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Yamashita H, Higashida T, Huchioka A, Asakawa Y, Nambu A, Ohyatsu S, Kohyama T, Takahashi M, Hayashi T, Tago M. Cardiac angiosarcoma with metastatic to lung, brain, and bone. Radiol Case Rep 2024; 19:473-478. [PMID: 38046925 PMCID: PMC10692493 DOI: 10.1016/j.radcr.2023.10.056] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 12/05/2023] Open
Abstract
Cardiac angiosarcoma is a malignant tumor derived from vascular endothelium with a dismal prognosis. The imaging findings of cardiac angiosarcoma are nonspecific and endomyocardial and pericardial biopsies have insufficient accuracy. For these reasons, the diagnosis is sometimes difficult. Primary and metastatic tumors tend to bleed easily, causing hemoptysis and neurological symptoms. Brain metastases are not often known to be fatal when they cause hemorrhage. We report a 27-year-old man diagnosed with right atrium angiosarcoma, with metastases in the lung, brain, and bone. The patient had only respiratory symptoms at the first visit and did not show any symptoms derived from brain metastases yet died after 27 days due to hemorrhage from brain metastases. If brain metastasis from angiosarcoma is suspected based on imaging findings, urgent radiotherapy should be considered before histological examination for a definitive diagnosis.
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Affiliation(s)
- Hiroshi Yamashita
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Tomohiko Higashida
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Aya Huchioka
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Yasuma Asakawa
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Atsushi Nambu
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Sho Ohyatsu
- Department of Internal Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Tadashi Kohyama
- Department of Internal Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Mikiko Takahashi
- Department of Pathology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Takaki Hayashi
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
| | - Masao Tago
- Department of Radiology, Teikyo University School of Medicine University Hospital, Mizonokuchi, 213-8507, 5-1-1 Futako, Takatsu-ku, Kawasaki-city, Kanagawa, Japan
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Suzuki Y, Nagase H, Toyota H, Ohyatsu S, Kobayashi K, Takeshita Y, Uehara Y, Hattori S, Ishizuka M, Sakasegawa H, Kuramochi M, Kohyama T, Sugimoto N. Questionnaire for diagnosing asthma-COPD overlap in COPD: Development of ACO screening questionnaire (ACO-Q). Allergol Int 2023:S1323-8930(23)00005-9. [PMID: 36868950 DOI: 10.1016/j.alit.2023.01.004] [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: 09/07/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The considerable prevalence and worse outcomes of asthma-COPD overlap (ACO) in COPD have been reported, and optimal introduction of ICS is essential for ACO. However, diagnostic criteria for ACO consist of multiple laboratory tests, which is challenging during this COVID-19 era. The purpose of this study was to create a simple questionnaire to diagnose ACO in patients with COPD. METHODS Among 100 COPD patients, 53 were diagnosed with ACO based on the Japanese Respiratory Society Guidelines for ACO. Firstly, 10 candidate questionnaire items were generated and further selected by a logistic regression model. An integer-based scoring system was generated based on the scaled estimates of items. RESULTS Five items, namely a history of asthma, wheezing, dyspnea at rest, nocturnal awakening, and weather- or season-dependent symptoms, contributed significantly to the diagnosis of ACO in COPD. History of asthma was related to FeNO >35 ppb. Two points were assigned to history of asthma and 1 point to other items in the ACO screening questionnaire (ACO-Q), and the area under the receiver operating characteristic curve was 0.883 (95% CI: 0.806-0.933). The best cutoff point was 1 point, and the positive predictive value was 100% at a cutoff of 3 points or higher. The result was reproducible in the validation cohort of 53 patients with COPD. CONCLUSIONS A simple questionnaire, ACO-Q, was developed. Patients with scores ≥3 could be reasonably recommended to be treated as ACO, and additional laboratory testing would be recommended for patients with 1 and 2 points.
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Affiliation(s)
- Yuki Suzuki
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Nagase
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Hikaru Toyota
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Sho Ohyatsu
- Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Konomi Kobayashi
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuri Takeshita
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuuki Uehara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Saya Hattori
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Mana Ishizuka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Hirokazu Sakasegawa
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Michio Kuramochi
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Tadashi Kohyama
- Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Naoya Sugimoto
- Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
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Osaki S, Kikuchi K, Moritoki Y, Motegi C, Ohyatsu S, Nariyama T, Matsumoto K, Tsunashima H, Kikuyama T, Kubota J, Nagumo K, Fujioka H, Kato R, Murakawa Y. Distinguishing coagulase-negative Staphylococcus bacteremia from contamination using blood-culture positive bottle detection pattern and time to positivity. J Infect Chemother 2020; 26:672-675. [PMID: 32131983 DOI: 10.1016/j.jiac.2020.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 02/01/2020] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
AIM Detection of coagulase-negative Staphylococcus in blood culture may be a result of either bacteremia or contamination. This often leads to diagnostic uncertainly. Our objective was to develop a method for differentiating whether a coagulase-negative Staphylococcus sp. positive blood culture represents bacteremia or contamination based on positive bottle detection pattern and time to positivity (TTP). METHODS This study included 155 and 51 adults with positive blood cultures for Staphylococcus epidermidis and Staphylococcus hominis, respectively, over a three-year period from 2016 to 2018. Positive blood culture cases were categorized as either bacteremia or contamination based on the clinically available information, and the detection pattern and TTP in each category were investigated. RESULTS A total of 57, 92, and 6 S. epidermidis positive blood cultures were categorized as bacteremia, contamination, and undetermined, respectively, whereas 15 and 36 S. hominis positive blood cultures were categorized as bacteremia and contamination, respectively. For positive blood cultures categorized as bacteremia, all four bottles in two sets of blood cultures were positive in 47/47 S. epidermidis and 14/14 S. hominis, respectively, whereas either one bottle in each of two sets or three bottles in two sets were positive in 10/19 S. epidermidis and 1/4 S. hominis, respectively; most of those TTPs were <48 h. Among them, the TTP in catheter-related blood stream infection was <24 h. CONCLUSION Although clinical assessment is crucial to differentiate between bacteremia and contamination, a combination of positive bottle detection pattern and TTP is a valuable diagnostic auxiliary tool.
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Affiliation(s)
- Sayuri Osaki
- Central Laboratory, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Kentaro Kikuchi
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
| | - Yuki Moritoki
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Chiyoko Motegi
- Central Laboratory, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Sho Ohyatsu
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Tomoyuki Nariyama
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Kotaro Matsumoto
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Hiromichi Tsunashima
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Tomohiro Kikuyama
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Juri Kubota
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Kozue Nagumo
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Hikari Fujioka
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Ryoko Kato
- Central Laboratory, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Yuji Murakawa
- Central Laboratory, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan; Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
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Takai A, Kikuchi K, Ichimura M, Tsuneyama K, Moritoki Y, Matsumoto K, Tsunashima H, Onda T, Kuniyoshi N, Nariyama T, Ohyatsu S, Kubota J, Nagumo K, Sato S, Hara M, Miyakawa H. Fructo-oligosaccharides ameliorate steatohepatitis, visceral adiposity, and associated chronic inflammation via increased production of short-chain fatty acids in a mouse model of non-alcoholic steatohepatitis. BMC Gastroenterol 2020; 20:46. [PMID: 32103741 PMCID: PMC7045471 DOI: 10.1186/s12876-020-01194-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/17/2020] [Indexed: 02/08/2023] Open
Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. Within the spectrum of NAFLD, non-alcoholic steatohepatitis (NASH) in combination with hepatic inflammation and fibrosis can lead to liver cirrhosis and hepatocellular carcinoma. Dysbiosis was reported to contribute to NASH pathogenesis. This study aimed to determine the effects of fructo-oligosaccharides (FOS) on steatohepatitis and visceral adiposity in an obese mouse model of NASH. Methods Twelve newborn C57BL/6 J male mice were subcutaneously injected with monosodium glutamate (MSG) to induce obesity on a conventional diet. Six mice were also administered 5% FOS via drinking water from 10 weeks of age. At 18 weeks, histological characteristics of the liver and epididymal fat were compared between the groups. Hepatic mRNA expression of lipid metabolism enzymes and SCFA in feces and sera were measured. Results Hepatic steatosis, inflammatory cell infiltration, and hepatocyte ballooning in the liver and increased hepatic mRNA expression of fatty acid synthase and glycerol-3-phosphate acyltransferase were observed in the MSG-treated mice. FOS treatment improved the liver pathology and blunted the increases in the mRNA expression levels of lipid metabolism enzymes. In addition, FOS inhibited adipocyte enlargement and formation of crown-like structures and reduced the M1 macrophage frequency in the epididymal fat of the MSG mice (39.4% ± 3.0% vs. 22.8% ± 0.7%; P = 0.001). FOS increased not only the fecal concentrations of n-butyric acid (0.04 ± 0.01 vs. 0.38 ± 0.14 mg/g, P = 0.02), propionic acid (0.09 ± 0.03 vs. 0.42 ± 0.16 mg/g, P = 0.02), and acetic acid (0.65 ± 0.16 vs. 1.48 ± 0.29 mg/g, P = 0.03) but also the serum concentration of propionic acid (3.9 ± 0.5 vs. 8.2 ± 0.5 μmol/L, P = 0.001). Conclusions FOS ameliorates steatohepatitis, visceral adiposity, and chronic inflammation by increasing SCFA production.
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Affiliation(s)
- Atsuko Takai
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Kentaro Kikuchi
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan.
| | - Mayuko Ichimura
- Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Koichi Tsuneyama
- Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima-shi, Tokushima, Japan
| | - Yuki Moritoki
- Department of General Internal Medicine and Clinical Laboratory Medicine, Akita University Graduate School of Medicine, Akita-shi, Akita, Japan
| | - Kotaro Matsumoto
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Hiromichi Tsunashima
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki-shi, Kanagawa, Japan
| | - Takeshi Onda
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki-shi, Kanagawa, Japan.,Department of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai-shi, Chiba, Japan
| | - Noriyuki Kuniyoshi
- Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kawasaki-shi, Kanagawa, Japan.,Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan
| | - Tomoyuki Nariyama
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Sho Ohyatsu
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Juri Kubota
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Kozue Nagumo
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Shinpei Sato
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Masumi Hara
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
| | - Hiroshi Miyakawa
- Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, 5-1-1 Futako, Takatsu-ku, Kawasaki-shi, Kanagawa, 213-8507, Japan
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