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Kato S, Mori H, Saiga M, Watanabe S, Sasada S, Sasaki A, Ogiya A, Yamamoto M, Narui K, Takano J, Seki H, Nagura N, Ishitobi M, Shien T. Nipple-areolar complex malposition in breast reconstruction after nipple-sparing mastectomy: a multi-institutional retrospective observational study in Japan. Breast Cancer 2024:10.1007/s12282-024-01578-2. [PMID: 38589713 DOI: 10.1007/s12282-024-01578-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Position of the nipple-areolar complex (NAC) is an important factor in the esthetic impression of the breast, and NAC malposition is often an issue in breast reconstruction after nipple-sparing mastectomy (NSM). The purpose of this study was to evaluate the degree of NAC malposition depending on several factors using data quantified with the Mamma Balance application (Medic Engineering K.K., Kyoto, Japan). METHODS Patients who underwent unilateral breast reconstruction after NSM at eight hospitals in Japan between 2007 and 2020 were retrospectively investigated. Using Mamma Balance, NAC malposition was quantified separately in horizontal and vertical directions using patient photographs from pre-operatively and 6-24 months post-operatively. The degree of malpositioning was then statistically compared using various factors. RESULTS The NAC deviated more cranially and medially with implants than that with flaps. Cases with latissimus dorsi flap showed lateral malposition more often than cases with deep inferior epigastric artery perforator flap. With flaps, lateral incisions showed more lateral malposition, and peri-areolar incisions tended to show more medial NAC malposition. In cases with severe post-operative infection of the implant, the NAC tended to deviate cranially. In radiation cases, the NAC deviated cranially. No significant difference was observed according to the degree of breast ptosis or use of the pull-down operation. Only a very weak correlation was observed between a larger amount of mastectomy and more cranial NAC malposition with both flaps and implants. CONCLUSIONS This study provides insights into the tendencies and characteristics of NAC malposition.
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Affiliation(s)
- Sayuri Kato
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
| | - Hiroki Mori
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan.
| | - Miho Saiga
- Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan
| | - Satoko Watanabe
- Department of Plastic and Reconstructive Surgery, Okayama University, Okayama, Japan
| | - Shinsuke Sasada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Akiko Ogiya
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Mao Yamamoto
- Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8510, Japan
- Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Junji Takano
- Department of Plastic Surgery, Saitama Medical Center, Saitama, Japan
| | - Hirohito Seki
- Department of Surgery, Saitama Medical Center, Saitama, Japan
- Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Naomi Nagura
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University Hospital, Mie, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
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Kadono M, Nakashima A, Ishiuchi N, Sasaki K, Miura Y, Maeda S, Fujita A, Sasaki A, Nagamatsu S, Masaki T. Adipose-derived mesenchymal stem cells cultured in serum-free medium attenuate acute contrast-induced nephropathy by exerting anti-apoptotic effects. Stem Cell Res Ther 2023; 14:337. [PMID: 37993965 PMCID: PMC10664307 DOI: 10.1186/s13287-023-03553-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/30/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Contrast-induced nephropathy (CIN) is a major clinical problem associated with acute kidney injury during hospitalization. However, effective treatments for CIN are currently lacking. Mesenchymal stem cells (MSCs) have protective effects against kidney injury by suppressing inflammation and fibrosis. We previously showed that MSCs cultured in serum-free medium (SF-MSCs) enhance their anti-inflammatory and anti-fibrotic effects. However, whether SF-MSCs potentiate their anti-apoptotic effects is unknown. Here, we investigated the effects of SF-MSCs on a CIN mouse model. METHODS To create CIN model mice, we removed right kidney at first. One week later, the left renal artery was clamped for 30 min to cause ischemia-reperfusion injury, and mice were injected with iohexol. Then the kidney received 10 Gy of irradiation, and MSCs or SF-MSCs were injected immediately. At 24 h post-injection, mice were sacrificed, and their blood and kidneys were collected to evaluate renal function, DNA damage, and apoptosis. In addition, apoptosis was induced in HEK-293 cells by irradiation and cells were treated with conditioned medium from MSCs or SF-MSCs. RESULTS Treatment of CIN model mice with SF-MSCs markedly improved renal function compared with MSCs treatment. Cleaved caspase-3 levels and TUNEL-positive cell numbers were strongly suppressed in CIN model mice treated with SF-MSCs compared with the findings in those treated with MSCs. γH2AX levels, a chromosome damage marker, were reduced by MSCs and further reduced by SF-MSCs. In addition, cleaved caspase-3 in irradiated HEK-293 cells was more strongly suppressed by conditioned medium from SF-MSCs than by that from MSCs. Secretion of epidermal growth factor (EGF) was enhanced by culturing MSCs in serum-free medium. Knockdown of EGF by siRNA attenuated the inhibitory effects of SF-MSCs on CIN-induced renal dysfunction and tubular apoptosis. CONCLUSIONS These findings strongly suggest that SF-MSCs improve CIN in model mice by exerting anti-apoptotic effects in a paracrine manner. Thus, SF-MSCs represent a potential novel therapy for CIN.
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Affiliation(s)
- Mitsuki Kadono
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Ayumu Nakashima
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Naoki Ishiuchi
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kensuke Sasaki
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yoshie Miura
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- TWOCELLS Company, Limited, 16-35 Hijiyama-Honmachi, Minami-ku, Hiroshima, 732-0816, Japan
| | - Satoshi Maeda
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- TWOCELLS Company, Limited, 16-35 Hijiyama-Honmachi, Minami-ku, Hiroshima, 732-0816, Japan
| | - Asuka Fujita
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takao Masaki
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Imai H, Yoshida S, Mese T, Roh S, Sasaki A, Nagamatsu S, Koshima I. Osteocutaneous superficial circumflex iliac perforator flap for the lower extremity bone and soft tissue reconstruction with perforator-to-perforator anastomosis after radical debridement of tibia osteomyelitis: A case report. Microsurgery 2023; 43:713-716. [PMID: 37605559 DOI: 10.1002/micr.31100] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 08/23/2023]
Abstract
Reconstruction of soft tissue and bone defects in tibia chronic osteomyelitis is challenging and often managed by free flap with bone graft. However, the use of osteocutaneous free flap combined with perforator-to-perforator anastomosis has not been reported. We report the case of a 62-year-old man presenting with soft tissue and bone defects with right tibial chronic osteomyelitis, which was successfully treated with an osteocutaneous superficial circumflex iliac perforator (SCIP) flap with perforator-to-perforator anastomosis. After radical debridement and excision of the sequestrum, a 17 × 10-cm skin defect and a 4 × 3-cm bone defect remained. An osteocutaneous SCIP flap, containing a 16 × 9-cm skin paddle and 4 × 2-cm iliac bone, was transferred and anastomosed to the posterior tibial perforator in an end-to-end fashion. An artificial dermis was placed to cover the soft tissue. At 1 week postoperatively, the artificial dermis was partially infected, which required small debridement. Full weight-bearing was permitted 5 weeks postoperatively, and the patient walked independently. No evidence of recurrence of osteomyelitis or skin ulcers was observed at 15 months postoperatively. Therefore, osteocutaneous SCIP flap with perforator-to-perforator anastomosis may be a potential alternative treatment for soft tissue and bone defects after radical debridement of tibia osteomyelitis.
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Affiliation(s)
- Hirofumi Imai
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshiro Mese
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Solji Roh
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
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Iida Y, Higashi Y, Nishi O, Kouda M, Maeda K, Yoshida K, Asano S, Kawakami T, Nakajima K, Kuroda K, Tanaka C, Sasaki A, Kamiya K, Yamagishi N, Fujinaga M, Terami F, Yamanaka S, Kubota M. Entomopathogenic fungus Beauveria bassiana-based bioinsecticide suppresses severity of powdery mildews of vegetables by inducing the plant defense responses. Front Plant Sci 2023; 14:1211825. [PMID: 37692425 PMCID: PMC10484095 DOI: 10.3389/fpls.2023.1211825] [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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023]
Abstract
The entomopathogenic fungus Beauveria bassiana is used commercially as a microbial insecticides against a wide range of agricultural insect pests. Some strains of B. bassiana protect the plants from pathogens, but the underlying mechanisms are largely unknown. Here, we found that prophylactic sprays of commercial bioinsecticide Botanigard on cucumber, tomato, and strawberry plants suppressed the severity of economically damaging powdery mildews. On leaf surfaces, hyphal elongation and spore germination of cucumber powdery mildew, Podosphaera xanthii, were inhibited, but B. bassiana strain GHA, the active ingredient isolated from Botanigard, only inhibited hyphal elongation but had no effect on spore germination of P. xanthii. In addition, strain GHA suppressed powdery mildew symptoms locally, not systemically. Treatment with Botanigard and strain GHA induced a hypersensitive response (HR)-like cell death in epidermal cells of the cucumber leaves in a concentration-dependent manner and inhibited penetration by P. xanthii. Transcriptome analysis and mass spectrometry revealed that GHA induced expression of salicylic acid (SA)-related genes, and treatment with Botanigard and GHA increased the SA level in the cucumber leaves. In NahG-transgenic tomato plants, which do not accumulate SA, the biocontrol effect of tomato powdery mildew by GHA was significantly reduced. These results suggested that B. bassiana GHA induces SA accumulation, leading to the induction of HR-like cell death against powdery mildew and subsequent suppression of fungal penetration. Thus, Botanigard has the potential to control both insect pests and plant diseases.
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Affiliation(s)
- Yuichiro Iida
- Laboratory of Plant Pathology, Faculty of Agriculture, Setsunan University, Hirakata, Japan
- National Agriculture and Food Research Organization, Tsu, Japan
| | - Yumiko Higashi
- National Agriculture and Food Research Organization, Tsu, Japan
| | - Oumi Nishi
- National Agriculture and Food Research Organization, Tsu, Japan
| | - Mariko Kouda
- Laboratory of Plant Pathology, Faculty of Agriculture, Setsunan University, Hirakata, Japan
| | - Kazuya Maeda
- Laboratory of Plant Pathology, Faculty of Agriculture, Setsunan University, Hirakata, Japan
| | - Kandai Yoshida
- Nara Prefecture Agricultural Research and Development Center, Sakurai, Japan
| | - Shunsuke Asano
- Nara Prefecture Agricultural Research and Development Center, Sakurai, Japan
| | - Taku Kawakami
- Mie Prefecture Agricultural Research Institute, Matsusaka, Japan
| | - Kaori Nakajima
- Mie Prefecture Agricultural Research Institute, Matsusaka, Japan
| | | | - Chiharu Tanaka
- Mie Prefecture Agricultural Research Institute, Matsusaka, Japan
| | - Ayano Sasaki
- Mie Prefecture Agricultural Research Institute, Matsusaka, Japan
| | - Katsumi Kamiya
- Gifu Prefectural Agricultural Technology Center, Gifu, Japan
| | - Naho Yamagishi
- Nagano Vegetable and Ornamental Crops Experiment Station, Shiojiri, Japan
| | - Masashi Fujinaga
- Nagano Vegetable and Ornamental Crops Experiment Station, Shiojiri, Japan
| | - Fumihiro Terami
- National Agriculture and Food Research Organization, Tsu, Japan
| | | | - Masaharu Kubota
- National Agriculture and Food Research Organization, Tsukuba, Japan
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Imai H, Kawase T, Yoshida S, Mese T, Roh S, Fujita A, Uchiki T, Sasaki A, Nagamatsu S, Takazawa A, Ichinohe T, Koshima I. Peripheral T cell profiling reveals downregulated exhaustion marker and increased diversity in lymphedema post-lymphatic venous anastomosis. iScience 2023; 26:106822. [PMID: 37250774 PMCID: PMC10212982 DOI: 10.1016/j.isci.2023.106822] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/17/2023] [Accepted: 05/02/2023] [Indexed: 05/31/2023] Open
Abstract
Lymphedema is a progressive condition accompanying cellulitis and angiosarcoma, suggesting its association with immune dysfunction. Lymphatic venous anastomosis (LVA) can provide relief from cellulitis and angiosarcoma. However, the immune status of peripheral T cells during lymphedema and post-LVA remains poorly understood. Using peripheral blood T cells from lymphedema, post-LVA, and healthy controls (HCs), we compared the profile of T cell subsets and T cell receptor (TCR) diversity. PD-1+ Tim-3 + expression was downregulated in post-LVA compared with lymphedema. IFN-γ levels in CD4+PD-1+ T cells and IL-17A levels in CD4+ T cells were downregulated in post-LVA compared with lymphedema. TCR diversity was decreased in lymphedema compared with HCs; such TCR skewing was drastically improved in post-LVA. T cells in lymphedema were associated with exhaustion, inflammation, and diminished diversity, which were relieved post-LVA. The results provide insights into the peripheral T cell population in lymphedema and highlight the immune modulatory importance of LVA.
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Affiliation(s)
- Hirofumi Imai
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Takakazu Kawase
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
- International Center for Cell and Gene Therapy, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Toshiro Mese
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Solji Roh
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Asuka Fujita
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Toshio Uchiki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Atsushi Takazawa
- Department of Orthopaedic Surgery, Hiroshima Hiramatsu Hospital, Hiroshima 732-0816, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
| | - Isao Koshima
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
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Shirai Y, Sasaki A, Sato S, Aoki D, Arimitsu K. Fabrication of an Organic-Inorganic Hybrid Hard Coat with a Gradient Structure Controlled by Photoirradiation. ACS Appl Mater Interfaces 2023. [PMID: 37276382 DOI: 10.1021/acsami.3c04399] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Organic-inorganic materials have attracted attention because of the advantages of both organic and inorganic resins. Among their disadvantages, hard coating films made of organic-inorganic mixtures of resins have opacity and interface peeling problems because of organic-inorganic phase separation and surface segregation of inorganic resins. Although an organic-inorganic gradient-structured material comprising an inorganic-rich domain at the air interface and an organic-rich domain at the organic substrate has the potential to solve these problems, the fabrication of a gradient-structured material has not yet been achieved. Here, we describe the fabrication of an organic-inorganic gradient film by impeding the movement of organic and inorganic resins through radical photopolymerization of organic and inorganic oligomers. Moreover, we successfully enhanced gouge hardness by cross-linking with photobase-catalyzed sol-gel reactions of inorganic resins at the air interface. As a result, the organic-inorganic gradient coating contributed excellent gouge hardness (pencil hardness >9H), adhesion to an organic substrate such as polycarbonate, and transparency (visible light transmittance >99%T). In addition, we demonstrated that the formation of organic-inorganic gradient structures is dominated by the surface free energy and viscosity of each resin. Achieving a gradient structure required a significant difference in surface free energy (>20 mJ/m2) and high mixture viscosity (>65 mPa·s).
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Affiliation(s)
- Yoshiki Shirai
- Department of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
| | - Ayano Sasaki
- Toyota Industries Corporation, 2-1 Toyoda-cho, Kariya-shi, Aichi 448-8671, Japan
| | - Sayako Sato
- Toyota Industries Corporation, 2-1 Toyoda-cho, Kariya-shi, Aichi 448-8671, Japan
| | - Daisuke Aoki
- Department of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
| | - Koji Arimitsu
- Department of Pure and Applied Chemistry, Faculty of Science and Technology, Tokyo University of Science, 2641 Yamazaki, Noda, Chiba 278-8510, Japan
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Ishiuchi N, Nakashima A, Maeda S, Miura Y, Miyasako K, Sasaki K, Uchiki T, Sasaki A, Nagamatsu S, Nakao N, Nagao M, Masaki T. Comparison of therapeutic effects of mesenchymal stem cells derived from superficial and deep subcutaneous adipose tissues. Stem Cell Res Ther 2023; 14:121. [PMID: 37143086 PMCID: PMC10161523 DOI: 10.1186/s13287-023-03350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Fibrosis is a common histological feature in the process from chronic organ injury to organ failure. Chronic tissue injury causes inflammatory cell infiltration into the injured tissue. The persistence of this inflammatory cell infiltration leads to fibrosis and organ failure. Adipose-derived mesenchymal stem cells (ASCs) have received much attention as a regenerative therapeutic tool to prevent progression from organ injury to failure. Subcutaneous abdominal adipose tissue is divided into superficial and deep layers by a superficial fascia. Adipose tissue easily collected by liposuction is usually obtained from a deep layer, so ASCs derived from a deep layer are generally used for regenerative medicine. However, no research has been conducted to investigate differences in the therapeutic effects of ASCs from the superficial and deep layers (Sup-ASCs and Deep-ASCs, respectively). Therefore, we compared the therapeutic potencies of Sup-ASCs and Deep-ASCs. METHODS ASCs were isolated from superficial and deep subcutaneous abdominal adipose tissues collected from patients who underwent breast reconstruction. We first compared cell characteristics, such as morphology, cell proliferation, cell surface markers, adipogenic and osteogenic differentiation, cell senescence markers, and expression of coagulation and anticoagulant factors between Sup-ASCs and Deep-ASCs. Furthermore, we compared their ability to promote polarization of M2 macrophages and to inhibit transforming growth factor (TGF)-β/Smad signaling using THP-1 cells and TGF-β1 stimulated HK-2 cells incubated with conditioned media from Sup-ASCs or Deep-ASCs. In in vivo experiments, after renal ischemia-reperfusion injury (IRI) procedure, Sup-ASCs or Deep-ASCs were injected through the abdominal aorta. At 21 days post-injection, the rats were sacrificed and their left kidneys were collected to evaluate fibrosis. Finally, we performed RNA-sequencing analysis of Sup-ASCs and Deep-ASCs. RESULTS Sup-ASCs had greater proliferation and adipogenic differentiation compared with Deep-ASCs, whereas both ASC types had similar morphology, cell surface markers, senescence markers, and expression of coagulation and anticoagulant factors. Conditioned media from Sup-ASCs and Deep-ASCs equally promoted polarization of M2 macrophages and suppressed TGF-β/Smad signaling. Moreover, administration of Sup-ASCs and Deep-ASCs equally ameliorated renal fibrosis induced by IRI in rats. RNA-sequencing analysis revealed no significant difference in the expression of genes involved in anti-inflammatory and anti-fibrotic effects between Sup-ASCs and Deep-ASCs. CONCLUSIONS These results indicate that both Sup-ASCs and Deep-ASCs can be used effectively and safely as an intravascular ASC therapy for organ injury.
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Affiliation(s)
- Naoki Ishiuchi
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
- Center for Cause of Death Investigation Research, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Department of Forensic Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Ayumu Nakashima
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Satoshi Maeda
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- TWOCELLS Company, Limited, 16-35 Hijiyama-honmachi, Minami-ku, Hiroshima, 732-0816, Japan
| | - Yoshie Miura
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- TWOCELLS Company, Limited, 16-35 Hijiyama-honmachi, Minami-ku, Hiroshima, 732-0816, Japan
| | - Kisho Miyasako
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kensuke Sasaki
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Toshio Uchiki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Naoki Nakao
- Department of Forensic Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Masataka Nagao
- Center for Cause of Death Investigation Research, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Department of Forensic Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Takao Masaki
- Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Ota M, Tateuchi H, Hashiguchi T, Fujiwara K, Sasaki A, Okumura K, Ichihashi N. Validity of the frame subtraction method in dynamic postural stability. BMC Sports Sci Med Rehabil 2022; 14:174. [PMID: 36163189 PMCID: PMC9511721 DOI: 10.1186/s13102-022-00570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Background The movement of targeted subjects can be calculated using the frame subtraction method. However, the validity of this evaluation method of dynamic postural stability has not been clarified yet. This study aimed to verify the validity of the evaluation method for jump landing using the frame subtraction score based on the ground reaction force (GRF). Methods Twenty subjects performed single-leg jump landing, and their dynamic postural stability index (DPSI), medial‒lateral stability index (MLSI), anterior‒posterior stability index, and vertical stability index (VSI) were calculated from the GRF. Simultaneously, motion images were captured using digital video cameras in the sagittal and frontal planes. After the motion images were analyzed using the frame subtraction method, the frame subtraction scores in the frontal, sagittal, and combined planes were calculated. To confirm its validity, the relationship between the frame subtraction scores and GRF parameters was investigated using Pearson's correlation analysis. Results The frame subtraction scores in the frontal and combined planes were significantly correlated with the DPSI, MLSI, and VSI (r = 0.46–0.75, P < 0.05). Conclusions Therefore, the frame subtraction method could be applied to the evaluation of dynamic postural stability. Markerless systems are deemed useful in clinical practice.
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Affiliation(s)
- Megumi Ota
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takaya Hashiguchi
- Mixi Incorporated, Shibuya Scramble Square 36F, 2-24-12 Shibuya, Shibuya-ku, Tokyo, 150-6136, Japan
| | - Karen Fujiwara
- Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Ayano Sasaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kiseki Okumura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Imai H, Yoshida S, Mese T, Roh S, Fujita A, Sasaki A, Nagamatsu S, Koshima I. Correlation between Lymphatic Surgery Outcome and Lymphatic Image-Staging or Clinical Severity in Patients with Lymphedema. J Clin Med 2022; 11:jcm11174979. [PMID: 36078909 PMCID: PMC9456713 DOI: 10.3390/jcm11174979] [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: 07/21/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Lymphoscintigraphy and indocyanine green (ICG) lymphography reveal the severity of extremity lymphedema. Lower extremity lymphedema (LEL) index and NECST classification are related to the clinical severity of lymphedema. We aimed to investigate the correlation between lymphatic surgery, lymphatic imaging, and clinical severity in patients with lymphedema. Thirty-five patients with lower-extremity lymphedema who underwent lymphatic venous anastomosis (LVA) were evaluated. Ten of the thirty-five patients underwent multi-surgery (additional vascularized lymphatic transfer and/or liposuction). We investigated the correlation between the LEL index, NECST classification, lymphoscintigraphy staging, ICG lymphography staging, and rate of improvement (RI: [preoperative LEL index − postoperative LEL index]/[preoperative LEL index] × 100). The LEL index in 35 patients after LVA and all procedures decreased significantly compared to that of preoperative (272.4 vs. 256.2 vs. 243.5, p < 0.05). RI after LVA and all procedures showed positive correlations with the preoperative LEL index; however, there was no correlation with any other lymphatic image or clinical severity. LVA can reduce lymphedema circumference at any stage. Additional surgery improved the circumference. Hence, LVA as the first line of treatment, and vascularized lymphatic transfer and liposuction as additional procedures, should be considered as the standard treatment for lymphedema.
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Affiliation(s)
- Hirofumi Imai
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Correspondence: ; Tel.: +81-82-257-5555
| | - Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Toshiro Mese
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Solji Roh
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Asuka Fujita
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Isao Koshima
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima 734-8551, Japan
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Iida K, Suzuki N, Sasaki A, Ishida S, Arai T. Development of a novel light-up probe for detection of G-quadruplexes in stress granules. Sci Rep 2022; 12:12892. [PMID: 35902691 PMCID: PMC9334577 DOI: 10.1038/s41598-022-17230-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022] Open
Abstract
G-quadruplexes (G4s) regulate various biological processes in cells. However, cellular imaging of dynamically forming G4s in biomolecular condensates using small molecules has been poorly investigated. Herein, we present a fluorescent light-up probe with the ability to selectively stabilize G4s and enhance fluorescence upon G4 binding. The foci of the probe were mainly observed in the nucleoli. These were co-localized with anti-fibrillarin antibodies and anti-G4 antibodies (BG4). Moreover, we tested detection of G4 in stress granules using the developed probe. Stress granules were induced through treatment with not only thapsigargin, but also known G4 ligands (pyridostatin, RHPS4, and BRACO-19). In the stress granules, co-localization between the probe, BG4, and stress granule markers (TIA1 and G3BP1) was detected. We present a practical light-up probe for G4s in stress granules, providing potential targets for G4 ligands.
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Affiliation(s)
- Keisuke Iida
- Soft Molecular Activation Research Center (SMARC), Chiba Iodine Resource Innovation Center (CIRIC), Molecular Chirality Research Center (MCRC), and Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi, Inage, Chiba , 263-8522, Japan.
| | - Natsumi Suzuki
- Soft Molecular Activation Research Center (SMARC), Chiba Iodine Resource Innovation Center (CIRIC), Molecular Chirality Research Center (MCRC), and Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi, Inage, Chiba , 263-8522, Japan
| | - Ayano Sasaki
- Soft Molecular Activation Research Center (SMARC), Chiba Iodine Resource Innovation Center (CIRIC), Molecular Chirality Research Center (MCRC), and Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi, Inage, Chiba , 263-8522, Japan
| | - Shunsuke Ishida
- Soft Molecular Activation Research Center (SMARC), Chiba Iodine Resource Innovation Center (CIRIC), Molecular Chirality Research Center (MCRC), and Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi, Inage, Chiba , 263-8522, Japan
| | - Takayoshi Arai
- Soft Molecular Activation Research Center (SMARC), Chiba Iodine Resource Innovation Center (CIRIC), Molecular Chirality Research Center (MCRC), and Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi, Inage, Chiba , 263-8522, Japan
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Saito D, Takakubo Y, Yoshioka D, Monma R, Wanezaki Y, Aso M, Naganuma Y, Oki H, Honma R, Yang S, Sasaki A, Takagi M. AB0186 IMPROVEMENT OF RADIOGRAPHIC JOINT DESTRUCTION IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS IN THE LAST DECADE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2799] [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: 11/04/2022]
Abstract
BackgroundThe paradigm shift has caused in the treatment for rheumatoid arthritis (RA) before the last decade [1]. The advent of high-dose MTX and biologics has maked it possible to treat RA with early and aggressive therapy, and prevent the joint destruction [2].ObjectivesTo aim of this study, we investigated the joint destruction and clinical outcomes in patients with early RA every 5 years in the last decade.Methods81 patients with early RA (within 1 year from their onset of RA) enrolled retrospectively in this study. The number of patients with early RA were 21 in 2009, 23 in 2014, and 37 in 2019, respectively. They had 17 males and 64 females. Mean age was 59 years (19-92) at the first visit to our department. The following items were investigated: age, disease duration from onset to consultation, anti-cyclic citrullinated peptide antibody (ACPA) positivity (positivity was defined as >4.5 U/ml), CRP, DAS28CRP4, medications, and modified total sharp score (mTSS) at the time of initial consultation and 1 year later. Kruskal-Wallis test was used for statistics (PASW 25 software, SPSS Institute Inc., Chicago, IL, USA, p<0.05).ResultsThe ACPA positivity rates were 71.4% (15/21) in 2009, 78.3% (18/21) in 2014, and 78.4% (29/37) in 2019, respectively. The mean value of DAS28CRP4 was 4.7 (2.4-6.8) in 2009, 4.2 (1.2-6.2) in 2014, and 4.2 (2.1-6.7) in 2019 at the time of the first visit to our department respectively. DAS28CRP4 under 2.6 was 29% (6/21) in 2009, 61% (14/23) in 2014, and 54% (20/37) in 2019 1 year after the first visit. The mean improvement of DAS28CRP4 (ΔDAS28CRP4) was -1.2 (-3.9 - 2.1) in 2009, -1.5 (-4.0 - 1.7) in 2014, and -1.7 (-4.1 - 0.4) in 2019, respectively. It had tended to improve gradually, however, it was not significantly different (p= 0.20, Figure 1).Figure 1.Mean value of improvement of mTSS and DAS28CRP4 (ΔmTSS and ΔDAS28CRP4) from initial visit to 1 year later at 2009, 2014 and 2019.The changing of mTSS for a year (ΔmTSS) was 4.2 (0-17) in 2009, 0.9 (0-10) in 2014, and 0.6 (0-4) in 2019, respectivly. ΔmTSS in 2014 and 2019 was significantly lower compared to that in 2009 (p<0.05, Figure 1).One year after the first visit to our department, the mean dose of MTX increased to 9.2 mg/week (2-14) in 2014 and 8.7 mg/week (4-16) in 2019 compared to 6.6 mg/week (2-8) in 2009 (p=0.19). The mean dose of PSL decreased 4.2 mg/day (1-8) in 2014, and 3.8 mg/day (1-10) in 2019 compared to 4.9 mg/day (2-10) in 2009, respectively (p=0.11). On the other hand, biological DMARDs were introduced in 24% (5/21) in 2009, 13% (3/23) in 2014, and 13% (1/37) in 2019, respectively.ConclusionJonit destruction has been already reported to begin in patients with early-stage of RA [1, 2]. Based on the results of this study, joint desctruction in early RA was decreased in the last decade, because of more early and aggressive therapy for early RA with increasing mean dose of MTX gradually, not biologic DMARDs in real world. In addition, the mean dose of PSL in 2014 and 2019 decreased compared to that in 2009. The intensive therapy for early RA at our hospital has shown the improvement of joint destruction in the last decade.References[1]Emery P, Breedveld FC, Dougados M, et al. Early referral recommendation for newly diagnosed rheumatoid arthritis: evidence based development of a clinical guide. Ann Rheum Dis 2002;61:290–297.[2]Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020;79:685-699.Disclosure of InterestsNone declared
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Honma R, Takakubo Y, Saito D, Wanezaki Y, Aso M, Monma R, Yang S, Sasaki A, Takagi M. AB0181 RADIOGRAPHIC DESTRUCTION OF CARPAL BONE IN PATIENTS WITH EARLY RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2507] [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
BackgroundThe pharmacotherapy for rheumatoid arthritis (RA) has changed dramatically and caused a paradigm shift with the advent of methotrexate (MTX) and biological disease-modifying antirheumatic drugs (bDMARDs).Before the paradigm shift of RA therapy, the frequency of carpal collapse was high in patients with RA.It has been reported that certain numbers of patients with RA rapidly advance the destruction of the carpal bones during the early onset in the natural course of it [1].Another report showed that hand function was positively correlated with disease activity[2]In Japan, bDMARDs were approved in 2003, and the maximum allowable dose of MTX was raised from 8 mg/week to 12 mg/week in 2012.We hypothesize early aggressive therapy for the patients with early RA may have improved outcomes of carpal bone destruction in this last decade.In this study, we investigated the change of drug therapy and carpal height ratio (CHR) in patients with early RA in the last decade.ObjectivesThe aim of this study was to investigate CHR and drugs for the patients with early RA who developed it and started the therapy in 2009, 2014, and 2019.MethodsPatients with early RA diagnosed in our department in 2009, 2014, and 2019 were included in the study.The CHR was measured at the first visit and two years later on radiographs of both hands.The drug history for RA was obtained in the medical records retrospectively.All statistical analyses were performed with EZR version 1.55.ResultsThis study included 43 cases (36 females, 7 males). The number of cases in 2009, 2014, and 2019 was 16, 13, and 14, respectively.The mean age at the time of initial examination was 55 years (30-72).There was no significant difference in the mean value of DAS28-CRP at the time of the first visit in each year.The left hand CHR of initial diagnosis was 0.554 (0.484-0.632), 0.551 (0.490-0.618), and 0.567 (0.517-0.632) in 2009, 2014, and 2019, respectively, with no significant difference.Two years later, the left-hand CHR was 0.541 (0.475-0.651), 0.549 (0.502-0.617), and 0.562 (0.528-0.591), respectively, with no significant difference.There was also no significant difference in the amount of change.The right hand CHR of initial diagnosis was 0.525 (0.475-0.607), 0.539 (0.459-0.589), and 0.557 (0.506-0.635) in 2009, 2014, and 2019, respectively, with no significant difference.Two years later, the right-hand CHR was 0.532 (0.444-0.627), 0.529 (0.478-0.588), and 0.548 (0.491-0.593), respectively, with no significant difference.There was also no significant difference in the amount of change.The DAS28-CRP of initial diagnosis for cases in 2009, 2014, and 2019 was 4.68 (3.11-6.83), 4.19 (1.21-6.15), and 4.23 (2.41-6.38), respectively.The DAS28-CRP at 2 years after treatment for cases in 2009, 2014, and 2019 was 2.12 (0.96-3.60), 2.25 (1.13-4.81), and 2.04 (0.99-3.45), respectively.Although DAS28-CRP was improved, there was no significance among the three groups.The usage rate of MTX was 56.3% in 2009, 76.9% in 2014, and 50% in 2019, with mean doses of 6.2 mg (2-8 mg), 8.6 mg (4-12 mg), and 9.1 mg (4-16 mg), respectively. There was no significant difference in the rate and dosage of MTX use in each year.bDMARDs were used in one case in 2009, two cases in 2014, and one case in 2019.ConclusionIn this study, DAS28-CRP showed a trend of improvement in this decade, but there was no obvious improvement in the progression of carpal collapse.Further early aggressive therapy may be necessary to prevent the destruction of the carpal bones.References[1]Ochi T, Iwase R, Yonemasu K, Matsukawa M, Yoneda M, Yukioka M, et al. Natural course of joint destruction and fluctuation of serum C1q levels in patients with rheumatoid arthritis. Arthritis and rheumatism. 1988 Jan; 31(1):37-43.[2]Palamar D, Er G, Terlemez R, Ustun I, Can G, Saridogan M. Disease activity, handgrip strengths, and hand dexterity in patients with rheumatoid arthritis. Clinical rheumatology. 2017; 36(10):2201-2208.Disclosure of InterestsNone declared
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Imai H, Yoshida S, Mese T, Roh S, Fujita A, Uchiki T, Sasaki A, Nagamatsu S, Koshima I. Technical Tips for Anastomosis of 0.2-mm Diameter Vessels during Lymphatic Venous Anastomosis. Plast Reconstr Surg Glob Open 2022; 10:e4304. [PMID: 35572187 PMCID: PMC9094417 DOI: 10.1097/gox.0000000000004304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/15/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Hirofumi Imai
- From the International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Shuhei Yoshida
- From the International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshiro Mese
- From the International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Solji Roh
- From the International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Asuka Fujita
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- From the International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, Hiroshima, Japan
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Yoshida S, Eldahshoury TEM, Koshima I, Imai H, Uchiki T, Sasaki A, Nagamatsu S, Yokota K. Appropriate Loupe Magnification for Lymphatic Vessel Dissection during a Line Production System for Multiple Lymphaticovenular Anastomoses. J Plast Reconstr Aesthet Surg 2022; 75:1261-1282. [DOI: 10.1016/j.bjps.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 11/28/2021] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
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Yoshida S, Koshima I, Imai H, Roh S, Mese T, Uchiki T, Sasaki A, Nagamatsu S. Lymphaticovenous Anastomosis for Age-Related Lymphedema. J Clin Med 2021; 10:jcm10215129. [PMID: 34768657 PMCID: PMC8584733 DOI: 10.3390/jcm10215129] [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] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Primary lymphedema is usually caused by intrinsic disruption or genetic damage to the lymphatics but may also be the result of age-related deterioration of the lymphatics. The aims of this study were to determine the characteristics of age-related lymphedema and to assess the effectiveness of lymphaticovenous anastomosis (LVA) in its treatment. METHODS Eighty-six patients with primary lymphedema affecting 150 lower limbs were divided into three groups according to whether the age of onset was younger than 35 years, 35-64 years, or 65 years or older. Indocyanine green (ICG) lymphography was performed, followed by LVA surgery. ICG lymphography images were visually classified according to whether the pattern was linear, low enhancement (LE), distal dermal backflow (dDB), or extended dermal backflow (eDB). The lower extremity lymphedema (LEL) index score was calculated before and after LVA. Lymphatic vessel diameter and detection rates were also recorded. RESULTS In the ≥65 group, the lymphedema was bilateral in 54 patients and unilateral in 1 patient. There was statistically significant deterioration in the LEL index score with progression from the linear, LE, dDB through to the eDB pattern in the ≥65 group. The lymphatic vessel diameter was significantly greater in the ≥65 group. The rate of improvement was highest in the ≥65 group. CONCLUSION Age-related lymphedema was bilateral and deterioration started distally. The lymphatic vessels in patients with age-related lymphedema tended to be ectatic, which is advantageous for LVA and may increase the improvement rate.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
- Correspondence: ; Tel.: +81-82-257-5555
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Solji Roh
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Toshiro Mese
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Toshio Uchiki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan; (T.U.); (A.S.); (S.N.)
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan; (T.U.); (A.S.); (S.N.)
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 739-8551, Japan; (T.U.); (A.S.); (S.N.)
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Yoshida S, Koshima I, Imai H, Roh S, Mese T, Uchiki T, Sasaki A, Nagamatsu S. Effect of Postoperative Compression Therapy on the Success of Liposuction in Patients with Advanced Lower Limb Lymphedema. J Clin Med 2021; 10:jcm10214852. [PMID: 34768372 PMCID: PMC8584961 DOI: 10.3390/jcm10214852] [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] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: There is limited information on postoperative care after liposuction for lymphedema limb. The aim of this retrospective study was to identify the threshold compression pressure and other factors that lead liposuction for lower limb lymphedema to success. Materials and Methods: Patients were divided according to whether they underwent compression therapy with both stockings and bandaging (SB group), stockings alone (S group), or bandaging alone (B group) for 6 months after liposuction. The postoperative compression pressure and rate of improvement were compared according to the postoperative compression method. We also investigated whether it was possible to decrease the compression pressure after 6 months. Liposuction was considered successful if improvement rate was >15. Results: Mean compression pressure was significantly lower in the S group than in the SB group or B group. The liposuction success rate was significantly higher in the SB group than in the B group or S group. There was not a significant difference between the values at 6 months after liposuction and at 6 months after a decrease in compression pressure in the successful group. Conclusion: Our results suggest that stable high-pressure postoperative compression therapy is key to the success of liposuction for lower limb lymphedema and is best achieved by using both stockings and bandages. The postoperative compression pressure required for liposuction to be successful was >40 mmHg on the lower leg and >20 mmHg on the thigh. These pressures could be decreased after 6 months.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
- Correspondence: ; Tel.: +81-82-257-5555; Fax: +81-82-257-5851
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Solji Roh
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Toshiro Mese
- The International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan; (I.K.); (H.I.); (S.R.); (T.M.)
| | - Toshio Uchiki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima 739-8511, Japan; (T.U.); (A.S.); (S.N.)
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima 739-8511, Japan; (T.U.); (A.S.); (S.N.)
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima 739-8511, Japan; (T.U.); (A.S.); (S.N.)
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Nagamatsu S, Yokota K. Investigation of flow velocity in recipient perforator artery for a reliable indicator for the flap transfer with perforator to perforator anastomosis. Microsurgery 2021; 41:550-556. [PMID: 34213025 DOI: 10.1002/micr.30783] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/26/2021] [Accepted: 06/25/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In flap transfer with perforator to perforator anastomosis (FTPPA), encountering poor pulsation and blood flow in a recipient perforator intraoperatively often makes FTPPA impossible. This study sought to identify color and spectral Doppler ultrasonography (CSDUS) parameters that can aid reliable preoperative selection of a recipient perforator artery. PATIENTS AND METHODS The study enrolled 38 patients with lower extremity lymphedema who underwent vascularized lymphatic tissue transfer with perforator to perforator anastomosis for physiological lymphatic flow reconstruction. In all cases, three candidate recipient perforators were searched in each lower extremities, and vessel diameter and peak systolic flow velocity (PSFV) were measured. The inclusion criteria for candidates were a vessel diameter of >0.5 mm and a PSFV of >10 cm/s. These measures were compared with intraoperative findings, diameters and if there was pulsation and visible spurting evident. RESULTS A total of 114 candidates were selected, and 52 of the candidates were dissected until suitable perforators were found. PSFV (cm/s) on CSDUS was ≥20.0 in 32 perforators (84.2%) and was 15.0-19.9 in 6 perforators (15.8%) in the group with pulsation and visible spurting evident, and 15.0-19.9 in one perforator (7.1%) and ≤ 14.9 in 13 perforators (92.9%) in the group without pulsation and visible spurting evident. There was a statistically significant correlation between preoperative PSFV and intraoperative pulsation and visible spurting evident after dissection (P = 0.021 × 10-3 ). The flap survival rate was 92.1%. CONCLUSION PSFV is an important preoperative determinant of the suitability of a recipient perforator artery for FTPPA.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
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Komatsu H, Ishida K, Matsui Y, Amano S, Hashimoto M, Sasaki A. Treatment strategy for locally advanced breast cancer in our department. Breast 2021. [DOI: 10.1016/s0960-9776(21)00151-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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19
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S. Combined Lymphovenous Anastomosis and Great Saphenous Vein Stripping for Comorbid Lymphedema and Varicose Veins. Lymphat Res Biol 2021; 20:213-219. [PMID: 33794104 DOI: 10.1089/lrb.2019.0076] [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] [Indexed: 11/12/2022] Open
Abstract
Introduction: Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins. Patients and Methods: Thirteen patients were involved in the study, and the detail was 21 edematous lower limbs (with coexisting varicose veins and lymphedema; the varicose vein and lymphedema [VL] group) who underwent combined GSVS and LVA therapy. Fifteen patients (with 30 edematous lower limbs and lymphedema only; the lymphedema [L] group) who underwent LVA only were included as a control group. GSVS was performed before LVA in the VL group. Results: No significant differences were seen between the groups at baseline. There were no cases indocyanine green (ICG) lymphography pattern deteriorated after GSVS. No significant difference was seen in lymphatic detection rate; 129.71% ± 58.27% (67%-333%) in the VL group and 122.27% ± 39.47% (50%-250%) in the L group (p = 0.59 > 0.05), respective lymphatic diameters 0.66 ± 0.13 (0.45-0.9) mm and 0.75 ± 0.17 (0.45-1.0) mm (p = 0.07 > 0.05), and respective lymphedema improvement rate 12.17% ± 7.35% (0%-27.4%) and 12.65% ± 7.43% (3.7%-22.3%) (p = 0.86 > 0.05). Discussion: In this study, stripping surgery does not cause lymphatic impairment, at least to the extent that would impede the success of an LVA procedure. Comorbid varicose veins and lymphedema can be treated surgically by a combination of LVA and GSVS.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Plastic and reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Plastic and reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Yumio Fujioka
- Plastic and reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Plastic and reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Mitsunobu Harima
- Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
| | - Shuji Yamashita
- Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Yamashita S. Modified intraoperative distal compression method for lymphaticovenous anastomosis with high success and a low venous reflux rates. J Plast Reconstr Aesthet Surg 2021; 74:2050-2058. [PMID: 33541824 DOI: 10.1016/j.bjps.2020.12.103] [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: 02/27/2020] [Revised: 11/08/2020] [Accepted: 12/26/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION For successful lymphaticovenous anastomosis (LVA), it is important to create anastomoses with high flow to maintain patency. To ensure that this can be achieved, we compared the efficacy of a modified intraoperative distal compression (IDC) technique with the conventional no compression (NC) method for lower limb lymphedema. PATIENTS AND METHODS In the IDC group, compression was applied to an area of the foot distal to the first LVA site. After completion of the first LVA, the distal compression was extended over the first LVA site to the distal end of the second LVA site. RESULTS There was no significant difference between the IDC (n = 25) and NC (n = 25) groups in detection rate. However, significant differences were observed in lymphatic vessel diameter and LVA success rate. No intraoperative anastomotic obstruction was seen at the conclusion of surgery. Intraoperative congestion with blood was detected in lymphatic vessels in 8 of 79 anastomoses (10.1%) in the NC group, but not in any cases in the IDC group (p = 0.002). There was a significant between-group difference in the rate of improvement in lymphedema between the IDC (16.1±3.6) and NC groups (14.0±3.4; p = 0.03). DISCUSSION IDC during LVA is thought to increase lymph flow in larger caliber lymphatics, leading to a high success rate and a low rate of venous reflux. IDC is beneficial when performing LVA.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Japan.
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Japan
| | - Toshio Uchiki
- Plastic and reconstructive Surgery, Hiroshima University, Japan
| | - Ayano Sasaki
- Plastic and reconstructive Surgery, Hiroshima University, Japan
| | - Yumio Fujioka
- Plastic and reconstructive Surgery, Hiroshima University, Japan
| | - Shogo Nagamatsu
- Plastic and reconstructive Surgery, Hiroshima University, Japan
| | - Kazunori Yokota
- Plastic and reconstructive Surgery, Hiroshima University, Japan
| | - Shuji Yamashita
- Plastic and Reconstructive Surgery, The University of Tokyo, Japan
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21
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Eldahshoury TEM, Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Nagamatsu S, Yokota K. How to Dissect Lymphatics under Loupes for Line Production System for Multiple Lymphaticovenular Anastomosis. Journal of Reconstructive Microsurgery Open 2020. [DOI: 10.1055/s-0040-1714660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Abstract
Background A surgical line production system using loupes to dissect lymphatics and veins is a cost-effective way of performing multiple lymphaticovenular anastomoses. There is an art to successful dissection of lymphatics under loupes, and selection of the correct loupe magnification is important. Therefore, the aim of this study was to provide a detailed description of how to dissect lymphatics under loupes.
Patients and Methods Dissection of lymphatics under loupes was performed for a series of 13 patients. Lymphatics are transparent threadlike structures that are arranged longitudinally and may be oriented with feeding capillary vessels. At the start of dissection, it is helpful to have a reference scale in the field of vision when operating to appreciate the size of the structures seen under loupes. It is also helpful to be able to separate lymphatics from fat tissue in the background.
Results Mean time for exploration under loupes was 25 ± 7 minutes; lymphatics were successfully found in 27 sites (90%) of the 30 attempted with failure to identify lymphatics in three sites (10%) and failure to identify veins in three sites (10%); the average size of the lymphatics was found to be 0.5 ± 0.2 mm. No lymphatics could be found by the microscopes after loupes exploration in two sites.
Discussion Even a novice surgeon can identify lymphatics based on knowledge of the visual characteristics of these structures. However, a higher magnification is likely necessary for accurate discrimination.
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Affiliation(s)
| | - Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
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Horiguchi H, Kubota Y, Hatakeyama S, Yoneyama T, Hashimoto Y, Itou H, Yoshikawa K, Sasaki A, Kawaguchi T, Ohyama C. Trends in the utilizaton of platinum-based neoadjuvant chemotherapy for upper tract urothelial carcinoma. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32776-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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23
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Yoshida S, Koshima I, Imai H, Sasaki A, Nagamatsu S, Yokota K. Lymphaticovenular anastomosis for recurrent cellulitis in a dementia patient with lymphedema. J Vasc Surg Cases Innov Tech 2020; 6:340-343. [PMID: 32715167 PMCID: PMC7371726 DOI: 10.1016/j.jvscit.2020.06.007] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 11/15/2022]
Abstract
We describe a dementia patient with comorbid recurrent cellulitis and lymphedema in the left lower limb who was treated successfully for recurrent cellulitis by lymphaticovenular anastomosis (LVA). The patient, an 83-year-old woman, suffered from recurrent cellulitis three times a year on average for 15 years. Compression therapy was impossible because of dementia. After LVA, there has been no recurrence of cellulitis for 2 years. It is difficult to administer decongestive lymphatic therapy in some patients, such as patients with dementia. LVA is a promising treatment for recurrent cellulitis in a dementia patient with lymphedema.
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Affiliation(s)
- Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
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Shoji N, Tanese K, Sasaki A, Horiuchi T, Utsuno Y, Fukuda K, Hoshino Y, Noda S, Minami H, Asakura W. Pharmaceuticals and Medical Device Agency approval summary: Amenamevir for the treatment of herpes zoster. J Dermatol 2020; 47:683-688. [PMID: 32424854 DOI: 10.1111/1346-8138.15393] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 12/13/2022]
Abstract
In July 2017, Japan's Ministry of Health, Labor and Welfare issued a marketing authorization valid throughout Japan for N-(2,6-dimethylphenyl)-N-(2-{[4-(1,2,4-oxadiazol-3-yl)phenyl]amino}-2-oxoethyl)-1,1-dioxothiane-4-carboxamide (amenamevir) for the first time worldwide. The decision was based on the favorable opinion of the Pharmaceuticals and Medical Device Agency (PMDA) recommending a marketing authorization of amenamevir for treatment of herpes zoster (HZ). Amenamevir has a different action mechanism from previously approved synthetic nucleoside compounds for the treatment of HZ including acyclovir, valacyclovir and famciclovir. The usual adult dose is 400 mg amenamevir p.o. once daily for 7 days. The benefit is its ability to cure HZ as well as preventing postherpetic neuralgia. The most common side-effects are increase of urine N-acetyl-β-D-glucosaminidase and α1-microglobulin levels. However, based on the detailed evaluation of the submitted clinical studies, there seems to be no serious safety concerns about amenamevir regarding the kidney of both renally normal and impaired patients. The objective of this article is to summarize the scientific review of the application. The detailed scientific assessment report and product information, including the summary of product characteristics, are available on the PMDA website (www.pmda.go.jp/PmdaSearch/iyakuSearch/).
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Affiliation(s)
- Naoko Shoji
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Keiji Tanese
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Ayano Sasaki
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Taishi Horiuchi
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Yuji Utsuno
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Koichi Fukuda
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Yukiko Hoshino
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Shinichi Noda
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Hirofumi Minami
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
| | - Wataru Asakura
- Office of New Drug IV, Pharmaceuticals and Medical Device Agency, Tokyo, Japan
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Yoshida S, Hamada Y, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S. Role of lymphatico venular anastomosis for treatment of lymphorrhea in lower limbs. J Plast Reconstr Aesthet Surg 2020; 73:1357-1404. [PMID: 32113962 DOI: 10.1016/j.bjps.2020.02.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/07/2019] [Accepted: 02/08/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan.
| | - Yuichi Hamada
- Plastic and Reconstructive Surgery, Japanese Red Cross Fukuoka Hospital, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Plastic and Reconstructive Surgery, Japanese Red Cross Fukuoka Hospital, Japan
| | - Ayano Sasaki
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Yumio Fujioka
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Mitsunobu Harima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Yamashita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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26
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Yoshida S, Koshima I, Imai H, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S, Tashiro K. Indocyanine green lymphography findings in older patients with lower limb lymphedema. J Vasc Surg Venous Lymphat Disord 2020; 8:251-258. [DOI: 10.1016/j.jvsv.2019.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/04/2019] [Indexed: 01/21/2023]
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S, Tashiro K. Characteristics and outcomes of lymphaticovenular anastomosis in older patients with bilateral involvement versus younger patients with unilateral involvement in lower extremity lymphedema. J Vasc Surg Venous Lymphat Disord 2019; 8:646-657. [PMID: 31843479 DOI: 10.1016/j.jvsv.2019.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We have previously reported that patients with idiopathic primary lymphedema of adult onset can be classified into an older group with bilateral involvement and a younger group with unilateral involvement and that there are significant differences in the characteristics of these groups. The aims of this study were to investigate the features of these two groups further by evaluating the lymphatics while performing lymphaticovenular anastomosis (LVA) and to compare the effectiveness of LVA between the two groups. METHODS This study enrolled 74 patients (136 edematous legs) in whom indocyanine green (ICG) lymphography and LVA were performed. The rate of detection and the diameter of the lymphatic vessels were recorded. The lower extremity lymphedema index (the total sum of the squares of the circumference for five areas in each leg divided by the body mass index) was obtained before and 6 months after LVA. The rate of improvement in the affected lower limbs after LVA was also calculated. RESULTS The clinical lymphedema pattern was determined to be bilateral in 62 patients and unilateral in 12. Patients with bilateral lymphedema were significantly older than those with unilateral lymphedema (77.1 ± 7.8 years vs 55.5 ± 12.77 years; P < .01). A linear pattern was seen in 23 patients (46 legs), a low enhancement (LE) pattern in 12 patients (24 legs), a distal dermal backflow (dDB) pattern in 20 patients (40 legs), and an extended dermal backflow (eDB) pattern in 7 patients (14 legs). The lymphedema was unilateral in 12 patients (12 legs). There were significant between-group differences in lymphatic diameter in relation to lower leg area: linear (0.9 ± 0.1 mm) vs dDB (0.7 ± 0.2 mm), linear vs eDB (0.7 ± 0.2 mm), linear vs unilateral (0.5 ± 0.1 mm), LE (0.9 ± 0.2 mm) vs dDB, LE vs eDB, LE vs unilateral, and dDB vs unilateral, P < .01; and eDB vs unilateral, P < .05. There were also significant between-group differences in the rate of improvement in the lower extremity lymphedema index according to the ICG lymphography pattern and laterality: linear (10.5% ± 2.4%) vs unilateral (6.7% ± 0.6%), LE (10.4% ± 1.5%) vs unilateral, dDB (11.0% ± 1.3%) vs eDB (8.9% ± 1.5%), and dDB vs unilateral, P < .01; linear vs eDB, P < .05; and eDB vs unilateral, P < .05. CONCLUSIONS The lymphatic vessel diameter tended to be greater in older patients with bilateral lymphedema than in younger patients with unilateral lymphedema. The rate of detection and improvement tended to decrease with worsening of the ICG lymphography pattern. LVA is thought to be more effective in older patients with early-stage bilateral lower leg lymphedema than in their younger counterparts with late-stage unilateral lymphedema.
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Affiliation(s)
- Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University, Hiroshima, Japan.
| | - Isao Koshima
- International Center for Lymphedema, Hiroshima University, Hiroshima, Japan
| | - Hirofumi Imai
- International Center for Lymphedema, Hiroshima University, Hiroshima, Japan
| | - Toshio Uchiki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Yumio Fujioka
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Mitsunobu Harima
- Department of Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
| | - Shuji Yamashita
- Department of Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
| | - Kensuke Tashiro
- Department of Plastic and Reconstructive Surgery, Jichi Medical University, Tochigi, Japan
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S. Localized lymphedema after treatment for soft tissue sarcoma in the lower limbs: Comparison of improvement according to duration before lymphaticovenular anastomosis. Clin Case Rep 2019; 7:1534-1538. [PMID: 31428383 PMCID: PMC6692988 DOI: 10.1002/ccr3.2278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/25/2019] [Accepted: 05/29/2019] [Indexed: 11/09/2022] Open
Abstract
Surgically invasive procedures involving the medial knee and inguinal regions can cause lymphedema. Lymphaticovenular anastomosis (LVA) could improve volume reduction and decrease the risk of cellulitis. However, it may be preferable to performed LVA as early as possible to achieve optimal results.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for LymphedemaHiroshima University HospitalHiroshimaJapan
| | - Isao Koshima
- The International Center for LymphedemaHiroshima University HospitalHiroshimaJapan
| | - Hirofumi Imai
- The International Center for LymphedemaHiroshima University HospitalHiroshimaJapan
| | - Toshio Uchiki
- Plastic and reconstructive SurgeryHiroshima UniversityHiroshimaJapan
| | - Ayano Sasaki
- Plastic and reconstructive SurgeryHiroshima UniversityHiroshimaJapan
| | - Yumio Fujioka
- Plastic and reconstructive SurgeryHiroshima UniversityHiroshimaJapan
| | - Shogo Nagamatsu
- Plastic and reconstructive SurgeryHiroshima UniversityHiroshimaJapan
| | - Kazunori Yokota
- Plastic and reconstructive SurgeryHiroshima UniversityHiroshimaJapan
| | | | - Shuji Yamashita
- Plastic and Reconstructive SurgeryTokyo UniversityTokyoJapan
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29
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Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K. Lymphaticovenular anastomosis and venous arterialization in coexisting Raynaud's phenomenon and lymphedema: A case report. Microsurgery 2019; 39:553-558. [PMID: 31287178 DOI: 10.1002/micr.30490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/13/2019] [Accepted: 06/21/2019] [Indexed: 11/11/2022]
Abstract
Raynaud's phenomenon is highly prevalent in the general population. The optimal medical management for patients with severe Raynaud's phenomenon remains unclear. Venous arterialization (VA) may be considered as a salvage procedure when no distal vessels are available for vascular reconstruction. Surgical treatments for lymphedema, including lymphovenous anastomosis (LVA), are becoming popular alternatives to conservative therapy. Here, we report on a patient with comorbid primary Raynaud's phenomenon and lymphedema in whom both VA and LVA were performed. The patient was a 60-year-old woman with an edematous right upper limb and pain and cold sensitivity in the middle, ring, and small fingers that was refractory to medication. Indocyanine green lymphography and computed tomography angiography suggested coexistence of lymphedema and primary Raynaud's phenomenon. VA and LVA were performed to reduce the risks of cellulitis and amputation. Computed tomography angiography was performed regularly after surgery to examine the arterialized venous system and Doppler echography to search for developing branches. Five months later, three branches of the arterialized veins that flowed proximally at the level of the hand and wrist were ligated. By around 1 year after surgery, the lymphedema index in the affected upper limb had improved from 116 to 103 and the patient's numerical rating scale score for intractable pain and cold sensitivity had improved from 6-7 to 1-2. We believe that the combination of VA and LVA in the early stages of primary Raynaud's phenomenon and lymphedema was effective in this case.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Uchiki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Yumio Fujioka
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
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Takahashi K, Sasaki A, Shigemori M, Kanbara C, Ikeda M, Kita K, Nomura K, Sugiyama S, Oda H, Masaki T. MON-307 COOKING PRACTICES RELIEVE UNEASINESS FOR THE DISEASE AND DIET THERAPY IN PATIENTS WITH CHRONIC KIDNEY DISEASE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Yoshida S, Koshima I, Hamada Y, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S. Lymphovenous Anastomosis Aids Wound Healing in Lymphedema: Relationship Between Lymphedema and Delayed Wound Healing from a View of Immune Mechanisms. Adv Wound Care (New Rochelle) 2019; 8:263-269. [PMID: 31832276 DOI: 10.1089/wound.2018.0871] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 09/28/2018] [Accepted: 11/15/2018] [Indexed: 12/30/2022] Open
Abstract
Delayed wound healing in lymphedema is assumed to be caused by two reasons, pathophysiological and immunological effects of lymphedema. The aim of this review is to establish how impaired lymphatics alter wound healing pathophysiologically and immunologically, and to propose treatment modalities that can promote wound healing in lymphedema. Lymphaticovenular anastomoses (lymphovenous anastomoses [LVAs]) were performed on patients who had recurrent cellulitis several times with lymphorrhea and developed severe ulcers that were refractory to skin grafts, flaps, and conservative therapy. The lymphorrhea and the ulcer had healed by 4 weeks. Moreover, the lymphedema improved without compression therapy. Lymphedema is characterized pathophysiologically by localized peripheral edema that compresses the microvasculature and lymphatic vasculature and impairs tissue remodeling. Another suspected mechanism is an imbalance in the differentiation of participating immune cells. Profound suppression of T helper (Th)1 cells is likely to increase the risk of infection, and excessive differentiation of Th2 cells, including M2 macrophage polarization, may promote fibrosis, which disrupts the carefully orchestrated wound healing process. Although negative-pressure wound therapy is useful for the treatment of delayed wound healing in lymphedema, LVAs may be necessary to treat the fundamental problem of lymphedema. LVAs are considered to create a bypass to the lymph nodes through which dendritic cells (DCs) can transmit antigen information to T cells. LVAs are considered to neutralize chronic inflammation by allowing more DCs to return into the circulation, thereby improving wound healing.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuichi Hamada
- Plastic and Reconstructive Surgery, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Yumio Fujioka
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Mitsunobu Harima
- Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
| | - Shuji Yamashita
- Plastic and Reconstructive Surgery, Tokyo University, Tokyo, Japan
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Yoshida S, Koshima I, Imai H, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K. Lymphatic flow restoration after stripping surgery for varicose veins: A case report. SAGE Open Med Case Rep 2019; 7:2050313X19849265. [PMID: 31105958 PMCID: PMC6506910 DOI: 10.1177/2050313x19849265] [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: 01/29/2019] [Accepted: 04/16/2019] [Indexed: 11/24/2022] Open
Abstract
It has been suggested that the dynamics of the venous and lymphatic systems
interact as a mutually dependent dual outflow system and that derangement of
lymph flow could be reversed by surgical treatment of venous incompetence. In
this report, we describe a patient in whom lymphatic function was restored after
stripping of the great saphenous vein for varicosity. The patient was a
79-year-old woman who had varicose veins along the medial side of an edematous
left leg. Lymphatic function was investigated using indocyanine green imaging to
evaluate for the presence of lymphedema. Based on the findings, we made a
diagnosis of bilateral varicosity of the great saphenous vein with left-sided
lymphedema. The great saphenous vein was stripped between the groin and ankle on
both sides. At 3 months after the stripping procedure, lymphatic flow was
observed immediately after injection of indocyanine green in both legs along the
medial side from the foot to the groin. We therefore determined that lymphatic
flow had been restored after the stripping surgery. The functions of the venous
and lymphatic systems are thought to be closely related, and that, if the
function of one declines, the other will also be affected. Treatment of venous
system, including stripping, may help to break the vicious cycle of lymphatic
stasis and venous insufficiency.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Ayano Sasaki
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Yumio Fujioka
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic and Reconstructive Surgery, Hiroshima University, Hiroshima, Japan
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Yoshida S, Koshima I, Imai H, Eldahshoury TEM, Sasaki A, Fujioka Y, Nagamatsu S, Yokota K, Harima M, Yamashita S. Line production system for multiple lymphaticovenular anastomoses. J Plast Reconstr Aesthet Surg 2019; 72:1334-1339. [PMID: 31056432 DOI: 10.1016/j.bjps.2019.03.038] [Citation(s) in RCA: 5] [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: 09/19/2018] [Revised: 03/21/2019] [Accepted: 03/30/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND A drawback of multiple lymphaticovenular anastomoses (LVAs) is the need for at least two microsurgeons and the same number of microscopes. In practice, many hospitals find it difficult to access such resources. We have developed a novel line production system (LPS) to address this problem. We assessed whether or not the LPS is better than the conventional dual microscope (DM) system when performing multiple LVAs. METHODS An LPS group, wherein a novice microsurgeon used loupes to dissect lymphatics and an expert microsurgeon used a microscope to perform the LVAs, and a DM (control) group, wherein the surgeons used microscopes to perform the LVAs. We recorded the lymphatic detection rate through the loupes and the diameter of the detected lymphatics. We also investigated the impact of using the LPS by comparing the number and quality of LVAs and improvement in lymphedema between the study groups. RESULTS The mean lymphatic detection rate was 81%±15.60%, and the mean size of lymphatics was 0.44 ± 0.12 mm in the LPS. The number of LVAs/h in LPS was significantly higher than that in DM (2.15 ± 0.20 vs. 1.38 ± 0.17; p < 0.01). The number of successful LVAs/h in LPS was significantly higher than that in the DM (2.08 ± 0.22 vs. 0.84 ± 0.14; P < 0.01). Mean rate of improvement in LEL index was significantly higher than that in DM (9.36 ± 1.85 vs. 6.93 ± 1.73; P < 0.01). DISCUSSION The number and quality of the LVAs increase using the LPS, which leads to further improvement in lymphedema, with fewer microscopes and microsurgeons and a shorter operating time.
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Affiliation(s)
- Shuhei Yoshida
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan.
| | - Isao Koshima
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Imai
- The International Center for Lymphedema, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Ayano Sasaki
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Yumio Fujioka
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Shogo Nagamatsu
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazunori Yokota
- Department of Plastic Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Mitsunobu Harima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuji Yamashita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract
The authors describe 3 cases with successful fingertip replantations using supermicrosurgical arteriole (terminal branch of digital artery) anastomoses, arteriole graft obtained from the same fingertip defect, reverse arteriole flow to subdermal venule, and delayed venular drainage for venous congestion. Among these 16 consecutive distal phalangeal replantations, 7 fingers showed postoperative venous congestion (43.8% of the total fingers) and 5 were reoperated on with delayed venous drainage under digital block. All the reoperated fingers were successfully drained by additional single or double venous drainage with a vein graft (100% success rate). As a result, 13 fingers survived (81.3% success rate).
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Affiliation(s)
- Isao Koshima
- International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan.
| | - Shuhei Yoshida
- International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan
| | - Hirofumi Imai
- International Center for Lymphedema, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan
| | - Ayano Sasaki
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan
| | - Shogo Nagamatsu
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan
| | - Kazunori Yokota
- Plastic and Reconstructive Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima City 734-8551, Japan
| | - Haruki Mizuta
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 1-3-7, Hongo, Bunkyo-ku, Tokyo 113-0011, Japan
| | - Mitsunobu Harima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 1-3-7, Hongo, Bunkyo-ku, Tokyo 113-0011, Japan
| | - Jyunsuke Tashiro
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 1-3-7, Hongo, Bunkyo-ku, Tokyo 113-0011, Japan
| | - Shuji Yamashita
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 1-3-7, Hongo, Bunkyo-ku, Tokyo 113-0011, Japan
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Abe T, Sasaki A, Ochiai H. A novel technique for removing a metal constriction device causing genital strangulation using a bolt cutter: A case report. African Journal of Urology 2018. [DOI: 10.1016/j.afju.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Nakajima S, Ogai T, Sasaki A. Relapse of conditioned taste aversion in rats exposed to constant and graded extinction treatments. Learning and Motivation 2018. [DOI: 10.1016/j.lmot.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sasaki A, Yamano Y, Sugimoto S, Otsuka H, Matsunami K, Shinzato T. Phenolic compounds from the leaves of Breynia officinalis and their tyrosinase and melanogenesis inhibitory activities. J Nat Med 2017; 72:381-389. [PMID: 29264846 DOI: 10.1007/s11418-017-1148-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/27/2017] [Indexed: 10/18/2022]
Abstract
From the EtOAc-soluble fraction of a MeOH extract of the leaves of Breynia officinalis, five new compounds (1-5) along with 11 known compounds (6-16) were isolated. The structures of the new compounds were elucidated by spectroscopic methods and compounds 1-3 were found to be acylated hydroquinone apiofuranosylglucopyranosides, while compound 4 was an acylated hydroquinone glucopyranoside. Compound 5 was shown to be butyl p-coumarate and this seems to be its first isolation from a natural source. The tyrosinase inhibitory activity of all of the isolated compounds was assayed, and the activity was significant in p-coumarate derivatives. The most active compound, compound 3, also inhibited melanogenesis in an in vivo whole animal model, zebrafish.
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Affiliation(s)
- Ayano Sasaki
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yoshi Yamano
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Sachiko Sugimoto
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hideaki Otsuka
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan. .,Department of Natural Products Chemistry, Faculty of Pharmacy, Yasuda Women's University, 6-13-1 Yasuhigashi, Asaminami-ku, Hiroshima, 731-0153, Japan.
| | - Katsuyoshi Matsunami
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
| | - Takakazu Shinzato
- Subtropical Field Science Center, Faculty of Agriculture, University of the Ryukyus, 685 Aza Yona, Kunigami-son, Kunigami-Gun, 905-1427, Okinawa, Japan
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Uchiumi Y, Ohtsuki H, Sasaki A. Evolutionary emergence and maintenance of horizontally transmitted mutualism that do not rely on the supply of standing variation in symbiont quality. J Evol Biol 2017; 30:2211-2221. [PMID: 28977715 DOI: 10.1111/jeb.13187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/15/2016] [Revised: 09/26/2017] [Accepted: 09/28/2017] [Indexed: 11/29/2022]
Abstract
Mutualism based on reciprocal exchange of costly services must avoid exploitation by 'free-rides'. Accordingly, hosts discriminate against free-riding symbionts in many mutualistic relationships. However, as the selective advantage of discriminators comes from the presence of variability in symbiont quality that they eliminate, discrimination and thus mutualism have been considered to be maintained with exogenous supply of free-riders. In this study, we tried to resolve the 'paradoxical' co-evolution of discrimination by hosts and cooperation by symbionts, by comparing two different types of discrimination: 'one-shot' discrimination, where a host does not reacquire new symbionts after evicting free-riders, and 'resampling' discrimination, where a host does from the environment. Our study shows that this apparently minor difference in discrimination types leads to qualitatively different evolutionary outcomes. First, although it has been usually considered that the benefit of discriminators is derived from the variability of symbiont quality, the benefit of a certain type of discriminators (e.g. one-shot discrimination) is proportional to the frequency of free-riders, which is in stark contrast to the case of resampling discrimination. As a result, one-shot discriminators can invade the free-rider/nondiscriminator population, even if standing variation for symbiont quality is absent. Second, our one-shot discriminators can also be maintained without exogenous supply of free-riders and hence is free from the paradox of discrimination. Therefore, our result indicates that the paradox is not a common feature of evolution of discrimination but is a problem of specific types of discrimination.
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Affiliation(s)
- Y Uchiumi
- Department of Evolutionary Studies of Biosystems, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - H Ohtsuki
- Department of Evolutionary Studies of Biosystems, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan
| | - A Sasaki
- Department of Evolutionary Studies of Biosystems, SOKENDAI (The Graduate University for Advanced Studies), Hayama, Kanagawa, Japan.,Evolution and Ecology Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
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Yazawa I, Jin C, Sasaki A, Iwase T. Mouse models contribute to develop a therapeutic strategy for multiple system atrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Akiyama Y, Iwaya T, Endo F, Shioi Y, Chiba T, Takahara T, Otsuka K, Nitta H, Koeda K, Mizuno M, Kimura Y, Sasaki A. Stability of cervical esophagogastrostomy via hand-sewn anastomosis after esophagectomy for esophageal cancer. Dis Esophagus 2017; 30:1-7. [PMID: 28375439 DOI: 10.1093/dote/dow007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of the present study is to evaluate the outcome of hand-sewn esophagogastric anastomosis during radical esophagectomy for esophageal cancer. The outcomes of 467 consecutive esophageal cancer patients who underwent cervical esophagogastric anastomosis using interrupted and double-layered sutures after radical esophagectomy via right thoracotomy or thoracoscopic surgery were retrospectively reviewed. Anastomotic leakage, including conduit necrosis, occurred in 11 of 467 patients (2.4%); 7 of 11 (63.6%) cases experienced only minor leakage, whereas the other four (36.4%) patients had major leakage that required surgical or radiologic intervention, including two patients of conduit necrosis. Anastomotic leakages were more frequently observed after retrosternal reconstruction compared with the posterior mediastinal route (P < 0.0001). The median time to healing of leakage was 40 days (range: 14-97 days). Two patients (2/467, 0.4%) died in the hospital due to sepsis caused by the leakage and conduit necrosis. Twelve patients (2.6%) developed anastomotic stenosis, which was improved by dilatation in all patients. Hand-sewn cervical esophagogastric anastomosis is a stable and highly safe method of radical esophagectomy for esophageal cancer.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Y Kimura
- Department of Palliative Medicine, Iwate Medical University School of Medicine, Iwate, Japan
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Domae S, Takakura H, Kunisada Y, Ono T, Sasaki A, Asahina I. The immunological impact of chemotherapy on the tumour microenvironment of oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.953] [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]
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42
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Nishiyama A, Ibaragi S, Yoshioka N, Shimo T, Sasaki A. A case of maxillary protrusion and gummy smile treated by multi-segmental horseshoe le fort i osteotomy. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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43
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Kimura T, Otsuka K, Yaegashi M, Hakozaki M, Matuo T, Fujii H, Sato K, Kamishima M, Miyake T, Takahara T, Akiyama Y, Iwaya T, Nishizuka S, Nitta H, Koeda K, Mizuno M, Kimura Y, Sasaki A. 529P Exploratory study for preventing nausea and vomiting by switching from pranisetron + dexamethasone (Days 1–3) + aprepitant (Days 1–3) to palonosetron + pexamethasone (Day 1) in patients undergoing moderately emetogenic chemotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw599.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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44
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Tanaka E, Kawai N, Hanaoka K, Van Eijden T, Sasaki A, Aoyama J, Tanaka M, Tanne K. Shear Properties of the Temporomandibular Joint Disc in Relation to Compressive and Shear Strain. J Dent Res 2016; 83:476-9. [PMID: 15153455 DOI: 10.1177/154405910408300608] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Shear stress can result in fatigue, damage, and irreversible deformation of the temporomandibular joint disc. Insight into the dynamic shear properties of the disc may give insight into the mechanism inducing tissue failure due to shear. We tested the hypothesis that the dynamic shear properties of the disc depend on the amount of shear and compressive strain. Twenty-four porcine discs were used for dynamic shear tests. The specimens were clamped between the plates of a loading apparatus under compressive strains of 5%, 10%, and 15%. Dynamic shear was applied to the specimen by a sinusoidal strain of, respectively, 0.5%, 1.0%, and 1.5%. Both the dynamic elasticity and viscosity were proportional to compressive strain and inversely proportional to shear strain. These shear characteristics suggest a significant role of compressive and shear strain on the internal friction of the disc.
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Affiliation(s)
- E Tanaka
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
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Yoshioka N, Nishiyama A, Ibaragi S, Domae S, Shimo T, Sasaki A. Clinical study of multiple segmental Le Fort I osteotomy. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Nishiyama A, Yoshioka N, Ibaragi S, Domae S, Kishimoto K, Shimo T, Sasaki A. Modifications of horseshoe Le Fort I osteotomy for the safety. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Takakubo Y, Okuda S, Naganuma Y, Ooishi R, Oki H, Tamaki Y, Sasaki A, Narita A, Hirayama T, Tamaki Y, Sasaki K, Takagi M. AB0408 Are Atypical Femoral Fractures in Rheumatic Patients Increasing? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1906] [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: 11/04/2022]
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Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R, Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O. Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 2015; 74:10-7. [PMID: 25576673 DOI: 10.1016/j.bone.2014.12.064] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [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: 10/27/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Little is known about correlates of vitamin D status in Asian populations. In this study, we established the prevalence of vitamin D sufficiency in the Murakami region (latitude N38°13') in Niigata, Japan, and examined demographic, environmental, and lifestyle factors that might be associated with vitamin D sufficiency, with the aim of clarifying the relative contributions of previously described determinants of vitamin D status as well as identifying new determinants in this Japanese population. METHODS This study involved a cross-sectional analysis of baseline data obtained from a cohort study conducted in 2011-2013. Participants were 9084 individuals aged between 40 and 74 years who provided blood samples for the determination of plasma 25-hydroxyvitamin D [25(OH)D] concentrations. Lifestyle information was obtained from 8498 participants, with some missing values regarding different lifestyle factors. Multiple logistic regression analysis was used to obtain odds ratios for vitamin D sufficiency, which was defined as a plasma 25(OH)D concentration ≥ 75 nmol/L. RESULTS The prevalence of vitamin D sufficiency (i.e., plasma 25(OH)D concentration ≥ 75 nmol/L) was 9.1%, and significant associations were observed with male gender (P<0.0001; OR=2.37, 95% CI: 1.84-3.05), older age (P for trend <0.0001), lower BMI (P for trend <0.0001), higher METs score (P for trend=0.0138), higher vitamin D intake (P for trend=0.0467), summer season (P for trend <0.0001), longer duration outdoors (P for trend=0.0026), no sunscreen use (P=0.0135; OR=1.40, 95% CI: 1.07-1.82), higher salmon consumption (P for trend <0.0001), higher alcohol consumption (P for trend <0.0001), and lower coffee consumption (P for trend=0.0025). Unlike other populations previously reported, vitamin D sufficiency was associated with older age. CONCLUSIONS The prevalence of vitamin D sufficiency (i.e., 25[OH]D ≥ 75 nmol/L) was low (9.1%) in this Japanese population. A number of demographic, environmental, and lifestyle factors are associated with vitamin D sufficiency, and thus lifestyle modification may present an opportunity to achieve vitamin D sufficiency.
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Affiliation(s)
- K Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan.
| | - K Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - R Takachi
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - T Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City 951-3198, Japan
| | - R Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata City 951-3198, Kita-ku, Japan
| | - R Oshiki
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata City 951-3198, Kita-ku, Japan
| | - Y Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - S Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - A Sasaki
- Murakami Public Health Center, 10-15 Sakanamachi, Murakami, Niigata 958-0864, Japan
| | - O Yamazaki
- Niigata Prefectural Office, 4-1 Shinkocho, Chuo-ku, Niigata City 950-0965, Japan
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Muramatsu A, Ito H, Sasaki A, Kajihara A, Watanabe T. Cultivation of rice for animal feed with circulated irrigation of treated municipal wastewater for enhanced nitrogen removal: comparison of cultivation systems feeding irrigation water upward and downward. Water Sci Technol 2015; 72:579-584. [PMID: 26247756 DOI: 10.2166/wst.2015.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To achieve enhanced nitrogen removal, we modified a cultivation system with circulated irrigation of treated municipal wastewater by using rice for animal feed instead of human consumption. The performance of this modified system was evaluated through a bench-scale experiment by comparing the direction of circulated irrigation (i.e. passing through paddy soil upward and downward). The modified system achieved more than three times higher nitrogen removal (3.2 g) than the system in which rice for human consumption was cultivated. The removal efficiency was higher than 99.5%, regardless of the direction of circulated irrigation. Nitrogen in the treated municipal wastewater was adsorbed by the rice plant in this cultivation system as effectively as chemical fertilizer used in normal paddy fields. Circulated irrigation increased the nitrogen released to the atmosphere, probably due to enhanced denitrification. Neither the circulation of irrigation water nor its direction affected the growth of the rice plant and the yield and quality of harvested rice. The yield of rice harvested in this system did not reach the target value in normal paddy fields. To increase this yield, a larger amount of treated wastewater should be applied to the system, considering the significant amount of nitrogen released to the atmosphere.
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Affiliation(s)
- A Muramatsu
- Department of Science of Bioproduction, Yamagata University, 1-23 Wakaba-machi, Tsuruoka, Yamagata 997-8555, Japan
| | - H Ito
- Department of Food, Life and Environmental Sciences, Yamagata University, 1-23 Wakaba-machi, Tsuruoka, Yamagata 997-8555, Japan E-mail:
| | - A Sasaki
- Laboratory for Instrumental Analysis, Faculty of Engineering, Yamagata University, 4-3-16 Jonan, Yonezawa, Yamagata 992-8510, Japan
| | - A Kajihara
- Department of Food, Life and Environmental Sciences, Yamagata University, 1-23 Wakaba-machi, Tsuruoka, Yamagata 997-8555, Japan E-mail:
| | - T Watanabe
- Department of Food, Life and Environmental Sciences, Yamagata University, 1-23 Wakaba-machi, Tsuruoka, Yamagata 997-8555, Japan E-mail:
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Motomura K, Sasaki A, Hisano M, Yamaguchi K, Ito Y, Ito R, Kasahara M, Matsumoto K, Sago H. A case report of neonatal hemochromatosis treated by high-dose intravenous immunoglobulin. J Reprod Immunol 2014. [DOI: 10.1016/j.jri.2014.09.021] [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: 11/17/2022]
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