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Nishi M, Atsumi T, Yoshikawa Y, Okano I, Nakanishi R, Watanabe M, Usui Y, Kudo Y. Residual deformity after femoral neck fracture affects the location of osteonecrosis of the femoral head. Bone Jt Open 2024; 5:394-400. [PMID: 38745542 PMCID: PMC11094473 DOI: 10.1302/2633-1462.55.bjo-2024-0051.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Aims The localization of necrotic areas has been reported to impact the prognosis and treatment strategy for osteonecrosis of the femoral head (ONFH). Anteroposterior localization of the necrotic area after a femoral neck fracture (FNF) has not been properly investigated. We hypothesize that the change of the weight loading direction on the femoral head due to residual posterior tilt caused by malunited FNF may affect the location of ONFH. We investigate the relationship between the posterior tilt angle (PTA) and anteroposterior localization of osteonecrosis using lateral hip radiographs. Methods Patients aged younger than 55 years diagnosed with ONFH after FNF were retrospectively reviewed. Overall, 65 hips (38 males and 27 females; mean age 32.6 years (SD 12.2)) met the inclusion criteria. Patients with stage 1 or 4 ONFH, as per the Association Research Circulation Osseous classification, were excluded. The ratios of anterior and posterior viable areas and necrotic areas of the femoral head to the articular surface were calculated by setting the femoral head centre as the reference point. The PTA was measured using Palm's method. The association between the PTA and viable or necrotic areas of the femoral head was assessed using Spearman's rank correlation analysis (median PTA 6.0° (interquartile range 3 to 11.5)). Results We identified a negative correlation between PTA and anterior viable areas (rho -0.477; p = 0.001), and no correlation between PTA and necrotic (rho 0.229; p = 0.067) or posterior viable areas (rho 0.204; p = 0.132). Conclusion Our results suggest that residual posterior tilt after FNF could affect the anteroposterior localization of necrosis.
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, Tokyo, Japan
| | - Takashi Atsumi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, Tokyo, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Ichiro Okano
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan
| | - Minoru Watanabe
- Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan
| | - Yuki Usui
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yoshifumi Kudo
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Nishi M, Atsumi T, Yoshikawa Y, Nakanishi R, Watanabe M, Kudo Y. Long-term outcomes of the mayo conservative hip system in patients aged 30 years or less with osteonecrosis of the femoral head: mean follow-up of more than 10 years. Arch Orthop Trauma Surg 2024:10.1007/s00402-024-05339-w. [PMID: 38709289 DOI: 10.1007/s00402-024-05339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/14/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Historically, total hip arthroplasty (THA) in very young patients has been associated with lower survivorship. However, the long-term outcomes of THA using short stems for osteonecrosis of the femoral head (ONFH) in very young patients remain unclear. Therefore, this study aimed to investigate the long-term outcomes of the Mayo conservative hip system, a short metaphyseal stabilised stem, in patients with ONFH aged ≦30 years. MATERIALS AND METHODS We retrospectively reviewed 104 joints in 76 patients with ONFH who underwent THA using the Mayo conservative hip system with a minimum follow-up of 8 years. The mean follow-up period was 12.5 (range, 8-19) years. Patients were categorised into two age groups (≦30 years, n = 21 and > 30 years, n = 83). Radiographic evaluation was used to assess stem sinking, stress shielding, and spot welds. The clinical evaluations were performed using the Japanese Orthopedic Association (JOA) hip score. Postoperative major complication and revision surgery rates were also assessed. RESULTS The patient characteristics were similar between the two groups, except for the age. Revision surgeries were performed in five cases, with similar implant survival rates between the groups. Dislocations occurred in the older age group alone (four joints). One case of intra-operative periprosthetic femoral fracture was found in the younger age group. Stem sinking of > 3 mm occurred in one and seven joints in the younger and older age groups, respectively. Spot welds were observed in most joints (93.2%) in modified Gruen zones 2 and 6 without significant differences between the groups. Stress shielding showed no significant differences in the frequency of occurrence or location between the two groups. Furthermore,the JOA score showed no significant difference between the two groups. CONCLUSION The use of short stems in patients aged ≤ 30 years with ONFH showed favourable long-term outcomes.
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
- Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashicyo, Nishitokyo-shi, Tokyo, 188-0011, Japan.
| | - Takashi Atsumi
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashicyo, Nishitokyo-shi, Tokyo, 188-0011, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashicyo, Nishitokyo-shi, Tokyo, 188-0011, Japan
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama City, Kanagawa, 227-8501, Japan
| | - Minoru Watanabe
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka Aoba-ku, Yokohama City, Kanagawa, 227-8501, Japan
| | - Yoshifumi Kudo
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
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Ueki H, Ogawa C, Goto H, Nishi M, Yamanaka J, Mochizuki S, Nishikawa T, Kumamoto T, Nishiuchi R, Kikuta A, Yamamoto S, Igarashi S, Sato A, Hori T, Saito AM, Watanabe T, Deguchi T, Manabe A, Horibe K, Toyoda H. TBI, etoposide, and cyclophosphamide conditioning for intermediate-risk relapsed childhood acute lymphoblastic leukemia. Int J Hematol 2024; 119:450-458. [PMID: 38267673 DOI: 10.1007/s12185-024-03710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND In children with intermediate-risk relapsed acute lymphoblastic leukemia (ALL), allogeneic hematopoietic stem cell transplantation (allo-HSCT) has markedly improved the outcome of patients with an unsatisfactory minimal residual disease (MRD) response. Total body irradiation (TBI), etoposide (ETP), and cyclophosphamide (CY) have been shown to be equivalent to or better than TBI + ETP for conditioning, so we hypothesized that even greater survival could be achieved due to recent advances in HSCT and supportive care. PROCEDURE We prospectively analyzed the efficacy and safety of allo-HSCT with a unified conditioning regimen of TBI + ETP + CY in children with intermediate-risk relapsed ALL, based on MRD in the bone marrow after induction, from the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) ALL-R08-II nationwide cohort (UMIN000002025). RESULTS Twenty patients with post-induction MRD ≥ 10-3 and two not evaluated for MRD underwent allo-HSCT. Engraftment was confirmed in all patients, and no transplantation-related mortality was observed. The 3-year event-free survival and overall survival rates after transplantation were 86.4% ± 7.3% and 95.5% ± 4.4%, respectively. CONCLUSION Allo-HSCT based on post-induction MRD with TBI + ETP + CY conditioning was feasible in Japanese children with intermediate-risk relapsed ALL.
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Affiliation(s)
- Hideaki Ueki
- Department of Pediatric Hematology/Oncology, Japanese Red Cross Narita Hospital, Narita, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masanori Nishi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Junko Yamanaka
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinji Mochizuki
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuro Nishikawa
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tadashi Kumamoto
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shohei Yamamoto
- Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan
| | - Shunji Igarashi
- Department of Pediatric Hematology/Oncology, Japanese Red Cross Narita Hospital, Narita, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Toshinori Hori
- Department of Pediatrics, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiko M Saito
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Tomoyuki Watanabe
- Department of Nutritional Science, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin, Japan
| | - Takao Deguchi
- Division of Cancer Immunodiagnostics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Keizo Horibe
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Hidemi Toyoda
- Department of Pediatrics, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
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Nishi M, Yoshikawa Y, Okano I, Kaji Y, Usui Y, Okamoto S, Nakamura S, Kudo Y, Nakamura M, Miyaoka H. Long-Term Outcomes of Cementless Bipolar Hemiarthroplasty in Young Patients With Osteonecrosis of the Femoral Head: The Impact of Implant Improvements and Preoperative Stage. Cureus 2024; 16:e57633. [PMID: 38707012 PMCID: PMC11069613 DOI: 10.7759/cureus.57633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Advancements in bipolar hemiarthroplasty (BHA) implants in the mid-1990s contributed to favorable short-term outcomes for osteonecrosis of the femoral head (ONFH), particularly in cases without acetabular cartilage lesions. Nevertheless, long-term results remain unclear. In this study, we investigated (i) the impact of new-generation BHA implants and (ii) the effect of the preoperative stage on long-term outcomes in young patients with ONFH. Methods The records of consecutive patients with ONFH who underwent cementless BHA were retrospectively reviewed. Patients aged ≥60 years, with <10 years of follow-up, or who underwent acetabular reaming during surgery were excluded. Radiographical and clinical outcomes of patients who received first-generation BHAs and new-generation BHAs (developed after 1998) were compared by stratifying based on preoperative stage 2/3A and 3B/4, according to the Japanese Investigation Committee classification. Results Overall, 50 hips from 39 patients (mean age: 44.6 years; 64% male) with an average follow-up of 18.6 years were included. The frequency of advanced-stage patients was significantly higher in the first-generation BHA group than in the new-generation group. Regarding postoperative outcomes, the first-generation BHA group had higher acetabular erosion grades (p<0.001) and more femoral component loosening than those in the new-generation group (p<0.001). Revisions were performed in eight hips (seven in the first-generation and one in the new-generation BHA groups, p<0.001). In the new-generation BHA group, there were no significant differences in patient background between stage 2/3A and 3B/4 groups, and only one case in the stage 3B/4 group required revision. In the new-generation group, the grade of acetabular erosion was significantly higher for stage 3B/4 than stage 2/3A (p<0.001); other radiographical and clinical outcomes did not differ significantly between stages. Conclusion New-generation BHAs have significantly better implant survival rates for early-stage ONFH than those of first-generation BHAs. These findings indicate that BHA is an acceptable treatment option for early-stage ONFH in young patients.
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Affiliation(s)
- Masanori Nishi
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Yasushi Yoshikawa
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Ichiro Okano
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Yasutaka Kaji
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Yuki Usui
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Satoshi Okamoto
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Shota Nakamura
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Yoshifumi Kudo
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Masanori Nakamura
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
| | - Hideyo Miyaoka
- Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Atsumi T, Nakanishi R, Yoshikawa Y, Watanabe M, Nishi M, Inagaki K. High-degree posterior rotational osteotomy for extensive collapsed femoral head osteonecrosis in teenagers: remodeling and results with a mean of 10-year follow-up. Arch Orthop Trauma Surg 2023; 143:6039-6048. [PMID: 37106100 DOI: 10.1007/s00402-023-04864-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/26/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION This study evaluated the effectiveness of high-degree posterior rotational osteotomy for teenagers with extensively collapsed femoral head osteonecrosis. MATERIALS AND METHODS We reviewed 40 hips in 35 patients with severely collapsed femoral head osteonecrosis treated by this procedure with a mean follow-up period of 9.7 years (range 5-25 years). Thirteen hips had a history of steroid administration. Nine had slipped capital femoral epiphysis. Nine had femoral neck fracture. Two had traumatic dislocation and fracture. Seven had no apparent risk factors. The mean age of the patients (18 women and 17 men) was 14.8 years. All femoral heads were extensively collapsed below the acetabular roof, and 20 hips showed preoperative joint space narrowing (ARCO stage 4). Lateral radiographs of the femoral head revealed extensive lesions from the posterior to anterior portion. The mean degree of posterior rotation was 118° with intentional varus positioning [mean: 19° (range 10-30)]. The pre- and postoperative extent of the viable area of the femoral head was assessed using conventional anteroposterior radiographs and 45-degree flexion radiography. Further collapse, joint space narrowing, femoral head morphology, and congruency with the acetabulum based on the Stulberg classification were assessed using conventional anteroposterior radiographs. The clinical assessment was conducted using the Merle d'Aubigné hip scores at the last follow-up. RESULTS The viable area of the femoral head on the loaded portion was seen during a short period after operations. The necrotic lesions were gradually improved postoperatively. The mean extent of viable bone below the acetabular roof was 48% at less than 6 months after surgery and 92% at the final follow-up. The mean extent on 45° flexion radiography was 54% at less than 6 months after surgery and 89% at the final follow-up. Further collapse was prevented in 38 hips (95%). In 19 of 20 hips with preoperative narrowing of the joint space, the joint space was first improved, but narrowing progressively observed in 9 of 40 hips at the final follow-up. Thirty-four hips had excellent or good clinical outcomes, whereas 6 had fair or poor outcomes. CONCLUSIONS We concluded that this procedure is effective at delaying the progression of degeneration if adequate area of viable bone can be moved under the loaded portion of the acetabulum in teenagers with severe femoral head osteonecrosis.
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Affiliation(s)
- Takashi Atsumi
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawaku, Tokyo, 142-8666, Japan.
- Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashi-Cho, Nishitokyo-Shi, Tokyo, 188-0011, Japan.
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aobaku, Yokohama, Kanagawa, 227-8501, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawaku, Tokyo, 142-8666, Japan
| | - Minoru Watanabe
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aobaku, Yokohama, Kanagawa, 227-8501, Japan
| | - Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawaku, Tokyo, 142-8666, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, 4-24-15 Tanashi-Cho, Nishitokyo-Shi, Tokyo, 188-0011, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawaku, Tokyo, 142-8666, Japan
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Nakashima C, Shiotsu Y, Harada Y, Katsuya H, Ookuma E, Nishi M, Sato A, Nakamura H, Sueoka-Aragane N. Abstract 262: Heat Map Analysis, a new integrated pathway scoring system for cancer genome profiling. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background: Cancer genome profiling using next-generation sequencing (NGS) has become widespread. Multiple genetic abnormalities including variant of unknown significance (VUS) have been detected in various cancer types. However, there is a lack of an integrated analysis system capable of identifying relationships among multiple genetic abnormalities and weighting them appropriately. Here, we report heat map analysis, a new integrated pathway scoring system for cancer genome profiling.
Methods: In heat map analysis, approximately 180 cancer-related genes among 324 genes evaluated by FoundationOne CDxTM are scored based on gene annotation and variant allele fraction (VAF), and classified into 16 pathways. This system provides an overall picture of genetic abnormalities and easy recognition of abnormal pathways. To examine the usefulness of the heat map analysis, a retrospective observational study was conducted on 50 patients with solid tumors who underwent cancer genome profiling test at Saga University Hospital from June 2019 to February 2022. The primary end point was the presentation rate of pathways with significantly increased scores.
Results: A total of 749 genetic abnormalities including VUS were detected in 50 patients with 15 cancer types: 571 single nucleotide variants (SNVs), 156 copy number variants (CNVs), and 22 fusions. The median number of abnormalities detected was 11 (2-20) SNVs, 2 (0-23) CNVs, and 0 (0-4) fusions, respectively. Heat map analysis presented active pathways with significant score elevation in 42 cases (84%). The TP53 pathway was the most common, followed by the Receptor Tyrosine Kinase pathway, PIK3-AKT, RAS, and DNA repair-related pathways.
Conclusion: Heat map analysis could be a promising new method for integrated analysis using cancer genome profiling tests.
Citation Format: Chiho Nakashima, Yukimasa Shiotsu, Yohei Harada, Hiroo Katsuya, Emi Ookuma, Masanori Nishi, Akemi Sato, Hideaki Nakamura, Naoko Sueoka-Aragane. Heat Map Analysis, a new integrated pathway scoring system for cancer genome profiling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 262.
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Affiliation(s)
| | | | - Yohei Harada
- 3Graduate School of medicine and faculty of medicine Kyoto University, Kyoto, Japan
| | | | - Emi Ookuma
- 1Saga University Faculty of Medicine, Saga, Japan
| | | | - Akemi Sato
- 1Saga University Faculty of Medicine, Saga, Japan
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Nishi M, Atsumi T, Yoshikawa Y, Nakanishi R, Ishikawa T, Usui Y, Inagaki K. High-Degree Valgus Osteotomy for Severe Femoral Head Osteonecrosis After Femoral Neck Fracture with Nonunion: A Case Report. JBJS Case Connect 2023; 13:01709767-202306000-00031. [PMID: 37205772 DOI: 10.2106/jbjs.cc.23.00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
CASE A 15-year-old adolescent boy had severe groin pain because of extensive osteonecrosis of the femoral head with collapse, joint space narrowing, and nonunion after a failed internal fixation for femoral neck fracture. We performed a 60° valgus osteotomy that moved the posteromedial small viable portion of the femoral head to the weight-bearing acetabular area. The femoral neck nonunion and the necrosis healed completely, and the spherical contour of the femoral head was regained after postoperative hip joint remodeling. CONCLUSIONS Good remodeling and congruency were achieved by performing high-degree valgus osteotomy to obtain sufficient viable area below the acetabular roof.
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, Nishitokyo-shi, Tokyo, Japan
| | - Takashi Atsumi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
- Department of Orthopaedic Surgery, Sassa General Hospital, Nishitokyo-shi, Tokyo, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Ryosuke Nakanishi
- Department of Orthopaedic Surgery, National Hospital Organization Shizuoka Medical Center, Sunto-gun, Shimizu-cho, Shizuoka, Japan
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Yokohama City, Kanagawa, Japan
| | - Tsubasa Ishikawa
- Department of Orthopaedic Surgery, Showa University Fujigaoka Hospital, Yokohama City, Kanagawa, Japan
| | - Yuki Usui
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
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Kakiuchi T, Eguchi K, Koga D, Eguchi H, Nishi M, Sonoda M, Ishimura M, Matsuo M. Changes in bone marrow and peripheral blood lymphocyte subset findings with onset of hepatitis-associated aplastic anemia. Medicine (Baltimore) 2022; 101:e28953. [PMID: 35212305 PMCID: PMC8878616 DOI: 10.1097/md.0000000000028953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/11/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Hepatitis-associated aplastic anemia (HAAA) is a rare illness that results in bone marrow failure following hepatitis development. The etiological agent remains unknown in most HAAA cases. However, clinical features of the disease and immunotherapy response indicate that immune-mediated factors play a central role in the pathogenesis of HAAA. Activation of cytotoxic T cells and increase in CD8 cells could exert cytotoxic effects on the myelopoietic cells in the bone marrow. PATIENT CONCERNS A 15-month-old boy was brought to our hospital with complaints of generalized petechiae and purpura observed a week prior to hospitalization. His liver was palpated 3 cm below the costal margin, platelet count was 0 × 104/μL, and alanine aminotransferase level was 1346 IU/L. A blood test indicated cytomegalovirus infection, and 3 bone marrow examinations revealed progressive HAAA. As the disease progressed to the 3rd, 6th, and 9th week after onset, CD4+ T cells were markedly decreased, CD8+ T cells were markedly increased, and the CD4/CD8 ratio was significantly decreased. The number of B cells and natural killer cells decreased with time, eventually reaching 0.0%. DIAGNOSIS HAAA. INTERVENTIONS Rabbit antithymocyte globulin and eltrombopag olamine (a thrombopoietin receptor agonist) were administered. OUTCOMES The patient's platelet count returned to normal, and bone marrow transplantation was avoided. The peripheral blood lymphocytes (PBLs) improved as the patient's general condition recovered. LESSONS This case demonstrates that HAAA induced by cytomegalovirus infection features decreasing CD4+ and increasing CD8+ PBLs as the bone marrow hypoplasia progresses. The PBLs return to their normal levels with the recovery from the disease. Our case findings thus support the involvement of immunological abnormality in HAAA.
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Affiliation(s)
- Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Katsuhide Eguchi
- Department of Pediatrics, Faculty of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Daisuke Koga
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroi Eguchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Masanori Nishi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Motoshi Sonoda
- Department of Pediatrics, Faculty of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masataka Ishimura
- Department of Pediatrics, Faculty of Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
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Hata T, Seino S, Yokoyama Y, Narita M, Nishi M, Hida A, Shinkai S, Kitamura A, Fujiwara Y. Interaction of Eating Status and Dietary Variety on Incident Functional Disability among Older Japanese Adults. J Nutr Health Aging 2022; 26:698-705. [PMID: 35842760 PMCID: PMC9209632 DOI: 10.1007/s12603-022-1817-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/01/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To examine whether eating status and dietary variety were associated with functional disability during a 5-year follow-up analysis of older adults living in a Japanese metropolitan area. DESIGN A 5-year follow-up study. SETTING Ota City, Tokyo, Japan. PARTICIPANTS A total of 10,308 community-dwelling non-disabled adults aged 65-84 years. MEASUREMENTS Eating status was assessed using a self-reported questionnaire. Dietary variety was assessed using the dietary variety score (DVS). Based on the responses, participants were classified according to eating alone or together and DVS categories (low: 0-3; high: 4-10). Functional disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. Multilevel survival analyses calculated the adjusted hazard ratio (HR) and 95% confidence interval (CI) for incident functional disability. RESULTS During a 5-year follow-up, 1,991 (19.3%) individuals had functional disabilities. Eating status or DVS were not independently associated with incident functional disability. However, interaction terms between eating status and DVS were associated with functional disability; HR (95% CI) for eating together and low DVS was 1.00 (0.90-1.11), eating alone and high DVS was 0.95 (0.77-1.17), and eating alone and low DVS was 1.20 (1.02-1.42), compared to those with eating together and high DVS. CONCLUSION Older adults should avoid eating alone or increase dietary variety to prevent functional disability. This can be ensured by providing an environment of eating together or food provision services for eating a variety of foods in the community.
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Affiliation(s)
- T Hata
- Yoshinori Fujiwara, MD, PhD., Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae, Itabashi City, Tokyo 173-0015, Japan, E-mail: , Phone: +81 (3) 3964-3241 ext. 4257, Fax: +81 (3) 3579-4776
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Eguchi H, Kakiuchi T, Nishi M, Kojima-Ishii K, Nishiyama K, Koga Y, Matsuo M. Case Report: Juvenile Myelomonocytic Leukemia Underlying Ornithine Transcarbamylase Deficiency Safely Treated Using Hematopoietic Stem Cell Transplantation. Front Pediatr 2022; 10:898531. [PMID: 35601422 PMCID: PMC9120833 DOI: 10.3389/fped.2022.898531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/14/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Juvenile myelomonocytic leukemia (JMML), which is predominantly found in infants, is a clonal abnormality of pluripotent hematopoietic stem cells and presents with the symptoms of both myeloproliferative tumors and myelodysplastic syndromes. Estimates have shown that ~20 cases of JMML occur annually in Japan. Ornithine transcarbamylase deficiency (OTCD), the most common among all urea cycle disorders (UCDs), occurs in 1 of 80,000 people in Japan. CASE PRESENTATION A 10-month-old infant who had fever, vomiting, and diarrhea for 2 days was referred to our hospital for the following abnormalities in blood tests: white blood cell count, 48,200/μL; hemoglobin, 9.0 g/dL; and platelet count, 135,000/μL. Bone marrow examination showed a nucleated cell count of 396,000/mm3 and blast cell count of 5.0%, as well as decreased mature granulocyte count and slightly myeloperoxidase stain-negative blasts but no monoclonal cell proliferation on May-Giemsa staining. Colony assay showed the proliferation of spontaneous colony and high sensitivity to granulocyte-macrophage colony-stimulating factor. Genetic analysis of peripheral blood mononuclear cells showed that the patient was positive for neuroblastoma RAS (NRAS) mutation. The patient was ultimately diagnosed with JMML. Approximately 170 days after his first hematopoietic stem cell transplantation (HSCT), the patient's JMML relapsed. Shortly after the recurrence, nausea, vomiting, hyperventilation, and decreased vitality were observed, followed by a decrease in the level of consciousness. The patient's ammonia level was 472 μmol/L. A test for seven different genetic mutations for the UCD showed the presence of c. 119G>A (amino acid change p. Arg40His). As such, late-onset OTCD was added to his diagnosis. Administration of sodium phenylacetate, l-arginine hydrochloride, and carnitine was continued following the diagnosis of OTCD, after which hyperammonemia was not observed. Regarding JMML relapse, HSCT was performed on day 405 after the first transplantation. CONCLUSION Hyperammonemia should be considered a differential diagnosis when unexplained and non-specific symptoms occur during the treatment of hematologic malignancies. Patients should be tested for UCD as a cause of hyperammonemia, and treatment for hyperammonemia should be continued until the cause is identified. The patient shows normal developmental progress, has an intact neurological status, and has not experienced another hyperammonemia attack. His JMML has remained in remission for over 3 years.
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Affiliation(s)
- Hiroi Eguchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Masanori Nishi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Kanako Kojima-Ishii
- Department of Pediatrics, Graduate School of Medicine Sciences, Kyushu University, Fukuoka, Japan
| | - Kei Nishiyama
- Department of Pediatrics, Graduate School of Medicine Sciences, Kyushu University, Fukuoka, Japan
| | - Yuhki Koga
- Department of Pediatrics, Graduate School of Medicine Sciences, Kyushu University, Fukuoka, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
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13
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Nishi M, Okano I, Yoshikawa Y, Tochio H, Usui Y, Inagaki K. Relationship Between Acetabular Hounsfield Unit Values and Periprosthetic Fractures in Cementless Total Hip Arthroplasty: A Matched Case-Control Study. Arthroplast Today 2022; 14:216-222.e1. [PMID: 35510068 PMCID: PMC9059077 DOI: 10.1016/j.artd.2021.11.016] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background The association between regional bone status around the acetabulum and the incidence of intraoperative acetabulum fractures has not been extensively studied. We investigated the association of Hounsfield unit (HU) values on computed tomography in the regions of the acetabulum with periprosthetic fractures. Methods We retrospectively reviewed records of 301 consecutive patients who underwent cementless total hip arthroplasty between October 2016 and December 2020. Using preoperative computed tomography taken in the 4 weeks preceding total hip arthroplasty, we measured HU values in 4 different acetabulum regions (anterior, medial, posterior, and superior). After identifying fracture cases, we identified a control group—matched in terms of sex, age, and preoperative diagnosis—selected in a 1:3 ratio among nonfracture patients treated in the same inclusive period. As the average HU values differed by region, we used the standardized value to compare fracture-site HUs. We ranked the standardized HU values for each acetabular site and compared the fracture site rank between the groups. Results Intraoperative acetabular fractures were observed in 10 hips (3.2%), occurring most frequently in the superior region (40%). The standardized HU values of the fracture site were statistically lower in the fracture group (P = .039). We compared the ranks of the standardized HUs of the fractured parts with those of the corresponding parts in the control group; the fracture site had a significantly lower standardized HU rank, indicating that fractures tended to occur in the relatively “weaker-than-expected” parts. Conclusions Periprosthetic fractures tended to occur at relatively weak parts of the acetabulum.
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Affiliation(s)
- Masanori Nishi
- Corresponding author. Department of Orthopedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. Tel.: +81337848543.
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14
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Morioka M, Takashio S, Nakashima N, Nishi M, Hirakawa K, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Kaikita K, Tsujita K. Correlations between pathological deposition and non-invasive diagnostic modalities like 99mTc-PYP scintigraphy, cardiac magnetic resonance, GLS in patients with transthyretin cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) was previously considered a rare disease, recent diagnostic imaging modalities have revealed that it is considerably underdiagnosed among elderly patients with heart failure. The severity of CM is thought to be related to the extent of amyloid deposition in heart.
99mTc-labeled pyrophosphate (99mTc-PYP) scintigraphy, cardiovascular magnetic resonance (CMR), global longitudinal strain (GLS) provide diagnostic and prognostic information in ATTRwt-CM. However, the relevance of these imaging modalities and their association with cardiac amyloid load has not been fully evaluated.
Purpose
The aim of study was to elucidate the associations between pathological amyloid load and cardiac retention evaluated by 99mTc-PYP scintigraphy, CMR, GLS in patients with ATTRwt-CM.
Method
Cardiac amyloid load was calculated as (amyloid deposition area/ total myocardium area)×100 using endomyocardial biopsy specimen. Cardiac retention was quantified by heart to contralateral (H/CL) ratio by 99mTc-PYP scintigraphy. Native T1 and extracellular volume (ECV) were obtained by CMR. GLS was analyzed using the 2D echo at the time of diagnosis.
Result
The mean cardiac amyloid load was 23.0±15.2% (n=57) and correlation with H/CL ratio (1.94±0.36 n=57), native T1 (1426.7±52.5 n=57), ECV (57.9±12.9 n=54), GLS (−9.1±2.4 n=57) were positive (r=0.375 p=0.004, r=0.496 r=0.304 p<0.001, r=0.304 p=0.025, r=0.473 p<0.001).
Conclusion
Increased cardiac amyloid load correlated with an increased 99mTc-PYP positivity, native T1, ECV, and an impaired GLS. These results suggest that imaging parameters may reflect histological and functional changes due to amyloid deposition in the myocardium.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Morioka
- Kumamoto University, Kumamoto, Japan
| | | | | | - M Nishi
- Kumamoto University, Kumamoto, Japan
| | | | | | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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15
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Takashio S, Morioka M, Nishi M, Nakashima N, Yamada T, Hirakawa K, Hanatani S, Usuku H, Yamamoto E, Matsushita K, Kaikita K, Tsujita K. Gender differences in clinical characteristics in wild-type transthyretin amyloidosis cardiomyopathy. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
A significant male predominance has been reported in wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). In other words, the female ATTRwt-CM may be overlooked and gender differences in ATTRwt-CM remain unclear. This study aims to examine gender differences in clinical characteristics and diagnostic approaches in ATTRwt-CM.
Methods and results
We retrospectively evaluated 171 consecutive ATTRwt-CM patients diagnosed at our university hospital between December 2002 and December 2020. Twenty-two patients (12%) were women. Women were significantly older at diagnosis (77.3 years vs. 83.3 years; P<0.001) and had a higher advanced New York Health Association functional class (2.23±0.70 vs. 2.57±0.81; P=0.04) than men. In echocardiography, mean interventricular septum diameter was less thick (15.8 mm vs. 14.5 mm; P=0.03) and ejection fraction was preserved (51.7% vs. 57.7%; P=0.08) in women. The mean heart-to-contralateral ratio obtained using 99mTc-labeled pyrophosphate (99mTc-PYP) was significantly lower in women than in men (1.89 vs. 1.64; P=0.001). There was no significant gender difference in high-sensitivity median cardiac troponin T levels at diagnosis (0.055 ng/mL vs. 0.069 ng/mL; P=0.30) or history of carpal tunnel syndrome (57% vs. 55%; P=0.93) and electrocardiograms findings. However, the median B-type natriuretic peptide level was significantly higher (254 pg/mL vs. 434 pg/mL; P=0.02) in women. Moderate to severe aortic stenosis was more frequently observed in women (5% vs. 50%; P<0.001). Histological (78% vs. 59%; P=0.07) and genetic confirmation (78% vs. 59%; P=0.003) of ATTRwt-CM were not performed in women.
Conclusion
Women with ATTRwt-CM were predominantly octogenarians, less hypertrophic, and had weaker cardiac uptake of the 99mTc-PYP tracer than men with ATTRwt-CM. These characteristics contribute to the underdiagnosis of ATTRwt-CM in women. The diagnosis of ATTRwt-CM in women is challenging. Therefore, we must be familiar with the clinical characteristics of women with ATTRwt-CM.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Morioka
- Kumamoto University, Kumamoto, Japan
| | - M Nishi
- Kumamoto University, Kumamoto, Japan
| | | | - T Yamada
- Kumamoto University, Kumamoto, Japan
| | | | | | - H Usuku
- Kumamoto University, Kumamoto, Japan
| | | | | | - K Kaikita
- Kumamoto University, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University, Kumamoto, Japan
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Hayama T, Ijuin A, Ueno H, Hamada H, Miyakoshi A, Nishi M, Saito M, Hamanoue H, Komeya M, Takeshima T, Kuroda S, Sakakibara H, Yumura Y, Miyagi E, Murase M. P–572 Purifying selection for aneuploidy cells in mosaicism embryo at post-implantation stage. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Why low ratio mosaicism embryos develop to normal karyotype babies?
Summary answer
Our in vitro implantation assay clarified purifying selection for aneuploid cells in post implantation embryos.
What is known already
There are some reports about healthy live birth after transfer of mosaic embryos, which was reported for the first time from Italy in 2015. It is also reported that the abnormal cell is screened with the mouse in the embryo development, and only a normal cell contributes to the development. But it has not been examined in human.
Study design, size, duration
To clarify the change of aneuploid cells and mitochondrial activity in human embryo, we biopsied several parts from one blastocyst and examined karyotype. After in vitro implantation assay for biopsied embryos, we compared the karyotype of biopsy sample with that of cultured cell mass.
Participants/materials, setting, methods
Under the ethical review of Yokohama City University and informed consent with patients, we collected human surplus blastocysts those are donated after successful clinical treatment or discarded because of poor development grade. We biopsied multiple parts from one blastocyst and cultured the biopsied embryos, and extracted whole DNA from the biopsy samples and cultured embryos. Karyotyping by next generation sequencing were performed.
Main results and the role of chance
We analyzed 34 samples from 11 embryos, including 25 biopsy sample from 11 embryos and 9 cell mass from 7 cultured embryos. In the karyotype tracking results, even though biopsy sample analysis before the culture were uniformed aneuploid or chromosome mosaic, the developing embryo cell mass had normal karyotype. In one embryo as an example, among the three biopsied extra trophectoderm samples from that, two of them were mosaic, and one of them had uniformed chromosome 21 trisomy and chromosome 16 mosaic monosomy. But the embryo formed multiple cell mass in implantation assay. We examined karyotype of three cell mass, and the result from all were normal karyotype. We suggested that the chromosome aberration cells were screened in the human embryo development, and when the function was not carried out the embryo stopped the development.
Limitations, reasons for caution
Because of small number of samples available, we need more samples for a more accurate evaluation. Furthermore, we cannot evaluate the absolute mechanism that cells with chromosome aberration decreases.
Wider implications of the findings: Conventional PGT-A techniques are based on uniformed embryos developing hypothesized past time. As showed in some clinical reports, PGT-A can reduce of spontaneous abortion and chance of embryo transfer. Thinking about aneuploid cell purifying system in embryo development, effectiveness of PGT-A should be more questionable for infertility treatment.
Trial registration number
A200326004
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Affiliation(s)
- T Hayama
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Ueno
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamada
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Nishi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Saito
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamanoue
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Komeya
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - S Kuroda
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Sakakibara
- Yokohama City University Medical Center, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - E Miyagi
- Yokohama City University, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - M Murase
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
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Nishi M, Yoshikawa Y, Kaji Y, Okamoto S, Inagaki K. Isolated Septic Arthritis of the Hip Due to Fusobacterium Nucleatum in An Immunocompetent Adult: A Case Report and Review of the Literature. J Orthop Case Rep 2021; 11:37-40. [PMID: 34327162 PMCID: PMC8310635 DOI: 10.13107/jocr.2021.v11.i04.2142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Hip septic arthritis is more common in children than in adults. Staphylococcus aureus and Streptococcus spp. are commonly found in association with septic joints. In contrast, Fusobacterium nucleatum septic arthritis in adults is extremely rare. To the best of our knowledge, only five cases have been reported in the literature in English, and three of them were cases of periprosthetic joint infection. We report a rare case of hip septic arthritis due to F. nucleatum in an immunocompetent adult. Case Presentation: A 56-year-old Asian man with a history of bilateral Perthes’ disease and mild alcoholic liver disease presented to our hospital complaining of worsening right hip pain and difficulty in walking for the previous 3 weeks. On presentation, his temperature was 38.7°C, and laboratory results showed a white blood cell count of 19 200 cells/µL and a C-reactive protein level of 43.56 mg/dL. Hip movements were limited due to pain. Contrast-enhanced computed tomography and magnetic resonance imaging showed fluid retention, suggesting infection. F. nucleatum was detected in the culture test from joint aspirate. Surgical drainage was performed 3 times in combination with antibiotherapy. Finally, we performed two-stage total hip arthroplasty, and the post-operative course was uneventful without implant loosening or infection relapse. Conclusion: The patient had a history of Perthes’ disease and had hip osteoarthritis, which may have contributed to the development of hip septic arthritis. We treated this rare case of hip septic arthritis due to F. nucleatum with two-stage revision surgery and antibiotherapy. Clinicians should be aware that F. nucleatum could be the etiologic agent of hip septic arthritis in an immunocompetent patient.
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Yasutaka Kaji
- Department of Orthopaedic Surgery, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Satoshi Okamoto
- Department of Orthopaedic Surgery, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Hatanodai, Shinagawa-ku, Tokyo, Japan
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Yoshikawa Y, Toura M, Kudo Y, Okano I, Nishi M, Toyone T, Inagaki K. Unexpected Complications after Corrective Spinal Fusion Surgery for Adult Spinal Deformity with Severe Hip Contracture. J Orthop Case Rep 2021. [DOI: 10.13107/jocr.2021.v11.i02.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: In cases with markedly decreased hip function, patients predominantly utilize spine movement while standing up to compensate for the hip malfunction. However, spinal fusion surgeries might lead to the disruption of this compensatory mechanism, resulting in difficulties in walking and standing up as well as proximal junctional failure (PJF) due to the excessive stress on the spine caused by the pendulum-like motion needed for standing up. Hence, in patients with severe hip pathology, surgeons should be cautious about the indication for spinal fusion, which inevitably affects spinal mobility. This is the first report presenting a case that supports the aforementioned theory.
Case Report: In this study, we report the case of a 76-year-old Japanese woman who underwent corrective spinal fusion surgery for spinal scoliosis secondary to hip contracture. The patient exhibited post-operative complications, such as unexpected difficulty in walking and standing up and PJF. The patient underwent a revision spinal surgery with an extension of spinal fusion for PJF and muscle release around the hip for hip contracture which resulted in improved walking and standing movements with no reports of pain.
Conclusion: Spinal fusion surgeries performed on patients with severe hip pathology could cause early PJFs and unexpected decline in activities of daily living. Patients with such risks often do not complain of hip symptoms before spinal correction surgery. Surgeons should routinely evaluate hip joints and be cautious about the indication for spinal fusion which inevitably affects spinal mobility.
Keywords: Hip joint contracture, spinal correction surgery, proximal junctional failure, muscle release around the hip.
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Nishi M, Yoshikawa Y, Kaji Y, Okano I, Inagaki K. Multi-Site Insufficiency Pelvic Fracture Following Total Hip Arthroplasty. Am J Case Rep 2020; 21:e927776. [PMID: 33372173 PMCID: PMC7780195 DOI: 10.12659/ajcr.927776] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Patient: Female, 47-year-old Final Diagnosis: Pelvic fracture Symptoms: Hip pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yasushi Yoshikawa
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Yasutaka Kaji
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Ichiro Okano
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Yoshino T, Kotaka M, Manaka D, Eto T, Hasegawa J, Takagane A, Nakamura M, Kato T, Munemoto Y, Nakamura F, Bando H, Taniguchi H, Sakamoto Y, Shiozawa M, Nishi M, Horiuchi T, Mizushima T, Yamanaka T, Ohtsu A, Mori M. 401MO OS and long-term DFS with 3- vs. 6-month adjuvant oxaliplatin and fluoropyrimidine-based therapy for stage III colon cancer patients: A randomized phase III ACHIEVE trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.512] [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: 10/23/2022] Open
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21
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Nishi M, Okano I, Sawada T, Midorikawa N, Inagaki K. Cementless Bipolar Hemiarthroplasty for Low-energy Intracapsular Proximal Femoral Fracture in Elderly East-Asian Patients: A Longitudinal 10-year Follow-up Study. Hip Pelvis 2019; 31:206-215. [PMID: 31824875 PMCID: PMC6892899 DOI: 10.5371/hp.2019.31.4.206] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/07/2019] [Accepted: 08/07/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose Short-term outcomes following cemented and cementless hemiarthroplasties (HAs) are reported to be comparable, however, long-term outcomes of cementless HA—especially among Asian patients—is limited. We aimed to assess long-term outcomes in elderly East-Asian patients with intracapsular proximal femoral fractures treated with cementless HA. Materials and Methods We enrolled 135 patients treated with cementless HA who met our inclusion criteria. We documented bone/implant-related complications (e.g., incidences of revision hip surgery, femoral stem subsidence, dislocation, intraoperative and postoperative periprosthetic fractures, contralateral hip fractures). We included those patients who are still alive 10 years after the index surgery in the final functional analysis of the existence of pain, ambulatory status, and residential status. Results The mean age at injury was 78.3 years (range: 60–85 years). At the 10-year follow-up, 26 of the original patients (19.3%) had survived. During follow-up, revision hip surgery was conducted in two patients (1.5%). We recorded the incidence of intraoperative fractures, postoperative periprosthetic fractures, and contralateral fractures in two (1.5%), eight (5.9%), and six patients (4.4%), respectively. Among the 10-year survivors, six patients (23.1% of the survivors) complained of groin pain, but generally reported the pain to be tolerable. Conclusion Among elderly East-Asian patients, the incidence of revision surgery after cementless HA may be lower than that in their European counterparts, whereas the incidence of periprosthetic fractures can still be considerably higher. For patients undergoing cementless HA, prevention of such secondary fractures is of critical importance.
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Affiliation(s)
- Masanori Nishi
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Fukushima, Japan.,Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Ichiro Okano
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Fukushima, Japan
| | - Takatoshi Sawada
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Fukushima, Japan
| | - Natsuki Midorikawa
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Fukushima, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan
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Nishi M, Yamada T, Takashio S, Tsujita K. P897Diagnostic utility of tissue biopsy in transthyretin cardiac amyloidosis diagnosed by non-invasive diagnostic criteria. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the recent past, transthyretin cardiac amyloidosis (TTR-CA) is recognized as an important cause of heart failure with preserved ejection fraction, and diagnostic utility of 99mTc-pyrophosphate (99mTc-PYP) scintigraphy in TTR-CA has been established. However, pathological evaluation is still the basis to confirm diagnosis. Subcutaneous tissue and gastrointestinal tract biopsy are useful examinations alternative to endomyocardial biopsy. Nevertheless, the positive ratio of amyloid deposition in these organs is not fully evaluated based on recent non-invasive diagnostic criteria.
Purpose
Our aim was to evaluate the diagnostic sensitivity of tissue biopsy in TTR-CA patients diagnosed by 99mTc-PYP scintigraphy.
Methods
We retrospectively evaluated 124 consecutive TTR-CA patients [wild-type (ATTRwt): 90, hereditary (hATTR): 34] who were diagnosed by positive findings of 99mTc-PYP scintigraphy (visual score 2 or 3) between June 2002 and January 2019 at our institute.
Results
A total of 114 patients underwent tissue biopsy at least one organ. Amyloid was detected on Congo red staining of subcutaneous tissue (43/97: 44%), gastrointestinal tract (52/78: 67%) and heart (78/79: 99%), respectively. Among 70 patients who underwent both subcutaneous tissue and gastrointestinal tract biopsy, amyloid was detected at least one specimen in 57/70 (81%). Compared to hATTR CA patients, ATTRwt CA patients had lower positive ratio of subcutaneous tissue (81% vs. 27%) and gastrointestinal tract (73% vs. 63%) biopsy.
Conclusion
Non-invasive diagnostic criteria of TTR-CA had excellent sensitivity of amyloid deposition in heart. The diagnostic sensitivity of subcutaneous tissue and gastrointestinal tract biopsy was lower in ATTRwt CA compared to hATTR CA. Combination of subcutaneous tissue and gastrointestinal tract biopsy was useful for pathological confirmation of amyloid deposition without endomyocardial biopsy.
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Affiliation(s)
- M Nishi
- Kumamoto University Hospital, Kumamoto, Japan
| | - T Yamada
- Kumamoto University Hospital, Kumamoto, Japan
| | - S Takashio
- Kumamoto University Hospital, Kumamoto, Japan
| | - K Tsujita
- Kumamoto University Hospital, Kumamoto, Japan
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Okano I, Tachibana T, Nishi M, Midorikawa Y, Hoshino Y, Sawada T, Kudo Y, Toyone T, Inagaki K. Conservative treatment for stable low-energy thoracolumbar vertebral fractures in nonfused segments among elderly patients with diffuse idiopathic skeletal hyperostosis: A matched case-control study. Medicine (Baltimore) 2019; 98:e16032. [PMID: 31192958 PMCID: PMC6587625 DOI: 10.1097/md.0000000000016032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is the spontaneous osseous fusion of the spine with anterior bridging osteophytes. It is well-known that conservative treatment for vertebral fractures of fused segment among DISH spines is associated with worse clinical outcomes. However, the prognosis of conservatively treated stable vertebral fractures in neighboring nonfused segments among DISH spines is still unknown. The purpose of this study was to analyze the results of conservative treatment of stable low-energy thoracolumbar (TL) vertebral fracture in nonfused segments among patients with DISH lesions.A total of 390 consecutive patients who visited an emergency department by ambulance with spinal trauma between 2013 and 2017 were retrospectively reviewed. The diagnosis of DISH was determined based on fused spinal segments with bridging osteophytes in at least 3 adjacent vertebrae. For each case of stable TL vertebral fractures in nonfused segments of the DISH spine, we identified 2 age-, sex-, and fracture lesion-matched non-DISH controls who underwent conservative treatment for low-energy TL vertebral fractures during the same period.Of the 33 identified cases of TL fractures with DISH, 14 met our inclusion criteria. The bony union rates of the DISH group and control group were 57% and 75% at the 3-month follow-up examination (P = .38) and 69% and 100% at the 6-month follow-up examination (P = .02), respectively. Among the 13 patients with fractures below the TL junction, fused segments were not diagnosable based on the initial standard radiographs of the lumbar spine for 61.5% of patients.Although this study design was exploratory and the sample size was small, our results suggest that with conservative treatment, stable fractures in nonfused segments in the DISH spine might have a worse prognosis than ordinary osteoporotic vertebral fractures. The diagnosis of coexisting DISH lesions can be missed when only radiographs of the lumbar spine are used to determine the diagnosis.
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Affiliation(s)
- Ichiro Okano
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Koriyama, Fukushima
| | - Tetsuya Tachibana
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Koriyama, Fukushima
| | - Masanori Nishi
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Koriyama, Fukushima
| | - Yuki Midorikawa
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Koriyama, Fukushima
| | - Yushi Hoshino
- Department of Orthopaedic Surgery, Showa University Koto Toyosu Hospital, Koto-ku
| | - Takatoshi Sawada
- Department of Orthopaedic Surgery, Ohta-Nishinouchi Hospital, Koriyama, Fukushima
| | - Yoshifumi Kudo
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagama-ku, Tokyo, Japan
| | - Tomoaki Toyone
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagama-ku, Tokyo, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, Shinagama-ku, Tokyo, Japan
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Sakamoto K, Nishi M, Ishiji K, Takatori Y, Chiwata R. Induction of flower-colour mutation by synchrotron-light irradiation in spray chrysanthemum. ACTA ACUST UNITED AC 2019. [DOI: 10.17660/actahortic.2019.1237.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yokoyama Y, Kitamura A, Yoshizaki T, Nishi M, Seino S, Taniguchi Y, Amano H, Narita M, Shinkai S. Score-Based and Nutrient-Derived Dietary Patterns Are Associated with Depressive Symptoms in Community-Dwelling Older Japanese: A Cross-Sectional Study. J Nutr Health Aging 2019; 23:896-903. [PMID: 31641742 DOI: 10.1007/s12603-019-1238-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study evaluated associations of score-based and nutrient-derived dietary patterns with depressive symptoms in community-dwelling older Japanese. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS 982 community-dwelling adults aged 65 years or older. MEASUREMENTS Score-based pattern was assessed by using dietary variety score (DVS), which covers 10 food group items in Japanese meals. Nutrient-derived dietary patterns were identified by using reduced rank regression (RRR), with folate, vitamin C, magnesium, calcium, iron, and zinc intakes as response variables. Depressive symptoms were assessed with the Geriatric Depression Scale. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for these dietary patterns in multivariate logistic regression analyses with potential confounders. The lowest consumption category was used as the reference group. RESULTS The prevalence of depressive symptoms was 13.5%. Higher DVS was associated with fewer depressive symptoms (OR=0.52, 95% CI=0.27-1.03 for the highest vs the lowest DVS; P for trend=0.031). The first RRR dietary pattern score was characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, fruits, and green tea and a low intake of rice and was inversely associated with the prevalence of depressive symptoms (OR=0.53, 95% CI=0.30-0.92; P for trend=0.030). CONCLUSION Greater dietary variety and a dietary pattern characterized by high intakes of fish, soybean products, potatoes, most vegetables, mushrooms, seaweeds, fruit, and green tea and a low intake of rice were consistently associated with lower prevalence of depressive symptoms in community-dwelling older Japanese. Therefore, both patterns identified the components of dietary habits essential to depression prevention.
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Affiliation(s)
- Y Yokoyama
- Yuri Yokoyama, PhD, Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2, Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan, Tel: +81(3)3964-3241, Fax: +81(3)3579-4776, E-mail:
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Nakamura T, Nishi M, Rikitake M, Koga D, Eto J, Tajima D, Toda S, Matsuo M. A case of subacute combined degeneration of the spinal cord due to folic acid and copper deficiency. Brain Dev 2019; 41:111-115. [PMID: 30104084 DOI: 10.1016/j.braindev.2018.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/02/2018] [Accepted: 07/11/2018] [Indexed: 11/27/2022]
Abstract
Subacute combined degeneration of the spinal cord (SACD) is a rare neurologic disorder manifesting progressive symptoms of paresthesia and spastic paralysis. Herein we present an autopsy case of SACD caused by folic acid and copper deficiency. A 16-year-old male presented with gradually worsening unsteady gait, and bladder and rectal dysfunction. He had a medical history of T-cell acute lymphoblastic leukemia (T-ALL), diagnosed 1.5 years previously. The patient had undergone chemotherapy, including methotrexate, as well as allogeneic bone mallow transplantation. Laboratory tests revealed normal vitamin B12 and methylmalonic acid concentration, but reduced serum copper, ceruloplasmin and folic acid concentrations. Magnetic resonance imaging revealed symmetrical T2 signal hyperintensities in the posterior and lateral spinal cord. The patient was treated with oral copper, oral folate, and intravenous vitamin B12. A month after this treatment, the patient's symptoms were unchanged, and 2 months later he died of acute adrenal insufficiency. The pathological findings of the spinal cord were compatible with SACD. Because SACD is usually reversible with early treatment, it should be suspected in high-risk patients undergoing chemotherapy or those who are malnourished with characteristic symptoms of SACD, even in young patients.
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Affiliation(s)
- Takuji Nakamura
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; Department of Pediatrics, National Hospital Organization Ureshino Medical Center, 2436 Ureshino, Saga 843-0393, Japan.
| | - Masanori Nishi
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Mihoko Rikitake
- Department of Pathology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Daisuke Koga
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Junya Eto
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; Department of Pediatrics, Saga-ken Medical Center Koseikan, 400 Nakabaru, Kase-machi, Saga 840-8571, Japan
| | - Daisuke Tajima
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; Department of Pediatrics, Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga 847-8588, Japan
| | - Shuji Toda
- Department of Pathology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
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Amano H, Kitamura A, Yokoyama Y, Narita M, Nishi M, Yoshida H, Fujiwara Y, Shinkai S. RISK FACTORS FOR TYPES OF DEMENTIA CLASSIFIED ON MULTIVARIATE TRAJECTORIES OF COGNITIVE FUNCTIONS BEFORE INCIDENCE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.510] [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)
- H Amano
- Tokyo Metropolitan Institute of Gerontology
| | - A Kitamura
- Tokyo Metropolitan Institute of Gerontology
| | - Y Yokoyama
- Tokyo Metropolitan Institute of Gerontology
| | - M Narita
- Tokyo Metropolitan Institute of Gerontology
| | - M Nishi
- Tokyo Metropolitan Institute of Gerontology
| | | | - Y Fujiwara
- Tokyo Metropolitan Institute of Gerontology
| | - S Shinkai
- Tokyo Metropolitan Institute of Gerontology
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Shinkai S, Seino S, Tanaka I, Tomine Y, Nishi M, Yokoyama Y, Kitamura A. EATING ALONE AND FRAILTY AND MENTAL ILL-HEALTH AMONG JAPANESE OLDER ADULTS LIVING IN A METROPOLITAN AREA. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.970] [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)
- S Shinkai
- Tokyo Metropolitan Institute of Gerontology
| | - S Seino
- Tokyo Metropolitan Institute of Gerontology
| | - I Tanaka
- Tokyo Metropolitan Institute of Gerontology
| | - Y Tomine
- Tokyo Metropolitan Institute of Gerontology
| | - M Nishi
- Tokyo Metropolitan Institute of Gerontology
| | - Y Yokoyama
- Tokyo Metropolitan Institute of Gerontology
| | - A Kitamura
- Tokyo Metropolitan Institute of Gerontology
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Murayama H, Shinkai S, Nishi M, Taniguchi Y, Amano H, Seino S, Yokoyama Y, Yoshida H, Fujiwara Y, Ito H. Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study. J Prev Alzheimers Dis 2018; 4:93-99. [PMID: 29186279 DOI: 10.14283/jpad.2016.113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. OBJECTIVES We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. DESIGN Longitudinal study. SETTING Community-based. PARTICIPANTS A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. MEASUREMENTS Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. RESULTS Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. CONCLUSIONS These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.
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Affiliation(s)
- H Murayama
- Hiroshi Murayama, Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan, Tel: +81-3-3964-3241, fax: +81-3-3579-4776,
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Adachi T, Abe T, Mizuno T, Iida Y, Yamada T, Uchiyama S, Nishi M, Nagao T, Sakamoto K, Ito T, Fujimoto N, Kobayashi K, Okumura T, Yamada S. P3196Anorexia coexisted in frailty predicts 1-year prognosis in patients with heart failure: a multicenter prospective cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3196] [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: 11/12/2022] Open
Affiliation(s)
- T Adachi
- Nagoya University Graduate School of Medicine, Department of Rehabilitation, Nagoya, Japan
| | - T Abe
- Aichi Medical University Hospital, Department of Rehabilitation, Nagakute, Japan
| | - T Mizuno
- Aichi Medical University Hospital, Department of Cardiology, Nagakute, Japan
| | - Y Iida
- Kainan Hospital, Department of Rehabilitation, Yatomi, Japan
| | - T Yamada
- Kainan Hospital, Department of Cardiology, Yatomi, Japan
| | - S Uchiyama
- New Tokyo hospital, Department of Rehabilitation, Matsudo, Japan
| | - M Nishi
- New Tokyo hospital, Department of Rehabilitation, Matsudo, Japan
| | - T Nagao
- Hoshi General Hospital, Department of Rehabilitation, Koriyama, Japan
| | - K Sakamoto
- Hoshi General Hospital, Department of Cardiology, Koriyama, Japan
| | - T Ito
- Mie University Hospital, Department of Rehabilitation, Tsu, Japan
| | - N Fujimoto
- Mie University Graduate School of Medicine, Department of Cardiology, Tsu, Japan
| | - K Kobayashi
- Nagoya University Hospital, Department of Rehabilitation, Nagoya, Japan
| | - T Okumura
- Nagoya University Hospital, Department of Cardiology, Nagoya, Japan
| | - S Yamada
- Nagoya University, Department of Health Sciences, Nagoya, Japan
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Nishi M, Ogata T, Nakanishi N, Higuchi Y, Sakamoto A, Matoba S. P1683MURC/Cavin-4 deletion protects murine heart from ischemia-reperfusion injury. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1683] [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)
- M Nishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - T Ogata
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - N Nakanishi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Y Higuchi
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - A Sakamoto
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto, Japan
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Nishi M, Okano I, Sawada T, Hara Y, Nakamura K, Inagaki K, Yaguchi T. Chronic Kirschsteiniothelia infection superimposed on a pre-existing non-infectious bursitis of the ankle: the first case report of human infection. BMC Infect Dis 2018; 18:236. [PMID: 29788927 PMCID: PMC5964637 DOI: 10.1186/s12879-018-3152-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022] Open
Abstract
Background Kirschsteiniothelia is a saprophytic fungus that is abundantly present in the environment. To date, there have been no reports of human infection caused by this fungus. We report a case of Kirschsteiniothelia infection superimposed on a pre-existing non-infectious bursitis of the ankle. Case presentation An 81-year-old immunocompetent female local farmer noticed the presence of a nodule on her right ankle 5 years before her first visit to our hospital. A cystic mass of approximately 45 mm × 30 mm was present at the tip of the right lateral malleolus. Culture of the aspirated fluid revealed visibly black colonies and characteristic blackish hyphae; nucleotide sequence of the internal transcribed spacer region was determined and compared in a GenBank database. The results indicated Kirschsteiniothelia infection. Conclusions We described the first case of Kirschsteiniothelia infection manifested as ankle bursitis. The disease seemed to be localized and systemic antibiotics had not been used in this case. However, continued observation is needed because of the possibility of disease progression with the pathogen. Electronic supplementary material The online version of this article (10.1186/s12879-018-3152-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Masanori Nishi
- Department of OrthopaedicSurgery, Ohta-Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan
| | - Ichiro Okano
- Department of OrthopaedicSurgery, Ohta-Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan.
| | - Takatoshi Sawada
- Department of OrthopaedicSurgery, Ohta-Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan
| | - Yasuka Hara
- Department of Respiratory Medicine, Ohta-Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama, Fukushima, 963-8558, Japan
| | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Katsunori Inagaki
- Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Takashi Yaguchi
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8673, Japan
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Abstract
Neuroblastoma is one of the most common solid tumors in children and has a diverse clinical behavior that largely depends on the tumor biology. Neuroblastoma exhibits unique features, such as early age of onset, high frequency of metastatic disease at diagnosis in patients over 1 year of age and the tendency for spontaneous regression of tumors in infants. The high-risk tumors frequently have amplification of the MYCN oncogene as well as segmental chromosome alterations with poor survival. Recent advanced genomic sequencing technology has revealed that mutation of ALK, which is present in ~10% of primary tumors, often causes familial neuroblastoma with germline mutation. However, the frequency of gene mutations is relatively small and other aberrations, such as epigenetic abnormalities, have also been proposed. The risk-stratified therapy was introduced by the Japan Neuroblastoma Study Group (JNBSG), which is now moving to the Neuroblastoma Committee of Japan Children's Cancer Group (JCCG). Several clinical studies have facilitated the reduction of therapy for children with low-risk neuroblastoma disease and the significant improvement of cure rates for patients with intermediate-risk as well as high-risk disease. Therapy for patients with high-risk disease includes intensive induction chemotherapy and myeloablative chemotherapy, followed by the treatment of minimal residual disease using differentiation therapy and immunotherapy. The JCCG aims for better cures and long-term quality of life for children with cancer by facilitating new approaches targeting novel driver proteins, genetic pathways and the tumor microenvironment.
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Affiliation(s)
| | - Yuanyuan Li
- Laboratory of Molecular Biology, Life Science Research Institute, Saga Medical Center Koseikan
| | - Hideki Izumi
- Laboratory of Molecular Biology, Life Science Research Institute, Saga Medical Center Koseikan
| | | | - Hiroko Inada
- Department of Pediatrics, Saga Medical Center Koseikan
| | - Masanori Nishi
- Department of Pediatrics, Saga University, Saga 849-8501, Japan
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Kato M, Itoh T, Sugai H, Kawamura Y, Hayashi T, Nishi M, Tanasec M, Matsuzaki T, Ishida K, Nagamine K. Development of Electrochemical Hydrogen Pump Under Vacuum Condition for a Compact Tritium Gas Recycling System. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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. Kato
- Tritium Engineering Laboratory, Department of Fusion Engineering Research, Japan Atomic Energy Research Institute (JAERI), Tokai, Naka, Ibaraki 319-1195, Japan
| | - T Itoh
- KAKEN Co., 1044 Horimachi, Mito, Ibaraki 310-0903, Japan
| | - H. Sugai
- Tritium Engineering Laboratory, Department of Fusion Engineering Research, Japan Atomic Energy Research Institute (JAERI), Tokai, Naka, Ibaraki 319-1195, Japan
| | - Y Kawamura
- Tritium Engineering Laboratory, Department of Fusion Engineering Research, Japan Atomic Energy Research Institute (JAERI), Tokai, Naka, Ibaraki 319-1195, Japan
| | - T. Hayashi
- Tritium Engineering Laboratory, Department of Fusion Engineering Research, Japan Atomic Energy Research Institute (JAERI), Tokai, Naka, Ibaraki 319-1195, Japan
| | - M. Nishi
- Tritium Engineering Laboratory, Department of Fusion Engineering Research, Japan Atomic Energy Research Institute (JAERI), Tokai, Naka, Ibaraki 319-1195, Japan
| | - M. Tanasec
- Department of Radiation Research for Environmental and Resources, Takasaki Institute, JAERI, Takasaki, Gunma 370-1292, Japan
| | - T. Matsuzaki
- Muon Science Laboratory, The Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198, Japan
| | - K. Ishida
- Muon Science Laboratory, The Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198, Japan
| | - K. Nagamine
- Muon Science Laboratory, The Institute of Physical and Chemical Research (RIKEN), Wako, Saitama 351-0198, Japan
- Meson Science Laboratory, Institute of Material Structure Science, High Energy Accelerator Research Organization (KEK-MSL), Oho, Tsukuba, Ibaraki 305-0801, Japan
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Hirata S, Kakuta T, Hayashi T, Kobayashi K, Yamada M, Nishi M. Design of Atmosphere Detritiation System for ITER. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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)
- S. Hirata
- Kawasaki Heavy Industries, Ltd. 2-6-5 Minamisuna, Koto-ku, Tokyo 136-8588, Japan +81-3-3615-5169
| | - T. Kakuta
- Kawasaki Heavy Industries, Ltd. 2-6-5 Minamisuna, Koto-ku, Tokyo 136-8588, Japan +81-3-3615-5169
| | - T. Hayashi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai-mura, Naka-gun Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - K. Kobayashi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai-mura, Naka-gun Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - M. Yamada
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai-mura, Naka-gun Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - M. Nishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai-mura, Naka-gun Ibaraki-ken 319-1195, Japan +81-29-282-6207
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Tanabe T, Miyasaka K, Saze T, Nishizawa K, Kobayashi T, Hayashi T, Nishi M. Surface Tritium Detection by Imaging Plate Technique. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22645] [Citation(s) in RCA: 9] [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)
- T. Tanabe
- Center for Integrated Research in Science and Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan +81-52-789-5157
| | - K. Miyasaka
- Department of Nuclear Engineering, Graduate School of Engineering Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan, +81-52-789-5158
| | - T. Saze
- Radioisotope Center, Nagoya University Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan, +81-52-789-2569
| | - K. Nishizawa
- Radioisotope Center, Nagoya University Furo-cho, Chikusa-ku, Nagoya 464-8603, Japan, +81-52-789-2569
| | - T. Kobayashi
- Tritium Engineering. Laboratory, Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan, +81-29-282-6390
| | - T. Hayashi
- Tritium Engineering. Laboratory, Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan, +81-29-282-6390
| | - M. Nishi
- Tritium Engineering. Laboratory, Japan Atomic Energy Research Institute, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, Japan, +81-29-282-6390
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Skinner CH, Gentile CA, Guttadora G, Carpe A, Langish S, Young KM, Nishi M, Shu W. Tritium Removal by Laser Heating and Its Application to Tokamaks. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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)
- C. H. Skinner
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - C. A. Gentile
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - G. Guttadora
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - A. Carpe
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - S. Langish
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - K. M. Young
- Princeton Plasma Physics Lab, Princeton NJ 08543, USA
| | - M. Nishi
- Tritium Engineering Laboratory, JAERI, Ibaraki 319-11, Japan
| | - W. Shu
- Tritium Engineering Laboratory, JAERI, Ibaraki 319-11, Japan
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Affiliation(s)
- S. Tanaka
- The University of Tokyo Hongou, Bunkyo, Tokyo 113-8656, JAPAN
| | - M. Nishikawa
- Kyushu University Hakozaki, Higashi, Fukuoka 812-8581, JAPAN
| | - Y. Ichimasa
- Ibaraki University HBunkyo, Mito, Ibaraki 310-8512, JAPAN
| | - M. Nishi
- Japan Atomic Energy Research Institute Tokai, Ibaraki, 319-1195, JAPAN
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Isobe K, Imaizumi H, Hayashi T, Konishi S, Nishi M. Demonstration of Fuel Cleanup System Consisting of Electrolytic Reactor and Tubular Reservoir Tank for Fusion Reactors. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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)
- K. Isobe
- Japan Atomic Energy Research Institute Tokai-mura, Ibaraki-ken 319-1195, Japan
| | - H. Imaizumi
- Japan Atomic Energy Research Institute Tokai-mura, Ibaraki-ken 319-1195, Japan
| | - T. Hayashi
- Japan Atomic Energy Research Institute Tokai-mura, Ibaraki-ken 319-1195, Japan
| | - S. Konishi
- Japan Atomic Energy Research Institute Tokai-mura, Ibaraki-ken 319-1195, Japan
| | - M. Nishi
- Japan Atomic Energy Research Institute Tokai-mura, Ibaraki-ken 319-1195, Japan
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Iwai Y, Misaki Y, Hayashi T, Yamanishi T, Konishi S, Nishi M, Ninomiya R, Yanagimachi S, Senrui S, Yoshida H. The Water Detritiation System of the ITER Tritium Plant. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22759] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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)
- Y. Iwai
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - Y. Misaki
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - T. Hayashi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - T. Yamanishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - S. Konishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - M. Nishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - R. Ninomiya
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - S. Yanagimachi
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - S. Senrui
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - H. Yoshida
- ITER-JCT Naka, Ibaraki, 311-0102, Japan +81-29270-7710
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Hayashi T, Suzuki T, Konishi S, Yamanishi T, Nishi M, Kurita K. Development of ZrCo Beds for ITER Tritium Storage and Delivery. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22695] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [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. Hayashi
- Japan Atomic Energy Research Institute Shirakata Shirane 2-4, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, JAPAN +81-29-282-6393
| | - T. Suzuki
- Japan Atomic Energy Research Institute Shirakata Shirane 2-4, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, JAPAN +81-29-282-6393
| | - S. Konishi
- Japan Atomic Energy Research Institute Shirakata Shirane 2-4, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, JAPAN +81-29-282-6393
| | - T. Yamanishi
- Japan Atomic Energy Research Institute Shirakata Shirane 2-4, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, JAPAN +81-29-282-6393
| | - M. Nishi
- Japan Atomic Energy Research Institute Shirakata Shirane 2-4, Tokai-mura, Naka-gun, Ibaraki-ken 319-1195, JAPAN +81-29-282-6393
| | - K. Kurita
- Mitsubishi Heavy Industries, LTD. Wadasaki 1-1-1, Kobe Hyogo 652-8585, JAPAN +81-78-672-3416
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Oka H, Nishikawa M, Takeishi T, Yamaguchi J, Nishi M, Hayashi T, Kobayashi K. Calculation Code of System Effect Using Serial Reactor Model. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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)
- H. Oka
- Kyushu University, Graduate School of Engineering Science Hakozaki 6-10-1, Higashi-ku, Fukuoka 812-8581, Japan 81-92-642-3785
| | - M. Nishikawa
- Kyushu University, Graduate School of Engineering Science Hakozaki 6-10-1, Higashi-ku, Fukuoka 812-8581, Japan 81-92-642-3785
| | - T. Takeishi
- Kyushu University, Graduate School of Engineering Science Hakozaki 6-10-1, Higashi-ku, Fukuoka 812-8581, Japan 81-92-642-3785
| | - J. Yamaguchi
- Kyushu University, Graduate School of Engineering Science Hakozaki 6-10-1, Higashi-ku, Fukuoka 812-8581, Japan 81-92-642-3785
| | - M. Nishi
- Tritium Process Laboratory, Japan Atomic Energy Research Institute, Tokai, Ibaraki, Japan
| | - T. Hayashi
- Tritium Process Laboratory, Japan Atomic Energy Research Institute, Tokai, Ibaraki, Japan
| | - K. Kobayashi
- Tritium Process Laboratory, Japan Atomic Energy Research Institute, Tokai, Ibaraki, Japan
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Kakuta T, Hirata S, Mori S, Konishi S, Kawamura Y, Nishi M, Ohara Y. Conceptual Design of the Blanket Tritium Recovery System for the Prototype Fusion Reactor. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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. Kakuta
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Hirata
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Mori
- Kawasaki Heavy Industries, LTD., Minamisuna 2-6-5, Koto-ku, Tokyo 136-8588, Japan +81-33615-5148
| | - S. Konishi
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - Y. Kawamura
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - M. Nishi
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
| | - Y. Ohara
- Japan Atomic Eneigy Research Institute, Mukoyama 801 -1, Naka-machi, Naka-gun, Ibaraki-ken 311-0193, Japan +81-29270-7520
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Kobayashi K, Hayashi T, Iwai Y, Asanuma N, Nishi M. Tritium Behavior Study for Detritiation of Atmosphere in a Room. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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)
- K. Kobayashi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - T. Hayashi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - Y. Iwai
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - N. Asanuma
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - M. Nishi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
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Nishi M, Ogata T, Nakanishi N, Kasahara T, Higuchi Y, Matoba S. P1094Myocardial ischemia-reperfusion injury is reduced in MURC/Cavin-4-deficeint mice. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1094] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Taniguchi Y, Murayama H, Seino S, Nishi M, Amano H, Fujiwara Y, Kitamura A, Shinkai S. PROSPECTIVE STUDY OF TRAJECTORIES OF PHYSICAL PERFORMANCE AND ALL-CAUSE MORTALITY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4749] [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)
- Y. Taniguchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H. Murayama
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan,
| | - S. Seino
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - M. Nishi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H. Amano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y. Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - A. Kitamura
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - S. Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Seino S, Kitamura A, Nishi M, Murayama H, Narita M, Yokoyama Y, Nofuji Y, Shinkai S. A MULTIFACTORIAL INTERVENTION FOR IMPROVING FRAILTY STATUS: EXPLORING SHORT- AND LONG-TERM EFFECTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1384] [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)
- S. Seino
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
| | - A. Kitamura
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
| | - M. Nishi
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
| | | | - M. Narita
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
| | - Y. Yokoyama
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
| | - Y. Nofuji
- Japan Association for Development of Community Medicine, Chiyoda, Japan
| | - S. Shinkai
- Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan,
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Amano H, Kitamura A, Nishi M, Taniguchi Y, Seino S, Yokoyama Y, Fujiwara Y, Shinkai S. MULTIVARIATE TRAJECTORIES OF COGNITIVE DECLINE IN OLD AGE: CLUSTERS AND RISK FACTORS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.654] [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)
- H. Amano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - A. Kitamura
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - M. Nishi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y. Taniguchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - S. Seino
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y. Yokoyama
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y. Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - S. Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Yasunaga M, Nishi M, Hasebe M, Nonaka K, Koike T, Suzuki H, Murayama Y, Fujiwara Y. SYNERGISTIC IMPACTS OF PRE-HOMEBOUND AND SOCIAL ISOLATION ON MORTALITY AMONG THE OLDER IN JAPAN. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3173] [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: 11/14/2022] Open
Affiliation(s)
- M. Yasunaga
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
| | - M. Nishi
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
| | - M. Hasebe
- Sei-Gakuin University, Saitama, Japan,
| | - K. Nonaka
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
| | - T. Koike
- Kyushu Sangyo University, Fukuoka, Fukuoka, Japan
| | - H. Suzuki
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
| | - Y. Murayama
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
| | - Y. Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan,
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