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Krispin E, Javinani A, Odibo A, Carreras E, Emery SP, Sepulveda Gonzalez G, Habli M, Hecher K, Ishii K, Miller J, Papanna R, Johnson A, Khalil A, Kilby MD, Lewi L, Bennasar Sans M, Otaño L, Zaretsky MV, Sananes N, Turan OM, Slaghekke F, Stirnemann J, Van Mieghem T, Welsh AW, Yoav Y, Chmait R, Shamshirsaz AA. Consensus protocol for management of early and late twin-twin transfusion syndrome: Delphi study. Ultrasound Obstet Gynecol 2024; 63:371-377. [PMID: 37553800 DOI: 10.1002/uog.27446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/11/2023] [Accepted: 07/21/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE Fetoscopic laser photocoagulation (FLP) is a well-established treatment for twin-twin transfusion syndrome (TTTS) between 16 and 26 weeks' gestation. High-quality evidence and guidelines regarding the optimal clinical management of very early (prior to 16 weeks), early (between 16 and 18 weeks) and late (after 26 weeks) TTTS are lacking. The aim of this study was to construct a structured expert-based clinical consensus for the management of early and late TTTS. METHODS A Delphi procedure was conducted among an international panel of experts. Participants were chosen based on their clinical expertise, affiliation and relevant publications. A four-round Delphi survey was conducted using an online platform and responses were collected anonymously. In the first round, a core group of experts was asked to answer open-ended questions regarding the indications, timing and modes of treatment for early and late TTTS. In the second and third rounds, participants were asked to grade each statement on a Likert scale (1, completely disagree; 5, completely agree) and to add any suggestions or modifications. At the end of each round, the median score for each statement was calculated. Statements with a median grade of 5 without suggestions for change were accepted as the consensus. Statements with a median grade of 3 or less were excluded from the Delphi process. Statements with a median grade of 4 were modified according to suggestions and reconsidered in the next round. In the last round, participants were asked to agree or disagree with the statements, and those with more than 70% agreement without suggestions for change were considered the consensus. RESULTS A total of 122 experts met the inclusion criteria and were invited to participate, of whom 53 (43.4%) agreed to take part in the study. Of those, 75.5% completed all four rounds. A consensus on the optimal management of early and late TTTS was obtained. FLP can be offered as early as 15 weeks' gestation for selected cases, and can be considered up to 28 weeks. Between 16 and 18 weeks, management should be tailored according to Doppler findings. CONCLUSIONS A consensus-based treatment protocol for early and late TTTS was agreed upon by a panel of experts. This protocol should be modified at the discretion of the operator, according to their experience and the specific demands of each case. This should advance the quality of future studies, guide clinical practice and improve patient care. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- E Krispin
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Javinani
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Odibo
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA
| | - E Carreras
- Maternal-Fetal Medicine Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S P Emery
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - G Sepulveda Gonzalez
- Instituto de Salud Fetal (ISF), Hospital Regional Materno Infantil, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, México
| | - M Habli
- Department of Pediatric Surgery, Fetal Care Center of Cincinnati, Good Samaritan Hospital, Cincinnati, OH, USA
| | - K Hecher
- Department of Obstetrics and Prenatal Medicine, University Medical Center Eppendorf, Hamburg, Germany
| | - K Ishii
- Maternal-Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - J Miller
- The Johns Hopkins Center for Fetal Therapy, Department of Gynecology and Obstetrics, Baltimore, MD, USA
| | - R Papanna
- Fetal Center, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - A Johnson
- Fetal Center, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas McGovern Medical School at Houston, Houston, TX, USA
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
- Fetal Medicine Unit, Liverpool Women's Hospital, Liverpool, UK
| | - M D Kilby
- Fetal Medicine Center, Birmingham Women's and Children's Foundation Trust, Birmingham, UK
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Illumina UK, Great Abbington, Cambridge, UK
| | - L Lewi
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - M Bennasar Sans
- BCNatal, Maternal-Fetal Medicine Center, Hospital Clínic i Hospital Sant Joan de Déu, Barcelona, Spain
| | - L Otaño
- Maternal-Fetal Medicine Unit, Obstetric Division, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
| | - M V Zaretsky
- Colorado Fetal Care Center, Children's Hospital of Colorado, University of Colorado, Denver, CO, USA
| | - N Sananes
- Obstetrics and Gynecology Department, Strasbourg University Hospital, Strasbourg, France
- Inserm 1121 'Biomaterials and Bioengineering', Strasbourg University, Strasbourg, France
| | - O M Turan
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - F Slaghekke
- Department of Obstetrics, Fetal Medicine Unit, Leiden University Medical Center, Leiden, The Netherlands
| | - J Stirnemann
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, University of Paris, Paris, France
| | - T Van Mieghem
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada
| | - A W Welsh
- Maternal-Fetal Medicine, Royal Hospital for Women, University of New South Wales, Sydney, Australia
| | - Y Yoav
- Fetal Medicine Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Chmait
- Los Angeles Fetal Surgery, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A A Shamshirsaz
- Maternal Fetal Care Center (MFCC), Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Lin CY, Shibata A, Ishii K, Koohsari MJ, Hadgraft N, Dunstan DW, Owen N, Oka K. Reallocating desk workers' sitting time to standing or stepping: associations with work performance. Occup Med (Lond) 2023; 73:575-580. [PMID: 38104251 PMCID: PMC10824261 DOI: 10.1093/occmed/kqad142] [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] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Studies have suggested that sitting time at work may lead to underperformance but they may underestimate the benefits to desk workers' performance of reducing occupational sitting time without considering the relative effects of the specific activities replaced. AIMS To estimate differences in work performance (presenteeism, absenteeism and engagement) when occupational sitting time is reallocated to standing/stepping in desk workers. METHODS Data for middle-aged desk workers were from a Japan-wide online survey (n = 2228). Self-report proportion of occupational sitting and standing/stepping, work hours and work performance indicators, including absolute (ratings relating only to self) and relative (ratings of self, compared to others) presenteeism and absenteeism, and dimensions of work engagement, were collected. Partition and isotemporal substitution models were used to investigate the associations of occupational sitting and standing/stepping time with work performance, including their reallocation effects. RESULTS In partition models, longer occupational sitting time was associated with a lower absolute presenteeism score (i.e. less productivity), lower absolute absenteeism (i.e. longer-than-expected work hours), and lower engagement. Longer occupational standing/stepping time was associated with lower absolute absenteeism and more engagement. Isotemporal substitution models showed that each hour of occupational sitting reallocated to standing/stepping was favourably associated with overall work engagement (B = 0.087; 95% confidence interval 0.051, 0.122) and its dimensions (B ranged from 0.078 to 0.092), but was not associated with presenteeism or absenteeism. CONCLUSIONS These findings suggest that management support and practical initiatives to encourage desk workers to replace portions of their sitting time with standing/stepping may contribute to enhanced work engagement.
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Affiliation(s)
- C-Y Lin
- Department of Public Health, College of Public Health, China Medical University, Taichung, 406040Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
| | - A Shibata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, 305-8577Japan
| | - K Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
| | - M J Koohsari
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, 923-1292Japan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
| | - N Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - D W Dunstan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - N Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - K Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
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Yamamoto R, Ozawa K, Wada S, Sago H, Nagasaki S, Takano M, Nakata M, Nozaki M, Ishii K. Infantile outcome at 3 years of age among monochorionic twins with Type-II or -III selective fetal growth restriction with isolated oligohydramnios who underwent fetoscopic laser photocoagulation. Ultrasound Obstet Gynecol 2023. [PMID: 38031151 DOI: 10.1002/uog.27551] [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: 07/18/2023] [Revised: 10/17/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE This study aimed to examine infantile outcomes at 3 years of age with selective fetal growth restriction (sFGR) Types II and III with isolated oligohydramnios who underwent fetoscopic laser photocoagulation (FLP). METHODS This multicenter prospective cohort study included monochorionic diamniotic twins who underwent FLP for sFGR between 16 and 25 weeks of gestation. The indication for performing FLP was in cases of sFGR Type II or III with oligohydramnios, where the maximal vertical pocket was ≤2 cm among twins with FGR. This was done in the absence of a typical twin-twin transfusion syndrome diagnosis. The primary outcome was the intact survival (IS) rate of infants at the corrected age of 40 weeks and 3 years. IS at the corrected age of 40 weeks was defined as survival without grade III or IV intraventricular hemorrhage or cystic periventricular leukomalacia, and IS at 3 years of age was defined as survival without neurodevelopmental morbidity, including cerebral palsy, neurodevelopmental impairment with a total developmental quotient of ≤70, bilateral deafness, or bilateral blindness. RESULTS Among 45 patients with sFGR, 30 (66.7%) were classified as having Type II and 15 (33.3%) as Type III sFGR. The prevalence of IS at the corrected age of 40 weeks was 51.1% (n=23) in FGR twins and 95.5% (n=42) in larger twins. The prevalence of IS at 3 years of age was 46.7% (n=21) in FGR twins and 86.4% (n=38) in larger twins. Among the 24 FGR twins who were not diagnosed with IS at 3 years of age, 91.7% (22 of 24 cases) suffered fetal or infantile demise other than miscarriage and neurodevelopmental impairment. All larger twins who were not diagnosed with IS at 3 years of age (n=6, 13.6%) had neurological morbidity, in addition to one case of miscarriage. CONCLUSIONS FGR twins and larger twins, when subjected to FLP due to sFGR coupled with umbilical artery Doppler abnormalities and isolated oligohydramnios, exhibit low rates of neurological morbidity and low mortality, respectively. Therefore, FLP for Type II or III sFGR with oligohydramnios may be a feasible and preferable management option. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- R Yamamoto
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
| | - K Ozawa
- National Center for Child Health and Development, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, Tokyo, Japan
| | - S Wada
- National Center for Child Health and Development, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, Tokyo, Japan
| | - H Sago
- National Center for Child Health and Development, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, Tokyo, Japan
| | - S Nagasaki
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - M Takano
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - M Nakata
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - M Nozaki
- Department of Neonatology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - K Ishii
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan
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Nassr AA, Hessami K, Corroenne R, Sanz Cortes M, Donepudi R, Espinoza J, Yamamoto R, Stirnemann J, Ishii K, Belfort MA, Chmait RH, Shamshirsaz AA. Outcome of laser photocoagulation in monochorionic diamniotic twin pregnancy complicated by Type-II selective fetal growth restriction. Ultrasound Obstet Gynecol 2023; 62:369-373. [PMID: 36704956 DOI: 10.1002/uog.26165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/05/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To evaluate the outcome of monochorionic diamniotic (MCDA) twins complicated by Type-II selective fetal growth restriction (sFGR) who underwent fetoscopic laser photocoagulation and to validate a previously proposed subclassification system for Type-II sFGR in a large multicenter cohort. METHODS This retrospective multicenter cohort study included all MCDA twins complicated by Type-II sFGR who underwent laser photocoagulation of placental anastomoses at four large tertiary fetal-care centers between 2006 and 2020. Cases were subclassified according to a recently proposed system based on Doppler evaluation of the ductus venosus (DV) and middle cerebral artery (MCA) into Type-IIA (normal DV flow and MCA peak systolic velocity (PSV) of the growth-restricted fetus) or Type-IIB (absent or reversed flow in the DV during atrial contraction and/or MCA-PSV ≥ 1.5 multiples of the median of the growth-restricted fetus). Demographic characteristics and pregnancy outcomes were compared between the groups. Data are presented as mean ± SD or n (%) as appropriate. P-values < 0.05 were considered statistically significant. RESULTS A total of 98 patients with MCDA twins met our inclusion criteria, with 56 subclassified as Type IIA and 42 as Type IIB. Demographic characteristics were similar between the groups; however, Type-IIB cases had a significantly earlier gestational age at diagnosis and at laser surgery, as well as larger intertwin estimated fetal weight discordance, which may be a reflection of disease severity. Postnatal survival of the growth-restricted fetus to 30 days of age was significantly lower in Type-IIB compared to Type-IIA cases (23.8% vs 46.4%; P = 0.034). CONCLUSIONS In MCDA twins complicated by Type-II sFGR and treated with laser photocoagulation of placental anastomoses, preoperative Doppler assessment of the DV and MCA helped identify a subset of patients at increased risk of demise of the growth-restricted fetus following intervention. This study provides valuable information for guiding surgical management and patient counseling. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- A A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - K Hessami
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - R Corroenne
- Department of Obstetrics and Gynecology, University Paris Descartes, Hopital Necker-Enfants Malades, Paris, France
| | - M Sanz Cortes
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - R Donepudi
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - J Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - R Yamamoto
- Department of Maternal-Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - J Stirnemann
- Department of Obstetrics and Gynecology, University Paris Descartes, Hopital Necker-Enfants Malades, Paris, France
| | - K Ishii
- Department of Maternal-Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Japan
| | - M A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - R H Chmait
- Department of Obstetrics and Gynecology, Los Angeles Fetal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A A Shamshirsaz
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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5
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Port M, Barquinero JF, Endesfelder D, Moquet J, Oestreicher U, Terzoudi G, Trompier F, Vral A, Abe Y, Ainsbury L, Alkebsi L, Amundson S, Badie C, Baeyens A, Balajee A, Balázs K, Barnard S, Bassinet C, Beaton-Green L, Beinke C, Bobyk L, Brochard P, Brzoska K, Bucher M, Ciesielski B, Cuceu C, Discher M, D,Oca M, Domínguez I, Doucha-Senf S, Dumitrescu A, Duy P, Finot F, Garty G, Ghandhi S, Gregoire E, Goh V, Güçlü I, Hadjiiska L, Hargitai R, Hristova R, Ishii K, Kis E, Juniewicz M, Kriehuber R, Lacombe J, Lee Y, Lopez Riego M, Lumniczky K, Mai T, Maltar-Strmečki N, Marrale M, Martinez J, Marciniak A, Maznyk N, McKeever S, Meher P, Milanova M, Miura T, Gil OM, Montoro A, Domene MM, Mrozik A, Nakayama R, O’Brien G, Oskamp D, Ostheim P, Pajic J, Pastor N, Patrono C, Pujol-Canadell M, Rodriguez MP, Repin M, Romanyukha A, Rößler U, Sabatier L, Sakai A, Scherthan H, Schüle S, Seong K, Sevriukova O, Sholom S, Sommer S, Suto Y, Sypko T, Szatmári T, Takahashi-Sugai M, Takebayashi K, Testa A, Testard I, Tichy A, Triantopoulou S, Tsuyama N, Unverricht-Yeboah M, Valente M, Van Hoey O, Wilkins R, Wojcik A, Wojewodzka M, Younghyun L, Zafiropoulos D, Abend M. RENEB Inter-Laboratory Comparison 2021: Inter-Assay Comparison of Eight Dosimetry Assays. Radiat Res 2023; 199:535-555. [PMID: 37310880 PMCID: PMC10508307 DOI: 10.1667/rade-22-00207.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/10/2023] [Indexed: 06/15/2023]
Abstract
Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses <2.5 Gy or >2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.
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Affiliation(s)
- M. Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | | | | | - J. Moquet
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | | | - G. Terzoudi
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - F. Trompier
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Vral
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - Y. Abe
- Department of Radiation Biology and Protection, Nagasaki University, Japan
| | - L. Ainsbury
- UK Health Security Agency and Office for Health Improvement and Disparities, Cytogenetics and Pathology Group, Oxfordshire, England
| | - L Alkebsi
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S.A. Amundson
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - C. Badie
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - A. Baeyens
- Ghent University, Radiobiology Research Unit, Gent, Belgium
| | - A.S. Balajee
- Cytogenetic Biodosimetry Laboratory, Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - K. Balázs
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - S. Barnard
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - C. Bassinet
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | | | - C. Beinke
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - L. Bobyk
- Institut de Recherche Biomédicale des Armées (IRBA), Bretigny Sur Orge, France
| | | | - K. Brzoska
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - M. Bucher
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | - B. Ciesielski
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - C. Cuceu
- Genevolution, Porcheville, France
| | - M. Discher
- Paris-Lodron-University of Salzburg, Department of Environment and Biodiversity, 5020 Salzburg, Austria
| | - M.C. D,Oca
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - I. Domínguez
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | | | - A. Dumitrescu
- National Institute of Public Health, Radiation Hygiene Laboratory, Bucharest, Romania
| | - P.N. Duy
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - F. Finot
- Genevolution, Porcheville, France
| | - G. Garty
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - S.A. Ghandhi
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | - E. Gregoire
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - V.S.T. Goh
- Department of Radiobiology, Singapore Nuclear Research and Safety Initiative (SNRSI), National University of Singapore, Singapore
| | - I. Güçlü
- TENMAK, Nuclear Energy Research Institute, Technology Development and Nuclear Research Department, Türkey
| | - L. Hadjiiska
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - R. Hargitai
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - R. Hristova
- National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria
| | - K. Ishii
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - E. Kis
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Juniewicz
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - R. Kriehuber
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - J. Lacombe
- University of Arizona, Center for Applied Nanobioscience & Medicine, Phoenix, Arizona
| | - Y. Lee
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - K. Lumniczky
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - T.T. Mai
- Dalat Nuclear Research Institute, Radiation Technlogy & Biotechnology Center, Dalat City, Vietnam
| | - N. Maltar-Strmečki
- Ruðer Boškovic Institute, Division of Physical Chemistry, Zagreb, Croatia
| | - M. Marrale
- Università Degli Studi di Palermo, Dipartimento di Fisica e Chimica “Emilio Segrè,” Palermo, Italy
| | - J.S. Martinez
- Institut de Radioprotection et de Surete Nucleaire, Fontenay aux Roses, France
| | - A. Marciniak
- Medical University of Gdansk, Department of Physics and Biophysics, Gdansk, Poland
| | - N. Maznyk
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - S.W.S. McKeever
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | | | - M. Milanova
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - T. Miura
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - O. Monteiro Gil
- Instituto Superior Técnico/ Campus Tecnológico e Nuclear, Lisbon, Portugal
| | - A. Montoro
- Servicio de Protección Radiológica. Laboratorio de Dosimetría Biológica, Valencia, Spain
| | - M. Moreno Domene
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - A. Mrozik
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland
| | - R. Nakayama
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - G. O’Brien
- UK Health Security Agency, Radiation, Chemical and Environmental Hazards Division, Oxfordshire, United Kingdom
| | - D. Oskamp
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - P. Ostheim
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - J. Pajic
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - N. Pastor
- Universidad de Sevilla, Departamento de Biología Celular, Sevilla, Spain
| | - C. Patrono
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | | | - M.J. Prieto Rodriguez
- Hospital General Universitario Gregorio Marañón, Laboratorio de dosimetría biológica, Madrid, Spain
| | - M. Repin
- Columbia University, Irving Medical Center, Center for Radiological Research, New York, New York
| | | | - U. Rößler
- Bundesamt für Strahlenschutz, Oberschleißheim, Germany
| | | | - A. Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - H. Scherthan
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - S. Schüle
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - K.M. Seong
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | | | - S. Sholom
- Radiation Dosimetry Laboratory, Oklahoma State University, Stillwater, Oklahoma
| | - S. Sommer
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Y. Suto
- Department of Radiation Measurement and Dose Assessment, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - T. Sypko
- Radiation Cytogenetics Laboratory, S.P. Grigoriev Institute for Medical Radiology and Oncology of Ukrainian National Academy of Medical Science, Kharkiv, Ukraine
| | - T. Szatmári
- Radiation Medicine Unit, Department of Radiobiology and Radiohygiene, National Public Health Centre, Budapest, Hungary
| | - M. Takahashi-Sugai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - K. Takebayashi
- Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - A. Testa
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Rome, Italy
| | - I. Testard
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - A. Tichy
- University of Defense, Faculty of Military Health Sciences, Hradec Králové, Czech Republic
| | - S. Triantopoulou
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics Laboratory, Agia Paraskevi, Greece
| | - N. Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M. Unverricht-Yeboah
- Department of Safety and Radiation Protection, Forschungszentrum Jülich, Jülich, Germany
| | - M. Valente
- CEA-Saclay, Gif-sur-Yvette Cedex, France
| | - O. Van Hoey
- Belgian Nuclear Research Center SCK CEN, Mol, Belgium
| | | | - A. Wojcik
- Stockholm University, Stockholm, Sweden
| | - M. Wojewodzka
- Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Lee Younghyun
- Laboratory of Biological Dosimetry, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - D. Zafiropoulos
- Laboratori Nazionali di Legnaro - Istituto Nazionale di Fisica Nucleare, Legnaro, Italy
| | - M. Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
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Ishii K, Yokoyama Y, Yonekawa Y, Hayashi D, Kinoshita F, Kuwatsuka Y, Okuno M, Natsume S, Minami T, Sugawara G, Seita K, Sato F, Aoba T, Shimizu Y, Kurumiya Y, Maeda A, Yamaguchi R, Hiramatsu K, Ebata T. Tranexamic acid and blood loss in pancreaticoduodenectomy: TAC-PD randomized clinical trial. Br J Surg 2023; 110:159-165. [PMID: 36379883 DOI: 10.1093/bjs/znac382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/04/2022] [Accepted: 10/21/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tranexamic acid (TXA) may reduce intraoperative blood loss, but it has not been investigated in pancreaticoduodenectomy (PD). METHODS A pragmatic, multicentre, randomized, blinded, placebo-controlled trial was conducted. Adult patients undergoing planned PD for biliary, duodenal, or pancreatic diseases were randomly assigned to TXA or placebo groups. Patients in the TXA group were administered 1 g TXA before incision, followed by a maintenance infusion of 125 mg/h TXA. Patients in the placebo group were administered the same volume of saline as those in the placebo group. The primary outcome was blood loss during PD. The secondary outcomes included perioperative blood transfusions, operating time, morbidity, and mortality. RESULTS Between September 2019 and May 2021, 218 patients were randomly assigned and underwent surgery (108 in the TXA group and 110 in the placebo group). Mean intraoperative blood loss was 659 ml in the TXA group and 701 ml in the placebo group (mean difference -42 ml, 95 per cent c.i. -191 to 106). Of the 218 patients, 202 received the intervention and underwent PD, and the mean blood loss during PD was 667 ml in the TXA group and 744 ml in the placebo group (mean difference -77 ml, 95 per cent c.i. -226 to 72). The secondary outcomes were comparable between the two groups. CONCLUSION Perioperative TXA use did not reduce blood loss during PD. REGISTRATION NUMBER jRCTs041190062 (https://jrct.niph.go.jp).
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Affiliation(s)
- Kenta Ishii
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,Department of General Surgery, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,Division of Perioperative Medicine, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshihiko Yonekawa
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Daisuke Hayashi
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Fumie Kinoshita
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Yachiyo Kuwatsuka
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Masataka Okuno
- Department of Gastroenterological Surgery, Aichi Cancer Centre Hospital, Nagoya, Aichi, Japan
| | - Seiji Natsume
- Department of Gastroenterological Surgery, Aichi Cancer Centre Hospital, Nagoya, Aichi, Japan
| | - Takayuki Minami
- Department of Surgery, Toyota Kosei Hospital, Toyota, Aichi, Japan
| | - Gen Sugawara
- Department of Surgery, Toyota Kosei Hospital, Toyota, Aichi, Japan
| | - Kazuaki Seita
- Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
| | - Fumiya Sato
- Department of Surgery, Kasugai Municipal Hospital, Kasugai, Aichi, Japan
| | - Taro Aoba
- Department of General Surgery, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Centre Hospital, Nagoya, Aichi, Japan
| | | | - Atsuyuki Maeda
- Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
| | - Ryuzo Yamaguchi
- Department of Surgery, Kasugai Municipal Hospital, Kasugai, Aichi, Japan
| | - Kazuhiro Hiramatsu
- Department of General Surgery, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Tomoki Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Ishii K, Matsue Y, Miyauchi K, Miyazaki S, Hidemori H, Nishizaki Y, Nojiri S, Saito Y, Nagashima K, Okumura Y, Daida H, Minamino T. Predicting new-onset heart failure hospitalization of patients with atrial fibrillation: development and external validations of a risk score. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a well-known risk factor for heart failure (HF), and HF development as a complication of AF is associated with a decline in the quality of life and poor prognosis. However, unlike thrombotic events, incidence of HF in patients with AF has not changed for decades, and a preventive strategy has yet to be developed.
Purpose
We sought to develop a risk model for new-onset HF admission in patients with AF and without a history of HF. Additionally, we attempted to externally validate the developed risk model.
Methods
We utilized two multicenter, prospective, observational registries of AF and analyzed the patients without a history of AF. One of which is defined as a derivation cohort, which included 2,857 patients, and the other is defined as a validation cohort, which included 2,516 patients. We developed a risk model by selecting variables with regularized regression and weighing coefficients by Cox regression analysis with the derivation cohort. The external validity was tested in the validation cohort.
Results
During the follow-up period, 148 patients (5.2%) in the derivation cohort and 104 patients (4.1%) in the validation cohort developed HF during the median follow-up period of 1,396 (interquartile range [IQR]: 1,078–1,820) days and 1,168 (IQR: 844–1,309) days, respectively. In the derivation cohort, four predictors (age, hemoglobin, serum creatinine, and log-transformed brain natriuretic peptide) were identified as potential risk factors for HF development. The developed risk model showed good discrimination and calibration in both the derivation (area under the curve [AUC], 0.77 [95% confidence interval (CI) 0.73–0.81]; Hosmer-Lemeshow test, P=0.257) and validation cohorts (AUC: 0.76 [95% CI 0.72–0.81]; Hosmer-Lemeshow test, P=0.475). Considering death not due to HF as a competing risk, the cumulative incidence curves for HF admission stratified by the risk score were generated, which showed higher HF hospitalization rate for the higher risk score categories.
Conclusion
The newly developed risk model with four readily available clinical characteristics and biomarkers performed well in the prediction of new-onset HF admission of patients with AF in both derivation and validation cohort.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Ishii
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - S Miyazaki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - H Hidemori
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - Y Nishizaki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - S Nojiri
- Juntendo University School of Medicine, Medical Technology Innovation Center , Tokyo , Japan
| | - Y Saito
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - K Nagashima
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - Y Okumura
- Nihon University School of Medicine, Division of Cardiology, Department of Medicine , Tokyo , Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine , Tokyo , Japan
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Kamarajah S, Evans R, Nepogodiev D, Hodson J, Bundred J, Gockel I, Gossage J, Isik A, Kidane B, Mahendran H, Negoi I, Okonta K, Sayyed R, van Hillegersberg R, Vohra R, Wijnhoven B, Singh P, Griffiths E, Kamarajah S, Hodson J, Griffiths E, Alderson D, Bundred J, Evans R, Gossage J, Griffiths E, Jefferies B, Kamarajah S, McKay S, Mohamed I, Nepogodiev D, Siaw-Acheampong K, Singh P, van Hillegersberg R, Vohra R, Wanigasooriya K, Whitehouse T, Gjata A, Moreno J, Takeda F, Kidane B, Guevara Castro R, Harustiak T, Bekele A, Kechagias A, Gockel I, Kennedy A, Da Roit A, Bagajevas A, Azagra J, Mahendran H, Mejía-Fernández L, Wijnhoven B, El Kafsi J, Sayyed R, Sousa M, Sampaio A, Negoi I, Blanco R, Wallner B, Schneider P, Hsu P, Isik A, Gananadha S, Wills V, Devadas M, Duong C, Talbot M, Hii M, Jacobs R, Andreollo N, Johnston B, Darling G, Isaza-Restrepo A, Rosero G, Arias-Amézquita F, Raptis D, Gaedcke J, Reim D, Izbicki J, Egberts J, Dikinis S, Kjaer D, Larsen M, Achiam M, Saarnio J, Theodorou D, Liakakos T, Korkolis D, Robb W, Collins C, Murphy T, Reynolds J, Tonini V, Migliore M, Bonavina L, Valmasoni M, Bardini R, Weindelmayer J, Terashima M, White R, Alghunaim E, Elhadi M, Leon-Takahashi A, Medina-Franco H, Lau P, Okonta K, Heisterkamp J, Rosman C, van Hillegersberg R, Beban G, Babor R, Gordon A, Rossaak J, Pal K, Qureshi A, Naqi S, Syed A, Barbosa J, Vicente C, Leite J, Freire J, Casaca R, Costa R, Scurtu R, Mogoanta S, Bolca C, Constantinoiu S, Sekhniaidze D, Bjelović M, So J, Gačevski G, Loureiro C, Pera M, Bianchi A, Moreno Gijón M, Martín Fernández J, Trugeda Carrera M, Vallve-Bernal M, Cítores Pascual M, Elmahi S, Halldestam I, Hedberg J, Mönig S, Gutknecht S, Tez M, Guner A, Tirnaksiz M, Colak E, Sevinç B, Hindmarsh A, Khan I, Khoo D, Byrom R, Gokhale J, Wilkerson P, Jain P, Chan D, Robertson K, Iftikhar S, Skipworth R, Forshaw M, Higgs S, Gossage J, Nijjar R, Viswanath Y, Turner P, Dexter S, Boddy A, Allum W, Oglesby S, Cheong E, Beardsmore D, Vohra R, Maynard N, Berrisford R, Mercer S, Puig S, Melhado R, Kelty C, Underwood T, Dawas K, Lewis W, Al-Bahrani A, Bryce G, Thomas M, Arndt A, Palazzo F, Meguid R, Fergusson J, Beenen E, Mosse C, Salim J, Cheah S, Wright T, Cerdeira M, McQuillan P, Richardson M, Liem H, Spillane J, Yacob M, Albadawi F, Thorpe T, Dingle A, Cabalag C, Loi K, Fisher O, Ward S, Read M, Johnson M, Bassari R, Bui H, Cecconello I, Sallum R, da Rocha J, Lopes L, Tercioti V, Coelho J, Ferrer J, Buduhan G, Tan L, Srinathan S, Shea P, Yeung J, Allison F, Carroll P, Vargas-Barato F, Gonzalez F, Ortega J, Nino-Torres L, Beltrán-García T, Castilla L, Pineda M, Bastidas A, Gómez-Mayorga J, Cortés N, Cetares C, Caceres S, Duarte S, Pazdro A, Snajdauf M, Faltova H, Sevcikova M, Mortensen P, Katballe N, Ingemann T, Morten B, Kruhlikava I, Ainswort A, Stilling N, Eckardt J, Holm J, Thorsteinsson M, Siemsen M, Brandt B, Nega B, Teferra E, Tizazu A, Kauppila J, Koivukangas V, Meriläinen S, Gruetzmann R, Krautz C, Weber G, Golcher H, Emons G, Azizian A, Ebeling M, Niebisch S, Kreuser N, Albanese G, Hesse J, Volovnik L, Boecher U, Reeh M, Triantafyllou S, Schizas D, Michalinos A, Balli E, Mpoura M, Charalabopoulos A, Manatakis D, Balalis D, Bolger J, Baban C, Mastrosimone A, McAnena O, Quinn A, Ó Súilleabháin C, Hennessy M, Ivanovski I, Khizer H, Ravi N, Donlon N, Cervellera M, Vaccari S, Bianchini S, Sartarelli L, Asti E, Bernardi D, Merigliano S, Provenzano L, Scarpa M, Saadeh L, Salmaso B, De Manzoni G, Giacopuzzi S, La Mendola R, De Pasqual C, Tsubosa Y, Niihara M, Irino T, Makuuchi R, Ishii K, Mwachiro M, Fekadu A, Odera A, Mwachiro E, AlShehab D, Ahmed H, Shebani A, Elhadi A, Elnagar F, Elnagar H, Makkai-Popa S, Wong L, Tan Y, Thannimalai S, Ho C, Pang W, Tan J, Basave H, Cortés-González R, Lagarde S, van Lanschot J, Cords C, Jansen W, Martijnse I, Matthijsen R, Bouwense S, Klarenbeek B, Verstegen M, van Workum F, Ruurda J, van der Sluis P, de Maat M, Evenett N, Johnston P, Patel R, MacCormick A, Young M, Smith B, Ekwunife C, Memon A, Shaikh K, Wajid A, Khalil N, Haris M, Mirza Z, Qudus S, Sarwar M, Shehzadi A, Raza A, Jhanzaib M, Farmanali J, Zakir Z, Shakeel O, Nasir I, Khattak S, Baig M, MA N, Ahmed H, Naeem A, Pinho A, da Silva R, Bernardes A, Campos J, Matos H, Braga T, Monteiro C, Ramos P, Cabral F, Gomes M, Martins P, Correia A, Videira J, Ciuce C, Drasovean R, Apostu R, Ciuce C, Paitici S, Racu A, Obleaga C, Beuran M, Stoica B, Ciubotaru C, Negoita V, Cordos I, Birla R, Predescu D, Hoara P, Tomsa R, Shneider V, Agasiev M, Ganjara I, Gunjić D, Veselinović M, Babič T, Chin T, Shabbir A, Kim G, Crnjac A, Samo H, Díez del Val I, Leturio S, Ramón J, Dal Cero M, Rifá S, Rico M, Pagan Pomar A, Martinez Corcoles J, Rodicio Miravalles J, Pais S, Turienzo S, Alvarez L, Campos P, Rendo A, García S, Santos E, Martínez E, Fernández Díaz M, Magadán Álvarez C, Concepción Martín V, Díaz López C, Rosat Rodrigo A, Pérez Sánchez L, Bailón Cuadrado M, Tinoco Carrasco C, Choolani Bhojwani E, Sánchez D, Ahmed M, Dzhendov T, Lindberg F, Rutegård M, Sundbom M, Mickael C, Colucci N, Schnider A, Er S, Kurnaz E, Turkyilmaz S, Turkyilmaz A, Yildirim R, Baki B, Akkapulu N, Karahan O, Damburaci N, Hardwick R, Safranek P, Sujendran V, Bennett J, Afzal Z, Shrotri M, Chan B, Exarchou K, Gilbert T, Amalesh T, Mukherjee D, Mukherjee S, Wiggins T, Kennedy R, McCain S, Harris A, Dobson G, Davies N, Wilson I, Mayo D, Bennett D, Young R, Manby P, Blencowe N, Schiller M, Byrne B, Mitton D, Wong V, Elshaer A, Cowen M, Menon V, Tan L, McLaughlin E, Koshy R, Sharp C, Brewer H, Das N, Cox M, Al Khyatt W, Worku D, Iqbal R, Walls L, McGregor R, Fullarton G, Macdonald A, MacKay C, Craig C, Dwerryhouse S, Hornby S, Jaunoo S, Wadley M, Baker C, Saad M, Kelly M, Davies A, Di Maggio F, McKay S, Mistry P, Singhal R, Tucker O, Kapoulas S, Powell-Brett S, Davis P, Bromley G, Watson L, Verma R, Ward J, Shetty V, Ball C, Pursnani K, Sarela A, Sue Ling H, Mehta S, Hayden J, To N, Palser T, Hunter D, Supramaniam K, Butt Z, Ahmed A, Kumar S, Chaudry A, Moussa O, Kordzadeh A, Lorenzi B, Wilson M, Patil P, Noaman I, Willem J, Bouras G, Evans R, Singh M, Warrilow H, Ahmad A, Tewari N, Yanni F, Couch J, Theophilidou E, Reilly J, Singh P, van Boxel Gijs, Akbari K, Zanotti D, Sgromo B, Sanders G, Wheatley T, Ariyarathenam A, Reece-Smith A, Humphreys L, Choh C, Carter N, Knight B, Pucher P, Athanasiou A, Mohamed I, Tan B, Abdulrahman M, Vickers J, Akhtar K, Chaparala R, Brown R, Alasmar M, Ackroyd R, Patel K, Tamhankar A, Wyman A, Walker R, Grace B, Abbassi N, Slim N, Ioannidi L, Blackshaw G, Havard T, Escofet X, Powell A, Owera A, Rashid F, Jambulingam P, Padickakudi J, Ben-Younes H, Mccormack K, Makey I, Karush M, Seder C, Liptay M, Chmielewski G, Rosato E, Berger A, Zheng R, Okolo E, Singh A, Scott C, Weyant M, Mitchell J. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit. J Thorac Cardiovasc Surg 2022; 164:674-684.e5. [PMID: 35249756 DOI: 10.1016/j.jtcvs.2022.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND The optimal anastomotic techniques in esophagectomy to minimize rates of anastomotic leakage and conduit necrosis are not known. The aim of this study was to assess whether the anastomotic technique was associated with anastomotic failure after esophagectomy in the international Oesophago-Gastric Anastomosis Audit cohort. METHODS This prospective observational multicenter cohort study included patients undergoing esophagectomy for esophageal cancer over 9 months during 2018. The primary exposure was the anastomotic technique, classified as handsewn, linear stapled, or circular stapled. The primary outcome was anastomotic failure, namely a composite of anastomotic leakage and conduit necrosis, as defined by the Esophageal Complications Consensus Group. Multivariable logistic regression modeling was used to identify the association between anastomotic techniques and anastomotic failure, after adjustment for confounders. RESULTS Of the 2238 esophagectomies, the anastomosis was handsewn in 27.1%, linear stapled in 21.0%, and circular stapled in 51.9%. Anastomotic techniques differed significantly by the anastomosis sites (P < .001), with the majority of neck anastomoses being handsewn (69.9%), whereas most chest anastomoses were stapled (66.3% circular stapled and 19.3% linear stapled). Rates of anastomotic failure differed significantly among the anastomotic techniques (P < .001), from 19.3% in handsewn anastomoses, to 14.0% in linear stapled anastomoses, and 12.1% in circular stapled anastomoses. This effect remained significant after adjustment for confounding factors on multivariable analysis, with an odds ratio of 0.63 (95% CI, 0.46-0.86; P = .004) for circular stapled versus handsewn anastomosis. However, subgroup analysis by anastomosis site suggested that this effect was predominantly present in neck anastomoses, with anastomotic failure rates of 23.2% versus 14.6% versus 5.9% for handsewn versus linear stapled anastomoses versus circular stapled neck anastomoses, compared with 13.7% versus 13.8% versus 12.2% for chest anastomoses. CONCLUSIONS Handsewn anastomoses appear to be independently associated with higher rates of anastomotic failure compared with stapled anastomoses. However, this effect seems to be largely confined to neck anastomoses, with minimal differences between techniques observed for chest anastomoses. Further research into standardization of anastomotic approach and techniques may further improve outcomes.
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Endoh D, Ishii K, Kohno K, Virgona N, Miyakoshi Y, Yano T, Ishida T. CHEMORESISTANCE RELATED TO HYPOXIA ADAPTATION IN MESOTHELIOMA CELLS FROM TUMOR SPHEROIDS. Exp Oncol 2022; 44:121-125. [PMID: 35964640 DOI: 10.32471/exp-oncology.2312-8852.vol-44-no-2.18045] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hypoxia has been noted as a key factor for induction and maintenance of cancer stemness thereby leading to therapy resistance. Three-dimensional (3D) spheroid models demonstrate a heterogeneity of hypoxic regions replicating the in vivo situation within tumors. Utilizing an established 3D spheroid model, we investigated whether extrinsic hypoxia reinforced chemoresistance in malignant pleural mesothelioma (MPM) spheroids. MATERIALS AND METHODS Tumor spheres were generated from Meso-1 (a typical human MPM cell line) cells having high spheroid-forming ability. To induce hypoxia condition, we utilized a hypoxia chamber with regulation of O2 and CO2 levels. Cell viability was estimated by a WST-8 assay. Real-time polymerase chain reaction and Western blot were performed to evaluate the expression at mRNA and protein levels. RESULTS Compared with cells cultured in the two-dimensional monolayer model, tumor sphere cells showed elevated mRNA levels of cancer stemness markers (CD26, CD44 and ABCG2) and protein levels of the stemness and hypoxia adaptation markers (ABCG2, ALDH1A1 and HIFs). Correlating with this, 3D spheroid cells were more resistant to permetrexed and topotecan than the two-dimensional cells, indicative of their potential for hypoxic adaptation. Furthermore, significantly stronger resistance to both chemotherapeutic agents was observed in spheroid cells upon hypoxic challenge compared to spheroid cells under normoxia. CONCLUSION From the present data, it is concluded that hypoxia adaptation of MPM cells from tumor spheres could enhance their chemoresistance.
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Affiliation(s)
- D Endoh
- Graduate School of Food and Nutritional Sciences, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan
| | - K Ishii
- Graduate School of Food and Nutritional Sciences, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan
| | - K Kohno
- Research Institute of Life Innovation, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan.
| | - N Virgona
- Research Institute of Life Innovation, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan.
| | - Y Miyakoshi
- Research Institute of Life Innovation, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan.
| | - T Yano
- Research Institute of Life Innovation, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan.
| | - T Ishida
- Research Institute of Life Innovation, Toyo University, 1-1-1 Izumino, Oura-gun, Gunma 374-0193, Japan.
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Masters NB, Mathis AD, Leung J, Raines K, Clemmons NS, Miele K, Balajee SA, Lanzieri TM, Marin M, Christensen DL, Clarke KR, Cruz MA, Gallagher K, Gearhart S, Gertz AM, Grady-Erickson O, Habrun CA, Kim G, Kinzer MH, Miko S, Oberste MS, Petras JK, Pieracci EG, Pray IW, Rosenblum HG, Ross JM, Rothney EE, Segaloff HE, Shepersky LV, Skrobarcek KA, Stadelman AM, Sumner KM, Waltenburg MA, Weinberg M, Worrell MC, Bessette NE, Peake LR, Vogt MP, Robinson M, Westergaard RP, Griesser RH, Icenogle JP, Crooke SN, Bankamp B, Stanley SE, Friedrichs PA, Fletcher LD, Zapata IA, Wolfe HO, Gandhi PH, Charles JY, Brown CM, Cetron MS, Pesik N, Knight NW, Alvarado-Ramy F, Bell M, Talley LE, Rotz LD, Rota PA, Sugerman DE, Gastañaduy PA, Ahluwalia IB, Akinkugbe OA, Aranas A, Arons M, Atherstone C, Bampoe V, Bessler P, Bligh L, Bonner K, Bowen VB, Broadwater K, Brunette GW, Brunkard JM, Burns DA, Cantrell M, Christensen BE, Cope JR, Cory J, Crawford NE, Daigle D, Daly SM, Dejonge P, Dualeh M, Dunn KH, Eidex RB, Elgethun K, Fajardo G, Fonseca-Ford M, Franc K, Gaines J, George N, Goodson J, Green C, Grober AJ, Hailu K, Hammond DR, Harcourt BH, Hess A, Hesse E, Hirst DV, Hornsby-Myers J, Humrighouse B, Ishaq M, Ishii K, James A, Jayapaul-Philip B, Jentes ES, Johnson L, Johnston M, Jolley CD, Kacha-Ochana A, Kaur H, Keaveney M, Kelly HC, Krishnasamy V, Kumar GS, Larkin M, Layde M, LeBouf RF, Lee D, Lira RC, Lopez R, Lozier MJ, Macler A, Mainzer H, Malden D, Malenfant J, Marano N, Marsh Z, Mayer O, McDonald R, Mehta N, Menon AN, Meyer E, Miles ST, Minhaj F, Mirza S, Moller KM, Morris SB, Neu DT, Oakley LP, Ocasio DV, Osborne T, Ou AC, Peck M, Person M, Posey D, Pullia A, Qi C, Raziano AJ, Richmond-Crum M, Roohi S, Saindon JM, Sami S, Sanchez-Gonzalez L, Schweitzer R, Schwitters AM, Shamout M, Shockey CE, Shragai T, Singler KB, Sison EJ, Smith D, Smith M, Sood NJ, Sunshine BJ, Trujillo A, Vallabhaneni S, Wickson A, Yoder JS, Zambuto LR, Cozzarelli T, Rice M, Ricks M, Birchfield JS, Nambiar A, Avrakatos A, Ballard TP, Dennis E, Gambino-Shirley K, Huston AE, Jennings MG, Oldham DM, Rabener MJ, Fandre MN, Jablonka RJ, Love A, Peduzzi OL, Snow K, Greer JA, Hughes CA, Humphreys MA, Korduba AB, Neamand-Cheney KA, Pritchard NL, Smith AM, Whelpley JL, Adekoya S, Alexander V, Davis M, Falk J, Kurkjian K, McCarty E, Moss J, Myrick-West A, Patel C, Pruitt R, Saady D, Sockwell D, Touma A, Wheawill S, Woolard D, Young A, Griffin-Thomas L, Kelly S, McLeod J, Lambert MC, Danz TL, Davis T, Guenther K, Hanson E. Public Health Actions to Control Measles Among Afghan Evacuees During Operation Allies Welcome - United States, September-November 2021. MMWR Morb Mortal Wkly Rep 2022; 71:592-596. [PMID: 35482557 PMCID: PMC9098237 DOI: 10.15585/mmwr.mm7117a2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.S. Department of Defense (DoD) and U.S. Department of State (DoS), to safely resettle U.S. citizens and Afghan nationals from Afghanistan to the United States. Evacuees were temporarily housed at several overseas locations in Europe and Asia* before being transported via military and charter flights through two U.S. international airports, and onward to eight U.S. military bases,† with hotel A used for isolation and quarantine of persons with or exposed to certain infectious diseases.§ On August 30, CDC issued an Epi-X notice encouraging public health officials to maintain vigilance for measles among Afghan evacuees because of an ongoing measles outbreak in Afghanistan (25,988 clinical cases reported nationwide during January-November 2021) (1) and low routine measles vaccination coverage (66% and 43% for the first and second doses, respectively, in 2020) (2).
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Nishimoto-Kusunose S, Sawa M, Inaba Y, Ushiyama A, Ishii K, Hattori K, Ogasawara Y. Exposure to aerosol extract from heated tobacco products causes a drastic decrease of glutathione and protein carbonylation in human lung epithelial cells. Biochem Biophys Res Commun 2022; 589:92-99. [PMID: 34896781 DOI: 10.1016/j.bbrc.2021.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/02/2021] [Indexed: 12/20/2022]
Abstract
Heated tobacco products (HTPs) are an emerging class of tobacco goods that claim to have lower health risks than those of smoking combustible tobacco products. In this study, we exposed human lung epithelial cell lines to extracts prepared from HTP aerosols and combustible cigarette smoke to compare cytotoxicity. We focused on the effects of aldehydes present in the aerosols of HTPs at levels close to those in combustible cigarette smoke. Significant toxicity was confirmed for the HTP extract, albeit to a lesser extent than that with the combustible cigarette extract. When redox balance was evaluated by the oxidative loss of low-molecular-weight thiols in the cells, we found that total glutathione (GSH) contents and low-molecular-weight thiol levels were significantly decreased after exposure to the aerosol extract of HTPs. These results indicated that GSH is rapidly consumed during the detoxification of xenobiotics, such as aldehydes from tobacco extracts. Accordingly, exposure to the aerosol extract of HTPs resulted in the enhanced carbonylation of many proteins. In a simple comparison, the results for HTPs were significantly different from those obtained with combustible cigarette smoke, suggesting reduced toxicity of HTPs. However, we found significant and harmful effects after exposing lung epithelial cells to the aerosol extract of HTPs. Thus, a further comprehensive study is needed to clarify the lung damage induced via the long-term inhalation of aerosols from HTPs.
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Affiliation(s)
- S Nishimoto-Kusunose
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda-shi, Chiba, Japan
| | - M Sawa
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - Y Inaba
- Department of Environmental Health, National Institute of Public Health. Minami, Wako-shi, Saitama, 351-0197, Japan
| | - A Ushiyama
- Department of Environmental Health, National Institute of Public Health. Minami, Wako-shi, Saitama, 351-0197, Japan
| | - K Ishii
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - K Hattori
- Department of Environmental Science, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan
| | - Y Ogasawara
- Department of Analytical Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo, 204-8588, Japan.
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12
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Ishii K, Takeuchi A, Nishinoiri O, Endo G, Ono‐Ogasawara M. Development of a method to determine workers' personal exposure levels to glyphosate. J Occup Health 2022; 64:e12345. [PMID: 35797136 PMCID: PMC9262121 DOI: 10.1002/1348-9585.12345] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES We aimed to develop a method to determine workers' personal exposure levels to N-(phosphonomethyl)glycine (glyphosate) for their risk assessments. METHODS The proposed method was assessed as follows: recovery, stability of samples on storage, method limit of quantification, and reproducibility. Glyphosate in air was sampled using an air-sampling cassette containing a glass fiber filter. Ultrapure water was used to extract glyphosate from sampler filters. After derivation with 9-fluorenylmethyloxycarbonyl chloride, samples were analyzed by high-performance liquid chromatography using a fluorescence detector. RESULTS Spiked samples indicated an overall recovery of 101%. After 7 days of storage at 4°C, recoveries were approximately 100%. The method limit of quantification was 0.060 μg/sample. Relative standard deviations representing overall reproducibility, defined as precision, were 1.4%-1.8%. CONCLUSIONS The method developed in this study allows 4-h personal exposure monitoring of glyphosate at 0.250-500 μg/m3 . Thus, this method can be used to estimate worker exposure to glyphosate.
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Affiliation(s)
- Kenta Ishii
- Osaka Occupational Health Service CenterJapan Industrial Safety and Health AssociationOsakaJapan
- Laboratory of Environmental Toxicology and Carcinogenesis, School of PharmacyNihon UniversityChibaJapan
| | - Akito Takeuchi
- Osaka Occupational Health Service CenterJapan Industrial Safety and Health AssociationOsakaJapan
| | - Osamu Nishinoiri
- Kanto Regional Safety and Health Service CenterJapan Industrial Safety and Health AssociationTokyoJapan
| | - Ginji Endo
- Osaka Occupational Health Service CenterJapan Industrial Safety and Health AssociationOsakaJapan
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Hermans SJ, Nero TL, Morton CJ, Gooi JH, Crespi GAN, Hancock NC, Gao C, Ishii K, Markulić J, Parker MW. Structural biology of cell surface receptors implicated in Alzheimer’s disease. Biophys Rev 2021; 14:233-255. [DOI: 10.1007/s12551-021-00903-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/02/2021] [Indexed: 02/06/2023] Open
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Evans RPT, Kamarajah SK, Bundred J, Nepogodiev D, Hodson J, van Hillegersberg R, Gossage J, Vohra R, Griffiths EA, Singh P, Evans RPT, Hodson J, Kamarajah SK, Griffiths EA, Singh P, Alderson D, Bundred J, Evans RPT, Gossage J, Griffiths EA, Jefferies B, Kamarajah SK, McKay S, Mohamed I, Nepogodiev D, Siaw- Acheampong K, Singh P, van Hillegersberg R, Vohra R, Wanigasooriya K, Whitehouse T, Gjata A, Moreno JI, Takeda FR, Kidane B, Guevara Castro R, Harustiak T, Bekele A, Kechagias A, Gockel I, Kennedy A, Da Roit A, Bagajevas A, Azagra JS, Mahendran HA, Mejía-Fernández L, Wijnhoven BPL, El Kafsi J, Sayyed RH, Sousa M, Sampaio AS, Negoi I, Blanco R, Wallner B, Schneider PM, Hsu PK, Isik A, Gananadha S, Wills V, Devadas M, Duong C, Talbot M, Hii MW, Jacobs R, Andreollo NA, Johnston B, Darling G, Isaza-Restrepo A, Rosero G, Arias-Amézquita F, Raptis D, Gaedcke J, Reim D, Izbicki J, Egberts JH, Dikinis S, Kjaer DW, Larsen MH, Achiam MP, Saarnio J, Theodorou D, Liakakos T, Korkolis DP, Robb WB, Collins C, Murphy T, Reynolds J, Tonini V, Migliore M, Bonavina L, Valmasoni M, Bardini R, Weindelmayer J, Terashima M, White RE, Alghunaim E, Elhadi M, Leon-Takahashi AM, Medina-Franco H, Lau PC, Okonta KE, Heisterkamp J, Rosman C, van Hillegersberg R, Beban G, Babor R, Gordon A, Rossaak JI, Pal KMI, Qureshi AU, Naqi SA, Syed AA, Barbosa J, Vicente CS, Leite J, Freire J, Casaca R, Costa RCT, Scurtu RR, Mogoanta SS, Bolca C, Constantinoiu S, Sekhniaidze D, Bjelović M, So JBY, Gačevski G, Loureiro C, Pera M, Bianchi A, Moreno Gijón M, Martín Fernández J, Trugeda Carrera MS, Vallve-Bernal M, Cítores Pascual MA, Elmahi S, Hedberg J, Mönig S, Gutknecht S, Tez M, Guner A, Tirnaksiz TB, Colak E, Sevinç B, Hindmarsh A, Khan I, Khoo D, Byrom R, Gokhale J, Wilkerson P, Jain P, Chan D, Robertson K, Iftikhar S, Skipworth R, Forshaw M, Higgs S, Gossage J, Nijjar R, Viswanath YKS, Turner P, Dexter S, Boddy A, Allum WH, Oglesby S, Cheong E, Beardsmore D, Vohra R, Maynard N, Berrisford R, Mercer S, Puig S, Melhado R, Kelty C, Underwood T, Dawas K, Lewis W, Al-Bahrani A, Bryce G, Thomas M, Arndt AT, Palazzo F, Meguid RA, Fergusson J, Beenen E, Mosse C, Salim J, Cheah S, Wright T, Cerdeira MP, McQuillan P, Richardson M, Liem H, Spillane J, Yacob M, Albadawi F, Thorpe T, Dingle A, Cabalag C, Loi K, Fisher OM, Ward S, Read M, Johnson M, Bassari R, Bui H, Cecconello I, Sallum RAA, da Rocha JRM, Lopes LR, Tercioti V, Coelho JDS, Ferrer JAP, Buduhan G, Tan L, Srinathan S, Shea P, Yeung J, Allison F, Carroll P, Vargas-Barato F, Gonzalez F, Ortega J, Nino-Torres L, Beltrán-García TC, Castilla L, Pineda M, Bastidas A, Gómez-Mayorga J, Cortés N, Cetares C, Caceres S, Duarte S, Pazdro A, Snajdauf M, Faltova H, Sevcikova M, Mortensen PB, Katballe N, Ingemann T, Morten B, Kruhlikava I, Ainswort AP, Stilling NM, Eckardt J, Holm J, Thorsteinsson M, Siemsen M, Brandt B, Nega B, Teferra E, Tizazu A, Kauppila JS, Koivukangas V, Meriläinen S, Gruetzmann R, Krautz C, Weber G, Golcher H, Emons G, Azizian A, Ebeling M, Niebisch S, Kreuser N, Albanese G, Hesse J, Volovnik L, Boecher U, Reeh M, Triantafyllou S, Schizas D, Michalinos A, Baili E, Mpoura M, Charalabopoulos A, Manatakis DK, Balalis D, Bolger J, Baban C, Mastrosimone A, McAnena O, Quinn A, Súilleabháin CBÓ, Hennessy MM, Ivanovski I, Khizer H, Ravi N, Donlon N, Cervellera M, Vaccari S, Bianchini S, Sartarelli L, Asti E, Bernardi D, Merigliano S, Provenzano L, Scarpa M, Saadeh L, Salmaso B, De Manzoni G, Giacopuzzi S, La Mendola R, De Pasqual CA, Tsubosa Y, Niihara M, Irino T, Makuuchi R, Ishii K, Mwachiro M, Fekadu A, Odera A, Mwachiro E, AlShehab D, Ahmed HA, Shebani AO, Elhadi A, Elnagar FA, Elnagar HF, Makkai-Popa ST, Wong LF, Yunrong T, Thanninalai S, Aik HC, Soon PW, Huei TJ, Basave HNL, Cortés-González R, Lagarde SM, van Lanschot JJB, Cords C, Jansen WA, Martijnse I, Matthijsen R, Bouwense S, Klarenbeek B, Verstegen M, van Workum F, Ruurda JP, van der Veen A, van den Berg JW, Evenett N, Johnston P, Patel R, MacCormick A, Young M, Smith B, Ekwunife C, Memon AH, Shaikh K, Wajid A, Khalil N, Haris M, Mirza ZU, Qudus SBA, Sarwar MZ, Shehzadi A, Raza A, Jhanzaib MH, Farmanali J, Zakir Z, Shakeel O, Nasir I, Khattak S, Baig M, Noor MA, Ahmed HH, Naeem A, Pinho AC, da Silva R, Matos H, Braga T, Monteiro C, Ramos P, Cabral F, Gomes MP, Martins PC, Correia AM, Videira JF, Ciuce C, Drasovean R, Apostu R, Ciuce C, Paitici S, Racu AE, Obleaga CV, Beuran M, Stoica B, Ciubotaru C, Negoita V, Cordos I, Birla RD, Predescu D, Hoara PA, Tomsa R, Shneider V, Agasiev M, Ganjara I, Gunjić D, Veselinović M, Babič T, Chin TS, Shabbir A, Kim G, Crnjac A, Samo H, Díez del Val I, Leturio S, Díez del Val I, Leturio S, Ramón JM, Dal Cero M, Rifá S, Rico M, Pagan Pomar A, Martinez Corcoles JA, Rodicio Miravalles JL, Pais SA, Turienzo SA, Alvarez LS, Campos PV, Rendo AG, García SS, Santos EPG, Martínez ET, Fernández Díaz MJ, Magadán Álvarez C, Concepción Martín V, Díaz López C, Rosat Rodrigo A, Pérez Sánchez LE, Bailón Cuadrado M, Tinoco Carrasco C, Choolani Bhojwani E, Sánchez DP, Ahmed ME, Dzhendov T, Lindberg F, Rutegård M, Sundbom M, Mickael C, Colucci N, Schnider A, Er S, Kurnaz E, Turkyilmaz S, Turkyilmaz A, Yildirim R, Baki BE, Akkapulu N, Karahan O, Damburaci N, Hardwick R, Safranek P, Sujendran V, Bennett J, Afzal Z, Shrotri M, Chan B, Exarchou K, Gilbert T, Amalesh T, Mukherjee D, Mukherjee S, Wiggins TH, Kennedy R, McCain S, Harris A, Dobson G, Davies N, Wilson I, Mayo D, Bennett D, Young R, Manby P, Blencowe N, Schiller M, Byrne B, Mitton D, Wong V, Elshaer A, Cowen M, Menon V, Tan LC, McLaughlin E, Koshy R, Sharp C, Brewer H, Das N, Cox M, Al Khyatt W, Worku D, Iqbal R, Walls L, McGregor R, Fullarton G, Macdonald A, MacKay C, Craig C, Dwerryhouse S, Hornby S, Jaunoo S, Wadley M, Baker C, Saad M, Kelly M, Davies A, Di Maggio F, McKay S, Mistry P, Singhal R, Tucker O, Kapoulas S, Powell-Brett S, Davis P, Bromley G, Watson L, Verma R, Ward J, Shetty V, Ball C, Pursnani K, Sarela A, Sue Ling H, Mehta S, Hayden J, To N, Palser T, Hunter D, Supramaniam K, Butt Z, Ahmed A, Kumar S, Chaudry A, Moussa O, Kordzadeh A, Lorenzi B, Wilson M, Patil P, Noaman I, Willem J, Bouras G, Evans R, Singh M, Warrilow H, Ahmad A, Tewari N, Yanni F, Couch J, Theophilidou E, Reilly JJ, Singh P, van Boxel G, Akbari K, Zanotti D, Sgromo B, Sanders G, Wheatley T, Ariyarathenam A, Reece-Smith A, Humphreys L, Choh C, Carter N, Knight B, Pucher P, Athanasiou A, Mohamed I, Tan B, Abdulrahman M, Vickers J, Akhtar K, Chaparala R, Brown R, Alasmar MMA, Ackroyd R, Patel K, Tamhankar A, Wyman A, Walker R, Grace B, Abbassi N, Slim N, Ioannidi L, Blackshaw G, Havard T, Escofet X, Powell A, Owera A, Rashid F, Jambulingam P, Padickakudi J, Ben-Younes H, McCormack K, Makey IA, Karush MK, Seder CW, Liptay MJ, Chmielewski G, Rosato EL, Berger AC, Zheng R, Okolo E, Singh A, Scott CD, Weyant MJ, Mitchell JD. Postoperative outcomes in oesophagectomy with trainee involvement. BJS Open 2021; 5:zrab132. [PMID: 35038327 PMCID: PMC8763367 DOI: 10.1093/bjsopen/zrab132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery.
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Zhao WL, Ishii K, Egami S, Xu Z, Funakoshi T, Takahashi H, Tanikawa A, Ishiko A, Amagai M, Yamagami J. Analysis of clinical characteristics, prognosis and antibody pathogenicity of pemphigus patients positive for anti-desmoglein IgG autoantibodies in remission: a retrospective cohort study. J Eur Acad Dermatol Venereol 2021; 36:271-278. [PMID: 34704306 DOI: 10.1111/jdv.17770] [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: 04/12/2021] [Accepted: 08/12/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The detection of serum anti-desmoglein (Dsg) IgG autoantibodies has been reported to be useful for assessment of disease activity in pemphigus. However, previous studies have reported that anti-Dsg autoantibodies remain detectable in some patients without active pemphigus lesions. OBJECTIVES To investigate the clinical characteristics and antibody pathogenicity of pemphigus patients positive for anti-Dsg IgG autoantibodies in remission. METHODS We retrospectively investigated pemphigus patients with a history of clinical remission who visited the Department of Dermatology of Keio University during 2019 and 2020. The antibody pathogenicity was assessed by bead aggregation assay. RESULTS When patients were recognized as having entered remission (PDAI = 0 and PSL ≦ 10 mg/day for 2 months), serum autoantibodies against Dsg were detected in 72 of 132 patients (54.5%, positive group; PG), but were not detected in 60 patients (45.5%, negative group; NG). Anti-Dsg antibody titres in remission declined from the active phase in 33 patients in the PG for whom data were available. There were no differences in the chance of reducing PSL to 5 mg/day (P = 0.885) and rate of relapse (P = 0.279) between PG and NG, but fewer patients in PG discontinued corticosteroids (P = 0.004). The ability of patients' sera to block aggregation of Dsg/desmocollin beads was significantly reduced in remission compared to the active phase. However, our results revealed that whole sera in remission still had pathogenic activity in seven of nine patients, and the approximately equal amounts of anti-Dsg antibodies in active phase and remission showed similar pathogenicity. CONCLUSIONS This study will provide guidance in cases where autoantibodies are found to be positive in pemphigus patients during remission or steroid reduction.
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Affiliation(s)
- W L Zhao
- Department of Dermatology, Shunyi Maternal and Children's Hospital of Beijing Children's Hospital, Beijing, China
| | - K Ishii
- Department of Dermatology, Toho University School of Medicine, Tokyo, Japan
| | - S Egami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Z Xu
- Department of Dermatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - T Funakoshi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - H Takahashi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - A Tanikawa
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - A Ishiko
- Department of Dermatology, Toho University School of Medicine, Tokyo, Japan
| | - M Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - J Yamagami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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Senda M, Ishii K, Ito K, Ikeuchi T, Matsuda H, Iwatsubo T, Iwata A, Ihara R, Suzuki K, Kasuga K, Ikari Y, Niimi Y, Arai H, Tamaoka A, Arahata Y, Itoh Y, Tachibana H, Ichimiya Y, Washizuka S, Odawara T, Ishii K, Ono K, Yokota T, Nakanishi A, Matsubara E, Mori H, Shimada H. A Japanese Multicenter Study on PET and Other Biomarkers for Subjects with Potential Preclinical and Prodromal Alzheimer's Disease. J Prev Alzheimers Dis 2021; 8:495-502. [PMID: 34585225 DOI: 10.14283/jpad.2021.37] [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: 11/11/2022]
Abstract
BACKGROUND PET (positron emission tomography) and CSF (cerebrospinal fluid) provide the "ATN" (Amyloid, Tau, Neurodegeneration) classification and play an essential role in early and differential diagnosis of Alzheimer's disease (AD). OBJECTIVE Biomarkers were evaluated in a Japanese multicenter study on cognitively unimpaired subjects (CU) and early (E) and late (L) mild cognitive impairment (MCI) patients. MEASUREMENTS A total of 38 (26 CU, 7 EMCI, 5 LMCI) subjects with the age of 65-84 were enrolled. Amyloid-PET and FDG-PET as well as structural MRI were acquired on all of them, with an additional tau-PET with 18F-flortaucipir on 15 and CSF measurement of Aβ1-42, P-tau, and T-tau on 18 subjects. Positivity of amyloid and tau was determined based on the positive result of either PET or CSF. RESULTS The amyloid positivity was 13/38, with discordance between PET and CSF in 6/18. Cortical tau deposition quantified with PET was significantly correlated with CSF P-tau, in spite of discordance in the binary positivity between visual PET interpretation and CSF P-tau in 5/8 (PET-/CSF+). Tau was positive in 7/9 amyloid positive and 8/16 amyloid negative subjects who underwent tau measurement, respectively. Overall, a large number of subjects presented quantitative measures and/or visual read that are close to the borderline of binary positivity, which caused, at least partly, the discordance between PET and CSF in amyloid and/or tau. Nine subjects presented either tau or FDG-PET positive while amyloid was negative, suggesting the possibility of non-AD disorders. CONCLUSION Positivity rate of amyloid and tau, together with their relationship, was consistent with previous reports. Multicenter study on subjects with very mild or no cognitive impairment may need refining the positivity criteria and cutoff level as well as strict quality control of the measurements.
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Affiliation(s)
- M Senda
- Michio Senda, Division of Molecular Imaging Research Kobe City Medical Center General Hospital (KCGH), 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe 650-0047 Japan, E-mail: , Phone: 81-78-304-5212, Fax: 81-78-304-5201
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Kamarajah S, Nepogodiev D, Bekele A, Cecconello I, Evans R, Guner A, Gossage J, Harustiak T, Hodson J, Isik A, Kidane B, Leon-Takahashi A, Mahendran H, Negoi I, Okonta K, Rosero G, Sayyed R, Singh P, Takeda F, van Hillegersberg R, Vohra R, White R, Griffiths E, Alderson D, Bundred J, Evans R, Gossage J, Griffiths E, Jefferies B, Kamarajah S, McKay S, Mohamed I, Nepogodiev D, Siaw- Acheampong K, Singh P, van Hillegersberg R, Vohra R, Wanigasooriya K, Whitehouse T, Gjata A, Moreno J, Takeda F, Kidane B, Guevara CR, Harustiak T, Bekele A, Kechagias A, Gockel I, Kennedy A, Da Roit A, Bagajevas A, Azagra J, Mahendran H, Mejía-Fernández L, Wijnhoven B, El Kafsi J, Sayyed R, Sousa M, Sampaio A, Negoi I, Blanco R, Wallner B, Schneider P, Hsu P, Isik A, Gananadha S, Wills V, Devadas M, Duong C, Talbot M, Hii M, Jacobs R, Andreollo N, Johnston B, Darling G, Isaza-Restrepo A, Rosero G, Arias- Amézquita F, Raptis D, Gaedcke J, Reim D, Izbicki J, Egberts J, Dikinis S, Kjaer D, Larsen M, Achiam M, Saarnio J, Theodorou D, Liakakos T, Korkolis D, Robb W, Collins C, Murphy T, Reynolds J, Tonini V, Migliore M, Bonavina L, Valmasoni M, Bardini R, Weindelmayer J, Terashima M, White R, Alghunaim E, Elhadi M, Leon-Takahashi A, Medina-Franco H, Lau P, Okonta K, Heisterkamp J, Rosman C, van Hillegersberg R, Beban G, Babor R, Gordon A, Rossaak J, Pal K, Qureshi A, Naqi S, Syed A, Barbosa J, Vicente C, Leite J, Freire J, Casaca R, Costa R, Scurtu R, Mogoanta S, Bolca C, Constantinoiu S, Sekhniaidze D, Bjelović M, So J, Gačevski G, Loureiro C, Pera M, Bianchi A, Moreno GM, Martín Fernández J, Trugeda Carrera M, Vallve-Bernal M, Cítores Pascual M, Elmahi S, Halldestam I, Hedberg J, Mönig S, Gutknecht S, Tez M, Guner A, Tirnaksiz M, Colak E, Sevinç B, Hindmarsh A, Khan I, Khoo D, Byrom R, Gokhale J, Wilkerson P, Jain P, Chan D, Robertson K, Iftikhar S, Skipworth R, Forshaw M, Higgs S, Gossage J, Nijjar R, Viswanath Y, Turner P, Dexter S, Boddy A, Allum W, Oglesby S, Cheong E, Beardsmore D, Vohra R, Maynard N, Berrisford R, Mercer S, Puig S, Melhado R, Kelty C, Underwood T, Dawas K, Lewis W, Al-Bahrani A, Bryce G, Thomas M, Arndt A, Palazzo F, Meguid R, Fergusson J, Beenen E, Mosse C, Salim J, Cheah S, Wright T, Cerdeira M, McQuillan P, Richardson M, Liem H, Spillane J, Yacob M, Albadawi F, Thorpe T, Dingle A, Cabalag C, Loi K, Fisher O, Ward S, Read M, Johnson M, Bassari R, Bui H, Cecconello I, Sallum R, da Rocha J, Lopes L, Tercioti V, Coelho J, Ferrer J, Buduhan G, Tan L, Srinathan S, Shea P, Yeung J, Allison F, Carroll P, Vargas-Barato F, Gonzalez F, Ortega J, Nino-Torres L, Beltrán-García T, Castilla L, Pineda M, Bastidas A, Gómez-Mayorga J, Cortés N, Cetares C, Caceres S, Duarte S, Pazdro A, Snajdauf M, Faltova H, Sevcikova M, Mortensen P, Katballe N, Ingemann T, Morten B, Kruhlikava I, Ainswort A, Stilling N, Eckardt J, Holm J, Thorsteinsson M, Siemsen M, Brandt B, Nega B, Teferra E, Tizazu A, Kauppila J, Koivukangas V, Meriläinen S, Gruetzmann R, Krautz C, Weber G, Golcher H, Emons G, Azizian A, Ebeling M, Niebisch S, Kreuser N, Albanese G, Hesse J, Volovnik L, Boecher U, Reeh M, Triantafyllou S, Schizas D, Michalinos A, Mpali E, Mpoura M, Charalabopoulos A, Manatakis D, Balalis D, Bolger J, Baban C, Mastrosimone A, McAnena O, Quinn A, Ó Súilleabháin C, Hennessy M, Ivanovski I, Khizer H, Ravi N, Donlon N, Cervellera M, Vaccari S, Bianchini S, Sartarelli L, Asti E, Bernardi D, Merigliano S, Provenzano L, Scarpa M, Saadeh L, Salmaso B, De Manzoni G, Giacopuzzi S, La Mendola R, De Pasqual C, Tsubosa Y, Niihara M, Irino T, Makuuchi R, Ishii K, Mwachiro M, Fekadu A, Odera A, Mwachiro E, AlShehab D, Ahmed H, Shebani A, Elhadi A, Elnagar F, Elnagar H, Makkai-Popa S, Wong L, Tan Y, Thannimalai S, Ho C, Pang W, Tan J, Basave H, Cortés-González R, Lagarde S, van Lanschot J, Cords C, Jansen W, Martijnse I, Matthijsen R, Bouwense S, Klarenbeek B, Verstegen M, van Workum F, Ruurda J, van der Sluis P, de Maat M, Evenett N, Johnston P, Patel R, MacCormick A, Young M, Smith B, Ekwunife C, Memon A, Shaikh K, Wajid A, Khalil N, Haris M, Mirza Z, Qudus S, Sarwar M, Shehzadi A, Raza A, Jhanzaib M, Farmanali J, Zakir Z, Shakeel O, Nasir I, Khattak S, Baig M, Noor M, Ahmed H, Naeem A, Pinho A, da Silva R, Bernardes A, Campos J, Matos H, Braga T, Monteiro C, Ramos P, Cabral F, Gomes M, Martins P, Correia A, Videira J, Ciuce C, Drasovean R, Apostu R, Ciuce C, Paitici S, Racu A, Obleaga C, Beuran M, Stoica B, Ciubotaru C, Negoita V, Cordos I, Birla R, Predescu D, Hoara P, Tomsa R, Shneider V, Agasiev M, Ganjara I, Gunjić D, Veselinović M, Babič T, Chin T, Shabbir A, Kim G, Crnjac A, Samo H, Díez del Val I, Leturio S, Ramón J, Dal Cero M, Rifá S, Rico M, Pagan Pomar A, Martinez Corcoles J, Rodicio Miravalles J, Pais S, Turienzo S, Alvarez L, Campos P, Rendo A, García S, Santos E, Martínez E, Fernández DMJ, Magadán ÁC, Concepción MV, Díaz LC, Rosat RA, Pérez SLE, Bailón CM, Tinoco CC, Choolani Bhojwani E, Sánchez D, Ahmed M, Dzhendov T, Lindberg F, Rutegård M, Sundbom M, Mickael C, Colucci N, Schnider A, Er S, Kurnaz E, Turkyilmaz S, Turkyilmaz A, Yildirim R, Baki B, Akkapulu N, Karahan O, Damburaci N, Hardwick R, Safranek P, Sujendran V, Bennett J, Afzal Z, Shrotri M, Chan B, Exarchou K, Gilbert T, Amalesh T, Mukherjee D, Mukherjee S, Wiggins T, Kennedy R, McCain S, Harris A, Dobson G, Davies N, Wilson I, Mayo D, Bennett D, Young R, Manby P, Blencowe N, Schiller M, Byrne B, Mitton D, Wong V, Elshaer A, Cowen M, Menon V, Tan L, McLaughlin E, Koshy R, Sharp C, Brewer H, Das N, Cox M, Al Khyatt W, Worku D, Iqbal R, Walls L, McGregor R, Fullarton G, Macdonald A, MacKay C, Craig C, Dwerryhouse S, Hornby S, Jaunoo S, Wadley M, Baker C, Saad M, Kelly M, Davies A, Di Maggio F, McKay S, Mistry P, Singhal R, Tucker O, Kapoulas S, Powell-Brett S, Davis P, Bromley G, Watson L, Verma R, Ward J, Shetty V, Ball C, Pursnani K, Sarela A, Sue LH, Mehta S, Hayden J, To N, Palser T, Hunter D, Supramaniam K, Butt Z, Ahmed A, Kumar S, Chaudry A, Moussa O, Kordzadeh A, Lorenzi B, Wilson M, Patil P, Noaman I, Willem J, Bouras G, Evans R, Singh M, Warrilow H, Ahmad A, Tewari N, Yanni F, Couch J, Theophilidou E, Reilly J, Singh P, van Boxel G, Akbari K, Zanotti D, Sgromo B, Sanders G, Wheatley T, Ariyarathenam A, Reece-Smith A, Humphreys L, Choh C, Carter N, Knight B, Pucher P, Athanasiou A, Mohamed I, Tan B, Abdulrahman M, Vickers J, Akhtar K, Chaparala R, Brown R, Alasmar M, Ackroyd R, Patel K, Tamhankar A, Wyman A, Walker R, Grace B, Abbassi N, Slim N, Ioannidi L, Blackshaw G, Havard T, Escofet X, Powell A, Owera A, Rashid F, Jambulingam P, Padickakudi J, Ben-Younes H, Mccormack K, Makey I, Karush M, Seder C, Liptay M, Chmielewski G, Rosato E, Berger A, Zheng R, Okolo E, Singh A, Scott C, Weyant M, Mitchell J. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study. Eur J Surg Oncol 2021; 47:1481-1488. [PMID: 33451919 DOI: 10.1016/j.ejso.2020.12.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/09/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. METHOD This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). RESULTS Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC. CONCLUSION Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer.
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Fergusson J, Beenen E, Mosse C, Salim J, Cheah S, Wright T, Cerdeira MP, McQuillan P, Richardson M, Liem H, Spillane J, Yacob M, Albadawi F, Thorpe T, Dingle A, Cabalag C, Loi K, Fisher OM, Ward S, Read M, Johnson M, Bassari R, Bui H, Cecconello I, Sallum RAA, da Rocha JRM, Lopes LR, Tercioti V, Coelho JDS, Ferrer JAP, Buduhan G, Tan L, Srinathan S, Shea P, Yeung J, Allison F, Carroll P, Vargas-Barato F, Gonzalez F, Ortega J, Nino-Torres L, Beltrán-García TC, Castilla L, Pineda M, Bastidas A, Gómez-Mayorga J, Cortés N, Cetares C, Caceres S, Duarte S, Pazdro A, Snajdauf M, Faltova H, Sevcikova M, Mortensen PB, Katballe N, Ingemann T, Morten B, Kruhlikava I, Ainswort AP, Stilling NM, Eckardt J, Holm J, Thorsteinsson M, Siemsen M, Brandt B, Nega B, Teferra E, Tizazu A, Kauppila JS, Koivukangas V, Meriläinen S, Gruetzmann R, Krautz C, Weber G, Golcher H, Emons G, Azizian A, Ebeling M, Niebisch S, Kreuser N, Albanese G, Hesse J, Volovnik L, Boecher U, Reeh M, Triantafyllou S, Schizas D, Michalinos A, Mpali E, Mpoura M, Charalabopoulos A, Manatakis DK, Balalis D, Bolger J, Baban C, Mastrosimone A, McAnena O, Quinn A, Ó Súilleabháin CB, Hennessy MM, Ivanovski I, Khizer H, Ravi N, Donlon N, Cervellera M, Vaccari S, Bianchini S, Sartarelli L, Asti E, Bernardi D, Merigliano S, Provenzano L, Scarpa M, Saadeh L, Salmaso B, De Manzoni G, Giacopuzzi S, La Mendola R, De Pasqual CA, Tsubosa Y, Niihara M, Irino T, Makuuchi R, Ishii K, Mwachiro M, Fekadu A, Odera A, Mwachiro E, AlShehab D, Ahmed HA, Shebani AO, Elhadi A, Elnagar FA, Elnagar HF, Makkai-Popa ST, Wong LF, Yunrong T, Thanninalai S, Aik HC, Soon PW, Huei TJ, Basave HNL, Cortés-González R, Lagarde SM, van Lanschot JJB, Cords C, Jansen WA, Martijnse I, Matthijsen R, Bouwense S, Klarenbeek B, Verstegen M, van Workum F, Ruurda JP, van der Sluis PC, de Maat M, Evenett N, Johnston P, Patel R, MacCormick A, Young M, Smith B, Ekwunife C, Memon AH, Shaikh K, Wajid A, Khalil N, Haris M, Mirza ZU, Qudus SBA, Sarwar MZ, Shehzadi A, Raza A, Jhanzaib MH, Farmanali J, Zakir Z, Shakeel O, Nasir I, Khattak S, Baig M, Noor MA, Ahmed HH, Naeem A, Pinho AC, da Silva R, Matos H, Braga T, Monteiro C, Ramos P, Cabral F, Gomes MP, Martins PC, Correia AM, Videira JF, Ciuce C, Drasovean R, Apostu R, Ciuce C, Paitici S, Racu AE, Obleaga CV, Beuran M, Stoica B, Ciubotaru C, Negoita V, Cordos I, Birla RD, Predescu D, Hoara PA, Tomsa R, Shneider V, Agasiev M, Ganjara I, Gunjic´ D, Veselinovic´ M, Babič T, Chin TS, Shabbir A, Kim G, Crnjac A, Samo H, Díez del Val I, Leturio S, Díez del Val I, Leturio S, Ramón JM, Dal Cero M, Rifá S, Rico M, Pagan Pomar A, Martinez Corcoles JA, Rodicio Miravalles JL, Pais SA, Turienzo SA, Alvarez LS, Campos PV, Rendo AG, García SS, Santos EPG, Martínez ET, Fernández Díaz MJ, Magadán Álvarez C, Concepción Martín V, Díaz López C, Rosat Rodrigo A, Pérez Sánchez LE, Bailón Cuadrado M, Tinoco Carrasco C, Choolani Bhojwani E, Sánchez DP, Ahmed ME, Dzhendov T, Lindberg F, Rutegård M, Sundbom M, Mickael C, Colucci N, Schnider A, Er S, Kurnaz E, Turkyilmaz S, Turkyilmaz A, Yildirim R, Baki BE, Akkapulu N, Karahan O, Damburaci N, Hardwick R, Safranek P, Sujendran V, Bennett J, Afzal Z, Shrotri M, Chan B, Exarchou K, Gilbert T, Amalesh T, Mukherjee D, Mukherjee S, Wiggins TH, Kennedy R, McCain S, Harris A, Dobson G, Davies N, Wilson I, Mayo D, Bennett D, Young R, Manby P, Blencowe N, Schiller M, Byrne B, Mitton D, Wong V, Elshaer A, Cowen M, Menon V, Tan LC, McLaughlin E, Koshy R, Sharp C, Brewer H, Das N, Cox M, Al Khyatt W, Worku D, Iqbal R, Walls L, McGregor R, Fullarton G, Macdonald A, MacKay C, Craig C, Dwerryhouse S, Hornby S, Jaunoo S, Wadley M, Baker C, Saad M, Kelly M, Davies A, Di Maggio F, McKay S, Mistry P, Singhal R, Tucker O, Kapoulas S, Powell-Brett S, Davis P, Bromley G, Watson L, Verma R, Ward J, Shetty V, Ball C, Pursnani K, Sarela A, Sue Ling H, Mehta S, Hayden J, To N, Palser T, Hunter D, Supramaniam K, Butt Z, Ahmed A, Kumar S, Chaudry A, Moussa O, Kordzadeh A, Lorenzi B, Willem J, Bouras G, Evans R, Singh M, Warrilow H, Ahmad A, Tewari N, Yanni F, Couch J, Theophilidou E, Reilly JJ, Singh P, van Boxel G, Akbari K, Zanotti D, Sgromo B, Sanders G, Wheatley T, Ariyarathenam A, Reece-Smith A, Humphreys L, Choh C, Carter N, Knight B, Pucher P, Athanasiou A, Mohamed I, Tan B, Abdulrahman M, Vickers J, Akhtar K, Chaparala R, Brown R, Alasmar MMA, Ackroyd R, Patel K, Tamhankar A, Wyman A, Walker R, Grace B, Abbassi N, Slim N, Ioannidi L, Blackshaw G, Havard T, Escofet X, Powell A, Owera A, Rashid F, Jambulingam P, Padickakudi J, Ben-Younes H, Mccormack K, Makey IA, Karush MK, Seder CW, Liptay MJ, Chmielewski G, Rosato EL, Berger AC, Zheng R, Okolo E, Singh A, Scott CD, Weyant MJ, Mitchell JD. Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA). BJS Open 2021; 5:zrab010. [PMID: 35179183 PMCID: PMC8140199 DOI: 10.1093/bjsopen/zrab010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/27/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA). METHODS The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up. RESULTS The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P < 0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P < 0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien-Dindo grades (P = 0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P = 0.013). CONCLUSION Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts.
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Kurosaki H, Nakatake M, Sakamoto T, Kuwano N, Yamane M, Ishii K, Fujiwara Y, Nakamura T. Anti-Tumor Effects of MAPK-Dependent Tumor-Selective Oncolytic Vaccinia Virus Armed with CD/UPRT against Pancreatic Ductal Adenocarcinoma in Mice. Cells 2021; 10:cells10050985. [PMID: 33922406 PMCID: PMC8145488 DOI: 10.3390/cells10050985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/14/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023] Open
Abstract
Engineered vaccinia virus serves as an oncolytic virus for cancer virotherapy. We evaluated the oncolytic characteristics of VGF- and O1-deleted recombinant mitogen-activated protein kinase (MAPK)-dependent vaccinia virus (MDRVV). We found that compared with viruses with the deletion of either gene alone, MDRVV is more attenuated in normal cells and can replicate in cancer cells that exhibit constitutive ERK1/2 activation in the MAPK pathway. We armed MDRVV with a bifunctional fusion gene encoding cytosine deaminase and uracil phosphoribosyltransferase (CD/UPRT), which converts 5-fluorocytosine (5-FC) into chemotherapeutic agents, and evaluated its oncolytic activity alone or in combination with 5-FC in human pancreatic cancer cell lines, tumor mouse models of peritoneal dissemination and liver metastasis, and ex vivo-infected live pancreatic cancer patient-derived tissues. CD/UPRT-armed MDRVV alone could efficiently eliminate pancreatic cancers, and its antitumor effects were partially enhanced in combination with 5-FC in vitro and in vivo. Moreover, the replication of MDRVV was detected in tumor cells of patient-derived, surgically resected tissues, which showed enlarged nuclei and high expression of pERK1/2 and Ki-67, and not in stromal cells. Our findings suggest that systemic injections of CD/UPRT-armed MDRVV alone or in combination with 5-FC are promising therapeutic strategies for pancreatic ductal adenocarcinoma.
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Affiliation(s)
- Hajime Kurosaki
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
| | - Motomu Nakatake
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
| | - Teruhisa Sakamoto
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan; (T.S.); (Y.F.)
| | - Nozomi Kuwano
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
| | - Masato Yamane
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
| | - Kenta Ishii
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
| | - Yoshiyuki Fujiwara
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan; (T.S.); (Y.F.)
| | - Takafumi Nakamura
- Division of Molecular Medicine, Department of Genomic Medicine and Regenerative Therapy, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan; (H.K.); (M.N.); (N.K.); (M.Y.); (K.I.)
- Correspondence: ; Tel.: +81-859-38-7550; Fax: +81-859-38-6422
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Shibata J, Kawamura H, Hiramatsu K, Honda M, Shibata Y, Aoba T, Fujii M, Arimoto A, Ito A, Ishii K, Omiya K, Asai M, Arakawa T, Gonda H, Asai S, Hasegawa T, Kawashima K, Kato T. Impact of chest subcutaneous fat on the occurrence of central venous port-related infectious complications in cancer patients. Support Care Cancer 2021; 29:5391-5398. [PMID: 33694086 PMCID: PMC8295155 DOI: 10.1007/s00520-021-06109-9] [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: 07/09/2020] [Accepted: 02/24/2021] [Indexed: 01/17/2023]
Abstract
Purpose There is no concrete evidence to support the association between the amount of subcutaneous fat area (SFA) in the central venous port-insertion site (precordium) and port-related complications. We aimed to investigate the relationship between SFA in the midclavicular line and postoperative infectious complications in patients undergoing port-insertion surgery. Methods This was a single-institute and historical cohort study of 174 patients who underwent first central venous port implantation surgery for chemotherapy between January 2014 and December 2018. SFA in the midclavicular line was measured using preoperative computed tomography scans. The patients were divided into three groups according to SFA amount tertiles, and we investigated the association of SFA with infectious and all-cause complication events within 1 year. Results Within a median follow-up of 306 days, the patients with intermediate SFA had significantly higher infection-free survival than those with low and high SFA (low vs. intermediate vs. high: 80.4% vs. 97.7% vs. 83.4%, respectively, p=0.034). In contrast, there was no significant difference in the overall complication-free survival among the groups (low vs. intermediate vs. high: 80.4% vs. 88.9% vs. 81.8%, respectively, p=0.29). Low SFA was independently associated with high risk of infectious complications (hazard ratio, 9.45; 95% confidence interval, 1.07–83.22, p=0.043). Conclusion Low SFA in the midclavicular line was an independent risk factor for infectious complications in the chemotherapy setting. This practical indicator can be useful for optimizing patients’ nutritional status and when considering other types of vascular access to support administration of intravenous chemotherapy.
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Affiliation(s)
- Jumpei Shibata
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan.
| | - Hidetaka Kawamura
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan
| | - Kazuhiro Hiramatsu
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan
| | - Yoshihisa Shibata
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Taro Aoba
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Masahiro Fujii
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Atsuki Arimoto
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Akira Ito
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Kenta Ishii
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Kojiro Omiya
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Mariko Asai
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Takuya Arakawa
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Hirotake Gonda
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Shuhei Asai
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Takuya Hasegawa
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Kento Kawashima
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
| | - Takehito Kato
- Department of General Surgery, Toyohashi Municipal Hospital, 50 Aza Hachiken Nishi, Aotake-Cho, Toyohashi, Aichi, 441-8570, Japan
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Ishii K, Yokoyama Y, Nishida Y, Koike H, Yamada S, Kodera Y, Sassa N, Gotoh M, Nagino M. Characteristics of primary and repeated recurrent retroperitoneal liposarcoma: outcomes after aggressive surgeries at a single institution. Jpn J Clin Oncol 2021; 50:1412-1418. [PMID: 32699905 DOI: 10.1093/jjco/hyaa126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 06/25/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This study sought to investigate the characteristics of primary and repeated recurrent retroperitoneal liposarcoma. METHODS Patients treated with primary or recurrent retroperitoneal liposarcoma between 2005 and 2018 were retrospectively reviewed. Survival time analysis of recurrence-free survival and overall survival was conducted using Kaplan-Meier analysis and log-rank test. RESULTS Fifty-two patients with primary retroperitoneal liposarcoma were analysed. Amongst them, 46 patients (88%) had undergone surgery. Histologic grades included well-differentiated (n = 21), dedifferentiated (n = 21), myxoid (n = 3) and pleomorphic (n = 1) subtypes. The patients undergoing R0 resection in the first surgery had significantly higher recurrence-free survival rates compared with the patients undergoing non-R0 resection (3-year recurrence-free survival: 80 versus 38%; 5-year recurrence-free survival: 49 versus 29%, P = 0.033). Although overall survival rates tended to be higher in the patients undergoing R0 resection compared with the non-R0 resection, it did not reach to a statistical significant difference (5-year overall survival: 93 versus 75%; 10-year overall survival: 93 versus 59%, P = 0.124). The recurrence rates were 65, 67, 73 and 100%, and the median recurrence-free survival times were 46, 20, 9 and 3 months after the first, second, third and fourth surgeries, respectively. The 5-year overall survival rates were 82, 69, 40 and 0% after the first, second, third and fourth surgeries, respectively. CONCLUSIONS With repeated recurrence and surgeries, the time to recurrence decreased and the recurrence rate increased. R0 resection in the first surgery was considered the most important for longer recurrence-free survival and radical cure.
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Affiliation(s)
- Kenta Ishii
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | | | - Hiroshi Koike
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Suguru Yamada
- Division of Digestive surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Yasuhiro Kodera
- Division of Digestive surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
| | - Naoto Sassa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya
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Ogawa Y, Naganuma A, Kudou T, Hoshino T, Ishii K, Kishi A, Shimoda C, Masuda T, Ogawa T, Ishihara H. Relationship between sarcopenia and length of hospital stay in patients with ulcerative colitis. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.148] [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: 11/26/2022]
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Abstract
INTRODUCTION Pancreaticoduodenectomy (PD) is a major gastroenterological surgery that results in a substantial amount of blood loss. Several studies have demonstrated that major blood loss during PD is associated with both short-term and long-term poor outcomes. Administration of perioperative tranexamic acid (TXA) has been reported to reduce intraoperative blood loss in various surgeries, including cardiovascular surgery and orthopaedic surgery. Nevertheless, the effect of perioperative TXA use in patients undergoing PD has not been investigated. This study aims to investigate the effect of TXA on blood loss during PD. METHODS AND ANALYSIS A multicentre (six hospitals), randomised, blind (patient-blinded, surgeon-blinded, anaesthesiologist-blinded, monitor-blinded), placebo-controlled trial of TXA during PD was started in September 2019. Patients undergoing PD for biliary, duodenal or pancreatic diseases are randomly assigned to the TXA or placebo group. The stratification factors are the institutions and preoperative clinical diagnosis. Before skin incision, the participants in TXA group are administrated 1 g TXA as a loading infusion followed by a maintenance infusion of 125 mg/hour TXA until the end of surgery or 8 hours from the incision. Participants in the placebo group are administrated the same volume of saline that is indistinguishable from the TXA. The primary outcome is blood loss during PD. The secondary outcomes are intraoperative and postoperative (up to day 2) blood transfusions, operation time, anaesthesia time, postoperative laboratory variables, length of hospital stay, in-hospital and 90-day mortality and postoperative complications occurring within 28 days of surgery or requiring readmission. To date, 115 patients of a planned 220 have been enrolled in the study. ETHICS AND DISSEMINATION This protocol was approved by the Nagoya University Clinical Research Review Board and is registered with Japan Registry of Clinical Trials on 15 August 2019. The results of this trial will be disseminated through peer-reviewed journals. TRIAL REGISTRATION NUMBER jRCTs041190062.
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Affiliation(s)
- Kenta Ishii
- Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukihiro Yokoyama
- Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiko Yonekawa
- Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoki Ebata
- Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Ishii K, Yoshikawa Y, Hyodo E, Seo Y, Ishizu T, Kihara H, Daimon M, Tanaka A, Watanabe H, Akasaka T, Ito H, Yoshikawa J. Diagnostic accuracy of left ventricular diastolic transverse strain imaging by speckle tracking echocardiography for diagnosing chest pain in diabetic patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Two-dimensional speckle tracking echocardiography (2D-STE) has been reported to be useful for the diagnosis of myocardial ischemia by detecting delayed relaxation (diastolic stunning) after an episode of angina. 2D-longitudinal strain is not specific besides ischemia such as diastolic dysfunction, and diabetes have been associated with abnormal longitudinal fibers. The aim is to evaluate the diagnostic accuracy of Left ventricular (LV) diastolic transverse strain imaging by STE to detect the presence of acute coronary syndrome (ACS) in diabetic patients with acute chest pain.
Methods
385 consecutive patients with acute chest pain and without wall motion abnormality, who were admitted to an emergency department (ED) at 1 of 12 clinical sites in Japan, were enrolled and underwent 2D-STE at ED. Left ventricular (LV) transverse strain values at aortic valve closure (A) and one-third of diastole duration (B) were measured. The strain imaging diastolic index (SI-DI) was value was determined as: (A − B)/A × 100% to assess the LV diastolic strain imaging and was used to identify the regional LV delayed relaxation. All patients underwent coronary CT or coronary angiography to establish the diagnosis of ACS. Clinicians were blinded to the 2D-STE results.
Results
Out of 385 patients, 2D-STE analysis was possible in 365 patients (94%). 76 patients were diabetic (DM+), and 289 patients were non-diabetic (DM-). With assessment of coronary CT or coronary angiography, ACS was diagnosed in 125 patients (34%). 2D-STE was obtained at a mean of 5.3 hours after chest pain episode. Transverse SI-DI of ischemic segments were significantly lower than those of non-ischemic segments (p value <0.001) in both diabetic and non-diabetic patients, and transverse SI-DI of both diabetic and non-diabetic patients demonstrated high area under curve (AUC) for detection of myocardial ischemia (Figure: RCA; right coronary artery, LAD; left anterior descending artery, LCX; left circumferencial artery). In diabetic patients, sensitivity, specificity, and negative predictive value for ACS of transverse SI-DI are 100%, 95%, 100% in RCA (a cut-off value of 36.2), and 86.4%, 95%, 93% in LAD (a cut-off value of 50.2), and 75%, 85%, 94% in LCX (a cut-off value of 52), respectively.
Conclusion
LV diastolic transverse strain imaging by 2D-STE at ED increase the sensitivity, specificity and accuracy to predict the presence of ACS in diabetic patients with chest pain, as well as non-diabetic patients. (UMIN000013859).
Figure 1. Transverse Strain (SI-DI): AUC (95% CI)
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Ishii
- Kansai Electric Power Hospital, Cardiology, Osaka, Japan
| | - Y Yoshikawa
- Kyoto University Graduate School of Medicine, Cardiology, Kyoto, Japan
| | - E Hyodo
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
| | - Y Seo
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - T Ishizu
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - H Kihara
- Kihara Cardiovascular Clinic, Cardiology, Asahikawa, Japan
| | - M Daimon
- University of Tokyo Hospital, Cardiology, Tokyo, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - H Watanabe
- Tokyo Bay Urayasu/Ichikawa Medical Center, Cardiology, Urayasu, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - H Ito
- Okayama University Hospital, Cardiology, Okayama, Japan
| | - J Yoshikawa
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
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Hallowell BD, Carlson CM, Jacobs JR, Pomeroy M, Steinberg J, Tenforde MW, McDonald E, Foster L, Feldstein LR, Rolfes MA, Haynes A, Abedi GR, Odongo GS, Saruwatari K, Rider EC, Douville G, Bhakta N, Maniatis P, Lindstrom S, Thornburg NJ, Lu X, Whitaker BL, Kamili S, Sakthivel SK, Wang L, Malapati L, Murray JR, Lynch B, Cetron M, Brown C, Roohi S, Rotz L, Borntrager D, Ishii K, Moser K, Rasheed M, Freeman B, Lester S, Corbett KS, Abiona OM, Hutchinson GB, Graham BS, Pesik N, Mahon B, Braden C, Behravesh CB, Stewart R, Knight N, Hall AJ, Killerby ME. Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence, Seroprevalence, and Exposure among Evacuees from Wuhan, China, 2020. Emerg Infect Dis 2020; 26:1998-2004. [PMID: 32620182 PMCID: PMC7454104 DOI: 10.3201/eid2609.201590] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
To determine prevalence of, seroprevalence of, and potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among a cohort of evacuees returning to the United States from Wuhan, China, in January 2020, we conducted a cross-sectional study of quarantined evacuees from 1 repatriation flight. Overall, 193 of 195 evacuees completed exposure surveys and submitted upper respiratory or serum specimens or both at arrival in the United States. Nearly all evacuees had taken preventive measures to limit potential exposure while in Wuhan, and none had detectable SARS-CoV-2 in upper respiratory tract specimens, suggesting the absence of asymptomatic respiratory shedding among this group at the time of testing. Evidence of antibodies to SARS-CoV-2 was detected in 1 evacuee, who reported experiencing no symptoms or high-risk exposures in the previous 2 months. These findings demonstrated that this group of evacuees posed a low risk of introducing SARS-CoV-2 to the United States.
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Ishii K, Yokoyama Y, Ebata T, Igami T, Mizuno T, Yamaguchi J, Onoe S, Watanabe N, Nagino M. Impact of the preoperative body composition indexes on intraoperative blood loss in patients undergoing pancreatoduodenectomy. Surg Today 2020; 51:52-60. [PMID: 32564145 DOI: 10.1007/s00595-020-02054-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/07/2020] [Indexed: 12/11/2022]
Abstract
PURPOSES This study sought to identify any significant predictors of blood loss during pancreatoduodenectomy (PD) among preoperative variables, including the body composition indexes. METHODS The preoperative data of patients undergoing PD were retrospectively reviewed. The objective variable was the percentage of blood loss during PD to the estimated circulating blood volume (proportional blood loss: PBL). The circulating blood volume was estimated using Nadler's formula. The total psoas area, average Hounsfield units of psoas area (psoas muscle density: PMD), and visceral to subcutaneous adipose tissue area ratio (VSR) were measured at the third vertebra using preoperative plain computed tomography images. A univariate analysis and multiple linear regression analysis for PBL were conducted using the preoperative variables. RESULTS A total of 415 patients were analyzed. The median PBL was 24.5%. The PMD (coefficient - 0.267; 95% CI - 0.518, - 0.015), VSR (coefficient 2.719; 95% CI 0.238, 5.201), serum albumin level (coefficient - 8.458; 95% CI - 13.02, - 3.898), neoadjuvant therapy (coefficient 9.605; 95% CI 1.722, 17.49), and prothrombin time-international normalized ratio (PT-INR, coefficient 38.63; 95% CI 10.94, 66.31) were independently associated with PBL. CONCLUSIONS The preoperative PMD, VSR, serum albumin level, neoadjuvant therapy, and PT-INR independently affected PBL. These factors could therefore be potential targets to reduce blood loss during PD.
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Affiliation(s)
- Kenta Ishii
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. .,Division of Perioperative Medicine, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan.
| | - Tomoki Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tsuyoshi Igami
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Mizuno
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Junpei Yamaguchi
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shunsuke Onoe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Nobuyuki Watanabe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.,Division of Perioperative Medicine, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 4668550, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Thiel PG, Sydenham EW, Shephard GS, Van Schalkwyk DJ, Casper HH, Gilbert J, Ishii K, Norred WP, Ross PF, Stack ME, Stockenström S, Trinder DW, Egmond HPV, Viljoen CC, Visconti A. Study of the Reproducibility Characteristics of a Liquid Chromatographic Method for the Determination of Fumonisins B1 and B2 in Corn: IUPAC Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/76.2.361] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
An interlaboratory study of the reproducibility characteristics of a liquid chromatographic method for the determination of fumonisins B1 and B2 in corn was conducted in 11 laboratories in the United States, South Africa, Italy, Japan, United Kingdom, and The Netherlands. Each laboratory was supplied with 12 coded, blind duplicates of 6 samples of naturally contaminated corn containing different amounts of fumonisins B1 and B2 . Samples are extracted with methanol-water (3 + 1), extracts are centrifuged, and supernatants are cleaned up on strong-anion-exchange cartridges, which were supplied to participants. Solutions are derivatized with o-phthaldialdehyde, and individual fumonisins are determined by reversed-phase liquid chromatography with fluorescence detection. Quantitation is by comparison with the supplied fumonisin standards. The within-laboratory repeatability was determined by statistical analysis of data after exclusion of outliers. Relative standard deviations for within-laboratory repeatability varied from 7.7 to 25.5% for fumonisin B1 at concentrations between 200 and 2000 ng/g and from 12.5 to 36.8% for fumonisin B2 at concentrations between 70 and 740 ng/g. Relative standard deviations for betweenlaboratory reproducibility varied from 18.0 to 26.7% for fumonisin B1 and from 28.0 to 45.6% for fumonisin B2 at the concentrations mentioned above. These measures of variability indicate that the method is suitable for adoption as an official method provided that the accuracy characteristics are verified collaboratively.
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Affiliation(s)
- Pieter G Thiel
- Medical Research Council, Programme on Mycotoxins and Experimental Carcinogenesis, PO Box 19070, Tygerberg 7505, South Africa
| | - Eric W Sydenham
- Medical Research Council, Programme on Mycotoxins and Experimental Carcinogenesis, PO Box 19070, Tygerberg 7505, South Africa
| | - Gordon S Shephard
- Medical Research Council, Programme on Mycotoxins and Experimental Carcinogenesis, PO Box 19070, Tygerberg 7505, South Africa
| | - Dirk J Van Schalkwyk
- Medical Research Council, Programme on Mycotoxins and Experimental Carcinogenesis, PO Box 19070, Tygerberg 7505, South Africa
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Ishii K, Hyodo E, Seo Y, Ishizu T, Tada E, Kihara H, Daimon M, Tanaka A, Akasaka T, Watanabe H, Ito H, Yoshikawa J. 1225 Diagnostic accuracy of left ventricular diastolic strain imaging by speckle tracking echocardiography in detecting ischemic etiology of acute chest pain. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
none
OnBehalf
A TRAC-SI Multicenter Trial
Background
Two-dimensional speckle tracking echocardiography (2D-STE) has been reported to be useful for the diagnosis of myocardial ischemia by detecting delay in regional myocardial expansion (diastolic stunning) up to many hours after an episode of angina. The aim is to evaluate the diagnostic accuracy of Left ventricular (LV) diastolic longitudinal, circumferential, transverse and radial strain imaging by STE to detect the presence of acute coronary syndrome (ACS) in patients with acute chest pain.
Methods
388 consecutive patients with acute chest pain and without wall motion abnormality, who were admitted to an emergency department (ED) at 1 of 12 clinical sites in Japan, were enrolled and underwent 2D-STE at ED. Left ventricular (LV) longitudinal, circumferential, transverse and radial strain values at aortic valve closure (A) and one-third of diastole duration (B) were measured. The strain imaging diastolic index (SI-DI) was value was determined as: (A-B)/A × 100% to assess the LV diastolic strain imaging and was used to identify the regional LV delayed relaxation. All patients underwent coronary CT or coronary angiography to establish the diagnosis of ACS. Clinicians were blinded to the 2D-STE results.
Results
Out of 388 patients, 2D-STE analysis was possible in 358 patients (92%). With assessment of coronary CT or coronary angiography, ACS was diagnosed in 118 patients (33%). 2D-STE was obtained at a mean of 5.3 hours after chest pain episode. SI-DI of longitudinal, circumferential, transverse and radial strain of ischemic segments were significantly lower than those of non-ischemic segments (p value < 0.001), and transverse and radial SI-DI demonstrated high diagnostic accuracy, compared with longitudinal SI-DI (Figure 1). Sensitivity, specificity, and negative predictive value for ACS of transverse SI-DI are 87%, 88%, % and 95%, respectively, using a cut-off value of 63.3.
Conclusion
LV diastolic strain imaging by 2D-STE at ED increase the sensitivity, specificity and accuracy to predict the presence of ACS in patients with chest pain. Compared with longitudinal diastolic strain imaging, transverse diastolic strain imaging is more sensitive marker to detect the myocardial ischemic episode (UMIN000013859).
Abstract 1225 Figure 1
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Affiliation(s)
- K Ishii
- Kansai Electric Power Hospital, Cardiology, Osaka, Japan
| | - E Hyodo
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
| | - Y Seo
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - T Ishizu
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - E Tada
- Kansai Electric Power Medical Reseach Institute, Cardiology, Osaka, Japan
| | - H Kihara
- Kihara Cardiovascular Clinic, Cardiology, Asahikawa, Japan
| | - M Daimon
- University of Tokyo, Cardiology, Tokyo, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - H Watanabe
- Tokyo Bay Urayasu/Ichikawa Medical Center , Cardiology, Urayasu, Japan
| | - H Ito
- Okayama University Hospital, Cardiology, Okayama, Japan
| | - J Yoshikawa
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
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Hara S, Tanaka Y, Hayashi S, Inaji M, Maehara T, Hori M, Aoki S, Ishii K, Nariai T. Bayesian Estimation of CBF Measured by DSC-MRI in Patients with Moyamoya Disease: Comparison with 15O-Gas PET and Singular Value Decomposition. AJNR Am J Neuroradiol 2019; 40:1894-1900. [PMID: 31601573 DOI: 10.3174/ajnr.a6248] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/19/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE CBF analysis of DSC perfusion using the singular value decomposition algorithm is not accurate in patients with Moyamoya disease. This study compared the Bayesian estimation of CBF against the criterion standard PET and singular value decomposition methods in patients with Moyamoya disease. MATERIALS AND METHODS Nineteen patients with Moyamoya disease (10 women; 22-52 years of age) were evaluated with both DSC and 15O-gas PET within 60 days. DSC-CBF maps were created using Bayesian analysis and 3 singular value decomposition analyses (standard singular value decomposition, a block-circulant deconvolution method with a fixed noise cutoff, and a block-circulant deconvolution method that adopts an occillating noise cutoff for each voxel according to the strength of noise). Qualitative and quantitative analyses of the Bayesian-CBF and singular value decomposition-CBF methods were performed against 15O-gas PET and compared with each other. RESULTS In qualitative assessments of DSC-CBF maps, Bayesian-CBF maps showed better visualization of decreased CBF on PET (sensitivity = 62.5%, specificity = 100%, positive predictive value = 100%, negative predictive value = 78.6%) than a block-circulant deconvolution method with a fixed noise cutoff and a block-circulant deconvolution method that adopts an oscillating noise cutoff for each voxel according to the strength of noise (P < .03 for all except for specificity). Quantitative analysis of CBF showed that the correlation between Bayesian-CBF and PET-CBF values (ρ = 0.46, P < .001) was similar among the 3 singular value decomposition methods, and Bayesian analysis overestimated true CBF (mean difference, 47.28 mL/min/100 g). However, the correlation between CBF values normalized to the cerebellum was better in Bayesian analysis (ρ = 0.56, P < .001) than in the 3 singular value decomposition methods (P < .02). CONCLUSIONS Compared with previously reported singular value decomposition algorithms, Bayesian analysis of DSC perfusion enabled better qualitative and quantitative assessments of CBF in patients with Moyamoya disease.
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Affiliation(s)
- S Hara
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan .,Department of Radiology (S. Hara. M.H., S.A.), Juntendo University, Tokyo, Japan
| | - Y Tanaka
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - S Hayashi
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan.,Research Team for Neuroimaging (S. Hayashi, M.I., K.I., T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - M Inaji
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan.,Research Team for Neuroimaging (S. Hayashi, M.I., K.I., T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - T Maehara
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - M Hori
- Department of Radiology (S. Hara. M.H., S.A.), Juntendo University, Tokyo, Japan
| | - S Aoki
- Department of Radiology (S. Hara. M.H., S.A.), Juntendo University, Tokyo, Japan
| | - K Ishii
- Research Team for Neuroimaging (S. Hayashi, M.I., K.I., T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - T Nariai
- From the Department of Neurosurgery (S. Hara, Y.T., S. Hayashi, M.I., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan.,Research Team for Neuroimaging (S. Hayashi, M.I., K.I., T.N.), Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Naganuma A, Tateyama Y, Taira T, Shibasaki E, Murakami T, Masuda T, Uehara S, Yasuoka H, Hoshino T, Kudo T, Ishihara H, Ogawa Y, Shimizu T, Ishii K, Inagawa M, Tanaka T, Ogawa T, Oishi H. SUN-PO265: Usefulness of Nutrition Management by Percutaneous Trans-Esophageal Gastro-Tubing. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32895-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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31
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Asakura T, Ishii M, Ishii K, Suzuki S, Namkoong H, Okamori S, Kamata H, Yagi K, Funatsu Y, Betsuyaku T, Hasegawa N. Health-related QOL of elderly patients with pulmonary M. avium complex disease in a university hospital. Int J Tuberc Lung Dis 2019; 22:695-703. [PMID: 29862956 DOI: 10.5588/ijtld.17.0433] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the clinical characteristics and health-related quality of life (HQOL) of elderly patients with pulmonary Mycobacterium avium complex (pMAC) disease. OBJECTIVES To evaluate HQOL using the 36-Item Short-Form Health Survey and St George's Respiratory Questionnaire (SGRQ) and to investigate the predictors of HQOL changes among elderly patients with pMAC disease. METHODS This prospective cohort registry was conducted at Keio University Hospital, Tokyo, Japan, between May 2012 and July 2015 and included 84 patients with pMAC disease aged 75 years who had completed the HQOL questionnaire and 48 patients with pMAC disease who had been followed up and completed the HQOL questionnaire in cross-sectional and longitudinal analyses, respectively. RESULTS In cross-sectional analyses, elderly patients with pMAC disease had significantly lower role-physical, general health, vitality, social functioning, role-emotional and role/social component scores than the general Japanese elderly population. Analysis of covariance revealed that patients with cavitary lesions had significantly worse physical functioning and SGRQ scores (P < 0.05). Longitudinal analysis showed that under-treatment, short duration of disease and positive sputum smear at baseline were predictors of worse HQOL at 12 months. CONCLUSIONS Elderly patients with pMAC disease have reduced HQOL. Further large studies on HQOL are required to refine the use of this parameter in the treatment of these patients.
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Affiliation(s)
- T Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Society for the Promotion of Science, Tokyo
| | - M Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - K Ishii
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - S Suzuki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Society for the Promotion of Science, Tokyo
| | - H Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Department of Pulmonary Medicine, Eiju General Hospital, Tokyo
| | - S Okamori
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - H Kamata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - K Yagi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - Y Funatsu
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - T Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo
| | - N Hasegawa
- Center for Infectious Diseases and Infection Control, Keio University School of Medicine, Tokyo, Japan
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Ishii K, Kinoshita T, Kiridume K, Watanabe A, Yamakawa K, Nakao S, Fujimi S, Matsuoka T. Impact of initial coagulation and fibrinolytic markers on mortality in patients with severe blunt trauma: a multicentre retrospective observational study. Scand J Trauma Resusc Emerg Med 2019; 27:25. [PMID: 30819212 PMCID: PMC6394102 DOI: 10.1186/s13049-019-0606-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/04/2018] [Accepted: 02/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background Acute coagulopathy is a well-known predictor of poor outcomes in patients with severe trauma. However, using coagulation and fibrinolytic markers, how one can best predict mortality to find out potential candidates for treatment of coagulopathy remains unclear. This study aimed to determine preferential markers and their optimal cut-off values for mortality prediction. Methods We conducted a retrospective observational study of patients with severe blunt trauma (injury severity score ≥ 16) transferred directly from the scene to emergency departments at two trauma centres in Japan from January 2013 to December 2015. We investigated the impact and optimal cut-off values of initial coagulation (platelet counts, fibrinogen and prothrombin time-international normalised ratio) and a fibrinolytic marker (D-dimer) on 28-day mortality via classification and regression tree (CART) analysis. Multivariate logistic regression analysis confirmed the importance of these markers. Receiver operating characteristic curve analyses were used to examine the prediction accuracy for mortality. Results Totally 666 patients with severe blunt trauma were analysed. CART analysis revealed that the initial discriminator was fibrinogen (cut-off, 130 mg/dL) and the second discriminator was D-dimer (cut-off, 110 μg/mL in the lower fibrinogen subgroup; 118 μg/mL in the higher fibrinogen subgroup). The 28-day mortality was 90.0% (lower fibrinogen, higher D-dimer), 27.8% (lower fibrinogen, lower D-dimer), 27.7% (higher fibrinogen, higher D-dimer) and 3.4% (higher fibrinogen, lower D-dimer). Multivariate logistic regression demonstrated that fibrinogen levels < 130 mg/dL (adjusted odds ratio [aOR], 9.55; 95% confidence interval [CI], 4.50–22.60) and D-dimer ≥110 μg/mL (aOR, 5.89; 95% CI, 2.78–12.70) were independently associated with 28-day mortality after adjusting for probability of survival by the trauma and injury severity score (TRISS Ps). Compared with the TRISS Ps alone (0.900; 95% CI, 0.870–0.931), TRISS Ps with fibrinogen and D-dimer yielded a significantly higher area under the curve (0.942; 95% CI, 0.920–0.964; p < 0.001). Conclusions Fibrinogen and D-dimer were the principal markers for stratification of mortality in patients with severe blunt trauma. These markers could function as therapeutic targets because they were significant predictors of mortality, independent from severity of injury.
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Affiliation(s)
- Kenta Ishii
- Department of Trauma and Critical Care, Rinku General Medical Centre, Senshu Trauma and Critical Care Centre, 2-23 Rinku Orai-kita, Izumisano, Osaka, 598-8577, Japan.
| | - Takahiro Kinoshita
- Division of Trauma and Surgical Critical Care, Osaka General Medical Centre, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Kazutaka Kiridume
- Department of Trauma and Critical Care, Rinku General Medical Centre, Senshu Trauma and Critical Care Centre, 2-23 Rinku Orai-kita, Izumisano, Osaka, 598-8577, Japan
| | - Atsushi Watanabe
- Division of Trauma and Surgical Critical Care, Osaka General Medical Centre, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Kazuma Yamakawa
- Division of Trauma and Surgical Critical Care, Osaka General Medical Centre, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Shota Nakao
- Department of Trauma and Critical Care, Rinku General Medical Centre, Senshu Trauma and Critical Care Centre, 2-23 Rinku Orai-kita, Izumisano, Osaka, 598-8577, Japan
| | - Satoshi Fujimi
- Division of Trauma and Surgical Critical Care, Osaka General Medical Centre, 3-1-56 Bandai-Higashi, Sumiyoshi-ku, Osaka, 558-8558, Japan
| | - Tetsuya Matsuoka
- Department of Trauma and Critical Care, Rinku General Medical Centre, Senshu Trauma and Critical Care Centre, 2-23 Rinku Orai-kita, Izumisano, Osaka, 598-8577, Japan
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Okamura T, Nishio M, Ishii K, Takahashi K, Yoshino J, Kobashikawa H, Jordão de Magalhães Rosa G, Satoh M, Sasaki O. 301 Inferring phenotypic causal networks of reproductive traits in Landrace pigs in Japan. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Okamura
- Institute of Livestock and Grassland Science, NARO,Ibaraki, Japan
| | - M Nishio
- Institute of Livestock and Grassland Science, NARO,Ibaraki, Japan
| | - K Ishii
- Institute of Livestock and Grassland Science, NARO,Ibaraki, Japan
| | - K Takahashi
- Chiba Prefectural Livestock Research Center,Ibaraki, Japan
| | - J Yoshino
- Miyagi Livestock Experimental Station,Ibaraki, Japan
| | - H Kobashikawa
- Livestock Industry Division, Department of Agriculture Forestry and Fisheries Okinawa,Ibaraki, Japan
| | | | - M Satoh
- Graduate School of Agricultural Sciences, Tohoku University,Sendai, Japan
| | - O Sasaki
- Institute of Livestock and Grassland Science, NARO,Ibaraki, Japan
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Yotsumoto K, Ishii K, Kokubo M, Yasuoka S. Improvement of the skin penetration of hydrophobic drugs by polymeric micelles. Int J Pharm 2018; 553:132-140. [PMID: 30339944 DOI: 10.1016/j.ijpharm.2018.10.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/20/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
Abstract
Polymeric micelles, which form through the self-assembly of poly(ethylene glycol)-poly(amino acid) block copolymers, are systemic nanocarriers in targeted cancer therapy. These micelles can encapsulate therapeutic compounds, such as lipophilic substances, charged compounds, and metal complexes, that have characteristics of increased solubility, sustained release, and improved tissue distribution. However, few studies have been conducted on the local distribution of polymeric micelles. Thus, we evaluated the skin penetration pattern of hydrophobic drugs in polymeric micelles. We revealed that improved water solubility by the encapsulation of the hydrophobic drugs indomethacin and resveratrol in polymeric micelles significantly increased the amount of drugs penetrating into the skin. Moreover, polymeric micelles did not enhance the permeability of drugs. Furthermore, although the polymers remained on or in the stratum corneum, the encapsulated drugs gradually moved deeper into the skin. These results indicate that encapsulated hydrophobic drugs in polymeric micelles can penetrate the living cell layer of the skin without bringing about unexpected side effects associated with other ingredients in the formulation. Thus, polymeric micelles for encapsulating hydrophobic drugs can be used for skin applications.
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Affiliation(s)
- Kensuke Yotsumoto
- Cosmetic Division, NanoCarrier Co., Ltd., 144-15 Chuo, 226-39 Wakashiba, Kashiwa, Chiba 277-0871, Japan.
| | - Kenta Ishii
- Cosmetic Division, NanoCarrier Co., Ltd., 144-15 Chuo, 226-39 Wakashiba, Kashiwa, Chiba 277-0871, Japan
| | - Miho Kokubo
- Cosmetic Division, NanoCarrier Co., Ltd., 144-15 Chuo, 226-39 Wakashiba, Kashiwa, Chiba 277-0871, Japan
| | - Sakiko Yasuoka
- Cosmetic Division, NanoCarrier Co., Ltd., 144-15 Chuo, 226-39 Wakashiba, Kashiwa, Chiba 277-0871, Japan
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Ishii K, Nemoto K, Iwasaki N, Takeda T, Masuda T, Shibata Y, Tamaoka A. Decreased regional cerebral blood flow in patients with diphenylarsinic acid intoxication. Eur J Neurol 2018; 26:136-141. [PMID: 30133051 DOI: 10.1111/ene.13783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND PURPOSE Diphenylarsinic acid (DPAA) intoxication caused by drinking contaminated well water was found in Kamisu, Japan. The symptoms indicated cerebellar-brainstem and temporo-occipital involvement. However, it remains unclear how it affects the human brain. To elucidate the effect of DPAA on the human brain, we analyzed cerebral blood flow (CBF) data after the drinking of DPAA-contaminated water was stopped and investigated the correlation between DPAA exposure level and CBF by single-photon emission computed tomography (CBF-SPECT). METHODS The DPAA-exposed inhabitants (n = 78) were divided into 35 symptomatic and 43 asymptomatic subjects and compared with 38 healthy controls. The DPAA concentration in nails or hair and well water was measured using a high-performance liquid chromatography system and coupled plasma mass spectrometry after adequate extraction treatment. CBF-SPECT data, obtained within 1 year after the drinking of contaminated well water was stopped, were analyzed by statistical parametric mapping. We also examined the relationship between variations in CBF-SPECT signals and variations in DPAA concentrations in the hair or nails of the subjects. RESULTS Compared with control subjects, CBF in symptomatic DPAA-exposed subjects was significantly lower in the occipital lobe, including the cuneus and inferior occipital gyri. The DPAA concentration in the nails or hair of subjects was inversely and significantly related to their CBF. CONCLUSION These data suggest that CBF-SPECT may be useful as a clinical marker to infer the effect of accumulated DPAA on the brain.
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Affiliation(s)
- K Ishii
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - K Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - N Iwasaki
- Department of Pediatrics, Ibaraki Prefectural University of Health Sciences, Ami-machi, Japan
| | - T Takeda
- Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - T Masuda
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Neurobiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Shibata
- Center for Environmental Measurement and Analysis, National Institute for Environmental Studies, Tsukuba, Japan
| | - A Tamaoka
- Department of Neurology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Ishii K, Isoda K, Kitamura K, Sato-Okabayashi Y, Akita K, Kadoguchi T, Ohtomo F, Shimada K, Daida H. P1843Deficiency of interleukin-1 receptor antagonist continues angiotensin II induced aortic inflammation and promotes aneurysm formation after the cessation of its infusion. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Ishii
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - Y Sato-Okabayashi
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Akita
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - F Ohtomo
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Cardiovascular Medicine, Tokyo, Japan
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Machino T, Ishii K, Yamagami F, Komine H, Kitazaki S, Akamatsu M, Yamasaki H, Sekiguchi Y, Tsurushima H, Nogami A, Aonuma K. P4428Near-infrared spectroscopy demonstrated a heart rate-dependent decrease in cerebral oxygenation during paroxysmal supraventricular tachycardia as well as ventricular tachycardia. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Machino
- University of Tsukuba, Tsukuba, Japan
| | - K Ishii
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | | | - H Komine
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - S Kitazaki
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - M Akamatsu
- National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | | | | | | | - A Nogami
- University of Tsukuba, Tsukuba, Japan
| | - K Aonuma
- University of Tsukuba, Tsukuba, Japan
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Ishii K, Hyodo E, Seo Y, Ishizu T, Tada E, Kihara H, Daimon M, Tanaka A, Akasaka T, Ito H, Watanabe H, Yoshikawa J. P2746Two-dimensional speckle tracking echocardiography for early triage of patients with acute chest pain: a TRAC-SI multicenter trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Ishii
- Kansai Electric Power Hospital, Cardiology, Osaka, Japan
| | - E Hyodo
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
| | - Y Seo
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - T Ishizu
- Tsukuba University Hospital, Cardiology, Tsukuba, Japan
| | - E Tada
- Kansai Electric Power Medical Reseach Institute, Cardiology, Osaka, Japan
| | - H Kihara
- Kihara Cardiovascular Clinic, Cardiology, Asahikawa, Japan
| | - M Daimon
- University of Tokyo, Cardiology, Tokyo, Japan
| | - A Tanaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - T Akasaka
- Wakayama Medical University, Cardiology, Wakayama, Japan
| | - H Ito
- Okayama University Hospital, Cardiology, Okayama, Japan
| | - H Watanabe
- Tokyo Bay Urayasu/Ichikawa Medical Center, Cardiology, Urayasu, Japan
| | - J Yoshikawa
- Nishinomiya Watanabe Cardiovascular Center, Cardiology, Nishinomiya, Japan
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Matsuda K, Lopez JCA, Rehman S, Misawa M, Suzuki Y, Takeuchi A, Yasumoto M, Hibino K, Roy M, Hanayama R, Ishii K. Differential interference contrast microscopy for cells using hard x-ray holography. Appl Opt 2018; 57:4795-4801. [PMID: 30118100 DOI: 10.1364/ao.57.004795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/15/2018] [Indexed: 06/08/2023]
Abstract
We propose a differential interference contrast method for cells using hard x-ray Gabor holography and knife-edge filtering in the spatial frequency domain, without relying on beam shearing. A phase object is holographically recorded and reconstructed by computer. Interference between the wavefronts of zeroth order weighted by ejπ/2 in the positive frequency region produces a dark image. Similarly, interference between the wavefronts of the zeroth order weighted by ej3π/2 in the negative frequency region produces a bright image. By adding these two intensity distributions, good quality phase-contrast images of 8-μm-diameter polystyrene beads and human HeLa cells were obtained.
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Yotsumoto K, Ishii K, Miho K, Yasuoka S. 1052 The improvement on the skin penetration of water insoluble drugs by polymeric micelles. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1065] [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: 10/17/2022]
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Naito K, Katayoshi T, Ishii K, Obuchi S, Ino C, Takeoka A. 427 Efficacy of the topical application of collagen-derived dipeptide and grifola frondosa extract for treating atopic dermatitis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.434] [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: 10/17/2022]
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Asano S, Suzuki KM, Matsumura D, Ishii K, Ina T, Fujita M. Reduction and oxidation annealing effects on Cu K-edge XAFS for electron-doped cuprate superconductors. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1742-6596/969/1/012051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cho T, Higaki H, Hirata M, Hojo H, Ichimura M, Ishii K, Itakura A, Katanuma I, Kohagura J, Nakashima Y, Saito T, Tatematsu Y, Yoshikawa M, Itoh H, Minami R, Nagashima S, Numakura T, Watanabe H, Yoshida M, Yatsu K, Miyoshi S. Summarized Scaling Laws of Plasma Confining Potential Formation and Effects in the Gamma 10 Tandem Mirror. Fusion Science and Technology 2018. [DOI: 10.13182/fst03-a11963560] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Cho
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - H. Higaki
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - M. Hirata
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - H. Hojo
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - M. Ichimura
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - K. Ishii
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - A. Itakura
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - I. Katanuma
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - J. Kohagura
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Nakashima
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Saito
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Tatematsu
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - M. Yoshikawa
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - H. Itoh
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - R. Minami
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - S. Nagashima
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - T. Numakura
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - H. Watanabe
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - M. Yoshida
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - K. Yatsu
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
| | - S. Miyoshi
- Plasma Research Centre, University of Tsukuba, Ibaraki 305-8577, Japan
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Yoshikawa M, Furukawa T, Kubota Y, Sedo K, Kobayashi T, Takemura Y, Ishii K, Cho T, Yatsu K, Kawamori E, Okamoto Y, Yamaguchi N. Study of Impurity Ions Behavior in The Gamma 10 Plasma. Fusion Science and Technology 2018. [DOI: 10.13182/fst03-a11963592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Yoshikawa
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Furukawa
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Kubota
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - K. Sedo
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Kobayashi
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Takemura
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - K. Ishii
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Cho
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - K. Yatsu
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - E. Kawamori
- High Temperature Plasma Center, University of Tokyo, Tokyo 113-8656, Japan
| | - Y. Okamoto
- Toyota Technological Institute, Tenpaku, Nagoya, Aichi 468-8511, Japan
| | - N. Yamaguchi
- Toyota Technological Institute, Tenpaku, Nagoya, Aichi 468-8511, Japan
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Saito T, Tatematsu Y, Imaizumi Y, Tsuda E, Yasuoka T, Ichimura M, Ishii K, Katanuma I, Yatsu K. Study of The Potential Structure from the Plug-Barrier Cell to the End Plate in Gamma 10. Fusion Science and Technology 2018. [DOI: 10.13182/fst03-a11963586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Saito
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - Y. Tatematsu
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - Y. Imaizumi
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - E. Tsuda
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - T. Yasuoka
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - M. Ichimura
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - K. Ishii
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - I. Katanuma
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
| | - K. Yatsu
- Plasma Research Center, University of Tsukuba Tsukuba City, Ibaraki 305-8577
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Ishida M, Sakata N, Ise I, Ono T, Shimura M, Ishii K, Murakami M, Takadate T, Aoki T, Kudo K, Ohnuma S, Fukase K, Ohtsuka H, Mizuma M, Hayashi H, Nakagawa K, Morikawa T, Motoi F, Naitoh T, Unno M. The comparative anatomy of the folds, fossae, and adhesions around the duodenojejunal flexure in mammals. Folia Morphol (Warsz) 2017; 77:286-292. [PMID: 29064554 DOI: 10.5603/fm.a2017.0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 08/29/2017] [Accepted: 09/20/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anatomical knowledge of the duodenojejunal flexure is necessary for abdominal surgeries, and also important for physiologic studies about the duodenum. But little is known about the anatomy of this region in mammals. Here, we examined comparative anatomy to understand the anatomical formation of the duodenojejunal flexure in mammals. MATERIALS AND METHODS The areas around the duonenojejunal flexure were ob-served in mouse, rat, dog, pig, and human, and the anatomical structures around the duodenojejunal junction in the animals were compared with those in human. RESULTS The superior and inferior duodenal folds, and the superior and inferior duodenal fossae were identified in all examined humans. In pig, the structures were not clearly identified because the duodenum strongly adhered to the retroperitoneum and to the mesocolon. In mouse, rat, and dog, only the plica duodenocolica, which is regarded as the animal counterpart of the superior duo-denal fold in human, was identified, and other folds or fossae were not observed, probably because the duodenum was not fixed to the parietal peritoneum in those animals. Transection of the plica duodenocolica could return the normally rotated intestine back to the state of non-rotation in rat. CONCLUSIONS This study showed the anatomical similarities and dissimilarities of the duodenojejunal flexure among the mammals. Anatomical knowledge of the area is useful for duodenal and pancreatic surgeries, and for animal studies about the duodenum. (Folia Morphol 2018; 77, 2: 286-292).
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Mishina M, Suzuki M, Ishii K, Sakata M, Wagatsuma K, Ishibashi K, Toyohara J, Zhang M, Kimura K, Ishiwata K. Relationship between density of metabotropic glutamate receptors subtype 1 and asymmetrical parkinsonism in Parkinson’s disease – a ITMM PET study –. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2271] [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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Ishibashi K, Miura Y, Wagatsuma K, Toyohara J, Ishii K. Pet imaging of type 1 metabotropic glutamate receptors in a family with spinocerebellar ataxia type 6. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.744] [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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49
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Ishii K, Masuda T, Itoh J, Koide T, Tomidokoro Y, Takei Y, Tamaoka A. Transforming growth factor-β1 levels in the cerebrospinal fluid of patients with neurodegenerative diseases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.868] [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: 11/29/2022]
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50
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Takeda H, Ishii A, Nohara S, Tozaka N, Miyake Z, Okune S, Tsuji H, Tomidokoro Y, Nakamagoe K, Watanabe M, Ishii K, Tamaoka A. Lambert-Eaton myasthenic syndrome; Report of two cases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1859] [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: 11/24/2022]
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