | | | | | - Koichi Ikeda
- Tokatsu Clinic Koiwa, Edogawa 133-0056, Tokyo, Japan;
| | - Masato Tsuboi
- Kaikoukai Anjo Kyoritsu Clinic, Anjo 446-0065, Aichi, Japan;
| | | | - Shouzaburo Kato
- Nishi Interchange Clinic for Internal Medicine and Dialysis, Kanazawa 921-8001, Ishikawa, Japan;
| | - Maki Ooura
- Maro Clinic, Tanabe 646-0004, Wakayama, Japan;
| | | | - Tsukasa Naganuma
- Department of Nephrology, Yamanashi Prefectural Central Hospital, Kofu 400-0027, Yamanashi, Japan;
| | - Makoto Ogi
- Department of Internal Medicine, Yuurinkouseikai Fuji Hospital, Gotemba 412-0043, Shizuoka, Japan;
| | | | | | - Shigemi Kameda
- Joetsu General Hospital, Joetsu 943-8507, Niigata, Japan;
| | - Sayuri Shirai
- Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University Yokohama Seibu Hospital, Yokohama 241-0811, Kanagawa, Japan;
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2
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Rimini M, Rimassa L, Ueshima K, Burgio V, Shigeo S, Tada T, Suda G, Yoo C, Cheon J, Pinato DJ, Lonardi S, Scartozzi M, Iavarone M, Di Costanzo GG, Marra F, Soldà C, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Pressiani T, Nishida N, Iwamoto H, Sakamoto N, Ryoo BY, Chon HJ, Claudia F, Niizeki T, Sho T, Kang B, D'Alessio A, Kumada T, Hiraoka A, Hirooka M, Kariyama K, Tani J, Atsukawa M, Takaguchi K, Itobayashi E, Fukunishi S, Tsuji K, Ishikawa T, Tajiri K, Ochi H, Yasuda S, Toyoda H, Ogawa C, Nishimur T, Hatanaka T, Kakizaki S, Shimada N, Kawata K, Tanaka T, Ohama H, Nouso K, Morishita A, Tsutsui A, Nagano T, Itokawa N, Okubo T, Arai T, Imai M, Naganuma A, Koizumi Y, Nakamura S, Joko K, Iijima H, Hiasa Y, Pedica F, De Cobelli F, Ratti F, Aldrighetti L, Kudo M, Cascinu S, Casadei-Gardini A. Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis. ESMO Open 2022; 7:100591. [PMID: 36208496 PMCID: PMC9808460 DOI: 10.1016/j.esmoop.2022.100591] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. MATERIALS AND METHODS We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population. RESULTS One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed. CONCLUSIONS The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.
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Affiliation(s)
- M Rimini
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - L Rimassa
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - K Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - V Burgio
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - S Shigeo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Cheon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - D J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - S Lonardi
- Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Scartozzi
- Medical Oncology, University and University Hospital of Cagliari, Cagliari, Italy
| | - M Iavarone
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | | | - F Marra
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy
| | - C Soldà
- Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - E Tamburini
- Department of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy
| | - F Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - G Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - F G Foschi
- Internal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy
| | - M Silletta
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - T Pressiani
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - N Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - H Iwamoto
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H J Chon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - F Claudia
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B Kang
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - A D'Alessio
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - M Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - J Tani
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - E Itobayashi
- Department of Gastroenterology, Asahi General Hospital, Asahi, Japan
| | - S Fukunishi
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - T Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - H Ochi
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - S Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - C Ogawa
- Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan
| | - T Nishimur
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - T Hatanaka
- Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan
| | - S Kakizaki
- Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
| | - K Kawata
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Tanaka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Ohama
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - A Morishita
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - A Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - N Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - A Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Y Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - S Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - K Joko
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - H Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Y Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - F Pedica
- Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F De Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - F Ratti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Aldrighetti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - S Cascinu
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - A Casadei-Gardini
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
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Tamiya M, Goto Y, Kenmotsu H, Kurata T, Murakami S, Yanagitani N, Taniguchi H, Kuyama S, Shimizu J, Yokoyama T, Shimada N, T. M, Tamiya A, Uchiyama A, Imaizumi K, Takahama T, Nishio M, Hayashi H, Shiraiwa N, Okura M, Kikkawa H, Thomaidou D, Kato T. EP08.02-115 A Retrospective, Multicenter, Observational Study to Evaluate Outcomes With Lorlatinib After Alectinib in ALK+ NSCLC in Japan. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.798] [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: 10/14/2022]
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Rimini M, Kudo M, Tada T, Shigeo S, Kang W, Suda G, Jefremow A, Burgio V, Iavarone M, Tortora R, Marra F, Lonardi S, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Kumada T, Iwamoto H, Aoki T, Goh MJ, Sakamoto N, Siebler J, Hiraoka A, Niizeki T, Ueshima K, Sho T, Atsukawa M, Hirooka M, Tsuji K, Ishikawa T, Takaguchi K, Kariyama K, Itobayashi E, Tajiri K, Shimada N, Shibata H, Ochi H, Yasuda S, Toyoda H, Fukunishi S, Ohama H, Kawata K, Tani J, Nakamura S, Nouso K, Tsutsui A, Nagano T, Takaaki T, Itokawa N, Okubo T, Arai T, Imai M, Joko K, Koizumi Y, Hiasa Y, Cucchetti A, Ratti F, Aldrighetti L, Cascinu S, Casadei-Gardini A. Nonalcoholic steatohepatitis in hepatocarcinoma: new insights about its prognostic role in patients treated with lenvatinib. ESMO Open 2021; 6:100330. [PMID: 34847382 PMCID: PMC8710492 DOI: 10.1016/j.esmoop.2021.100330] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) treatment remains a big challenge in the field of oncology. The liver disease (viral or not viral) underlying HCC turned out to be crucial in determining the biologic behavior of the tumor, including its response to treatment. The aim of this analysis was to investigate the role of the etiology of the underlying liver disease in survival outcomes. PATIENTS AND METHODS We conducted a multicenter retrospective study on a large cohort of patients treated with lenvatinib as first-line therapy for advanced HCC from both Eastern and Western institutions. Univariate and multivariate analyses were performed. RESULTS Among the 1232 lenvatinib-treated HCC patients, 453 (36.8%) were hepatitis C virus positive, 268 hepatitis B virus positive (21.8%), 236 nonalcoholic steatohepatitis (NASH) correlate (19.2%) and 275 had other etiologies (22.3%). The median progression-free survival (mPFS) was 6.2 months [95% confidence interval (CI) 5.9-6.7 months] and the median overall survival (mOS) was 15.8 months (95% CI 14.9-17.2 months). In the univariate analysis for OS NASH-HCC was associated with longer mOS [22.2 versus 15.1 months; hazard ratio (HR) 0.69; 95% CI 0.56-0.85; P = 0.0006]. In the univariate analysis for PFS NASH-HCC was associated with longer mPFS (7.5 versus 6.5 months; HR 0.84; 95% CI 0.71-0.99; P = 0.0436). The multivariate analysis confirmed NASH-HCC (HR 0.64; 95% CI 0.48-0.86; P = 0.0028) as an independent prognostic factor for OS, along with albumin-bilirubin (ALBI) grade, extrahepatic spread, neutrophil-to-lymphocyte ratio, portal vein thrombosis, Eastern Cooperative Oncology Group (ECOG) performance status and alpha-fetoprotein. An interaction test was performed between sorafenib and lenvatinib cohorts and the results highlighted the positive predictive role of NASH in favor of the lenvatinib arm (P = 0.0047). CONCLUSION NASH has been identified as an independent prognostic factor in a large cohort of patients with advanced HCC treated with lenvatinib, thereby suggesting the role of the etiology in the selection of patients for tyrosine kinase treatment. If validated, this result could provide new insights useful to improve the management of these patients.
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Affiliation(s)
- M Rimini
- Department of Oncology and Hematology, Division of Oncology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - S Shigeo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - W Kang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - G Suda
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - A Jefremow
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Erlangen, Germany
| | - V Burgio
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - M Iavarone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Division of Gastroenterology and Hepatology, Milan, Italy
| | - R Tortora
- Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy
| | - F Marra
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - S Lonardi
- Medical Oncology Unit 3, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - E Tamburini
- Department of Medical Oncology, Card. G. Panico Hospital of Tricase, Tricase, Italy
| | - F Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Masi
- Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | - G Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - F G Foschi
- Azienda Unità Sanitaria della Romagna, Ospedale degli Infermi, Faenza, Italy
| | - M Silletta
- Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy
| | - T Kumada
- Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - H Iwamoto
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - T Aoki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - M J Goh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - J Siebler
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Erlangen, Germany
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - K Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - K Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - T Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - K Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - E Itobayashi
- Department of Gastroenterology, Asahi General Hospital, Asahi, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
| | - H Shibata
- Department of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - H Ochi
- Hepato-biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - S Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - S Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - H Ohama
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - K Kawata
- Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - J Tani
- Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa, Japan
| | - S Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - K Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - A Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Takaaki
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - N Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Joko
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Koizumi
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Hiasa
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - A Cucchetti
- Department of Medical and Surgical Sciences-DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Department of Surgery, Morgagni - Pierantoni Hospital, Forlì, Italy
| | - F Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - S Cascinu
- Vita-Salute San Raffaele University, Milan, Italy; Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - A Casadei-Gardini
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
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5
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Aizawa N, Konishi M, Kitai T, Tsujisaka Y, Kawase Y, Shimada N, Tamura K, Kimura K, Ohya Y. Infrequent use of nighttime dialysis for emergency admission due to worsening heart failure in patients on maintenance hemodialysis. Ther Apher Dial 2021; 26:85-93. [PMID: 33686756 DOI: 10.1111/1744-9987.13644] [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: 12/14/2020] [Revised: 02/22/2021] [Accepted: 03/06/2021] [Indexed: 11/30/2022]
Abstract
In the emergency admission due to worsening heart failure (HF) in patients on maintenance hemodialysis, emergent dialysis may be indicated, which increases personnel expenses. To clarify the characteristics and in-hospital management of the patients, we conducted a multicenter retrospective study including 142 patients on maintenance hemodialysis emergently admitted for worsening HF (71.6 ± 9.2 years, 69.0% male, 44.4% HF with preserved [≥50%] ejection fraction). The interval between last hemodialysis and admission was long (median 55 h), suggesting that fluid accumulation triggered HF events. Although most patients (73.9%) were admitted in the nighttime (5 p.m. to 9 a.m.), only 17.9% of them needed nighttime dialysis and were managed medically until the first in-hospital dialysis, with the use of noninvasive positive pressure ventilation in 45.1% and oxygen supplementation in 95.8%. While patients on hemodialysis with worsening HF were frequently admitted in the nighttime, nighttime dialysis was indicated in a limited population.
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Affiliation(s)
- Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan
| | - Masaaki Konishi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuta Tsujisaka
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuichi Kawase
- Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Noriaki Shimada
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan
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6
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Shimada N, Shimada H, Itaya Y, Tomino Y. Novel coronavirus disease in patients with end-stage kidney disease. Ther Apher Dial 2020; 25:544-550. [PMID: 33040443 PMCID: PMC7675310 DOI: 10.1111/1744-9987.13599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022]
Abstract
The novel coronavirus disease outbreak started in Wuhan, China, in December 2019 and has since spread rapidly worldwide. As almost all patients with end‐stage kidney disease have been treated with HD in Japan, they have a higher risk of infection than the healthy population. Moreover, the complications of renal failure, such as hypertension and cardiovascular diseases, appear to be a risk factor of death owing to novel coronavirus disease. The reported morbidity and mortality rates of novel coronavirus disease are significantly higher in dialysis patients than in the healthy population. No treatment for novel coronavirus disease has yet been developed; thus, countermeasures to prevent the spread of coronavirus disease in dialysis facilities must be rapidly established. The latest findings on novel coronavirus disease in patients with end‐stage kidney disease and the guidelines for countermeasures against the spread of novel coronavirus disease worldwide are summarized in this review.
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Affiliation(s)
| | - Hiroaki Shimada
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan
| | - Yoshiaki Itaya
- Medical Corporation JISEIKAI Tachibana Clinic, Tokyo, Japan
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7
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Nishikawa M, Shimada N, Kawazoe T, Sawaki R, Ikuta H, Kanzaki M, Fukuoka K, Fukushima M, Asano K. Long-term Successful Treatment of Rituximab for Steroid-resistant Minimal Change Nephrotic Syndrome and Idiopathic Thrombocytopenic Purpura. Intern Med 2020; 59:983-986. [PMID: 31866629 PMCID: PMC7184077 DOI: 10.2169/internalmedicine.3837-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A 22-year-old woman had been diagnosed with idiopathic thrombocytopenic purpura (ITP) 5 years earlier. After undergoing splenectomy, she relapsed frequently following prednisolone tapering. She was complicated with minimal change nephrotic syndrome (MCNS) while taking 20 mg of prednisolone. Despite treatment with prednisolone, cyclosporin and low-density lipoprotein-apheresis, MCNS and ITP did not improve. We added rituximab in 4 weekly infusions of 375 mg/m2. MCNS and ITP were in complete remission. After administering rituximab once, all medicines were discontinued. No relapse had occurred by 50 months following the first rituximab administration. Rituximab affects steroid-resistant MCNS and ITP for a long time without complications.
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Affiliation(s)
- Mana Nishikawa
- Department of Nephrology, Kurashiki Central Hospital, Japan
| | | | | | - Ryo Sawaki
- Department of Nephrology, Kurashiki Central Hospital, Japan
| | - Haruka Ikuta
- Department of Nephrology, Kurashiki Central Hospital, Japan
| | - Motoko Kanzaki
- Department of Nephrology, Kurashiki Central Hospital, Japan
| | - Kosuke Fukuoka
- Department of Nephrology, Kurashiki Central Hospital, Japan
| | - Masaki Fukushima
- Department of Internal Medicine, Shigei Research Institute Hospital, Japan
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8
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Ebihara I, Nakamura T, Takahashi T, Tomino Y, Shimada N, Koide H. Increased Endothelin-1 Mrna Expression in Peripheral Blood Monocytes of Dialysis Patients. Perit Dial Int 2020. [DOI: 10.1177/089686089701700612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
ObjectiveTo compare plasma endothelin (ET)-1 level and ET-1 mRNA level in peripheral blood monocytes of patients undergoing hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).DesignEndothelin-1 mRNA level in peripheral blood monocytes and plasma ET -1 level were studied in 30 HD patients, 15 CAPD patients, 20 chronic renal failure patients not being dialyzed, and 20 normal healthy controls. Hemodialysis patients were dialyzed three times per week with a bicarbonate dialysate. Different types of dialyzer membrane, viz., cellulose triacetate, cuprophane, poly-sulfone, polyacrylonitrile, and ethylenevinylalcohol were used in 8,6,6,5, and 5 patients, respectively. Continuous ambulatory peritoneal dialysis patients were dialyzed with four daily exchanges of a 2-L dialysate containing glucose at a concentration of 1.5% to 2.5%.ResultsHigher levels of ET -1 mRNA in monocytes were observed in HD patients than in CAPD patients (p < 0.01), chronic renal failure patients (p < 0.01), or normal healthy controls (p < 0.001). The level of ET -1 mRNA in monocytes at the end of HD was not significantly higher than that at the start of HD. ln addition, these mRNA levels in HD patients showed littledifference with different types of dialysis membrane. Plasma ET -1 level in HD patients (10.2 ± 2.4 pg/mL) was also higher than that in CAPD patients (7.8 ± 1.6 pg/mL, p < 0.01), in chronic renal failure patients (4.8 ± 1.2 pg/mL, p < 0.01), or in normal controls (2.6 ± 0.8 pg/mL, p < 0.001).ConclusionDialysis itself did not significantly affect ET -1 mRNA levels in monocytes. Chronic stimulation of peripheral blood monocytes may be associated with higher levels of ET -1 mRNA and plasma ET -1 in HD patients than in CAPD patients.
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Affiliation(s)
| | - Tsukasa Nakamura
- Koto Hospital and Juntendo University School of Medicine, Tokyo, Japan
| | | | - Yasuhiko Tomino
- Koto Hospital and Juntendo University School of Medicine, Tokyo, Japan
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9
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Tokito T, Ko R, Imamura C, Shukuya T, Shimada N, Koyama R, Yamada K, Ishii H, Azuma K, Takahashi K. P1.14-30 Phase I Study of Afatinib Plus Bevacizumab in Patients with Advanced Non-Small Cell Lung Cancer Harboring EGFR Mutations. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1181] [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: 10/25/2022]
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10
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Kawakami K, Koyama Y, Morioka M, Tobaru Y, Sakura Y, Fukumoto M, Nagamine A, Hattori K, Taira I, Shimada N, Okuno E, Tsuyuki S, Kanazawa A. Compression therapy of both hands is safely applicable for the prevention of oxaliplatin-induced neuropathy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Onishi Y, Uchida HA, Takeuchi H, Kakio Y, Sugiyama H, Wada J, Shimada N, Tokumasu H, Fukushima M, Asano K. Impaired mental health status in patients with chronic kidney disease is associated with estimated glomerular filtration rate decline. Nephrology (Carlton) 2018; 24:926-932. [PMID: 30334305 DOI: 10.1111/nep.13515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2018] [Indexed: 11/29/2022]
Abstract
AIM Deteriorated health-related quality of life (HRQOL) is associated with increased risk for death in both chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients; however, the impact of HRQOL on CKD progression is not well investigated. METHODS We aimed to evaluate the association between HRQOL and CKD progression in Japanese patients with CKD. One hundred and three outpatients who visited the department of nephrology at our hospital (mean estimated glomerular filtration rate (eGFR); 32.1 ± 11.2 mL/min per 1.73 m2 ) between April 2007 and March 2012 were enrolled in this study. The primary outcome was 30% decline of eGFR or ESRD. We assessed HRQOL of all participants at baseline, including the physical component summary (PCS), the mental component summary (MCS) and the role/social component summary (RCS), using SF-36. Based on the baseline score of PCS, MCS and RCS, we divided all subjects into two groups by median. RESULTS We studied 66 men (64.1%) and 37 women aged 61.7 ± 10.0 years old. During approximately 2.5 years of follow-up period, 59 patients (57.3%) reached 30% eGFR decline or ESRD. Cox regression analyses demonstrated that lower MCS score was significantly associated with CKD progression (hazard ratio (HR) = 1.83, 95% CI = 1.04-3.21, P = 0.035), but that lower PCS score and RCS score were not (HR = 0.70, 95% CI = 0.39-1.25, P = 0.223; HR = 0.95, 95% CI = 0.54-1.67, P = 0.854, respectively). CONCLUSION We found that impaired mental health was associated with CKD progression. The evaluation of the mental health should be performed in the patients with CKD.
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Affiliation(s)
- Yasuhiro Onishi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Haruhito A Uchida
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hidemi Takeuchi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Kakio
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hitoshi Sugiyama
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriaki Shimada
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Masaki Fukushima
- Department of Nephrology, Shigei Medical Research Hospital, Okayama, Japan
| | - Kenichiro Asano
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
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12
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Kawakita C, Kinomura M, Gon Y, Okita C, Katayama K, Nishikawa M, Shimada N, Notohara K, Fukushima M, Asano K. A case of fatal osteolytic hypercalcemia complicated with IgG4-related ophthalmic disease leading to renal failure. CEN Case Rep 2018; 8:23-30. [PMID: 30109565 DOI: 10.1007/s13730-018-0358-6] [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] [Received: 10/10/2017] [Accepted: 08/09/2018] [Indexed: 01/18/2023] Open
Abstract
A 40-year-old male was hospitalized with renal impairment and severe hypercalcemia. His concentration of serum IgG4 was high, but serum whole PTH, 1-25(OH)2 vitamin D3 and PTHrP were not elevated. Computed tomography showed swelling of the bilateral lacrimal glands and systemic lymphadenopathy. The histological findings of lacrimal gland biopsy fulfilled the diagnostic criteria of IgG4-related ophthalmic disease (IgG4ROD). Bone scintigraphy showed increased ectopic uptake in the stomach, heart, lungs, and kidneys. He died on day 16 of admission, although the therapies for hypercalcemia were continued. Autopsy results showed an increase of osteoclasts in the bone marrow and metastatic calcification in multiple organs, and excluded from the differential diagnosis other disorders which present lymph-node swelling and hypercalcemia such as cancer, lymphoma, Castleman's disease, and sarcoidosis. He was given a diagnosis of IgG4ROD with osteolytic hypercalcemia.
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Affiliation(s)
- Chieko Kawakita
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan. .,Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
| | - Masaru Kinomura
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshie Gon
- Department of Rheumatology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Chika Okita
- Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Mana Nishikawa
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Noriaki Shimada
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kenji Notohara
- Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Masaki Fukushima
- Department of Internal Medicine, Shigei Medical Research Hospital, Okayama, Japan
| | - Kenichiro Asano
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, Japan
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13
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Abstract
SummaryIsolation of adenylate cyclase-enriched membranes from human platelets was attempted using glycerol lysis technique followed by ultracentrifugation on discontinuous sucrose gradients composed of 24, 30, 34, 37, and 41% (w/w). Adenylate cyclase activity was enriched 4-fold in sample/24% sucrose interface, 7-fold in 24%/30% sucrose interface, and 4-fold in 30%/ 34% sucrose interface fractions with the recovery of 15-20% of the total activity. The enrichment and subcellular distribution of adenylate cyclase resembled in general those of phosphodiesterase and acid phosphatase with slight differences in each other. Protein profiles from SDS-polyacrylamide gel electrophoresis showed that the heavy chain of myosin (Mr = 200,000) was enriched in sample/24% sucrose interface and lower molecular weight proteins in 34%/37% sucrose interface and pellet. The interface fractions between 24 and 34% sucrose were, therefore, collected as adenylate cyclase-enriched membranes.Adenylate cyclase associated with the membranes displayed high specific activity (0.1 and 1-2 nmol/min/mg protein in the absence and presence of stimulants, respectively), and possessed sensitivities to prostaglandins (E1, I2, and D2) as well as cholera toxin. Activation of adenylate cyclase by these compounds required added GTP, indicating that the contamination of the membrane preparations with GTP-like substance (s) was minimal, if at all present.
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Affiliation(s)
- N Shimada
- The Department of Biochemistry, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - M Tsubokura
- The Tokyo Red Cross Blood Center, Tokyo, Japan
| | - N Kimura
- The Department of Biochemistry, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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14
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Shimada N, ShirakiIt K, Saita K. Arthroscopic Osteosynthesis for the Treatment of Coronoid Process Fractures: A Case Series. Case Rep Orthop 2018; 2018:8512963. [PMID: 30018835 PMCID: PMC6029437 DOI: 10.1155/2018/8512963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 05/30/2018] [Indexed: 12/03/2022] Open
Abstract
The treatment strategy and surgical indication for coronoid process fractures are not clear. Many methods of surgery have been described. We report on the use of arthroscopic osteosynthesis for this type of fracture. This method is minimally invasive and effective for confirming the reduction, and it is advantageous for postoperative pain and early recovery after surgery.
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Affiliation(s)
- Noriaki Shimada
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Katsuhiko ShirakiIt
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Kazuo Saita
- Department of Orthopaedic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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15
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Hosoda Y, Yoshikawa M, Miyake M, Tabara Y, Shimada N, Zhao W, Oishi A, Nakanishi H, Hata M, Akagi T, Ooto S, Nagaoka N, Fang Y, Ohno-Matsui K, Cheng CY, Saw SM, Yamada R, Matsuda F, Tsujikawa A, Yamashiro K. CCDC102B confers risk of low vision and blindness in high myopia. Nat Commun 2018; 9:1782. [PMID: 29725004 PMCID: PMC5934384 DOI: 10.1038/s41467-018-03649-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 03/02/2018] [Indexed: 11/28/2022] Open
Abstract
The incidence of high myopia is increasing worldwide with myopic maculopathy, a complication of myopia, often progressing to blindness. Our two-stage genome-wide association study of myopic maculopathy identifies a susceptibility locus at rs11873439 in an intron of CCDC102B (P = 1.77 × 10−12 and Pcorr = 1.61 × 10−10). In contrast, this SNP is not significantly associated with myopia itself. The association between rs11873439 and myopic maculopathy is further confirmed in 2317 highly myopic patients (P = 2.40 × 10−6 and Pcorr = 1.72 × 10−4). CCDC102B is strongly expressed in the retinal pigment epithelium and choroids, where atrophic changes initially occur in myopic maculopathy. The development of myopic maculopathy thus likely exhibits a unique background apart from the development of myopia itself; elucidation of the roles of CCDC102B in myopic maculopathy development may thus provide insights into preventive methods for blindness in patients with high myopia. Myopic maculopathy is a complication of myopia that often progresses to blindness. Here, in a genome-wide association study, Hosoda et al. find that rs11873439 intronic to CCDC102B is associated with myopic maculopathy, but not with myopia, thus representing a risk factor independent of myopia.
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Affiliation(s)
- Yoshikatsu Hosoda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Munemitsu Yoshikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan.,Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Noriaki Shimada
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, 1138510, Japan
| | - Wanting Zhao
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Hideo Nakanishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Masayuki Hata
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Natsuko Nagaoka
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, 1138510, Japan
| | - Yuxin Fang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, 1138510, Japan
| | | | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, 1138510, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, 169857, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 199228, Singapore
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, 168751, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 199228, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore
| | - Ryo Yamada
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 6068503, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, 6068507, Japan. .,Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, 5208511, Japan.
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Nishikawa M, Shimada N, Kanzaki M, Ikegami T, Fukuoka T, Fukushima M, Asano K. The characteristics of patients with hypermagnesemia who underwent emergency hemodialysis. Acute Med Surg 2018; 5:222-229. [PMID: 29988705 PMCID: PMC6028801 DOI: 10.1002/ams2.334] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/01/2018] [Indexed: 12/17/2022] Open
Abstract
Aim This study aimed to clarify the characteristics of patients who presented with severe hypermagnesemia and subsequently underwent emergency hemodialysis. Methods We investigated the age, gender, complications, clinical symptoms, causal drugs, electrocardiogram findings, and laboratory data of 15 patients. Results Magnesium oxide had been administered in all cases and 14 patients were over 65 years old. The male : female ratio was 6:9. Chief complaints included a disturbance of consciousness, hypotension, bradycardia, and respiratory failure. The median serum magnesium value before hemodialysis was 6.0 (3.7–18.6) mg/dL. The daily dosage of magnesium oxide was ≤ 2.0 g in 12 cases. The median serum creatinine value before hemodialysis was 5.39 (0.54–10.29) mg/dL. However, in two cases, the creatinine value was not elevated. Complications of acute kidney injury exacerbated the hypermagnesemia in nine cases. Conclusions We recommend that the serum magnesium value should be measured in older patients who are taking magnesium oxide and are showing signs and symptoms of a disturbance of consciousness, hypotension, bradycardia, and respiratory failure of an uncertain etiology, even if the serum creatinine value is not elevated or the dosage of magnesium oxide is within recommended levels.
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Affiliation(s)
- Mana Nishikawa
- Department of Nephrology Kurashiki Central Hospital Kurashiki Japan
| | - Noriaki Shimada
- Department of Nephrology Kurashiki Central Hospital Kurashiki Japan
| | - Motoko Kanzaki
- Department of Nephrology Kurashiki Central Hospital Kurashiki Japan
| | - Tetsunori Ikegami
- Department of Emergency Medicine Kurashiki Central Hospital Kurashiki Japan
| | - Toshio Fukuoka
- Department of General Medicine Kurashiki Central Hospital Kurashiki Japan
| | - Masaki Fukushima
- Department of Internal Medicine Shigei Research Institute Hospital Okayama Japan
| | - Kenichiro Asano
- Department of Nephrology Kurashiki Central Hospital Kurashiki Japan
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Wirawan A, Tajima K, Takahashi F, Hidayat M, Kanemaru R, Koinuma Y, Hayakawa D, Tajima M, Matsumoto N, Kanamori K, Takeda I, Kato M, Kobayashi I, Shimada N, Takahashi K. P2.02-012 The Epigenetic Role of LSD1+8a in Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hidayat M, Takahashi F, Tajima K, Nurwidya F, Wirawan A, Kanemaru R, Koinuma Y, Ihara H, Tajima M, Matsumoto N, Kanamori K, Takeda I, Haraguchi M, Hayakawa D, Ko R, Kato M, Shibayama R, Koyama R, Takahashi M, Shimada N, Takahashi K. P3.02-024 Role of FBXW7 in the Maintenance of Quiescent Cancer Stem Cells Resistant to Gefitinib in EGFR Mutation-Positive Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Nurwidya F, Takahashi F, Hidayat M, Kobayashi I, Wirawan A, Kato M, Tajima K, Shimada N, Takeda I, Tajima M, Matsumoto N, Kanemori K, Koinuma Y, Yunus F, Andarini S, Takahashi K. P1.02-065 Histone Deacetylase Inhibition Alters Stem Cell Phenotype in Gefitinib-Resistant Lung Cancer Cells with EGFR Mutation. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Fujinaga J, Kuriyama A, Shimada N. Incidence and risk factors of acute kidney injury in the Japanese trauma population: A prospective cohort study. Injury 2017; 48:2145-2149. [PMID: 28842286 DOI: 10.1016/j.injury.2017.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Previous studies have reported the prevalence and risk factors of acute kidney injury (AKI) in relatively young trauma patients. The aims of this study were to identify the prevalence and risk factors of AKI among older Japanese trauma patients. METHODS We conducted a prospective observational study in the 8-bed intensive care unit (ICU) of a Japanese tertiary-care hospital. Participants comprised trauma patients aged 18 years or older admitted to the ICU. Our primary outcome was the incidence of AKI within 10days of admission, according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. RESULTS Among 333 patients, 66 (19.8%) developed AKI (Stage 1, n=54; Stages 2, n=5; and Stage 3, n=7). Multivariate logistic regression analysis revealed that the incidence of AKI was associated with increased age (odds ratio (OR), 1.38; 95% confidence interval (CI), 1.15-1.65), male sex (OR, 2.06; 95%CI, 1.04-4.07), greater amount of red blood cell transfusions (OR, 1.61; 95%CI, 1.04-1.17), and presence of underlying chronic kidney disease (CKD) (OR, 3.97; 95%CI, 1.78-8.83). Length of stay in the ICU was significantly longer in patients with AKI (6days) than in those without (3days; p<0.001). Patients ≥65 years old were more likely to develop AKI (26.2% vs 11.6%; p<0.001). No significant differences in ICU stay (median, 4 vs 4days; p=0.70), hospital stay (median, 24 vs 21days; p=0.45), or 28-day mortality (2.1% vs 1.4%; p=0.19) were evident between age groups. CONCLUSIONS Approximately 20% of trauma patients developed AKI, and the elderly were more likely to develop AKI. Older age, male, greater units of red blood cell transfusions, and underlying CKD were associated with incidence of AKI.
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Affiliation(s)
- Jun Fujinaga
- Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, 1-1-1 Miwa Kurashiki Okayama 710-8602, Japan
| | - Akira Kuriyama
- Department of General Medicine, Kurashiki Central Hospital, Kurashiki, 1-1-1 Miwa Kurashiki Okayama 710-8602, Japan.
| | - Noriaki Shimada
- Department of Nephrology, Kurashiki Central Hospital, Kurashiki, 1-1-1 Miwa Kurashiki Okayama 710-8602, Japan
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Shinohara K, Shimada N, Moriyama M, Yoshida T, Jonas JB, Yoshimura N, Ohno-Matsui K. Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2017; 58:3750-3758. [PMID: 28738419 DOI: 10.1167/iovs.17-22319] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine posterior staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI). Methods Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT. Results The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44-85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1-36.5 mm). All staphylomas detected on the 3D-MRI, except for two very large staphylomas, were visualized on the WF-OCT images. Morphologic hallmarks of the staphylomas were smoothly configured staphyloma border with a gradual thinning of the choroid and an inward protrusion of the sclera at the staphyloma edge. Comparing the detectability of the staphylomas on the WF-OCT images versus 3D-MRI revealed no significant difference between both techniques (P = 0.12; χ2 test). Comparing the staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50-0.72). A spatial relationship between the staphylomatous areas and the macula and optic nerve head was observed by WF-OCT. Conclusions WF-OCT can provide tomographic images of posterior staphylomas in a resolution and size unachievable so far, and may replace 3D-MRI in assessing posterior staphylomas. Future studies using WF-OCT may explore the detailed morphologic characteristics of posterior staphylomas and give clues to the etiology of staphylomas.
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Affiliation(s)
- Kosei Shinohara
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriaki Shimada
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Muka Moriyama
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Seegartenklinik Heidelberg, Germany
| | - Nagahisa Yoshimura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Toyoda H, Tada T, Takaguchi K, Senoh T, Shimada N, Hiraoka A, Michitaka K, Ishikawa T, Kumada T. Differences in background characteristics of patients with chronic hepatitis C who achieved sustained virologic response with interferon-free versus interferon-based therapy and the risk of developing hepatocellular carcinoma after eradication of hepatitis C virus in Japan. J Viral Hepat 2017; 24:472-476. [PMID: 27983762 DOI: 10.1111/jvh.12665] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 08/07/2016] [Accepted: 11/28/2016] [Indexed: 01/14/2023]
Abstract
We compared the background characteristics of patients with chronic hepatitis C who achieved eradication of hepatitis C virus (HCV), that is sustained virologic response (SVR), with interferon (IFN)-based versus IFN-free antiviral therapy in Japan. In addition, we used a previously reported risk assessment model to compare the incidence of hepatocellular carcinoma (HCC) after SVR by treatment type. Pretreatment characteristics of 1533 patients who achieved SVR with IFN-based therapy and 1086 patients with IFN-free therapy from five institutions across Japan were compared. The risk of HCC after SVR was assessed based on pretreatment characteristics, and the incidence of HCC after SVR was estimated in both groups. Age and serum alpha-fetoprotein levels were higher, platelet count was lower, and liver fibrosis was more advanced in patients who achieved SVR with IFN-free therapy compared with IFN-based therapy. The incidence of HCC after SVR in the IFN-free group was estimated to be more than twofold higher than in the IFN-based therapy group (7.29% vs. 3.09%, and 6.23% vs. 3.01% when excluding patients who have underwent curative treatment for HCC). There are large differences in pretreatment characteristics between patients who achieved SVR with IFN-based and IFN-free therapies in Japan, which are associated with differential risk of HCC after SVR. These differences can influence the incidence of HCC after SVR and should be taken into consideration when comparing IFN-based and IFN-free therapies in terms of hepatocarcinogenesis suppression with HCV eradication.
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Affiliation(s)
- H Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - T Tada
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Senoh
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - N Shimada
- Department of Gastroenterology, Otakanomori Hospital, Kashiwa, Japan
| | - A Hiraoka
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - K Michitaka
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Ishikawa
- Department of Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - T Kumada
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
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Sakai K, Maeda T, Kuriyama A, Shimada N, Notohara K, Ueda Y. TAFRO syndrome successfully treated with tocilizumab: A case report and systematic review. Mod Rheumatol 2016; 28:564-569. [PMID: 26886414 DOI: 10.3109/14397595.2015.1120389] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 12/22/2022]
Abstract
Thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome is considered as a unique clinicopathologic variant of multicentric Castleman's disease and is recently reported in Japan. This entity represents a severe inflammatory state leading to organ failures such as severe liver dysfunction seen in our case, and can be treated by immunosuppressive agents, steroids, and cyclosporine shown in several case reports. A systematic review and our case suggest the potential utility of tocilizumab as a treatment for TAFRO syndrome.
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Affiliation(s)
| | | | | | | | - Kenji Notohara
- d Department of Anatomic Pathology , Kurashiki Central Hospital , Kurashiki , Japan
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Higashide T, Ohkubo S, Hangai M, Ito Y, Shimada N, Ohno-Matsui K, Terasaki H, Sugiyama K, Chew P, Li KKW, Yoshimura N. Influence of Clinical Factors and Magnification Correction on Normal Thickness Profiles of Macular Retinal Layers Using Optical Coherence Tomography. PLoS One 2016; 11:e0147782. [PMID: 26814541 PMCID: PMC4729678 DOI: 10.1371/journal.pone.0147782] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/10/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To identify the factors which significantly contribute to the thickness variabilities in macular retinal layers measured by optical coherence tomography with or without magnification correction of analytical areas in normal subjects. METHODS The thickness of retinal layers {retinal nerve fiber layer (RNFL), ganglion cell layer plus inner plexiform layer (GCLIPL), RNFL plus GCLIPL (ganglion cell complex, GCC), total retina, total retina minus GCC (outer retina)} were measured by macular scans (RS-3000, NIDEK) in 202 eyes of 202 normal Asian subjects aged 20 to 60 years. The analytical areas were defined by three concentric circles (1-, 3- and 6-mm nominal diameters) with or without magnification correction. For each layer thickness, a semipartial correlation (sr) was calculated for explanatory variables including age, gender, axial length, corneal curvature, and signal strength index. RESULTS Outer retinal thickness was significantly thinner in females than in males (sr2, 0.07 to 0.13) regardless of analytical areas or magnification correction. Without magnification correction, axial length had a significant positive sr with RNFL (sr2, 0.12 to 0.33) and a negative sr with GCLIPL (sr2, 0.22 to 0.31), GCC (sr2, 0.03 to 0.17), total retina (sr2, 0.07 to 0.17) and outer retina (sr2, 0.16 to 0.29) in multiple analytical areas. The significant sr in RNFL, GCLIPL and GCC became mostly insignificant following magnification correction. CONCLUSIONS The strong correlation between the thickness of inner retinal layers and axial length appeared to result from magnification effects. Outer retinal thickness may differ by gender and axial length independently of magnification correction.
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Affiliation(s)
- Tomomi Higashide
- Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
- * E-mail:
| | - Shinji Ohkubo
- Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masanori Hangai
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Yasuki Ito
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Noriaki Shimada
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuhisa Sugiyama
- Department of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Paul Chew
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Kenneth K. W. Li
- Department of Ophthalmology, United Christian Hospital and Tseung Kwan O Hospital, Hong Kong, China
| | - Nagahisa Yoshimura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Lv Y, Xu ZL, Asai H, Shimada N, Nakane K. Thoroughly mesoporous TiO2 nanotubes prepared by a foaming agent-assisted electrospun template for photocatalytic applications. RSC Adv 2016. [DOI: 10.1039/c6ra00241b] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A thoroughly mesoporous long TiO2 nanotube with intact morphology was firstly prepared using a foaming agent-assisted electrospun template method for photocatalytic applications.
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Affiliation(s)
- Y. Lv
- Frontier Fiber Technology and Science
- Graduate School of Engineering
- University of Fukui
- Fukui
- Japan
| | - Z. L. Xu
- Headquarters for Innovative Society-Academic Cooperation
- University of Fukui
- Fukui
- Japan
| | - H. Asai
- Frontier Fiber Technology and Science
- Graduate School of Engineering
- University of Fukui
- Fukui
- Japan
| | - N. Shimada
- Frontier Fiber Technology and Science
- Graduate School of Engineering
- University of Fukui
- Fukui
- Japan
| | - K. Nakane
- Frontier Fiber Technology and Science
- Graduate School of Engineering
- University of Fukui
- Fukui
- Japan
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Kondo C, Atsukawa M, Tsubota A, Shimada N, Abe H, Aizawa Y. Evaluation of factors associated with relapse in telaprevir-based triple therapy for chronic hepatitis C. J Postgrad Med 2016; 62:20-5. [PMID: 26732192 PMCID: PMC4944324 DOI: 10.4103/0022-3859.173191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 05/13/2015] [Accepted: 10/14/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND RATIONALE Most patients with chronic hepatitis C show virological response to telaprevir-based triple therapy, and achieve an end-of-treatment response (ETR). However, some patients showing ETR develop virological relapse. This study was carried out to evaluate factors associated with relapse after triple therapy. MATERIALS AND METHODS A prospective, multicentric study was conducted in chronic hepatitis C patients who received telaprevir-based triple therapy. We evaluated independent variables such as age, with or without cirrhosis, prior treatment response to interferon (IFN) therapy, IL28B genotype, core amino acid (aa) 70 mutation, drug adherence, white blood cell counts, hemoglobin level, and serum low-density lipoprotein (LDL) cholesterol level. The characteristics of the patients who relapsed after achieving ETR were compared with those who did not. RESULTS Among 168 patients, 157 patients achieved ETR (93.5%) and 11 discontinued. Of these 157 patients, relapse occurred in 21 patients (13.4%). Nineteen patients (90.5%) of 21 relapsed patients had the IL28B non-TT genotype (P = 1.79 × 10 -9 ). Multivariate analysis identified core amino acid 70 [P = 0.018, crude odds ratio (OR): 6.927] and the IL28B genotype (P = 3.758 × 10 -5 , crude OR: 39.311) as significantly independent factors that influenced the relapse-related variables. Among the 49 patients with the IL28B non-TT, 18 patients had core aa70 mutation and 31 patients had core aa70 wild-type. In addition, 66.7% (12/18) of those with core aa70 mutation and 22.6% (7/31) of those with core aa70 wild-type developed relapse (P = 0.005). DISCUSSION Core aa70 mutation and the IL28B non-TT genotype were identified as independent factors that influenced relapse after achievement of ETR for telaprevir-based triple therapy.
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Affiliation(s)
- C Kondo
- Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - M Atsukawa
- Department of Internal Medicine, Division of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - A Tsubota
- Core Research Facilities for Basic Science, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Chiba Tokushukai Hospital, Chiba, Japan
| | - H Abe
- Department of Internal Medicine, Jikei University School of Medicine Katsushika Medical Center, Tokyo, Japan
| | - Y Aizawa
- Department of Internal Medicine, Jikei University School of Medicine Katsushika Medical Center, Tokyo, Japan
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Nagai M, Ohta A, Nishina M, Shimada N, Nakao S, Kurokawa M. Sex, Age and other Epidemiological Characteristics of Aplastic Anemia Patients in Japan. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.236] [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: 11/14/2022] Open
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Ohta A, Nagai M, Nishina M, Shimada N, Nakao S, Kurokawa M. Incidence of Aplastic Anemia in Japan: Analysis of Data from a Nationwide Registration System. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hirata K, Shimada N, Kimura H, Deie M, Adachi N, Ochi M. The relationship between proprioceptive function and dynamic balance in ACL injured knees. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Asaeda M, Deie M, Shimada N, Orita N, Iwaki D, Kono Y, Terai C, Kuwahara W, Okamoto T, Watanabe H, Ochi M. Gait analysis after medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shimada N, Deie M, Hirata K, Asaeda R, Kono Y, Terai C, Ueda K, Kimura H, Ochi M. Characteristics of knee kinetics during gait for two types of total knee arthroplasty (PS type and CS type). Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Shimada N, Fukuda T, Ishii Y, Sekikawa D, Ohtsuki M, Matsuda H, Kodeki K, Ohya G, Nagao F, Kimura N, Nakano S, Murakami S, Miyamoto S, Tsuchiya T. Serum hepatitis in Japan. Bibl Haematol 2015; 23:1066-70. [PMID: 5879441 DOI: 10.1159/000384359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Tanaka Y, Shimada N, Ohno-Matsui K. Extreme thinning or loss of inner neural retina along the staphyloma edge in eyes with pathologic myopia. Am J Ophthalmol 2015; 159:677-82. [PMID: 25579643 DOI: 10.1016/j.ajo.2015.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 01/05/2015] [Accepted: 01/06/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the morphologic changes along the edge of posterior staphyloma in highly myopic eyes with patchy chorioretinal atrophy and to identify the relationship between retinal thinning and the visual field (VF) defects found in these eyes. DESIGN Retrospective, observational case series. METHODS Twenty eyes (17 patients) with pathologic myopia (myopic refractive error ≥ 8 diopters or an axial length ≥ 26.5 mm) and patchy atrophy along the staphyloma edge were analyzed retrospectively. The VFs were obtained by Goldmann kinetic perimetry. RESULTS In the area of patchy atrophy, the inner retinal tissue was very thin or completely absent. Any remnants of the retinal tissue appeared to be adherent to the layer of large choroidal vessels or to the sclera. The mean thickness of the retina at its thinnest point in the area was 51.6 ± 29.0 μm in 20 eyes. The retina was thinner than 50 μm at its thinnest point in 12 (60.0%) of the 20 eyes, and the mean retinal thickness at its thinnest point in these 12 eyes was 32.1 ± 16.0 μm (range, 4 to 49 μm). Nineteen eyes (VF of 1 eye was not determined) had very similar VF findings by Goldmann perimetry, that is, a defect of the sector corresponding to the course of retinal nerve fiber over the patchy atrophy. CONCLUSIONS The results show that the thickness of not only the outer retina, but also of most of the inner retina, including the nerve fiber layer, is significantly thinner at the staphyloma edge. Such damage to the inner retina along the staphyloma edge causes the VF defects in highly myopic eyes.
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Ishida T, Moriyama M, Tanaka Y, Shinohara K, Shimada N, Yoshida T, Ohno-Matsui K. Radial Tracts Emanating from Staphyloma Edge in Eyes with Pathologic Myopia. Ophthalmology 2015; 122:215-6. [DOI: 10.1016/j.ophtha.2014.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/06/2014] [Indexed: 12/12/2022] Open
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Kinomura M, Shimada N, Nishikawa M, Omori K, Jo T, Ueda Y, Notohara K, Kitazawa R, Kitazawa S, Fukushima M, Asano K. Parathyroid Hormone-related Peptide-producing Multiple Myeloma and Renal Impairment. Intern Med 2015; 54:3029-33. [PMID: 26631887 DOI: 10.2169/internalmedicine.54.5085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 68-year-old man was hospitalized and examined for renal impairment. A laboratory analysis showed hypercalcemia. Although the serum parathyroid hormone and serum 1-25(OH)2 vitamin D3 levels were not elevated, the serum parathyroid hormone-related peptide (PTHrP) level was increased. Immunoelectrophoresis of the urine and bone marrow aspiration indicated multiple myeloma (MM). He was diagnosed with the coexistence of cast nephropathy and light chain deposition disease by a renal biopsy. Notably, PTHrP expression was detected in the myeloma cells based on immunohistochemistry and in situ hybridization. It is therefore important to examine the PTHrP concentration in MM patients with hypercalcemia.
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Asano K, Ogata A, Tanaka K, Ide Y, Sankoda A, Kawakita C, Nishikawa M, Ohmori K, Kinomura M, Shimada N, Fukushima M. Acoustic radiation force impulse elastography of the kidneys: is shear wave velocity affected by tissue fibrosis or renal blood flow? J Ultrasound Med 2014; 33:793-801. [PMID: 24764334 DOI: 10.7863/ultra.33.5.793] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES The aim of this study was to identify the main influencing factor of the shear wave velocity (SWV) of the kidneys measured by acoustic radiation force impulse elastography. METHODS The SWV was measured in the kidneys of 14 healthy volunteers and 319 patients with chronic kidney disease. The estimated glomerular filtration rate was calculated by the serum creatinine concentration and age. As an indicator of arteriosclerosis of large vessels, the brachial-ankle pulse wave velocity was measured in 183 patients. RESULTS Compared to the degree of interobserver and intraobserver deviation, a large variance of SWV values was observed in the kidneys of the patients with chronic kidney disease. Shear wave velocity values in the right and left kidneys of each patient correlated well, with high correlation coefficients (r = 0.580-0.732). The SWV decreased concurrently with a decline in the estimated glomerular filtration rate. A low SWV was obtained in patients with a high brachial-ankle pulse wave velocity. Despite progression of renal fibrosis in the advanced stages of chronic kidney disease, these results were in contrast to findings for chronic liver disease, in which progression of hepatic fibrosis results in an increase in the SWV. Considering that a high brachial-ankle pulse wave velocity represents the progression of arteriosclerosis in the large vessels, the reduction of elasticity succeeding diminution of blood flow was suspected to be the main influencing factor of the SWV in the kidneys. CONCLUSIONS This study indicates that diminution of blood flow may affect SWV values in the kidneys more than the progression of tissue fibrosis. Future studies for reducing data variance are needed for effective use of acoustic radiation force impulse elastography in patients with chronic kidney disease.
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Affiliation(s)
- Kenichiro Asano
- Department of Nephrology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki 710-8602, Japan.
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Asao T, Honma Y, Suina K, Muraki K, Shukuya T, Ohashi R, Koyama R, Shimada N, Sakuraba S, Takahashi K. Efficacy and Toxicity of Crizotinib for Patients with ALK-Positive Advanced NSCLC. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Shimada N, Tanaka Y, Tokoro T, Ohno-Matsui K. Natural course of myopic traction maculopathy and factors associated with progression or resolution. Am J Ophthalmol 2013; 156:948-957.e1. [PMID: 23972301 DOI: 10.1016/j.ajo.2013.06.031] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/18/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate the natural course of myopic traction maculopathy and to identify the factors associated with its progression or resolution in 207 highly myopic eyes. DESIGN Retrospective, consecutive case series. METHODS We investigated 207 highly myopic eyes with myopic traction maculopathy by optical coherence tomography (OCT) and followed the patients for at least 24 months. The size of the macular retinoschisis was categorized according to its extent and location relative to the fovea. The clinical data, status of the myopic traction maculopathy, and changes in the posterior vitreous and inner limiting membrane (ILM) were analyzed during the natural course of the disease process. RESULTS During a mean follow-up of 36.2 ± 6.2 months, 8 of 207 eyes (3.9%) showed a decrease or complete resolution of the macular retinoschisis. Of these 8 eyes, 6 had release of retinal traction in the OCT images, and 4 of the 6 eyes developed posterior vitreous detachment. A spontaneous disruption of the ILM occurred in 2 eyes before the improvement of the myopic traction maculopathy. Of the 207 eyes, 24 (11.6%) experienced progression of the myopic traction maculopathy. The eyes with more extensive macular retinoschisis showed progression significantly more commonly (42.9%) than the eyes having less extensive macular retinoschisis areas (6.7%). CONCLUSIONS The natural course of myopic traction maculopathy varies, and eyes with more extensive macular retinoschisis tend to progress more commonly. A complete resolution of macular retinoschisis can occur after a release of traction on the retina. These findings can be used to determine whether surgery should be performed.
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Shinohara K, Moriyama M, Shimada N, Nagaoka N, Ishibashi T, Tokoro T, Ohno-Matsui K. Analyses of shape of eyes and structure of optic nerves in eyes with tilted disc syndrome by swept-source optical coherence tomography and three-dimensional magnetic resonance imaging. Eye (Lond) 2013; 27:1233-41; quiz 1242. [PMID: 24113301 DOI: 10.1038/eye.2013.202] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/14/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the deeper structures of the optic nerve and to analyze the shape of eyes with tilted disc syndrome (TDS) by swept-source optical coherence tomography (OCT) and three-dimensional magnetic resonance imaging (3D MRI). METHODS The medical records of 54 eyes of 36 patients with TDS were reviewed. The patients with TDS and high myopia were analyzed separately from those without high myopia. All the eyes were examined with a swept-source OCT, and 22 of the eyes were examined by 3D MRI. RESULTS A total of 38 eyes of 29 patients were highly myopic and 16 eyes of 15 patients were not highly myopic. The representative OCT findings of the optic disc were: a sloping of the lamina cribrosa posteriorly from the upper part to the lower part, a protrusion of the upper edge of Bruch's membrane, and choroid. The distance and the depth of the most protruded point from the fovea were significantly greater in the eyes with non-highly myopic TDS than those with highly myopic TDS. In the 3D MRI, the lower part of the posterior segment was protruded outward, and the optic nerves attached at the upper nasal edge of the protrusion. CONCLUSIONS The abnormalities detected by swept-source OCT and 3D MRI analyses indicate the possibility that the essential pathology of TDS is a deformity of the inferior globe below the optic nerve, and the positional relation between the fovea and the inferior protrusion determines the degree of myopia.
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Affiliation(s)
- K Shinohara
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
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Shimada N, Shigemoto N, Kayama S, Ohge H, Sugai M. P88 Survey of metallo-β-lactamase producing Pseudomonas aeruginosa in Hiroshima. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70333-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sanaka T, Mochizuki T, Kinugasa E, Kusano E, Ohwada S, Kuno T, Kojima K, Kobayashi S, Satoh M, Shimada N, Nakao K, Nakazawa R, Nishimura H, Noiri E, Shigematsu T, Tomo T, Maeda T. Randomized controlled open-label trial of vitamin E-bonded polysulfone dialyzer and erythropoiesis-stimulating agent response. Clin J Am Soc Nephrol 2013; 8:969-78. [PMID: 23599410 DOI: 10.2215/cjn.04680512] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES A 1-year multicenter prospective randomized controlled study was conducted on the effects of vitamin E-bonded polysulfone dialyzers on erythropoiesis-stimulating agent response in hemodialysis patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Major inclusion criteria were use of high-flux polysulfone dialyzers with 50-70 ml/min β2-microglobulin clearance over 3 months, transferrin saturation over 20%, same erythropoiesis-stimulating agent for over 3 months, and hemoglobin at 10-12 g/dl. Hemodialysis patients were placed in four interventional groups: two hemoglobin ranges (10.0-10.9 or 11.0-11.9 g/dl) and two dialyzers. Patients were randomly assigned by central registration to a vitamin E-bonded polysulfone dialyzers or polysulfone control group. Primary end point was relative erythropoiesis resistance index at baseline between groups at 12 months. Erythropoiesis resistance index was defined as total weekly erythropoiesis-stimulating agent dose divided by hemoglobin. RESULTS There were no statistically significant differences in age or sex. There was no significant difference in relative erythropoiesis resistance index between vitamin E-bonded polysulfone dialyzers and control groups at 12 months (vitamin E-bonded polysulfone dialyzers: 1.1, control: 1.3). The vitamin E-bonded polysulfone dialyzers group showed better relative erythropoiesis resistance index than the control group at 11.0-11.9 g/dl hemoglobin (vitamin E-bonded polysulfone dialyzers: 1.0, control: 1.4 at 12 months, significant difference) but no difference at 10.0-10.9 g/dl hemoglobin. CONCLUSIONS The overall relative erythropoiesis resistance index showed no difference between the vitamin E-bonded polysulfone dialyzers and control groups, although the change in relative erythropoiesis resistance index differed according to hemoglobin level.
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Affiliation(s)
- Tsutomu Sanaka
- Lifestyle Disease and CKD Center, Edogawa General Hospital, Tokyo, Japan.
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Ohno-Matsui K, Shimada N, Akiba M, Moriyama M, Ishibashi T, Tokoro T. Characteristics of intrachoroidal cavitation located temporal to optic disc in highly myopic eyes. Eye (Lond) 2013; 27:630-8. [PMID: 23470792 DOI: 10.1038/eye.2013.16] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To investigate the anatomic characteristics of eyes with pathological myopia and peripapillary intrachoroidal cavitation (ICC) located temporal to the optic disc. METHODS A total of 125 with pathologic myopia were scanned with swept-source optical coherence tomography (OCT). Temporal ICC was defined as ICC located temporal to the optic disc seen in horizontal OCT section through the optic disc center. Definition of pathologic myopia was refractive error >8.00 diopters (D) or an axial length >26.5 mm. RESULTS In all, 17 eyes of 16 patients had temporal ICC. All of the eyes had temporal or temporally wider annular conus. The ICC was observed temporal to the optic disc in 15 of 17 eyes, and 2 of the remaining eyes also had inferior ICC. Even in the two eyes with both temporal and inferior ICC, the temporal ICC was much wider than the inferior ICC. Inner retinal defect at the border of conus and temporal ICC was detected in two eyes. The temporal ICC was extensive in the posterior fundus with the average width of 1467.8 ± 1328.1 μm (range; 442-6200 μm) in a horizontal section. In two eyes, the temporal ICC extended beyond the central fovea. CONCLUSIONS Peripapillary ICC can develop temporal to the optic disc without involving the area inferior to optic disc in highly myopic eyes. Temporal ICC appeared much wider than inferior ICC, which is usually restricted to the area around the optic disc. The possible reasons why ICC develops in temporal to the optic disc are presented.
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Affiliation(s)
- K Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
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Yokoi T, Moriyama M, Hayashi K, Shimada N, Ohno-Matsui K. Evaluation of refractive error after cataract surgery in highly myopic eyes. Int Ophthalmol 2013; 33:343-8. [DOI: 10.1007/s10792-012-9690-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
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Goto M, Matsuzaki M, Fuchinoue A, Urabe N, Kawagoe N, Takemoto I, Tanaka H, Watanabe T, Miyazaki T, Takeuchi M, Honda Y, Nakanishi K, Urita Y, Shimada N, Nakajima H, Sugimoto M, Goto T. Chronic atherosclerotic mesenteric ischemia that started to develop symptoms just after anaphylaxis. Case Rep Gastroenterol 2012; 6:300-8. [PMID: 22754490 PMCID: PMC3376342 DOI: 10.1159/000339204] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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] [Indexed: 12/04/2022] Open
Abstract
An 83-year-old woman was referred to our emergency department with acute urticaria and sudden shortness of breath approximately 30 min after taking rectal diclofenac potassium for lumbago. After treatment with adrenaline and corticosteroids, the patient became hemodynamically stable and left the hospital on the next day. She attended our hospital 1 week after the onset of anaphylaxis because of repeated postprandial epigastric pain. No abnormal lesions were found in endoscopy. Radiographic selective catheter angiography revealed chronic mesenteric ischemia caused by atherosclerosis and abundant collateral arteries between the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery. Patients with chronic mesenteric ischemia usually present with a clinical syndrome characterized by painful abdominal cramps and colic occurring typically during the postprandial phase. Fear of eating resulted in malnutrition. She was prescribed proton pump inhibitor, digestants, anticholinergic agents, serine protease inhibitors, prokinetics, antiplatelet agents and transdermal nitroglycerin intermittently, but these had no beneficial effects. It was most probable that this patient with chronic atherosclerotic mesenteric ischemia was suffering from functional abdominal pain syndrome induced by anaphylaxis. Since psychiatric disorders were associated with alterations in the processing of visceral sensation, we facilitated the patient's understanding of functional abdominal pain syndrome with the psychologist. Postprandial abdominal pain gradually faded after administration of these drugs and the patient left the hospital. Developing a satisfactory patient-physician relationship was considered more effective for the management of persistent abdominal pain caused by complicated mechanisms.
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Affiliation(s)
- M. Goto
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - M. Matsuzaki
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - A. Fuchinoue
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - N. Urabe
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - N. Kawagoe
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - I. Takemoto
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - H. Tanaka
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - T. Watanabe
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - T. Miyazaki
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - M. Takeuchi
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - Y. Honda
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - K. Nakanishi
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - Y. Urita
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
- *Yoshihisa Urita, 6-11-1, Omori-Nishi, Ota-Ku, Tokyo 143-8541 (Japan), Tel. +81 3 3762 4151, E-Mail
| | - N. Shimada
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - H. Nakajima
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - M. Sugimoto
- Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan
| | - T. Goto
- Masutani Clinic, Hiroshima, Japan
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Ohno-Matsui K, Akiba M, Moriyama M, Shimada N, Ishibashi T, Tokoro T, Spaide RF. Acquired optic nerve and peripapillary pits in pathologic myopia. Ophthalmology 2012; 119:1685-92. [PMID: 22494632 DOI: 10.1016/j.ophtha.2012.01.047] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [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: 10/11/2011] [Revised: 01/25/2012] [Accepted: 01/25/2012] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To examine the incidence and characteristics of pit-like structures around the optic disc and myopic conus in eyes with high myopia. DESIGN Prospective, observational case series. PARTICIPANTS We evaluated 198 eyes of 119 patients with pathologic myopia (spherical equivalent >-8 diopters [D]). We also evaluated 32 eyes of 32 subjects with emmetropia (refractive error ≤±3 D) as controls. METHODS The papillary and peripapillary areas were examined with a prototype swept-source optical coherence tomography (OCT) system with a center wavelength of 1050 nm. We studied the structural characteristics of pit-like changes. MAIN OUTCOME MEASURES The incidence and characteristics of the optic nerve (ON) pits in eyes with high myopia. RESULTS Pit-like clefts were found at the outer border of the ON or within the adjacent scleral crescent in 32 of 198 highly myopic eyes (16.2%) but in none of the emmetropic eyes. The eyes with these pits were more myopic, had significantly longer axial lengths, and had significantly larger optic discs than the highly myopic eyes without pits. The pits were located in the optic disc area (optic disc pits) in 11 of 32 eyes and in the area of the conus outside the optic disc (conus pits) in 22 of 32 eyes. One eye had both optic disc pits and conus pits. The optic disc pits existed in the superior or inferior border of the optic disc. All but 1 eye with conus pits had a type IX staphyloma, and the location of the conus pits were present nasal to the scleral ridge or outside the ridge temporal to the nerve. The optic disc pits were associated with discontinuities of the lamina cribrosa, whereas the conus pits appeared to develop from a scleral stretch-associated schisis or to emissary openings for the short posterior ciliary arteries in the sclera. The nerve fiber tissue overlying the pits was discontinuous at the site of the pits. CONCLUSIONS Optic nerve pits are common in highly myopic eyes. The ON pits are barely visible ophthalmoscopically but can be demonstrated by using swept-source OCT.
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Affiliation(s)
- Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
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Nakajima H, Watanabe T, Miyazaki T, Takeuchi M, Honda Y, Shimada N, Nakanishi K, Urita Y, Sugimoto M. Acute liver dysfunction in the course of norovirus gastroenteritis. Case Rep Gastroenterol 2012; 6:69-73. [PMID: 22423242 PMCID: PMC3304080 DOI: 10.1159/000336202] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A 48-year-old female with abdominal pain and malaise who showed delayed symptom of acute gastroenteritis came to see us. Her illness was diagnosed as norovirus infection, but liver dysfunction accompanied this gastroenteritis. We investigated the pathogenesis of this hepatitis for all causes including drugs, but we could not detect norovirus infection. The liver damage improved shortly in course of the gastroenteritis. She recovered completely within 2 weeks without any damage left. Norovirus-induced liver dysfunction is not known, and there is no report in the literature. We report, for the first time, the case of liver dysfunction with norovirus gastroenteritis.
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Affiliation(s)
- H Nakajima
- Department of General Medicine and Emergency Care, Toho University, Tokyo, Japan
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Nakamura T, Ushiyama C, Suzuki Y, Shoji H, Osada S, Shimada N, Koide H. Effect of polymyxin B-immobilized fibre on various mediators in patients with hypothermic sepsis. ACTA ACUST UNITED AC 2011. [DOI: 10.3109/tcic.12.5-6.223.228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ohno-Matsui K, Shimada N, Yasuzumi K, Hayashi K, Yoshida T, Kojima A, Moriyama M, Tokoro T. Reply. Am J Ophthalmol 2011. [DOI: 10.1016/j.ajo.2011.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nagaoka N, Shimada N, Hayashi W, Hayashi K, Moriyama M, Yoshida T, Tokoro T, Ohno-Matsui K. Characteristics of periconus choroidal neovascularization in pathologic myopia. Am J Ophthalmol 2011; 152:420-427.e1. [PMID: 21696698 DOI: 10.1016/j.ajo.2011.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Revised: 03/01/2011] [Accepted: 03/01/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine the clinical characteristics of periconus choroidal neovascularizations (CNVs) in eyes with pathologic myopia. DESIGN Retrospective observational case series. METHODS We reviewed the medical records of 260 eyes of 254 patients with a myopic CNV and selected those with a periconus CNV. A periconus CNV was defined as a CNV that is located next to a myopic conus. To differentiate a periconus CNV from a subfoveal CNV that has expanded to the edge of the disc, eyes whose CNV involved the fovea were excluded. The data of the eyes with a subfoveal CNV were used for comparison. RESULTS Eleven eyes (4.2%) of 11 patients had a periconus CNV. These CNVs had a triangular or oval shape whose base was directed toward the myopic conus. The eyes with a periconus CNV had a significantly larger myopic conus than eyes with a subfoveal myopic CNV. The degree of myopia and axial length were not significantly associated with the incidence of periconus CNV. In 5 of the 11patients, the periconus CNV had a spontaneous regression without treatment, and none had a recurrence. The other 6 patients received treatment and obtained an angiographic closure after a single treatment. A chorioretinal atrophy (ChRA) developed in 3 eyes, and the ChRA enlarged over the fovea in 2 of these eyes, which led to a significant decrease of vision. CONCLUSION A periconus CNV is rare (4.2%) among the eyes with a myopic CNV and is more likely to develop in eyes with a large myopic conus. The absence of a significant association between the degree of myopia and incidence of periconus CNV suggests that the morphologic characteristics of the eye are not the causes of the periconus CNV. Although an angiographic closure can be easily attained with or without the treatment, the later development and progression of ChRA can impair vision.
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Ohno-Matsui K, Shimada N, Yasuzumi K, Hayashi K, Yoshida T, Kojima A, Moriyama M, Tokoro T. Long-term development of significant visual field defects in highly myopic eyes. Am J Ophthalmol 2011; 152:256-265.e1. [PMID: 21664594 DOI: 10.1016/j.ajo.2011.01.052] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [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: 09/01/2010] [Revised: 01/25/2011] [Accepted: 01/26/2011] [Indexed: 11/28/2022]
Abstract
PURPOSE To identify the characteristics that are associated significantly with visual field (VF) defects in highly myopic eyes. DESIGN Retrospective, observational series. METHODS The medical records of 492 eyes of 308 patients with high myopia (myopic refractive error > 8 diopters or axial length ≥ 26.5 mm) with a follow-up of 5 years or more were reviewed. The VFs were determined by Goldmann kinetic perimetry, and the VFs were quantified in 100 sectors within the V4 isopter. Eyes with loss of 10% or more of the sectors were classified as having significant VF defects, and a further loss of 10% or more during the follow-up period was classified as a significant progression. To avoid the influence of the posterior fundus changes resulting from the high myopia, eyes with any type of myopic macular or peripheral lesions that could cause visual field defects were excluded. RESULTS Significant VF defects were newly developed in 13.2% of these selected highly myopic eyes during a mean follow-up ± standard deviation of 11.6 ± 5.5 years. The incidence of significant VF defects in myopic eyes was significantly higher in eyes with an oval optic disc than that in eyes with a round optic disc. An oval optic disc was present significantly more frequently in the myopic eyes with VF defects. Temporal and nasal VF defects were present in the same eye. Among the eyes with significant VF defect, the temporal VF defects were observed in 61.5% of the eyes with round discs, in 75.0% of the eyes with vertically oval discs, and in 68.2% of the eyes with obliquely oval discs. During a mean follow-up ± standard deviation of 10.2 ± 3.4 years, 73.8% of the eyes showed a significant progression of the VF defects. An abrupt change of the scleral curvature (types VII and IX staphyloma by Curtin) was the only factor significantly associated with a progression of the VF defects. CONCLUSIONS Because the VF defects are progressive, we suggest that high myopia is a high risk factor for VF defects and that these eyes be examined at least once yearly. The combination of stretching and distortion of the optic nerve fibers resulting from an abrupt change of scleral curvature may be the factors that lead to the damage of the optic nerve fibers in highly myopic eyes.
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Affiliation(s)
- Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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