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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Matsuzawa R, Nagai K, Takahashi K, Mori T, Onishi M, Tsuji S, Hashimoto K, Tamaki K, Wada Y, Kusunoki H, Nagasawa Y, Shinmura K. Serum Creatinine-Cystatin C Based Screening of Sarcopenia in Community Dwelling Older Adults: A Cross-Sectional Analysis. J Frailty Aging 2024; 13:116-124. [PMID: 38616367 DOI: 10.14283/jfa.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVES To compare the discriminative capabilities for the manifestation of sarcopenia or physical frailty between serum creatinine- and cystatin C-derived indices among community-dwelling older adults. DESIGN Cross-sectional study. SETTING Primary Care and Community. PARTICIPANTS We utilized a subset of data from the Frail Elderly in the Sasayama-Tamba Area (FESTA) study, which was initiated in 2015 to gather comprehensive information on various health-related parameters among community-dwelling older individuals (age ≥65 years). MEASUREMENTS Five serum creatinine-cystatin C based indices including the Sarcopenia Index, the serum creatinine/cystatin C ratio, the disparity between serum cystatin-C-based and creatinine-based estimated GFR, the total body muscle mass index (TBMM), and the prediction equation for skeletal muscle mass index (pSMI) were employed. Sarcopenia and physical frailty were identified based on the Asian Working Group for Sarcopenia criteria and the revised Japanese version of the Cardiovascular Health Study criteria, respectively. The receiver operating characteristic (ROC) and logistic regression analyses were performed to assess the discriminative abilities of these tools. RESULTS In the analysis of 954 participants, 52 (5.5%) were identified with sarcopenia and 35 (3.7%) with physical frailty. Regarding sarcopenia discrimination, TBMM and pSMI both exhibited area under the curve (AUC) values exceeding 0.8 for both men and women. Concerning the identification of physical frailty, AUC values ranged from 0.61 to 0.77 for males and 0.50 to 0.69 for females. In the multivariate logistic regression analyses, only TBMM and pSMI consistently displayed associations with sarcopenia, irrespective of sex (P<0.001, respectively). On the other hand, no consistent associations were observed between the indices and physical frailty. CONCLUSIONS This study provides a robust association of a serum creatinine- and cystatin C-derived indices, especially TBMM and pSMI, with sarcopenia among community-dwelling older adults. Conversely, the application of these indices for the screening of physical frailty has its constraints, necessitating further investigation.
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Affiliation(s)
- R Matsuzawa
- Ryota Matsuzawa, PT, PhD., Department of Physical Therapy, School of Rehabilitation, Hyogo Medical University, 1-3-6 Minatojima, Chuo-ku, Kobe, Hyogo 650-8530, Japan. Tel: +81-78-304-3181; Fax: +81-78-304-2811; E-mail:
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Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Tomioka K, Aoki T, Tashiro Y, Kusano T, Matsuda K, Yamada K, Nogaki K, Wada Y, Shibata H, Hirai T, Yamazaki T, Saito K, Uchida M, Nagaishi S, Fujimori A, Enami Y. Laparoscopic Anatomical Liver Resection Using Liver Mapping of Incidental Indocyanine Green Fluorescence due to Cholestasis. Anticancer Res 2023; 43:5583-5588. [PMID: 38030204 DOI: 10.21873/anticanres.16760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND/AIM Indocyanine green (ICG) fluorescence is useful in laparoscopic hepatectomy (LH) for tumor identification and staining, as well as determination of resection margins. At our Institution, patient-specific, three-dimensional simulations and rehearsal of surgical strategies are carried out preoperatively. We describe cases in which ICG administered preoperatively became stagnated and fluoresced in an area similar to the preoperatively established resection area and the pathological findings in these cases. PATIENTS AND METHODS Four patients who underwent LH at our hospital between 2020 and 2023 (due to hepatocellular carcinoma in two and colorectal liver metastasis in two) were enrolled in the present study. The ICG-fluorescing liver segments were resected laparoscopically and their pathological characteristics were examined using a fluorescence microscope. RESULTS In four cases, the areas of ICG fluorescence seen intraoperatively were due to stasis of preoperatively administered ICG, which fortuitously was equivalent to the planned resection area in the preoperative patient-specific simulation. The fluorescent areas were resected; there were no cases of bile leakage or recurrence. Fluorescence microscopy revealed areas with diffuse ICG fluorescence in normal hepatocytes on the tumor's peripheral side. CONCLUSION It was suggested that resection of the liver area that was fluorescent due to stagnation of preoperatively administered ICG was rational and justified both anatomically and oncologically. This resection may also contribute to the prevention of bile leakage and recurrence.
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Affiliation(s)
- Kodai Tomioka
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Takeshi Aoki
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Tomokazu Kusano
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Kosuke Yamada
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Koji Nogaki
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Yusuke Wada
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Hideki Shibata
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Takahito Hirai
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Kazuhiko Saito
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Marie Uchida
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Shodai Nagaishi
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Akira Fujimori
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
| | - Yuta Enami
- Division of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, Japan
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Yamauchi R, Fujisawa M, Koyanagi S, Muramatsu A, Kobayashi T, Wada Y, Akama K, Tanaka M, Kurashige H, Sato A, Horiuchi H, Mukai T, Yamamoto Y, Sasaki Y. Formate-producing capacity provided by reducing ability of Streptococcus thermophilus nicotinamide adenine dinucleotide oxidase determines yogurt acidification rate. J Dairy Sci 2023; 106:6710-6722. [PMID: 37211485 DOI: 10.3168/jds.2023-23245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/19/2023] [Indexed: 05/23/2023]
Abstract
Yogurt is made by fermenting milk with 2 lactic acid bacteria, Lactobacillus delbrueckii ssp. bulgaricus and Streptococcus thermophilus. To comprehensively understand the protocooperation mechanism between S. thermophilus and L. bulgaricus in yogurt fermentation, we examined 24 combinations of cocultures comprising 7 fast- or slow-acidifying S. thermophilus strains with 6 fast- or slow-acidifying L. bulgaricus strains. Furthermore, 3 NADH oxidase (Nox)-deficient mutants (Δnox) and one pyruvate formate-lyase deficient mutant (ΔpflB) of S. thermophilus were used to evaluate the factor that determines the acidification rate of S. thermophilus. The results revealed that the acidification rate of S. thermophilus monoculture determined the yogurt fermentation rates, despite the coexistence of L. bulgaricus, whose acidification rate was either fast or slow. Significant correlation was found between the acidification rate of S. thermophilus monoculture and the amount of formate production. Result using ΔpflB showed that the formate was indispensable for the acidification of S. thermophilus. Moreover, results of the Δnox experiments revealed that formate production required Nox activity, which not only regulated dissolved oxygen, but also the redox potential. The Nox provided the large decrease in redox potential required by pyruvate formate-lyase to produce formate. A highly significant correlation was found between formate accumulation and Nox activity in S. thermophilus. In conclusion, the formate production ability provided by the action of Nox activity determines the acidification rate of S. thermophilus, and consequently, regulates yogurt coculture fermentation.
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Affiliation(s)
- R Yamauchi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - M Fujisawa
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - S Koyanagi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - A Muramatsu
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - T Kobayashi
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - Y Wada
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - K Akama
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - M Tanaka
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan
| | - H Kurashige
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - A Sato
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - H Horiuchi
- Food Science and Technology Research Laboratories, R&D Division, Meiji Co. Ltd., 1-29-1 Nanakuni, Hachioji, Tokyo 192-0919, Japan
| | - T Mukai
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - Y Yamamoto
- Department of Animal Science, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23, Towada, Aomori 034-8628, Japan
| | - Y Sasaki
- Graduate School of Agriculture, University of Meiji, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa 214-8571, Japan.
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Sakamoto R, Mukai J, Kotake Y, Takehara R, Nishimura M, Yamada K, Okuda H, Wada Y. [Modified Premedication of Infusion Reaction with Obinutuzumab Therapy]. Gan To Kagaku Ryoho 2023; 50:1073-1076. [PMID: 38035837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Obinutuzumab frequently triggers an infusion reaction(IR). In the GALLIUM study, despite the use of corticosteroids, antipyretic analgesics, and antihistamines to prevent IR, IR occurred at a high frequency of 68.2% for all Grades and 12.4% for Grades 3 or higher. The dose of methylprednisolone was increased from 80 mg administered in the GALLIUM study to 125 mg, and the development of IR was investigated in 30 patients with follicular lymphoma who received the initial dose of obinutuzumab. The incidence of IR was 43.3% for all Grades and 0% for Grades 3 or higher, and no serious IR was observed. It also had no effect on infectious diseases. Increased doses of corticosteroids were well tolerated and suggested as an effective method for reducing the frequency of IR.
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Tanaka T, Wada Y, Tomihari M, Nishida H, Akiyoshi H. Diameter of the shunt vessel in dogs with incidental extrahepatic portosystemic shunts. Anat Histol Embryol 2023; 52:815-820. [PMID: 37173857 DOI: 10.1111/ahe.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Clinical signs of extrahepatic portosystemic shunts (EHPSS) depend on the amount of blood shunted. In this study, dogs with EHPSS without noticeable clinical signs including 34 left gastro-phrenic, 3 left gastro-azygos and 2 left spleno-gonadal shunts were evaluated. In dogs with EHPSS without noticeable clinical signs, the median maximum diameter of the shunt vessel was significantly smaller compared to PV (p < 0.005). Whenever the diameter of the EHPSS is small in relation to the diameter of the PV, it seems likely that no obvious clinical signs of EHPSS are observed by the owners.
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Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery, School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
- Kinki Animal Medical Training Institute & Veterinary Clinic, Osaka, Japan
| | - Yusuke Wada
- Veterinary Medical Center, School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | - Mizuki Tomihari
- Laboratory of Veterinary Advanced Diagnosis and Treatment, School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery, School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, School of Veterinary Science, Osaka Metropolitan University, Osaka, Japan
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Tanaka T, Wada Y, Noguchi S, Nishida H, Akiyoshi H. Contrast-enhanced CT features of pyloric lesions in 17 dogs: Case series. Vet Radiol Ultrasound 2023; 64:262-270. [PMID: 36571176 DOI: 10.1111/vru.13193] [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: 08/14/2022] [Revised: 10/06/2022] [Accepted: 10/15/2022] [Indexed: 12/27/2022] Open
Abstract
Pyloric outflow obstructions can be caused by several types of lesions. When a thickened gastric wall and pyloric mass are detected, malignant neoplasia must be differentiated from chronic hypertrophic pyloric gastropathy. CT can characterize gastric tumors. However, based on the authors' review of the literature, there is limited information about the CT findings of pyloric lesions. The purpose of this retrospective case series study was to assess the CT findings of canine pyloric lesions. The following CT parameters were recorded: anatomical area, involved area, lesion shape, growth patterns of wall thickening lesions, enhancement pattern of the lesion in the early and delayed phases, lymphomegaly, and pulmonary metastasis. Seventeen dogs were included in this study and had the following final diagnoses: hyperplasia (five dogs), adenoma (five dogs), adenocarcinoma (three dogs), gastrointestinal stromal tumor (GIST; two dogs), polyposis (one dog), and pyogenic granuloma (one dog). Hyperplasia, adenoma, and polyposis formed mass lesions that involved the mucosal layer. Lymphomegaly was detected in two Jack Russell terriers with hyperplasia; however, the causes were unknown because we did not perform biopsies. All adenocarcinomas formed wall-thickened lesion that involved the outer layer, with lymphomegaly. All GISTs formed mass lesion that involved the outer layer. The pyogenic granulomas formed symmetric wall-thickened lesion that involved the mucosal and outer layers. CT facilitated the characterization of canine pyloric lesions using contrast enhancement, based on the involved area and lesion shape. However, polyposis may require caution in diagnosis based on CT findings alone.
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Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan.,Kinki Animal Medical Training Institute & Veterinary Clinic, Higashiosaka, Osaka, Japan
| | - Yusuke Wada
- Veterinary Medical Center, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, School of veterinary Science, Osaka Metropolitan University, Izumisano-shi, Osaka, Japan
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Wada Y, Jensen C, Meyer S, Yamamoto Y, Honda H. Effects of interleukin-6 inhibition with ziltivekimab in patients at high risk of atherosclerotic events in Japan: results from the phase 2 RESCUE-2 trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2618] [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
In the US phase 2 RESCUE trial, ziltivekimab, a fully human monoclonal antibody against the ligand of the pro-inflammatory cytokine interleukin-6, was shown to reduce biomarkers of inflammation in patients with chronic kidney disease (CKD) and elevated levels of high-sensitivity C-reactive protein (hsCRP), a marker of inflammation and cardiac risk.1 Here, we present outcomes from the phase 2 RESCUE-2 trial of ziltivekimab in a patient population from Japan.
Purpose
To evaluate the efficacy and safety of ziltivekimab 15 mg and 30 mg compared with placebo in Japanese patients with non-dialysis-dependent CKD (NDD-CKD).
Methods
We conducted a randomized, double-blind, placebo-controlled trial in 36 patients aged ≥20 years with stage 3–5 NDD-CKD and hsCRP ≥2 mg/L. Patients were randomly assigned to receive subcutaneous ziltivekimab 15 mg (n=11) or 30 mg (n=12), or placebo (n=13) at weeks 0, 4 and 8. The primary endpoint was percentage change in hsCRP levels from baseline to end of treatment (EOT) (average of week 10 and week 12 values); secondary endpoints included percentage change from baseline to EOT in levels of fibrinogen, serum amyloid A (SAA), N-terminal pro B-type natriuretic peptide (NT-proBNP) and lipids. Analysis of endpoints was performed using Wilcoxon two-sample test; differences between treatment groups were calculated using the Hodges–Lehmann estimator.
Results
Baseline characteristics are shown in the Table. At EOT, median hsCRP levels were reduced by 96% and 93% in the ziltivekimab 15 mg and 30 mg groups, respectively, compared with 27% for placebo (both p<0.001 vs placebo). At both doses, ziltivekimab provided rapid and sustained suppression of hsCRP over the 12-week treatment period (Figure). Statistically significant reductions in levels of the inflammatory markers SAA (15 mg: 71%; 30 mg: 58%; placebo: 30%; both p<0.01 vs placebo) and fibrinogen (38%; 34%; 2%; both p<0.0001 vs placebo) were also observed. Ziltivekimab was well tolerated, did not result in persistent neutropenia or thrombocytopenia, and had minimal effect on liver enzyme levels. There was a non-significant increase in low-density lipoprotein levels and a neutral effect on high-density lipoprotein levels. There was a limited, but statistically significant (p<0.05 vs placebo) increase in triglycerides, whereby levels increased in some patients and decreased in others.
Conclusion
Ziltivekimab effectively reduced inflammatory biomarkers associated with atherosclerosis in patients from Japan with CKD and residual inflammatory risk as measured by hsCRP. A significant reduction of more than 90% in hsCRP levels for both doses of ziltivekimab was demonstrated, with a safety profile similar to placebo. Overall, the results of the RESCUE-2 trial in Japan are consistent with the efficacy and safety results of the US-based RESCUE trial.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was funded by Novo Nordisk A/S. Medical writing support was provided by Johanna Scheinost PhD, PharmaGenesis Oxford Central, Oxford, UK, with funding from Novo Nordisk A/S.
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Affiliation(s)
- Y Wada
- Showa University School of Medicine , Tokyo , Japan
| | - C Jensen
- Novo Nordisk A/S , Søborg , Denmark
| | - S Meyer
- Novo Nordisk A/S , Søborg , Denmark
| | | | - H Honda
- Showa University School of Medicine , Tokyo , Japan
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10
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Tanaka T, Noguchi S, Wada Y, Yamazaki H, Nishida H, Akiyoshi H. Computed tomography and magnetic resonance imaging findings in dogs with vaginal leiomyoma and leiomyosarcoma. Vet Med Sci 2022; 8:2337-2344. [DOI: 10.1002/vms3.930] [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: 11/10/2022] Open
Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery Graduate School of Veterinary Science Osaka Metropolitan University Osaka Japan
- Kinki Animal Medical Training Institute & Veterinary Clinic Osaka Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology Graduate School of Veterinary Science Osaka Metropolitan University Osaka Japan
| | - Yusuke Wada
- Veterinary Medical Center Graduate School of Veterinary Science Osaka Metropolitan University Osaka Japan
| | - Hiroki Yamazaki
- Laboratory of Veterinary Internal Medicine Department of Small Animal Clinical Sciences School of Veterinary Medicine Rakuno Gakuen University Hokkaido Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery Graduate School of Veterinary Science Osaka Metropolitan University Osaka Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery Graduate School of Veterinary Science Osaka Metropolitan University Osaka Japan
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11
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Wada Y, Harun A, Yean C, Abdul-Rahman Z. Global Prevalence of Vancomycin-resistant Enterococcus in Wildlife: The First Meta-Analysis and Systematic Review. Int J Infect Dis 2022. [DOI: 10.1016/j.ijid.2021.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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12
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Yamazaki H, Wada Y, Tanaka T, Noguchi S. Single-modality palliative radiotherapy versus palliative radiotherapy after chemotherapy failure for cats with nasal lymphoma. Vet Radiol Ultrasound 2022; 63:498-505. [PMID: 35188319 DOI: 10.1111/vru.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 12/26/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
Published studies describing outcomes for cats with nasal lymphoma (NLSA) receiving first-line palliative radiation (PRT) versus PRT after chemotherapy failure are currently lacking. The aims of this retrospective observational study were to compare outcomes for cats with NLSA that were treated with these two methods. A total of 48 cats were included in analyses; 32 receiving PRT alone and 16 receiving PRT after chemotherapy failure. The treatment response, progression-free survival (PFS), disease-specific survival (DSS), overall survival (OS), and incidence rate of systemic disease were compared between the two groups. The overall response rate (ORR) was calculated from the same target lesions between pre-RT (within a week before starting PRT) and post-RT (on date of PRT completion) by computed tomography (CT) imaging. The ORR was 94% in cats that received PRT alone, 13 had a complete response (CR) and 17 had a partial response (PR). The ORR was 88% in cats that received PRT after chemotherapy failure, with five having CR and nine with PR. There were no significant differences in the ORR between the two groups. The PFS, DSS, and OS significantly increased in the cats that received PRT alone compared to the cats that received PRT after chemotherapy failure (median PFS: 336 vs 228 days, P = 0.0012, median DSS: 360 vs 242 days, P = 0.0025, median OS: 346 vs 242 days, P = 0.0036, respectively). The incidence rate of systemic disease significantly increased in 75% (12/16) of cats receiving PRT after chemotherapy failure compared to 41% (13/32) of cats receiving PRT alone. The results suggested that clinical outcomes may improve in cats with NLSA with first-line PRT compared to PRT after chemotherapy failure.
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Affiliation(s)
- Hiroki Yamazaki
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Laboratory of Veterinary Internal Medicine, Department of Small Animal Clinical Sciences School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, Japan
| | - Yusuke Wada
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Toshiyuki Tanaka
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Shunsuke Noguchi
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
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13
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Tanaka T, Noguchi S, Wada Y, Nishida H, Akiyoshi H. Computed tomography findings in canine cholangiocellular carcinoma. Vet Record Case Reports 2022. [DOI: 10.1002/vrc2.303] [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: 11/10/2022]
Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery Department of Graduate School of Life and Environmental Sciences Osaka Prefecture University Osaka Japan
- Kinki Animal Medical Training Institute & Veterinary Clinic Osaka Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology Department of Graduate School of Life and Environmental Sciences Osaka Prefecture University Osaka Japan
| | - Yusuke Wada
- Veterinary Medical Centre College of Life Environmental and Advanced Sciences Osaka Prefecture University Osaka Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery Department of Graduate School of Life and Environmental Sciences Osaka Prefecture University Osaka Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery Department of Graduate School of Life and Environmental Sciences Osaka Prefecture University Osaka Japan
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14
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Koizumi T, Aoki T, Yamochi T, Tashiro Y, Yamazaki T, Kusano T, Matsuda K, Wada Y, Shibata H, Saito K, Nogaki K, Hakozaki T, Tomioka K, Hirai T, Fujimori A, Mansour DA, Abbas Gahin AE, Hoffman RM. Determinative Structural Features Identified With Probe-based Confocal Endomicroscopy for the Accurate Diagnosis of Gallbladder Malignancy. Anticancer Res 2022; 42:67-73. [PMID: 34969710 DOI: 10.21873/anticanres.15458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/13/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Probe-based confocal laser endomicroscopy (pCLE) can visualize microscopic structures at high resolution but has not yet yielded definitive diagnostic features of gallbladder malignancy, as opposed to benign changes. PATIENTS AND METHODS A total of 73 patients had their gallbladder evaluated with pCLE performed on resected benign and malignant gallbladder surgical specimens, which were sprayed with fluorescein. Malignant and benign features of pCLE findings were identified on the basis of Miami and Paris Classifications. Standard histopathological diagnoses and individual patient pCLE findings of gallbladder lesions were correlated. RESULTS Of the 73 consecutive patients that had their gallbladder evaluated ex vivo with pCLE, 11 were identified with gallbladder malignancy. pCLE identified features of gallbladders examined ex vivo, including the presence of thick dark bands and dark clumps, which together correlated with histopathologically-determined biliary malignancy at 100% sensitivity. Thick white bands and visualized epithelium, also identified with pCLE, together correlated with histopathologically-determined malignancy at 100% specificity. CONCLUSION pCLE can be used for real-time differentiation of cancerous/non-cancerous regions in the gallbladder using the diagnostic criteria identified in the present study.
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Affiliation(s)
- Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Toshiko Yamochi
- Department of Pathology and Laboratory Medicine, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Akira Fujimori
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Doaa A Mansour
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.,General Surgery Department, Cairo University Hospitals, Cairo, Egypt
| | - Ahmed Elewa Abbas Gahin
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.,General Surgery Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Robert M Hoffman
- Department of Surgery, University of California, San Diego, CA, U.S.A.,AntiCancer Inc., San Diego, CA, U.S.A
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15
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Tsuji Y, Nonoguchi N, Okuzaki D, Wada Y, Motooka D, Hirota Y, Toho T, Yoshikawa N, Furuse M, Kawabata S, Miyatake SI, Nakamura H, Yamamoto R, Nakamura S, Kuroiwa T, Wanibuchi M. Chronic pathophysiological changes in the normal brain parenchyma caused by radiotherapy accelerate glioma progression. Sci Rep 2021; 11:22110. [PMID: 34764346 PMCID: PMC8585920 DOI: 10.1038/s41598-021-01475-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/28/2021] [Indexed: 12/14/2022] Open
Abstract
Radiation therapy is one of standard treatment for malignant glioma after surgery. The microenvironment after irradiation is considered not to be suitable for the survival of tumor cells (tumor bed effect). This study investigated whether the effect of changes in the microenvironment of parenchymal brain tissue caused by radiotherapy affect the recurrence and progression of glioma. 65-Gy irradiation had been applied to the right hemisphere of Fisher rats. After 3 months from irradiation, we extracted RNA and protein from the irradiated rat brain. To study effects of proteins extracted from the brains, we performed WST-8 assay and tube formation assay in vitro. Cytokine production were investigated for qPCR. Additionally, we transplanted glioma cell into the irradiated and sham animals and the median survival time of F98 transplanted rats was also examined in vivo. Immunohistochemical analyses and invasiveness of implanted tumor were evaluated. X-ray irradiation promoted the secretion of cytokines such as CXCL12, VEGF-A, TGF-β1 and TNFα from the irradiated brain. Proteins extracted from the irradiated brain promoted the proliferation and angiogenic activity of F98 glioma cells. Glioma cells implanted in the irradiated brains showed significantly high proliferation, angiogenesis and invasive ability, and the post-irradiation F98 tumor-implanted rats showed a shorter median survival time compared to the Sham-irradiation group. The current study suggests that the microenvironment around the brain tissue in the chronic phase after exposure to X-ray radiation becomes suitable for glioma cell growth and invasion.
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Affiliation(s)
- Yuichiro Tsuji
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
| | - Naosuke Nonoguchi
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
| | - Daisuke Okuzaki
- grid.136593.b0000 0004 0373 3971Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yusuke Wada
- grid.261455.10000 0001 0676 0594Department of Advanced Pathobiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai-Kita, Izumisano, Osaka 598-8531 Japan
| | - Daisuke Motooka
- grid.136593.b0000 0004 0373 3971Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Yuki Hirota
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
| | - Taichiro Toho
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
| | - Nobuhiko Yoshikawa
- Department of Radiology, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Motomasa Furuse
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
| | - Shinji Kawabata
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
| | - Shin-Ichi Miyatake
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan ,Division for Advanced Medical Development, Cancer Center, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
| | - Hiroyuki Nakamura
- grid.32197.3e0000 0001 2179 2105Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8503 Japan
| | - Ryohei Yamamoto
- grid.261455.10000 0001 0676 0594Department of Advanced Pathobiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai-Kita, Izumisano, Osaka 598-8531 Japan
| | - Shota Nakamura
- grid.136593.b0000 0004 0373 3971Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Toshihiko Kuroiwa
- Department of Neurosurgery, Tesseikai Neurosurgical Hospital, 28-1, Nakanohommachi, Shijyonawate, Osaka 575-8511 Japan
| | - Masahiko Wanibuchi
- Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686 Japan
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16
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Kurokawa S, Tanaka T, Yamazaki H, Noguchi S, Wada Y, Nishida H, Akiyoshi H. Comparing the CT and MRI findings for canine primary hepatocellular lesions. Vet Rec 2021; 190:e1083. [PMID: 34751436 DOI: 10.1002/vetr.1083] [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: 03/10/2021] [Revised: 08/24/2021] [Accepted: 10/17/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Triple-phase CT and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) MRI have been used to differentiate hepatocellular carcinomas (HCCs) in dogs. METHODS This retrospective case series aimed to compare the CT findings with MRI findings of 20 canine hepatocellular lesions, including eight poorly/moderately-differentiated HCCs, eight well-differentiated HCCs and four hyperplasias. CT data were analysed, and the following parameters were noted: vessel enhancement, enhancement pattern in the equilibrium phase, maximal transverse diameter, the lowest enhancement, and the attenuation values of each hepatocellular lesion in the precontrast and triple-phase series, including the arterial phase, portal phase and equilibrium phase. MRI data were analysed, and the following parameters were noted: signal intensities of each hepatocellular lesion on T2-weighted images and T1-weighted images, and signal intensity ratio of the hepatocellular lesions in the hepatobiliary phase. RESULTS In 62.5% of poorly/moderately-differentiated HCC and 75% of well-differentiated HCC, presumptive necrosis was detected on CT and MRI. In the hepatobiliary phase on MRI, the median signal intensity ratio of poorly/moderately-differentiated HCC (0.54 [range: 0.3-0.71]) was significantly lower than that of well-differentiated HCC (0.75 [range: 0.6-0.96]) and hyperplasia (0.79 [range: 071-0.98]; p = 0.02 and p = 0.02, respectively). CONCLUSION Gd-EOB-DTPA-enhanced MRI may be a superior modality for differentiating hepatocellular origin lesions.
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Affiliation(s)
- Shohei Kurokawa
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Surgery, Osaka Prefecture University, Izumisano, Japan
| | - Toshiyuki Tanaka
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Surgery, Osaka Prefecture University, Izumisano, Japan.,Kinki Animal Medical Training Institute & Veterinary Clinic, Higashiosaka, Japan
| | - Hiroki Yamazaki
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Surgery, Osaka Prefecture University, Izumisano, Japan
| | - Shunsuke Noguchi
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Radiology, Osaka Prefecture University, Izumisano, Japan
| | - Yusuke Wada
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano, Japan
| | - Hidetaka Nishida
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Surgery, Osaka Prefecture University, Izumisano, Japan
| | - Hideo Akiyoshi
- Department of Graduate School of Life and Environmental Sciences, Laboratory of Veterinary Surgery, Osaka Prefecture University, Izumisano, Japan
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17
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Nishiura D, Nambu I, Maruyama Y, Wada Y. Improvement of human error prediction accuracy in single-trial analysis of electroencephalogram. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:6179-6182. [PMID: 34892527 DOI: 10.1109/embc46164.2021.9629586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The prevention of human error is an important task that has already been researched. Previous studies have shown that EEG signals can predict the occurrence of human errors. However, high accuracy has not yet been achieved in a single-trial analysis. This study is aimed to improve the accuracy of single-trial analysis, and propose a method for anomaly detection with auto encoder(AE). In the experiment, we conducted "Press the button(Go)" or "Do nothing(No-Go)" according to the visual stimulus and analyzed the EEG signal from -1000 ms to 0 ms when the stimulus was displayed. We prepared two types of inputs, time series data and frequency spectrum, and an AE was trained to reconstruct the inputs. We then calculated the difference between the reconstructed data and input data and predicted human error by its largeness. In the prediction using Support Vector Machine (SVM) based on the frequency spectrum, some over-fitting occurred and the average accuracy was 43 %. In the prediction using anomaly detection with frequency spectrum was 53 % and could not be classified. The time series data was 63 % which improved the accuracy. A previous study has shown frequency-dependent features such as -band activity and rhythm, as precursors of human error. However, in single-trial analysis, we obtained a higher accuracy by time series data than when by using the frequency spectrum. However, there was no noticeable difference between SVM and anomaly detection methods other than over-fitting. Therefore, in this case, the improvement in accuracy by the anomaly detection method could not be confirmed. However, the result suggests that it is more effective to use the frequency spectrum than the time series data in the single-trial analysis in the future.
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18
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Tanaka T, Noguchi S, Wada Y, Nishida H, Akiyoshi H. Preliminary study of CT features of intermediate- and high-grade alimentary lymphoma and adenocarcinoma in cats. J Feline Med Surg 2021; 24:1065-1071. [PMID: 34663124 DOI: 10.1177/1098612x211046847] [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] [Indexed: 11/16/2022]
Abstract
CASE SERIES SUMMARY The ultrasonographic findings of many feline intestinal tumours are similar. This study evaluated the CT features of intermediate- and high-grade alimentary lymphoma and adenocarcinoma in cats. CT was performed on six cats with adenocarcinoma and 14 cats with lymphoma. Comparisons between tumour types were conducted, focusing on CT features, including obstruction (present or absent), growth patterns of lesions (symmetry or asymmetry), layering enhancement (present or absent), location of the lesion, number of lesions (solitary or multiple), lymphadenopathy (present or absent), location of lymphadenopathy, pulmonary metastasis (present or absent) and maximum thickness (mm) of the lesion. The cats with adenocarcinoma (n = 5/6 [83%]) experienced intestinal obstruction significantly more often than cats with lymphoma (n = 0/14 [0%]; P = 0.0004). Layering enhancement was observed significantly more often in cats with adenocarcinoma (n = 6/6 [100%]) than in cats with lymphoma (n = 1/14 [7%]; P = 0.0002). Lymphadenopathy was detected significantly more often in cats with lymphoma (n = 14/14 [100%]) than in cats with adenocarcinoma (n = 2/6 [33%]) (P = 0.003). In cats with lymphoma, the intestine (12.1 ± 3.9 mm) was significantly thicker than that in cats with adenocarcinoma (6.4 ± 2.3 mm; P = 0.005). RELEVANCE AND NOVEL INFORMATION To the best of our knowledge, no reports have described the characteristics of feline intestinal tumours using CT. Layering enhancement was observed in cats with intestinal adenocarcinomas. No layering enhancement was observed in alimentary lymphoma in cats, but enlarged regional nodes were noted. Lesions with lymphoma were thicker than those with adenocarcinoma. These findings may help differentiate between adenocarcinomas and lymphomas.
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Affiliation(s)
- Toshiyuki Tanaka
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Kinki Animal Medical Training institute, Higashiosaka, Osaka, Japan
| | - Shunsuke Noguchi
- Laboratory of Veterinary Radiology, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, Japan
| | - Yusuke Wada
- Veterinary Medical Centre, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, Japan
| | - Hidetaka Nishida
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - Hideo Akiyoshi
- Department of Advanced Clinical Medicine, School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
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19
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Kinoshita N, Nawata T, Okuda S, Kubo M, Wada Y, Kobayashi S, Tanaka N, Yano M. Cardiac phenotypes in the acute-phase of microscopic polyangiitis involves dilatation of the left atrium caused by LV diastolic dysfunction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2756] [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
Microscopic polyangiitis (MPA) is a type of primary systemic vasculitis that affects various organs, especially the lungs and kidneys. However, few reports regarding cardiac features of MPA patients were found.
Purpose
We aim to investigate the echocardiographic parameters of acute-phase MPA.
Methods and results
This single-center retrospective study included 15 patients with MPA (Mean age at 72.2±7.1 years, women 73.3%) who underwent echocardiography within two weeks of commencing steroid therapy for induction or reinduction. The echocardiography parameters of the patients were compared with those of 30 age and sex-matched controls. In the MPA group, the commonly affected organs were kidneys (93.3%) and lungs (46.7%); 5 patients (33.3%) had a history of hypertension, which had a similar frequency as the control group. No significant difference in left ventricular (LV) diameter, LV ejection fraction, e', or inferior vena cava diameter was observed between the two groups. However, the MPA group showed significantly higher left atrial (LA) diameter (p=0.033) and LA volume index (p=0.001), as well as higher early diastolic filling velocity (E-wave, p=0.015; E/A, p=0.043; E/e', p=0.041), diastolic pulmonary venous flow velocity (p=0.013), trans-tricuspid pressure gradient (p=0.019), and shorter deceleration time (p=0.038), associated with mildly thicker ventricular walls of left ventricle (LV) than the control group. Moreover, serum levels of C-reactive protein showed significant correlation between E wave (r=0.58, p=0.023), E/A (r=0.67, p=0.006), and deceleration time (r=−0.69, p=0.005) in the MPA group. These results may indicate that in MPA, increased LV stiffness, rather than impairment of LV relaxation was contributed to LV diastolic function, resulting in LA enlargement.
Conclusion
Patients with acute-phase MPA had LA dilatation associated with LV diastolic dysfunction. This finding indicates the importance of cardiac assessment in patients with MPA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Kinoshita
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - T Nawata
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - S Okuda
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - M Kubo
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - Y Wada
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - S Kobayashi
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - N Tanaka
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
| | - M Yano
- Yamaguchi University Graduate School of Medicine, Department of Medicine and Clinical Science, Ube, Japan
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20
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Tatsuno S, Doi H, Okada W, Inoue E, Nakamura K, Sano K, Wada Y, Uehara T, Inada M, Nakamatsu K, Monzen K, Hosono M, Matsumoto K, Tanooka M, Tanaka M, Nishimura Y. PO-1173 Previous pneumectomy is a risk factor of severe radiation pneumonitis after IMRT for lung cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07624-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Oura K, Aoki T, Tashiro Y, Matsuda K, Koizumi T, Kusano T, Wada Y, Shibata H, Yamashita T, Date H, Ariyoshi T, Goto S, Yamazaki K, Watanabe M, Fujimori A, Enami Y, Otsuka K, Hoffman RM, Murakami M. Indocyanine Green Fluorescence Image-guided Laparoscopic Hepatectomy Enabled Resection of a Tumor Invisible With Ultrasonography. Anticancer Res 2021; 41:3867-3869. [PMID: 34281847 DOI: 10.21873/anticanres.15180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/13/2021] [Revised: 06/02/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Ultrasonography (US) is widely used for pre-operative detection of liver tumors. However, US does not have high resolution and very small tumors, tumors located near the liver surface, or those in cirrhotic livers are often not detected. CASE REPORT A 47-year-old woman with a previous surgery for sigmoid colon cancer (T3N1bM0 Stage3b) showed a liver tumor on the surface of segment 2 by contrast-enhanced computed tomography (CT) and gadoliniumethoxybenzyldiethlenetriaminepen-taacetic acid (Gd-EOB-DTPA) magnetic resonance imaging (MRI). However, preoperative US could not identify a tumor lesion at the same site. The most likely preoperative diagnosis was metastasis from her sigmoid colon cancer and laparoscopic liver resection was performed. Intraoperative ultrasonography (IOUS) did not identify the tumor, but it was visualized with indocyanine green (ICG) fluorescence at the surface of segment 2. Laparoscopic liver resection was performed under fluorescence guidance. Pathological examination showed a pseudotumor with negative margins. CONCLUSION ICG fluorescence imaging can allow visualization of liver tumors that are undetectable on US.
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Affiliation(s)
- Keisuke Oura
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Takeshi Aoki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yoshihiko Tashiro
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kazuhiro Matsuda
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tomotake Koizumi
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tomokazu Kusano
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yusuke Wada
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Hideki Shibata
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Takeshi Yamashita
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Hiromi Date
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tomotake Ariyoshi
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Satoru Goto
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kimiyasu Yamazaki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Makoto Watanabe
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Akira Fujimori
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yuta Enami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Koji Otsuka
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Robert M Hoffman
- Department of Surgery, University of California, San Diego, CA, U.S.A.,AntiCancer Inc., San Diego, CA, U.S.A
| | - Masahiko Murakami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
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22
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Aoki T, Mansour DA, Koizumi T, Wada Y, Enami Y, Fujimori A, Kusano T, Matsuda K, Nogaki K, Tashiro Y, Hakozaki T, Shibata H, Tomioka K, Hirai T, Yamazaki T, Saito K, Goto S, Watanabe M, Otsuka K, Murakami M. Laparoscopic Liver Surgery Guided by Virtual Real-time CT-Guided Volume Navigation. J Gastrointest Surg 2021; 25:1779-1786. [PMID: 32901425 DOI: 10.1007/s11605-020-04784-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/27/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Recently, virtual navigation system has been applied to hepatic surgery, enabling better visualization of intrahepatic vascular branches and location of tumor. Intraoperative ultrasonography (IOUS) is the most common form of image guidance during liver surgery. However, during laparoscopic hepatectomies (LH), IOUS has several limitations and its reliability has been poorly evaluated. The objective of this work is to evaluate VRCT (virtual real-time CT-guided volume navigation) during LH. This system aims to provide accurate anatomical orientation for surgeons enhancing the safety of LH. METHODS Twenty-seven hepatic neoplasms were resected laparoscopically at our institution under reference guidance of VRCT. During operation, electromagnetic tracking of the surgical instrument was used for navigating the direction of accurate liver transection. RESULTS Twenty-six (96.3%) of the 27 lesions (mean diameter 11 mm) were successfully performed under VRCT guidance. Average registration time was < 2 min. Average setup time was approximately 7 min per procedure. VRCT allows the surgeon to navigate liver transection with acceptable accuracy. The mean error was 12 mm. All surgical margins were negative and the mean histologic resection margin was 9 mm. CONCLUSIONS VRCT-guided LH is feasible and provides valuable real-time anatomical feedback during hepatic resections. Advancement of such systems to improve accuracy might greatly compensate for the limitation of laparoscopic IOUS.
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Affiliation(s)
- Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
| | - Doaa A Mansour
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
- General Surgery Department, Cairo University Hospitals, Kasr Alainy, Al-Saray Street, El-Manial, Cairo, 11956, Egypt
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yuta Enami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Akira Fujimori
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Satoru Goto
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Makoto Watanabe
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Koji Otsuka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
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23
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Abstract
A 13-year-old, female, mixed-breed dog with a huge cranial mediastinal mass underwent
radiotherapy (RT). On the following day, the dog presented with lethargy and anorexia.
Hematological examination revealed elevated levels of blood urea nitrogen, creatinine,
inorganic phosphorus, potassium, lactate dehydrogenase, creatine phosphokinase and
aspartate aminotransferase, decreased calcium level, and metabolic acidosis. Urine output
markedly decreased. The patient recovered with fluid therapy and diuretic therapy;
however, died suddenly from an unknown cause 11 days after RT completion.
Histopathological examination after necropsy showed thymoma in the cranial mediastinum and
extensive tubular necrosis of both kidneys which may be due to RT-induced tumor lysis
syndrome (TLS). This report suggests that the risk of TLS should be evaluated in dogs with
thymoma who undergo RT.
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Affiliation(s)
- Yusuke Wada
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Hiroki Yamazaki
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan.,Laboratory of Veterinary Surgery, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Miyuu Tanaka
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Ayumi Kaneguchi
- Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Toshiyuki Tanaka
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan.,Laboratory of Veterinary Surgery, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Hideo Akiyoshi
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan.,Laboratory of Veterinary Surgery, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
| | - Shunsuke Noguchi
- Veterinary Medical Center, College of Life, Environmental and Advanced Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan.,Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Ourai kita, Izumisano, Osaka 598-8531, Japan
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24
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Tomioka K, Aoki T, Koizumi T, Elewa A, Kusano T, Matsuda K, Nogaki K, Tashiro Y, Wada Y, Hakozaki T, Shibata H, Hirai T, Yamazaki T, Saito K, Enami Y, Sugiura I, Nakajima Y, Arai J, Kajiwara A, Uozumi S, Shimozuma YU, Uchikoshi M, Sakaki M, Yoshida H, Miura S, Murakami M. Laparoscopic Treatment of a Hepatoduodenal Ligament Schwannoma With Infrared Indocyanine Green Fluorescence. In Vivo 2021; 34:2037-2041. [PMID: 32606179 DOI: 10.21873/invivo.12004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/24/2020] [Accepted: 04/02/2020] [Indexed: 02/07/2023]
Abstract
Schwannomas occurring in the hepatoduodenal ligament are extremely rare, with only four cases reported. Here, we describe a case of a 30-mm schwannoma that originated in the hepatoduodenal ligament of a 38-year-old female found during a periodic medical check-up. Magnetic resonance imaging demonstrated a tumor in the hepatoduodenal ligament. Following an ultrasound-guided microbiopsy, histological examination showed solitary fibrous tumor or schwannomas in the liver or originating from the hepαtoduodenal ligament. The relationship between the tumor and associated organs was confirmed intraoperatively, and the tumor was removed safely in its entirety using indocyanine green. The postoperative histopathological examination revealed the presence of a schwannoma with typical characteristics. To our knowledge, this is the first case of hepatoduodenal ligament schwannoma treated by laparoscopic surgery using indocyanine green fluorescence imaging.
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Affiliation(s)
- Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Ahmed Elewa
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Yuta Enami
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
| | - Ikuya Sugiura
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Yoko Nakajima
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Jun Arai
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Atsushi Kajiwara
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Shojiro Uozumi
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Y U Shimozuma
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Manabu Uchikoshi
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Masashi Sakaki
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Hitoshi Yoshida
- Department of Medicine, Division of Gastroenterology, Showa University, Tokyo, Japan
| | - Sakiko Miura
- Department of Medicine, Division of Pathology, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, Showa University, Tokyo, Japan
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25
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Nagai N, Shindo N, Wada A, Izu H, Fujii T, Matsubara K, Wada Y, Sakane N. Effects of Rice Wine Lees on Cognitive Function in Community-Dwelling Physically Active Older Adults: A Pilot Randomized Controlled Trial. J Prev Alzheimers Dis 2021; 7:95-103. [PMID: 32236398 DOI: 10.14283/jpad.2019.45] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Rice wine lees (RWL), a Japanese traditional fermented product, is a rich source of one-carbon metabolism-related nutrients, which may have beneficial effects on cognitive function. OBJECTIVES We aimed to examine the effect of the RWL on cognitive function in community-dwelling physically active older adults. DESIGN Double-blind, randomized, placebo-controlled study (clinical trial number: UMIN 000027158). SETTING Community-based intervention including assessments conducted at the University of Hyogo and a public liberal arts school in Himeji City, Japan. PARTICIPANTS A total of 35 community-dwelling older adults (68-80 years) who performed mild exercise before and during the trial were assigned to either the RWL (n=17) or the placebo group (n=18). INTERVENTION Daily consumption of 50 g RWL powder, which contained one-carbon metabolism-related nutrients, or the placebo powder (made from soy protein and dextrin) for 12 weeks. Both supplements included equivalent amounts of energy and protein. MEASUREMENTS Montreal Cognitive Assessment, computerized cognitive function test, and measurements of serum predictive biomarkers (transthyretin, apolipoprotein A1, and complement C3) were conducted at baseline and follow-up. RESULTS Visual selective attention and serum transthyretin significantly improved in the RWL group, whereas there was no significant change in the placebo group. No significant group difference was observed in the remaining cognitive performance tests. CONCLUSIONS RWL supplements seem to have a few effects on cognitive function in community-dwelling physically active older adults. However, the impact was limited; therefore, further studies with sufficient sample size are warranted to elucidate this issue.
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Affiliation(s)
- N Nagai
- Narumi Nagai, Department of Food and Nutritional Science, School of Human Science and Environment, University of Hyogo, 1-1-12 Shinzaike-honcho, Himeji, Hyogo, 670-0092 Japan, , Tel.: +81792921515, Fax.: +81792935710
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26
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Shibata H, Aoki T, Koizumi T, Kusano T, Yamazaki T, Saito K, Hirai T, Tomioka K, Wada Y, Hakozaki T, Tashiro Y, Nogaki K, Yamada K, Matsuda K, Fujimori A, Enami Y, Murakami M. The Efficacy of Intraoperative Fluorescent Imaging Using Indocyanine Green for Cholangiography During Cholecystectomy and Hepatectomy. Clin Exp Gastroenterol 2021; 14:145-154. [PMID: 33958888 PMCID: PMC8096340 DOI: 10.2147/ceg.s275985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/10/2020] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose Bile duct injury is one of the most serious complications of laparoscopic cholecystectomy. Intraoperative indocyanine green (ICG) cholangiography is a safe and useful navigation modality for confirming the biliary anatomy. ICG cholangiography is expected to be a routine method for helping avoid bile duct injuries. Patients and Methods We examined 25 patients who underwent intraoperative cholangiography using ICG fluorescence. Two methods of ICG injection are used: intrabiliary injection (percutaneous transhepatic gallbladder drainage [PTGBD], gallbladder [GB] puncture and endoscopic nasobiliary drainage [ENBD]) at a dosage of 0.025 mg during the operation or intravenous injection with 2.5 mg ICG preoperatively. Results There were 24 patients who underwent laparoscopic cholecystectomy and 1 patient who underwent hepatectomy. For laparoscopic cholecystectomy, the average operation time was 127 (50–197) minutes, and estimated blood loss was 43.2 (0–400) g. The ICG administration route was intravenous injections in 12 cases and intrabiliary injection in 12 cases (GB injection: 3 cases, PTGBD: 8 cases, ENBD:1 case). The course of the biliary tree was able to be confirmed in all cases that received direct injection into the biliary tract, whereas bile structures were recognizable in only 10 cases (83.3%) with intravenous injection. The postoperative hospital stay was 4.6 (3–9) days, and no postoperative complications (Clavien–Dindo ≧IIIa) were observed. For hepatectomy, a tumor located near the left Glissonian pedicle was resected using a fluorescence image guide. Biliary structures were fluorescent without injury after resecting the tumor. No adverse events due to ICG administration were observed, and the procedure was able to be performed safely. Conclusion ICG fluorescence imaging allows surgeons to visualize the course of the biliary tree in real time during cholecystectomy and hepatectomy. This is considered essential for hepatobiliary surgery to prevent biliary tree injury and ensure safe surgery.
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Affiliation(s)
- Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kosuke Yamada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Akira Fujimori
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yuta Enami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
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27
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Rai S, Inoue H, Hanamoto H, Matsuda M, Maeda Y, Wada Y, Haeno T, Watatani Y, Kumode T, Hirase C, Espinoza JL, Morita Y, Tanaka H, Tatsumi Y, Matsumura I. Low absolute lymphocyte count is a poor prognostic factor for untreated advanced follicular lymphoma treated with rituximab plus bendamustine: results of the prospective phase 2 CONVERT trial. Int J Hematol 2021; 114:205-216. [PMID: 33864623 DOI: 10.1007/s12185-021-03148-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 01/10/2023]
Abstract
The aim of this trial is to evaluate the utility of rituximab-bendamustine (R-B) for untreated advanced follicular lymphoma (FL) showing non-optimal response (nOR) to R-CHOP, and to identify clinical prognostic factors for FL patients receiving R-B. Patients who failed to achieve complete response/complete response unconfirmed (CR/CRu) [nOR-group] after 2 cycles of R-CHOP subsequently received 6 cycles of R-B. The primary endpoint was the 3-year progression-free survival (PFS) rate. Secondary endpoints included determination of prognostic factors. Fifty-six patients initially received R-CHOP, 43/56 patients (76.8%) were judged as nOR, and 33/43 patients (76.7%) completed 6 cycles of R-B. At a median follow-up of 50.6 months in the nOR-group, the 3-year PFS rate was 69.0%, and the 3-year overall survival (OS) rate was 92.7%. The most common toxicities associated with R-B were grade 3-4 lymphopenia (93.0%) and neutropenia (74.4%), both of which were manageable. A multivariate analysis including dose intensity, serum soluble interleukin-2 receptor, and FL international prognostic index-2 revealed low absolute lymphocyte count (< 869/μL) at diagnosis was an independent poor prognostic factor for both PFS and OS in the R-B-treated nOR-group. This result was further confirmed in validation cohorts including R-B-treated de novo (n = 40) and relapsed (n = 49) FL patients.
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Affiliation(s)
- Shinya Rai
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.
| | - Hiroaki Inoue
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Hitoshi Hanamoto
- Department of Hematology, Faculty of Medicine, Nara Hospital Kindai University, Ikoma, Japan
| | | | - Yasuhiro Maeda
- Department of Hematology, Minami Sakai Hospital, Sakai, Japan
| | - Yusuke Wada
- Department of Hematology, Izumi City General Hospital, Izumi, Japan
| | - Takahiro Haeno
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Yosaku Watatani
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Takahiro Kumode
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Chikara Hirase
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - J Luis Espinoza
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Yasuyoshi Morita
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Hirokazu Tanaka
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Yoichi Tatsumi
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, 377-2, Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan
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Tomioka K, Murakami M, Aoki T, Matsuda K, Koizumi T, Kusano T, Nogaki K, Tashiro Y, Wada Y, Hakozaki T, Shibata H, Hirai T, Yamazaki T, Saito K, Sato Y, Mochizuki K, Fujimori A, Enami Y. Use of Transumbilical Incision as an Organ Removal Site in Laparoscopic Pancreatectomy. Anticancer Res 2021; 41:2197-2201. [PMID: 33813434 DOI: 10.21873/anticanres.14995] [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: 02/10/2021] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To evaluate complications and risk factors associated with transumbilical incision as an organ removal site in laparoscopic pancreatectomy (LP). PATIENTS AND METHODS In total, 52 patients who underwent LP between 2009 and 2017 were included in this study. The development of superficial surgical site infection (SSI) and transumbilical port-site incisional hernia was recorded. RESULTS None of the patients had SSI. However, three (5.77%) presented with transumbilical incisional hernia. No variables were significantly associated with the risk of transumbilical incisional hernia. CONCLUSION No evident risk factors correlated with hernia formation. Hence, incisional hernia might have occurred at a certain probability. In some cases, it was caused by technical problems. However, the use of transumbilical incision as an organ removal site was feasible, and a new incision for organ removal alone was not required.
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Affiliation(s)
- Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihito Sato
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kiyotaka Mochizuki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Akira Fujimori
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yuta Enami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
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Wada Y, Aoki T, Fujimori A, Ohike N, Koizumi T, Kusano T, Matsuda K, Nogaki K, Tashiro Y, Hakozaki T, Shibata H, Tomioka K, Hirai T, Saito K, Yamazaki T, Murakami M. Intraoperative Shear Wave Elastography as a Quantitative Predictor of Pancreatic Fibrosis and Exocrine Function. Anticancer Res 2021; 41:1013-1019. [PMID: 33517309 DOI: 10.21873/anticanres.14856] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Soft pancreatic texture is a risk factor for postoperative pancreatic fistula (POPF). However, conventional evaluation of pancreatic texture is largely dependent on subjective assessment and lacks quantitative parameters. The study aimed to use ultrasonic shear wave elastography (SWE) to evaluate pancreatic stiffness to determine if the intraoperative SWE measurement could be a quantitative predictor for POPF. PATIENTS AND METHODS Fifteen patients scheduled for pancreaticoduodenectomy were included. Both pre- and intra-operative measurement of the pancreatic SWE index (SWEI) were evaluated. Relationships between intraoperative and preoperative SWEI, pathological fibrosis of the resected pancreatic specimen, postoperative exocrine function of the remnant pancreas, and the incidence of POPF were evaluated. RESULTS The intraoperative SWEI was correlated with the preoperative SWEI, pathological fibrosis of pancreatic tissue, and pancreatic exocrine function. CONCLUSION Intraoperative SWE measurement of pancreatic elasticity may be useful as a quantitative method for evaluating pancreatic fibrosis and exocrine function.
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Affiliation(s)
- Yusuke Wada
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan;
| | - Akira Fujimori
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Nobuyuki Ohike
- Department of Pathology, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - Tomotake Koizumi
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Kodai Tomioka
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Department of Surgery, Division of Gastroenterological Surgery and General Surgery, Showa University, Tokyo, Japan
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Yamazaki T, Aoki T, Tashiro Y, Koizumi T, Kusano T, Matsuda K, Fujimori A, Yamada K, Nogaki K, Hakozaki T, Wada Y, Shibata H, Tomioka K, Enami Y, Murakami M. Relationship Between Remnant Pancreatic Volume and Endocrine Function After Pancreaticoduodenectomy. Am Surg 2021; 88:233-237. [PMID: 33522272 DOI: 10.1177/0003134821989049] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND Decreased pancreatic volume (PV) is a predictive factor for diabetes mellitus (DM) after surgery. There are few reports on PV and endocrine function pre- and post-surgery. We investigated the correlation between PV and insulin secretion. METHODS Seventeen patients underwent pancreaticoduodenectomy (PD) Pre- and post-surgery PV and C-peptide index (CPI) measurements were performed. Additionally, the correlation between PV and CPI was analyzed. RESULTS The mean preoperative PV (PPV) was 55.1 ± 31.6 mL, postoperative remnant PV (RPV) was 25.3±17.3 mL, and PV reduction was 53%. The mean preoperative C-peptide immunoreactivity (CPR) was 1.39 ± .51 and postoperative CPR was .85±.51. The mean preoperative CPI was 1.29±.72 and postoperative CPI was .73 ± .48. Significant correlations were observed between RPV and post CPR (ρ = .507, P = .03) and post CPI (ρ = .619, P = .008). DISCUSSION There was a significant correlation between RPV and CPI after PD. A smaller RPV resulted in lower insulin secretion ability, increasing the potential risk of new-onset DM after PD.
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Affiliation(s)
- Tatsuya Yamazaki
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Akira Fujimori
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Kosuke Yamada
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Koji Nogaki
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Yusuke Wada
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Hideki Shibata
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Kodai Tomioka
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Yuta Enami
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Department of General and Gastroenterological Surgery, School of Medicine, 13059Showa University, Tokyo, Japan
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Sasamoto S, Aoki T, Tashiro Y, Matsuda K, Koizumi T, Kusano T, Wada Y, Shibata H, Tomioka K, Yamashita T, Date H, Ariyoshi T, Goto S, Yamazaki K, Fujimori A, Watanabe M, Enami Y, Otsuka K, Norose T, Ohike N, Yamochi T, Takimoto M, Murakami M. Experience of the pancreas duodenectomy for so-called carcinosarcoma of the common bile duct:a case report and review of literature. Int Cancer Conf J 2021; 10:134-138. [PMID: 33786287 DOI: 10.1007/s13691-020-00462-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/17/2020] [Indexed: 02/05/2023] Open
Abstract
A 79-year-old man presented with malaise and jaundice at a local hospital. His blood tests showed severe inflammation, liver failure, and high expression of several tumour markers. Radiological findings revealed dilated common and intrahepatic bile ducts and a lower bile duct constricted by a soft tissue mass. Histological findings by endoscopy showed a suspected adenocarcinoma, which was determined as class IV by cytology. The patient was referred to our hospital for surgical treatment. He underwent pancreaticoduodenectomy and the final diagnosis was so-called carcinosarcoma of the bile duct. He had liver metastasis and died at 26 postoperative months.
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Affiliation(s)
- Suguru Sasamoto
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Takeshi Aoki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Yoshihiko Tashiro
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Kazuhiro Matsuda
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Tomotake Koizumi
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Tomokazu Kusano
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Yusuke Wada
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Hideki Shibata
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Kodai Tomioka
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Takeshi Yamashita
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Hiromi Date
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Tomotake Ariyoshi
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Satoru Goto
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Kimiyasu Yamazaki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Akira Fujimori
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Makoto Watanabe
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Yuta Enami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Koji Otsuka
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Tomoko Norose
- Department of Diagnostic Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Nobuyuki Ohike
- Department of Diagnostic Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Toshiko Yamochi
- Department of Diagnostic Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Masafumi Takimoto
- Department of Diagnostic Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
| | - Masahiko Murakami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 Japan
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Tomioka K, Aoki T, Matsuda K, Fujimori A, Koizumi T, Kusano T, Nogaki K, Tashiro Y, Wada Y, Hakozaki T, Shibata H, Hirai T, Yamazaki T, Saito K, Enami Y, Murakami M. Usefulness of a Transumbilical Incision for Organ Removal in Laparoscopic Hepatectomy. Anticancer Res 2020; 40:6545-6550. [PMID: 33109596 DOI: 10.21873/anticanres.14679] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/03/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To evaluate the complication rates and risk factors associated with transumbilical wounds and investigate the usefulness of an incision for organ removal in laparoscopic hepatectomy (Lap-H). PATIENTS AND METHODS We enrolled 42 patients who underwent Lap-H excluding a small partial resection in our hospital between 2013 and 2018. The occurrences of superficial surgical site infection (SSI) and transumbilical port-site incisional hernia were recorded. RESULTS SSI was not observed, and hernia occurred in 3 patients (7.14%). Univariate analysis revealed that body mass index (BMI) (p=0.004) was significantly associated with the risk of hernia formation. CONCLUSION High BMI is a risk factor for hernia formation in patients undergoing Lap-H with transumbilical incision; hence, wound closure should be performed carefully. The construction of the transumbilical wound for organ removal was feasible with rationality, with no need to create a new wound.
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Affiliation(s)
- Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Akira Fujimori
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiko Saito
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yuta Enami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, Tokyo, Japan
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Aoki T, Mansour DA, Koizumi T, Matsuda K, Kusano T, Wada Y, Hakozaki T, Tomioka K, Hirai T, Yamazaki T, Watanabe M, Otsuka K, Gahin AEA, Murakami M. Preventing clinically relevant pancreatic fistula with combination of linear stapling plus continuous suture of the stump in laparoscopic distal pancreatectomy. BMC Surg 2020; 20:223. [PMID: 33023558 PMCID: PMC7541328 DOI: 10.1186/s12893-020-00876-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
Background Pancreatic fistula is one of the serious complications for patients undergoing distal pancreatectomy, which leads to significant morbidity. The aim of our study is to compare linear stapling closure plus continuous suture with linear stapling closure alone during laparoscopic distal pancreatectomy (LDP) in terms of clinically relevant postoperative pancreatic fistula (POPF) rate. Methods Twenty-two patients underwent LDP at our institution between 2011 and 2013. Twelve patients had linear stapling closure with peri-firing compression (LSC) alone compared with ten patients who had linear stapling closure, peri-firing compression plus continuous suture (LSC/CS) for stump closure of remnant pancreas in LDP. Biochemical leak and clinically relevant POPF were compared between both groups. Results POPF occurred in 4 of 12 (33.3%) patients with linear stapling closure while no patient developed a clinically relevant POPF in the triple combination of linear stapling, peri-firing compression plus continuous suture group (p = 0.043).1 patient (8.3%) in the LSC group and 5 patients (50%) in the LSC/CS group had evidence of a biochemical leak. There were no significant differences in operative time (188.3 vs 187.0 min) and blood loss (135 vs. 240 g) between both groups but there was a significantly of shorter length of hospital stay (11.9 vs. 19.9 days) in LSC/CS group (p = 0.037). There was no mortality in either group. Conclusions The triple combination of linear stapling, peri-firing compression plus continuous suture in LDP has effectively prevented occurrence of clinically relevant ISGPF POPF. Trial registration The study was retrospectively registered September 30, 2019 at Showa University Ethics Committee as IRB protocol numbers 2943.
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Affiliation(s)
- Takeshi Aoki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan.
| | - Doaa A Mansour
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan.,General Surgery Department, Cairo University Hospitals, Kasr Alainy, Al-Saray street, El-Manial, Cairo, 11956, Egypt
| | - Tomotake Koizumi
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Yusuke Wada
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Kodai Tomioka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Takahito Hirai
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Tatsuya Yamazaki
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Makoto Watanabe
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Koji Otsuka
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
| | - Ahmed Elewa Abbas Gahin
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan.,General Surgery Department, National Hepatology and Tropical Medicine Research Institute, 10. Kasr Alainy street, Cairo, 11562, Egypt
| | - Masahiko Murakami
- Division of Gastroenterological and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
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Yamada K, Aoki T, Enami Y, Tashiro Y, Zehaou Z, Koizumi T, Kusano T, Matsuda K, Wada Y, Shibata H, Tomioka K, Siriratsivawong K, Hoffman RM, Murakami M. An Improved Encapsulation Method for Cryopreserving Hepatocytes for Functional Transplantation Using a Thermo-reversible Gelation Polymer. In Vivo 2020; 34:2309-2316. [PMID: 32871755 DOI: 10.21873/invivo.12043] [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: 05/13/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Thermo-reversible gelation polymer (TGP) can be converted into a gel state upon warming and liquid upon cooling. The present study aimed to demonstrate a new method for cryopreservation and encapsulation of rat hepatocytes using a TGP and their successful transplantation. MATERIALS AND METHODS The isolated rat hepatocytes were microencapsulated using TGP, and stored in liquid nitrogen. After cryopreservation, hepatocytes were cultured. Moreover, hepatocytes were transplanted into the spleen without a TGP capsule. RESULTS The viability of hepatocytes that were cryopreserved in TGP was 71.2±2.3%. The hepatocytes demonstrated adequate survival, maintained their hepatic function in culture, and expressed albumin after transplantation to the rat spleen. CONCLUSION We demonstrated a cryopreservation method of rat hepatocyte encapsulation using a TGP gel in the hydrogel state which subsequently allowed successful transplantation of unencapsulated hepatocytes in a sol state TGP gel at low temperature.
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Affiliation(s)
- Kosuke Yamada
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Takeshi Aoki
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yuta Enami
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yoshihiko Tashiro
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan.,Department of Surgery, University of California, San Diego, CA, U.S.A.,AntiCancer Inc, San Diego, CA, U.S.A
| | - Zin Zehaou
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomotake Koizumi
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Tomokazu Kusano
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kazuhiro Matsuda
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Yusuke Wada
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Hideki Shibata
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kodai Tomioka
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
| | - Kris Siriratsivawong
- Department of Medical Education, School of Medicine, Showa University, Tokyo, Japan
| | - Robert M Hoffman
- Department of Surgery, University of California, San Diego, CA, U.S.A.,AntiCancer Inc, San Diego, CA, U.S.A
| | - Masahiko Murakami
- Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan
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Tashiro Y, Aoki T, Hirai T, Koizumi T, Mansou DA, Kusano T, Matsuda K, Yamada K, Nogaki K, Hakozaki T, Wada Y, Shibata H, Tomioka K, Yamazaki T, Saito K, Fujimori A, Enami Y, Hoffman RM, Murakami M. Pathological Validity of Using Near-infrared Fluorescence Imaging for Securing Surgical Margins During Liver Resection. Anticancer Res 2020; 40:3873-3882. [PMID: 32620627 DOI: 10.21873/anticanres.14377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 05/13/2020] [Revised: 05/31/2020] [Accepted: 06/11/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study investigated the use of near-infrared fluorescent imaging for securing safe margins during liver resection. PATIENTS AND METHODS This study included 125 patients who underwent liver tumor resection in 2014-2018. Indocyanine green testing was performed 2-14 days before surgery. Histopathological specimens of hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) were evaluated using fluorescent microscopy. RESULTS Fluorescence microscopy identified signals in 26/53 (49.0%) and 36/72 (50%) cases of HCC and CRLM, respectively. HCC demonstrated total, partial, rim, and combined fluorescence patterns; CRLM uniformly demonstrated rim fluorescence. Although rim fluorescence was seen in both HCC and CRLM, no malignancy was confirmed pathologically in the peritumoral area demonstrating fluorescence. The median widths of fluorescence from the tumor edge in HCC and CRLM were 1227.5 μm and 1608 μm, respectively, with no significant difference. CONCLUSION Near-infrared fluorescent imaging can reliably detect safe surgical margins intraoperatively during liver resection.
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Affiliation(s)
- Yoshihiko Tashiro
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Takeshi Aoki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Takahito Hirai
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tomotake Koizumi
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Doaa A Mansou
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan.,General Surgery Department, Cairo University Hospitals, Kasr Alainy, Al-Saray street, El-Manial, Cairo, Egypt
| | - Tomokazu Kusano
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kazuhiro Matsuda
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kosuke Yamada
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Koji Nogaki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Hakozaki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yusuke Wada
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Hideki Shibata
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kodai Tomioka
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Tatsuya Yamazaki
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kazuhiko Saito
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Akira Fujimori
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yuta Enami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Robert M Hoffman
- Department of Surgery, University of California, San Diego, CA, U.S.A.,AntiCancer Inc., San Diego, CA, U.S.A
| | - Masahiko Murakami
- Department of General and Gastroenterological Surgery, Showa University School of Medicine, Tokyo, Japan
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Noguchi S, Hattori A, Tanimoto N, Nishida R, Hirano K, Wada Y, Matsuyama S, Shimada T, Akiyoshi H. Establishing cell lines for canine tonsillar and non-tonsillar oral squamous cell carcinoma and identifying characteristics associated with malignancy. Tissue Cell 2020; 67:101408. [PMID: 32835941 DOI: 10.1016/j.tice.2020.101408] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 02/07/2023]
Abstract
Canine tonsillar squamous cell carcinoma (TSCC) shows a higher metastasis rate than non-tonsillar oral SCC (NTSCC). The mechanisms of metastasis for TSCC have been less studied, because both TSCC and NTSCC cell lines are few. In this study, 6 cloned TSCC (TSCCLN#1-#6), which were from a metastatic lymph node, and 2 cloned NTSCC (oSCC-1 and -4) cell lines, which were from the primary lesion, were established, and their characteristics were evaluated in vitro and in vivo. Results showed that increased expression level of Vimentin in TSCC cell lines and increased expression levels of mesenchymal markers including Vimentin, Snail, and Slug in NTSCC cell lines corelated with the malignant phenotypes such as the cell growth and colony formation abilities in vitro. However, expression levels of mesenchymal markers and in vitro characteristics were unrelated to tumorigenic ability in nude mice. Additionally, the expression levels of E-cadherin and Vimentin were also evaluated by immunohistochemistry using the formalin-fixed paraffin embedded canine oral SCC tissues, and the results show that the expression level of Vimentin in TSCC was higher than in NTSCC. In conclusion, the cell lines established in this study might contribute to elucidating the mechanisms involved in TSCC metastasis.
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Affiliation(s)
- Shunsuke Noguchi
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan.
| | - Asuka Hattori
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Nanami Tanimoto
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Ruisa Nishida
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Kazuya Hirano
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Yusuke Wada
- Veterinary Medical Center, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Satoshi Matsuyama
- Laboratory of Veterinary Radiology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Terumasa Shimada
- Veterinary Medical Center, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku Ourai Kita, Izumisano-shi, Osaka 598-8531, Japan
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Wada Y, Kondo M, Sakairi K, Nagashima A, Tokita K, Tominaga H, Tomiyama H, Ishikawa T. Renoprotective Effects of a Novel Receptor-Interacting Protein Kinase 2 Inhibitor, AS3334034, in Uninephrectomized Adriamycin-Induced Chronic Kidney Disease Rats. J Pharmacol Exp Ther 2020; 374:428-437. [PMID: 32561685 DOI: 10.1124/jpet.120.265678] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/12/2020] [Indexed: 12/16/2022] Open
Abstract
Renal inflammation is a final common pathway of chronic kidney disease (CKD), and its progression can be used to effectively gauge the degree of renal dysfunction. Inflammatory mechanisms contribute to glomerulosclerosis and tubulointerstitial fibrosis, which are hallmarks of CKD leading to end-stage renal disease. Receptor-interacting protein kinase 2 (RIP2) is largely committed to nucleotide-binding oligomerization domain signaling as a direct effector and transmits nuclear factor-κB (NF-κB)-mediated proinflammatory cytokine production. In the present study, we hypothesized that if inflammation via RIP2 and NF-κB signaling plays an important role in renal failure, then the anti-inflammatory effect of RIP2 inhibitors should be effective in improving CKD. To determine its pharmacologic potency, we investigated the renoprotective properties of the novel RIP2 inhibitor AS3334034 [7-methoxy-6-(2-methylpropane-2-sulfonyl)-N-(4-methyl-1H-pyrazol-3-yl)quinolin-4-amine] in uninephrectomized adriamycin-induced CKD rats. Six weeks' repeated administration of AS3334034 (10 mg/kg, once daily) significantly reduced urinary protein excretion and prevented the development of glomerulosclerosis and tubulointerstitial fibrosis. In addition, AS3334034 showed beneficial effects on renal function, as demonstrated by a decrease in levels of plasma creatinine and blood urea nitrogen and attenuation of a decline in creatinine clearance. Furthermore, AS3334034 significantly attenuated inflammation, renal apoptosis, and glomerular podocyte loss. These results suggest that the RIP2 inhibitor AS3334034 suppresses the progression of chronic renal failure via an anti-inflammatory effect and is therefore potentially useful in treating patients with CKD. SIGNIFICANCE STATEMENT: The receptor-interacting protein kinase 2 (RIP2) inhibitor AS3334034 suppresses the progression of chronic renal failure via an anti-inflammatory effect, suggesting that the nucleotide-binding oligomerization domain-RIP2 axis might play a crucial role in the pathogenesis of inflammatory kidney diseases. AS3334034 is expected to be potentially useful in the treatment of patients with chronic kidney disease.
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Affiliation(s)
- Yusuke Wada
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Mitsuhiro Kondo
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Kumi Sakairi
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Akira Nagashima
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Kenichi Tokita
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Hiroaki Tominaga
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Hiroshi Tomiyama
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
| | - Tomohisa Ishikawa
- Drug Discovery Research, Astellas Pharma Inc., Ibaraki, Japan (Y.W., M.K., K.S., A.N., K.T., H.T.); Research and Development Department, Kotobuki Pharmaceutical Co., Ltd., Nagano, Japan (H.T.); and Department of Pharmacology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan (Y.W., T.I.)
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Wada Y, Sudo M, Kobayashi D, Kuroda T, Narita I. THU0155 SERUM MYOSTATIN IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ITS CORRELATION WITH BODY COMPOSITIONS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:Altered body composition is one of common findings in rheumatoid arthritis (RA), and it is estimated that up to two-thirds of patients may be affected loss of muscle mass and strength and concomitant increase in fat mass, so-called “rheumatoid cachexia”. Despite great advances in the treatment of RA such as biologics and small molecule compounds, it appears that rheumatoid cachexia persists even after joint inflammation improves. Myostatin, a member of the transforming growth factor-beta superfamily, is a potent negative regulator of skeletal muscle growth and its inactivation can induce skeletal muscle hypertrophy, while its overexpression or systemic administration causes muscle atrophy. It enhances proteolysis and inhibits protein synthesis in skeletal muscle, and has generated increasing interest as a potential regulator of cachexic status such as patients with cancers, cardiac failure, and HIV infections.Objectives:In this study, we investigated the possible role of myostatin for altered body compositions in patients with RA.Methods:This was a cross-sectional study. Ninety-six RA patients who visited Niigata University Hospital between April to June 2017, were recruited in this study. Body composition was measured by bioelectrical impedance analysis with a tetrapolar impedance meter (InBody S-10, InBody Japan Inc, Tokyo, Japan) in each subject. The right femoral neck bone density was measured using the dual energy X-ray absorption method (DEXA). Serum myostatin level was measured by enzyme-linked immunosorbent assay with a commercially available kit (Quantikine ELISA GDF-8/ Myostatin Immunoassay, R&D systems, MN, USA). Patients’ laboratory findings and disease activities were also measured, and the correlations between the titer of serum myostatin and these factors were analyzed by Spearman’s correlation coefficient and stepwise multiple regression analysis. A p-value of <0.05 was taken to denote statistical significance.Results:In Spearman’s correlation coefficient analysis, serum myostatin level was positively correlated with skeletal muscle mass index and FFMI, and negatively correlated with percent body fat (%BF), fat mass index (FMI), right femoral neck bone density, swollen joint counts, ESR, and DAS28(4)-ESR. In stepwise multiple regression analysis, FFMI was selected as a positive independent variable (rho=0.3620, p=0.00019) and DAS28(4)-ESR as a negative independent variable (rho=-0.2298, p=0.0154) against serum myostatin levels, respectively. In 70 female patients in this study, %BF and FMI/FFMI ratio was significantly higher in patients with low FFMI group, compared to those with normal FFMI group.Conclusion:Serum myostatin level was significantly correlated with body composition and disease activity in patients with RA. Patients with lower level of myostatin showed a trend of decreased skeletal muscle and increased body fat, suggesting serum myostatin as a possible biomarker for rheumatoid cachexia.References:[1]Elkan A-C, et al. Arthritis Res Therapy 2009; 11: R37.[2]Lemmey AB, et al. Rheumatology 2016; 55: 1736-45.[3]Rodriguez J, et al. Cell Mol Life Sci 2014; 71: 4361-71.Disclosure of Interests:None declared
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Kobayashi D, Wada Y, Hasegawa E, Wakamatsu A, Nakatsue T, Sato H, Kuroda T, Narita I. FRI0440 RISK FACTORS FOR CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH AUTOIMMUNE DISEASES. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The risk for opportunistic infections in patients with autoimmune diseases requiring intensive immunosuppressive therapy is high and cytomegalovirus (CMV) infection is one of the most common opportunistic infections. Since 2011, we have performed weekly CMV pp65 antigen testing for patients at risk of opportunistic infections owing to autoimmune diseases to ensure appropriate patient management.Objectives:To evaluate the risk factors that predict CMV infection in patients that received remission-induction therapy for autoimmune diseases.Methods:We enrolled 254 patients (93 male, 161 female) from our hospital with autoimmune disease and who received remission-induction therapy with prednisolone at a dose greater than 0.5 mg/kg/day between January 2011 and December 2018. We retrospectively analysed their clinical characteristics and laboratory data, including treatment regimens and CMV pp65 antigen test results. The presence of more than five CMV pp65 antigen-positive cells over two slides was considered a positive result. We conducted univariate and multivariate analyses to extract CMV risk factors.Results:Of the patients we evaluated, 60 suffered from systemic lupus erythematosus (SLE), 55 from anti-nucleolar cytoplasmic antibody-associated vasculitis (AAV), 31 from dermatomyositis (DM), 14 from interstitial pneumonia with anti-aminoacyl tRNA synthetase antibody, 14 from adult-onset Still’s disease (AOSD), 14 from rheumatoid arthritis (RA), 11 from mixed connective tissue disease (MCTD), 10 from Takayasu’s aortitis, and 45 suffered from other autoimmune diseases. Pulse therapy with methylprednisolone (mPSL) and immunosuppressive reagents were administered to 103 (40.6 %) and 97 (38.2 %), respectively. The median follow-up period was 61.0 days, and 66 patients became CMV pp65 antigen-positive during this period (SLE, 15; DM, 14; AAV, 9; AOSD, 8; and other, 20). Univariate analysis revealed that when compared to patients testing negative for the CMV pp65 antigen patients testing positive had lower total lymphocyte count (TLC) (825 /uL vs. 1220 /uL; p < 0.01), a lower serum albumin level (2.70 g/dL vs. 3.30 g/dL; p < 0.01), a higher HbA1c level (6.3 % vs. 5.9 %; p<0.01), and were older (66.0 vs. 59.5 year old; p < 0.01). Forty-nine of the 66 patients in the positive group received mPSL pulse therapy (p < 0.01), and 38 received immunosuppressive reagents (p < 0.01). Logistic regression analyses indicated that a higher age by decade (OR; 1.46 [95%CI 1.06 - 2.00]), a lower TLC per 100/uL (OR; 0.83 [95%CI 0.73 -0.94]), a higher HbA1c level per 1% (OR; 2.37 [95%CI 1.25-4.53]), and mPSL pulse therapy (OR; 3.92 [95%CI 1.33-11.5]) were risk factors for CMV pp65 antigen positivity.Conclusion:Higher age, lower TLC, higher HbA1c, and treatment with mPSL pulse therapy were risk factors for acquiring CMV infection, as measured by the presence of the CMV pp65 antigen, in patients receiving remission-induction therapy for autoimmune diseases. Careful monitoring of these, at risk, patients is necessary.Disclosure of Interests:None declared
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Wada Y, Sudo M, Kobayashi D, Kuroda T, Narita I. AB0539 URINARY INFLAMMATORY CELL ANALYSIS REFLECTS THE RENAL HISTOPATHOLOGY IN ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The anti-neutrophil cytoplasmic autoantibody (ANCA)- associated vasculitides (AAVs) include microscopic polyangiitis (MPA), granulomatosis with polyangitis (GPA), and eosinophilic granulomatosis with polyangitis (EGPA). These small-vessel vasculitides are characterized by necrotizing inflammation of the vessel wall, particularly affecting small arteries, arterioles, and capillaries in systemic organs, and the kidney is one of the most frequently involved organs. Although kidney biopsy is necessary for deciding the therapeutic protocol, it is invasive and is sometimes hard to perform biopsy because of patient’s severe general condition. We have already reported that T cells and macrophages appear in the urine of patients with glomerulonephritis, accompanied by active cellular infiltration such as cellular crescent formation and diffuse interstitial cell infiltration, but not in the urine of patients with glomerulonephritis without the active inflammatory lesions.Objectives:In this study, we examined the utility of urinary inflammatory cell analysis for accessing kidney histopathological findings in AAVs.Methods:This was a cross-sectional, retrospective chart study. Thirty-six AAV patients who had been referred to Niigata University Hospital between 2002 and 2018, and performed percutaneous kidney biopsy and urinary inflammatory cell analysis, were participated in this study. Thirty-two patients had MPA, and 4 had GPA. The kidney biopsy findings were classified into Berden’s classification (a method to categorize glomerular lesions into four classes) and Neumann’s classification (a method to evaluate glomerular, tubulo-interstitial, and vascular lesions by using activity indexes and chronicity indexes). Flow-cytometric analysis of urinary inflammatory cells was performed for each subject. Numbers of urinary T cells or macrophages were determined by multiplying the number of viable cells in the gated mononuclear cell region in each sample by the percentage of urinary CD3-positive or CD14-positive cells in the population, respectively. The correlations between the results of both methods and the numbers of urinary inflammatory cells were examined using Kruskal-Wallis test and Spearmann’s rank correlation coefficient. A p-value of <0.05 was taken to denote statistical significance.Results:The numbers of urinary inflammatory cells showed a trend of increase in crescentic category without statistical significance in Berden’s classification. Meanwhile, activity indexes had significant positive correlations with the number of urinary CD3-positive cells (r = 0.541, p = <0.001), CD14-positive cells (r = 0.354, p = 0.034), and total inflammatory cells (r = 0.449, p = 0.006) in Neumann’s classification.Conclusion:The numbers of urinary inflammatory cells reflect the active lesions of kidney histopathological findings, and these results indicate the usefulness of urinary inflammatory cell analysis for assessment of kidney biopsy findings in patients with AAVs.References:[1]Berden AE, et al. J Am Soc Nephrol. 2010 Oct;21(10):1628-36. 2) Neumann I, et al. Nephrol Dial Transplant. 2005 Jan;20(1):96-104.Disclosure of Interests:None declared
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Kobayashi D, Hasegawa E, Wada Y, Ito S, Abe A, Nakazono K, Murasawa A, Narita I, Ishikawa H. SAT0147 EFFICACY AND SAFETY OF IGURATIMOD AS FIRST-LINE DISEASE-MODIFYING ANTIRHEUMATIC DRUG THERAPY FOR PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Although methotrexate is the anchor drug, it took some days to check contraindications, such as interstitial pneumonia, hepatitis B virus infection, and latent tuberculosis infection. Therefore, we sometimes start rheumatoid arthritis (RA) treatment with other disease-modifying antirheumatic drug (DMARD) in daily clinical setting. Iguratimod (IGU) is a newly developed DMARD approved in Japan in September 2012, and the efficacy of IGU for DMARD naïve patients has not been thoroughly evaluated.Objectives:The aim of this prospective single-center study was to demonstrate the efficacy and safety of IGU when used as a first-line daily DMARD for patients with RA in a clinical setting.Methods:Enrolled patients included those diagnosed with RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) classification criteria who took IGU as a first-line DMARD at Niigata Rheumatic Center between April 2016 and December 2018 (IGU group). There were no constraints regarding the addition or withdrawal of other DMARDs. Details of the patients’ background, clinical parameters, and laboratory findings were obtained, including C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), matrix metalloprotease-3 (MMP-3), rheumatoid factor (RF), Disease Activity Score for 28-joint counts based on the erythrocyte sedimentation rate (DAS28-4[ESR]), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire Disability Index (HAQ-DI). The efficacy of IGU was evaluated at week 24. The IGU group’s data were then compared with 64 patients who took salazosulfapyridine or bucillamine as first-line DMARD in our hospital (other DMARD group). The data were expressed as median values. Comparisons between the parameters were performed using nonparametric method.Results:Forty-three patients (15 males, 28 females) received IGU as a first-line DMARD for RA. The age was 69.0 years and the duration of disease was 2.0 months. Twenty patients received prednisolone (PSL) concomitantly at a median dose of 5.0 mg/day. At 24 weeks medications were utilized in patients as follows: IGU in 36 (83.7 %), methotrexate in 18 (41.2%), PSL in 17 (39.5%), BUC in 10 (23.2 %), and biological DMARD in 7 (15.2 %) patients. Although 7 patients discontinued taking IGU due to liver enzyme elevation (n=4), nausea (n=1), creatinine elevation (n=1), and skin rash (n=1) during the 24-week period, serious adverse events requiring hospitalization were not observed. Clinical parameters that improved from baseline after 24 weeks of treatment included: ESR from 42.0 mm/h to 16.0 mm/h with p < 0.001; CRP from 0.70 mg/dL to 0.10 mg/dL with p< 0.001; MMP-3 from 136 ng/mL to 91.5 ng/mL with a p value of 0.11; RF went from 18.0 IU/mL to 8.00 IU/mL with p < 0.001; DAS28(4)-ESR dropped from 5.13 to 2.73 with p< 0.001; CDAI dropped from 20.0 to 5.00 with p< 0.001, and HAQ-DI decreased from 0.55 to 0.00 with p< 0.001. Patients who achieved a good or moderate response based on EULAR response at 24 weeks, included 90.7% in the IGU group versus 70.5% in the other DMARD group (Fisher`s exact test, p=0.046). The retention rate of the IGU group was 81.4 %, roughly equivalent to the 81.2% retention rate in the other DMARD group (Log-rank test, p=0.733).Conclusion:Our study indicates IGU is safe and effective for DMARD naïve RA patients. Starting treatment with IGU might be a new and effective strategy for RA patients without previous use of a DMARD.Disclosure of Interests:Daisuke Kobayashi: None declared, Eriko Hasegawa: None declared, Yoko Wada: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Asami Abe: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared
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Morita C, Tanaka M, Noguchi S, Shimamura S, Wada Y, Izawa T, Yamate J, Kuwamura M. An aortic body carcinoma with sarcomatoid morphology and chondroid metaplasia in a French Bulldog. J Vet Med Sci 2020; 82:576-579. [PMID: 32161252 PMCID: PMC7273586 DOI: 10.1292/jvms.20-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An 11-year-old female French Bulldog was presented with a mass at the base of the heart, detected by X-ray and echocardiography. Clinical abnormality included abdominal retention by
ascites. Radiation therapy was performed for 5 weeks. The mass volume didn’t change during the radiotherapy. The condition became worse and the dog died 6 months after the initial
presentation and necropsy was performed. Grossly, the mass, 12.5 × 6.5 × 6.0 cm in size, was found at the base of the heart. Histopathological examination revealed that cardiac mass was
composed of alveolar, bundle and diffuse proliferation of neoplastic cells. Most of the neoplastic cells showed a spindle morphology; in some areas small round or polyhedral neoplastic cells
were observed. Occasional cartilage metaplasia was seen multifocal in the mass, and it was surrounded by the sarcomatoid proliferation. Electron microscopy revealed a few neuroendocrine
granules in the cytoplasm of spindle and polyhedral neoplastic cells. Metastatic cells in the lungs which had not irradiated demonstrated typical morphology of aortic body tumors. Based on
these findings, the case was diagnosed as an aortic body carcinoma with sarcomatoid morphology and chondroid metaplasia.
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Affiliation(s)
- Chiaki Morita
- Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Miyuu Tanaka
- Veterinary Medical Center, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Shunsuke Noguchi
- Veterinary Medical Center, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Shunsuke Shimamura
- Veterinary Medical Center, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Yusuke Wada
- Veterinary Medical Center, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Takeshi Izawa
- Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Jyoji Yamate
- Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
| | - Mitsuru Kuwamura
- Laboratory of Veterinary Pathology, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka 598-8531, Japan
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Wada Y, Aoki T, Murakami M, Fujimori A, Koizumi T, Kusano T, Matsuda K, Nogaki K, Hakozaki T, Shibata H, Tomioka K. Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy. BMC Surg 2020; 20:32. [PMID: 32054460 PMCID: PMC7017478 DOI: 10.1186/s12893-020-00694-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 02/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT). METHODS Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach. RESULTS Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery. CONCLUSION The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.
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Affiliation(s)
- Yusuke Wada
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan.
| | - Takeshi Aoki
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Masahiko Murakami
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Akira Fujimori
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Tomotake Koizumi
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Tomokazu Kusano
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Kazuhiro Matsuda
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Koji Nogaki
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Tomoki Hakozaki
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Hideki Shibata
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Kodai Tomioka
- Division of Gastroenterological Surgery and General Surgery, Department of Surgery, School of Medicine, Showa University, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, Japan
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Fujioka T, Fujisawa TX, Inohara K, Okamoto Y, Matsumura Y, Tsuchiya KJ, Katayama T, Munesue T, Tomoda A, Wada Y, Kosaka H. Attenuated relationship between salivary oxytocin levels and attention to social information in adolescents and adults with autism spectrum disorder: a comparative study. Ann Gen Psychiatry 2020; 19:38. [PMID: 32518579 PMCID: PMC7275403 DOI: 10.1186/s12991-020-00287-2] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 05/23/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previous research studies have assessed the relationship between attention to social information and peripheral (e.g., plasma and salivary) oxytocin (OT) levels in typically developing (TD) children and children with autism spectrum disorder (ASD). A relationship between them was observed in TD children, but not in children with ASD. However, this relationship remains unexamined in other age groups. To clarify whether this lack of association is maintained throughout development in individuals with ASD, we aimed to assess the relationship between salivary OT levels and attention to social information in adolescents and adults with and without ASD. METHODS We recruited male adolescents and adults with ASD (n = 17) and TD participants (n = 24). Using the all-in-one eye-tracking system Gazefinder, we measured the percentage fixation time allocated to social information. We also measured the salivary OT levels and Autism Spectrum Quotient (AQ) of participants. Subsequently, we confirmed group differences and conducted a correlation analysis to investigate the relationships between these three measures. RESULTS Salivary OT levels did not show any significant difference between the ASD and TD groups and were negatively correlated with the AQ in the whole-group analysis, but not in within-group analysis. Individuals with ASD had significantly lower percentage fixation times than did TD individuals for eye regions in human faces with/without mouth motion, for upright biological motion, and for people regions in the people and geometry movies. The percentage of fixation for geometric shapes in the people and geometry movies was significantly higher in the ASD than in the TD group. In the TD group, salivary OT levels were positively correlated with percentage fixation times for upright biological motion and people and negatively correlated with inverted biological motion and geometry. However, no significant correlations were found in the ASD group. CONCLUSIONS Our exploratory results suggest that salivary OT levels in adolescents and adults with ASD are less indicative of attention to social stimuli than they are in TD adolescents and adults. It is suggested that their association is slightly weaker in adolescents and adults with ASD and that this attenuated relationship appears to be maintained throughout development.
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Affiliation(s)
- T Fujioka
- Faculty of Education, University of Fukui, Fukui, Fukui Japan.,Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui Japan
| | - T X Fujisawa
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui Japan
| | - K Inohara
- College of Liberal Arts and Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui Japan
| | - Y Okamoto
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui Japan.,Waseda Institute for Advanced Study, Waseda University, Shinjuku, Tokyo Japan
| | - Y Matsumura
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui Japan
| | - K J Tsuchiya
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Japan.,Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Japan
| | - T Katayama
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan
| | - T Munesue
- Kaga Mental Hospital, Kaga, Ishikawa Japan
| | - A Tomoda
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui Japan
| | - Y Wada
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui Japan.,Kaga Mental Hospital, Kaga, Ishikawa Japan
| | - H Kosaka
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Suita, Osaka Japan.,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui Japan.,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui Japan
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Hoshino Y, Shimohara S, Wada Y, Nakamoto M, Miura Y. Affinity purification of multifunctional oligomeric ligands synthesizedviacontrolled radical polymerization. J Mater Chem B 2020; 8:5597-5601. [DOI: 10.1039/d0tb00849d] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abiotic oligomeric ligands with a strong affinity for a target peptide sequence were isolated by affinity purification from a pool of 30-mer acrylic random ter-oligomers that were synthesizedviaa controlled radical polymerization process.
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Affiliation(s)
- Yu Hoshino
- Department of Chemical Engineering
- Graduate School of Engineering
- Kyushu University
- Fukuoka 819-0395
- Japan
| | - Shinnosuke Shimohara
- Department of Chemical Engineering
- Graduate School of Engineering
- Kyushu University
- Fukuoka 819-0395
- Japan
| | - Yusuke Wada
- Department of Chemical Engineering
- Graduate School of Engineering
- Kyushu University
- Fukuoka 819-0395
- Japan
| | - Masahiko Nakamoto
- Department of Chemical Engineering
- Graduate School of Engineering
- Kyushu University
- Fukuoka 819-0395
- Japan
| | - Yoshiko Miura
- Department of Chemical Engineering
- Graduate School of Engineering
- Kyushu University
- Fukuoka 819-0395
- Japan
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Khatun H, Ihara Y, Takakura K, Wada Y, Yamanaka KI. 47 Inhibition of endoplasmic reticulum stress during invitro maturation improves the developmental competence of bovine cumulus-oocyte complexes. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Endoplasmic reticulum (ER) stress, a dysfunction in protein-folding capacity of ER, is involved in many physiological responses including embryonic development. Evidence shows that the ER stress-induced unfolded protein response signaling pathway is associated with impairment of oocyte maturation and pre-implantation embryonic development; supplementation of culture medium with tauroursodeoxycholic acid (TUDCA), an ER stress inhibitor, improved the developmental process of oocytes and embryos by attenuating ER stress. However, no reports are available on the role of TUDCA in reducing ER stress during IVM of bovine oocytes. Therefore, the aim of this study was to examine the mechanism of TUDCA on reducing ER stress in maturation of bovine cumulus-oocyte complexes (COCs) and whether inhibition of ER stress during maturation can promote subsequent embryonic development. Bovine ovaries were collected from a local slaughterhouse, and after aspiration COCs were matured with/without TUDCA (50, 100, and 200 µM) for 22h at 38.5°C in a humidified atmosphere of 5% CO2. After IVM, we examined the maturation rate, reactive oxygen species, apoptosis, protein/mRNA expression levels, and subsequent embryonic development after IVF. The data were analysed using analysis of variance followed by the Tukey-Kramer multiple comparison test. As a result, the dose-dependent experiment shows that a 100μM concentration of TUDCA significantly increased the maturation rate and decreased the percentage of apoptotic cells in COCs and reactive oxygen species levels in denuded oocytes. Subsequently, the expression of ER stress inducible protein GRP78/BIP significantly decreased in COCs treated with 100 µM TUDCA compared with the control COCs. In addition, the mRNA expression of ER stress and pro-apoptotic markers (GRP78/BIP, PERK, IER1, ATF4, XBP1, CHOP, and BAX) in COCs were significantly decreased by TUDCA (100 µM) treatment, whereas it increased anti-apoptotic BCL2 expression. Moreover, we show that TUDCA (100 µM) supplementation enhances embryonic development by significantly increasing the blastocyst formation rate (43.6±1.8% vs. 49.7±1.3%) and decreasing the number of apoptotic cells (7.7±1.1% vs. 5.03±0.6%) in blastocysts. These findings suggest that existence of ER stress during maturation alters the developmental competence of bovine COCs. Therefore, for the first time, we demonstrate that application of TUDCA during IVM plays a crucial role in reducing ER stress and improves the meiotic maturation, oocyte quality, and subsequent embryonic development invitro.
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Ihara Y, Tatakura K, Wada Y, Kawahara H, Yamanaka K. 34 Effect of polysaccharide from Flammulina velutipes on the vitrification of bovine oocytes. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The developmental competence of oocytes after cryopreservation is compromised by the physical injury due to the ice crystallisation. Recent studies have reported that polysaccharide (xylomannan) derived from the mycelium and fruit body of the basidiomycete Flammulina velutipes inhibits the ice recrystallisation in the cryopreserved Chinese hamster ovary cells. In this study, we aimed to clarify the effect of xylomannan from Flammulina velutipes on the developmental competence of bovine vitrified oocytes. Bovine ovaries were obtained from a local abattoir, and cumulus-oocyte complexes (COCs) were aspirated from follicles (2-6mm in diameter) using a 19-gauge needle attached to a syringe. The COCs were matured for 22h in tissue culture medium-199 supplemented with 5% fetal bovine serum (FBS), 0.02IUmL−1 FSH, and 10μgmL−1 gentamycin. After maturation, COCs were incubated in base solution (BS: 10% FBS-tissue culture medium-199, control group; n=149) or BS supplemented with 100μgmL−1 xylomannan (xylomannan group; n=175) for 1h before vitrification. All vitrification procedures were performed at room temperature. The COCs were equilibrated in BS with 3% ethylene glycol for 12min and then in vitrification solution (BS with 30% ethylene glycol, 1.0M sucrose) for 1min. The COCs were loaded on a Cryotop (Kitazato) and transferred into liquid nitrogen. The warming procedure was performed on a warm plate (42°C). The COCs were placed into BS supplemented with 0.5, 0.25, 0.125, and 0M sucrose for 5min each. After washing with IVF100 solution (Research Institute for the Functional Peptide), COCs were applied for IVF. The viability of putative zygotes was morphologically evaluated following IVF, and ones that survived were cultured in CR1aa supplemented with 5% FBS. The cleavage pattern was evaluated at 28h after IVF as follows: embryos with blastomeres of the same size without fragmentation were classified as normal cleavage; embryos with 2 blastomeres and several small fragments, direct cleavage from the 1-cell stage to 3 or 4 blastomeres, or 2 blastomeres of different size were classified as abnormal cleavage. The rates of cleavage and blastocyst formation were calculated on 2 and 8 days after culture, respectively. Total cell number and apoptosis of blastocysts were measured by terminal deoxynucleotidyl transferase dUTP nick end labelling assay. All data were obtained from more than four replicates. Viability and invitro development data were analysed using the chi-squared test. Total cell number and apoptosis data were analysed by a Student's t-test. Although no significant differences in viability, cleavage pattern, and cleavage rate (85.8 vs. 80.3%, 17.2 vs. 14.8%, and 35.4 vs. 36.7%, respectively) were observed, the developmental rate to blastocysts in the xylomannan group was significantly higher than that in the control group (68.6 vs. 42.2%; P<0.01). The present results suggest that co-incubation with xylomannan before vitrification is an effective method to improve the vitrification outcome in bovine oocytes.
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Immerzeel WW, Lutz AF, Andrade M, Bahl A, Biemans H, Bolch T, Hyde S, Brumby S, Davies BJ, Elmore AC, Emmer A, Feng M, Fernández A, Haritashya U, Kargel JS, Koppes M, Kraaijenbrink PDA, Kulkarni AV, Mayewski PA, Nepal S, Pacheco P, Painter TH, Pellicciotti F, Rajaram H, Rupper S, Sinisalo A, Shrestha AB, Viviroli D, Wada Y, Xiao C, Yao T, Baillie JEM. Importance and vulnerability of the world’s water towers. Nature 2019; 577:364-369. [DOI: 10.1038/s41586-019-1822-y] [Citation(s) in RCA: 477] [Impact Index Per Article: 95.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/11/2019] [Indexed: 11/09/2022]
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Satou A, Wada Y, Sibamoto Y, Yonomoto T. Study on dryout and rewetting during accidents including ATWS for the BWR at JAEA. Nuclear Engineering and Design 2019. [DOI: 10.1016/j.nucengdes.2019.110164] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Igarashi T, Aursand M, Sacchi R, Paolillo L, Nonaka M, Wada Y, Arata Y, Bildsoe H, Falcigno L, Fauhl C, Guillou C, Halvorsen J, Honma E, Ijuuin Y, Kushida K, Martin GJ, Miyake Y, Optum OI, Oshima Y, Remaud G, Retif M, Robins R, Satake M, Shimidzu N, Tsuchiya F, Watanabe K, Watanuki C. Determination of Docosahexaenoic Acid and n-3 Fatty Acids in Refined Fish Oils by H-NMR Spectroscopy: IUPAC Interlaboratory Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.6.1341] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A high-resolution proton nuclear magnetic resonance (NMR) method for determining the concentration (mg/g) of docosahexaenoic acid (DHA), the molar proportion (mol%) of DHA, and the molar proportion of total n-3 fatty acids in fish oils was validated by an IUPAC interlaboratory study (the Commission VI-6 on Oils, Fats, and Derivatives WG 3/98). Thirteen laboratories from 5 countries tested 6 pairs of blind duplicate fish oils: a refined tuna oil, 2 extracted tuna oils, an extracted bonito oil, an extracted salmon oil, and an extracted sardine oil ranging from 9 to 30 mol% DHA and from 20 to 35 mol% n-3 fatty acids. Before 1D-proton NMR measurements with 300–500 MHz instruments, oil samples were weighed and diluted with deuterochloroform solution containing ethylene glycol dimethyl ether as internal standard. To achieve precise performance, a detailed procedure for signal area measurement was described in the protocol, and all participants were instructed about the critical importance of following the protocol. Statistical performances with invalid and outlier data removed were as follows: repeatability relative standard deviations (RSDr) ranged from 0.91 to 2.62% and reproducibility relative standard deviation (RSDR) ranged from 1.73 to 4.27% for DHA concentration (mg/g); RSDr ranged from 0.39 to 2.06%, and RSDR ranged from 0.59 to 3.46% for mol% DHA; RSDr ranged from 0.23 to 0.90% and RSDR ranged from 0.85 to 2.01% for mol% total n-3 fatty acids. The method is expected to be recommended by IUPAC.
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Affiliation(s)
- Tomoji Igarashi
- Japan Marine Oil Association, 32-7 Motoyoyogi-cho, Shibuya-ku, 151-0062, Tokyo, Japan; Japan Food Research Laboratories, Tama Laboratory, 6-11-10 Nagayama, Tama-shi, 206-0025, Tokyo, Japan
| | - Marit Aursand
- SINTEF, Division of Applied Chemistry, Fisheries and Aquaculture, N-7034, Trondheim, Norway
| | - Raffaele Sacchi
- University of Naples Federico II, Department of Food Science, Parco Gussone, 80055 Portici, Italy
| | - Livio Paolillo
- University of Naples Federico II, Department of Chemistry, via Mezzocannone 4, 80134 Naples, Italy
| | - Michio Nonaka
- Japan Marine Oil Association, 32-7 Motoyoyogi-cho, Shibuya-ku, 151-0062, Tokyo, Japan
| | - Y Wada
- Tokyo University of Fisheries, Department of Food Science and Technology, 4-5-7 Konan, Minato-ku, 108-8477, Tokyo, Japan
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