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Iwai T, Imagumbai T, Hiraoka S, Kishi T, Okabayashi S, Ashida R, Mitsuyoshi T, Matsuo Y, Ishigaki T, Mizowaki T, Kokubo M. Clinical outcomes of scalp or face angiosarcoma treatment with intensity-modulated radiotherapy: a multicenter study. J Radiat Res 2024; 65:78-86. [PMID: 37996084 PMCID: PMC10803163 DOI: 10.1093/jrr/rrad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/04/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Abstract
Combined modality therapy, including radiotherapy (RT), is a common treatment for scalp or face angiosarcoma. Although intensity-modulated radiotherapy (IMRT) can deliver homogeneous doses to the scalp or face, clinical data are limited. This multicenter study aimed to evaluate scalp or face angiosarcoma treated with definitive or post-operative IMRT. We retrospectively analyzed data from patients who received IMRT for scalp or face angiosarcoma at three institutions between January 2015 and March 2020. Local control (LC) rate, overall survival (OS), progression-free survival (PFS), recurrence patterns and toxicity were evaluated. Fifteen patients underwent IMRT during the study period. Definitive RT was performed on 10 patients and post-operative RT was performed on 5 patients. The 1-year LC rate was 85.7% (95% confidence interval [CI], 53.9-96.2%). The 1-year OS and PFS rates were 66.7% (95% CI, 37.5-84.6%) and 53.3% (95% CI, 26.3%-74.4%), respectively. Univariate analysis revealed that a clinical target volume over 500 cm3 was associated with poor LC. Distant metastasis was the most common recurrence pattern. All patients experienced Grade 2 or 3 radiation dermatitis, and five patients experienced grade ≥ 3 skin ulceration. One patient who underwent maintenance therapy with pazopanib developed Grade 5 skin ulceration. Fisher's exact test showed that post-operative RT was significantly associated with an increased risk of skin ulceration of grade ≥ 3. These results demonstrate that IMRT is a feasible and effective treatment for scalp or face angiosarcoma, although skin ulceration of grade ≥ 3 is a common adverse event in patients who receive post-operative RT.
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Affiliation(s)
- Takahiro Iwai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Shinya Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Takahiro Kishi
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Shun Okabayashi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Takamasa Mitsuyoshi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan
| | - Takashi Ishigaki
- Department of Radiation Oncology, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, 543-8555, Osaka, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, 606-8507, Kyoto, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 21-1, Minatojima, Chuo-ku, Kobe 650-0047, Hyogo, Japan
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Watanabe S, Yamane H, Iwai T, Matsushita R, Seto Y. In vitro metabolic profiling of new synthetic cannabinoids, ADB-FUBIATA, AFUBIATA, CH-FUBIATA, and CH-PIATA. Arch Toxicol 2023; 97:3085-3094. [PMID: 37755504 DOI: 10.1007/s00204-023-03605-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
In the recreational drug market, synthetic cannabinoids with a new acetamide linker structure emerged, most likely to circumvent the law. As the knowledge of drug metabolites is vital for proving drug consumption, the phase I metabolism of the newly emerging cannabinoids, ADB-FUBIATA, AFUBIATA, CH-FUBIATA, and CH-PIATA, was investigated. Each drug (10 μmol/L) was incubated with human liver microsomes for 1 h, and the samples, after dilution, were analyzed by liquid chromatography-high-resolution mass spectrometry. All drugs were metabolized via hydroxylation and N-dealkylation, while AFUBIATA and CH-PIATA additionally underwent ketone formation. The metabolites AF7 (hydroxylated at the indole/adjacent methylene) of ADB-FUBIATA, A16 (hydroxylated at the adamantane) of AFUBIATA, CF15 (hydroxylated at the cyclohexane) of CH-FUBIATA, and CP9 (hydroxylated at the pentane) of CH-PIATA were the most abundant metabolites by considering the peak areas on the chromatograms, and are recommended for urinalysis. The structure-metabolism relationship was also discussed, which generally agreed well with previously reported metabolic pathways of other synthetic cannabinoids. However, the preferred hydroxylation site of ADB-FUBIATA, the indole/adjacent methylene, clearly differed from that of ADB-FUBICA, the 3,3-dimethylbutanamide moiety, despite their structures differing only by a methylene group, emphasizing that metabolic predictions of new drugs should not replace in vitro experimental analyses, albeit helpful.
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Affiliation(s)
- Shimpei Watanabe
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Physical Science Research Building, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo, 679-5148, Japan.
| | - Hiroshi Yamane
- Forensic Science Laboratory, Hyogo Prefectural Police Headquarters, Kobe, Japan
| | - Takahiro Iwai
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Physical Science Research Building, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo, 679-5148, Japan
| | - Ritsuko Matsushita
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Physical Science Research Building, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo, 679-5148, Japan
| | - Yasuo Seto
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Physical Science Research Building, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo, 679-5148, Japan
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Iwai T, Yoshimura M, Ogawa A, Ono Y, Masui T, Nagai K, Anazawa T, Mizowaki T. The Outcomes of Neoadjuvant Chemoradiotherapy Using Moderately Hypofractionated Intensity Modulated Radiotherapy for Borderline Resectable Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e306. [PMID: 37785112 DOI: 10.1016/j.ijrobp.2023.06.2328] [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) Complete resection of borderline resectable pancreatic cancer (BRPC) is difficult because of its invasion to the vital vessels. Although neoadjuvant therapy is recommended for BRPC, its optimal regimens remain unclear. Neoadjuvant chemoradiotherapy using moderately hypofractionated intensity-modulated radiotherapy (NAC-MH-IMRT) has potentials to improve the treatment outcomes with shorter treatment periods. Therefore, we evaluated the outcomes for BRPC patients treated with NAC-MH-IMRT. MATERIALS/METHODS Between February 2013 and June 2021, patients with BRPC treated with NAC-MH-IMRT at our institution were evaluated. All patients were classified as BRPC-A and BRPC-V according to NCCN guidelines. Information regarding patient status, tumor and treatment characteristics, margin-negative resection (R0) rates, histological effects assessed by Evans classification, and outcomes were obtained from the clinical records. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan-Meier method from the start date of any first treatment for BRPC. Toxicity was evaluated by CTCAE version 5.0. RESULTS Sixty-eight patients were included in this study (Table). All patients underwent induction chemotherapy, and 67 were treated with IMRT at 42 Gy in 15 fractions with concurrent gemcitabine (for 65) or S-1 (for 2). All patients achieved completion of radiotherapy. Fifty-seven of the 68 patients (83.8%) underwent surgical exploration, and 48 patients (70.6%) had a resection. The R0 resection was achieved in 44 patients, and the R0 resection rate was 91.7% in resected patients. Therapeutic effects by Evans classification showed as below: Grade 1/2a/2b/3/4 = 6 (12.5%)/17 (35.4%)/17 (35.4%)/7 (14.6%)/1 (2.1%). Adjuvant chemotherapy was performed for 41 patients, and S-1 and gemcitabine were used for 40 and 1 patient(s), respectively. The median follow-up time and median survival time (MST) were 23.6 months and 42.7 months, and 2-year OS and PFS were 67.3% and 30.2%, respectively. Recurrence was observed in 54 patients (79.4%), and the first recurrence pattern was as follows: 7 (13.0%)/42 (77.8%)/5 (9.3%) patients had local recurrence, distant metastases, and both of them, respectively. Regarding ≥ Grade 3 gastrointestinal toxicity related NAC-MH-IMRT, grade 3 ileus was observed in 1 patient. CONCLUSION NAC-MH-IMRT for BRPC showed preferable outcomes and acceptable toxicities with high completion rate.
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Affiliation(s)
- T Iwai
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Yoshimura
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Ogawa
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Ono
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Masui
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Nagai
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Anazawa
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Ogawa A, Yoshimura M, Nakamura M, Adachi T, Iwai T, Ashida R, Mizowaki T. Correction: Impact of planning organ at risk volume margins and matching method on late gastrointestinal toxicity in moderately hypofractionated IMRT for locally advanced pancreatic ductal adenocarcinoma. Radiat Oncol 2023; 18:139. [PMID: 37612744 PMCID: PMC10463611 DOI: 10.1186/s13014-023-02321-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
- Ayaka Ogawa
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, 53 Kawahara- cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takanori Adachi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takahiro Iwai
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Ogawa A, Yoshimura M, Nakamura M, Adachi T, Iwai T, Ashida R, Mizowaki T. Impact of planning organ at risk volume margins and matching method on late gastrointestinal toxicity in moderately hypofractionated IMRT for locally advanced pancreatic ductal adenocarcinoma. Radiat Oncol 2023; 18:103. [PMID: 37337247 PMCID: PMC10280835 DOI: 10.1186/s13014-023-02288-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/24/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND This study examined the differences in late gastrointestinal (GI) toxicities in moderately hypofractionated intensity-modulated radiation therapy (IMRT) for locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) by changing the planning organs at risk volume (PRV) margin and the target matching method and assessed the causes of adverse events. METHODS We examined 37 patients with LA-PDAC who underwent moderately hypofractionated IMRT between 2016 and 2020 at our institution; 23 patients were treated with wide PRV margins and soft tissue matching (Protocol A) and 14 with narrow PRV margins and fiducial marker matching (Protocol B). The GI toxicities, local control (LC) rate, and overall survival (OS) were assessed for each protocol. The initially planned and daily doses to the gross tumor volume (GTV), stomach, and duodenum, reproduced from cone-beam computed tomography, were evaluated. RESULTS The late GI toxicity rate of grades 3-4 was higher in Protocol B (42.9%) than in Protocol A (4.3%). Although the 2-year LC rates were significantly higher in Protocol B (90.0%) than in Protocol A (33.3%), no significant difference was observed in OS rates. In the initial plan, no deviations were found for the stomach and duodenum from the dose constraints in either protocol. In contrast, daily dose evaluation for the stomach to duodenal bulb revealed that the frequency of deviation of V3 Gy per session was 44.8% in Protocol B, which was significantly higher than the 24.3% in Protocol A. CONCLUSIONS Reducing PRV margins with fiducial marker matching increased GI toxicities in exchange for improved LC. Daily dose analysis indicated the trade-off between the GTV dose coverage and the irradiated doses to the GI. This study showed that even with strict matching methods, the PRV margin could not be reduced safely because of GI inter-fractional error, which is expected to be resolved with online adaptive radiotherapy.
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Affiliation(s)
- Ayaka Ogawa
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Advanced Medical Physics, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takanori Adachi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takahiro Iwai
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Watanabe S, Baginski S, Iwai T, Matsushita R, Takatsu M, Nakanishi T, Lindbom K, Mckenzie C, Vikingsson S, Kronstrand R, Gréen H, Seto Y. Systematic in vitro metabolic profiling of the OXIZID synthetic cannabinoids BZO-4en-POXIZID, BZO-POXIZID, 5F-BZO-POXIZID, BZO-HEXOXIZID and BZO-CHMOXIZID. J Anal Toxicol 2023; 47:455-463. [PMID: 36857377 DOI: 10.1093/jat/bkad016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/27/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/02/2023] Open
Abstract
The new class of synthetic cannabinoids termed OXIZIDs has recently emerged on the recreational drug market. In order to continue detection of new drugs in biological specimens, identification of metabolites is essential. The aim of this study was to elucidate the metabolites of BZO-4en-POXIZID produced in human liver microsomes (HLM) and human hepatocyte incubations and to compare the results with closely related analogs using the same experimental setup. Each drug was incubated for 1 h in HLM and BZO-4en-POXIZID was also incubated in human hepatocytes for up to 3 h. Subsequently, the incubates were analyzed by liquid chromatography-high-resolution mass spectrometry. BZO-4en-POXIZID metabolites were obtained in the incubation with HLM and human hepatocytes, via the metabolic pathways of dihydrodiol formation, hydroxylation, reduction of the alkene bond, and glucuronidation. The major metabolic pathway was found to be dihydrodiol formation at the pentenyl tail moiety. BZO-POXIZID, 5F-BZO-POXIZID, BZO-HEXOXIZID and BZO-CHMOXIZID underwent similar metabolism to those reported in the literature, via the metabolic pathways of N-dealkylation, hydroxylation, ketone formation, and oxidative defluorination (to alcohol or carboxylic acid). The results suggest that OXIZIDs are mainly metabolized at the N-alkyl moiety and the major metabolic pathways are hydroxylation when the N-alkyl moiety is a simple hydrocarbon, whereas functional-group-specific pathways (dihydrodiol formation and oxidative defluorination) are preferred when the moiety contains specific functional groups (alkene or fluoro), as has been observed for other synthetic cannabinoids. The major metabolites generated via these major metabolic pathways should serve as useful analytical targets for urine analysis. Furthermore, the higher abundance of glucuronidated metabolite suggests that enzymatic hydrolysis of glucuronides may be necessary in urine analysis to increase phase I metabolite concentration and improve detection.
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Affiliation(s)
- Shimpei Watanabe
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Steven Baginski
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Takahiro Iwai
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Ritsuko Matsushita
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Masahisa Takatsu
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Toshio Nakanishi
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - Karin Lindbom
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Craig Mckenzie
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK.,Chiron AS, Trondheim, Norway
| | - Svante Vikingsson
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Center for Forensic Science, RTI International, 3040 East Cornwallis Rd., Research Triangle Park, NC, 27709, USA
| | - Robert Kronstrand
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Forensic Genetics and Forensic Toxicology National Board of Forensic Medicine, Linköping, Sweden
| | - Henrik Gréen
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Forensic Genetics and Forensic Toxicology National Board of Forensic Medicine, Linköping, Sweden
| | - Yasuo Seto
- Forensic Science Group, Photon Science Research Division, RIKEN SPring-8 Center, Hyogo 679-5148, Japan
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Watanabe S, Kikuchi T, Iwai T, Matsushita R, Takatsu M, Honda S, Nakanishi T, Nakamura Y, Seto Y. Single crystal X-ray analysis using the crystalline sponge method for direct structure determination of new and earlier synthetic cannabinoids including OXIZIDs, AKB48, and JWH-424 from a trace sample. Forensic Chem 2023. [DOI: 10.1016/j.forc.2023.100480] [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: 02/16/2023]
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Iwai T, Honda S, Watanabe S, Matsushita R, Nakanishi T, Takatsu M, Moriwaki T, Yabashi M, Ishikawa T, Seto Y. Forensic Discrimination of Drug Powder Based on Drug Mixing Condition Determined Using Micro Fourier Transform Infrared Spectroscopy. ACS Omega 2023; 8:4285-4293. [PMID: 36743070 PMCID: PMC9893443 DOI: 10.1021/acsomega.2c07573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
The quantitative evaluation of the drug mixing condition was conducted for application in the forensic discrimination of drug powders using micro Fourier transform infrared (FT-IR) spectroscopy. Bromhexine hydrochloride (BHCl) and p-hydroxybenzoic acid (PHBA) were used as the simulated drug and additive, respectively. Equal masses of two chemicals were (1) simply mixed, (2) homogenized using agate mortar, or (3) dissolved in methanol and dried, and then (4) homogenized using agate mortar. The mixed powders dispersed on BaF2 plates were subjected to mapping analysis of micro FT-IR spectroscopy using synchrotron radiation (SR) or globar light in transmission mode with aperture sizes of 2.5 x 2.5 and 10 x 10μm2, and x-y scanning steps of 2.5 and 10 μm, respectively. The areas of the vibration bands specific to BHCl (C-N bending) and PHBA (C=O stretching) were converted to the molar contents (CBHCl, CPHBA), and the relative content ratio (RCR: CPHBA/[CBHCl + CPHBA]) was used as one mixing parameter. The resulting two-dimensional distribution map provided the relative spatial localizations of the two species, and frequency histograms with a horizontal axis of RCR were plotted to evaluate the RCR distribution. The percentage frequency of the extreme value in which RCR was 0 or 1 (%EV) was used as one mixing index. After excluding the extreme values, the coefficient of variation (CV) of the RCR distribution was used as another mixing index. The differentiation among four mixing modes could be evaluated from the standpoint of %EV and CV, and the discrimination capacity by SR instrument was superior to that by globe light instrument.
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Affiliation(s)
- Takahiro Iwai
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Sadao Honda
- Japan
Synchrotron Radiation Research Institute, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo679-5198, Japan
| | - Shimpei Watanabe
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Ritsuko Matsushita
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Toshio Nakanishi
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Masahisa Takatsu
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Taro Moriwaki
- Japan
Synchrotron Radiation Research Institute, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo679-5198, Japan
| | - Makina Yabashi
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Tetsuya Ishikawa
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
| | - Yasuo Seto
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo679-5148, Japan
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Iwai T, Imagumbai T, Okabayashi S, Ashida R, Mitsuyoshi T, Tai Y, Matsumoto T, Yamashita D, Nagano T, Kokubo M. Perianal Bowen's disease treated with radiotherapy preserving anal function with a unique skin reaction considered as 'tumoritis'. Int Cancer Conf J 2023; 12:41-45. [PMID: 36605842 PMCID: PMC9807712 DOI: 10.1007/s13691-022-00574-7] [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: 05/20/2022] [Accepted: 08/14/2022] [Indexed: 01/07/2023] Open
Abstract
Bowen's disease (BD) is a form of intraepidermal squamous cell carcinoma (SCC), and it occasionally occurs on the perianal site. BD is often treated with surgical excision; however, sometimes surgical excision for perianal BD cannot preserve anal function. We report the case of a 72-year-old man presenting with perianal pain and BD. He was treated with Radiotherapy (RT) and preserved his normal anal sphincter function without any recurrence or late adverse event. Moreover, we observed the unique skin reaction called 'tumoritis', which is characterized by mucosal inflammation. Tumoritis indicates the true extent of the tumor and evaluating the tumor or lesion size based on the extent of tumoritis when performing RT is important.
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Affiliation(s)
- Takahiro Iwai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Shun Okabayashi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Takamasa Mitsuyoshi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Yukimasa Tai
- Department of Dermatology, Kobe City Medical Center General Hospital, Kobe, Hyogo Japan
| | - Toshihiko Matsumoto
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Hyogo Japan
| | - Daisuke Yamashita
- Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo Japan
| | - Tohru Nagano
- Department of Dermatology, Kobe City Medical Center General Hospital, Kobe, Hyogo Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Minamimachi 2-1-1, Minatojima, Chuo-ku, Kobe, Hyogo 650-0047 Japan
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10
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Matsushita R, Nakanishi T, Watanabe S, Iwai T, Takatsu M, Honda S, Funaki K, Ishikawa T, Seto Y. Effects of Machine Washing on the Chromatography Parameters of Polyester Fiber Gel Permeation. ACS Omega 2022; 7:38789-38795. [PMID: 36340080 PMCID: PMC9631878 DOI: 10.1021/acsomega.2c04446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Fiber examination is frequently performed in forensics, and gel permeation chromatography (GPC) is one candidate method for discriminating polyester fibers. Here, the effects of machine washing on weight-average molecular weight (M w), polydispersity index (PDI), and the percentage peak area of cyclic ethylene terephthalate trimer (PPAL) of commercial polyester shirts and manufactured poly(ethylene terephthalate) (PET) yarns were investigated using GPC. GPC was performed using a 1,1,1,3,3,3-hexafluoro-propan-2-ol polymer solubilizer, styrene-divinylbenzene copolymer GPC columns, a chloroform mobile phase, and a 254 nm absorbance monitor. The statistical change in the polyester fibers during machine washing was evaluated by comparing three GPC parameters of the same fiber samples before and after machine washing. Among the commercial polyester shirts examined, the GPC parameters changed significantly after machine washing with a considerable PPAL decrease. In contrast, the GPC parameters of manufactured PET yarns changed significantly with a moderate increase in M w. This work elucidates the change on GPC parameters of polyester fibers by machine washing.
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Affiliation(s)
- Ritsuko Matsushita
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Toshio Nakanishi
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Shimpei Watanabe
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Takahiro Iwai
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Masahisa Takatsu
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Sadao Honda
- Japan
Synchrotron Radiation Research Institute, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5198, Japan
| | - Kenichi Funaki
- TOYOBO
Co., Ltd., 2-1-2 Katata, Otsu, Shiga 520-0292, Japan
| | - Tetsuya Ishikawa
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - Yasuo Seto
- RIKEN
SPring-8 Center, 1-1-1
Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
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11
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Mitsui K, Kataoka Y, Murai K, Kitahara S, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Takagi K, Yoneda S, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. Characterization of lipidic plaque materials at calcified atheroma: its association with calcification thickness evaluated by optical coherence tomography and near-infrared spectroscopy imaging. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1207] [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
Introduction
The degree of calcification and its thickness have been considered to affect stent expansion, leading to an increases risk of repeat revascularization in patients receiving PCI. Pathophysiologically, accumulation of lipidic materials within vessel wall could trigger the formation of plaque calcification. Elucidating characteristics of lipidic plaque components at calcified atheroma may enable to identify phenotypes with thick calcification which less likely responds to PCI.
Purpose
This study investigated the relationship of calcification thickness with lipidic plaque materials at calcified atheroma by using OCT and near-infrared spectroscopy (NIRS) imaging.
Methods
We analyzed 52 calcified lesions (culprit/non culprit lesions=44/8) in 47 CAD patients (stable CAD/ACS=36/11) from the REASSURE-NIRS registry (NCT04864171). OCT and NIRS imaging evaluated 4-mm segment exhibiting maximum superficial calcification arc. Calcification thickness on OCT imaging, its arc on IVUS imaging, and NIRS-derived lipid arc were analyzed at every 1-mm interval cross-sectional images. In addition, yellow-calcification ratio (YCR = lipid arc/calcification arc) was calculated (Figure 1).
Results
53% of study subjects exhibited chronic kidney disease and 70% of them received a statin (averaged on-treatment LDL-C =89mg/dL). Throughout OCT and NIRS/IVUS imaging analysis of 260 cross-sectional images, the averaged calcification arc, its maximum thickness, lipid arc and YCR were 210° (167–285°), 0.78mm (0.62–0.95mm), 95° (31–169°) and 0.33 (0.09–0.59), respectively. As expected, thicker calcification more likely exhibited a greater calcification arc (r=0.30, p<0.001). Furthermore, a greater thickness of calcification was associated with smaller lipidic plaque burden, reflected by yellow arc (r=−0.36, p<0.001) and YCR (r=−0.36, p<0.001) (Figure 2). After adjusting age, gender and ACS, calcification arc (p<0.001) and YCR (p<0.001) continued to predict thicker calcification.
Conclusion
Thickening of calcification was associated with severer calcification arc, which was accompanied by the shrinkage of lipidic plaques. Our findings suggest the evaluation of lipidic plaque component as a potential tool to identify calcified atheroma harbouring thick calcification, which may cause a greater risk of stent underexpansion.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Mitsui
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - Y Kataoka
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Murai
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Kitahara
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - H Matama
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Honda
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center , Suita , Japan
| | - K Tsujita
- Kumamoto University, Cardiovascular Medicine Graduate School of Medical Sciences , Kumamoto , Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center , Suita , Japan
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12
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Mukaida T, Kataoka Y, Murai Y, Iwai T, Sawada K, Matama H, Honda S, Takagi K, Fujino M, Yoneda S, Otsuka F, Tahara Y, Asaumi Y, Noguchi T. Deterioration of cardiogenic shock after acute myocardial infarction defined by the society for cardiovascular angiography and intervention cardiogenic shock classification scheme. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1444] [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
Cardiogenic shock (CS) in patients with AMI presents worse cardiovascular outcomes, which suggests the need for better risk stratification and management. The Society for Cardiovascular Angiography and Intervention (SCAI) has recently proposed CS classification scheme, which stratifies CS into 5 groups according to hypotension and hypoperfusion. While stage A and B exhibits CS without hypotension and/or hypoperfusion, their clinical condition could rapidly deteriorate into stage C-E. However, clinical characteristics and in-hospital outcomes of CS exhibiting its deterioration remains uncertain.
Purpose
To characterize AMI patients who deteriorated their CS status from stage A and B into stage C-E.
Methods
This single-center observational study included 326 consecutive AMI patients receiving primary PCI who presented CS stage A and B on arrival (2019.09.01–2021.09.30). Deterioration of CS (D-CS) was defined as the progression from stage A and B on arrival to stage C-E after primary PCI. Clinical characteristics and outcomes were compared in those with and without D-CS.
Results
D-CS was identified in 16.0% of entire subjects (=52/326). Of these, 94.2 and 5.8% of them exhibited stage C and E, respectively (Figure). Patients with D-CS more likely presented STEMI (84.6 vs. 67.9%, p=0.01) with a lower systolic BP (sBP) level (130±31 vs. 148±26mmHg, p<0.001) and a reduced LVEF (43±13 vs. 51±9%, p<0.001), whereas there was no significant difference in lactate level (1.5±0.4 vs. 1.2±0.3 mmol/L, p=0.22). Pre-TIMI flow grade 0–1 (69.2 vs. 47.8%, p=0.006), left main trunk stenosis (9.6 vs. 1.5%, p=0.007) and chronic total occlusion (21.2 vs. 8.4%, p=0.01) were more frequently observed in those with D-CS. Despite achieving a shorter onset-to-reperfusion time (199 vs. 276 minutes, p=0.002), D-CS was associated with in-hospital all-cause mortality after adjusting clinical characteristics (HR=33.6, 95% CI: 2.2–502.0, p=0.01). Furthermore, mechanical circulatory support (MCS) (30.8 vs. 0%, p<0.001) was more frequently required in patients with D-CS (IABP: 28.8 vs. 0%, p<0.001, ECMO: 11.5 vs. 0%, p<0.001, Impella: 3.8 vs. 0%, p=0.02). Further analysis identified sBP (HR=0.98, 95% CI: 0.97–1.00, p=0.008), LVEF (HR=0.94, 95% CI: 0.90–0.97, p<0.001) and pre-TIMI flow grade 0–1 (HR=0.41, 95% CI: 0.19–0.86, p=0.01) as independent contributors to D-CS. ROC analysis demonstrated sBP <135 mmHg (AUC=0.65) and LVEF <50% (AUC=0.69) as best cut-off values to predict D-CS. Of note, a risk of D-CS increased in association with the number of these three factors (p<0.001), and 44.0% of those with all of these factors presented D-CS (Figure).
Conclusion
16.0% of AMI without any hypotension/hypoperfusion on arrival exhibited deterioration of CS status on SCAI classification. The combination of sBP, LVEF and pre-TIMI flow grade could help to identify AMI subjects with a risk of D-CS, who may benefit from early adoption of intensified management including MCS prior to PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Mukaida
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Kataoka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Murai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - T Iwai
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - K Sawada
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - H Matama
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - S Honda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - K Takagi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - M Fujino
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - S Yoneda
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - F Otsuka
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Tahara
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - Y Asaumi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
| | - T Noguchi
- Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center , Osaka , Japan
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13
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Matsushita R, Watanabe S, Iwai T, Nakanishi T, Takatsu M, Honda S, Funaki K, Ishikawa T, Seto Y. Forensic Discrimination of Polyester Fibers Using Gel Permeation Chromatography. Forensic Chem 2022. [DOI: 10.1016/j.forc.2022.100428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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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14
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Iwai T, Minamiyama S, Mitsudo K. A solitary asymptomatic submandibular mass. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:309-310. [DOI: 10.1016/j.anorl.2021.11.009] [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] [Received: 09/28/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
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15
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Iwai T, Minamiyama S, Mitsudo K. A solitary, asymptomatic cystic lesion in the submandibular region. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:305-307. [PMID: 34955447 DOI: 10.1016/j.anorl.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/03/2022]
Affiliation(s)
- T Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan.
| | - S Minamiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan
| | - K Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, Yokohama, Japan
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16
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Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Takagi K, Fujino M, Yoneda S, Otsuka F, Tahara Y, Asaumi Y, Toyoda K, Noguchi T. Substantially elevated thromboembolic and bleeding risks in patients with AMI following acute/subacute stroke events. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2057] [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
Introduction
AMI infrequently but concomitantly occurs after stroke events. Current guideline recommends primary PCI with DAPT in the setting of AMI. However, this approach is not necessarily applicable in AMI subjects following acute/subacute stroke events due to its bleeding risk. Clinical management and outcomes of these AMI subjects following remains uncertain.
Purpose
To characterize management and clinical outcomes in patients with AMI following acute/subacute stroke events (=post-stroke AMI).
Methods
The current study retrospectively analyzed 2041 AMI patients hospitalized at our institute from 2007 to 2018. Post-stroke AMI was defined as its occurrence within 14 days after ischemic/hemorrhagic stroke. The use of reperfusion and anti-thrombotic therapies, and the occurrence of major adverse cardiovascular events (=CV death, non-fatal MI and non-fatal stroke) and major bleeding events (BARC type 3 or 5) were compared in post-stroke and non-post-stroke AMI patients.
Results
Post-stroke AMI was identified in 1.1% of entire subjects (=23/2041). Of these, 65% of them (=15/23) had AMI within 3 days from the onset of stoke event. Over 60% of them was due to cardioembolic stroke, followed by hemorrhagic (9%), atherothrombotic ones (8%) and other causes (22%). Post-stroke AMI patients were more likely to exhibit Af (p=0.02) and a history of hemodialysis (p=0.009), and have a lower BMI (p=0.04) and hemoglobin level (p=0.02). They were less likely to receive emergent coronary angiography, and primary PCI was conducted in only 65% of post-stroke AMI patients (Table). Furthermore, they more frequently received thrombectomy (p=0.04) alone rather than stent implantation (p=0.002) (Table). With regard to anti-thrombotic therapy, the proportion of DAPT use was significantly lower in post-stroke AMI subjects (52 vs. 89%, p=0.0001), and 17% of them did not receive any anti-thrombotic agents. Of note, only 48% (p=0.04) and 43% (p=0.0001) of post-stroke AMI patients were treated with other established medical therapies including β-blocker and statin, respectively. During the observational period (median = 2.9 years), post-stroke AMI was associated with a greater likelihood experiencing major adverse cardiovascular events (log-rank p<0.001, Figure), CV death (log-rank p<0.0001) and stroke events (log-rank p<0.0001). Furthermore, the frequency of their major bleeding events was substantially elevated (log-rank p<0.001, Figure).
Conclusions
In our real-world data, the adoption of guideline-recommended reperfusion and anti-thrombotic therapies were considerably low in AMI subjects following acute/subacute stroke events. Given their elevated risk of cardiovascular and bleeding events, it is required to establish better therapeutic management for mitigating their thrombotic/bleeding risks.
Funding Acknowledgement
Type of funding sources: None. Table 1Figure 1
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Affiliation(s)
- Y Kataoka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - H Matama
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Tahara
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
| | - K Toyoda
- National Cerebral & Cardiovascular Center, Department of Cerebrovascular Medicine and Neurology, Suita, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Department of Cardiovascular Medicine, Suita, Japan
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17
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Murai K, Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Yoneda S, Takagi K, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. The relationship of the underlying lipidic plaque at the implanted newer-generation drug-eluting stents with future stent-related events: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2088] [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
Lipid-rich plaque is an important substrate causing acute coronary events. Near-infrared spectroscopy (NIRS) imaging has been shown to visualize lipidic coronary plaque at non-culprit site associated with future coronary events. Given that histopathological studies reported that the unstable plaque underlying the implanted drug-eluting stent (DES) could cause neoatherosclerosis formation, we hypothesized that NIRS-based evaluation of lipidic plaque burden behind the implanted DES may clinically predict the occurrence of stent failure in patients with CAD receiving PCI.
Purpose
We aimed to investigate the relationship of stent-related events' risk with lipidic plaque materials behind the implanted DES imaged by NIRS/intravascular ultrasound (NIRS/IVUS) imaging.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving NIRS/IVUS-guided PCI. In this registry data, 406 lesions in 379 CAD subjects (ACS/non-ACS=150/229) receiving new-generation DES were analyzed. Minimum stent area (MSA) after PCI and maximum lipid-core-burden index in any 4mm-segment within the implanted stents (in-stent maxLCBI4mm) were measured. A 3-year lesion-oriented composite outcome [LOCO: culprit lesion-related MI + ischemia-driven target lesion revascularization (ID-TLR)] was compared in subjects stratified according to the tertile of in-stent maxLCBI4mm.
Results
The mean value of in-stent maxLCBI4mm was 221, and 17% of lesions exhibited in-stent maxLCBI4mm >400. Patients with a greater in-stent maxLCBI4mm were more likely to exhibit a higher LDL-C level (p=0.026) with a longer stent length (p<0.001) and a smaller MSA (p=0.033) (Picture 1). Over 95% of entire study subjects received a statin. During the observational period (median=726 days), the frequency of LOCO up to 3 years was 3.4% in entire study subjects (culprit lesion-related MI=1.0%, ID-TLR=2.8%). Kaplan-Meier curve analysis demonstrated that the occurrence of LOCO did not increase in association with in-stent maxLCBI4mm (log-rank p-value=0.25, Picture 2). In addition, in-stent maxLCBI4mm did not associate with each component of LOCO (culprit lesion-related MI: p=0.502, ID-TLR: p=0.872). Receiver Operating Characteristic analysis revealed that the predictive ability of in-stent maxLCBI4mm for the occurrence of LOCO was unsatisfactorily (c-statistics=0.486).
Conclusion
The amount of underlying lipidic materials at culprit lesions receiving new-generation DES implantation did not necessarily predict future stent-related events. Clinical significance of maxLCBI4mm behind the implanted DES may be different from that at naïve non-culprit plaques.
Funding Acknowledgement
Type of funding sources: None. Background and lesion characteristicsKaplan-Meier analysis for LOCO
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Affiliation(s)
- K Murai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Kataoka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - T Iwai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Sawada
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Matama
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Takagi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Tsujita
- Kumamoto University, Department of Cardiovascular Medicine, Kumamoto, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
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18
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Iwai T, Katoka Y, Murai K, Hosoda H, Honda S, Fujino M, Yoneda S, Otsuka F, Nishihira K, Kanaya T, Asaumi Y, Murata S, Miyamoto Y, Yasuda S, Noguchi T. Comparison of coronary atherosclerotic features in response to achieving LDL-C <55 mg/dl between non-diabetic and diabetic patients: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2563] [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
Introduction
Current ESC guideline recommends achieving LDL-C <1.4 mmol/l in very high-risk subjects. Despite fabvourable anti-atherosclerotic effects of lowering LDL-C, its efficacy is diminished in type 2 diabetic patients. Whether response of coronary atheroma to on-treatment LDL-C <1.4 mmol/l differs in diabetic and non-diabetic subjects has not been elucidated yet.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving PCI under the guidance of near-infrared spectroscopy/intravascular ultrasound (NIRS/IVUS: DualProTM, Nipro, Tokyo, Japan) imaging. Culprit lesions in 557 CAD patients who already received a statin were evaluated by NIRS/IVUS. Maximum 4-mm-lipid-core burden-index (maxLCBI4mm) and plaque calcification grade at culprit sites were measured. Calcification grade at each 1-mm cross-sectional image was defined as follows: calcium arc 0° = 0, 0–90° = 1, 90–180° = 2, 180–270° = 3, 270–360° = 4. MaxLCBI4mm and the averaged calcification grade were compared in diabetic and non-diabetic subjects stratified according to on-treatment LDL-C level, respectively.
Result
The proportion of diabetic (n=293, HbA1c; 6.9±0.9%) and non-diabetic patients (n=264) with on-treatment LDL-C <1.4 mmol/l was 8.54 and 16.67%, respectivey (p=0.01). In non-diabetic patients, achieving LDL-C <1.4mmol/L was associated with a lower maxLCBI4mm, whereas, in diabetic patients, maxLCBI4mm was numerically smaller under achieving LDL-C <1.4 mmol/l, but this comparison did not meet statistical significance (Figure 1). Furthermore, a greater degree of calcification grade in non-diabetic patients was observed in association with on-treatment LDL-C level (Figure 2). However, plaque calcification at diabetic coronary atheroma was not necessarily induced under achieving stricter LDL-C goal. Subgroup analysis demonstrated that diabetic patients with body mass index ≥25 (odds ratio = 0.15; 95% CI: 0.18–1.19, p=0.04), estimated glomerular filtration rate <60 (mL/min/1.73m2) (odds ratio = 0.31; 95% CI: 0.10–0.90, p=0.03) and non-insulin use (odds ratio = 0.36; 95% CI: 0.14–0.87, p=0.02) benefit from achieving LDL-C <1.4 mmol/l.
Conclusion
Achieving LDL-C <1.4 mmol/l was associated with more stabilized atheroma in non-diabetic patients with CAD, whereas these favourable effects were not observed in diabetic subjects. Our findings suggest the potential need to modify additional atherogenic risks for stabilizing diabetic coronary atheroma under achieving LDL-C <1.4 mmol/l.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- T Iwai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Katoka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Murai
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - H Hosoda
- Chikamori Hospital, Department of Cardiology, Kochi, Japan
| | - S Honda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - M Fujino
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yoneda
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - F Otsuka
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Asaumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Murata
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Suita, Japan
| | - S Yasuda
- Tohoku University, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Noguchi
- National Cerebral & Cardiovascular Center, Suita, Japan
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19
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Kitahara S, Kataoka Y, Iwai T, Sawada K, Matama H, Honda S, Fujino M, Yoneda S, Takagi K, Nishihira K, Kanaya T, Otsuka F, Asaumi Y, Tsujita K, Noguchi T. Characterization of residual lipid-rich plaques despite achieving LDL-C <1.8mmol/l with a statin in patients with coronary artery disease: insights from the REASSURE-NIRS registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1192] [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
Introduction
Recent studies have demonstrated favourable modification of lipidic plaque materials under achieving LDL-C <1.8mmol/l with a statin, which potentially accounts for its clinical benefit. However, coronary events still occur even under optimal LDL-C management. This may suggest the presence of residual lipid-rich coronary plaque despite on-treatment LDL-C <1.8mmol/l. Given that near-infrared spectroscopy (NIRS) enables quantitative evaluation of lipidic plaque in vivo, we employed this imaging modality to investigate characteristics and drivers of residual lipid-rich plaques in statin-treated patients with coronary artery disease (CAD) who achieved LDL-C <1.8mmol/l.
Purpose
To clarify the frequency, clinical demographics and factors associated with residual lipid-rich plaques under LDL-C <1.8mmol/l.
Methods
The REASSURE-NIRS registry is an on-going multi-center registry to enroll CAD subjects receiving NIRS/intravascular ultrasound-guided PCI. The current analysis included 133 statin-treated stable CAD patients with on-treatment LDL-C <1.8mmol/l from August 2015 to December 2020. The maximum 4-mm lipid core burden index (maxLCBI4mm) at culprit lesions was measured by NIRS imaging prior to PCI. Clinical characteristics were compared in patients with and without maxLCBI4mm ≥400 at culprit lesions.
Results
In the current study, 45% (=58/128) of study subjects exhibited maxLCBI4mm ≥400 at culprit lesions under on-treatment LDL-C <1.8 mmol/l. They were more likely to be female, whereas there were no differences in age and the frequency of risk factors. Most of study subjects received moderate to high-intensity statin (p=0.79), and over one-fourth of them were treated with ezetimibe (p=0.56). Under these lipid-lowering therapies, LDL-C level was significantly higher in patients with maxLCBI4mm ≥400 (Table). Additionally, a lower frequency of LDL-C <1.4mmol/l was observed in those exhibiting maxLCBI4mm ≥400 (31.0 vs. 45.7%), but this comparison failed to meet statistical significance (p=0.09). Despite LDL-C control with a statin, deterioration of coronary flow after PCI with stent implantation more frequently occurred in patients with maxLCBI4mm ≥400 (Table). Multivariate analysis demonstrated that an independent factor associated with maxLCBI4mm ≥400 was LDL-C level (OR=1.05; 95% CI=1.00–1.10, p=0.03), but not other lipid and clinical parameters.
Conclusion
Almost half of CAD subjects who achieved LDL-C level <1.8mmol/l still exhibited the accumulation of lipidic plaque materials within vessel wall. Given that LDL-C level was associated with this residual lipid-rich plaque features, our findings support current ESC-guideline recommended LDL-C goal (<1.4mmol/l) to optimize the secondary prevention in stable CAD patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Kitahara
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Iwai
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Sawada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Matama
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Takagi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Nishihira
- Miyazaki Medical Association Hospital, Department of Cardiology, Miyazaki, Japan
| | - T Kanaya
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Tsujita
- Kumamoto University, Department of Cardiovascular Medicine Graduate School of Medical Sciences, Kumamoto, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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20
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Shinohara S, Takebayashi S, Hamaguchi K, Michida T, Tobe Y, Ikenaga T, Yasumoto M, Hamamoto A, Imagumbai T, Mitsuyoshi T, Ashida R, Iwai T, Okabayashi S. Concurrent Chemoradiotherapy With Weekly Low-Dose Cisplatin for Japanese Patients With Head and Neck Squamous Cell Carcinoma. Clin Med Insights Oncol 2021; 15:11795549211048417. [PMID: 34629923 PMCID: PMC8493312 DOI: 10.1177/11795549211048417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
Background: Concurrent chemoradiotherapy (CCRT) with tri-weekly high-dose cisplatin (HDC) is considered the standard regimen. However, due to significant toxicity, various weekly low-dose schedules have been increasingly used. We investigated the tolerability and survival of patients with head and neck squamous cell carcinoma (HNSCC) who underwent CCRT with low-dose weekly cisplatin (LDC) for Japanese population. Methods: A retrospective review was conducted among patients with HNSCC who were treated with CCRT/LDC in our institute. Ninety-five patients who met the criteria were enrolled in this study. We evaluated the cycle and cumulative cisplatin dose, completion rate of radiotherapy, adverse events, and survival outcome. Results: The mean cycles and cumulative cisplatin dose were 4.7 cycles and 187 mg/m2. All patients completed planned dose of radiation without prolonged breaks. Leucopoenia was the most frequent dose-limiting factor and 44% patients developed grade 3 or 4 toxicity. The 2-year overall survival and recurrence-free survival were 93% and 74%, respectively. The significant differences of survival outcomes between the patients with total cisplatin dose (⩾200 mg and <200 mg) or among age distribution (35-55, 56-75, and ⩾76) were not observed. Conclusions: Concurrent chemoradiotherapy/LDC can be safely administered with acceptable toxicity and survival outcome even if the patients with higher age, lower eGFR, and so on.
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Affiliation(s)
- Shogo Shinohara
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuhiko Michida
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yota Tobe
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tadashi Ikenaga
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mami Yasumoto
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ayami Hamamoto
- Department of Otolaryngology-Head and Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshiyuki Imagumbai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takamasa Mitsuyoshi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Ashida
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takahiro Iwai
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shun Okabayashi
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
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21
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Iwai T, Okabayashi S, Ashida R, Mitsuyoshi T, Imagumbai T, Kokubo M. PO-1427 Clinical outcomes of scalp angiosarcoma treated with intensity-modulated radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07878-6] [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: 11/27/2022]
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22
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Okabayashi S, Kawane L, Mrabawani NY, Iwai T, Narukawa T, Tsuboi M, Chiba K. Speciation analysis of Gadolinium-based contrast agents using aqueous eluent-hydrophilic interaction liquid chromatography hyphenated with inductively coupled plasma-mass spectrometry. Talanta 2021; 222:121531. [PMID: 33167239 DOI: 10.1016/j.talanta.2020.121531] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022]
Abstract
Gadolinium chelates are widely used as contrast agents for magnetic resonance imaging (MRI). In recent decades, the amount of Gd in river water has been increasing owing to the input of Gd-based contrast agents. To identify and quantify the Gd-based contrast agents in river water, the novel technique of hydrophilic interaction liquid chromatography (HILIC) hyphenated with inductively coupled plasma-mass spectrometry (ICP-MS) was developed. To avoid deposition of carbon on the ICP-MS interface, a mobile phase consisting of an ammonium acetate buffer diluted with pure water was applied to separate Gd-based contrast agents. Despite the absence of an organic solvent in the mobile phase, six Gd-based contrast agents, Gd-DTPA, Gd-EOB-DTPA, Gd-DOTA, Gd-DTPA-BMA, Gd-BT-DO3A, and Gd-HP-DO3A, were successfully separated. This technique was applied for river water samples. As a result, Gd-DOTA, Gd-BT-DO3A, and Gd-HP-DO3A were observed from the sample near the outfall of a wastewater treatment plant (WWTP), indicating that at least some of the Gd-based contrast agents are passed through treatment in a WWTP. In addition to Gd-based contrast agents, unidentified Gd compounds were found to be present in river water. These results infer that transformation and/or dissociation of Gd chelates may be caused during the treatment procedure in a WWTP.
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Affiliation(s)
- Satoki Okabayashi
- Department of Applied Chemistry for Environment, Kwansei Gakuin University, 2-1 Gakuen, Sanda, Hyogo, 669-1337, Japan.
| | - Leona Kawane
- Department of Applied Chemistry for Environment, Kwansei Gakuin University, 2-1 Gakuen, Sanda, Hyogo, 669-1337, Japan
| | - Nanda Yusentri Mrabawani
- Transforming the Mining Value Chain (TMVC), An Australia Research Council (ARC) Industrial Transformation Research Hub, University of Tasmania, Hobart, Tasmania, 7001, Australia
| | - Takahiro Iwai
- Forensic Science Group, Photon Science Research Division, RIKEN Spring-8 Center, Kouto 1-1-1, Sayo-cho, Sayo-gun, Hyogo, 679-5148, Japan
| | - Tomohiro Narukawa
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, 1-1-1 Umezono, Tsukuba, Ibaraki, 305-8563, Japan
| | - Motohiro Tsuboi
- Department of Applied Chemistry for Environment, Kwansei Gakuin University, 2-1 Gakuen, Sanda, Hyogo, 669-1337, Japan
| | - Koichi Chiba
- Department of Applied Chemistry for Environment, Kwansei Gakuin University, 2-1 Gakuen, Sanda, Hyogo, 669-1337, Japan
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23
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Iwai T, Yoshimura M, Ashida R, Goto Y, Kishi T, Itasaka S, Shibuya K, Kanai M, Masui T, Fukuda A, Isoda H, Hiraoka M, Mizowaki T. Hypofractionated intensity-modulated radiotherapy with concurrent chemotherapy for elderly patients with locally advanced pancreatic carcinoma. Radiat Oncol 2020; 15:264. [PMID: 33187523 PMCID: PMC7666451 DOI: 10.1186/s13014-020-01712-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 11/06/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND It is important to understand how elderly patients with locally advanced pancreatic carcinoma (LAPC) should be treated, since the number of elderly cancer patients will increase. However, the optimal treatment for elderly patients with LAPC remains unclear. The purpose of this study was to evaluate the efficacy and safety of hypofractionated intensity-modulated radiotherapy (IMRT) with concurrent gemcitabine for elderly patients with LAPC. METHODS We retrospectively analysed the data from LAPC patients aged ≥ 75 years treated with hypofractionated IMRT (48 Gy in 15 fractions) with concurrent weekly gemcitabine at our institution from February 2013 to December 2018. Overall survival (OS), progression-free survival (PFS), locoregional progression-free survival (LRPFS), distant metastasis-free survival (DMFS), and the pattern of recurrence and toxicity were analysed. RESULTS Fifteen patients received treatment during the study period. The median age was 78 years (range 75-86 years), and the Eastern Cooperative Oncology Group (ECOG) performance status (PS) of all patients was 0-1. The median survival time (MST) and median PFS were 20.4 [95% confidence interval (CI) 10.3-36.8] and 13.5 (95% CI 6.4-20.3) months, respectively, and the 1-year OS and PFS rates were 80.0% (95% CI 50-93.1%) and 66.7% (95% CI 37.5-84.6%), respectively. The median LRPFS and median DMFS were 15.6 (95% CI 6.4-36.8) and 14.9 (95% CI 7.0-20.5) months, respectively, and the 1-year LRPFS and DMFS rates were 73.3% (95% CI 43.6-89.1%) and 66.7% (95% CI 37.5-84.6%), respectively. Non-haematologic grade 3 toxicity was observed in three cases, of which only one was induced by radiotherapy, whereas grade 4-5 non-haematologic acute or late toxicities were not observed. CONCLUSIONS The OS and PFS of elderly patients with LAPC treated using hypofractionated IMRT with concurrent gemcitabine were favourable and without the occurrence of severe toxicity. This treatment strategy is feasible and promising for elderly LAPC patients with good PS.
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Affiliation(s)
- Takahiro Iwai
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Ryo Ashida
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoko Goto
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takahiro Kishi
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Satoshi Itasaka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Radiation Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Keiko Shibuya
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Radiation Oncology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masashi Kanai
- Department of Clinical Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toshihiko Masui
- Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihisa Fukuda
- Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of Radiation Oncology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
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24
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Iwai T, Ogura K, Yamashita M, Ogata T, Hattori T, Mitsuyoshi T, Imagumbai T, Kokubo M. PO-1036: Analysis of serum pancreatic exocrine enzyme after radiotherapy for pancreatic carcinoma. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01053-7] [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: 10/22/2022]
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Abstract
The formation of reactive metabolites (RMs) is a problem in drug development that sometimes results in severe hepatotoxicity. As detecting RMs themselves is difficult, a covalent binding assay using expensive radiolabelled tracers is usually performed for candidate selection. This study aimed to provide a practical approach toward the risk assessment of hepatotoxicity induced by covalent binding before candidate selection. We focused on flutamide because it contains a trifluoromethyl group that shows a strong singlet peak by 19F nuclear magnetic resonance (NMR) spectrometry. The covalent binding of flutamide was evaluated using quantitative NMR and its risk for hepatotoxicity was assessed by estimating the RM burden, an index that reflects the body burden associated with RM exposure by determining the extent of covalent binding, clinical dose and in vivo clearance. The extent of covalent binding and RM burden was 296 pmol/mg/h and 37.9 mg/day, respectively. Flutamide was categorised as high risk with an RM burden >10 mg/day consistent with its clinical hepatotoxicity. These results indicate that a combination of covalent binding assay using 19F-NMR and RM burden is useful for the risk assessment of RMs without using radiolabelled compounds.
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Affiliation(s)
- Nobuyuki Kakutani
- Drug Metabolism and Pharmacokinetics Research Laboratories, Japan Tobacco Inc, Takatsuki, Japan
| | - Takahiro Iwai
- Product Development Laboratories, Japan Tobacco Inc, Takatsuki, Japan
| | - Yasushi Ohno
- Product Development Laboratories, Japan Tobacco Inc, Takatsuki, Japan
| | - Satoru Kobayashi
- Drug Metabolism and Pharmacokinetics Research Laboratories, Japan Tobacco Inc, Takatsuki, Japan
| | - Yukihiro Nomura
- Drug Metabolism and Pharmacokinetics Research Laboratories, Japan Tobacco Inc, Takatsuki, Japan
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26
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Narukawa T, Iwai T, Chiba K. Simultaneous speciation analysis of inorganic arsenic and methylmercury in edible oil by high-performance liquid chromatography–inductively coupled plasma mass spectrometry. Talanta 2020; 210:120646. [DOI: 10.1016/j.talanta.2019.120646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
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27
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Hiraoka S, Sakanaka K, Iwai T, Fujii K, Inoo H, Mizowaki T. Therapy-Related Acute Myeloid Leukemia 2 Months after Chemoradiotherapy for Esophageal Cancer: A Case Report. Case Rep Oncol 2020; 13:299-303. [PMID: 32308595 PMCID: PMC7154239 DOI: 10.1159/000506449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/07/2020] [Indexed: 11/19/2022] Open
Abstract
Therapy-related acute myeloid leukemia (AML) is a rare but potentially fatal adverse event caused by chemotherapy or radiotherapy. Herein we report a patient diagnosed with therapy-related AML 2 months after chemoradiotherapy for esophageal cancer. A 61-year-old man with dysphagia was diagnosed with locally advanced esophageal cancer with para-aortic lymph node metastasis. Laboratory blood test did not reveal any abnormality except mild macrocytic anemia. To alleviate dysphagia due to malignant esophageal stenosis, the patient underwent concurrent chemoradiotherapy of 60 Gy in 30 fractions with cisplatin and 5-fluorouracil at a local area in thoracic esophagus. Dysphagia alleviated during chemoradiotherapy; however, pancytopenia did not recover after the completion of chemoradiotherapy, and general fatigue with fever developed 13 weeks after the last day of chemoradiotherapy. To rule out hematological malignancy, bone marrow biopsy was performed. The bone marrow smear and flow cytometry analysis indicated the development of AML. Chromosomal test revealed a complex karyotype, suggesting that AML was associated with myelodysplastic syndrome. The patient died 1 month after the diagnosis of therapy-related AML. Thus, the findings indicate that therapy-related AML may develop during the acute phase of chemoradiotherapy and bone marrow biopsy is necessary when prolonged pancytopenia exists after chemoradiotherapy.
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Affiliation(s)
| | - Katsuyuki Sakanaka
- *Katsuyuki Sakanaka, Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 (Japan),
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Morizane C, Okusaka T, Mizusawa J, Katayama H, Ueno M, Ikeda M, Ozaka M, Okano N, Sugimori K, Fukutomi A, Hara H, Mizuno N, Yanagimoto H, Wada K, Tobimatsu K, Yane K, Nakamori S, Yamaguchi H, Asagi A, Yukisawa S, Kojima Y, Kawabe K, Kawamoto Y, Sugimoto R, Iwai T, Nakamura K, Miyakawa H, Yamashita T, Hosokawa A, Ioka T, Kato N, Shioji K, Shimizu K, Nakagohri T, Kamata K, Ishii H, Furuse J. Combination gemcitabine plus S-1 versus gemcitabine plus cisplatin for advanced/recurrent biliary tract cancer: the FUGA-BT (JCOG1113) randomized phase III clinical trial. Ann Oncol 2019; 30:1950-1958. [PMID: 31566666 DOI: 10.1093/annonc/mdz402] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gemcitabine plus cisplatin (GC) is the standard treatment of advanced biliary tract cancer (BTC); however, it causes nausea, vomiting, and anorexia, and requires hydration. Gemcitabine plus S-1 (GS) reportedly has equal to, or better, efficacy and an acceptable toxicity profile. We aimed to confirm the non-inferiority of GS to GC for patients with advanced/recurrent BTC in terms of overall survival (OS). PATIENTS AND METHODS We undertook a phase III randomized trial in 33 institutions in Japan. Eligibility criteria included chemotherapy-naïve patients with recurrent or unresectable BTC, an Eastern Cooperative Oncology Group Performance Status of 0 - 1, and adequate organ function. The calculated sample size was 350 with a one-sided α of 5%, a power of 80%, and non-inferiority margin hazard ratio (HR) of 1.155. The primary end point was OS, while the secondary end points included progression-free survival (PFS), response rate (RR), adverse events (AEs), and clinically significant AEs defined as grade ≥2 fatigue, anorexia, nausea, vomiting, oral mucositis, or diarrhea. RESULTS Between May 2013 and March 2016, 354 patients were enrolled. GS was found to be non-inferior to GC [median OS: 13.4 months with GC and 15.1 months with GS, HR, 0.945; 90% confidence interval (CI), 0.78-1.15; P = 0.046 for non-inferiority]. The median PFS was 5.8 months with GC and 6.8 months with GS (HR 0.86; 95% CI 0.70-1.07). The RR was 32.4% with GC and 29.8% with GS. Both treatments were generally well-tolerated. Clinically significant AEs were observed in 35.1% of patients in the GC arm and 29.9% in the GS arm. CONCLUSIONS GS, which does not require hydration, should be considered a new, convenient standard of care option for patients with advanced/recurrent BTC. CLINICAL TRIAL NUMBER This trial has been registered with the UMIN Clinical Trials Registry (http://www.umin.ac.jp/ctr/index.htm), number UMIN000010667.
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Affiliation(s)
- C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, Tokyo.
| | - T Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, Tokyo
| | - J Mizusawa
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - H Katayama
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo
| | - M Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama
| | - M Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa
| | - M Ozaka
- Hepato-Biliary-Pancreatic Medicine Department, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - N Okano
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo
| | - K Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama
| | - A Fukutomi
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - H Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - N Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University Hospital, Hirakata
| | - K Wada
- Department of Surgery, Teikyo University School of Medicine, Tokyo
| | - K Tobimatsu
- Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine, Kobe
| | - K Yane
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo
| | - S Nakamori
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka
| | - H Yamaguchi
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke
| | - A Asagi
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama
| | - S Yukisawa
- Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya
| | - Y Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo
| | - K Kawabe
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Y Kawamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo
| | - R Sugimoto
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - T Iwai
- Department of Gastroenterology, Kitasato University Hospital, Sagamihara
| | - K Nakamura
- Division of Gastroenterology, Chiba Cancer Center, Chiba
| | - H Miyakawa
- Department of Bilio-Pancreatology, Sapporo Kousei General Hospital, Sapporo
| | - T Yamashita
- Department of Gastroenterology, Kanazawa University, Kanazawa
| | - A Hosokawa
- Department of Gastroenterology and Hematology, University of Toyama, Faculty of Medicine, Toyama
| | - T Ioka
- Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka
| | - N Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba
| | - K Shioji
- Department of Internal medicine, Niigata Cancer Center Hospital, Niigata
| | - K Shimizu
- Department of Gastroenterology, Tokyo Women's Medical University, Tokyo
| | - T Nakagohri
- Gastroenterological Surgery, Tokai University School of Medicine, Isehara
| | - K Kamata
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka
| | - H Ishii
- Clinical Research Center, Chiba Cancer Center, Chiba, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo
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Wakai E, Kitazawa S, Takaya S, Okubo N, Nagae Y, Iwai T, Omata T, Abe H, Aoto K. Effects of helium production, displacement damage on mechanical properties and surface acoustic wave in austenitic stainless steels and martensitic steel. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Miyata E, Okuwaki K, Imaizumi H, Kida M, Iwai T, Yamauchi H, Kaneko T, Hasegawa R, Adachi K, Tadehara M, Koizumi W. A phase I study of IRISOX (irinotecan/S-1/oxaliplatin) in the second-line treatment for gemcitabine-refractory pancreatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.104] [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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31
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Okuwaki K, Imaizumi H, Masutani H, Yoshida T, Kida M, Iwai T, Yamauchi H, Kaneko T, Hasegawa R, Miyata E, Adachi K, Tadehara M, Koizumi W. Analysis of BRCAness with MLPA in pancreatic ductal adenocarcinoma patients using FFPE sample obtained via EUS-FNAB. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.096] [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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32
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Narukawa T, Iwai T, Chiba K, Feldmann J. A Method for Methylmercury and Inorganic Mercury in Biological Samples Using High Performance Liquid Chromatography-Inductively Coupled Plasma Mass Spectrometry. ANAL SCI 2018; 34:1329-1334. [PMID: 30122737 DOI: 10.2116/analsci.18p255] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A new determination method was developed for the measurement of methylmercury (Me-Hg) and inorganic mercury (i-Hg) in biological samples using high-performance liquid chromatography-inductively coupled plasma-mass spectrometry (HPLC-ICP-MS) following alkaline extraction. Mercury species in biological samples were extracted with 10% (w/w) tetramethylammonium hydroxide (TMAH) solution at 80°C for 2 h. Methylmercury was completely separated from i-Hg by adamantyl type and octadecylsilyl type columns within 6 and 4 min using isocratic elution, respectively. The detection limits (3σ) of adamantyl and octadecylsilyl columns using the proposed system were 0.08 and 0.13 ng g-1 (as Hg), respectively. Inorganic Hg completely separates from Me-Hg without tailing. The proposed determination methods were applied to several biological certified reference materials (CRMs). The measurement results of Me-Hg obtained by the present method were in good agreement within the expanded uncertainties (k = 2) with the certified values. The analytical precision (n = 3) of Me-Hg was less than 2%, and the recoveries of Me-Hg and i-Hg were 101 ± 1 and 103 ± 3%, respectively. In addition, this method enables the determination of Me-Hg and i-Hg for 20 samples in 1 h.
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Affiliation(s)
- Tomohiro Narukawa
- National Metrology Institute of Japan (NMIJ), National Institute of Advanced Industrial Science and Technology (AIST)
| | - Takahiro Iwai
- Department of Environmental and Applied Chemistry, School of Science and Technology, Kwansei Gakuin University
| | - Koichi Chiba
- Department of Environmental and Applied Chemistry, School of Science and Technology, Kwansei Gakuin University
| | - Joerg Feldmann
- Environmental Analytical Chemistry TESLA-Trace Element Speciation Laboratory, University of Aberdeen
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33
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Hara K, Yamada T, Koizumi M, Shinji S, Yokoyama Y, Takahashi G, Hotta M, Iwai T, Takeda K, Yoshida H. Adjuvant chemotherapy for colorectal cancer using oxaliplatin induced irreversible sinusoidal obstruction syndrome. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.234] [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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Yamada T, Takahashi G, Iwai T, Takeda K, Furuki H, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Hotta M, Hara K, Yoshida H. Emergence of KRAS mutation may play a major role in the secondary resistance to EGFR blockade. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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35
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Hikita H, Sato M, Endo M, Sato M, Soroida Y, Kobayashi T, Gotoh H, Iwai T, Nakagomi R, Tateishi R, Komuro T, Sone S, Koike K, Yatomi Y, Ikeda H. Disappearance of perihepatic lymph node enlargement after hepatitis C viral eradication with direct-acting antivirals. J Viral Hepat 2018; 25:329-334. [PMID: 29091333 DOI: 10.1111/jvh.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/19/2017] [Indexed: 12/09/2022]
Abstract
Perihepatic lymph node enlargement (PLNE) which has been shown to be negatively associated with hepatocellular carcinoma (HCC) occurrence is frequently observed in chronic liver disease; however, changes in the state of perihepatic lymph nodes after eradication of hepatitis C virus (HCV) have not been investigated yet. We aimed to evaluate this issue. We enrolled 472 patients with chronic HCV infection who achieved viral eradication with direct-acting antivirals (DAA). We investigated whether the status of perihepatic lymph nodes changed before and after HCV eradication (primary endpoint). We also evaluated the association between PLNE and clinical findings such as liver fibrosis or hepatocellular injury before HCV eradication (secondary endpoint). Perihepatic lymph node enlargement was detected in 164 of 472 (34.7%) patients before DAA treatment. Surprisingly, disappearance of PLNE was observed in 23.8% (39 patients) of all PLNE-positive patients after eradication of HCV. Disappearance of PLNE was not associated with baseline clinical parameters or changing rates of clinical findings before and after DAA treatment. At baseline, presence of PLNE was significantly associated with a lower serum HCV-RNA level (P = .03), a higher serum AST level (P = .004) and a higher ALT level (P < .001) after adjustment for sex and age. In conclusion, PLNEs became undetectable after DAA treatment in 23.8% of PLNE-positive patients. Further study with a longer follow-up period is needed to clarify the clinical importance of this phenomenon especially in relationship with the risk of HCC development.
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Affiliation(s)
- H Hikita
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - Masaya Sato
- Department of Clinical Laboratory Medicine, Tokyo, Japan.,Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Momoe Endo
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - Mamiko Sato
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - Y Soroida
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - T Kobayashi
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - H Gotoh
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - T Iwai
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - R Nakagomi
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - R Tateishi
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Komuro
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - S Sone
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - K Koike
- Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Yatomi
- Department of Clinical Laboratory Medicine, Tokyo, Japan
| | - H Ikeda
- Department of Clinical Laboratory Medicine, Tokyo, Japan
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36
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Iwai T, Uchida J, Matsuoka Y, Kosoku A, Shimada H, Nishide S, Kabei K, Kuwabara N, Yamamoto A, Naganuma T, Hamuro M, Kumada N, Takemoto Y, Nakatani T. Experience of Lymphangiography as a Therapeutic Tool for Lymphatic Leakage After Kidney Transplantation. Transplant Proc 2018; 50:2526-2530. [PMID: 30316391 DOI: 10.1016/j.transproceed.2018.03.095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/02/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Lymphatic leakage after kidney transplantation is a relatively frequent complication but sometimes resistant to treatment, and there is no fixed treatment algorithm. The effectiveness of therapeutic lymphangiography for postoperative lymphatic or chyle leakage has been reported, but few reports are available regarding patients who have undergone kidney transplantation. In this study, we report our experience with lymphangiography as a therapeutic tool for lymphatic leakage after kidney transplantation. PATIENTS AND METHODS Intranodal lymphangiography for lymphatic leakage was performed in 4 patients (3 male, 1 female; age range, 38 to 70 years old) after living kidney transplantation at the Osaka City University Hospital in Japan. The amount of drainage before lymphangiography was 169 to 361 mL/day. The procedure for intranodal lymphangiography was as follows: the inguinal lymph node was punctured under ultrasound guidance, and the tip of the needle was instilled at the junction between the cortex and the hilum, after which Lipiodol was slowly and manually injected. RESULTS Lymphangiography was technically successful in 3 out of the 4 patients. In all successful cases, the amount of drainage decreased and leakage finally stopped without additional therapy such as sclerotherapy or fenestration. In 2 cases, we were able to directly detect the leakage site using lymphangiography. The time between lymphangiography and leakage resolution ranged from 8 to 13 days. There were neither complications of lymphangiography nor recurrence of lymphatic leakage in the successful cases. CONCLUSIONS Intranodal lymphangiography may be not only a diagnostic tool but also an effective, minimally-invasive, and safe method for treatment of lymphatic leakage resistant to drainage after kidney transplantation.
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Affiliation(s)
- T Iwai
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - J Uchida
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Matsuoka
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Kosoku
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Shimada
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Nishide
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Kabei
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - N Kuwabara
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Yamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Naganuma
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Hamuro
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - N Kumada
- Department of Urology, Suita Municipal Hospital, Suita, Japan
| | - Y Takemoto
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Nakatani
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
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37
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Wada N, Kersten RD, Iwai T, Lee S, Sakurai F, Kikuchi T, Fujita D, Fujita M, Weng JK. Crystalline-Sponge-Based Structural Analysis of Crude Natural Product Extracts. Angew Chem Int Ed Engl 2018; 57:3671-3675. [DOI: 10.1002/anie.201713219] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Naoki Wada
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Roland D. Kersten
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
| | - Takahiro Iwai
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Shoukou Lee
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Fumie Sakurai
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Takashi Kikuchi
- Rigaku Corporation; 3-9-12 Matsubara-cho, Akishima-shi Tokyo 196-8628 Japan
| | - Daishi Fujita
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
| | - Makoto Fujita
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Jing-Ke Weng
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
- Department of Biology; Massachusetts Institute of Technology; Cambridge MA USA
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38
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Wada N, Kersten RD, Iwai T, Lee S, Sakurai F, Kikuchi T, Fujita D, Fujita M, Weng JK. Crystalline-Sponge-Based Structural Analysis of Crude Natural Product Extracts. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201713219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Naoki Wada
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Roland D. Kersten
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
| | - Takahiro Iwai
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Shoukou Lee
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Fumie Sakurai
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Takashi Kikuchi
- Rigaku Corporation; 3-9-12 Matsubara-cho, Akishima-shi Tokyo 196-8628 Japan
| | - Daishi Fujita
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
| | - Makoto Fujita
- Department of Applied Chemistry; Graduate School of Engineering; The University of Tokyo, and JST- ACCEL; 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8656 Japan
| | - Jing-Ke Weng
- Whitehead Institute for Biomedical Research; 455 Main Street Cambridge MA USA
- Department of Biology; Massachusetts Institute of Technology; Cambridge MA USA
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39
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Aida M, Iwai T, Okamoto Y, Kohno S, Kakegawa K, Miyahara H, Seto Y, Okino A. Development of a Dual Plasma Desorption/Ionization System for the Noncontact and Highly Sensitive Analysis of Surface Adhesive Compounds. ACTA ACUST UNITED AC 2017; 6:S0075. [PMID: 29234573 PMCID: PMC5720943 DOI: 10.5702/massspectrometry.s0075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/11/2017] [Indexed: 11/23/2022]
Abstract
We developed a dual plasma desorption/ionization system using two plasmas for the semi-invasive analysis of compounds on heat-sensitive substrates such as skin. The first plasma was used for the desorption of the surface compounds, whereas the second was used for the ionization of the desorbed compounds. Using the two plasmas, each process can be optimized individually. A successful analysis of phenyl salicylate and 2-isopropylpyridine was achieved using the developed system. Furthermore, we showed that it was possible to detect the mass signals derived from a sample even at a distance 50 times greater than the distance from the position at which the samples were detached. In addition, to increase the intensity of the mass signal, 0%–0.02% (v/v) of hydrogen gas was added to the base gas generated in the ionizing plasma. We found that by optimizing the gas flow rate through the addition of a small amount of hydrogen gas, it was possible to obtain the intensity of the mass signal that was 45–824 times greater than that obtained without the addition of hydrogen gas.
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Affiliation(s)
- Mari Aida
- Laboratory for Future Interdisciplinary Research of Science and Technology, Tokyo Institute of Technology
| | - Takahiro Iwai
- Department of Applied Chemistry for Environment, Kwansei Gakuin University
| | - Yuki Okamoto
- FIRST, Institute of Innovative Research, Tokyo Institute of Technology
| | - Satoshi Kohno
- FIRST, Institute of Innovative Research, Tokyo Institute of Technology
| | - Ken Kakegawa
- Laboratory for Future Interdisciplinary Research of Science and Technology, Tokyo Institute of Technology
| | - Hidekazu Miyahara
- Laboratory for Future Interdisciplinary Research of Science and Technology, Tokyo Institute of Technology
| | - Yasuo Seto
- National Research Institute of Police Science
| | - Akitoshi Okino
- Laboratory for Future Interdisciplinary Research of Science and Technology, Tokyo Institute of Technology
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40
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Kersten RD, Lee S, Fujita D, Pluskal T, Kram S, Smith JE, Iwai T, Noel JP, Fujita M, Weng JK. A Red Algal Bourbonane Sesquiterpene Synthase Defined by Microgram-Scale NMR-Coupled Crystalline Sponge X-ray Diffraction Analysis. J Am Chem Soc 2017; 139:16838-16844. [PMID: 29083151 DOI: 10.1021/jacs.7b09452] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Sesquiterpene scaffolds are the core backbones of many medicinally and industrially important natural products. A plethora of sesquiterpene synthases, widely present in bacteria, fungi, and plants, catalyze the formation of these intricate structures often with multiple stereocenters starting from linear farnesyl diphosphate substrates. Recent advances in next-generation sequencing and metabolomics technologies have greatly facilitated gene discovery for sesquiterpene synthases. However, a major bottleneck limits biochemical characterization of recombinant sesquiterpene synthases: the absolute structural elucidation of the derived sesquiterpene products. Here, we report the identification and biochemical characterization of LphTPS-A, a sesquiterpene synthase from the red macroalga Laurencia pacifica. Using the combination of transcriptomics, sesquiterpene synthase expression in yeast, and microgram-scale nuclear magnetic resonance-coupled crystalline sponge X-ray diffraction analysis, we resolved the absolute stereochemistry of prespatane, the major sesquiterpene product of LphTPS-A, and thereby functionally define LphTPS-A as the first bourbonane-producing sesquiterpene synthase and the first biochemically characterized sesquiterpene synthase from red algae. Our study showcases a workflow integrating multiomics approaches, synthetic biology, and the crystalline sponge method, which is generally applicable for uncovering new terpene chemistry and biochemistry from source-limited living organisms.
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Affiliation(s)
- Roland D Kersten
- Whitehead Institute for Biomedical Research , 455 Main Street, Cambridge, Massachusetts 02142, United States
| | - Shoukou Lee
- Graduate School of Engineering, The University of Tokyo, JST-ACCEL , Tokyo 113-8654, Japan
| | - Daishi Fujita
- Whitehead Institute for Biomedical Research , 455 Main Street, Cambridge, Massachusetts 02142, United States.,Graduate School of Engineering, The University of Tokyo, JST-ACCEL , Tokyo 113-8654, Japan
| | - Tomáš Pluskal
- Whitehead Institute for Biomedical Research , 455 Main Street, Cambridge, Massachusetts 02142, United States
| | - Susan Kram
- Scripps Institution of Oceanography, University of California, San Diego , La Jolla, California 92093, United States
| | - Jennifer E Smith
- Scripps Institution of Oceanography, University of California, San Diego , La Jolla, California 92093, United States
| | - Takahiro Iwai
- Graduate School of Engineering, The University of Tokyo, JST-ACCEL , Tokyo 113-8654, Japan
| | - Joseph P Noel
- Howard Hughes Medical Institute, Jack H. Skirball Center for Chemical Biology and Proteomics, The Salk Institute for Biological Studies , La Jolla, California 92037, United States
| | - Makoto Fujita
- Graduate School of Engineering, The University of Tokyo, JST-ACCEL , Tokyo 113-8654, Japan
| | - Jing-Ke Weng
- Whitehead Institute for Biomedical Research , 455 Main Street, Cambridge, Massachusetts 02142, United States.,Department of Biology, Massachusetts Institute of Technology , Cambridge, Massachusetts 02139, United States
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Ichimura M, Yamaguchi Y, Ikezoe R, Imai Y, Murakami T, Iwai T, Yokoyama T, Sato T, Ugajin Y, Imai T. Radial Transport of High-Energy Ions Caused by Low-Frequency Fluctuations in the GAMMA 10 Tandem Mirror. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a11583] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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)
- M. Ichimura
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Yamaguchi
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - R. Ikezoe
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Imai
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Murakami
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Iwai
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Yokoyama
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Sato
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - Y. Ugajin
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
| | - T. Imai
- Affiliation Information: Plasma Research Center, University of Tsukuba, 305-8577 Tsukuba, Japan
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Yamaguchi Y, Ichimura M, Yokoyama T, Fukuyama A, Ikezoe R, Imai Y, Murakami T, Iwai T, Sato T, Ugajin Y, Imai T. Ion-Cyclotron Resonance Heating Experiment in the Quadruple Minimum-B Field on GAMMA 10. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a11625] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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)
- Y. Yamaguchi
- Research Center for Development of Far-Infrared Region, University of Fukui, Fukui 910-8507, Japan
| | - M. Ichimura
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Yokoyama
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - A. Fukuyama
- Department of Nuclear Engineering, Kyoto University, Kyoto 606-8501, Japan
| | - R. Ikezoe
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Imai
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Murakami
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Iwai
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Sato
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Ugajin
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Imai
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
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Yajima Y, Oshima M, Iwai T, Kitajima H, Omura S, Tohnai I. Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 2017; 46:839-844. [PMID: 28412180 DOI: 10.1016/j.ijom.2017.03.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 08/11/2016] [Revised: 01/21/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to investigate the relationship between the pressure drop in the pharyngeal airway space (ΔPPAS) and the minimum cross-sectional area (minCSA) of the pharyngeal airway before and after mandibular setback surgery using computational fluid dynamics, in order to prevent iatrogenic obstructive sleep apnoea. Eleven patients with mandibular prognathism underwent bilateral sagittal split osteotomy for mandibular setback. Three-dimensional models of the upper airway were reconstructed from preoperative and postoperative computed tomography images, and simulations were performed using computational fluid dynamics. ΔPPAS and the minCSA of the pharyngeal airway were calculated, and the relationship between them was evaluated by non-linear regression analysis. In all cases, the minCSA was found at the level of the velopharynx. After surgery, ΔPPAS increased significantly and the minCSA decreased significantly. The non-linear regression equation expressing the relationship between these variables was ΔPPAS=3.73×minCSA-2.06. When the minCSA was <1cm2, ΔPPAS increased greatly. The results of this study suggest that surgeons should consider bimaxillary orthognathic surgery rather than mandibular setback surgery to prevent the development of iatrogenic obstructive sleep apnoea when correcting a skeletal class III malocclusion.
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Affiliation(s)
- Y Yajima
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - M Oshima
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - T Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
| | - H Kitajima
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - S Omura
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - I Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Aoki N, Endoh H, Baba J, Kosugi Y, Iida M, Iwai T, Tohnai I. Methotrexate-associated lymphoproliferative disorder considered as neck metastatic cancer: a case report. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.811] [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: 10/19/2022]
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45
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Iwai T, Yajima Y, Honda K, Murata S, Omura S, Tohnai I. Computational fluid dynamic simulation of pharyngeal airway before and after mandibular setback surgery. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1092] [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: 10/19/2022]
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46
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Iwai T, Kitajima H, Ohhara Y, Yajima Y, Mitsudo K, Tohnai I. Computational fluid dynamic simulation of intraarterial chemotherapy for tongue cancer. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.969] [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: 10/19/2022]
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47
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Uchida J, Iwai T, Kuwabara N, Kabei K, Nishide S, Yamasaki T, Naganuma T, Kumada N, Takemoto Y, Nakatanti T. Clinical Experience of Late Conversion From Antimetabolites With Standard Exposure Calcineurin Inhibitors to Everolimus With Calcineurin Inhibitor Minimization in Stable Kidney Transplant Recipients With Good Renal Function. Transplant Proc 2017; 48:775-80. [PMID: 27234734 DOI: 10.1016/j.transproceed.2016.02.038] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/30/2016] [Accepted: 02/18/2016] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study describes our clinical experience of late conversion from antimetabolites with standard exposure calcineurin inhibitors (CNIs) to everolimus with CNI minimization in stable kidney transplant recipients with good graft function. PATIENTS AND METHODS A 1-year retrospective pilot study of 26 kidney recipients converted from antimetabolites with standard exposure CNIs to everolimus with CNI minimization was performed. The recipients enrolled in this study had normal or slightly impaired renal function defined as a serum creatinine value <2.0 mg/dL, and normal or slightly increased albuminuria defined as a urinary albumin excretion rate <100 mg/g creatinine. RESULTS The median time from transplant to conversion was 39.5 months posttransplant (range, 3-275). Treatment with everolimus was stopped owing to adverse events in 11 patients (42.3%). In the analysis of the patients in whom everolimus was maintained, the mean estimated glomerular filtration rate (eGFR) significantly increased from 50.7 ± 11.9 mL/min/1.73 m(2) at baseline to 53.6 ± 13.9 mL/min/1.73 m(2) at 1 year after conversion. In the patients in whom everolimus was stopped during the observation period, there was no difference in eGFR between baseline and 1 year after conversion. CONCLUSIONS This study demonstrated that, among the patients converted to everolimus at a late stage, there was no deterioration in renal function whether everolimus was maintained or stopped within 1 year after conversion.
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Affiliation(s)
- J Uchida
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - T Iwai
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - N Kuwabara
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Kabei
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Nishide
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Yamasaki
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Naganuma
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - N Kumada
- Department of Urology, Suita Municipal Hospital, Suita, Japan
| | - Y Takemoto
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Nakatanti
- Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Iwai T, Harada Y, Maehara Y, Yonemitsu Y. Overcoming anti-VEGF therapy resistance through use of PMN-MDSC-derived PyNPase. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32653-3] [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: 10/20/2022]
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Iwai T, Yamada T, Takahashi G, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Hara K, Takeda K, Nakayama M, Kitano S, Ohta K, Uchida E. Circulating cell-free DNA can predict relapse after resection of metastatic liver tumors from colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.13] [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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50
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Yamada T, Takahashi G, Iwai T, Takeda K, Koizumi M, Shinji S, Yokoyama Y, Hara K, Hotta M, Matsuda A, Matsumoto S, Ohta K, Uchida E. Tracking emerging KRAS and BRAF mutations through ccfDNA in colorectal cancers treated with EGFR blockade. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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