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Yamamoto K, Ito H, Fukutake S, Odo T, Kamei T, Yamaguchi T, Taira T. Movement during focused ultrasound therapy caused by an unstable magnetic resonance table: case report. J Neurosurg 2021; 134:1724-1727. [DOI: 10.3171/2020.4.jns20219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/17/2020] [Indexed: 11/06/2022]
Abstract
Transcranial MR-guided focused ultrasound (MRgFUS) therapy is a less invasive form of stereotactic treatment for tremors and other movement disorders. Its stereotactic accuracy is ensured by stability of the stereotactic frame and MR table. The authors report a case wherein the patient’s movement was detected, and the MR images were repeated to continue the treatment.
A 72-year-old man with essential tremor underwent unilateral ventralis intermedius thalamotomy using MRgFUS. The stereotactic frame was correctly fixed to the patient’s skull and the table. During the seventh sonication, the patient pressed the emergency button and vomited several times. Before the eighth sonication, the patient’s movement was detected and was verified on coronal images. The MR images were repeated, and the treatment was successfully completed with significant improvement in the tremors. After treatment, it was discovered that the MR table was laterally unstable due to the absence of ball bearings, which should be present on both sides of the guide rail of the MR table. The ball bearings were attached to the reverse side of the table, and the table was stabilized. Stereotactic accuracy of MRgFUS is not only ensured by rigid fixation of the stereotactic frame, but also by stability of the MR table.
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Affiliation(s)
- Kazuaki Yamamoto
- Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
- Department of Neurosurgery, Shonan Kamakura General Hospital, Kamakura
| | - Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Takashi Odo
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Toshio Yamaguchi
- Research Institute of Diagnostic Imaging, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
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Ito H, Fukutake S, Odake S, Okeda R, Tokunaga O, Kamei T. The Authors' Reply to "The m.3243A>G Genotype Can Be Associated with Rhabdomyolysis". Intern Med 2021; 60:661. [PMID: 32963174 PMCID: PMC7946506 DOI: 10.2169/internalmedicine.6021-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Sanae Odake
- Department of Internal Medicine, Sodegaura Satsuki-dai Hospital, Japan
| | - Riki Okeda
- Department of Pathology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Osamu Tokunaga
- Department of Pathology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
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3
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Kamei T, Kobayashi H, Nishida M, Muramoto K, Nishimoto S. Effect of Psychoeducational Intervention on Donepezil Retention Rate and Analysis of Reasons for the Discontinuation in Patients with Alzheimer's Dementia: A Randomized Study. Patient Prefer Adherence 2021; 15:2103-2111. [PMID: 34566409 PMCID: PMC8457860 DOI: 10.2147/ppa.s330372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Medication discontinuation for patients with Alzheimer's dementia (AD) influences treatment efficacy. This study aimed to evaluate the effect of psychoeducational intervention (PI) on donepezil retention rates and identify the factors associated with donepezil continuation in patients with AD. PATIENTS AND METHODS One hundred and seventeen patients with AD were randomly allocated to the PI (n = 58) or standard care (SC; n = 59) groups. All patients were prescribed donepezil for 48 weeks. Primary endpoints were the 48-week donepezil retention rate and the reasons for donepezil discontinuation in the PI and SC groups. The secondary endpoint was the predictive factors, among the baseline clinical variables, for donepezil continuation in all patients. RESULTS The donepezil retention rate was 62.1% (36/58) in the PI group and 66.1% (39/59) in the SC group. The most common reason for discontinuation in both groups was adverse events (PI, 12.1%; SC, 10.2%). Logistic regression analysis revealed that the results of the pentagon copying test in the Mini-Mental State Examination administered at baseline was a significant predictor of donepezil continuation for all patients in both the groups (odds ratio: 0.359; 95% confidence interval: 0.154-0.839). CONCLUSION There was no significant difference between the PI and SC groups concerning donepezil retention rate in patients with AD. Our results demonstrate that the pentagon copying test can significantly predict donepezil continuation in patients with AD, indicating that impaired visuospatial and executive functions may reflect medication discontinuation. TRIAL REGISTRATION UMIN-CTR:UMIN000012617.
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Affiliation(s)
| | - Hiroyuki Kobayashi
- Eisai Co., Ltd., Medical Headquarters, Tokyo, Japan
- Department of Neuropsychiatry, School of Medicine, Toho University, Tokyo, Japan
| | | | | | - Shohei Nishimoto
- Eisai Co., Ltd., Medical Headquarters, Tokyo, Japan
- Correspondence: Shohei Nishimoto Eisai Co., Ltd., 4-6-10 Koishikawa, Bunkyo-ku, Tokyo, 112-8088, JapanTel +81-3-3817-3700Fax +81-3-5229-0705 Email
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Yamamoto K, Ito H, Fukutake S, Odo T, Kamei T, Yamaguchi T, Taira T. Factors Associated with Heating Efficiency in Transcranial Focused Ultrasound Therapy. Neurol Med Chir (Tokyo) 2020; 60:594-599. [PMID: 33162467 PMCID: PMC7803702 DOI: 10.2176/nmc.oa.2020-0225] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Transcranial magnetic resonance-guided focused ultrasound (FUS) therapy is a less invasive stereotactic treatment for tremor and other movement disorders. A sufficiently high temperature in the target brain tissue is crucial during ablation procedures for good outcomes. Therefore, maximizing the heating efficiency is critical in cases where high temperature cannot be achieved because of patient-related characteristics. However, a strategy to achieve the desired therapeutic temperature with FUS has not yet been established. This study aimed to investigate the procedural factors associated with heating efficiency in FUS. We retrospectively reviewed and analyzed data from patients who underwent FUS for ventralis intermedius (VIM) nucleus thalamotomy. In all, 30 consecutive patients were enrolled. 18 with essential tremor (ET), 11 with tremor-dominant Parkinson’s disease (TDPD), and 1 with Holmes tremor. Multivariate regression analysis showed that decline in heating efficiency was associated with lower skull density ratio (SDR) and a greater subtotal rise in temperature until the previous sonication. To maximize heating efficiency, the temperature increase should be set to the least value in the target alignment and verification phases, and subsequently should be increased sufficiently in the treatment phase. This strategy may be particularly beneficial in cases where high ablation temperatures cannot be achieved because of patient-related characteristics. Importantly, a broad patient population would benefit from this strategy as it could reduce the need for high energy to achieve therapeutic temperatures, thereby decreasing the risks of adverse events.
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Affiliation(s)
- Kazuaki Yamamoto
- Department of Neurosurgery, Tokyo Women's Medical University.,Department of Neurosurgery, Shonan Kamakura General Hospital
| | - Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital
| | | | - Takashi Odo
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital
| | - Toshio Yamaguchi
- Research Institute of Diagnostic Imaging, Shin-Yurigaoka General Hospital
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University
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Abstract
We herein present a patient with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), who developed serious acute renal failure with lactic acidosis, followed by rhabdomyolysis. Despite receiving intensive care, he suffered multiple cardiopulmonary arrests and died 10 days after presentation due to a sudden deterioration of his symptoms. Renal pathology revealed diffuse tubular necrosis with interstitial edema and tubular dilatation on light microscopy, and a severe degeneration of intracellular organelles on electron microscopy. These pathological findings could have resulted from multiple cardiopulmonary arrests; however, we must be aware of the extremely rare but sudden occurrence of these fatal conditions in MELAS patients.
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Affiliation(s)
- Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Sanae Odake
- Department of Internal Medicine, Sodegaura Satsuki-dai Hospital, Japan
| | - Riki Okeda
- Department of Pathology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Osamu Tokunaga
- Department of Pathology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
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Ito H, Yamamoto K, Fukutake S, Odo T, Kamei T. Two-year Follow-up Results of Magnetic Resonance Imaging-guided Focused Ultrasound Unilateral Thalamotomy for Medication-refractory Essential Tremor. Intern Med 2020; 59:2481-2483. [PMID: 32641664 PMCID: PMC7662049 DOI: 10.2169/internalmedicine.4360-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the long-term efficacy and safety of magnetic resonance imaging-guided focused ultrasound (MRgFUS) unilateral ventral intermediate nucleus (Vim) thalamotomy for medication-refractory essential tremor (ET). Methods We performed MRgFUS left-sided Vim thalamotomy for 10 medication-refractory ET patients (8 men and 2 women, aged 67.1±17.5 years, all right-handed). We followed them for 2 years using the clinical rating scale for tremor (CRST) and the quality of life in essential tremor questionnaire (QUEST). Results Right-handed tremor improved immediately after the left Vim thalamotomy in all patients. The tremor became re-exacerbated in 2 patients by 6 months after treatment; however, an approximately 60% decrease in the average CRST score of the right hand persisted until 2 years. On the other hand, the average CRST score of the left hand and the average QUEST score showed no improvement. Headache was the most common adverse event during the sonication (8 patients), followed by a floating sensation (4 patients). On the other hand, sensory disturbances (4 patients) and gait instability (4 patients) were observed after the treatment, but most of them were mild and transient. There were no delayed adverse events. Conclusion MRgFUS unilateral Vim thalamotomy could be adopted as one of the therapeutic options for intractable ET. Further improvement of tremor in the targeted hand or contralateral Vim thalamotomy may be necessary to improve the quality of life.
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Affiliation(s)
- Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Kazuaki Yamamoto
- Department of Neurosurgery, Tokyo Women's Medical University, Japan
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Takashi Odo
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
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7
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Yamamura A, Matsuo J, Lim Yi Hui M, Liana Heng D, Kofu K, Md Z, Douchi D, Yeoh K, Kamei T, Naitoh T, Osato M, Unno M, Ito Y. Chief cell in stomach have stem cell activity and potential to develop gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.055] [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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8
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Watanabe K, Kohyama A, Suzuki H, Kajiwara T, Karasawa H, Ohnuma S, Musha H, Kamei T, Naitoh T, Unno M. Clinical features of anorectal cancer in patients with Crohn’s disease: Japanese single center study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.024] [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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9
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Miura T, Aoki T, Ohtsuka H, Aoki S, Hata T, Iseki M, Takadate T, Ariake K, Kawaguchi K, Masuda K, Ishida M, Mizuma M, Hayashi H, Nakagawa K, Morikawa T, Motoi F, Sasano H, Naitoh T, Kamei T, Unno M. Preoperative neutrophil‐to‐lymphocyte ratio (NLR) predicts recurrence after surgery in patient with pancreatic neuroendocrine neoplasm (PanNEN). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.049] [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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10
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Mushiroda T, Takahashi Y, Onuma T, Yamamoto Y, Kamei T, Hoshida T, Takeuchi K, Otsuka K, Okazaki M, Watanabe M, Kanemoto K, Oshima T, Watanabe A, Minami S, Saito K, Tanii H, Shimo Y, Hara M, Saitoh S, Kinoshita T, Kato M, Yamada N, Akamatsu N, Fukuchi T, Ishida S, Yasumoto S, Takahashi A, Ozeki T, Furuta T, Saito Y, Izumida N, Kano Y, Shiohara T, Kubo M. Association of HLA-A*31:01 Screening With the Incidence of Carbamazepine-Induced Cutaneous Adverse Reactions in a Japanese Population. JAMA Neurol 2019; 75:842-849. [PMID: 29610831 DOI: 10.1001/jamaneurol.2018.0278] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Importance Carbamazepine, a commonly used antiepileptic drug, is one of the most common causes of cutaneous adverse drug reactions (cADRs) worldwide. The allele HLA-A*31:01 is reportedly associated with carbamazepine-induced cADRs in Japanese and European populations; however, the clinical utility of HLA-A*31:01 has not been evaluated. Objective To assess the use of HLA-A*31:01 genetic screening to identify Japanese individuals at risk of carbamazepine-induced cADRs. Design, Setting, and Participants This cohort study was conducted across 36 hospitals in Japan from January 2012 to November 2014 among 1202 patients who had been deemed suitable to start treatment with carbamazepine. Preemptive HLA-A*31:01 genetic screening was performed for 1187 participants. Patients who did not start treatment with carbamazepine or alternative drugs were excluded. Participants were interviewed once weekly for 8 weeks to monitor the development of cADRs. Data analysis was performed from June 8, 2015, to December 27, 2016. Exposures Neuropsychiatrists were asked to prescribe carbamazepine for patients who tested negative for HLA-A*31:01 and alternative drugs for those who tested positive for HLA-A*31:01. Main Outcomes and Measures Incidence of carbamazepine-induced cADRs. Results Of the 1130 included patients who were prescribed carbamazepine or alternative drugs, the mean (range) age was 37.4 (0-95) years, 614 (54.3%) were men, and 198 (17.5%) were positive for HLA-A*31:01. Expert dermatologists identified 23 patients (2.0%) who had carbamazepine-induced cADRs, of which 4 patients required hospitalization. Drug-induced hypersensitivity syndrome was observed for 3 patients, maculopapular eruption for 9 patients, erythema multiforme for 5 patients, and an undetermined type of cADR for 6 patients. No patient developed Stevens-Johnson syndrome or toxic epidermal necrolysis. Compared with historical controls, the incidence of carbamazepine-induced cADRs was significantly decreased (for BioBank Japan data: incidence, 3.4%; odds ratio, 0.60; 95% CI, 0.36-1.00; P = .048; for the Japan Medical Data Centre claims database: incidence, 5.1%; odds ratio, 0.39; 95% CI, 0.26-0.59; P < .001). Conclusions and Relevance Preemptive HLA-A*31:01 genetic screening significantly decreased the incidence of carbamazepine-induced cADRs among Japanese patients, which suggests that it may be warranted in routine clinical practice.
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Affiliation(s)
| | - Yukitoshi Takahashi
- Department of Clinical Research, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | | | - Yoshiaki Yamamoto
- Department of Clinical Research, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka, Japan
| | | | - Tohru Hoshida
- National Hospital Organization Nara Medical Center, Nara, Japan
| | - Katsuya Takeuchi
- Department of Neuropsychiatry, Iwate Medical University, Iwate, Japan.,Kitariasu Hospital, Iwate, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, Iwate Medical University, Iwate, Japan
| | - Mitsutoshi Okazaki
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masako Watanabe
- Department of Psychiatry, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kosuke Kanemoto
- Neuropsychiatric Department, Aichi Medical University, Aichi, Japan
| | - Tomohiro Oshima
- Neuropsychiatric Department, Aichi Medical University, Aichi, Japan
| | - Atsushi Watanabe
- Division of Personalized Genetic Medicine, Nippon Medical School, Tokyo, Japan
| | - Shiro Minami
- Institute for Advanced Medical Sciences, Nippon Medical School, Kawasaki, Japan
| | - Kayoko Saito
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisashi Tanii
- Department of Psychiatry, Mie University Graduate School of Medicine, Mie, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Naoki Akamatsu
- Department of Neurology, University of Occupational and Environmental Health, Kitakyusyu, Japan
| | | | - Shigenobu Ishida
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - Shingo Yasumoto
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Takeshi Ozeki
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Takahisa Furuta
- Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences, Tokyo, Japan
| | - Nobuyuki Izumida
- Department of Empirical Social Security Research, National Institute of Population and Social Security Research, Tokyo, Japan
| | - Yoko Kano
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Tetsuo Shiohara
- Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
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Kamei T, Kobayashi H, Nishimoto S. P2-033: ASSOCIATION BETWEEN LATER DISCONTINUATION OF DONEPEZIL AND PENTAGON COPYING TASK IN AD PATIENTS: A RANDOMIZED CONTROLLED TRIAL IN JAPAN. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.1255] [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: 11/29/2022]
Affiliation(s)
- Tetsumasa Kamei
- Shonan Fujisawa Tokushukai Hospital; Fujisawa Kanagawa Japan
| | - Hiroyuki Kobayashi
- Eisai Co., Ltd.; Tokyo Japan
- Toho University; School of Medicine; Tokyo Japan
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12
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Yamamoto K, Ito H, Fukutake S, Kamei T, Yamaguchi T, Taira T. Ventralis intermedius thalamotomy with focused ultrasound for patients with low skull density ratio. Mov Disord 2019; 34:1239-1240. [PMID: 31136679 DOI: 10.1002/mds.27726] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/04/2019] [Accepted: 05/02/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kazuaki Yamamoto
- Department of Neurosurgery, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan
| | - Toshio Yamaguchi
- Research Institute of Diagnostic Imaging, Shin-Yurigaoka General Hospital, Kawasaki, Japan
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
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13
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Konno-Kumagai T, Fujishima F, Nakamura Y, Nakano T, Nagai T, Kamei T, Sasano H. Programmed death-1 ligands and tumor infiltrating T lymphocytes in primary and lymph node metastasis of esophageal cancer patients. Dis Esophagus 2019; 32:5066745. [PMID: 30085020 DOI: 10.1093/dote/doy063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Neoadjuvant chemotherapy (NAC) is administered to many patients with esophageal squamous cell carcinoma (ESCC) prior to surgery, but it is also true that some of these patients demonstrated no response to the therapy following surgery. In addition, the prognosis of advanced case such as ESCC patients with lymph node metastasis has remained relatively low. Programmed death ligand-1 (PD-L1) in conjunction with tumor-infiltrating lymphocytes (TILs) has been studied as a potential mechanism of "immune escape" in several human malignancies. Therefore, in this study, we studied PD-L1 status in carcinoma cells and forkhead box protein 3 (FOXP3) and CD8 status among TILs in the residual tumors of primary and metastatic sites following NAC. We also studied the association of these factors with the clinicopathological findings in 44 patients with ESCC harboring lymph node metastasis. There was discordance in the pathological response to chemotherapy between the primary tumor and lymph node metastasis, and histologically identified resistance to NAC in lymph node metastases tended to be correlated with an adverse clinical outcome (P = 0.0765) than resistance in the primary tumor. Both univariate and multivariate analyses for disease-specific survival (DSS) revealed that the PD-L1 status of carcinoma cells in metastatic lymph nodes and a higher FOXP3/CD8 ratio in the primary tumor were both significantly correlated with an eventual adverse clinical outcome of the patients (P = 0.0178, P = 0.0463, respectively). These results all indicated that the PD-L1 status of carcinoma cells in metastatic lymph nodes and the FOXP3/CD8 ratio in primary tumors could predict eventual clinical outcomes in ESCC patients with NAC.
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Affiliation(s)
- T Konno-Kumagai
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine.,Department of Pathology, Tohoku University Hospital
| | - F Fujishima
- Department of Pathology, Tohoku University Hospital
| | - Y Nakamura
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - T Nakano
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - T Nagai
- School of Medicine, Tohoku University, Miyagi, Japan
| | - T Kamei
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - H Sasano
- Department of Pathology, Tohoku University Hospital
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14
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Onodera Y, Nakano T, Fukutomi T, Naitoh T, Unno M, Shibata C, Kamei T. Thoracoscopic Esophagectomy for a Patient With Perforated Esophageal Epiphrenic Diverticulum After Kidney Transplantation: A Case Report. Transplant Proc 2018; 50:3964-3967. [PMID: 30577297 DOI: 10.1016/j.transproceed.2018.08.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022]
Abstract
A 58-year-old man who underwent cadaveric kidney transplantation twice presented to hospital with a perforated epiphrenic diverticulum. Computed tomography revealed epiphrenic diverticulitis and right pleural effusion. Upper gastrointestinal fibroscopy showed an epiphrenic diverticulum full of food residue. He was transferred to our hospital, where we performed percutaneous endoscopic gastrostomy under general anesthesia in the supine position before thoracoscopy. Thoracoscopic esophagectomy was performed in the semi-prone position under 6-10 mmHg artificial pneumothorax via the right thoracic cavity. We performed subtotal esophagectomy to remove sources of infection because the esophageal wall surrounding the diverticulum was too thick to close or to perform diverticulectomy. A cervical esophagostomy was constructed after the thoracic procedure. The patient was managed with continuous hemodiafiltration and administered immunosuppressants and steroids to preserve the transplanted kidney. Continuous hemodiafiltration was stopped on postoperative day (POD) 4. The patient was discharged from the intensive care unit on POD 10 and transferred to the original hospital on POD 24 for rehabilitation. The second operative stage was performed on POD 157 at our hospital. We performed gastric tube reconstruction via the ante-sternal route and anastomosed the tube to the cervical esophagus. The postoperative course was uneventful; the patient was transferred to the original hospital on POD 15 after the second operation. Minimally invasive surgery was sufficient to treat perforated epiphrenic diverticulum while preserving the transplanted kidney. We recommend completely removing the source of infection and reducing surgical invasiveness to preserve the transplanted kidney in cases of esophageal perforation following kidney transplantation.
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Affiliation(s)
- Y Onodera
- Department of Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi, Japan
| | - T Nakano
- Division of Gastroenterological and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai Miyagi, Japan.
| | - T Fukutomi
- Department of Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi, Japan
| | - T Naitoh
- Department of Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi, Japan
| | - M Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi, Japan
| | - C Shibata
- Division of Gastroenterological and Hepatobiliarypancreatic Surgery, Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai Miyagi, Japan
| | - T Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai Miyagi, Japan
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15
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Miyagi S, Nakanishi C, Hara Y, Nakanishi W, Tokodai K, Shimizu K, Uematsu S, Kumata H, Kakizaki Y, Goto M, Kamei T, Unno M, Satomi S. Correlation Between Splenectomy and Portal Vein Complications in Living Donor Liver Transplantation. Transplant Proc 2018; 50:2611-2613. [PMID: 30401361 DOI: 10.1016/j.transproceed.2018.03.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 03/06/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES In adults undergoing living donor liver transplantation (LDLT), the transplanted livers are partial grafts, and the portal venous pressure is higher than that observed with whole liver grafts. In patients undergoing LDLT concomitant with splenomegaly, portal venous flow is often diverted to collateral vessels, leading to a high risk of portal vein thrombosis. In such cases, occlusion of the collateral veins is important; however, complete occlusion of all collaterals without blocking the blood flow through the splenic artery causes portal hypertension and liver failure. We aimed to examine the effect of performing a splenectomy concomitant with LDLT to reduce portal vein complications. METHODS Between 1991 and 2017, we performed 170 LDLT operations, including 83 in adults. For this cohort study, adult cases were divided into 2 groups. Group I was those who underwent LDLT without splenectomy (n = 60); Group II was those who underwent LDLT with splenectomy for the reduction of portal hypertension (n = 23). We investigated the incident rates of complications, including blood loss, lethal portal vein thrombosis (intrahepatic thrombosis), acute rejection, and so on. We also investigated the survival rates in both groups. RESULTS The incident rate of lethal portal vein thrombosis in Group II was significantly lower than that observed in Group I (4.4% vs 21.7%, respectively, P = .0363). There were no statistically significant differences observed between the groups with respect to blood loss, survival rates, and other such parameters. CONCLUSION LDLT concomitant with splenectomy might effectively reduce the occurrence of portal vein complications in adults.
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Affiliation(s)
- S Miyagi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - C Nakanishi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Hara
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - W Nakanishi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Tokodai
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Shimizu
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Uematsu
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - H Kumata
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kakizaki
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Goto
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Satomi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
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16
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Miyazawa K, Miyagi S, Nakanishi C, Hara Y, Tokodai K, Nakanishi W, Uematsu S, Shimizu K, Goto M, Kamei T, Unno M. Effect of Middle Hepatic Vein Tributaries Preserving Technique Until Just Before Graft Retrieval on Donors' Surgical Outcomes in Living Donor Liver Transplantation. Transplant Proc 2018; 50:2636-2639. [PMID: 30401365 DOI: 10.1016/j.transproceed.2018.03.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/02/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND The technique of preserving the major tributaries of the middle hepatic vein (MHV) (V5 and V8) until just before graft retrieval is beneficial to minimize congestion time of the graft. However, it remains unclear whether this technique exerts a burden on donors in terms of operative time, blood loss, and postoperative hepatic dysfunction. In this study we investigated adverse effects of the MHV tributaries preserving technique until immediately before graft retrieval on donors' surgical outcomes. METHODS Data from 71 donors who underwent right hepatectomy without MHV for a liver transplantation at our hospital from January 2002 to August 2016 were retrospectively reviewed. Donors were divided into 3 groups as follows: group 1 (n = 12), no MHV tributary reconstruction; group 2 (n = 33), single MHV tributary reconstruction; group 3 (n = 26), 2 or 3 MHV tributaries reconstruction. Donor operation time, blood loss, proportion of the remnant liver, maximum postoperative total bilirubin, aspartate aminotransferase, alanine transaminase, minimum platelets, prothrombin time, albumin level, number of days in hospital from surgery to discharge, and surgical complications were compared. RESULTS Compared with groups 2 and 3, group 1 exhibited shorter average operational time and less average blood loss, but the difference was not significant. Comparisons of all other factors indicated no significant differences. CONCLUSION The technique of preserving the major tributaries of the MHV until just immediately before graft retrieval does not appear to impose an apparent burden on donors.
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Affiliation(s)
- K Miyazawa
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - S Miyagi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - C Nakanishi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Y Hara
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - K Tokodai
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - W Nakanishi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - S Uematsu
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - K Shimizu
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - M Goto
- Transplantation and Regenerative Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - T Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - M Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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17
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Karasawa H, Ohnuma S, Suzuki H, Kohyama A, Watanabe K, Kamei T, Naitoh T, Unno M. The role of perioperative radiotherapy for patients with local recurrence of rectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Aizawa T, Karasawa H, Suzuki H, Yamamura A, Ohnuma S, Kamei T, Naitoh T, Unno M. Molecular characterization of cancer associated fibroblasts in colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.045] [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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19
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Sato H, Yamamura A, Matsuo J, Hossain Z, Osato M, Naitoh T, Kamei T, Unno M, Ito Y. Runx1 enhancer element marks stem/progenitor cells in pancreas and can be an origin of cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.046] [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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20
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Fujishima F, Taniyama Y, Nakamura Y, Okamoto H, Ozawa Y, Ito K, Ishida H, Konno-Kumagai T, Kasajima A, Taniuchi S, Watanabe M, Kamei T, Sasano H. Residual carcinoma cells after chemoradiotherapy for esophageal squamous cell carcinoma patients: striving toward appropriate judgment of biopsy. Dis Esophagus 2018; 31:4807355. [PMID: 29346536 DOI: 10.1093/dote/dox141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Indexed: 12/11/2022]
Abstract
In esophageal squamous cell carcinoma (ESCC) patients who are treated with chemoradiotherapy (CRT), identification of the presence or absence of residual or recurrent carcinoma is usually pivotal in their clinical management. In addition, the extent of carcinoma invasion into the esophageal wall could determine the clinical outcome of these patients following CRT. Therefore, in this study, we evaluated the response to CRT both macroscopically and histologically in a consecutive series of 42 ESCC patients receiving neoadjuvant chemoradiotherapy following curative esophageal resection at Tohoku University Hospital between August 2011 and December 2012. The histological grading of tumor regression was as follows: grade 3, markedly effective (no viable residual tumor cells); grade 2, moderately effective (residual tumor cells in less than one-third of the tumor); grade 1, slightly effective (1b, residual tumor cells in one-third to two-thirds of the tumor; 1a, residual tumor cells in more than two-thirds of the tumor); and grade 0, ineffective. In this study, we selected grade 2 and 1b cases because they might show a complete response with definitive CRT. We evaluated the presence of any residual in situ lesions and tumor depth in detail. The grading of tumor regression in primary sites was as follows: grade 3 (7 cases), grade 2 (16 cases), grade 1b (13 cases), and grade 1a (6 cases). The concordance rate between macroscopic and histopathological evaluation on the depth of the tumor was 40% (17/42). Among 29 cases (grade 2 and grade 1b), intraepithelial lesions were not detected in 17 cases, and tumor nests were not detected in the lamina propria mucosae in 9 cases. The results of this study highlight the difficulties of detecting residual carcinoma cells using conventional endoscopic biopsy in patients who have received CRT. Therefore, when residual cancer is clinically suspected in patients who have received CRT, the biopsy specimen should be obtained from the deep layer of the esophagus whenever possible. Additionally, close follow-up is required using positron emission tomography/computed tomography, endoscopy, and other radiological evaluations.
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Affiliation(s)
| | - Y Taniyama
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - Y Nakamura
- Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - H Okamoto
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - Y Ozawa
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - K Ito
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - H Ishida
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - T Konno-Kumagai
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | | | - S Taniuchi
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - M Watanabe
- Department of Pathology, Tohoku University Hospital, Sendai, Japan
| | - T Kamei
- Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine
| | - H Sasano
- Department of Pathology.,Department of Pathology, Tohoku University Hospital, Sendai, Japan
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Abstract
Thalamotomy is effective in treating refractory tremor in Parkinson's disease (PD). We herein report a PD patient who underwent left ventral intermediate nucleus and ventro oralis posterior nucleus thalamotomy using magnetic resonance imaging-guided focused ultrasound (MRgFUS). Right-side resting tremor and rigidity were abolished immediately following the ultrasound energy delivery. In addition, left-side resting tremor and rigidity also improved. No adverse events occurred during the procedure. We observed the exacerbation of bradykinesia, which might have been caused by edema around the target. This is the first report of thalamotomy using MRgFUS for PD patient from Japan. Further investigations concerning the efficacy and safety of this procedure are necessary.
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Affiliation(s)
- Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Shigeru Fukutake
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
| | - Kazuaki Yamamoto
- Department of Neurosurgery, Shonan Kamakura General Hospital, Japan
| | - Toshio Yamaguchi
- Research Institute of Diagnostic Imaging, Shin-Yurigaoka General Hospital, Japan
| | - Takaomi Taira
- Department of Neurosurgery, Tokyo Women's Medical University, Japan
| | - Tetsumasa Kamei
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
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22
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Sasajima H, Miyagi S, Kakizaki Y, Kamei T, Unno M, Satomi S, Goto M. Cytoprotective Effects of Mesenchymal Stem Cells During Liver Transplantation from Donors After Cardiac Death in Rats. Transplant Proc 2018; 50:2815-2820. [PMID: 30401403 DOI: 10.1016/j.transproceed.2018.02.180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/19/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Liver transplantation from donors after cardiac death (DCD) might increase the pool of available organs. Recently, some investigators reported the potential use of mesenchymal stem cells (MSCs) to improve the outcome of liver transplantation from DCD. The aim of this study was to evaluate the cytoprotective effects and safety of MSC transplantation on liver grafts from DCD. METHODS Rats were divided into 4 groups (n = 5) as follows: 1. the heart-beating group, in which liver grafts were retrieved from heart-beating donors; 2. the DCD group, in which liver grafts were retrieved from DCD that had experienced apnea-induced agonal conditions; 3. the MSC-1 group, and 4. the MSC-2 group, in which liver grafts were retrieved as with the DCD group, but were infused MSCs (2.0 × 105 or 1.0 × 106, respectively). The retrieved livers were perfused with oxygenated Krebs-Henseleit bicarbonate buffer (37°C) through the portal vein for 2 hours after 6 hours of cold preservation. Perfusate, bile, and liver tissues were then investigated. RESULTS Bile production in the MSC-2 group was significantly improved compared with that in the DCD group. Based on histologic findings, narrowing of the sinusoidal space in the both MSC groups was improved compared with that in the DCD group. CONCLUSIONS MSCs could protect the function of liver grafts from warm ischemia-reperfusion injury and improve the viability of DCD liver grafts. In addition, we found that the infusion of 1.0 × 106 MSCs does not obstruct the hepatic sinusoids of grafts from DCD.
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Affiliation(s)
- H Sasajima
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - S Miyagi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kakizaki
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Kamei
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Satomi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Goto
- Division of Transplantation and Regenerative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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23
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Ito H, Fukutake S, Yamamoto K, Tanaka S, Yamaguchi T, Taira T, Kamei T. Magnetic Resonance Imaging-guided Focused Ultrasound Thalamotomy for Parkinson's Disease with Cardiac Pacemaker: A Case Report. Mov Disord Clin Pract 2018; 5:339-340. [PMID: 30800708 DOI: 10.1002/mdc3.12578] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hisashi Ito
- Department of Neurology Shonan Fujisawa Tokushukai Hospital Fujisawa Japan
| | - Shigeru Fukutake
- Department of Neurology Shonan Fujisawa Tokushukai Hospital Fujisawa Japan
| | - Kazuaki Yamamoto
- Department of Neurosurgery Shonan Kamakura General Hospital Kamakura Japan
| | - Shinji Tanaka
- Department of Cardiology Shonan Fujisawa Tokushukai Hospital Fujisawa Japan
| | - Toshio Yamaguchi
- Research Institute of Diagnostic Imaging Shin-Yurigaoka General Hospital Kawasaki Japan
| | - Takaomi Taira
- Department of Neurosurgery Tokyo Women's Medical University Tokyo Japan
| | - Tetsumasa Kamei
- Department of Neurology Shonan Fujisawa Tokushukai Hospital Fujisawa Japan
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24
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Miyagi S, Shimizu K, Miyazawa K, Nakanishi W, Hara Y, Tokodai K, Nakanishi C, Satomi S, Goto M, Unno M, Kamei T. A Case of Successful Simultaneous Pancreas-Kidney Transplantation Using the Injured Pancreas Graft. Transplant Proc 2017; 49:2315-2317. [PMID: 29198668 DOI: 10.1016/j.transproceed.2017.10.017] [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] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Graft injuries sometimes occur and may cause complications such as the leakage of pancreatic secretions, which is often lethal. We report our experience of a case of successful simultaneous pancreas-kidney transplantation using injured pancreas graft. PATIENTS AND METHODS The recipient was a 57-year-old woman with type 1 diabetes mellitus, and the donor was a 30-year-old man with a brain injury. In the donation, the pancreas parenchyma, splenic artery, and gastroduodenal artery were injured iatrogenically. We therefore reconstructed these arteries using vessel grafts and then performed simultaneous pancreas-kidney transplantation. RESULTS Five days after transplantation, we noted a high titer of amylase in the ascites; therefore, we performed an urgent laparotomy. The origin of the amylase was the injured pancreatic parenchyma, and continued washing and drainage were carried out. We reconstructed the duodenojejunostomy using the Roux-en-Y technique to separate the passage of food from the pancreas graft to prevent injury to other organs due to exposure to pancreatic secretions. Thereafter, we inserted a decompression tube into the anastomosis thorough the blind end of the jejunum. Finally, we inserted 3 drainage tubes for lavage. Following this procedure, the patient recovered gradually and no longer required hemodialysis and insulin therapy. She was discharged from our hospital 56 days after transplantation. CONCLUSION The restoration of the injured graft was possible by management of pancreatic secretions and use of the donor's vessel grafts. Shortage of donors is a problem throughout the world; thus, it is important to use injured grafts for transplantation if possible.
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Affiliation(s)
- S Miyagi
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan.
| | - K Shimizu
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - K Miyazawa
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - W Nakanishi
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - Y Hara
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - K Tokodai
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - C Nakanishi
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - S Satomi
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - M Goto
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - M Unno
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
| | - T Kamei
- Department of Surgery, Tohoku University, Aoba-ku, Sendai, Japan
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Nakanishi W, Kamei T, Ohuchi N. Splenectomy for Severe Intestinal Bleeding Caused by Portal Hypertensive Enteropathy After Pediatric Living-Donor Liver Transplantation: A Report of Three Cases. Transplant Proc 2017; 49:1129-1132. [DOI: 10.1016/j.transproceed.2017.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Miyagi S, Kawagishi N, Kashiwadate T, Fujio A, Tokodai K, Hara Y, Nakanishi C, Kamei T, Ohuchi N, Satomi S. Relationship Between Bile Duct Reconstruction and Complications in Living Donor Liver Transplantation. Transplant Proc 2017; 48:1166-9. [PMID: 27320579 DOI: 10.1016/j.transproceed.2015.10.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES In living donor liver transplantation (LDLT), the recipient bile duct is thin and short. Bile duct complications often occur in LDLT, with persistent long-term adverse effects. Recently, we began to perform microsurgical reconstruction of the bile duct. The purpose of this study was to investigate the relationship between bile duct reconstruction methods and complications in LDLT. METHODS From 1991 to 2014, we performed 161 LDLTs (pediatric:adult = 90:71; left lobe:right lobe = 95:66). In this study, we retrospectively investigated the initial bile duct complications in LDLT and performed univariate and multivariate analyses to identify the independent risk factors for complications. RESULTS The most frequent complication was biliary stricture (9.9%), followed by biliary leakage (6.8%). On univariate and multiple logistic regression analysis, the independent risk factors for biliary stricture were bile leakage (P = .0103) and recurrent cholangitis (P = .0077). However, there were no risk factors for biliary leakage on univariate analysis in our study. The reconstruction methods (hepaticojejunostomy or duct-to-duct anastomosis) and reconstruction technique (with or without microsurgery) were not risk factors for biliary stricture and leakage. CONCLUSION In this study, the most frequent complication of LDLT was biliary stricture. The independent risk factors for biliary stricture were biliary leakage and recurrent cholangitis. Duct-to-duct anastomosis and microsurgical reconstruction of the bile duct were not risk factors for biliary stricture and leakage.
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Affiliation(s)
- S Miyagi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan.
| | - N Kawagishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kashiwadate
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - A Fujio
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - K Tokodai
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - Y Hara
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kamei
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - S Satomi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. The Significance of Screening for HLA Antibodies in the Long-Term Follow-up of Pediatric Liver Transplant Recipients. Transplant Proc 2017; 48:1139-41. [PMID: 27320574 DOI: 10.1016/j.transproceed.2015.12.081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 12/07/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Post-transplant donor-specific anti-HLA antibodies (DSA) reportedly have detrimental effects on the outcomes of organ transplantation. However, the prevalence of post-transplant DSA in the long term after pediatric liver transplantation remains unclear, and the significance of post-transplant DSA is unknown. The aim of this cross-sectional study was to determine the prevalence of and characteristics of patients with post-transplant DSA. MATERIALS AND METHODS Of the 84 pediatric liver transplant recipients who were followed up in the outpatient department of our institution, 34 patients with available HLA typing data were included after they or their parent(s) provided informed consent for DSA evaluations. Luminex single-antigen bead assays were performed, and a mean fluorescence intensity of ≥1000 was used as the cut-off for a positive reaction. RESULTS No class I DSA were detected, whereas class II DSA were detected in 11 patients (32%). There were no differences in age at transplantation, immunosuppressive drugs, or follow-up period between the DSA-positive and DSA-negative patients. The rate of positive pre-transplant complement-dependent cytotoxicity crossmatch was higher with class II DSA than without, although the difference was not statistically significant. CONCLUSIONS The utility of screening for class I DSA was insignificant in the long-term follow-up of pediatric liver transplant recipients. The prevalence of class II DSA was relatively high; therefore, screening for class II DSA might be justified, although a follow-up survey of the association between post-transplant class II DSA and the long-term clinical course needs to be conducted.
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Affiliation(s)
- K Tokodai
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan.
| | - N Kawagishi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - S Miyagi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - Y Hara
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - A Fujio
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - T Kashiwadate
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - K Maida
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - H Goto
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - T Kamei
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Department of Advanced Surgical Science and Technology, Tohoku University, Sendai, Japan
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Kamei T, Okuma Y, Sone R, Nagamata M, Hosomi Y. 535P High flow nasal cannula oxygen for respiratory failure in patients with airway obstruction due to primary lung cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kamei T, Okuma Y, Sone R, Nagamata M, Hosomi Y. 535P High flow nasal cannula oxygen for respiratory failure in patients with airway obstruction due to primary lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw599.014] [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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Miyagi S, Fujio A, Tokodai K, Hara Y, Nakanishi C, Goto H, Kamei T, Kawagishi N, Ohuchi N, Satomi S. Successful Case of Somatostatin Analog Stopping Gastrointestinal Bleeding, One of the Most Frequent Complications After Simultaneous Pancreas-kidney Transplantation: A Case Report. Transplant Proc 2016; 48:985-7. [PMID: 27234785 DOI: 10.1016/j.transproceed.2015.10.072] [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: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 10/21/2022]
Abstract
OBJECT Pancreas transplantation has the highest surgical complication rate of all routinely performed organ transplantation procedures. The complications are not only caused by the pancreas itself but also occur due to issues with the transplant recipient. We report the case of a patient who experienced massive gastrointestinal bleeding after simultaneous pancreas-kidney transplantation (SPK), which was stopped successfully using somatostatin analog. PATIENTS AND METHODS The patient was a 45-year-old woman with diabetes mellitus type 1 who underwent SPK with enteric drainage. She had melena 5 days after SPK. RESULTS At first, we suspected that the melena was caused by the transplanted duodenum because of rejection and ischemic changes. The patient experienced severe bleeding 9 days after SPK. We quickly performed open surgery and inserted an endoscope from the recipient's ileum to investigate the transplanted duodenum. However, no bleeding source was found, including in the transplanted duodenum and the recipient's ileum end. We determined that the bleeding source was the recipient's ascending colon. We attempted to perform endovascular treatment but could not detect the source of the bleeding; therefore, we used somatostatin analog to let the blood vessels shrink and reduce pancreatic output. Thereafter, the function of the transplanted pancreas and kidney gradually recovered, and the recipient was discharged 154 days after SPK. CONCLUSION Gastrointestinal bleeding is a lethal complication and has several different causes, such as mucosal rejection, ischemic changes, and exocrine output of the pancreas graft. Somatostatin analog is one of the most acceptable treatments for patients who have gastrointestinal bleeding after SPK.
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Affiliation(s)
- S Miyagi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan.
| | - A Fujio
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - K Tokodai
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - Y Hara
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - C Nakanishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - H Goto
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - T Kamei
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Kawagishi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - N Ohuchi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
| | - S Satomi
- Division of Transplantation, Upper Digestive and Vascular Surgery, Tohoku University, Sendai, Japan
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. Poor Long-Term Outcomes of Adult Liver Transplantation Involving Elderly Living Donors. Transplant Proc 2016; 48:1130-3. [DOI: 10.1016/j.transproceed.2016.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/05/2016] [Accepted: 01/21/2016] [Indexed: 12/21/2022]
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Hjerpe A, Ascoli V, Bedrossian CWM, Boon ME, Creaney J, Davidson B, Dejmek A, Dobra K, Fassina A, Field A, Firat P, Kamei T, Kobayashi T, Michael CW, Önder S, Segal A, Vielh P. Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: a secondary publication. Cytopathology 2016; 26:142-56. [PMID: 26052757 DOI: 10.1111/cyt.12250] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma. DATA SOURCES Cytopathologists with an interest in the field involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC) contributed to this update. Reference material includes peer-reviewed publications and textbooks. RATIONALE This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in Cape Town.
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Affiliation(s)
- A Hjerpe
- Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - V Ascoli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
| | | | - M E Boon
- Leiden Cytology and Pathology Laboratory, Lieveren, The Netherlands
| | - J Creaney
- National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, University of Western Australia, QEII Medical Centre, Perth, WA, Australia
| | - B Davidson
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - A Dejmek
- Department of Laboratory Medicine in Malmö, Lund University, Malmö University Hospital, Malmö, Sweden
| | - K Dobra
- Division of Clinical Pathology/Cytology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - A Fassina
- Department of Medicine, University of Padova, Padova, Italy
| | - A Field
- Department of Anatomical Pathology, St Vincents Hospital, Sydney, NSW, Australia
| | - P Firat
- Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - T Kamei
- Division of Pathology, Yamaguchi Grand Medical Center, Hofu, Japan
| | - T Kobayashi
- Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
| | - C W Michael
- Department of Pathology, Case Western Reserve University/University Hospitals Case Medical Center, Cleveland, OH, USA
| | - S Önder
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - A Segal
- Department of Tissue Pathology, PathWest Laboratory Medicine WA, QE2 Medical Centre, Perth, WA, Australia
| | - P Vielh
- Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, Villejuif, France
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Abstract
Respiratory insufficiency is a critical problem in amyotrophic lateral sclerosis (ALS) patients. We herein present the case of an autopsied patient with sporadic ALS who underwent diaphragm pacing (DP). The pathology showed several localized adhesions with a markedly atrophied diaphragm. A marked loss of motor neurons with Bunina bodies and phosphorylated TDP-43 positive inclusions was found in the spinal cord and primary motor cortex. Mild hyalinization and a few multinucleated giant cells were present around the electrode tracks in the diaphragm. However, no infiltration of inflammatory cells was detected. Our findings suggest that full-time DP might not cause severe damage to adjacent diaphragm tissue.
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Affiliation(s)
- Hisashi Ito
- Department of Neurology, Shonan Fujisawa Tokushukai Hospital, Japan
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Ariga H, Jingu K, Kamei T, Umezawa R, Nemoto K, Miyazaki S, Yoshioka T. Chemoradiation Therapy for Esophageal Cancer Did Not Decrease Survival During the Later Period Compared With Surgery Alone at More Than 10 Year Follow-up. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.961] [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: 12/01/2022]
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Shimizu M, Ohe M, Ono A, Nam Y, Takei S, Tsuda H, Irie T, Hibino M, Kamei T. [Case report: A case of diabetic chorea associated hyperviscosity without abnormal findings of magnetic resonance imaging]. Nihon Naika Gakkai Zasshi 2014; 103:3103-3105. [PMID: 25812343 DOI: 10.2169/naika.103.3103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Nonaka M, Okita Y, Kanemura Y, Goto H, Kamei T, Iwata R, Takeda J, Oshige H, Yoshimura K, Asai A. NT-27 * SURGICAL RESECTION OF THALAMIC MALIGNANT GLIOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou265.25] [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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Miyata G, Kato T, Kamei T, Nakano T, Abe S, Katsura K, Taniyama Y, Teshima J, Naoshima K, Takaya K, Nakagawa T, Zuguchi M, Yamada M, Sato A, Ohuchi N. LB019-SUN NUMERICAL BENCHMARKS TO QUANTIFY A PATIENT'S PHYSICAL RECOVERY AFTER SURGERY. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nakano T, Miyata G, Kamei T, Naoshima K, Abe S, Katsura K, Taniyama Y, Teshima J, Ohuchi N. LB018-SUN EFFECTS OF LOW-CARBOHYDRATE ENTERAL NUTRITION ON STABILIZATION OF BLOOD SUGAR LEVELS AFTER ESOPHAGEAL SURGERY: A RANDOMIZED CONTROLLED TRIAL. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60596-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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39
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Khanitchaidecha W, Koshy P, Kamei T, Shakya M, Kazama F. Investigation of the effects of hydrogenotrophic denitrification and anammox on the improvement of the quality of the drinking water supply system. J Environ Sci Health A Tox Hazard Subst Environ Eng 2013; 48:1533-1542. [PMID: 23802162 DOI: 10.1080/10934529.2013.797249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A drinking water supply system operates at Chyasal (in the Kathmandu Valley, Nepal) for purifying the groundwater that has high levels of ammonium nitrogen (NH4-N). However, high NO3-N concentrations were seen in the water after treatment. To further improve the quality of the drinking water, two types of attached growth reactors were developed for the purification system: (i) a hydrogenotrophic denitrification (HD reactor) and (ii) a concurrent reactor with anammox and hydrogenotrophic denitrification (AnHD reactor). For the HD reactor fed by water containing NO3-N, the denitrification efficiency was high (95-98%) for all NO3-N feed rates (20-40 mg/L). The nitrite-nitrogen (NO2-N) and nitrate-nitrogen (NO3-N) concentrations in the effluent were ∼0.5 mg/L. On the other hand, the AnHD reactor fed with water containing NH4-N and NO2-N was operated under varying flow rates of H2(30-70 mL/min) and intermittent supply periods (1-2 h). The efficiency of the anammox process was found to increase with decreasing H2flow rates or with increasing intermittency of the H2supply, while the efficiency of denitrification decreased under these conditions. For the optimal condition of 1.5 h intermittent H2supply, the anammox and denitrification efficiencies of the AnHD reactor reached 80% and 42%, respectively, while the concentrations of both NH4-N and NO2-N in the effluent were <1.0 mg/L, and no NO3-N was detected. From the experimental results, it is clear that both HD and AnHD reactors can function as efficient and critical units of the water purification system.
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Affiliation(s)
- W Khanitchaidecha
- Department of Civil Engineering, Faculty of Engineering, Naresuan University, Phitsanulok, Thailand.
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40
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Kasahata N, Uchihara T, Nakamura A, Miyazawa Y, Kamei T. A 71-year-old woman with PSP-like symptoms. Brain Pathol 2012; 22:733-6. [PMID: 22925084 DOI: 10.1111/j.1750-3639.2012.00621.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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41
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Iida A, Hosono N, Sano M, Kamei T, Oshima S, Tokuda T, Nakajima M, Kubo M, Nakamura Y, Ikegawa S. Novel deletion mutations of OPTN in amyotrophic lateral sclerosis in Japanese. Neurobiol Aging 2012; 33:1843.e19-24. [DOI: 10.1016/j.neurobiolaging.2011.12.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 12/10/2011] [Accepted: 12/28/2011] [Indexed: 12/29/2022]
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42
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Iida A, Hosono N, Sano M, Kamei T, Oshima S, Tokuda T, Kubo M, Nakamura Y, Ikegawa S. Optineurin mutations in Japanese amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2012; 83:233-5. [PMID: 21217154 DOI: 10.1136/jnnp.2010.234963] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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43
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Iida A, Takahashi A, Kubo M, Saito S, Hosono N, Ohnishi Y, Kiyotani K, Mushiroda T, Nakajima M, Ozaki K, Tanaka T, Tsunoda T, Oshima S, Sano M, Kamei T, Tokuda T, Aoki M, Hasegawa K, Mizoguchi K, Morita M, Takahashi Y, Katsuno M, Atsuta N, Watanabe H, Tanaka F, Kaji R, Nakano I, Kamatani N, Tsuji S, Sobue G, Nakamura Y, Ikegawa S. A functional variant in ZNF512B is associated with susceptibility to amyotrophic lateral sclerosis in Japanese. Hum Mol Genet 2011; 20:3684-92. [DOI: 10.1093/hmg/ddr268] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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44
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Iida A, Takahashi A, Deng M, Zhang Y, Wang J, Atsuta N, Tanaka F, Kamei T, Sano M, Oshima S, Tokuda T, Morita M, Akimoto C, Nakajima M, Kubo M, Kamatani N, Nakano I, Sobue G, Nakamura Y, Fan D, Ikegawa S. Replication analysis of SNPs on 9p21.2 and 19p13.3 with amyotrophic lateral sclerosis in East Asians. Neurobiol Aging 2011; 32:757.e13-4. [DOI: 10.1016/j.neurobiolaging.2010.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 12/11/2010] [Accepted: 12/21/2010] [Indexed: 11/29/2022]
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46
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Ishigami H, Kitayama J, Kaisaki S, Kato M, Yamaguchi H, Otani K, Kamei T, Nagawa H. Gastrectomy in combination with S-1, intravenous, and intraperitoneal paclitaxel: A novel multidisciplinary treatment strategy for gastric cancer with peritoneal metastasis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14527] [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: 11/20/2022] Open
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47
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Kamei T. [Is PAM an effective antidote for organophosphate poisoning? Pros: PAM (pralidoxime) is effective for acute poisoning of organophosphorus]. Chudoku Kenkyu 2010; 23:31-35. [PMID: 20380319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Nagawa H. 6520 Weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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49
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Yamashita H, Nagawa H. Phase II study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. Ann Oncol 2009; 21:67-70. [PMID: 19605503 DOI: 10.1093/annonc/mdp260] [Citation(s) in RCA: 183] [Impact Index Per Article: 12.2] [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] Open
Abstract
BACKGROUND A phase II study to evaluate the efficacy and tolerability of weekly i.v. and i.p. paclitaxel (PTX) combined with S-1 was carried out in gastric cancer patients with peritoneal metastasis. PATIENTS AND METHODS Gastric cancer patients with peritoneal dissemination and/or cancer cells on peritoneal cytology were enrolled. PTX was administered i.v. at 50 mg/m(2) and i.p. at 20 mg/m(2) on days 1 and 8. S-1 was administered at 80 mg/m(2)/day for 14 consecutive days, followed by 7 days rest. The primary end point was the 1-year overall survival (OS) rate. Secondary end points were the response rate, efficacy against malignant ascites and safety. RESULTS Forty patients were enrolled, including 21 with primary tumors with peritoneal dissemination, 13 with peritoneal recurrence and six with positive peritoneal cytology only. The median number of courses was 7 (range 1-23). The 1-year OS rate was 78% (95% confidence interval 65% to 90%). The overall response rate was 56% in 18 patients with target lesions. Malignant ascites disappeared or decreased in 13 of 21 (62%) patients. The frequent grade 3/4 toxic effects included neutropenia (38%), leukopenia (18%) and anemia (10%). CONCLUSION Combination chemotherapy of i.v. and i.p. PTX with S-1 is well tolerated and active in gastric cancer patients with peritoneal metastasis.
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Affiliation(s)
- H Ishigami
- Department of Surgical Oncology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Yamashita H, Nagawa H. Phase II study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4542] [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: 11/20/2022] Open
Abstract
4542 Background: A phase II study to evaluate the efficacy and tolerability of weekly intravenous and intraperitoneal paclitaxel combined with S-1 was performed in gastric cancer patients with peritoneal metastasis. Methods: Gastric cancer patients with peritoneal dissemination and/or cancer cells on peritoneal cytology were enrolled. Paclitaxel was administered intravenously at 50 mg/m2 and intraperitoneally at 20 mg/m2 on days 1 and 8. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest. The primary endpoint was the 1-year overall survival rate. Secondary endpoints were the response rate, efficacy against malignant ascites and safety. Results: Forty patients were enrolled, including 21 with primary tumors with peritoneal dissemination confirmed by staging laparoscopy, 13 with peritoneal recurrence, and 6 with positive peritoneal cytology only. The median number of courses administered was 7 (range 1–23). The 1-year overall survival rate was 78% (95% CI, 65–90%). The overall response rate was 56% (95% CI, 32–79%) in 18 patients with target lesions. Malignant ascites disappeared or decreased in 13 of 21 (62%) patients. The incidences of grade 3/4 hematological and non- hematological toxicities were 40% and 15%, respectively. The frequent grade 3/4 toxicities included neutropenia (38%), leukopenia (18%), anemia (10%), and nausea (8%). Catheter obstruction observed in one patient was the only complication related to the peritoneal access device or intraperitoneal infusion. There were no treatment-related deaths. Conclusions: Combination chemotherapy of intravenous and intraperitoneal paclitaxel with S-1 is well tolerated and active in gastric cancer patients with peritoneal metastasis. No significant financial relationships to disclose.
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Affiliation(s)
| | | | | | | | - M. Kato
- The University of Tokyo, Tokyo, Japan
| | - K. Otani
- The University of Tokyo, Tokyo, Japan
| | - T. Kamei
- The University of Tokyo, Tokyo, Japan
| | - D. Soma
- The University of Tokyo, Tokyo, Japan
| | - H. Miyato
- The University of Tokyo, Tokyo, Japan
| | | | - H. Nagawa
- The University of Tokyo, Tokyo, Japan
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