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Washio H, Kashimoto K, Sakashita N, Ohira S, Tanaka J, Maeda N, Shimada M, Kawamata M, Yoneda A, Nakanishi K. Practical use of the central venous access port for contrast-enhanced CT: comparison with peripheral intravenous access regarding enhancement and safety. Clin Radiol 2024; 79:213-220. [PMID: 38218706 DOI: 10.1016/j.crad.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/01/2023] [Accepted: 12/09/2023] [Indexed: 01/15/2024]
Abstract
AIM To evaluate the efficacy of using the central venous (CV) port compared with peripheral intravenous access for contrast-material injection for contrast enhancement during the portal venous phase. MATERIALS AND METHODS Patients were divided into three groups: CV delay, CV routine, and peripheral access (PA) groups. Patients in the CV delay group underwent injection in the arm-down position with an additional delay, while those in the CV routine and PA groups underwent injections with the routine injection protocol for portal venous phase imaging. Contrast enhancement was evaluated by measuring the mean radiodensity (Hounsfield units) values for the aortic arch, abdominal aorta, inferior vena cava, portal vein, and spleen. The peak injection pressure was recorded and compared among the three groups. RESULTS No complications related to power injection were observed during 119 contrast-material injections performed using the CV port device. The CV delay group showed significantly lower radiodensity values than the PA group (165.7 ± 20.1 versus 181 ± 19 HU [p<0.01] for the portal vein); however, no significant differences in mean radiodensity values were observed between the CV routine and PA groups (p>0.05). The median peak injection pressure was 73.5, 67, and 47 psi in the CV delay, CV routine, and PA groups, respectively (p<0.01). CONCLUSION The CV port can be used for safe contrast-material injection while maintaining contrast enhancement on portal venous phase comparable to that achieved with peripheral intravenous access.
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Affiliation(s)
- H Washio
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan.
| | - K Kashimoto
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - N Sakashita
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - S Ohira
- Department of Comprehensive Radiation Oncology, The University of Tokyo, Tokyo, Japan; Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - J Tanaka
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - N Maeda
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - M Shimada
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - M Kawamata
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - A Yoneda
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
| | - K Nakanishi
- Department of Diagnosis and Interventional Radiology, Osaka International Cancer Institute, Osaka, Japan
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Inui S, Tomita N, Takaoka T, Ueda Y, Ohira S, Tsuchiya T, Miyazaki M, Nishio T, Koizumi M, Konishi K. Dosimetric Comparison of Automated Non-Coplanar Volumetric-Modulated Arc Therapy and Intensity-Modulated Proton Therapy in Angiosarcoma of the Scalp. Int J Radiat Oncol Biol Phys 2023; 117:e675. [PMID: 37785989 DOI: 10.1016/j.ijrobp.2023.06.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Angiosarcoma of the scalp (AS) is a rare tumor and has often been treated by total scalp irradiation (TSI). TSI is a challenging technique because of the target close to the organs at risks (OARs), located in the skin surface, and helmet-shape of the target. We performed the dosimetric comparison of automated non-coplanar volumetric-modulated arc therapy (HA) and intensity-modulated proton therapy (IMPT) in TSI for AS. MATERIALS/METHODS A planning study was performed on 20 patients with AS. The clinical target volume (CTV) 1 and CTV2 were defined as gross tumor volume with margin and entire scalp, respectively. For HA, planning target volume (PTV) 1 and PTV2 were defined as CTV1 and CTV2 with 5-mm margins, respectively. For IMPT, robust optimization was utilized which accounted for a 5-mm setup and a 3.5% range uncertainty and dose was prescribed to CTV1 robust and CTV2 robust. The prescription doses were 70 Gy and 56 Gy in 35 fractions to PTV1 (CTV1 robust) and PTV2 (CTV2 robust), respectively, using the simultaneous integrated boost technique. The HA plan was performed using a 6-MV photon beam machine and a 1-cm thick virtual bolus. The HA plan included three half non-coplanar and one full coplanar arc fields. The HA plan used collimator angles of 15°, 60°, 15°, and 120° in the beam with couch rotations of 0°, 45°, 90°, and 315°, respectively. The IMPT plan was performed using a compact proton beam machine dedicated to pencil beam scanning. The IMPT plan used gantry angles of 70°, 150°, 70°, 150°, and 30° in the beam with couch rotations of 0°, 0°, 180°, 180°, and 270°, respectively. The IMPT plan was optimized assuming a relative biological effectiveness of 1.1. The dose distribution and dosimetric parameters for each plan were evaluated. RESULTS All plans met the goals within the acceptable range in target volume coverage, conformity, and homogeneity. Table shows the dosimetric parameters of OARs in HA and IMPT plans. The doses receiving 0.1 cc of the volume for hippocampus, optic passway, eye, and lens in the IMPT plan were significantly lower than those in the HA plan. The IMPT plan showed a significant reduction in the percentage of brain volume receiving at least 5 Gy (V5 Gy) compared to the HA plan, while the HA plan showed a significant reduction of V10 Gy - V60 Gy and mean brain dose compared to the IMPT plan. The HA plan provided a shorter beam-on time (184 ± 9 s) than did the IMPT plan (446 ± 49 s). CONCLUSION The HA and IMPT plans demonstrated different strengths with respect to OARs sparing.
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Affiliation(s)
- S Inui
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan; Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - N Tomita
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - T Takaoka
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Y Ueda
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - S Ohira
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Tsuchiya
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - M Miyazaki
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Nishio
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - M Koizumi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - K Konishi
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
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Gregory V, Grunfeld M, Kanwal A, Bali A, Isath A, Pan S, Spielvogel D, Kai M, Ohira S. Escalation from Impella 5.5 to Ecpella Support as a Bridge to Mitral Valve Surgery in a Patient with Non-Ischemic Cardiomyopathy with Degenerative Mitral Regurgitation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1065] [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: 04/05/2023] Open
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Isath A, Gass A, Pan S, Levine E, Gupta C, Lanier G, Spielvogel D, Kai M, Ohira S. Impella 5.5 with Veno-Arterial Extracorporeal Membrane Oxygenation Support as Ecpella 5.5. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1531] [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: 04/05/2023] Open
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Isath A, Ohira S, Hoch E, Frenkel D, Jacobson J, Lanier G, Kai M, Gass A, Levine E. Escalation of Mechanical Circulatory Support in a Patient with an Acute Myocardial Infarction, Cardiogenic Shock and Refractory Ventricular Tachycardia. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.801] [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: 04/05/2023] Open
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Ohira S, Okumura K, Isath A, Abhay D, Lanier G, Levine E, Pan S, Aggarwal Gupta C, Gass A, Spielvogel D, Kai M. Utilization of Hepatitis C Virus Infected Donor in Heart Transplant Recipients with Elevated Meld-Xi Score. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.661] [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: 04/05/2023] Open
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Khan S, Seplowe M, Vemulakonda L, Shakil F, Aggarwal-Gupta C, Lanier G, Levine E, Ohira S, Spielvogel D, Gass A, Kai M, Pan S. Early Recurrence of Cardiac Sarcoidosis after Orthotopic Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.471] [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: 04/05/2023] Open
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Isath A, Ohira S, Levine E, Pan S, Lanier G, Gupta C, Wolfe K, Spielvogel D, Gass A, Kai M. Ex-Vivo Heart Perfusion for Cardiac Transplantation: An Initial Experience in the United States. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.516] [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: 04/05/2023] Open
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Nakatsuka T, Ohira S, Tone S, Kakumae S, Morinaka H, Hirata K, Kaifu M, Shimizu S, Fujii T, Miyaji Y. Search for novel biomarkers that reflect the pathology of age-related bladder dysfunction. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00110-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Hirata K, Ohira S, Tone S, Kakumae S, Nakatsuka T, Morinaka H, Takasaki H, Shimizu S, Kaifu M, Fujii T, Miyaji Y. Pathological analysis of spermatic dysfunction following testicular ischemia-reperfusion injury. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00260-9] [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: 02/12/2023]
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Morinaka H, Ohira S, Tone S, Kakumae S, Nakatsuka T, Takasaki H, Hirata K, Shimizu S, Kaifu M, Fujii T, Miyaji Y. Pathophysiological analysis of detrusor overactivity following partial bladder outlet obstruction. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00095-7] [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: 02/12/2023]
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Kanwal A, Ohira S, Levine A, Isath A, Pan S, Dhand A, Aggarwal-Gupta C, Lanier GM, Gass A, Spielvogel D, Kai M. Survival and renal outcomes of direct heart transplant from veno-arterial extracorporeal membrane oxygenation support. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Backgrounds
Patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support are given the highest priority for cardiac transplantation (OHT) in the new UNOS heart allocation policy adopted in October 2018. Although patients may receive an organ quicker there may not be enough time to recover end-organ function. To date, little is known about survival and renal outcomes of direct OHT in patients that have been supported with VA-ECMO as a bridge to transplant due to limited experience in most transplant centers.
Purpose
The aim of this study was to investigate survival and renal outcomes of direct OHT in patients supported with VA-ECMO prior to transplant.
Methods
From January 2010 to February 2022, 23 patients who received single organ OHT alone directly from VA-ECMO support were retrospectively analyzed (16 patients after the new allocation policy). Kaplan-Meier analysis was used to estimate event-free survival.
Results
The median age of recipients was 48 years. The median length of pre-transplant VA-ECMO support was 5 days. Additional pre-transplant support with intra-aortic balloon pump or Impella was utilized in 15 patients (65.2%) and 2 patients (9%) respectively. There was a trend toward improvement of serum creatinine after initiation of VA-ECMO support (Pre-ECMO: 1.66±1.22 mg/dl vs. Pre-OHT: 1.20±0.74 mg/dl, P=0.084). Four patients required preoperative renal replacement therapy (RRT); three were on RRT at the time of OHT. The median ischemic time of donor hearts was 168 minutes. VA-ECMO support was continued in 10 patients (43.5%) after OHT.
Hospital mortality was 8.7% (2 patients). Post-transplant RRT was required in 9 patients (39.1%), and, of these, 5 patients were transitioned to permanent dialysis. Among the 14 patients who did not require post-transplant RRT, none required RRT during the follow-up period (median, 21.5 months). Kaplan-Meier survival analysis showed that estimated survival at 1 year and 3 years were 86.1%, and 77.5%, respectively (Figure 1A). The freedom from dialysis rate was 82.4% at 1 year, and 74.9% at 3 years (Figure 2A). Both survival (100% vs. 66.7%, P=0.008, Fig.1B) and dialysis free rate (100% vs. 55.6%, P=0.002, Figure 2B) at one-year were significantly worse in patients who required postoperative RRT.
Conclusions
To our knowledge this is the largest single center study of OHT in patients that were supported with VA-ECMO. VA-ECMO as a bridge to end-organ recovery and OHT resulted in excellent outcomes. Patients who required post-transplant RRT more likely to require long-term dialysis, while those that did not receive RRT showed favorable outcomes. Overall survival in this patient population is comparable to patients that were not on VA-ECMO prior to transplant.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Kanwal
- Westchester Medical Center , New York , United States of America
| | - S Ohira
- Westchester Medical Center , New York , United States of America
| | - A Levine
- Westchester Medical Center , New York , United States of America
| | - A Isath
- Westchester Medical Center , New York , United States of America
| | - S Pan
- Westchester Medical Center , New York , United States of America
| | - A Dhand
- Westchester Medical Center , New York , United States of America
| | - C Aggarwal-Gupta
- Westchester Medical Center , New York , United States of America
| | - G M Lanier
- Westchester Medical Center , New York , United States of America
| | - A Gass
- Westchester Medical Center , New York , United States of America
| | - D Spielvogel
- Westchester Medical Center , New York , United States of America
| | - M Kai
- Westchester Medical Center , New York , United States of America
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Ohira S, Jo T, Kakumae S, Nakatsuka T, Morinaka H, Takasaki H, Hirata K, Sugiyama S, Shimizu S, Kaifu M, Fujii T, Miyaji Y, Nagai A. Long-term outcomes of testosterone replacement therapy for patients with late-onset hypogonadism syndrome. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ohira S, Tone S, Nakatsuka T, Morinaka H, Takasaki H, Hirata K, Shimizu S, Nagai A. Anti-inflammatory effect of indoleamine 2,3-dioxygenase 1 inhibition for lipopolysaccharide induced epididymitis. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hirata K, Ohira S, Tone S, Nakatsuka T, Morinaka H, Takasaki H, Sugiyama S, Shimizu S, Nagai A. Pathological analysis of spermatic dysfunction in testicular ischemia-reperfusion injury. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shimizu S, Jo T, Kakumae S, Nakatsuka T, Morinaka H, Hirata K, Takasaki H, Sugiyama S, Ohira S, Kaifu M, Fujii T, Miyaji Y, Nagai A. Surveillance of sexual function after Robot-assisted laparoscopic radical prostatectomy. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ohira S, Spielvogel D, Gass A, Lanier G, Aggarwal-Gupta C, Levine A, Pan S, Abraham B, Austin-Matison C, McCrink K, Jenning E, Spencer P, Kai M. Early Outcomes of Direct Heart Transplant Off Veno-Arterial Extracorporeal Membrane Oxygenation Support after New Heart Allocation Policy: Analysis Based on Etiology of Cardiomyopathy. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ohira S, Spielvogel D, Gass A, Levine A, Aggarwal-Gupta C, Pan S, Lanier G, Abraham B, Austin-Mattison C, Jenning E, McCrink K, Spencer P, Kai M. Direct Advanced Therapy Off Veno-Arterial Extracorporeal Membrane Oxygenation Support: Impact of New Heart Allocation Policy on Early Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ohira S, Tone S, Tsuji S, Morinaka H, Nishishita N, Takasaki H, Hirata K, Sugiyama S, Fujita M, Tsukimori S, Shimizu S, Kaifu M, Hara R, Fujii T, Miyaji Y, Nagai A. Anti-inflammatory effect of IDO1 inhibition for acute inflammation in the prostate. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32698-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Morinaka H, Ohira S, Tone S, Tsuji S, Nishishita N, Takasaki H, Hirata K, Sugiyama S, Fujita M, Tsukimori S, Shimizu S, Kaifu M, Hara R, Fujii T, Miyaji Y, Nagai A. Pathological analysis focused on inflammatory changes in bladder dysfunction following partial bladder outlet obstruction. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33245-6] [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: 11/30/2022] Open
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21
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Kawanishi H, Fukui H, Shigeko H, Imada A, Kawaguchi Y, Kawanishi H, Kim M, Kubo H, Nakamoto M, Ohira S, Shoji T. Encapsulating Peritoneal Sclerosis in Japan: Prospective Multicenter Controlled Study. Perit Dial Int 2020. [DOI: 10.1177/089686080102103s11] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
♦ Objective Encapsulating peritoneal sclerosis (EPS) is recognized as a serious complication of peritoneal dialysis. The aim of this study was to determine the incidence, clinical features, and variation in mortality rates for EPS. ♦ Design A prospective multicenter design was used, in which peritoneal dialysis patients were pre-registered by facilities across Japan and the incidence of EPS was observed in the registrants. The registrants were followed for a total of 4 years to accurately observe the onset of EPS. ♦ Results As of April 1999, 2216 peritoneal dialysis patients from 64 facilities were registered. By the end of March 2001, 332 patients had dropped out, and 17 of the dropouts had developed SEP. The incidence was 0.77%. After excluding 110 patients who died, the incidence in 2106 patients was 0.81%. The incidence of EPS increased with the duration of peritoneal dialysis. Of the 17 patients with EPS, 12 developed the condition after discontinuing peritoneal dialysis and changing to hemodialysis. During the 2-year survey period, 6 of the 17 EPS patients died. The interval from onset to death was 10.8 ± 5.8 months (range: 3 – 19.5 months). ♦ Conclusions From this prospective multicenter study, the current incidence of EPS is 0.77% (0.81% when dropout owing to death is censored). After a follow-up of 2 years, we conjecture that the incidence of EPS will increase. The incidence, etiology, and prognosis of EPS will be further clarified by periodic observation of dropouts until the end of March 2003.
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Affiliation(s)
| | | | | | - Akio Imada
- Kinki University School of Medicine, Sakai Branch Hospital, Osaka
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Washio H, Ohira S, Kanayama N, Wada K, Karino T, Komiyama R, Miyazaki M, Teshima T. Effect of a saline flush technique for head and neck imaging in dual-energy CT: improvement of image quality and perivenous artefact reduction using virtual monochromatic imaging. Clin Radiol 2019; 74:805-812. [PMID: 31320111 DOI: 10.1016/j.crad.2019.06.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate the effect of the saline flush (SF) technique on the depiction of lesions and the reduction of perivenous artefacts in the head and neck region using dual-energy computed tomography (CT) with virtual monochromatic imaging (VMI). MATERIALS AND METHODS Fifty patients with head and neck cancer were divided into two groups: group A, without a SF and group B, with a 30-ml SF. All images were acquired using fast kilovolt-switching CT (Revolution HD, GE Healthcare, Milwaukee, WI, USA). Contrast-to-noise ratios (CNRs) of the lesions were calculated at VMI energy levels ranging from 40 to 80 keV. Subjective analysis of overall image quality, delineation of lesions, and perivenous artefacts was conducted by two reviewers at both VMI energy level 40 keV and the optimal energy level (which showed optimal CNR by objective analysis). RESULTS Optimal energy level was 63 keV for group A and 61 keV for group B. At VMI energy levels ranging from 40 to 80 keV, the CNR was higher for group B. The highest subjective overall image quality was shown for group B at the optimal energy level (subjective image quality mean value, 3.40). Subjective delineation of lesions was comparable. The perivenous artefact score was significantly higher for group B (2.44 versus 2.74 [p<0.05] at 40 keV, 3.20 versus 3.46 [p<0.05] at the optimal energy level). CONCLUSION The SF technique results in an improvement of lesion CNR and a reduction of perivenous artefacts in VMI using duel-energy CT, especially at 40 keV.
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Affiliation(s)
- H Washio
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - S Ohira
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan; Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Suita, Japan.
| | - N Kanayama
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - K Wada
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Karino
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - R Komiyama
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - M Miyazaki
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Teshima
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
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Abstract
In Dr Ohira’s era, hemodialysis was done using an external arteriovenous shunt. External arteriovenous shunts surely made repeated hemodialysis possible, but they also brought about serious complications which necessarily produced the arteriovenous fistula. Arteriovenous fistula is definitely the most important contribution to long-term survival of the hemodialysis patient. Hemodialysis therapy soon became very common, so that various kinds of patients appeared for it. Then came the era of arteriovenous grafts, because many patients lost good vessels in order to create the arteriovenous fistula. More grafts are now becoming available, which are made from different materials and in different forms, thus creating greater expectations for the future. Unfortunately, at this time, the revolutionary vascular access surpassing the arteriovenous fistula has yet to appear and we must continue to make proper application of the arteriovenous fistula. Vascular access is surely one of the important factors to assure a smooth dialysis life for patients. So, we must recognize that we play an important role in the dialysis patients’ life. It is interesting to note that in every country, medical care exceeds physical care. This means that the mental factor somewhat compensates for the physical factor. Dr Ohira was a vascular surgeon, but he was also interested in the activities of daily living and quality of life, which must be one of the most delicate fields in medicine.
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Inui S, Ueda Y, Ono S, Ohira S, Isono M, Nitta Y, Murata S, Miyazaki M, Teshima T. EP-1747 In vivo dosimetry with electronic portal imaging device in VMAT for prostate cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aoyama H, Ebata T, Hattori M, Takano M, Yamamoto H, Inoue M, Asaba Y, Ando M, Nagino M, Aoba T, Kaneoka Y, Arai T, Shimizu Y, Kiriyama M, Sakamoto E, Miyake H, Takara D, Shirai K, Ohira S, Kobayashi S, Kato Y, Yamaguchi R, Hayashi E, Miyake T, Mizuno S, Sato T, Suzuki K, Hashimoto M, Kawai S, Matsubara H, Kato K, Yokoyama S, Suzumura K. Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. Br J Surg 2018; 105:867-875. [DOI: 10.1002/bjs.10869] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 02/22/2018] [Accepted: 03/02/2018] [Indexed: 02/02/2023]
Abstract
Abstract
Background
In the eighth edition of the AJCC cancer staging classification, the T system for distal cholangiocarcinoma (DCC) has been revised from a layer-based to a depth-based approach. The aim of this study was to propose an optimal T classification using a measured depth in resectable DCC.
Methods
Patients who underwent pancreatoduodenectomy for DCC at 32 hospitals between 2001 and 2010 were included. The distance between the level of the naive bile duct and the deepest cancer cells was measured as depth of invasion (DOI). Invasive cancer foci were measured as invasive tumour thickness (ITT). Log rank χ2 scores were used to determine the cut-off points, and concordance index (C-index) to assess the survival discrimination of each T system.
Results
Among 404 patients, DOI was measurable in 182 (45·0 per cent) and ITT was measurable in all patients, with median values of 2·3 and 5·6 mm respectively. ITT showed a positive correlation with DOI (rs = 0·854, P < 0·001), and the cut-off points for prognosis were 1, 5 and 10 mm. Median survival time was shorter with increased ITT: 12·4 years for ITT below 1 mm, 5·2 years for ITT at least 1 mm but less than 5 mm, 3·0 years for ITT at least 5 mm but less than 10 mm, and 1·5 years for ITT 10 mm or more (P < 0·001). This classification exhibited more favourable prognostic discrimination than the T systems of the seventh and eighth editions of the AJCC (C-index 0·646, 0·622 and 0·624 respectively).
Conclusion
ITT is an accurate approach for depth assessment in DCC. The four-tier ITT classification with cut-off points of 1, 5 and 10 mm seems to be a better T system than those in the seventh and eighth editions of the AJCC classification.
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Affiliation(s)
- H Aoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Hattori
- Department of Surgery, Nishichita General Hospital, Tokai, Japan
| | - M Takano
- Department of Surgery, Asahi Rousai Hospital, Owariasahi, Japan
| | - H Yamamoto
- Department of Surgery, Tokai Hospital, Nagoya, Japan
| | - M Inoue
- Department of Surgery, Tokoname City Hospital, Tokoname, Japan
| | - Y Asaba
- Department of Surgery, JA Shizuoka Kohseiren Enshu Hospital, Hamamatsu, Japan
| | - M Ando
- Centre for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - M Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Aoba
- Toyohashi Municipal Hospital, Toyohashi
| | | | - T Arai
- Anjo Kosei Hospital, Anjo
| | - Y Shimizu
- Aichi Cancer Centre Hospital, Nagoya
| | | | - E Sakamoto
- Japanese Red Cross Nagoya Daini Hospital, Nagoya
| | - H Miyake
- Japanese Red Cross Nagoya Daiichi Hospital, Nagoya
| | - D Takara
- Kiryu Kosei General Hospital, Kiryu
| | | | | | | | - Y Kato
- Nagoya Ekisaikai Hospital, Nagoya
| | | | - E Hayashi
- Japan Community Health Care Organization Chukyo Hospital, Nagoya
| | | | - S Mizuno
- Shizuoka Welfare Hospital, Shizuoka
| | - T Sato
- Hekinan Municipal Hospital, Hekinan
| | - K Suzuki
- Japan Community Health Care Organization Kani Tono Hospital, Kani
| | | | - S Kawai
- Tsushima City Hospital, Tsushima
| | | | - K Kato
- Inazawa Municipal Hospital, Inazawa
| | | | - K Suzumura
- Shizuoka Saiseikai General Hospital, Shizuoka
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Sugisawa H, Shinoda T, Shimizu Y, Kumagai T, Sugisaki H, Ohira S. Unmet service needs evaluated by case managers among disabled patients on hemodialysis in Japan. Int J Nephrol Renovasc Dis 2018; 11:113-123. [PMID: 29588610 PMCID: PMC5858655 DOI: 10.2147/ijnrd.s152606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to investigate the levels of unmet needs for home and community-based services (HCBS) evaluated by case managers (CMs) among disabled patients on hemodialysis (DPHD) and to examine factors related to unmet needs. Unmet needs for HCBS were defined as situations in which patients do not use or underuse HCBS despite needing them. Candidates for the factors relating to unmet needs for HCBS included three dimensions: predisposing, enabling, and need factors. Methods Self-administrated questionnaires were collected from 391 CMs of DPHD certified with long-term care insurance. These were introduced by the dialysis facilities that a member of the Japanese Association of Dialysis Physicians belonged to. CMs were asked questions about their management of each individual case. HCBS included home help, visiting nursing, daycare, and short stay. Results The prevalence of unmet needs for each HCBS ranged from 32% for home help to 48% for short stay. Barriers to service usage in the patients were associated with unmet needs for all four services. The patients with more severe cognitive malfunction were more likely to have unmet needs for visiting nursing and short stay. Heavier burden with caregiving was associated with more likelihood of unmet needs for home help and short stay. Conclusion CMs need to monitor unmet needs after coordinating HCBS for DPHD and need to encourage HBCS use among patients with impaired cognitive function and caregivers with heavier caregiving burdens.
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Affiliation(s)
- Hidehiro Sugisawa
- Department of Gerontology, Graduate School of Gerontology, J. F. Oberlin University, Tokyo
| | - Toshio Shinoda
- Department of Medical Care Technology, Faculty of Medical and Health Science, Tsukuba International University, Tsuchiura
| | - Yumiko Shimizu
- Department of Community Health Nursing, The Jikei University School of Nursing, Chofu
| | - Tamaki Kumagai
- Department of Fundamental Nursing, Graduate School of Nursing, Osaka City University, Osaka
| | | | - Seiji Ohira
- Sapporo Kita Clinic, Sapporo, Hokkai-do, Japan
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Sugisawa H, Shimizu Y, Kumagai T, Sugisaki H, Ohira S, Shinoda T. Barriers to Effective Case Management for Disabled Patients on Hemodialysis. Ther Apher Dial 2017; 22:133-141. [PMID: 29282900 DOI: 10.1111/1744-9987.12608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/02/2017] [Accepted: 08/03/2017] [Indexed: 11/28/2022]
Abstract
The present study examined the performance level and its related factors on the process of case management for disabled patients on hemodialysis. Case management performance was evaluated at three stages: patient assessment, making a care plan, and monitoring/evaluation. Candidates for targeting the factors relating to performance included four dimensions: nursing care level, physical malfunction, cognitive malfunction, and barriers to service were used as patient factors; the period of case management for the patient and the knowledge of dialysis emerged as case manager factors; work load was included as an organizational factor; and community resources for these services and communication with surrounding persons were included as system factors. Self-administrated questionnaires were collected from 391 case managers of patients with hemodialysis certified long-term insurance. These were introduced by the dialysis facilities that a member of the Japanese Association of Dialysis Physicians belonged to. Case managers were asked questions about their management of each individual case. The results indicate, for example, that poor knowledge of dialysis is significantly related to poor patient assessment, inadequate development of a care plan, and lower levels of monitoring/evaluation. In addition, work overload and diabetic nephropathy as the primary kidney disease were also found to be significantly related to poor patient assessment. Increasing the opportunity for case managers to learn about dialysis may be needed for better case management performance in respect of the hemodialysis of disabled patients.
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Affiliation(s)
- Hidehiro Sugisawa
- Graduate School of Gerontology, J. F. Oberlin University, Machida-city, Tokyo, Japan
| | - Yumiko Shimizu
- Faculty of Nursing, The Jikei University School of Medicine, Chofu-city, Tokyo, Japan
| | - Tamaki Kumagai
- School of Nursing, Osaka City University, Osaka-city, Osaka, Japan
| | | | - Seiji Ohira
- Sapporo Kita Clinic, Sapporo-city, Hokkai-do, Japan
| | - Toshio Shinoda
- Faculty of Health and Medical Science, Tsukuba International University, Tsuchiura-city, Ibaraki, Japan
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Pruneri G, Cara P, Heidinger R, Kasugai A, Knaster J, Ohira S, Okumura Y, Sakamoto K. Conventional facilities of the linear IFMIF prototype accelerator (LIPAc). Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.03.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sugisawa H, Shimizu Y, Kumagai T, Sugisaki H, Ohira S, Shinoda T. Earthquake Preparedness Among Japanese Hemodialysis Patients in Prefectures Heavily Damaged by the 2011 Great East Japan Earthquake. Ther Apher Dial 2017; 21:334-344. [PMID: 28691214 DOI: 10.1111/1744-9987.12542] [Citation(s) in RCA: 4] [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: 11/14/2016] [Revised: 01/12/2017] [Accepted: 02/08/2017] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to explore the factors related to earthquake preparedness in Japanese hemodialysis patients. We focused on three aspects of the related factors: health condition factors, social factors, and the experience of disasters. A mail survey of all the members of the Japan Association of Kidney Disease Patients in three Japanese prefectures (N = 4085) was conducted in March, 2013. We obtained 1841 valid responses for analysis. The health factors covered were: activities of daily living (ADL), mental distress, primary renal diseases, and the duration of dialysis. The social factors were: socioeconomic status, family structure, informational social support, and the provision of information regarding earthquake preparedness from dialysis facilities. The results show that the average percentage of participants that had met each criterion of earthquake preparedness in 2013 was 53%. Hemodialysis patients without disabled ADL, without mental distress, and requiring longer periods of dialysis, were likely to meet more of the earthquake preparedness criteria. Hemodialysis patients who had received informational social support from family or friends, had lived with spouse and children in comparison to living alone, and had obtained information regarding earthquake preparedness from dialysis facilities, were also likely to meet more of the earthquake preparedness criteria.
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Affiliation(s)
- Hidehiro Sugisawa
- Graduate School of Gerontology, J. F. Oberlin University, Machida-city, Tokyo, Japan
| | - Yumiko Shimizu
- Faculty of Nursing, The Jikei University School of Medicine, Chofu-city, Tokyo, Japan
| | - Tamaki Kumagai
- School of Nursing, Osaka City University, Osaka-city, Japan
| | | | - Seiji Ohira
- Sapporo Kita Clinic, Sapporo-city, Hokkai-do, Japan
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Nishitani* T, Kondo K, Ohira S, Yamanishi T, Sugimoto M, Hayashi T, Ochiai K. Neutron Source for Material and Component Tests by Using IFMIF/EVEDA Prototype Accelerator. Fusion Science and Technology 2017. [DOI: 10.13182/fst14-930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Nishitani*
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - K. Kondo
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - S. Ohira
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - T. Yamanishi
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - M. Sugimoto
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - T. Hayashi
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
| | - K. Ochiai
- Japan Atomic Energy Agency, Rokkasho, Aomori, Japan 039-3212
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Komaya K, Ebata T, Shirai K, Ohira S, Morofuji N, Akutagawa A, Yamaguchi R, Nagino M. Recurrence after resection with curative intent for distal cholangiocarcinoma. Br J Surg 2017; 104:426-433. [PMID: 28138968 DOI: 10.1002/bjs.10452] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/16/2016] [Accepted: 11/04/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few studies have been conducted on patterns of recurrence after resection for distal cholangiocarcinoma (DCC). The aim of this study was to investigate the incidence and pattern of recurrence after resection of DCC, and to evaluate prognostic factors for time to recurrence and recurrence-free survival (RFS). METHODS Patients who underwent pancreatoduodenectomy with curative intent for DCC between 2001 and 2010 at one of 30 hospitals in Japan were reviewed retrospectively, with special attention to recurrence patterns. The Cox proportional hazards model was used for multivariable analysis. RESULTS In the study interval, 389 patients underwent pancreatoduodenectomy for DCC with R0/M0 status. Recurrence developed in 213 patients (54·8 per cent). The estimated cumulative probability of recurrence was 54·3 per cent at 5 years. An initial locoregional recurrence occurred in 55 patients (14·1 per cent) and initial distant recurrence in 168 (43·2 per cent), most commonly in the liver. Isolated initial locoregional recurrence occurred in 45 patients (11·6 per cent). Independent prognostic factors for time to recurrence and RFS were perineural invasion (P = 0·001 and P = 0·009 respectively), pancreatic invasion (both P < 0·001) and lymph node metastasis (both P < 0·001). RFS worsened as the number of risk factors increased: the 5-year RFS rate was 70·6 per cent for patients without any risk factors, 50·3 per cent for patients with one factor, 31·8 per cent for those with two factors, and 13·4 per cent when three factors were present. CONCLUSION More than half of patients with DCC experienced recurrence after R0 resection, usually within 5 years. Perineural invasion, pancreatic invasion and positive nodal involvement are risk factors for recurrence.
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Affiliation(s)
- K Komaya
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Shirai
- Department of Surgery, Yamashita Hospital, Ichinomiya, Japan
| | - S Ohira
- Department of Surgery, Handa City Hospital, Handa, Japan
| | - N Morofuji
- Department of Surgery, The Gifu Prefectural Federation of Agricultural Cooperatives for Health and Welfare Kumiai Hospital, Takayama, Japan
| | - A Akutagawa
- Department of Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - R Yamaguchi
- Department of Surgery, Kasugai Municipal Hospital, Kasugai, Japan
| | - M Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yazawa M, Kido R, Ohira S, Hasegawa T, Hanafusa N, Iseki K, Tsubakihara Y, Shibagaki Y. Correction: Early Mortality Was Highly and Strongly Associated with Functional Status in Incident Japanese Hemodialysis Patients: A Cohort Study of the Large National Dialysis Registry. PLoS One 2016; 11:e0168811. [PMID: 27992573 PMCID: PMC5167421 DOI: 10.1371/journal.pone.0168811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wakai E, Kanemura T, Kondo H, Hirakawa Y, Ito Y, Serizawa H, Kawahito Y, Higashi T, Suzuki A, Fukada S, Furuya K, Esaki K, Yagi J, Tsuji Y, Ito T, Niitsuma S, Yoshihashi-Suzuki S, Watanabe K, Furukawa T, Groeschel F, Micciche G, Manorri S, Favuzza P, Nitti F, Heidinger R, Terai T, Horiike H, Sugimoto M, Ohira S, Knaster J. Engineering validation for lithium target facility of the IFMIF under IFMIF/EVEDA project. Nuclear Materials and Energy 2016. [DOI: 10.1016/j.nme.2016.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yamanishi T, Asakura N, Tobita K, Ohira S, Federici G, Heidinger R, Knaster J, Clement S, Nakajima N. Recent technical progress on BA Program: DEMO activities and IFMIF/EVEDA. Fusion Engineering and Design 2016. [DOI: 10.1016/j.fusengdes.2015.12.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sugisawa H, Shimizu Y, Kumagai T, Sugisaki H, Ohira S, Shinoda T. Effects of socioeconomic status on physical and mental health of hemodialysis patients in Japan: differences by age, period, and cohort. Int J Nephrol Renovasc Dis 2016; 9:171-82. [PMID: 27471405 PMCID: PMC4948840 DOI: 10.2147/ijnrd.s107031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Study purpose Whether or not socioeconomic status (SES)-related differences in the health of hemodialysis patients differ by age, period, and birth cohort remains unclear. We examined whether SES-related gaps in physical and mental health change with age, period, and birth cohort for hemodialysis patients. Methods Data were obtained from repeated cross-sectional surveys conducted in 1996, 2001, 2006, and 2011, with members of a national patients’ association as participants. We used raking adjustment to create a database which had similar characteristics to the total sample of dialysis patients in Japan. SES was assessed using family size-adjusted income levels. We divided patients into three groups based on their income levels: below the first quartile, over the second quartile and under the third quartile, and over the fourth quartile. We used the number of dialysis complications as a physical health indicator and depressive symptoms as a mental health indicator. We used a cross-classified random-effects model that estimated fixed effects of age categories and period as level-1 factors, and random effects of birth cohort as level-2 factors. Results Relative risk of dialysis complications in respondents below the first quartile compared with ones over the fourth quartile was reduced in age categories >60 years. Mean differences in depressive symptoms between respondents below the first quartile and ones over the fourth quartile peaked in the 50- to 59-year-old age group, and were reduced in age groups >60 years. In addition, mean differences varied across periods, widening from 1996 to 2006. There were no significant birth cohort effects on income differences for dialysis complications or depressive symptoms. Conclusion The number of dialysis complications and depressive symptoms in dialysis patients were affected by income differences, and the degree of these differences changed with age category and period.
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Affiliation(s)
| | - Yumiko Shimizu
- Faculty of Nursing, The Jikei University School of Medicine, Chofu
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Yazawa M, Kido R, Ohira S, Hasegawa T, Hanafusa N, Iseki K, Tsubakihara Y, Shibagaki Y. Early Mortality Was Highly and Strongly Associated with Functional Status in Incident Japanese Hemodialysis Patients: A Cohort Study of the Large National Dialysis Registry. PLoS One 2016; 11:e0156951. [PMID: 27270615 PMCID: PMC4896445 DOI: 10.1371/journal.pone.0156951] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/13/2016] [Indexed: 11/28/2022] Open
Abstract
Background Although dialysis is typically started in an effort to prolong survival, mortality is reportedly high in the first few months. However, it remains unclear whether this is true in Japanese patients who tend to have a better prognosis than other ethnicities, and if health conditions such as functional status (FS) at initiation of dialysis influence prognosis. Methods We investigated the epidemiology of early death and its association with FS using Japanese national registry data in 2007, which included 35,415 patients on incident dialysis and 7,664 with FS data. The main outcome was early death, defined as death within 3 months after initiation of hemodialysis (HD). The main predictor was FS at initiation of HD. Levels of functional disability were categorized as follows: severe (bedridden), moderate (overt difficulties in exerting basic activities of daily living), or mild/none (none or some functional disabilities). Results Early death remained relatively common, especially among elderly patients (overall: 7.1%; those aged ≥80 years: 15.8%). Severely and even only a moderately impaired FS were significantly associated with early death after starting dialysis (adjusted risk ratios: 3.93 and 2.38, respectively). The incidence of early death in those with impaired FS increased with age (36.5% in those with severely impaired FS and aged ≥80 years). Conclusions Early death after starting dialysis was relatively common, especially among the elderly, even in Japanese patients. Further, early death was significantly associated with impaired FS at initiation of HD.
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Affiliation(s)
- Masahiko Yazawa
- Division of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
- * E-mail:
| | - Ryo Kido
- Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
| | - Seiji Ohira
- Sapporo Kita Clinic, Sapporo, Hokkaido, Japan
| | - Takeshi Hasegawa
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
| | - Norio Hanafusa
- Division of Total Renal Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kunitoshi Iseki
- The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
| | - Yoshiharu Tsubakihara
- The Committee of Renal Data Registry, Japanese Society for Dialysis Therapy, Tokyo, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, St Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
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Favuzza P, Antonelli A, Furukawa T, Groeschel F, Hedinger R, Higashi T, Hirakawa Y, Iijima M, Ito Y, Kanemura T, Knaster J, Kondo H, Miccichè G, Nitti F, Ohira S, Severi M, Sugimoto M, Suzuki A, Traversi R, Wakai E. Round Robin test for the determination of nitrogen concentration in solid Lithium. Fusion Engineering and Design 2016. [DOI: 10.1016/j.fusengdes.2016.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Miyazaki M, Ueda Y, Ohira S, Tsujii K, Isono M, Masaoka A, Teshima T. OC-0269: Comparison of dosimetric parameters of two techniques with VMAT for head and neck cancers. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31518-3] [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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Kukita K, Ohira S, Amano I, Naito H, Azuma N, Ikeda K, Kanno Y, Satou T, Sakai S, Sugimoto T, Takemoto Y, Haruguchi H, Minakuchi J, Miyata A, Murotani N, Hirakata H, Tomo T, Akizawa T. 2011 update Japanese Society for Dialysis Therapy Guidelines of Vascular Access Construction and Repair for Chronic Hemodialysis. Ther Apher Dial 2015; 19 Suppl 1:1-39. [PMID: 25817931 DOI: 10.1111/1744-9987.12296] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Watanabe Y, Hirakata H, Okada K, Yamamoto H, Tsuruya K, Sakai K, Mori N, Itami N, Inaguma D, Iseki K, Uchida A, Kawaguchi Y, Ohira S, Tomo M, Masakane I, Akizawa T, Minakuchi J. Proposal for the shared decision-making process regarding initiation and continuation of maintenance hemodialysis. Ther Apher Dial 2015; 19 Suppl 1:108-17. [PMID: 25817935 DOI: 10.1111/1744-9987.12295] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Freedman BS, Lam AQ, Sundsbak JL, Morizane R, Iatrino R, Su X, Koon SJ, Wu M, Daheron L, Valerius T, Harris PC, Zhou J, Bonventre JV, Hwang SJ, Lin MY, Lee HL, Lin HL, Li WM, Wu WJ, Huang CH, Chen LT, Yazawa M, Kido R, Kimura K, Ohira S, Hasegawa T, Hanafusa N, Iseki K, Tsubakihara Y, Shibagaki Y, Kotwal S, Webster A, Cass A, Gallagher M, Raimann JG, Usvyat LA, Vega-Vega O, Penne L, Kooman J, Van Der Sande F, Thijssen S, Marcelli D, Canaud B, Levin NW, Wang Y, Kotanko P, Tripepi G, Maas R, Boger R, Zoccali C, Mallamaci F. TRANSLATIONAL CKD RESEARCH. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shiraga H, Fujioka S, Nakai M, Watari T, Nakamura H, Arikawa Y, Hosoda H, Nagai T, Koga M, Kikuchi H, Ishii Y, Sogo T, Shigemori K, Nishimura H, Zhang Z, Tanabe M, Ohira S, Fujii Y, Namimoto T, Sakawa Y, Maegawa O, Ozaki T, Tanaka K, Habara H, Iwawaki T, Shimada K, Key M, Norreys P, Pasley J, Nagatomo H, Johzaki T, Sunahara A, Murakami M, Sakagami H, Taguchi T, Norimatsu T, Homma H, Fujimoto Y, Iwamoto A, Miyanaga N, Kawanaka J, Kanabe T, Jitsuno T, Nakata Y, Tsubakimoto K, Sueda K, Kodama R, Kondo K, Morio N, Matsuo S, Kawasaki T, Sawai K, Tsuji K, Murakami H, Sarukura N, Shimizu T, Mima K, Azechi H. Implosion and heating experiments of fast ignition targets by Gekko-XII and LFEX lasers. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135901008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aoki N, Kawamura M, Yamaguchi-Aoki Y, Ohira S, Matsuda T. RETRACTION of: Down-regulation of protein tyrosine phosphatase gene expression in lactating mouse mammary gland. J Biochem 2013; 154:393. [DOI: 10.1093/jb/mvt083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dohi M, Doi K, Miyata H, Motomura N, Ohira S, Kawajiri H, Yamamoto T, Watanabe T, Okawa K, Takamoto S, Yaku H. 231 * THE OFF-PUMP TECHNIQUE REDUCED MORTALITY AND MAJOR MORBIDITIES IN REDO CORONARY ARTERY BYPASS GRAFTING: A PROPENSITY SCORE ANALYSIS FROM A JAPANESE CARDIOVASCULAR SURGERY DATABASE. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yokoyama T, Fukumoto K, Ohira S, Hara R, Fujii T, Jo Y, Miyaji Y, Nagai A. UP-03.195 Correlation of Urinary Nerve Growth Factor Level With the Response of Antimuscarinic Therapy in Patients With Overactive Bladder. Urology 2011. [DOI: 10.1016/j.urology.2011.07.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ohira S, Hara R, Obatake A, Fujita M, Shouhei T, Hukumotou K, Jo M, Fijii T, Yokoyama M, Miyaji S, Nagai A. MP-03.19 Efficacy of Transperineal Versus Transrectal 12-Core Initial Prostate Biopsy with PSA Levels Between 4.0 and 20.0 ng/ml. Urology 2011. [DOI: 10.1016/j.urology.2011.07.068] [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: 10/15/2022]
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Miyaji Y, Kanomata N, Ohira S, Tsukimori S, Fukumoto K, Hara R, Fujii T, Jo Y, Yokoyama T, Nagai A. UP-01.159 Prognostic Factors and Survival of Renal Cell Carcinoma in Japanese Patients. Urology 2011. [DOI: 10.1016/j.urology.2011.07.711] [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: 10/16/2022]
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Winkelmayer W, Liu J, Brookhart A, Wang HY, Kan WC, Chien CC, Fang TC, Lin HF, Li YH, Wang CH, Chou CL, Yazawa M, Shibagaki Y, Kimura K, Ohira S, Ryo K, Hasegawa T, Hanafusa N, Tsubakihara Y, Iseki K, Chen HY, Cheng IC, Pan YJ, Chiu YL, Hsu SP, Pai MF, Yang JY, Peng YS, Tsai TJ, Wu KD, Dzekova-Vidimliski P, Severova-Andreevska G, Pavlevska S, Trajceska L, Selim G, Gelev S, Sikole A, Hecking M, Karaboyas A, Saran R, Sen A, Inaba M, Horl WH, Pisoni R, Robinson B, Sunder-Plassmann G, Port FK, Chiroli S, Perrault L, Mitchell D, Mattin C, Krause R, Roth HJ, Schober-Halstenberg HJ, Edenharter G, Frei U, Wilson R, Adena M, Hodgkins P, Keith M, Smyth M, Couchoud C, Galland R, Man NK, Chanliau J, Lemaitre V, Traeger J, von Gersdorff G, Vega O, Schaller M, Usvyat L, Levin N, Barth C, Kotanko P, Vega O, Usvyat L, Rosales L, Thijssen S, Levin N, Kotanko P, Schmid H, Schiffl H, Romanos A, Lederer S, Chu KH, Lam B, Tang C, Wong S, Cheuk A, Yim KF, Tang HL, Lee W, Fung KS, Chan H, Ng TK, Tong KL, Doyle M, Severn A, Traynor J, Metcalfe W, Boyd J, Cairns S, Reilly J, Henderson A, Simpson K, Tovbin D, Douvdevani A, Novack V, Abd Elkadir A, Zlotnik M, Djuric Z, Dimkovic N, Popovic J, Furumatsu Y, Yamazaki S, Hayashino Y, Takegami M, Yamamoto Y, Kakudate N, Wakita T, Akizawa T, Akiba T, Saito A, Kurokawa K, Fukuhara S, Voronovitsky G, Pinelli L, Paganti L, Silva J, Garofalo R, Reiss E, Gimenez Torrado J, Lafroscia P, Lugo M, Laplante S, Vanovertveld P, Nordio M, Limido A, Maggiore U, Nichelatti M, Postorino M, Quintaliani G, Ebah L, Kanigicherla D, Nikam M, Dutton G, Mitra S, Attipoe L, Baharani J, Pinelli L, Voronovitsky G, Magrini G, Martorell A, Lugo M, Mashima Y, Konta T, Kudo K, Suzuki K, Ikeda A, Takasaki S, Kubota I, Chudek J, Wieczorowska-Tobis K, Wiecek A, Members of the "PolSenior" Study Group, des Grottes JM, Collart F, Lemaitre V, Maheut H, Couchoud C, Goodkin DA, Bieber B, Robinson BM, Jadoul M, Djogan M, Dudar I, Sergeyeva T, Hanafusa N, Yamagata K, Nishi H, Nishi S, Iseki K, Tsubakihara Y, Hommel K, Madsen M, Blicher TM, Kamper AL, Masakane I, Ito S, Seino M, Ito M, Nagasawa J, Rayner HC, Fuller DS, Gillespie BW, Hasegawa T, Morgenstern H, Robinson BM, Saran R, Tentori F, Pisoni RL, Chien CC, Wang JJ, Hwang JC, Wang HY, Kan WC, Trajceska L, Mladenovska D, Severova G, Amitov V, Selim G, Gelev S, Dzekova-Vidimliski P, Sikole A, Yadav P, Baharani J, Attipoe L, Baharani J, Carrero JJ, Jager DJ, Verduijn M, Ravani P, De Meester J, Heaf JG, Finne P, Hoitsma AJ, Pascual J, Jarraya F, Reisaeter AV, Collart F, Dekker FW, Jager KJ, Trajceska L, Mladenovska D, Severova G, Gelev S, Selim G, Amitov V, Sikole A, Sammut H, Ahmed MSA, Sheppard J, Attwood N, Cserep G, Sinnamon K, Pinelli L, Voronovitsky G, Lugo M, Reiss E, Katsipi I, Tatsiopoulos A, Doulgerakis C, Papanikolaou P, Kardouli E, Lamprinoudis G, Kintzoglanakis K, Gennadiou M, Kyriazis J, Granger Vallee A, Covic E, Morena M, Fournier A, Canaud B, Bolignano D, Rastelli S, Curatola G, Caridi G, Tripepi R, Tripepi G, Politi R, Catalano F, Delfino D, Ciccarelli M, Mallamaci F, Zoccali C. Epidemiology & outcome in CKD 5D (1). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.41] [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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Ohira S. Far-infrared irradiation can improve blood flow and patency of arteriovenous fistulas in hemodialysis patients. Nat Clin Pract Nephrol 2007; 3:422-3. [PMID: 17579597 DOI: 10.1038/ncpneph0538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Accepted: 05/11/2007] [Indexed: 05/15/2023]
Affiliation(s)
- Seiji Ohira
- Department of Surgery, Sapporo Kita Clinic, Kita ku, Kita 18 Jo, Nishi, Sapporo, Hokkaido, Japan.
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Suzuki N, Ohira S, Tanaka M, Sugawara T, Nakajima K, Shishido T. Fabrication and characterization of transparent conductive Sn-doped β-Ga2O3 single crystal. ACTA ACUST UNITED AC 2007. [DOI: 10.1002/pssc.200674884] [Citation(s) in RCA: 172] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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