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Takeuchi Y, Inoue S, Muta Y, Kawaguchi K, Odaka A. A rare case of oesophageal atresia complicated by duodenal atresia and anorectal malformation successfully treated with multi-stage surgery. Int J Surg Case Rep 2024; 116:109340. [PMID: 38310785 PMCID: PMC10847801 DOI: 10.1016/j.ijscr.2024.109340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
INTRODUCTION Oesophageal atresia, duodenal atresia, and anorectal malformations are rare. This report describes a case of an infant with these three conditions treated using a multi-stage surgical procedure. PRESENTATION OF CASE A male infant was delivered via caesarean section at 34 weeks and 4 days of gestation, weighing 1709 g. Radiography at birth showed a coil-up of the gastrointestinal tube in the oesophagus, a double bubble sign; the patient was subsequently diagnosed with gross type C oesophageal atresia with duodenal atresia. A gastrostomy was performed at day 0. Oesophago-oesophageal anastomosis was performed after tracheoesophageal fistula and blind-end dissection. A duodeno-duodenal diamond-shaped anastomosis was performed, and a tube enterostomy was created from the gastric area near gastrostomy as a trans-anastomotic feeding tube. A colostomy was performed in the descending colon owing to a non-rotation-type anomaly of intestinal malrotation. After other multi-stage surgeries and weight gain, posterior sagittal anorectoplasty was performed at age 1 year 2 months. DISCUSSION Triple atresia (TA), characterized by triumvirate oesophageal atresia, duodenal atresia, and anorectal malformations, remains a clinical puzzle. Notably, standardized therapeutic guidelines for managing TA are lacking. The complexity of this constellation of anomalies necessitates astute diagnostic acumen and strategic treatment planning. CONCLUSION Our patient showed a favourable clinical course with an accurate and timely diagnosis, serving as an experience for an innovative multi-stage therapeutic strategy. Our case showed the appropriate challenges of TA while illuminating the potential for successful outcomes through meticulous clinical management.
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Affiliation(s)
- Yuta Takeuchi
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Seiichiro Inoue
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Yuki Muta
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Kohei Kawaguchi
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Akio Odaka
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
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Inoue S, Muta Y, Takeuchi Y, Odaka A. Two cases of right congenital diaphragmatic hernia with stable respiratory condition: Two case reports. Int J Surg Case Rep 2024; 114:109036. [PMID: 38039568 PMCID: PMC10730737 DOI: 10.1016/j.ijscr.2023.109036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION Right congenital diaphragmatic defect (CDH) has been reported poor prognosis. However, laterality of the defect as the prognostic factor is recent controversial topic. We experienced two cases of right CDH with relatively stable respiratory condition and good clinical course. PRESENTATION OF CASES Case 1 was a girl diagnosed with right CDH by fetal ultrasonography and delivered by planned caesarian section at 37 weeks, 3 days. Fetal MRI showed liver herniation into the right thoracic cavity. High frequency oscillatory ventilation with nitric oxide gas was administered until day 5. At surgery on day 8, we found defects in the right posterolateral diaphragm and sac herniation of the right side of the liver into the right thoracic cavity. The postsurgical course was uneventful, and she was discharged on day 41. Case 2 was a girl with suspected congenital jejunal atresia after fetal ultrasonography detected polyhydramnios and dilatation. She was delivered by normal vaginal delivery at 38 weeks, 5 days, and thoraco-abdominal X ray showed right CDH but no small intestinal atresia. Surgery performed on day 3 found liver herniation into the diaphragmatic defect. Subsequently, bacterial infection occurred and was treated with the antibiotics, but her respiratory condition remained stable. She was discharged on day 49. DISCUSSION The volume of herniated abdominal organs is affected by the presence of a hernia sac or the size of the diaphragmatic defect. CONCLUSION The size of diaphragmatic defect, but not the laterality of the diaphragmatic defect, may be an important prognostic factor in right CDH.
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Affiliation(s)
- Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
| | - Yuki Muta
- Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic Surgery and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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Muta Y, Odaka A, Inoue S, Takeuchi Y, Beck Y. Letter to the Editor: Laparoscopic Pediatric Inguinal Hernia Repair Does Not Necessarily Require Prophylactic Antibiotic Agents. Surg Infect (Larchmt) 2023; 24:843-844. [PMID: 38015644 DOI: 10.1089/sur.2023.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Affiliation(s)
- Yuki Muta
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
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Muta Y, Odaka A, Inoue S, Takeuchi Y, Beck Y. Neonatal inguinal hernias containing the uterus: a case report on changes in uterine position. J Surg Case Rep 2023; 2023:rjad503. [PMID: 37680997 PMCID: PMC10480102 DOI: 10.1093/jscr/rjad503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023] Open
Abstract
A female newborn weighing 542 g and delivered at 27 weeks gestation presented with bilateral inguinal hernias while in the neonatal intensive care unit. Ultrasonography confirmed herniation of the uterus into the right inguinal hernia without signs of incarceration. Due to the absence of complications, she was discharged and scheduled for follow-up at the outpatient clinic. At 11 months of age, a subsequent ultrasonography showed only omental herniation, with no evidence of uterine prolapse. When she reached 1 year of age, a laparoscopic percutaneous extraperitoneal closure procedure was performed. During the surgery, it was observed that the uterus and fallopian tubes were located near the hernia orifice, but no clear prolapse was detected. The procedure concluded safely with successful high ligation. It has noted that in cases of uterine prolapse hernias, the uterus tends to recede as the child grows, which supports the decision to delay surgery for improved safety.
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Affiliation(s)
- Yuki Muta
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan
| | - Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama 3508550, Japan
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Inoue S, Takeuchi Y, Horiuchi Y, Murakami T, Odaka A. CD69 on Tumor-Infiltrating Cells Correlates With Neuroblastoma Suppression by Simultaneous PD-1 and PD-L1 Blockade. J Surg Res 2023; 289:190-201. [PMID: 37141702 DOI: 10.1016/j.jss.2023.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/15/2023] [Accepted: 03/26/2023] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Tumor-infiltrating cells play an important role in tumor immunology, and tumor-infiltrating lymphocytes (TILs) are critical in antitumor reaction related to immune checkpoint inhibition targeting programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1). METHODS In nude mice, which are immune deficient because they lack T cells, and inbred A/J mice, which are syngeneic to neuroblastoma cells (Neuro-2a) and have normal T cell function, we investigated the importance of T lymphocytes in immune checkpoint inhibition in mouse neuroblastoma and analyzed the immune cells in the tumor microenvironment. Then, we subcutaneously injected mouse Neuro-2ainto nude mice and A/J mice, administered anti-PD-1 and anti-PD-L1 antibodies by intraperitoneal injection, and evaluated tumor growth. At 16 d after Neuro-2a cells injection, mice were euthanized, tumors and spleens were harvested, and immune cells were analyzed by flow cytometry. RESULTS The antibodies suppressed tumor growth in A/J but not in nude mice. The co-administration of antibodies did not affect regulatory T cells (culster of differentiation [CD]4+CD25+FoxP3+ cells) or activated CD4+ lymphocytes (expressing CD69). No changes in activated CD8+ lymphocytes (expressing CD69) were observed in spleen tissue. However, increased infiltration of activated CD8+ TILs was seen in tumors weighing less than 300 mg, and the amount of activated CD8+ TILs was negatively correlated with tumor weight. CONCLUSIONS Our study confirms that lymphocytes are essential for the antitumor immune reaction induced by blocking PD-1/PD-L1 and raises the possibility that promoting the infiltration of activated CD8+ TIL into tumors may be an effective treatment for neuroblastoma.
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Affiliation(s)
- Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yutaka Horiuchi
- Department of Microbiology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takashi Murakami
- Department of Microbiology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Takeuchi Y, Inoue S, Odaka A. Expression of programmed cell death-1 on neuroblastoma cells in TH-MYCN transgenic mice. Pediatr Surg Int 2022; 39:6. [PMID: 36441248 DOI: 10.1007/s00383-022-05292-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Immunotherapy may improve the poor prognosis of high-risk neuroblastoma. Programmed cell death-1 (PD-1) is expressed in several cancers. The tyrosine hydroxylase MYCN (TH-MYCN) transgenic mouse model is widely used in neuroblastoma research, but detailed information on its immunological background is lacking. Therefore, we studied the immunological tumor microenvironment and tumor cell surface antigen expression in homozygote and hemizygote mice and effects of antibody therapy against PD-1. METHODS CD4, CD8, CD11b, and CD11c expression in immune cells from retroperitoneal lymph nodes and spleen was analyzed by flow cytometry. Tumor cell surface antigen expression was confirmed, and data from homozygote and hemizygote mice were compared. Effects of anti-PD-1 antibody were evaluated. RESULTS CD4-, CD8-, CD11b-, and CD11c-positive cells were not significantly different in homozygote and hemizygote mice, and CD11b- and CD11c-positive cells were identified in the tumor microenvironment in both. Tumor cells expressed PD-1, and anti-PD-1 antibody had anti-tumor effects and significantly reduced the percentage of living tumor cells in cultures after 2 h. CONCLUSION The immunological background is similar in homozygote and hemizygote TH-MYCN transgenic mice, and both have PD-1-positive tumor cells. Anti-PD-1 antibody suppresses tumor growth. This mouse model may be a useful for studying immunotherapy of neuroblastoma.
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Affiliation(s)
- Yuta Takeuchi
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Seiichiro Inoue
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Akio Odaka
- Department of Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
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Ishikawa T, Inoue S, Kawaguchi M. A pediatric case of severe systemic pneumatosis during airway pressure release ventilation. Medicina Intensiva (English Edition) 2022; 46:544-545. [PMID: 36057443 PMCID: PMC9432805 DOI: 10.1016/j.medine.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/19/2020] [Indexed: 11/20/2022]
Affiliation(s)
- T Ishikawa
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
| | - S Inoue
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan.
| | - M Kawaguchi
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
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Muta Y, Odaka A, Inoue S, Takechi Y, Beck Y. Minimally invasive fenestration for congenital hepatic cyst in infant. Oxf Med Case Reports 2022; 2022:omac072. [DOI: 10.1093/omcr/omac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/29/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
ABSTRACT
A 19-year-old woman underwent prenatal ultrasonography, which confirmed the presence of an isolated cystic mass in the upper abdominal cavity of a fetus. A female infant weighing 3085 g was delivered at 36 weeks’ gestation. Ultrasonography and computed tomography examination revealed a clear unilocular cyst and occupying the right side of the abdomen. The infant’s respiratory status was unstable, and she fed poorly, owing to compression by the hepatic cyst. We performed ultrasound-guided aspiration of a hepatic cyst at 15 days old, but it rapidly re-grew. Therefore, we performed laparoscopic findings and fenestration of the hepatic cyst via an umbilical arc incision and the cyst wall was excised at 43 days old. The histopathological diagnosis was mesothelial cell-derived hepatic cyst. Three years after the operation, no recurrence has been observed. Hepatic cyst fenestration by umbilical incision can be performed safely in infants and it is a cosmetically superior method.
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Affiliation(s)
- Yuki Muta
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
- Saitama Medical University , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
- Saitama Medical University , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
| | - Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
- Saitama Medical University , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
| | - Yuta Takechi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
- Saitama Medical University , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
- Saitama Medical University , Saitama Medical Center, ,Kawagoe City, Saitama Prefecture, Japan
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Muta Y, Odaka A, Inoue S, Takeuchi Y, Beck Y. Thoracoscopic removal with fluoroscopic radiographic guidance of thoracoamniotic shunting catheters in newborns. Surg Today 2022; 52:1504-1508. [PMID: 35752992 DOI: 10.1007/s00595-022-02535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
Fetal thoracoamniotic shunting (TAS), which drains pleural effusion, is a treatment for severe primary fetal pleural effusion. While TAS is an effective treatment, its complications include bleeding and the catheter becoming dislodged, and also penetrating the thoracic cavity or chest wall. Catheters dislodged into the thoracic cavity in TAS can be removed by thoracoscopy. However, if there are adhesions in the thoracic cavity, finding the TAS catheter with a thoracoscope can be difficult. We used fluoroscopic radiography in addition to a thoracoscope to remove a TAS catheter in four patients. A 5-mm trocar was inserted into the thoracic cavity, and a 2.7-mm scope and 3-mm forceps were inserted into the trocar. We searched for TAS catheters using a thoracoscope and fluoroscopic radiography. If there are adhesions in the thoracic cavity and removing the TAS catheter is difficult, the combined use of a thoracoscope and fluoroscopic radiography may prove helpful.
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Affiliation(s)
- Yuki Muta
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda1981, Kawagoe, Saitama, 350-8550, Japan.
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda1981, Kawagoe, Saitama, 350-8550, Japan
| | - Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda1981, Kawagoe, Saitama, 350-8550, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda1981, Kawagoe, Saitama, 350-8550, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kamoda1981, Kawagoe, Saitama, 350-8550, Japan
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Takeuchi Y, Inoue S, Odaka A, Muta Y, Beck Y. Anterolateral defect of left congenital diaphragmatic hernia with hepatic herniation. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102292] [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] Open
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Inoue S, Hayashi T, Teishima J. Impact of low-intensity extracorporeal shock wave therapy on sexual function after non-nerve-sparing robot-assisted laparoscopic radical prostatectomy. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Inoue S, Odaka A, Muta Y, Maruta S, Takeuchi Y, Beck Y, Yamashita T. Small bowel intussusception secondary to intestinal submucosal cyst in an infant. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102248] [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: 11/17/2022] Open
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Maruta S, Inoue S, Odaka A, Muta Y, Takeuchi Y, Beck Y, Kikuchi J. Small bowel intussusception caused by a solitary Peutz-Jeghers–type polyp. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102227] [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: 11/15/2022] Open
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Muta Y, Odaka A, Inoue S, Takeuchi Y, Beck Y. Female pediatric inguinal hernia: uterine deviation toward the hernia side. Pediatr Surg Int 2021; 37:1569-1574. [PMID: 34424379 DOI: 10.1007/s00383-021-04982-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE We aimed to clarify the frequency and the clinical significance of deviation of the uterus in female pediatric inguinal hernia. METHODS We retrospectively evaluated the data of 94 female pediatric inguinal hernia cases that were treated by laparoscopic percutaneous extraperitoneal closure. We assessed for correlations between uterine deviation and age, body weight, the size of the hernia orifice, and the presence of contralateral processus vaginalis (PV) patency. RESULTS Eighty-four of 94 cases were diagnosed with unilateral inguinal hernia. A total of 62 (73.8%) of these had uterine deviation to the hernia side (Group D); 22 (26.2%) had no deviation to the hernia side (Group N) (P < 0.001). Group D cases were significantly younger than those in Group N (P = 0.0351). There was no difference in body weight, size of the hernia orifice, or contralateral PV patency between the two groups. CONCLUSION The incidence of uterine deviation toward the hernia side was statistically significant. It is important to recognize that female pediatric inguinal hernia repair carries an increased risk of ovarian and fallopian tube damage, because these appendages are close to the hernia orifice as a result of the uterine deviation.
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Affiliation(s)
- Yuki Muta
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
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Watanabe T, Tachibana K, Shinoda Y, Minamisaka T, Inui H, Ueno K, Inoue S, Hoshida S. Impact of low-dose or under-dose direct oral anticoagulant on coagulation and fibrinolytic markers in patients with atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is known to increase the risks of cerebral and systemic embolism. Apart from vitamin K antagonists, edoxaban, a direct oral anticoagulant (DOAC), has been approved for oral anticoagulation in patients with non-valvular AF. On the other hand, DOACs are sometimes prescribed at off-label under-doses for patients who have undergone ablation for AF. Prothrombin fragment F1+2 is an activation peptide released from prothrombin during thrombin formation. The purpose of this study is to compare the effects of DOAC doses on coagulation and fibrinolytic markers.
Methods and results
A total of 88 patients with AF (age: 68±11 years, male:45%, paroxysmal AF n=49, persistent AF n=39) were recruited. All patients were received edoxaban (60mg or 30mg) once a day. For the purpose of the study, patients were divided into three groups according to whether they had been treated before the ablation procedure under an appropriate standard dose group (n=30 [34.1%]), appropriate low-dose group (n=35 [39.8%]), or off-label under-dose group (n=23 [26.1%]). We examined the coagulation and fibrinolytic markers, and echocardiographic parameters before ablation. All patients were followed up for 12 months after AF ablation. Creatinine clearance was significantly higher in appropriate standard-dose group than in appropriate low-dose or off-label under-dose group (101.1±38.4, 57.1±15.9 and 73.2±14.6 mL/min, respectively; P<0.001). There were no significant baseline differences in AF type, history of stroke/transient ischemic attack (TIA), plasma B-type natriuretic peptide, protein C, fibrinogen, D-dimer level, left ventricular ejection fraction or left atrium dimension among the three groups. Prothrombin fragment F1+2 level was significantly lower in the appropriate standard-dose group than the appropriate low-dose and off-label under-dose groups (105.9±29.4, 142.6±41.3 and 142.8±84.9 pmol/L, respectively; P=0.011, Figure). One patient in the appropriate low-dose group had a TIA and 1 patient in the off-label under-dose group had a bleeding event during the follow up period after ablation.
Conclusion
Our results suggest that an appropriate standard dose of edoxaban is needed to suppress hypercoagulability in patients with AF.
Funding Acknowledgement
Type of funding sources: None. Prothrombin fragment F1+2 level
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Affiliation(s)
- T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | | | | | | | - H Inui
- Yao Municipal Hospital, Yao, Japan
| | - K Ueno
- Yao Municipal Hospital, Yao, Japan
| | - S Inoue
- Yao Municipal Hospital, Yao, Japan
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Yasuda M, Tachi T, Osawa T, Watanabe H, Inoue S, Makino T, Nagaya K, Morita M, Tanaka K, Aoyama S, Kasahara S, Teramachi H, Mizui T. Risk factors for thrombocytopenia and analysis of time to platelet transfusion after azacitidine treatment. Pharmazie 2021; 76:444-449. [PMID: 34481536 DOI: 10.1691/ph.2021.1566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The use of azacitidine (AZA) has been known to lead to a high incidence of hematotoxic adverse events. The aims of this study were to identify the risk factors for thrombocytopenia after the administration of AZA and to analyze time to the initial platelet transfusion. Sixty-two patients with myelodysplastic syndrome (MDS), who were treated with AZA in Gifu Municipal Hospital between March 2012 and June 2020, were included in this study. The risk factors for thrombocytopenia were identified using univariate analysis of patient characteristics, disease type, and laboratory values immediately before the start of treatment. Variables with p<0.2 identified in the univariate analysis were used as independent variables in the multivariate analysis. This analysis identified "creatinine clearance (CCr) <60 mL/min" as a significant factor (odds ratio, 4.790; 95% confidence interval [CI], 1.380-16.70; p=0.014). Subsequently, time in days to the initial platelet transfusion after the initial administration of AZA was analyzed using the log-rank test. The overall median time in days to platelet transfusion was 370 days. The log-rank test was used to determine the influence of patient characteristics, disease type, and laboratory values immediately before the start of treatment. The subsequent Cox proportional hazard regression analysis using variables with p<0.2 as independent variables identified "hemoglobin (Hb) <8.0 g/dL" as a significant factor (hazard ratio, 2.143; 95% CI, 1.001-4.573; p=0.048). The results of this study led to the following clinical implications: first, patients with CCr of <60 mL/min at the start of treatment should be treated with caution due to the risk of thrombocytopenia. Second, patients with Hb of <8.0 g/dL at the start of treatment may require platelet transfusion in the early stage of treatment.
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Affiliation(s)
- M Yasuda
- Department of Pharmacy, Gifu Municipal Hospital, Japan; Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan;,
| | - T Tachi
- Department of Pharmacy, Gifu Municipal Hospital, Japan; Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan
| | - T Osawa
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - H Watanabe
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Inoue
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - T Makino
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - K Nagaya
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - M Morita
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - K Tanaka
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Aoyama
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Kasahara
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - H Teramachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan
| | - T Mizui
- Department of Pharmacy, Gifu Municipal Hospital, Japan
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Hayashi T, Ikeda K, Taniyama D, Hsi R, Inoue S, Teishima J, Akabane S, Sentani K, Yasui W, Yamamoto H, Kuraoka K, Hinoi T. Clinicopathological characteristics of upper tract urothelial cancer with loss of immunohistochemical expression of mismatch repair proteins. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Hayashi T, Ikeda K, Sakamoto N, Sentani K, Hsi RS, Sekino Y, Kitano H, Goto K, Inoue S, Yasui W, Black PC, Teishima J. Transition of ANXA10 expression is a useful diagnostic and prognostic marker in upper tract urothelial carcinoma. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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19
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Umemoto N, Imaoka T, Inoue S, Oshima S, Itou R, Sakakibara T, Shimizu K, Ishii H, Murohara T. Impact of stress myocardial blood flow as an important predictor for major adverse cardiac and cerebrovascular event in hemodialysis patients, even in patients without myocardial perfusion abnormality. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the clinical setting, ischemic heart disease (IHD) is a major problem not only in general patients but also in regular hemodialysis (HD) patients. Positron emission tomography (PET) is becoming a reliable modality for detecting coronary artery disease. Of course, PET illustrates myocardial perfusion (MP), PET also measures myocardial blood flow (MBF) directly. We have reported stress MBF is an independent predictor in HD population. Although some prior studies show CFR is an independent predictor for their prognosis in patients without MP abnormality, there is limited data about the predictability of stress MBF in HD patients without MP abnormality.
Methods
A total 438 of HD patients who undergone 13NH3PET for suspected IHD were enrolled. All patients were undergone13NH3PET at Nagoya Radiological Diagnosis Foundation. After we excluded patients whose summed stress score (SSS) <4, we identified 182 eligible patients. Patients were divided into two group according to the median value of CFR levels; low stress MBF group (≤2.56) and high stress MBF group (>2.56). We followed up them up to 4.2 years (median 2.4 years) and collected their data. We evaluated their major adverse cardiac cerebrovascular event. We performed Kaplan-Meyer analysis and multivariable cox regression models. Furthermore, we evaluated the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when CFR added into a model with established risk factors.
Result
There were intergroup difference in baseline characteristics: age, gender, prior CVD and diabetes. Kaplan-Meyer analysis shows statistically intergroup difference [log rank p=0.013, hazard ratio (HR) 0.413, 95% confidential interval (CI) 0.220–0.775]. Multivariable cox regression model for MACCE shows CFR is an independent risk factor (p=0.004, HR 0.311, 95% CI 0.137–0.684). As regarding model discrimination, all of C-index (0.832 vs 0.796, p=0.15), NRI (0.513, p=0.008) and IDI (0.032, p=0.033) were greatest in a predicting model with established risk factors plus stress MBF.
Conclusion
The low stress MBF group has poor prognosis in MACCE comparing to the high stress MBF group. Stress MBF is an independent risk factor for MACCE. Adding stress MBF on conventional risk factors could more accurately predict MACCE in HD patients, even in patients without MP abnormality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Imaoka
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Oshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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Umemoto N, Imaoka T, Inoue S, Itou R, Oshima S, Sakakibara T, Shimizu K, Ishii H, Murohara T. Diabetes and hemodialysis are important factor for decrease coronary flow reserve even in the patients with normal myocardial perfusion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In clinical setting, patients with traditional coronary risk factors are at high risk for coronary artery disease (CAD). Such patients who complain chest discomfort are usually performed nuclear myocardial perfusion (MP) test. We sometimes find patients whose PET result shows normal MP and abnormal coronary flow reserve (CFR). However, there are limited data about the predictors for decreased CFR. In the view of describe above, we have investigated the parameters for decreased CFR in the patients without MP abnormality.
Methods and results
From 20th April 2013 to 21st December 2018, we performed 2,930 13N- ammonia PET for suspected CAD. After excluding the follows; 966 patients with repeated test, 54 patients with incomplete data, one patient missed, we investigated 1,909 eligible patients' data. We performed least square to identify the factors decreased CFR. Hemodialysis (HD), age, prior revascularization, diabetes (DM) and body mass index (BMI) were independent risk factor for decreased CFR in all population. On the other hand, HD, age, DM, hypertension and BMI were independent risk factor for decreasing CFR in patients without MP abnormality. According to the result of least square methods, we classified all patients into four groups; without DM/ without HD group, with DM/ without HD group, without DM/ with HD group and with DM/ with HD group. The value of CFR in each group were as follows: without DM/ without HD group (median, 1st quartile-3rd quartile; 2.88, 2.21–3.52), with DM/ without HD group (2.65, 2.00–3.38), without DM/ with HD group (2.29, 1.67–2.95) and with DM/ with HD group (1.97, 1.43–2.68). There were statistically significant intergroup differences. The value of CFR in the patients without MP abnormality were as follows: without DM/ without HD group (3.04, 2.47–3.65), with DM/ without HD group (2.98, 2.40–3.61), without DM/ with HD group (2.52, 2.10–3.08) and with DM/ with HD group (2.38, 1.86–2.97). Even in the patients without MP abnormality, there were also statistically significant intergroup differences.
Conclusion
According to our 13N-ammonia PET data analysis, DM and HD were important and independent factors for decreased CFR. Even in the patients without MP abnormality, DM and HD were important factor for decreased CFR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Imaoka
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - S Oshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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21
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Inoue S, Setoyama Y, Beck Y, Kitagawa D, Odaka A. Erratum: Ex vivo induction of antitumor DEC-205 + CD11c + cells in a murine neuroblastoma model by co-stimulation with doxorubicin, lipopolysaccharide and interleukin-4. Biomed Rep 2020; 13:44. [PMID: 32953109 PMCID: PMC7484973 DOI: 10.3892/br.2020.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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22
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Inoue S, Odaka A, Muta Y, Takeuchi Y, Yamashita T, Kabe K, Sakurai Y. Left hemidiaphragmatic elevation: Value of histology. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101546] [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: 10/24/2022] Open
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23
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Acciari VA, Ansoldi S, Antonelli LA, Arbet Engels A, Baack D, Babić A, Banerjee B, Barres de Almeida U, Barrio JA, Becerra González J, Bednarek W, Bellizzi L, Bernardini E, Berti A, Besenrieder J, Bhattacharyya W, Bigongiari C, Biland A, Blanch O, Bonnoli G, Bošnjak Ž, Busetto G, Carosi R, Ceribella G, Cerruti M, Chai Y, Chilingarian A, Cikota S, Colak SM, Colin U, Colombo E, Contreras JL, Cortina J, Covino S, D'Amico G, D'Elia V, Da Vela P, Dazzi F, De Angelis A, De Lotto B, Delfino M, Delgado J, Depaoli D, Di Pierro F, Di Venere L, Do Souto Espiñeira E, Dominis Prester D, Donini A, Dorner D, Doro M, Elsaesser D, Fallah Ramazani V, Fattorini A, Ferrara G, Foffano L, Fonseca MV, Font L, Fruck C, Fukami S, García López RJ, Garczarczyk M, Gasparyan S, Gaug M, Giglietto N, Giordano F, Gliwny P, Godinović N, Green D, Hadasch D, Hahn A, Herrera J, Hoang J, Hrupec D, Hütten M, Inada T, Inoue S, Ishio K, Iwamura Y, Jouvin L, Kajiwara Y, Karjalainen M, Kerszberg D, Kobayashi Y, Kubo H, Kushida J, Lamastra A, Lelas D, Leone F, Lindfors E, Lombardi S, Longo F, López M, López-Coto R, López-Oramas A, Loporchio S, Machado de Oliveira Fraga B, Maggio C, Majumdar P, Makariev M, Mallamaci M, Maneva G, Manganaro M, Mannheim K, Maraschi L, Mariotti M, Martínez M, Mazin D, Mender S, Mićanović S, Miceli D, Miener T, Minev M, Miranda JM, Mirzoyan R, Molina E, Moralejo A, Morcuende D, Moreno V, Moretti E, Munar-Adrover P, Neustroev V, Nigro C, Nilsson K, Ninci D, Nishijima K, Noda K, Nogués L, Nozaki S, Ohtani Y, Oka T, Otero-Santos J, Palatiello M, Paneque D, Paoletti R, Paredes JM, Pavletić L, Peñil P, Perennes C, Peresano M, Persic M, Prada Moroni PG, Prandini E, Puljak I, Rhode W, Ribó M, Rico J, Righi C, Rugliancich A, Saha L, Sahakyan N, Saito T, Sakurai S, Satalecka K, Schleicher B, Schmidt K, Schweizer T, Sitarek J, Šnidarić I, Sobczynska D, Spolon A, Stamerra A, Strom D, Strzys M, Suda Y, Surić T, Takahashi M, Tavecchio F, Temnikov P, Terzić T, Teshima M, Torres-Albà N, Tosti L, van Scherpenberg J, Vanzo G, Vazquez Acosta M, Ventura S, Verguilov V, Vigorito CF, Vitale V, Vovk I, Will M, Zarić D, Nava L. Bounds on Lorentz Invariance Violation from MAGIC Observation of GRB 190114C. Phys Rev Lett 2020; 125:021301. [PMID: 32701326 DOI: 10.1103/physrevlett.125.021301] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/20/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
On January 14, 2019, the Major Atmospheric Gamma Imaging Cherenkov telescopes detected GRB 190114C above 0.2 TeV, recording the most energetic photons ever observed from a gamma-ray burst. We use this unique observation to probe an energy dependence of the speed of light in vacuo for photons as predicted by several quantum gravity models. Based on a set of assumptions on the possible intrinsic spectral and temporal evolution, we obtain competitive lower limits on the quadratic leading order of speed of light modification.
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Affiliation(s)
- V A Acciari
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ansoldi
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L A Antonelli
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | | | - D Baack
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - A Babić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - B Banerjee
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - U Barres de Almeida
- Centro Brasileiro de Pesquisas Fsicas (CBPF), 22290-180 URCA, Rio de Janeiro (RJ), Brasil
| | - J A Barrio
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Becerra González
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - W Bednarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - L Bellizzi
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - E Bernardini
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Berti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - J Besenrieder
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - W Bhattacharyya
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - C Bigongiari
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Biland
- ETH Zurich, CH-8093 Zurich, Switzerland
| | - O Blanch
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - G Bonnoli
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - Ž Bošnjak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - G Busetto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - R Carosi
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - G Ceribella
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Cerruti
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - Y Chai
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A Chilingarian
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - S Cikota
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - S M Colak
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - U Colin
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Colombo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J L Contreras
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Cortina
- Centro de Investigaciones Energticas, Medioambientales y Tecnolgicas, E-28040 Madrid, Spain
| | - S Covino
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - G D'Amico
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - V D'Elia
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Da Vela
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - F Dazzi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A De Angelis
- Università di Padova and INFN, I-35131 Padova, Italy
| | - B De Lotto
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Delfino
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - J Delgado
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Depaoli
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Di Pierro
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - L Di Venere
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - E Do Souto Espiñeira
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Dominis Prester
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - A Donini
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Dorner
- Universität Würzburg, D-97074 Würzburg, Germany
| | - M Doro
- Università di Padova and INFN, I-35131 Padova, Italy
| | - D Elsaesser
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - V Fallah Ramazani
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - A Fattorini
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - G Ferrara
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - L Foffano
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M V Fonseca
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - L Font
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - C Fruck
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Fukami
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - R J García López
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Garczarczyk
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gasparyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - M Gaug
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - N Giglietto
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Giordano
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - P Gliwny
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - N Godinović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Green
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Hadasch
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Hahn
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Herrera
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J Hoang
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - D Hrupec
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Hütten
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Inada
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Inoue
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Ishio
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - Y Iwamura
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Jouvin
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kajiwara
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Karjalainen
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - D Kerszberg
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kobayashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - H Kubo
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Kushida
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Lamastra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Lelas
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - F Leone
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - E Lindfors
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - S Lombardi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - F Longo
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M López
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - R López-Coto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A López-Oramas
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Loporchio
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - C Maggio
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - P Majumdar
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - M Makariev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Mallamaci
- Università di Padova and INFN, I-35131 Padova, Italy
| | - G Maneva
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Manganaro
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - K Mannheim
- Universität Würzburg, D-97074 Würzburg, Germany
| | - L Maraschi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - M Mariotti
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Martínez
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Mazin
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Mender
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - S Mićanović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Miceli
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - T Miener
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M Minev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - J M Miranda
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - R Mirzoyan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Molina
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - A Moralejo
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Morcuende
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - V Moreno
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - E Moretti
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - P Munar-Adrover
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - V Neustroev
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - C Nigro
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nilsson
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - D Ninci
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nishijima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Noda
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Nogués
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - S Nozaki
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Ohtani
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - T Oka
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Otero-Santos
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Palatiello
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Paneque
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - R Paoletti
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - J M Paredes
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Pavletić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - P Peñil
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - C Perennes
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Peresano
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Persic
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | | | - E Prandini
- Università di Padova and INFN, I-35131 Padova, Italy
| | - I Puljak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - W Rhode
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - M Ribó
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - J Rico
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - C Righi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Rugliancich
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - L Saha
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Sahakyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - T Saito
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Sakurai
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Satalecka
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | | | - K Schmidt
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - T Schweizer
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Sitarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - I Šnidarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Sobczynska
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - A Spolon
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Stamerra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Strom
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Strzys
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Suda
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Surić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Takahashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - F Tavecchio
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Temnikov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - T Terzić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Teshima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - N Torres-Albà
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Tosti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - G Vanzo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Vazquez Acosta
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ventura
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - V Verguilov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - C F Vigorito
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - V Vitale
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - I Vovk
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Will
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Zarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - L Nava
- National Institute for Astrophysics (INAF), Osservatorio Astronomico di Brera, 23807 Merate, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, 34149 Trieste, Italy
- Institute for Fundamental Physics of the Universe (IFPU), 34151 Trieste, Italy
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Inoue S, Hayashi T, Hieda K, Miyamoto S, Fujii S, Sekino Y, Kitano H, Ikeda K, Goto K, Teishima J, Matsubara A. Longitudinal analysis of conventional laparoscopic, posterior retroperitoneoscopic, and laparoendoscopic single-site adrenalectomy regarding cosmesis and satisfaction outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yamaki K, Terashi M, Ogura S, Inoue S, Naka N, Nakagaki T, Oka N, Koyama Y. Anti-allergic effect of the Src family kinase inhibitor saracatinib. Pharmazie 2020; 75:339-343. [PMID: 32635977 DOI: 10.1691/ph.2020.9949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The aim of this study was to evaluate the anti-anaphylactic and anti-allergic potentials of saracatinib, a Src family kinase inhibitor that was already shown to be safe in clinical trials when it was used as an anti-cancer drug. Using in vitro mast cell models, we found that saracatinib inhibited the degranulation response and cytokine production in RBL2H3 cells that were stimulated with IgE and antigen without affecting cell viability. Phosphorylation of Lyn, Akt, a PI3K substrate, and MAPKs including ERK, JNK, and p38, as well as the intracellular Ca2+ increase induced by this stimulation were also suppressed by saracatinib. This drug also inhibited symptoms in our established anaphylaxis mouse model, anaphylaxis-dependent spotted distribution of immune complex in skin (ASDIS). The intravenous injection of the mixture of IgE and antigen induced acute spotted distribution of immune complex in skin in hairless HR-1 mice, and its inhibition by intradermal injection of saracatinib was observed. Moreover, toluidine blue-stained skin sections indicated that the degranulation ratio of dermal mast cells was reduced in saracatinib-treated skin compared with vehicle-treated skin. Because only a few signaling inhibitors are used as anti-anaphylaxis and anti-allergic drugs, these results indicated the valuable suggestion that saracatinib and the Src family kinase inhibitors are good candidates for anti-anaphylaxis and anti-allergic drugs.
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Affiliation(s)
- K Yamaki
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan;,
| | - M Terashi
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - S Ogura
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - S Inoue
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - N Naka
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - T Nakagaki
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - N Oka
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - Y Koyama
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
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26
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Kohada Y, Hayashi T, Hsi R, Yukihiro K, Sentani K, Goto K, Inoue S, Ohara S, Teishima J, Kajiwara M, Nishisaka T, Mikami J, Anan G, Ito J, Kaiho Y, Sato M, Yasui W, Akio M. Recurrence and progression free survival of intermediate risk NMIBC: The impact of conditional evaluation and sub-classification. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33546-1] [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: 11/17/2022] Open
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Okiyama N, Nakamura Y, Ishitsuka Y, Inoue S, Kubota N, Saito A, Watanabe R, Fujisawa Y, Igawa K. Successful topical treatment with ketoconazole for facial rashes refractory to dupilumab in patients with atopic dermatitis: case reports. J Eur Acad Dermatol Venereol 2020; 34:e474-e476. [DOI: 10.1111/jdv.16383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
Affiliation(s)
- N. Okiyama
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Nakamura
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Ishitsuka
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - S. Inoue
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - N. Kubota
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - A. Saito
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - R. Watanabe
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Fujisawa
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - K. Igawa
- Department of Dermatology Dokkyo Medical University School of Medicine Tochigi Japan
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28
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Ishikawa T, Inoue S, Kawaguchi M. A pediatric case of severe systemic pneumatosis during airway pressure release ventilation. Med Intensiva 2020; 46:S0210-5691(20)30109-1. [PMID: 32482369 PMCID: PMC9402261 DOI: 10.1016/j.medin.2020.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 12/02/2022]
Affiliation(s)
- T Ishikawa
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
| | - S Inoue
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan.
| | - M Kawaguchi
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
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29
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Inoue S, Horiuchi Y, Setoyama Y, Takeuchi Y, Beck Y, Murakami T, Odaka A. Immune Checkpoint Inhibition Followed by Tumor Infiltration of Dendritic Cells in Murine Neuro-2a Neuroblastoma. J Surg Res 2020; 253:201-213. [PMID: 32380346 DOI: 10.1016/j.jss.2020.03.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/04/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Most tumors responding to immunotherapy with monoclonal antibodies targeting programmed cell death protein1 (PD1) and programmed death ligand-1 (PD-L1) show surface expression of PD-L1. Neuroblastoma has been reported to show low PD-L1 surface expression. METHODS The effect of immune checkpoint inhibitor on mouse neuroblastoma was investigated, and host immune cells were analyzed in the tumor microenvironment. Expression of co-stimulatory molecules by Neuro-2a mouse neuroblastoma cells was analyzed using flow cytometer. Neuro-2a cells were inoculated subcutaneously into A/J mice, followed by intraperitoneal injection of antibodies targeting PD-1 and PD-L1. Mice were sacrificed for the measurement of tumor weights on day 14 following tumor inoculation, and tumor-infiltrating cells were analyzed using a flow cytometer. RESULTS Dim expression of PD-L1 was observed on the cell surface of cultured Neuro-2a cells. Growth of subcutaneous tumors was significantly suppressed, and PD-L1-expressing tumor cells were depleted by the antibody treatment. We confirmed that Neuro-2a cells opsonized by the anti-PD-L1 antibody were phagocytosed in the in vitro setting. In the treated tumor microenvironments, CD8α+ lymphocyte and CD11c+ MHC II+ cells were significantly accumulated in comparison with the control group. These CD11c+ MHC II+ cells expressed CD80, CD86, CD14, and CD40, but not CD205, PD-L1, or CTLA4. PD-1 expression was detected dimly. Immune suppressive effects of CD11b+Gr-1+ myeloid-derived suppressor cells by the administration of anti-PD-1 and PD-L1 antibodies were not observed in spleen, regional lymph nodes, or tumor microenvironment. CONCLUSIONS Our findings raise the possibility that co-administration of anti-PD-1 and anti-PD-L1 antibodies have a synergistic effect on inhibition of tumor growth and could be an effective therapy against neuroblastoma with dim expression of PD-L1.
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Affiliation(s)
- Seiichiro Inoue
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
| | - Yutaka Horiuchi
- Department of Microbiology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Yumiko Setoyama
- Department of Biomedical Sciences, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Yuta Takeuchi
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Yoshifumi Beck
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
| | - Takashi Murakami
- Department of Microbiology, Faculty of Medicine, Saitama Medical University, Iruma-gun, Saitama, Japan
| | - Akio Odaka
- Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan
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Iwano T, Yoshimura K, Inoue S, Odate T, Ogata K, Funatsu S, Tanihata H, Kondo T, Ichikawa D, Takeda S. Breast cancer diagnosis based on lipid profiling by probe electrospray ionization mass spectrometry. Br J Surg 2020; 107:632-635. [PMID: 32246473 PMCID: PMC7216899 DOI: 10.1002/bjs.11613] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/08/2020] [Indexed: 12/14/2022]
Affiliation(s)
- T Iwano
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
| | - K Yoshimura
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
| | - S Inoue
- Department of Digestive , Breast and Endocrine Surgery, Yamanashi, Japan
| | - T Odate
- Department of Pathology, University of Yamanashi, Chu, Yamanashi, Japan
| | - K Ogata
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - S Funatsu
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - H Tanihata
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - T Kondo
- Department of Pathology, University of Yamanashi, Chu, Yamanashi, Japan
| | - D Ichikawa
- Department of Digestive , Breast and Endocrine Surgery, Yamanashi, Japan
| | - S Takeda
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
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Ro Y, Hamada C, Io H, Hayashi K, Inoue S, Hirahara I, Tomino Y. Early Diagnosis of CAPD Peritonitis Using a New Test Kit for Detection of Matrix Metalloproteinase (MMP)-9. Perit Dial Int 2020. [DOI: 10.1177/089686080402400119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Y. Ro
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - C. Hamada
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - H. Io
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - K. Hayashi
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - S. Inoue
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - I. Hirahara
- Terumo Corporation Biological Evaluation Center Kanagawa Japan
| | - Y. Tomino
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
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Ubara Y, Hara S, Katori H, Arizono K, Ikeguti H, Yokoyama K, Hinosita F, Inoue S, Kuzuhara K, Yamada A, Mimura N. Acute Pancreatitis in a Capd Patient in Association with Hemolytic Anemia. Perit Dial Int 2020. [DOI: 10.1177/089686089701700123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Y. Ubara
- Department of Interna Medicine1, Tokyo, Japan
| | - S. Hara
- Department of Interna Medicine1, Tokyo, Japan
| | - H. Katori
- Department of Interna Medicine1, Tokyo, Japan
| | - K. Arizono
- Department of Interna Medicine1, Tokyo, Japan
| | - H. Ikeguti
- Department of Interna Medicine1, Tokyo, Japan
| | - K. Yokoyama
- Department of Interna Medicine1, Tokyo, Japan
| | - F. Hinosita
- Department of Interna Medicine1, Tokyo, Japan
| | - S. Inoue
- Department of Surgery Toranomon Hospital Kidney Center Minatoku, Tokyo, Japan
| | - K. Kuzuhara
- Department of Surgery Toranomon Hospital Kidney Center Minatoku, Tokyo, Japan
| | - A. Yamada
- Department of Interna Medicine1, Tokyo, Japan
| | - N. Mimura
- Department of Interna Medicine1, Tokyo, Japan
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33
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Morita M, Nakamura A, Tanaka H, Saito R, Inoue S, Harada T, Yamada T, Nakagawa T, Jingu D, Sugawara S. Phase II study of low-dose afatinib maintenance treatment for patients with EGFR-mutated non-small cell lung cancer (NJLCG1601). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Shibata N, Sumi T, Umemoto N, Kajiura H, Inoue S, Iio Y, Sugiura T, Taniguchi T, Asai T, Yamada M, Shimizu K, Murohara T. P5410Combination assessment of renal and hepatic dysfunction improves the predictability of prognosis in patients with acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Renal dysfunction is associated with poor mortality in patients with heart failure (HF). Hepatic dysfunction, assessed by Fibrosis-4 (FIB4) index, has also prediction ability in acute decompensated HF (ADHF) patients. We investigated whether the assessment of the combination of FIB4 index and renal dysfunction improves predictability in patients with ADHF.
Methods
We retrospectively enrolled consecutive 758 patients who admitted due to ADHF from January 2011 to February 2018 and followed up for one year. FIB4 index on admission was calculated by the formula: age (yrs) × AST[U/L] / (platelets [103/μL] × (ALT[U/L])1/2). Study subjects were divided into high FIB4 index (>3.25) and low FIB4 index (≤3.25), furthermore each group were classified by the presence/absence of CKD (estimated glomerular filtration rate <60 ml/min/1.73m). We have generated four groups; low FIB4/without CKD (n=154), low FIB4/with CKD (n=294), high FIB4/without CKD (n=56), and high FIB4/with CKD (n=254). The primary outcome was defined as all-cause mortality in one year. We performed Kaplan-Meyer analysis and multivariable Cox regression models. Furthermore, we evaluated the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when FIB4 index and renal dysfunction added to a baseline model.
Results
In total, 106 patients died in one year. High FIB4 index and CKD showed significantly higher 1-year mortality (high FIB4 index: 19.7% vs 10.3%, p<0.001, CKD: 17.0% vs 6.7%, p<0.001, respectively). Kaplan-Meyer analysis shows that high FIB4 index with CKD showed statistically higher mortality than the others (vs low FIB4/without CKD, p<0.001, vs high FIB4/without CKD, p=0.031, vs low FIB4/with CKD, p<0.001, respectively).
Multivariate Cox regression model revealed that both high FIB4 index and CKD were an independent risk predictor of 1-year mortality (FIB4 index: p<0.001, HR 1.06, 95% CI 1.035–1.087, CKD: p=0.004, HR 1.834, 95% CI 1.213–2.773, respectively) in patients with ADHF.
A baseline model for prediction of 1-year mortality was determined by multivariable logistic regression including age, body mass index, systolic blood pressure, and serum albumin (C-index: 0.688). Adding high FIB4 index and CKD to the baseline model, all of C-index (0.738, p=0.04), NRI (0.122, p=0.067), and IDI (0.024, p=0.004) were improved.
Receiver operating characteristic curves
Conclusions
Combination assessment of renal and hepatic dysfunction could improve the predictability of prognosis in patients with ADHF.
Acknowledgement/Funding
None
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Affiliation(s)
- N Shibata
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Sumi
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - N Umemoto
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - H Kajiura
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Sugiura
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Taniguchi
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Asai
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - M Yamada
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - K Shimizu
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Hospital, Department of cardiology, Nagoya, Japan
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Sumi T, Umemoto N, Kajiura H, Inoue S, Iio Y, Shibata N, Sugiura T, Taniguchi T, Asai T, Yamada M, Shimizu K, Murohara T. P4551Prognostic utility of Palliative Prognostic Index for prediction of 30-day and 1-year outcome in patients with acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prognosis of heart failure remains poor similar to the terminal cancer patients, although recent progress in medical treatment. Palliative Prognostic Index (PPI) is a widely used prognostic index for terminal cancer patients (PPI includes: Palliative Performance Scale, oral intake, oedema, dyspnea at rest and delirium), suggesting the short-term prognostic marker of terminal cancer patients.
Purpose
The purpose of this study was to evaluate the impact of PPI on 30-day mortality, 1-year mortality and 1-year events (including all-cause mortality, readmission due to heart failure and new onset of cerebral infarction after hospital discharge) among acute decompensated heart failure (ADHF) patients.
Method
Study subjects comprised of consecutive 764 patients who admitted due to ADHF and followed up for 1-year. PPI were calculated at the time of hospital admission. Study subjects were divided into two groups based on the PPI: L-PPI (PPI<6) and H-PPI (6≤PPI). We calculated the C-index, net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) to evaluate the improvement of prediction ability on 30-day mortality.
Result
H-PPI showed significantly higher 30-day mortality than L-PPI [7.9% vs 2.0%, log rank p<0.001, Hazard retio (HR): 1.26, 95% confidential interval(CI): 1.14–1.37, p<0.001], 1-year mortality [20.0% vs 12.7%, log rank p=0.022, HR 1.15, 95% CI 1.09–1.21, p<0.001]and 1-year events [45.5% vs 31.1%, log rank p<0.001, HR 1.13, 95% CI 1.09–1.17, p<0.001]. Multivariate cox proportional hazard models adjusted with several covariates revealed that PPI was an independent predictor of 30-day mortality (HR: 1.23, 95% CI: 1.10–1.36, p<0.001), 1-year mortality (HR: 1.10, 95% CI: 1.04–1.16, p<0.001) and 1-year events (HR: 1.11, 95% CI: 1.07–1.15, p<0.001), respectively.
A reference model for prediction of 30-day mortality was determined including left ventricular ejection fraction and serum albumin concentration by multivariable logistic regression analysis. (P<0.05) (C-index: 0.720) Adding PPI to the reference model (C-index: 0.773) significantly improved both NRI (0.458, p=0.038) and IDI (0.046, p=0.007), respectively.
Conclusion
We suggest that assessment of PPI showed good prognostic ability for 30-day and 1-year outcome, while PPI provided additional prognostic information in patients with ADHF.
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Affiliation(s)
- T Sumi
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Kajiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - N Shibata
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Sugiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Taniguchi
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Asai
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - M Yamada
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya, Japan
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Umemoto N, Ooshima S, Katou M, Kajiura H, Inoue S, Iio Y, Itou R, Sakakibara T, Ishii H, Shimizu K, Murohara T. P6240The impact of stress myocardial blood flow as a very strong predictor for all-cause mortality, cardiovascular mortality and adverse cardiac and cerebrovascular event in hemodialysis population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the clinical setting, ischemic heart disease (IHD) is a major problem not only in general patients but also in regular hemodialysis (HD) patients. 13ammonia positron emission tomography (13NH3PET) is an established and excellent diagnostic device for IHD. Although coronary flow reserve is the most important index in IHD diagnosis, there are limited data about stress myocardial blood flow (MBF). We investigated the prognosis predictability of stress MBF in all-cause mortality, cardiovascular (CV) mortality and adverse cardiac and cerebrovascular event (MACCE).
Methods and results
A total 438 of HD patients who undergone 13NH3PET for suspected IHD were enrolled. 29 cases were excluded due to revascularization therapy in 60 days. In total we collected 409 eligible cases. All patients were undergone13NH3PET at Nagoya Radiological Diagnosis Foundation. Patients were divided into two group according to the median value of stress MBF levels; low stress MBF group (<2.12) and high stress MBF group (≥2.12). We followed up them up to 4.2 years (median 2.4 years) and collected their data. We evaluated their all-cause mortality, CV mortality and MACCE. Kaplan-Meyer analysis shows that intergroup difference in all-cause mortality (log rank p=0.001, hazard ratio [HR] 0.411, 95% confident interval [CI] 0.261–0.632), CV mortality (log rank p=0.002, HR 0.324, 95% CI 0.157–0.625) and MACCE (log rank p<0.001, HR 0.465, 95% CI 0.324–0.657). Multiple cox analysis that include established risk factors shows CFR is an independent risk factor for all-cause mortality (HR 0.261, 95% CI 0.154–0.442), CV mortality (HR 0.172, 95% CI 0.079–0.374) and MACCE (HR 0.329, 95% CI 0.213–0.503). As a result of the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when CFR added into a model with established risk factors, each indicator shows adding stress MBF on established risk factors improve the predictability in all-cause mortality, CV mortality and MACCE (all-cause mortality; NRI 0.642, p<0.001, IDI 0.091, p<0.001, CV mortality NRI 0.809, p<0.001, IDI 0.116, p<0.001, MACCE; NRI 0.646, p<0.001, IDI 0.072, p<0.001).
Conclusion
Considering prognosis of HD population, stress MBF is an important and independent predictor for all-cause mortality, CV mortality and MACCE. As a result of our investigation, stress MBF is one of most strong predictors in HD population.
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Ooshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - M Katou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - H Kajiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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Muta Y, Odaka A, Inoue S, Beck Y. Isolated anorectal malformation with rectoperineal fistula in monozygotic twins. Journal of Pediatric Surgery Case Reports 2019. [DOI: 10.1016/j.epsc.2019.101285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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38
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Yakabe D, Ikeda S, Chishaki A, Tsutsui H. P3764Morphological mechanisms of atrial functional mitral regurgitation in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial functional mitral regurgitation (AFMR) occurs in patients with atrial fibrillation. However, morphological mechanisms of AFMR are poorly understood.
Purpose
The purpose of this study was to examine the morphological characteristics in patients with AFMR.
Methods
Among consecutive 795 patients undergoing initial radiofrequency catheter ablation (RFCA) at our hospital, twenty-five patients with persistent AF accompanied by AFMR (≥ moderate) before RFCA (AFMR group) were studied. Age-matched 25 patients with persistent AF without MR were defined as a control group.
Results
Left ventricular ejection fraction (LVEF) was lower and left atrium volume index was larger in the AFMR group (Table). Mitral valve annulus diameter and length of anterior mitral leaflet (AML) were similar between groups, whereas length of posterior mitral leaflet (PML) was significantly shorter in the AFMR group. Smaller tethering angle of AML (γ in the figure) and shorter tethering height were significantly associated with the occurrence of AFMR, which were different from morphology of functional mitral regurgitation in patients with dilated LV. Multiple regression analysis revealed that less tenting height (p<0.05) and LA dilatation toward the posterior (p<0.01) were significantly related to AFMR.
Echocardiographic parameters AFMR (n=25) Control (n=25) P value Age, y 69±8 66±10 NS Male, n (%) 9 (36) 20 (80) P=0.001 LVEF,% 60±9 67±6 P=0.004 LAD, mm 44±5 41±7 NS LAVI, ml/m2 56±17 41±13 P<0.001 MV diameter, mm 3.9±0.4 3.8±0.5 NS α angle, ° 34±9 35±7 NS β angle, ° 48±9 50±8 NS γ angle, ° 32±5 37±5 P=0.0005 AML length, mm 3.0±0.5 3.0±0.5 NS PML length, mm 2.1±0.1 2.4±0.1 P=0.03 Tenting height, mm 1.5±0.1 1.8±0.1 P=0.02 D, mm 0.8±0.3 0.5±0.3 P=0.001 LVEF: left ventricular ejection fraction; LAD: left atrial diameter; LAVI: left atrial volume index; AML: anterior mitral leaflet; PML: posterior mitral leaftlet.
Conclusions
AFMR occurs in patients with unique morphological features, such as less tethering height and LA dilatation toward the posterior.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Omori Y, Inoue S, Otsuka T, Nagamatsu Y, Sorimachi A, Ishikawa T. REDUCTION IN AMBIENT GAMMA DOSE RATE FROM RADIOCESIUM DUE TO SNOW COVER. Radiat Prot Dosimetry 2019; 184:510-513. [PMID: 31038711 DOI: 10.1093/rpd/ncz091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the present study, variations in ambient gamma dose rate associated with snow cover were examined in a radioactive-contaminated site in Fukushima Prefecture, Japan. The ambient gamma dose rates decreased with increasing snow depth. The reduction trends were different between fresh snow (0.1-0.2 g/cm3) and granular snow (0.3-0.4 g/cm3) depending on snow density. Snow cover water content (snow water equivalent) calculated from snow depth and density was a key parameter governing the reduction in the ambient gamma dose rate. The ambient gamma dose rates reduced to 0.6 and 0.5 at 4 g/cm2 and 8 g/cm2 of snow water equivalent, respectively. Based on gamma-ray flux density distributions, the ambient gamma dose rates from the primary gamma rays decreased more compared to those from scattered gamma rays due to snow cover.
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Affiliation(s)
- Y Omori
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - S Inoue
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - T Otsuka
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - Y Nagamatsu
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - A Sorimachi
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - T Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Ikeda S, Chishaki A, Tsutsui H. P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.
Purpose
We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.
Method
Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.
Results
In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p<0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p<0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.
Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p<0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p<0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p<0.05
Conclusion
Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Biswas K, Mizutani Y, Takayama S, Ishitsuka A, Iddamalgoda A, Takahashi A, Yang L, Yang F, Katayama I, Inoue S. 549 Disappearance of keratinocyte expression of Glycoprotein Non-metastatic B (GPNMB) / Osteoactivin in vitiligo – possible involvement of Th1/Th 17 cytokines. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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42
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Nakata Y, Furuya S, Shimizu H, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kawaida H, Inoue S, Kono H, Ichikawa D. MON-PO416: Effects of Preoperative Skeletal Muscle Mass and Neutrophil Lymphocyte Ratio on the Prognosis of Stage II and III Colorectal Cancer. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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43
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Wang Q, Yang L, Biswas K, Iddamalgoda A, Guo J, Kuroda Y, Murase D, Inoue S, Tsuruta D, Katayama I. 545 Keratinocyte-derived glycoprotein non-metastatic melanoma protein B protects melanocytes from oxidative stress in a CD44-independent manner. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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44
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Furuya S, Ashizawa N, Nakata Y, Shimizu H, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kawaida H, Inoue S, Kono H, Ichikawa D. MON-PO398: Examination of Immune-Nutritional Index Before and After Surgery and Prognosis for Colon Cancer Patients: Possibility to Nutritional Precision Medicine. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32231-9] [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: 11/15/2022]
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45
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Uchida M, Hada M, Yamada M, Inma D, Ariyoshi S, Aoki K, Inoue S, Shimazoe T, Mitsuiki K, Haraguchi T. Impact of a systematic education model for palliative care in cancer. Pharmazie 2019; 74:499-504. [PMID: 31526444 DOI: 10.1691/ph.2019.9417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In clinical practice, pharmacists are continually required to improve their knowledge and expertise; however, the postgraduate education system for professional development cannot be confidently stated to be well established. The establishment of a systematic and multifaceted educational curriculum should be useful to improve home care and pharmacists' contribution; therefore, we developed a curriculum in collaboration with the university faculty of pharmaceutical sciences, department of pharmacy in hospital, and the Fukuoka Pharmaceutical Association. Class topics were extracted from the "Kanwa-Iryou-Yakugaku", edited by the Japanese Society for Pharmaceutical Palliative Care and Sciences. The items are necessary to perform palliative care as a pharmacist. A class schedule of 6 days (24 classes in total) was formulated. Questionnaires on comprehension degree before and after each class were provided to the participants. Comprehension was assessed on a scale of 1 to 10, where "I do not understand at all" was 1 and "I understand enough" was 10. The average recovery rates of questionnaires from each class were 92.6 % and 88.9 % before and after class, respectively. The average number of participants who completely answered the questionnaire before and after class was 45.6; therefore, these data were analyzed. Comprehension degree on each topic had significantly increased after attendance of all classes (p < 0.01). The comprehension degree of participants of the medical science of palliative care did greatly improve. Consequently, it is clear that the standard education model constructed was meaningful for the professional development of pharmacists in palliative care medicine.
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Tanaka K, Tachi T, Hori A, Osawa T, Nagaya K, Makino T, Inoue S, Yasuda M, Mizui T, Nakada T, Goto C, Teramachi H. Cost utility analysis of pharmacist counseling care for breast cancer chemotherapy outpatients. Pharmazie 2019; 74:439-442. [PMID: 31288902 DOI: 10.1691/ph.2019.9327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Chemotherapy for cancer is increasingly implemented in the outpatient setting. Pharmacists contribute to cancer treatment by conducting counseling during outpatient chemotherapy visits. They provide guidance on drug treatment, side effects, and side effect countermeasures on every visit. However, there have been few economic evaluations of pharmacist involvement in outpatient chemotherapy. Therefore, we performed a cost utility analysis. We assigned usual care (control) and pharmacist counseling to two groups of 19 patients receiving outpatient chemotherapy for breast cancer at Gifu Municipal hospital. Quality of life was measured at three timepoints before and during chemotherapy treatment using the EuroQol 5 dimension instrument (EQ-5D). EQ-5D values across the timepoints were 0.831, 0.757, and 0.791 for the control group, and 0.882, 0.883, and 0.921 for the pharmacist counseling group. The additional cost in the pharmacist counseling group was 2,227 yen per counseling session. The change in quality-adjusted life years (QALY) was a maximum of -0.021±0.186 in the control group and 0.007±0.199 in the pharmacist counseling group. The maximum cost for one QALY was 1,360,558 yen (≈12,460 US dollars). Pharmacists' counseling in outpatient cancer chemotherapy for breast cancer patients had an acceptable incremental cost-effect ratio, contributing to improved patient quality of life without significant additional expenditure to healthcare.
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Ishitsuka Y, Inoue S, Furuta J, Koguchi-Yoshioka H, Nakamura Y, Watanabe R, Okiyama N, Fujisawa Y, Enokizono T, Fukushima H, Suzuki H, Nishino I, Kosaki K, Fujimoto M. Sweat retention anhidrosis associated with tubular aggregate myopathy. Br J Dermatol 2019; 181:1104-1106. [PMID: 31145807 DOI: 10.1111/bjd.18175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y Ishitsuka
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - S Inoue
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - J Furuta
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | | | - Y Nakamura
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - R Watanabe
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - N Okiyama
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - Y Fujisawa
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - T Enokizono
- Department of Paediatrics, University of Tsukuba, Tsukuba, Japan
| | - H Fukushima
- Department of Paediatrics, University of Tsukuba, Tsukuba, Japan
| | - H Suzuki
- Centre for Medical Genetics, Keio University, Tokyo, Japan
| | - I Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Centre of Neurology and Psychiatry, Tokyo, Japan
| | - K Kosaki
- Centre for Medical Genetics, Keio University, Tokyo, Japan
| | - M Fujimoto
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
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Fukami K, Azumi N, Inoue S, Kai T, Kimura H, Kiuchi J, Matsui S, Takano S, Watanabe T, Zhang C. Performance verification of a precise vibrating-wire magnet alignment technique for next-generation light sources. Rev Sci Instrum 2019; 90:054703. [PMID: 31153263 DOI: 10.1063/1.5086505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
The high-accuracy alignment of magnets is a key issue in the development of next-generation light-source rings. To obtain adequate dynamic apertures, the magnets must be aligned to an accuracy of 10 µm or better. Recently, a new technique that utilizes a vibrating wire has attracted attention for this purpose as it can directly determine with high resolution the magnetic centers in a series of multipole magnets on a straight section between bending magnets. In conventional vibrating-wire alignment techniques, wire sag, which causes alignment errors, is determined from the theoretical catenary curve. By contrast, in the present study, we have measured the sag profiles of various wires in the longitudinal direction to micrometer-order accuracy. We concluded that we can reduce deviations of the actual wire sag from the theoretical curve by choosing a suitable wire. By setting up a test bench of a vibrating-wire alignment system for a series of multipole magnet on a straight section, we have achieved the total error of the magnetic-center measurements of micrometer-order in the standard deviation. Moreover, two systematic error factors, the drift of the magnetic centers due to thermal deformations of the magnets after they are excited and the change in the magnetic centers due to reassembly of the magnets after installing the vacuum chamber, are included in practical magnet alignments. We have experimentally investigated these error factors using the test bench.
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Affiliation(s)
- K Fukami
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - N Azumi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - S Inoue
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - T Kai
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - H Kimura
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - J Kiuchi
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - S Matsui
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - S Takano
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - T Watanabe
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - C Zhang
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
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Ohuchi M, Inoue S, Ozaki Y, Ueda K. Platelet count and mean platelet volume are associated with not only bone, soft tissue, and lymph node metastases but also with malignant pleural effusion in lung cancer patients. Neoplasma 2019; 64:140-147. [PMID: 27881016 DOI: 10.4149/neo_2017_118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
An increased platelet count is often observed in lung cancer patients. Whether and how the platelets affect cancer progression have yet to be established. The aim of the study was to investigate the involvement of the platelet count and mean platelet volume (MPV) in the prognosis and progression of lung cancer patients. This retrospective study included 146 patients with newly diagnosed primary lung cancer. The platelet count and MPV were measured before invasive diagnostic procedures and treatment. These platelet indices, overall survival of the patients, and tumor metastases for each organ were analyzed. On Kaplan-Meier survival analysis, the overall survivals of patients with platelet counts ≤ 244.0 × 109/L or MPV > 9.7 fL were longer than those of patients with platelet counts > 244.0 × 109/L or MPV ≤ 9.7 fL. Cox regression analysis showed that poor performance status, increased platelet count, and increased C-reactive protein were independent prognostic factors. The platelet indices were associated with metastases to bone, soft tissue, and lymph node, in addition to malignant pleural effusion. Increased platelet count and decreased MPV were unfavorable prognostic factors for patients with lung cancer, and they were involved in bone, soft tissue, and lymph node metastases and malignant pleural effusion.
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50
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Ogawa T, Inoue S, Inada M, Kawaguchi M. Postoperative intensive care unit admission does not affect outcomes in elective surgical patients with severe comorbidity. Med Intensiva 2019; 44:216-225. [PMID: 30799043 DOI: 10.1016/j.medin.2019.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/09/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The impact of postoperative intensive care upon patient outcomes was evaluated by retrospectively investigating the rate of poor outcomes among miscellaneous elective surgical patients with severe comorbidities. DESIGN A retrospective cohort study was carried out. SETTING University hospital. PATIENTS Surgical patients with severe comorbidities. INTERVENTION The outcomes of 1218 surgical patients treated in intensive care units (ICUs) and postsurgical wards (ICU group vs. non-ICU group) were reviewed for poor outcomes (i.e., no discharge or death). A propensity score analysis was used to generate 248 matched pairs of ICU-admitted patients and controls. VARIABLES OF INTEREST Poor outcome rates on postoperative day 90 and mortality on postoperative days 30 and 90. RESULTS No significant between-group differences were observed in terms of poor outcomes on postoperative day 90 [ICU vs. non-ICU: 33/248 (13%) vs. 28/248 (11%), respectively; ICU odds ratio (OR): 1.19, 95% confidence interval (CI), 0.71-2.01, p=0.596] or in between-group differences in terms of mortality on postoperative days 30 and 90 [ICU vs. non-ICU: 4/248 (1.6%) vs. 2/248 (0.8%) on postoperative day 30 and 5/248 (2.0%) vs. 3/248 (1.2%) on day 90, respectively; ICU OR (95% CI), 2.00 (0.37-10.9) and 1.67 (0.40-6.97) for postoperative 30- and 90-day mortality, respectively (p=0.683 and 0.724)]. Low preoperative body weight was negatively correlated to patient outcomes [OR (95% CI): 0.82/10kg (0.70-0.97), p=0.019], whereas regional analgesia combined with general anesthesia was positively correlated to patient outcomes [OR (95% CI): 0.39 (0.69-0.96), p=0.006]. Extra ICU admission was correlated to poor patient outcomes [OR (95% CI): 4.18 (2.23-7.81), p < 0.0001]. CONCLUSIONS Postoperative ICU admission failed to demonstrate any meaningful benefits in patients with severe comorbidities undergoing miscellaneous elective surgeries.
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Affiliation(s)
- T Ogawa
- Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8521, Japan
| | - S Inoue
- Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8521, Japan.
| | - M Inada
- Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8521, Japan
| | - M Kawaguchi
- Division of Intensive Care, Nara Medical University, 840 Shijo-cho Kashihara, Nara 634-8521, Japan
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