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Nakamura Y, Shibata M, Morisaki Y, Hirabayashi N, Higashioka M, Hata J, Hosoi M, Sudo N, Yamaura K, Ninomiya T. Autonomic nervous system function assessed by heart rate variability and the presence of symptoms affecting activities of daily living in community-dwelling residents with chronic pain: The Hisayama Study. Eur J Pain 2024; 28:831-844. [PMID: 38102889 DOI: 10.1002/ejp.2224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Autonomic nervous system dysfunction has been reported to be associated with impaired activities of daily living (ADL) among patients with chronic pain, but the association has not been fully addressed in general populations. This study cross-sectionally investigated the association between autonomic nervous system function and the presence of subjective symptoms affecting ADL in community-dwelling residents with chronic pain. METHODS A total of 888 residents with chronic pain, aged 40-79 years, who underwent a health examination in 2017-2018 were included. Based on heart rate variability measured by fingertip pulse wave, the standard deviation of normal-to-normal intervals (SDNN), root mean square of successive RR interval differences (RMSSD), low frequency (LF) power, and high frequency (HF) power were calculated. Symptoms affecting ADL were defined as those scoring ≥1 on the modified Rankin Scale. Odds ratios (ORs) and their 95% confidence intervals (CIs) for symptoms affecting ADL were estimated using a logistic regression analysis. RESULTS The overall prevalence of symptoms affecting ADL was 39.4%. The ORs for symptoms affecting ADL increased significantly per 1-standard-deviation decrement in log-transformed SDNN (OR 1.23 [95% CI 1.06-1.44]), RMSSD (1.25 [1.08-1.45]), LF power (1.29 [1.11-1.52]), and HF power (1.29 [1.11-1.51]) after adjusting for age, sex, education, hypertension, diabetes, serum total cholesterol level, body mass index, past medical history, current smoking, current drinking, exercise, depressive symptoms, and pain intensity. CONCLUSIONS Decreased heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. SIGNIFICANCE Decrease in heart rate variability was associated with the presence of symptoms affecting ADL among individuals with chronic pain in a Japanese community. This article could help scientists understand the significance of autonomic nervous system dysfunction in the pathology of chronic pain. Approaches that target autonomic nervous system dysfunction may be an option to relieve or prevent symptoms affecting ADL for chronic pain sufferers.
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Affiliation(s)
- Yuri Nakamura
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Morisaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mayu Higashioka
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Diabetes and Molecular Genetics, Graduate School of Medicine, Ehime University, Matsuyama, Ehime, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ken Yamaura
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Hirabayashi N, Hata J, Furuta Y, Nakazawa T, Ohara T, Shibata M, Yamashita F, Kitazono T, Sudo N, Ninomiya T. Association Between Serum NT-proBNP and Gray Matter Atrophy Patterns in an Older Japanese Population: The Hisayama Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae075. [PMID: 38452153 DOI: 10.1093/gerona/glae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Indexed: 03/09/2024] Open
Abstract
Several population-based studies have reported that higher serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are associated with brain morphological changes. However, no population-based studies have examined the relationship between serum NT-proBNP and various regional brain volumes in detail. We here analyzed the brain MRI data of 1 201 community-dwelling Japanese aged ≥65 years. Regional gray matter volumes (GMV) and intracranial volume (ICV) were estimated by applying voxel-based morphometry (VBM) methods. The associations of serum NT-proBNP with regional GMV/ICV were examined by analysis of covariance. The regional gray matter atrophy patterns associated with elevated serum NT-proBNP levels were investigated using VBM without a priori regions of interest. The multivariable-adjusted means of the frontal, temporal, hippocampal, parahippocampal, and entorhinal GMV/ICV decreased significantly with elevated serum NT-proBNP levels (all p for trend and q values of false discovery rate correction < .05). In VBM, elevated serum NT-proBNP levels were correlated with atrophy of the bilateral hippocampi, bilateral amygdalas, bilateral parahippocampal gyri, bilateral entorhinal areas, bilateral fusiform gyri, left middle temporal gyrus, left inferior temporal gyrus, right central operculum, right posterior orbital gyrus, bilateral middle frontal gyri, anterior cingulate gyrus and bilateral medial frontal cortices. In a sensitivity analysis excluding 254 participants with mild cognitive impairment or dementia, serum NT-proBNP levels were correlated with atrophy of the bilateral hippocampi, bilateral amygdalas, bilateral parahippocampal gyri, bilateral fusiform gyri, and left middle frontal gyrus. Our data suggest that elevated serum NT-proBNP levels are associated with gray matter atrophy in brain regions that play an important role in cognitive function.
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Affiliation(s)
- Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taro Nakazawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Shibata M, Hosoi M, Anno K, Hirabayashi N, Hirakawa Y, Kawata H, Iwaki R, Sawamoto R, Sudo N, Ninomiya T. Correction: Inadequate care and excessive overprotection during childhood are associated with the presence of Diabetes Mellitus in adulthood in a general Japanese population: a cross-sectional analysis from the Hisayama Study. BMC Endocr Disord 2023; 23:253. [PMID: 37990230 PMCID: PMC10662924 DOI: 10.1186/s12902-023-01513-0] [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: 11/23/2023] Open
Affiliation(s)
- Mao Shibata
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Kawata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rie Iwaki
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ryoko Sawamoto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Izuno S, Yoshihara K, Hosoi M, Eto S, Hirabayashi N, Todani T, Gondo M, Hayaki C, Anno K, Hiwatashi A, Sudo N. Psychological characteristics associated with the brain volume of patients with fibromyalgia. Biopsychosoc Med 2023; 17:36. [PMID: 37875931 PMCID: PMC10594713 DOI: 10.1186/s13030-023-00293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
Fibromyalgia (FM) is a disease characterized by chronic widespread pain concomitant with psychiatric symptoms such as anxiety and depression. It has been reported that FM patients engage in pain catastrophizing. In this study, we investigated characteristics of the brain volume of female FM patients and the association between psychological indices and brain volume. Thirty-nine female FM patients and 25 female healthy controls (HCs) were recruited for the study, and five FM patients were excluded due to white matter lesions. The following analyses were performed: (1) T1-weighted MRI were acquired for 34 FM patients (age 41.6 ± 7.4) and 25 HCs (age 39.5 ± 7.4). SPM12 was used to compare their gray and white matter volumes. (2) Data from anxiety and depression questionnaires (State-Trait Anxiety Inventory and Hospital Anxiety and Depression Scale), the Pain Catastrophizing Scale (subscales rumination, helplessness, magnification), and MRI were acquired for 34 FM patients (age 41.6 ± 7.4). Correlation analysis was done of the psychological indices and brain volume. We found that (1) The white matter volume of the temporal pole was larger in the FM patient group than in the HC group. (2) Correlation analysis of the psychological indices and gray matter volume showed a negative correlation between trait anxiety and the amygdala. For the white matter volume, positive correlations were found between depression and the brainstem and between magnification and the postcentral gyrus. Changes in the brain volume of female FM patients may be related to anxiety, depression, and pain catastrophizing.
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Grants
- JP16K15414 Ministry of Education, Culture, Sports, Science and Technology
- JP19H03752 Ministry of Education, Culture, Sports, Science and Technology
- JP20K03417 Ministry of Education, Culture, Sports, Science and Technology
- JP19FG2001 Ministry of Health, Labour and Welfare
- JP20FC1056 Ministry of Health, Labour and Welfare
- JP19ek0610015h0003 Japan Agency for Medical Research and Development
- JP19dm0307104 Japan Agency for Medical Research and Development
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Affiliation(s)
- Satoshi Izuno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan.
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Sanami Eto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | | | - Tae Todani
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Chie Hayaki
- Department of Psychosomatic Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
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Shibata M, Hosoi M, Anno K, Hirabayashi N, Hirakawa Y, Kawata H, Iwaki R, Sawamoto R, Sudo N, Ninomiya T. Inadequate care and excessive overprotection during childhood are associated with the presence of diabetes mellitus in adulthood in a general Japanese population: a cross-sectional analysis from the Hisayama Study. BMC Endocr Disord 2023; 23:222. [PMID: 37821847 PMCID: PMC10568832 DOI: 10.1186/s12902-023-01474-4] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 09/30/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To investigate associations between parenting styles during childhood and diabetes in adulthood in a Japanese community. METHODS In 2011, 710 community-dwelling Japanese residents aged ≥ 40 years were assessed for the presence of diabetes and for their perceptions of the parenting style of their parents, as measured using the "care" and "overprotection" scales of the Parental Bonding Instrument. Care and overprotection scores for each parent were dichotomized by age-specific median values. Diabetes mellitus was defined as a fasting plasma glucose level of ≥ 7.0 mmol/L, a 2-h post-loaded glucose level of ≥ 11.1 mmol/L, HbA1c ≥ 6.5%, and/or the current use of insulin or oral glucose-lowering agents. The odds ratios (ORs) for prevalent diabetes were calculated using a logistic regression model. RESULTS The prevalence of diabetes was 14.9%. Subjects with a high paternal overprotection score had a significantly greater likelihood of prevalent diabetes than those with a low paternal overprotection score after adjusting for confounders (OR 1.71, 95% confidence interval [CI] 1.06-2.77), while there was no significant association between paternal care and diabetes. Additionally, the multivariable-adjusted ORs for the presence of diabetes were significantly higher in subjects with a low maternal care score (OR 1.61, 95%CI 1.00-2.60) or in subjects with a high maternal overprotection score (OR 1.73, 95%CI 1.08-2.80). Moreover, the subjects with a low care score and high overprotection score for both their father and mother had a significantly higher multivariable-adjusted OR of diabetes than those with a high care score and low overprotection score for both parents (OR 2,12, 95%CI 1.14-3.95). CONCLUSIONS This study suggests that inadequate care and excessive overprotection during childhood may contribute to the development of diabetes in adulthood.
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Grants
- JSPS KAKENHI Grant Number JP19H03752, JP19H03752, JP21H03200, JP21K07522, JP21K11725, JP21K10448, JP22K07421, JP22K17396, JP23K09692, JP23K09717, JP23K16330, JP23K06787, and JP23K09060 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JSPS KAKENHI Grant Number JP19H03752, JP19H03752, JP21H03200, JP21K07522, JP21K11725, JP21K10448, JP22K07421, JP22K17396, JP23K09692, JP23K09717, JP23K16330, JP23K06787, and JP23K09060 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JSPS KAKENHI Grant Number JP19H03752, JP19H03752, JP21H03200, JP21K07522, JP21K11725, JP21K10448, JP22K07421, JP22K17396, JP23K09692, JP23K09717, JP23K16330, JP23K06787, and JP23K09060 Ministry of Education, Culture, Sports, Science and Technology of Japan
- JPMH23FA1006, and JPMH23FA1022 Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan
- JP23dk0207053, JP23km0405209 Japan Agency for Medical Research and Development
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Affiliation(s)
- Mao Shibata
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroshi Kawata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rie Iwaki
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ryoko Sawamoto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Division of Research Management, Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Hirabayashi N, Honda T, Hata J, Furuta Y, Shibata M, Ohara T, Tatewaki Y, Taki Y, Nakaji S, Maeda T, Ono K, Mimura M, Nakashima K, Iga JI, Takebayashi M, Ninomiya T. Association Between Frequency of Social Contact and Brain Atrophy in Community-Dwelling Older People Without Dementia: The JPSC-AD Study. Neurology 2023; 101:e1108-e1117. [PMID: 37438128 DOI: 10.1212/wnl.0000000000207602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/16/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Epidemiologic evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study. METHODS Dementia-free community-dwelling Japanese aged 65 years or older underwent brain MRI scans and a comprehensive health examination. Frequency of contact with noncohabiting relatives and friends was determined by asking a single question with 4 categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV), and white matter lesion volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms. RESULTS We included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared with that in the group with the highest frequency of social contact (67.3% vs 67.8%), with a significant increasing trend across the groups (p value for trend <0.001). The white matter lesion volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency group vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q values of false discovery rate correction <0.05). The relationships seemed to be partly mediated by depressive symptoms, which accounted for 15%-29% of the observed associations. DISCUSSION Lower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.
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Affiliation(s)
- Naoki Hirabayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Takanori Honda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun Hata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yoshihiko Furuta
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Mao Shibata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tomoyuki Ohara
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuko Tatewaki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuyuki Taki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Shigeyuki Nakaji
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tetsuya Maeda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenjiro Ono
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Masaru Mimura
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenji Nakashima
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun-Ichi Iga
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Minoru Takebayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Toshiharu Ninomiya
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan.
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7
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Motomura Y, Fukuzaki A, Eto S, Hirabayashi N, Gondo M, Izuno S, Togao O, Yamashita K, Kikuchi K, Sudo N, Yoshihara K. Alexithymia characteristics are associated with salience network activity in healthy participants: an arterial spin labeling study. J Physiol Anthropol 2023; 42:18. [PMID: 37674183 PMCID: PMC10483865 DOI: 10.1186/s40101-023-00336-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Alexithymia, a personality trait characterized by difficulties in identifying and expressing their emotions despite having a range of emotional experiences, can impact individuals' stress coping mechanisms. While many studies have investigated brain functions associated with specific tasks in relation to emotion processing, research focusing on resting-state brain functions has been limited. Thus, the aim of this study was to investigate the relationship between alexithymia and brain function by analyzing arterial spin labeling (ASL) data obtained during the resting state. METHODS A brain structural and functional imaging study was conducted on 42 healthy adult men and women using ASL and the 20-item Toronto Alexithymia Scale (TAS-20) questionnaire survey. Cerebral blood flow and functional connectivity values were calculated for regions of interest in the default mode network, saliency network, and central executive network from the ASL data. Correlation analysis was performed with TAS20 scores, and partial correlation analysis was conducted to control for anxiety and depression. RESULTS The functional connectivity analysis revealed a negative correlation between the functional connectivity of the right insular cortex and left anterior cingulate cortex and the total score of TAS, as well as difficulty identifying feelings and difficulty describing feeling subscores, indicating that the higher the scores, the weaker the functional connectivity between these regions (T = -3.830, p = 0.0013, R = -0.5180). This correlation remained significant even after controlling for anxiety and depression using partial correlation analysis. CONCLUSION The present study revealed differences in the activity of the Saliency Network at rest as measured by ASL, which were independent of anxiety and depression, and varied depending on the severity of alexithymia. This functional change may underlie the neural basis of decreased emotional processing observed in alexithymia. These findings may contribute to the elucidation of the neural mechanisms of alexithymia, which can lead to social impairments, and suggest the usefulness of ASL measurement as a biomarker of alexithymia.
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Affiliation(s)
- Yuki Motomura
- Department of Human Life Design, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan.
| | - Ayaka Fukuzaki
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University, 4-9-1 Shiobaru, Minamiku, Fukuoka, 815-8540, Japan
| | - Sanami Eto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Satoshi Izuno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Division of Cerebral Integration, Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki, Japan
| | - Osamu Togao
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Kikuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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8
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Saito T, Shibata M, Hirabayashi N, Honda T, Morisaki Y, Anno K, Sudo N, Hosoi M, Ninomiya T. Family dysfunction is associated with chronic pain in a community-dwelling Japanese population: The Hisayama study. Eur J Pain 2023; 27:518-529. [PMID: 36585949 DOI: 10.1002/ejp.2076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Poor family functioning has been reported to be associated with the severity of chronic pain in outpatients, but the association has not been fully addressed in general populations. The present study aimed to examine the association between family dysfunction levels and the presence of chronic pain in a community-dwelling Japanese population. METHODS A total of 2598 participants aged ≥40 years were classified as having healthy, borderline or unhealthy family functioning. Chronic pain was defined as subjective pain for three months or longer, and further classified by pain intensity, the number of chronic pain sites, pain duration and the extent of pain spread. A logistic regression model was used to compute the odds ratios (ORs) for chronic pain outcomes. RESULTS The prevalence of chronic pain was 49%. The age- and sex-adjusted prevalence of total and severe chronic pain were increased significantly with increasing family dysfunction levels (all p for trend <0.01). After adjusting for sociodemographic, physical, social and family structure factors, the ORs (95% confidence intervals [CI]) for having chronic pain among borderline and unhealthy groups were 1.20 (1.01-1.44) and 1.43 (1.15-1.79), respectively, as compared with a healthy family function group. The association was stronger among people who were employed and those who were living with their children. In addition, the ORs for severe chronic pain increased significantly with increasing levels of family dysfunction. CONCLUSIONS The family dysfunction level was positively associated with the presence as well as the severity of chronic pain in a community-dwelling population. SIGNIFICANCE A biopsychosocial burden due to family relationships could worsen the clinical presentation of pain. Social support or family therapy for dysfunctional families would be a potential initiative for the prevention or management of chronic pain.
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Affiliation(s)
- Takafumi Saito
- Faculty of Rehabilitation, School of Physical Therapy, Reiwa Health Sciences University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Morisaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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9
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Tajimi T, Furuta Y, Hirabayashi N, Honda T, Hata J, Ohara T, Shibata M, Nakao T, Kitazono T, Nakashima Y, Ninomiya T. Association of gait speed with regional brain volumes and risk of dementia in older Japanese: The Hisayama study. Arch Gerontol Geriatr 2023; 106:104883. [PMID: 36495658 DOI: 10.1016/j.archger.2022.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND To investigate the association of gait speed with regional brain volumes and the risk of incident dementia. METHODS A total of 1112 dementia-free Japanese residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years (median). The participants were classified into the age- and sex-specific quartile levels of maximum gait speed. Regional gray matter volumes (GMV) and white matter hyperintensities volumes (WMHV) were measured by applying voxel-based morphometry methods. The cross-sectional association of maximum gait speed with regional GMV was examined using an analysis of covariance. We also estimated the association between maximum gait speed level and the risk of developing dementia using a Cox proportional hazards model. Mediation analyses were conducted to determine the contribution of regional brain volumes to the association between maximum gait speed and dementia. RESULTS Lower maximum gait speed was significantly associated with lower GMV of the total brain, frontal lobe, temporal lobe, cingulate gyrus, insula, hippocampus, amygdala, basal ganglia, thalamus, and cerebellum, and increased WMHV at baseline. During the follow-up, 108 participants developed dementia. The incidence rate of all dementias increased significantly with decreasing maximum gait speed after adjusting for potential confounders (P for trend = 0.03). The mediating effects of the GMV of the hippocampus, GMV of the insula, and WMHV were significant. CONCLUSIONS Lower maximum gait speed was significantly associated with an increased risk of dementia. Reduced GMV of the hippocampus or insula, and an increase in WMHV was likely to be involved in this association.
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Affiliation(s)
- Takahiro Tajimi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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10
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Maki K, Ohara T, Hata J, Shibata M, Hirabayashi N, Honda T, Sakata S, Furuta Y, Akiyama M, Yamasaki K, Tatewaki Y, Taki Y, Kitazono T, Mikami T, Maeda T, Ono K, Mimura M, Nakashima K, Iga JI, Takebayashi M, Ninomiya T. CKD, Brain Atrophy, and White Matter Lesion Volume: The Japan Prospective Studies Collaboration for Aging and Dementia. Kidney Med 2023; 5:100593. [PMID: 36874508 PMCID: PMC9982615 DOI: 10.1016/j.xkme.2022.100593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022] Open
Abstract
Rationale & Objective Chronic kidney disease, defined by albuminuria and/or reduced estimated glomerular filtration rate (eGFR), has been reported to be associated with brain atrophy and/or higher white matter lesion volume (WMLV), but there are few large-scale population-based studies assessing this issue. This study aimed to examine the associations between the urinary albumin-creatinine ratio (UACR) and eGFR levels and brain atrophy and WMLV in a large-scale community-dwelling older population of Japanese. Study Design Population-based cross-sectional study. Setting & Participants A total of 8,630 dementia-free community-dwelling Japanese aged greater than or equal to 65 years underwent brain magnetic resonance imaging scanning and screening examination of health status in 2016-2018. Exposures UACR and eGFR levels. Outcomes The total brain volume (TBV)-to-intracranial volume (ICV) ratio (TBV/ICV), the regional brain volume-to-TBV ratio, and the WMLV-to-ICV ratio (WMLV/ICV). Analytical Approach The associations of UACR and eGFR levels with the TBV/ICV, the regional brain volume-to-TBV ratio, and the WMLV/ICV were assessed by using an analysis of covariance. Results Higher UACR levels were significantly associated with lower TBV/ICV and higher geometric mean values of the WMLV/ICV (P for trend = 0.009 and <0.001, respectively). Lower eGFR levels were significantly associated with lower TBV/ICV, but not clearly associated with WMLV/ICV. In addition, higher UACR levels, but not lower eGFR, were significantly associated with lower temporal cortex volume-to-TBV ratio and lower hippocampal volume-to-TBV ratio. Limitations Cross-sectional study, misclassification of UACR or eGFR levels, generalizability to other ethnicities and younger populations, and residual confounding factors. Conclusions The present study demonstrated that higher UACR was associated with brain atrophy, especially in the temporal cortex and hippocampus, and with increased WMLV. These findings suggest that chronic kidney disease is involved in the progression of morphologic brain changes associated with cognitive impairment.
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Affiliation(s)
- Kenji Maki
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masato Akiyama
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keisuke Yamasaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tatsuya Mikami
- Department of Preemptive Medicine, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Kenjiro Ono
- Department of Neurology, Kanazawa University Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Nakashima
- National Hospital Organization, Matsue Medical Center, Shimane, Japan
| | - Jun-Ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Ehime University, Ehime, Japan
| | - Minoru Takebayashi
- Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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11
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Nakazawa T, Ohara T, Hirabayashi N, Furuta Y, Hata J, Shibata M, Honda T, Kitazono T, Nakao T, Ninomiya T. Association of white matter lesions and brain atrophy with the development of dementia in a community: the Hisayama Study. Psychiatry Clin Neurosci 2023. [PMID: 36700514 DOI: 10.1111/pcn.13533] [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: 10/05/2022] [Revised: 12/05/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
AIM To investigate the association of white matter lesions volume (WMLV) levels with dementia risk and the association between dementia risk and the combined measures of WMLV and either total brain atrophy or dementia-related gray matter atrophy in a general older population. METHODS One thousand one hundred fifty-eight Japanese dementia-free community-residents aged ≥65 years who underwent brain magnetic resonance imaging were followed for 5.0 years. WMLV were segmented using the Lesion Segmentation Toolbox. Total brain volume (TBV) and regional gray matter volume were estimated by voxel-based morphometry. The WMLV-to-intracranial brain volume ratio (WMLV/ICV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. Total brain atrophy, defined as the TBV-to-ICV ratio (TBV/ICV), and dementia-related regional brain atrophy defined based on our previous report were calculated. The association between dementia risk and the combined measures of WMLV/ICV and either total brain atrophy or the number of atrophied regions was also tested. RESULTS During the follow-up, 113 participants developed dementia. The risks of dementia increased significantly with higher WMLV/ICV levels. In addition, dementia risk increased additively both in participants with higher WMLV/ICV levels and lower TBV/ICV levels and in those with higher WMLV/ICV levels and a higher number of dementia-related brain regional atrophy. CONCLUSION The risk of dementia increased significantly with higher WMLV/ICV levels. An additive increment in dementia risk was observed with higher WMLV/ICV levels and lower TBV/ICV levels or a higher number of dementia-related brain regional atrophy, suggesting the importance of prevention or control of cardiovascular risk factors.
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Affiliation(s)
- Taro Nakazawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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12
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Hirabayashi N, Hata J, Furuta Y, Ohara T, Shibata M, Hirakawa Y, Yamashita F, Yoshihara K, Kitazono T, Sudo N, Ninomiya T. Association Between Diabetes and Gray Matter Atrophy Patterns in a General Older Japanese Population: The Hisayama Study. Diabetes Care 2022; 45:1364-1371. [PMID: 35500069 DOI: 10.2337/dc21-1911] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine the association between diabetes and gray matter atrophy patterns in a general older Japanese population. RESEARCH DESIGN AND METHODS In 2012, a total of 1,189 community-dwelling Japanese aged ≥65 years underwent brain MRI scans. Regional gray matter volumes (GMV) and intracranial volume (ICV) were measured by applying voxel-based morphometry (VBM) methods. The associations of diabetes and related parameters with the regional GMV/ICV were examined using an ANCOVA. The regional gray matter atrophy patterns in the subjects with diabetes or elevated fasting plasma glucose (FPG) or 2-h postload glucose (2hPG) levels were investigated using VBM. RESULTS Subjects with diabetes had significantly lower mean values of GMV/ICV in the frontal lobe, temporal lobe, insula, deep gray matter structures, and cerebellum than subjects without diabetes after adjusting for potential confounders. A longer duration of diabetes was also significantly associated with lower mean values of GMV/ICV in these brain regions. The multivariable-adjusted mean values of the temporal, insular, and deep GMV/ICV decreased significantly with elevating 2hPG levels, whereas higher FPG levels were not significantly associated with GMV/ICV of any brain regions. In the VBM analysis, diabetes was associated with gray matter atrophy in the bilateral superior temporal gyri, right middle temporal gyrus, left inferior temporal gyrus, right middle frontal gyrus, bilateral thalami, right caudate, and right cerebellum. CONCLUSIONS The current study suggests that a longer duration of diabetes and elevated 2hPG levels are significant risk factors for gray matter atrophy in various brain regions.
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Affiliation(s)
- Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Ito Clinic, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medical-Engineering Collaboration for Healthy Longevity, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumio Yamashita
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Iwate, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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13
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Ueda E, Hirabayashi N, Ohara T, Hata J, Honda T, Fujiwara K, Furuta Y, Shibata M, Hashimoto S, Nakamura S, Nakazawa T, Nakao T, Kitazono T, Ninomiya T, Sonoda KH. Association of Inner Retinal Thickness with Prevalent Dementia and Brain Atrophy in a General Older Population. Ophthalmology Science 2022; 2:100157. [PMID: 36249677 PMCID: PMC9559916 DOI: 10.1016/j.xops.2022.100157] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 10/27/2022]
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14
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Thyreau B, Tatewaki Y, Chen L, Takano Y, Hirabayashi N, Furuta Y, Hata J, Nakaji S, Maeda T, Noguchi‐Shinohara M, Mimura M, Nakashima K, Mori T, Takebayashi M, Ninomiya T, Taki Y. Higher-resolution quantification of white matter hypointensities by large-scale transfer learning from 2D images on the JPSC-AD cohort. Hum Brain Mapp 2022; 43:3998-4012. [PMID: 35524684 PMCID: PMC9374893 DOI: 10.1002/hbm.25899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/24/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022] Open
Abstract
White matter lesions (WML) commonly occur in older brains and are quantifiable on MRI, often used as a biomarker in Aging research. Although algorithms are regularly proposed that identify these lesions from T2‐fluid‐attenuated inversion recovery (FLAIR) sequences, none so far can estimate lesions directly from T1‐weighted images with acceptable accuracy. Since 3D T1 is a polyvalent and higher‐resolution sequence, it could be beneficial to obtain the distribution of WML directly from it. However a serious difficulty, both for algorithms and human, can be found in the ambiguities of brain signal intensity in T1 images. This manuscript shows that a cross‐domain ConvNet (Convolutional Neural Network) approach can help solve this problem. Still, this is non‐trivial, as it would appear to require a large and varied dataset (for robustness) labelled at the same high resolution (for spatial accuracy). Instead, our model was taught from two‐dimensional FLAIR images with a loss function designed to handle the super‐resolution need. And crucially, we leveraged a very large training set for this task, the recently assembled, multi‐sites Japan Prospective Studies Collaboration for Aging and Dementia (JPSC‐AD) cohort. We describe the two‐step procedure that we followed to handle such a large number of imperfectly labeled samples. A large‐scale accuracy evaluation conducted against FreeSurfer 7, and a further visual expert rating revealed that WML segmentation from our ConvNet was consistently better. Finally, we made a directly usable software program based on that trained ConvNet model, available at https://github.com/bthyreau/deep-T1-WMH.
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Affiliation(s)
- Benjamin Thyreau
- Smart‐Aging Research Center, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
- Department of Geriatric Medicine and NeuroimagingTohoku University HospitalSendaiJapan
| | - Liying Chen
- Smart‐Aging Research Center, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
| | - Yuji Takano
- Smart‐Aging Research Center, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
- Department of Psychological SciencesUniversity of Human EnvironmentsMatsuyamaJapan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Graduate School of MedicineHirosaki UniversityHirosakiJapan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of MedicineIwate Medical UniversityIwateJapan
| | - Moeko Noguchi‐Shinohara
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | | | - Kenji Nakashima
- National Hospital Organization, Matsue Medical CenterShimaneJapan
| | - Takaaki Mori
- Department of Neuropsychiatry, Ehime University Graduate School of MedicineEhime UniversityEhimeJapan
| | - Minoru Takebayashi
- Faculty of Life Sciences, Department of NeuropsychiatryKumamoto UniversityKumamotoJapan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yasuyuki Taki
- Smart‐Aging Research Center, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging, and CancerTohoku UniversitySendaiJapan
- Department of Geriatric Medicine and NeuroimagingTohoku University HospitalSendaiJapan
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15
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Liu Y, Zhang Y, Thyreau B, Tatewaki Y, Matsudaira I, Takano Y, Hirabayashi N, Furuta Y, Jun H, Ninomiya T, Taki Y. Altruistic Social Activity, Depressive Symptoms, and Brain Regional Gray Matter Volume: Voxel-Based Morphometry Analysis from 8695 Old Adults. J Gerontol A Biol Sci Med Sci 2022; 77:1789-1797. [PMID: 35443061 DOI: 10.1093/gerona/glac093] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Indexed: 11/14/2022] Open
Abstract
Altruistic social activity, such as giving support to others, has shown protective benefits on dementia risk and cognitive decline. However, the pathological mechanism is unclear. In the present study, we investigated the association between altruistic social activity and brain regional gray matter. Furthermore, to explore the psychological interplay in altruistic social activity, we tested mediating effect of depressive symptoms on brain regional gray matter. We performed a cross-sectional Voxel-Based Morphology (VBM) analysis including 8695 old adults (72.9±6.1 years) from Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD) Cohort. We measured altruistic social activities by self-report questionnaire, depressive symptoms by Geriatric Depression Scale (GDS)-short version. We employed the whole-brain VBM method to detect relevant structural properties related to altruistic social activity. We then performed multiple regression models to detect the mediating effect of depressive symptoms on particular brain regional gray matter volume while adjusting possible physical and social lifestyle covariables. We found that altruistic social activity is associated with larger gray matter volume in posterior insula, middle cingulate gyrus, hippocampus, thalamus, superior temporal gyrus, anterior orbital gyrus, and middle occipital gyrus. Depressive symptoms mediated over 10% on altruistic social activity and hippocampus volume, over 20% on altruistic social activity and cingulate gyrus volume. Our results indicated that altruistic social activity might preserve brain regional gray matter where are sensitive to aging and cognitive decline. Meanwhile, this association may be explained by indirect effect on depressive symptoms, suggesting that altruistic social activity may mitigate the neuropathology of dementia.
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Affiliation(s)
- Yingxu Liu
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ye Zhang
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Benjamin Thyreau
- Smart-Aging Research Center, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yasuko Tatewaki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
| | - Izumi Matsudaira
- Smart-Aging Research Center, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yuji Takano
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - YoshihikTo Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hata Jun
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuyuki Taki
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Smart-Aging Research Center, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Sendai, Japan
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16
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Nakazawa T, Ohara T, Hirabayashi N, Furuta Y, Hata J, Shibata M, Honda T, Kitazono T, Nakao T, Ninomiya T. Multiple-region grey matter atrophy as a predictor for the development of dementia in a community: the Hisayama Study. J Neurol Neurosurg Psychiatry 2022; 93:263-271. [PMID: 34670843 PMCID: PMC8862082 DOI: 10.1136/jnnp-2021-326611] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 03/11/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the association of regional grey matter atrophy with dementia risk in a general older Japanese population. METHODS We followed 1158 dementia-free Japanese residents aged ≥65 years for 5.0 years. Regional grey matter volume (GMV) at baseline was estimated by applying voxel-based morphometry methods. The GMV-to-total brain volume ratio (GMV/TBV) was calculated, and its association with dementia risk was estimated using Cox proportional hazard models. We assessed whether the predictive ability of a model based on known dementia risk factors could be improved by adding the total number of regions with grey matter atrophy among dementia-related brain regions, where the cut-off value for grey matter atrophy in each region was determined by receiver operating characteristic curves. RESULTS During the follow-up, 113 participants developed all-cause dementia, including 83 with Alzheimer's disease (AD). Lower GMV/TBV of the medial temporal lobe, insula, hippocampus and amygdala were significantly/marginally associated with higher risk of all-cause dementia and AD (all p for trend ≤0.08). The risks of all-cause dementia and AD increased significantly with increasing total number of brain regions exhibiting grey matter atrophy (both p for trend <0.01). Adding the total number of regions with grey matter atrophy into a model consisting of known risk factors significantly improved the predictive ability for AD (Harrell's c-statistics: 0.765-0.802; p=0.02). CONCLUSIONS Our findings suggest that the total number of regions with grey matter atrophy among the medial temporal lobe, insula, hippocampus and amygdala is a significant predictor for developing dementia, especially AD, in the general older population.
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Affiliation(s)
- Taro Nakazawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan .,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Shibata M, Ohara T, Hosoi M, Hata J, Yoshida D, Hirabayashi N, Morisaki Y, Nakazawa T, Mihara A, Nagata T, Oishi E, Anno K, Sudo N, Ninomiya T. Emotional Loneliness Is Associated With a Risk of Dementia in a General Japanese Older Population: The Hisayama Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:1756-1766. [PMID: 33170218 DOI: 10.1093/geronb/gbaa196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To investigate the association of loneliness and its component subscales with the risk of dementia in a general Japanese older population. METHOD A total of 1,141 community-dwelling Japanese residents aged ≥65 years without dementia were prospectively followed up for a median 5.0 years. We evaluated any loneliness and its component subscales-namely, social and emotional loneliness-by using the 6-item de Jong Gierveld Loneliness Scale. Cox proportional hazards models were used to estimate hazard ratios (HRs) of each loneliness type on the risk of dementia controlling for demographic factors, lifestyle factors, physical factors, social isolation factors, and depression. RESULTS During the follow-up, 114 participants developed dementia. The age- and sex-adjusted incidence rate of dementia was significantly greater in participants with any loneliness and emotional loneliness than those without. The multivariable-adjusted HRs (95% confidence intervals) of participants with any loneliness and emotional loneliness on incident dementia were 1.61 (1.08-2.40) and 1.65 (1.07-2.54), respectively, as compared to those without. However, there was no significant association between social loneliness and dementia risk. In subgroup analyses of social isolation factors, excess risks of dementia associated with emotional loneliness were observed in participants who had a partner, lived with someone, or rarely communicated with relatives or friends, but such association was not significant in participants who had no partner, lived alone, or frequently communicated with friends or relatives. DISCUSSION The present study suggested that loneliness, especially emotional loneliness, was a significant risk factor for the development of dementia in the general older population in Japan.
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Affiliation(s)
- Mao Shibata
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Morisaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taro Nakazawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akane Mihara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Nagata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Emi Oishi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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18
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Kito Y, Inoue E, Akamaru Y, Takahashi M, Matsuyama J, Yabusaki H, Makiyama A, Suzuki T, Tsuda M, Yasui H, Hirabayashi N, Takeno A, Kawakami H, Okuda H, Yoshioka T, Kawada J, Kodera Y, Ichikawa W, Fujii M, Sunakawa Y. Survival analysis by tumor response from real-world data in advanced gastric cancer treated with nivolumab: The DELIVER trial (JACCRO GC-08). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.4044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4044 Background: The phase III ATTRACTION-2 trial demonstrated survival benefit of nivolumab (Nivo) as third- or later-line treatment in previously treated advanced gastric or gastroesophageal junction (GEJ) cancer, with response rate (RR) of 11% (Kang YK, et al. Lancet 2017). It has been shown that some tumors grow rapidly after Nivo treatment, but the proportion and survival are still uncertain. We therefore prospectively investigated clinical outcomes from real-world data of Nivo treatment in advanced gastric cancer (GC). Methods: The DELIVER trial was a prospective, multicenter, observational study which assessed patients (pts) with advanced gastric or GEJ adenocarcinoma treated with Nivo alone and ECOG PS 0-2 (UMIN000030850). The aims were to evaluate the efficacy and safety of Nivo treatment in real world. Primary endpoint was overall survival (OS), secondary endpoints were RR, disease control rate (DCR), progression-free survival (PFS), tumor growth rate (TGR) at 1st evaluation, and safety. The sub-group analyses were performed for survival according to tumor response and clinical factors. The survival data was fixed at the timepoint of 1 year after the last enrollment. Results: In 501 pts enrolled from Mar 2018 to Aug 2019, 487 pts were evaluable (median age 70y, 71% male, ECOG PS0/1/2 42/44/14%, no. of prior regimen 1/2/≥3 2/39/59%, 21% HER2-pos, 42% pts with ascites). Median OS was 5.8 months (m) (95%CI 5.3-7.0) with 1y-survival rate of 30%, and median PFS was 1.8 m (95%CI 1.7-2.0), at 454 events for PFS and 389 events for OS. The DCR were 39.4%, and RR was 14.2% in 282 pts with measurable lesions. Median OS and PFS by tumor response (CR/PR/SD/PD) were Not Reached (NR)/NR/11.3/4.1m and NR/11.7/3.8/1.4m, respectively. A sub-group analysis of OS by clinical factors is the following: male/female; 6.5/5.0m ( p= 0.002), tub/por/sig; 8.1/5.4/4.1m ( p< 0.0001), albumin < 3.5/≥3.5; 4.2/8.9m ( p< 0.0001), w/peritoneal mets/w/o; 4.9/8.4m ( p< 0.0001), and w/ascites/w/o; 3.7/8.9m ( p< 0.0001). These findings were also observed in PFS. In 219 evaluable pts for TGR, 20.5% pts were identified as hyper-progressive disease (HPD). An exploratory approach by logistic regression analysis indicated that level of free-T3 in blood before Nivo treatment was higher in the HPD compared to the non-HPD group (2.5 vs. 2.2 pg/ml, p= 0.005). Survival time was comparable between the HPD group and PD without HPD group. Median period from 1st evaluation to death was 2.8 m for HPD, 5.7 m for non-HPD, and 2.4 m for PD at 1st evaluation without HPD. Conclusions: The real-world data of Nivo treatment in advanced GC indicated comparable survival to previous result in a clinical trial. Differences in survival time by tumor response or some clinical factors were observed in Nivo treatment. In addition, our study revealed the rate of HPD and the prognosis in advanced GC pts treated with Nivo. Clinical trial information: UMIN000030850.
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Affiliation(s)
- Yosuke Kito
- Department of Medical Oncology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Eisuke Inoue
- Showa University Research Administration Center, Tokyo, Japan
| | - Yusuke Akamaru
- Department of Gastrointestinal Surgery, Ikeda City Hospital, Ikeda, Japan
| | - Masazumi Takahashi
- Department of Surgery, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Jin Matsuyama
- Department of Gastrointestinal Surgery, Higashiosaka City Medical Center, Higashiosaka, Japan
| | - Hiroshi Yabusaki
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Akitaka Makiyama
- Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
| | - Takahisa Suzuki
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Masahiro Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi, Japan
| | - Hisateru Yasui
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Atsushi Takeno
- Department of Surgery, Kansai Rosai Hospital, Amagasaki, Japan
| | - Hisato Kawakami
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroyuki Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - Takashi Yoshioka
- Department of Medical Oncology, Yamagata University, Sendai, Japan
| | - Junji Kawada
- Department of Surgery, Yao Municipal Hospital, Yao, Japan
| | | | - Wataru Ichikawa
- Division of Medical Oncology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Masashi Fujii
- Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Yu Sunakawa
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki, Japan
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19
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Ohara T, Yoshida D, Hata J, Shibata M, Honda T, Furuta Y, Hirabayashi N, Kitazono T, Nakao T, Ninomiya T. Current status of the certification of long-term care insurance among individuals with dementia in a Japanese community: The Hisayama Study. Psychiatry Clin Neurosci 2021; 75:182-184. [PMID: 33491279 PMCID: PMC8248379 DOI: 10.1111/pcn.13204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/05/2021] [Accepted: 01/20/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tomoyuki Ohara
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Center for Cohort Studies, Kyushu University, Fukuoka, Japan.,Department of Medicine and Clinical Science, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan.,Center for Cohort Studies, Kyushu University, Fukuoka, Japan
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20
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Yoshimitsu M, Egi H, Kaneko M, Shimomura M, Hakoda K, Miguchi M, Kohashi T, Hihara J, Hirabayashi N, Ohdan H. Laparoscopic anterior resection for rectal stenosis caused by ALTA injection for internal hemorrhoids: A case report. Asian J Endosc Surg 2021; 14:271-274. [PMID: 32789974 DOI: 10.1111/ases.12849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/09/2020] [Accepted: 07/08/2020] [Indexed: 12/25/2022]
Abstract
We herein report the first case of rectal stenosis that developed after internal hemorrhoid treatment with aluminum potassium sulfate and tannic acid (ALTA) therapy that was successfully treated by laparoscopic surgery. A 72-year-old man suffered from a fever and rectal stenosis after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA at a previous clinic. Three months after ALTA therapy, he developed frequent mucous and bloody stools. Lower intestinal tract endoscopy revealed circumferential severe rectal stenosis. He was therefore referred to our hospital. The patient suffered from frequent stool build-up and difficulty defecating. We performed balloon-dilatation intervention. The stenosis was not improved at all. Five months after ALTA therapy, we performed laparoscopic low anterior resection with diverting ileostomy. Three months after the operation, ileostomy takedown was performed. The patient has experienced no rectal stenosis in the 2 years since his radical operation.
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Affiliation(s)
- Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Manabu Shimomura
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Keishi Hakoda
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masashi Miguchi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Jun Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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21
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Miguchi M, Yoshimitsu M, Shimomura M, Kohashi T, Egi H, Ohdan H, Hirabayashi N. Long-term outcomes of laparoscopic surgery in elderly patients with colorectal cancer: A single institutional matched case-control study. Asian J Endosc Surg 2021; 14:200-206. [PMID: 33244892 DOI: 10.1111/ases.12848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The number of elderly patients with colorectal cancer has gradually increased. Laparoscopic colorectal surgery is widely used to approach colorectal cancer. The aim of this study was to evaluate long-term outcomes in octogenarians who underwent laparoscopic colorectal surgery for colorectal cancer. METHODS This study included 158 patients aged 80 or over who underwent surgery for colorectal cancer between 2010 and 2015. We compared long-term outcomes of a laparoscopic colorectal surgery group with those of an open colorectal surgery group by propensity score matching equalizing factors that could affect prognosis such as prognostic nutritional index and Charlson comorbidity index score. RESULTS Forty-eight pairs were selected after propensity score matching. The cancer-specific 5-year survival rate was 97.1% in the laparoscopic colorectal surgery group and 87.6% in the open colorectal surgery group (P = .17). The overall 5-year survival rate was 77.3% in the laparoscopic colorectal surgery group and 73.9% in the open colorectal surgery group (P = .32). The 5-year recurrence-free survival rate was 95.1% in the laparoscopic colorectal surgery group and 85.4% in the open colorectal surgery group (P = .14). CONCLUSION Laparoscopic colorectal surgery for octogenarians with colorectal cancer achieves similar oncological outcomes to open colorectal surgery and should be considered as a treatment option.
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Affiliation(s)
- Masashi Miguchi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.,Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Manabu Shimomura
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
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22
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Watanabe M, Yamaguchi S, Kakizaki H, Hirabayashi N, Ishida H. Evaluation of Alpha 1 Adrenoceptor Antagonist Dose Increase Therapy: An Essential Strategy for Patients with Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia. Curr Urol 2020; 14:113-121. [PMID: 33224003 DOI: 10.1159/000499250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction There have been a number of reports on dose increase therapy (DI-T) with the alpha 1 adrenoceptor antagonists (α1-blockers) naftopidil and tamsulosin for lower urinary tract symptoms associated with benign prostatic hyperplasia. Methods and Results The reports on DI-T (naftopidil 75 mg/d, tamsulosin 0.4 mg/d) in non-responders to low-dose initial therapy (LI-T, naftopidil 50 mg/d, tamsulosin 0.2 mg/d) were summarized. In each study, a non-responder was defined as a patient without sufficient improvements on the International Prostate Symptom Score (IPSS), IPSS Quality of Life, maximum flow rate of urine, or treatment satisfaction. These reports showed that 22.4-76.1% of patients were non-responders to LI-T, indicating that a novel treatment strategy for such patients is important. Moreover, 22.5-90.0% of non-responders to LI-T showed a response to DI-T, which achieved the same level of efficacy as low-dose maintenance therapy. Specifically, the improvements of the IPSS voiding symptom sub-score and maximum flow rate of urine were superior. The predictive factors for non-response to α1-blockers LI-T were insufficient improvement of subjective symptoms and objective findings during LI-T. These patients require high-dose initial therapy or DI-T at an early stage, since adverse events associated with naftopidil and tamsulosin do not show a dose-response relationship. Conclusions DI-T with α1-blockers has high potential as an essential treatment strategy for lower urinary tract symptoms associated with benign prostatic hyperplasia.
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Affiliation(s)
- Masaki Watanabe
- Department of Urology, Hokkaido Social Welfare Association Furano Hospital, Furano
| | | | - Hidehiro Kakizaki
- Department of Renal and Urologic Surgery, Asahikawa Medical University, Asahikawa
| | - Naoki Hirabayashi
- Medical Affairs Department, Asahi Kasei Pharma Corporation, Tokyo, Japan
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23
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Sunakawa Y, Sakamoto Y, Inoue E, Kawabata R, Ishiguro A, Akamaru Y, Kito Y, Takahashi M, Matsuyama J, Yabusaki H, Makiyama A, Suzuki T, Tsuda M, Yasui H, Hirabayashi N, Takeno A, Kawakami H, Matoba R, Muro K, Nakajima T, Ichikawa W, Fujii M. LBA-4 Updated analysis of DELIVER trial (JACCRO GC-08): A large observational/translational study of nivolumab treatment in advanced gastric cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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24
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Ohara T, Furuta Y, Hirabayashi N, Hata J, Hirakawa Y, Honda T, Yoshida D, Shibata M, Kitazono T, Ninomiya T. Elevated serum glycated albumin and glycated albumin : hemoglobin A 1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study. J Diabetes Investig 2020; 11:971-979. [PMID: 31999889 PMCID: PMC7378434 DOI: 10.1111/jdi.13220] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/07/2020] [Accepted: 01/26/2020] [Indexed: 12/31/2022] Open
Abstract
AIMS/INTRODUCTION To investigate the association of alternative glycemic measures - namely, serum glycated albumin (GA), hemoglobin A1c (HbA1c ) and the GA : HbA1c ratio - with global brain and hippocampal atrophy in a general elderly Japanese population. MATERIALS AND METHODS A total of 1,278 Japanese individuals aged ≥65 years in a community participated in brain magnetic resonance imaging scanning and screening examination of health status in 2012. We measured total brain volume (TBV), hippocampal volume (HV) and intracranial volume (ICV) using the data from the magnetic resonance imaging examination. The association of each glycemic measure with the ratios of TBV : ICV (an indicator of global brain atrophy) and HV : ICV (an indicator of hippocampal atrophy) was examined by analysis of covariance. RESULTS The mean values of the TBV : ICV and HV : ICV ratios decreased significantly with elevating serum GA levels and GA : HbA1c ratio levels (all P for trend < 0.05), but not with higher HbA1c levels, after adjusting for age, sex, low education, systolic blood pressure, antihypertensive medication, diabetes mellitus, serum total cholesterol, electrocardiogram abnormalities, body mass index, smoking habits, alcohol drinking habits and regular exercise. These significant associations were still observed in the sensitivity analysis after excluding individuals with mild cognitive impairment and dementia. In addition, increased serum GA levels and the GA : HbA1c ratio levels, but not HbA1c , were closely associated with lower mean values of the TBV : ICV and HV : ICV ratios, irrespective of the presence or absence of diabetes mellitus. CONCLUSIONS The present study suggests that higher serum GA and higher GA : HbA1c ratio are significantly associated with global brain and hippocampal atrophy.
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Grants
- JP19dk0207025 Japan Agency for Medical Research and Development
- JP19ek0210080 Japan Agency for Medical Research and Development
- JP19ek0210082 Japan Agency for Medical Research and Development
- JP19ek0210083 Japan Agency for Medical Research and Development
- JP19fk0108075 Japan Agency for Medical Research and Development
- JP19km0405202 Japan Agency for Medical Research and Development
- H29-Junkankitou-Ippan-003 Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan
- H30-Shokuhin-[Sitei]-005 Health and Labour Sciences Research Grants of the Ministry of Health, Labour and Welfare of Japan
- JP16H02692 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP16H05850 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP17H04126 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP17K01853 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP17K09113 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP17K09114 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18H02737 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K07565 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K09412 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K17382 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18K17925 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP19K07890 Grants-in-Aid for Scientific Research of the Ministry of Education, Culture, Sports, Science and Technology of Japan
- Japan Agency for Medical Research and Development
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Affiliation(s)
- Tomoyuki Ohara
- Department of NeuropsychiatryGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoshihiko Furuta
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Psychosomatic MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Jun Hata
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanori Honda
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Daigo Yoshida
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Mao Shibata
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Psychosomatic MedicineGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takanari Kitazono
- Department of Medicine and Clinical ScienceGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public HealthGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Department of Center for Cohort StudiesGraduate School of Medical SciencesKyushu UniversityFukuokaJapan
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Yamasaki K, Hata J, Furuta Y, Hirabayashi N, Ohara T, Yoshida D, Hirakawa Y, Nakano T, Kitazono T, Ninomiya T. CORRIGENDUM: Association of Albuminuria With White Matter Hyperintensities Volume on Brain Magnetic Resonance Imaging in Elderly Japanese ― The Hisayama Study ―. Circ J 2020; 84:1207. [DOI: 10.1253/circj.cj-66-0179] [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: 11/09/2022]
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Yamasaki K, Hata J, Furuta Y, Hirabayashi N, Ohara T, Yoshida D, Hirakawa Y, Nakano T, Kitazono T, Ninomiya T. Association of Albuminuria With White Matter Hyperintensities Volume on Brain Magnetic Resonance Imaging in Elderly Japanese - The Hisayama Study. Circ J 2020; 84:935-942. [PMID: 32269184 DOI: 10.1253/circj.cj-19-1069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 11/09/2022]
Abstract
BACKGROUND Both chronic kidney disease and brain white matter hyperintensities (WMH) are known to be risk factors of dementia and mortality.Methods and Results:In 2012, 1,214 community-dwelling Japanese subjects aged ≥65 years underwent brain magnetic resonance imaging (MRI) scans and a comprehensive health examination. This study investigated associations of the urinary albumin : creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) with the WMH volume to intracranial volume (WMHV : ICV) ratio, and the association of the combination of UACR and the WMHV : ICV ratio with cognitive decline and mortality risk. The geometric mean of the WMHV : ICV ratio was 0.223% in the entire study population, and increased significantly with higher UACR levels after adjusting for potential confounding factors (0.213% for normoalbuminuria, 0.248% for microalbuminuria, and 0.332% for macroalbuminuria; Ptrend=0.01). In contrast, there was no clear association between eGFR and the WMHV : ICV ratio. Compared with subjects with normoalbuminuria and a smaller WMHV : ICV ratio (<0.257% [median]), subjects with albuminuria and a larger WMHV : ICV ratio (≥0.257%) had higher probabilities of cognitive decline at baseline and all-cause death during the follow-up. CONCLUSIONS This study suggests that subjects with albuminuria have a greater risk of WMH enlargement and that the combination of albuminuria and WMH enlargement increases the risk of cognitive decline and all-cause mortality in an elderly Japanese population.
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Affiliation(s)
- Keisuke Yamasaki
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoshihiko Furuta
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Ito Clinic, Kyushu University
| | - Tomoyuki Ohara
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Yoichiro Hirakawa
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Toshiaki Nakano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
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Hakoda K, Yoshimitsu M, Miguchi M, Kohashi T, Egi H, Ohdan H, Hirabayashi N. Characteristic findings of appendicular endometriosis treated with single incision laparoscopic ileocolectomy: Case report. Int J Surg Case Rep 2020; 67:9-12. [PMID: 31991379 PMCID: PMC7076268 DOI: 10.1016/j.ijscr.2019.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/11/2019] [Accepted: 12/24/2019] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION We report the case of characteristic findings of appendicular endometriosis that presented as a submucosal tumor in the cecum without any abdominal symptoms treated with single-incision laparoscopic ileocolectomy. PRESENTATION OF CASE The patient was a 51-year-old woman (body mass index: 21.5) who underwent an examination to investigate the cause of a positive fecal occult blood test. Her laboratory test results were normal, without anemia or tumor marker elevation. Colonoscopy revealed a submucosal tumor in the cecum. Enhanced computed tomography (CT), fluorodeoxyglucose-positron emission tomography-CT and magnetic resonance imaging failed to produce a clear diagnosis. Given the malignant potentiality of the tumor, ileocolectomy was considered potentially necessary, but she wished for minimally invasive surgery. She ultimately underwent ileocolectomy and lymphadenectomy with single-incision laparoscopic surgery. A pathological examination revealed the lesion to be appendicular endometriosis, and 14 lymph nodes with no malignancy were resected. CONCLUSION Appendicular endometriosis can present as a submucosal tumor in the cecum without any abdominal symptoms. Appendicular endometriosis should be considered in the differential diagnosis of ileocecal submucosal tumor. Single-incision laparoscopic ileocolectomy was useful procedure for cecum tumor resection.
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Affiliation(s)
- Keishi Hakoda
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Motomachi 7-33 Naka-ku, Hiroshima-shi, Hiroshima, Japan.
| | - Masashi Miguchi
- Department of Surgery, Hiroshima Prefectural Hospital, Ujinakanda 1-5-54 Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Kabeminami 2-1-1 Asakita-ku, Hiroshima-shi, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima-shi, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Kabeminami 2-1-1 Asakita-ku, Hiroshima-shi, Hiroshima, Japan
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Hayashi T, Yoshikawa T, Sakamaki K, Nishikawa K, Fujitani K, Tanabe K, Ito Y, Matsui T, Miki A, Fukunaga T, Nemoto H, Kimura Y, Hirabayashi N. Subgroup analyses of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with 2 and 4 courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ohsawa M, Miguchi M, Yoshimitsu M, Oishi K, Kohashi T, Hihara J, Mukaida H, Kaneko M, Egi H, Ohdan H, Hirabayashi N. Laparoscopic excision of a retroperitoneal schwannoma: A case report. Asian J Endosc Surg 2019; 12:192-196. [PMID: 29808539 DOI: 10.1111/ases.12607] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/01/2018] [Indexed: 01/04/2023]
Abstract
Schwannomas are tumors originating from the Schwann cells of the peripheral nerve sheath. Only 1%-3% of schwannomas reportedly occur in the pelvis. In a 67-year-old man, a pelvic mass that was 52 mm in diameter was incidentally diagnosed during a preoperative CT evaluation for prostate cancer. Preoperative 3-D reconstruction CT showed that the feeding artery to the tumor originated from the internal iliac artery and the drainage vein from the internal iliac vein. Each vessel could be isolated, clipped, and cut with minimal bleeding. The tumor was easily dissected from adjacent structures and was completely resected via laparoscopic surgery. Histopathology and immunohistochemistry of the excised specimen revealed a benign schwannoma. Using 3-D reconstruction to recognize a tumor's positional relation with the supplying vessels is important for avoiding complications during laparoscopic resection in the narrow pelvis. Laparoscopic resection is safe, feasible, and effective for retroperitoneal schwannoma.
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Affiliation(s)
- Manato Ohsawa
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Masashi Miguchi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Jun Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Hidenori Mukaida
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
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Yoshikawa T, Sakamaki K, Nishikawa K, Fujitani K, Tanabe K, Ito Y, Matsui T, Miki A, Nemoto H, Fukunaga T, Kimura Y, Hirabayashi N, Hayashi T. Primary results of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) as neoadjuvant chemotherapy for locally advanced gastric cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.4_suppl.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
93 Background: Neoadjuvant chemotherapy is promising to improve the survival of resectable gastric cancer. Cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) are both active for metastatic gastric cancer. Methods: We conducted a randomized phase II trial to compare two and four courses of neoadjuvant S-1/cisplatin (SC) and docetaxel/cisplatin/S-1 (DCS) using a two-by-two factorial design for locally resectable advanced gastric cancer. Patients with M0 and either T4 or T3 in case of junctional cancer or schirrhous type received two or four courses of cisplatin (60 mg/m2 at day 8)/S-1 (80 mg/m2 for 21 days with 1 week rest) or docetaxel (40 mg/m2 at day 1)/cisplatin (60 mg/m2 at day 1)/S-1 (80 mg/m2 for 14 days with 2 weeks rest) as neoadjuvant chemotherapy. Then, patients underwent D2 gastrectomy and adjuvant S-1 chemotherapy for 1 year. The primary endpoint was 3-year overall survival. The planned sample size was 120 eligible patients in total so that the treatment group with the superior observed 3-year OS rate by more than 60% as compared with 50% of the control group was to be selected with a probability of 85% or higher. Results: Between October 2011 and September 2014, 132 patients were assigned to CS (n = 66; 33 in 2-courses and 33 in 4-courses) and DCS (n = 66; 33 in 2-courses and 33 in 4-courses). The 3-year OS was 58.1% (95% CI, 45.8-70.3%) in CS and 60.0% (95% CI, 48.0-71.9%) in DCS with hazard ratio of 0796 (95% CI, 0.475-1.335), while that was 53.1% (95% CI, 40.9-65.4%) in the two courses and 65.0% (95% CI, 53.2-76.8%) in the four courses with hazard ratio of 0.722 (95% CI, 0.429-1.216). In the survival analysis by duration in each regimen, the 3-year OS was 58.1% (95% CI, 45.8-70.3%) both for two and four courses in CS, while that was 48.5% (95% CI, 31.4-65.5%) for two courses of DCS and was 71.9% (95% CI, 56.3-87.5%) for four courses of DCS. Conclusions: Considering high 3-year OS, four courses DCS has a value to be tested in a future phase III study to confirm superiority of neoadjuvant chemotherapy for locally advanced gastric cancer. Clinical trial information: UMIN000006378.
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Affiliation(s)
| | | | - Kazuhiro Nishikawa
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | | | | | - Yuichi Ito
- Aichi Cancer Center Hospital, Aichi, Japan
| | | | - Akira Miki
- Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Tetsu Fukunaga
- St. Marianna University Schoof of Medicine, Kawasaki, Japan
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Kimura Y, Kitagawa H, Funakoshi M, Mukaida H, Hirabayashi N, Kaneko M. [A Case of Primary Small Cell Carcinoma in the Breast with Neoadjuvant Chemotherapy That Were Difficult to Select Chemotherapy]. Gan To Kagaku Ryoho 2019; 46:263-266. [PMID: 30914530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Primary small cell carcinoma in the breast is a rare and aggressive tumor, and a standard treatment strategy has not been established. Herein, we report a 35-year-old woman with primary small cell carcinoma in the breast. She had an 8 cm diameter tumor in the right breast. She was diagnosed with small cell carcinoma(cT3N1M0, cStage ⅢA)in the right breast, and neoadjuvant chemotherapy was planned. She received a combination chemotherapy of cisplatin(CDDP)and etoposide(VP- 16)based on the regimen for pulmonary small cell carcinoma; however, the disease showed progression. Therefore, 5-FU plus epirubicin plus cyclophosphamide(FEC)and weekly paclitaxel(PTX)chemotherapy based on a regimen for breast cancer were administered, and the tumor was partially reduced in size. Modified radical mastectomy followed by radiotherapy and hormonal therapy was performed. Ten months after the surgery, multiple liver and bone metastases occurred, and the patient died the following month. Further studies in other such patients are needed.
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Affiliation(s)
- Yuri Kimura
- Dept. of Surgery, Hiroshima City Asa Citizens Hospital
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Komo T, Oishi K, Kohashi T, Hihara J, Yoshimitsu M, Tokumoto N, Kanou M, Nakashima A, Aoki Y, Shimomura M, Miguchi M, Funakoshi M, Mukaida H, Kaneko M, Matuura H, Hirabayashi N. Appendiceal neurofibroma with low-grade appendiceal mucinous neoplasm in neurofibromatosis type 1 patient: A case report. Int J Surg Case Rep 2018; 53:377-380. [PMID: 30481737 PMCID: PMC6260368 DOI: 10.1016/j.ijscr.2018.11.005] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/16/2018] [Accepted: 11/06/2018] [Indexed: 02/07/2023] Open
Abstract
Appendiceal neurofibromas (AN) in Neurofibromatosis type (NF) 1 are rare. AN in NF1 with Low-grade appendiceal mucinous neoplasms (LAMNs) are extremely rare. AN and LAMNs have potential for malignant transformation. Surgical resection is the standard treatment for patients with AN and LAMNs. However, appropriate surgical procedure remains controversial.
Introduction Neurofibromas are a characteristic of the autosomal dominant disorder Neurofibromatosis type 1 (NF1), also known as von Recklinghausen’s disease. Appendiceal neurofibromas are extremely rare, and low-grade appendiceal mucinous neoplasms (LAMNs) have not previously been reported in NF1. Presentation of case A 62-year-old man with NF1 was scheduled for elective surgical treatment of an asymptomatic, enlarged and diffusely thickened appendix that remained after curative antimicrobial treatment of acute appendicitis. Laboratory analysis revealed all normal. Colonoscopy showed thickened appendiceal mucosa projecting into the cecum. A sample of the mucosa was found to be pathologically benign. The patient was preoperatively diagnosed with treated acute appendicitis with chronic appendiceal inflammation versus appendiceal neoplasms. Laparoscopic cecectomy was performed. Multiple neurofibromas were observed in the muscle layer, submucosa, and mucosa of the appendix on histopathological examination. Immunohistochemical examination showed positive staining for S-100. Pathologically, the patient was diagnosed with appendiceal neurofibroma consistent with NF1 with LAMNs. His postoperative course was unremarkable. He was discharged on post-operative day 3 and remained in good health 7 month after surgery. Conclusions Appendiceal neurofibromas are often preoperatively diagnosed as appendicitis. Appendiceal neurofibromas should be considered in patients with NF1 who are suspected of having appendicitis.
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Affiliation(s)
- Toshiaki Komo
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Koichi Oishi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.
| | - Toshihiko Kohashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Jun Hihara
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Masanori Yoshimitsu
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Noriaki Tokumoto
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mikihiro Kanou
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Akira Nakashima
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Yoshirou Aoki
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Manabu Shimomura
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Masashi Miguchi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mahito Funakoshi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Hidenori Mukaida
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
| | - Hiroo Matuura
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
| | - Naoki Hirabayashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
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Sato Y, Mizusawa J, Nakamura K, Fukagawa T, Katai H, Haruta S, Yamada M, Takagi M, Tamura S, Yoshimura T, Inada T, Hirabayashi N, Wada I, Kodera Y, Tokunaga M, Yoshikawa T, Boku N, Sano T, Sasako M, Terashima M. Diagnosis of invasion depth in resectable advanced gastric cancer for neoadjuvant chemotherapy: An exploratory analysis of JCOG1302A. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nishikawa K, Tsuburaya A, Yoshikawa T, Kobayashi M, Kawada J, Fukushima R, Matsui T, Tanabe K, Yamaguchi K, Yoshino S, Takahashi M, Hirabayashi N, Sato S, Nemoto H, Rino Y, Nakajima J, Aoyama T, Miyagi Y, Oriuchi N, Yamaguchi K, Miyashita Y, Morita S, Sakamoto J. A randomised phase II trial of capecitabine plus cisplatin versus S-1 plus cisplatin as a first-line treatment for advanced gastric cancer: Capecitabine plus cisplatin ascertainment versus S-1 plus cisplatin randomised PII trial (XParTS II). Eur J Cancer 2018; 101:220-228. [DOI: 10.1016/j.ejca.2018.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/13/2018] [Accepted: 06/24/2018] [Indexed: 12/27/2022]
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Ohsawa M, Kohashi T, Hihara J, Mukaida H, Kaneko M, Hirabayashi N. A rare case of retroperitoneal hemolymphangioma. Int J Surg Case Rep 2018; 51:107-111. [PMID: 30149326 PMCID: PMC6111010 DOI: 10.1016/j.ijscr.2018.08.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 12/30/2022] Open
Abstract
Accurate diagnosis of hemolymphangioma preoperatively is difficult. Disease may vary from simple cystic to aggressive lesions, mimicking malignancy. Complete excision provides the best results with a lower recurrence rate.
Introduction Hemolymphangioma, a rare vascular developmental condition, is characterized by malformed venous and lymphatic components in various proportions. Herein, we report a case of a retroperitoneal cystic tumor in an adult patient. Presentation of case A 68-year-old man presented to our hospital with complaints of abdominal pain and vomiting. His abdomen was distended with upper tenderness but without rebound tenderness. Computed tomography (CT) scanning demonstrated a retroperitoneal cystic tumor at the dorsal part of the pancreatic head. Thus, a diagnosis of liposarcoma or lymphoma was made. The patient was scheduled for surgery after his general condition became stable. Intraoperatively, the cystic tumor was found to have originated from the retroperitoneal space. The tumor was in contact with the pancreatic head, abdominal aorta, and inferior vena cava. There was no invasion into the surrounding tissue. The cystic tumor was resected completely. Histopathological examination revealed that the resected retroperitoneal cystic tumor was a hemolymphangioma. The patient had no recurrence during the 12-month follow-up. Discussion Hemolymphangioma is a rare benign tumor, and its accurate diagnosis before surgery is still difficult. Disease presentation may vary from simple well-defined cystic lesions to aggressive ill-defined lesions, mimicking malignancy. Complete excision provides the best results with a low recurrence rate. Conclusion Further research is needed on the preoperative radiological diagnosis of such tumors and on how to determine tumor resectability in such cases.
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Affiliation(s)
- Manato Ohsawa
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Toshihiko Kohashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan.
| | - Jun Hihara
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Hidenori Mukaida
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
| | - Naoki Hirabayashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
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Komo T, Kohashi T, Hihara J, Oishi K, Yoshimitsu M, Kanou M, Nakashima A, Aoki Y, Miguchi M, Kaneko M, Mukaida H, Hirabayashi N. Intestinal obstruction caused by low-grade appendiceal mucinous neoplasm: A case report and review of the literature. Int J Surg Case Rep 2018; 51:37-40. [PMID: 30138868 PMCID: PMC6104576 DOI: 10.1016/j.ijscr.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 06/06/2018] [Accepted: 08/01/2018] [Indexed: 01/24/2023] Open
Abstract
Intestinal obstructions caused by external compression from the appendix are rare. Low-grade appendiceal mucinous neoplasm (LAMN) with torsion is rarer still. LAMN have the potential to lead to pseudomyxoma peritonei. Surgical resection for LAMN is the standard treatment. The appropriate surgical procedure, however, remains controversial.
Introduction Intestinal obstructions due to appendiceal pathology are rare. Obstructions caused by low-grade appendiceal mucinous neoplasms (LAMNs) are rarer still. Presentation of case A 79-year-old woman was referred to our hospital for mechanical small intestinal obstruction. The patient had undergone prior left oophorectomy via a lower abdominal incision. Physical examination revealed abdominal distension and slight tenderness. Laboratory analysis was unremarkable. Contrast enhanced computed tomography (CT) demonstrated dilation of an obstructed small intestinal loop without evidence of strangulation. There appeared to be a low density mass measuring 3.0 × 1.5 cm with a potential twist in the mesentery near the transition point in the small intestine. The patient was diagnosed with mechanical small intestinal obstruction and was treated conservatively with nasogastric tube decompression for one week. After no clinical improvement, we elected to surgically explore her. Intraoperative findings revealed that the ileum was compressed by the appendix, which had a cystic mass on its tip. There was no evidence of intestinal ischemia. Laparotomy appendectomy alone was performed. Pathology revealed a LAMN measuring 3.0 × 1.5 cm. She remains disease-free with 18 months of postoperative follow-up. Discussion Intestinal obstruction due to external compression by an appendiceal mass is rare, and is often difficult to preoperatively diagnose with CT. Conclusions The etiology of small intestinal obstruction with a transition point in the right lower quadrant of abdomen includes an appendiceal mass on the broad differential for this common problem.
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Affiliation(s)
- Toshiaki Komo
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.
| | - Toshihiko Kohashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan.
| | - Jun Hihara
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Koichi Oishi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Masanori Yoshimitsu
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mikihiro Kanou
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Akira Nakashima
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Yoshirou Aoki
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Masashi Miguchi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
| | - Hidenori Mukaida
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Naoki Hirabayashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
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Komo T, Oishi K, Kohashi T, Hihara J, Kanou M, Nakashima A, Kaneko M, Mukaida H, Hirabayashi N. Pancreatobiliary fistula associated with intraductal papillary mucinous carcinoma accompanying obstructive jaundice: A case report. Int J Surg Case Rep 2018; 48:126-130. [PMID: 29890488 PMCID: PMC6035910 DOI: 10.1016/j.ijscr.2018.05.019] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/20/2018] [Accepted: 05/25/2018] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Intraductal papillary mucinous neoplasms (IPMNs) occasionally involve formation of fistulas with other adjacent organs. Pancreatobiliary fistulas associated with IPMNs are rare, but affected patients often develop obstructive jaundice and cholangitis. PRESENTATION OF CASE A 79-year-old man was referred to our hospital for evaluation of abnormal biliary enzymes. Contrast-enhanced computed tomography and endoscopic retrograde cholangiopancreatography demonstrated multiple cystic lesions with septa in the pancreatic head and fistulas between the cystic lesions and common bile duct. The clinical diagnosis was pancreatobiliary fistula associated with a mixed-type IPMN and accompanying obstructive jaundice. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy. The resected specimen showed fistulas between the cystic lesions and common bile duct. Histopathological examination showed that the main and branch ducts of the pancreatic head were dilated and filled with mucus. The epithelia of the pancreatic ducts revealed papillary proliferation and an invasive adenocarcinoma arising from an intraductal neoplasm. Immunohistochemistry examination showed CDX2- and MUC2-positive reactions. The final diagnosis was an intraductal papillary mucinous carcinoma of the intestinal-type. The patient remained disease-free for 9 months postoperatively. DISCUSSION The causes of death in patients who have pancreatobiliary fistulas associated with IPMNs without resection are cholangitis or hepatic insufficiency. Nonoperative treatment is limited for cases with obstructive jaundice. It is necessary to prevent obstructive jaundice and cholangitis due to a large quantity of mucinous material. CONCLUSIONS Surgical resection should be considered, if possible, in patients with pancreatobiliary fistulas associated with IPMNs. A better prognosis is expected with prevention of obstructive jaundice or cholangitis.
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Affiliation(s)
- Toshiaki Komo
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Koichi Oishi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.
| | - Toshihiko Kohashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Jun Hihara
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mikihiro Kanou
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Akira Nakashima
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
| | - Hidenori Mukaida
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Naoki Hirabayashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
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Yubi T, Hata J, Ohara T, Mukai N, Hirakawa Y, Yoshida D, Gotoh S, Hirabayashi N, Furuta Y, Ago T, Kitazono T, Kiyohara Y, Ninomiya T. Prevalence of and risk factors for cerebral microbleeds in a general Japanese elderly community. Neurol Clin Pract 2018; 8:223-231. [PMID: 30105162 DOI: 10.1212/cpj.0000000000000464] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/28/2018] [Indexed: 11/15/2022]
Abstract
Background We investigated the prevalence of and risk factors for cerebral microbleeds (CMBs) in a cross-sectional study of a general population of Japanese elderly. Methods In 2012, brain MRI scanning at 1.5T and comprehensive health examination were conducted for 1281 residents aged 65 years or older. CMBs were defined as ovoid hypointensity lesions less than 10 mm in diameter on T2*-weighted images and classified into deep/infratentorial or lobar CMBs. Age- and sex-specific and overall prevalence of CMBs were estimated, and the associations of traditional cardiovascular risk factors and APOE polymorphism with the presence of CMBs were examined using a logistic regression analysis. Results The crude prevalences of total, deep/infratentorial, and lobar CMBs were 18.7% (n = 240), 13.5% (n = 173), and 9.6% (n = 123), respectively. The prevalence of total CMBs was 23.0% in men and 15.5% in women and increased with aging in both sexes (both p for trend <0.01). Hypertension was significantly associated with the presence of both deep/infratentorial and lobar CMBs. Lower serum total cholesterol was a significant risk factor for deep/infratentorial CMBs, but not for lobar CMBs, while APOE ε4 carriers had a significantly higher likelihood only of lobar CMBs compared with noncarriers. Conclusions Our study suggests that approximately 1 of 5 Japanese elderly people have CMBs, and that risk factors for deep/infratentorial and lobar CMBs are different, indicating the distinct pathologic backgrounds of these lesions.
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Affiliation(s)
- Tomohiro Yubi
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Jun Hata
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Tomoyuki Ohara
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Naoko Mukai
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Yoichiro Hirakawa
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Daigo Yoshida
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Seiji Gotoh
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Naoki Hirabayashi
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Yoshihiko Furuta
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Tetsuro Ago
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Takanari Kitazono
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Yutaka Kiyohara
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
| | - Toshiharu Ninomiya
- Departments of Epidemiology and Public Health (TY, JH, DY, YF, TN), Department of Neuropsychiatry (TO), Center for Cohort Studies (NM), Department of Medicine and Clinical Sciences (YH, SG, TA, TK), and Department of Psychosomatic Medicine (NH), Graduate School of Medical Sciences, Kyushu University, Fukuoka; and Hisayama Research Institute for Lifestyle Diseases (YK), Fukuoka, Japan
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Iwasaki Y, Terashima M, Mizusawa J, Katayama H, Nakamura K, Katai H, Yoshikawa T, Ito Y, Kaji M, Kimura Y, Hirao M, Yamada M, Kurita A, Takagi M, Gotoh M, Takagane A, Yabusaki H, Hirabayashi N, Sano T, Sasako M. Randomized phase III trial of gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer: Japan Clinical Oncology Group study (JCOG0501). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.4046] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yoshiaki Iwasaki
- Department of Surgery, IMS Tokyo-Katsushika General Hospital, Tokyo, Japan
| | | | - Junki Mizusawa
- JCOG Data Center/ Operation Office, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Katayama
- JCOG Data Center/ Operation Office, National Cancer Center, Tokyo, Japan
| | - Kenichi Nakamura
- Japan Clinical Oncology Group Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Yuichi Ito
- Aichi Cancer Center Hospital, Aichi, Japan
| | | | - Yutaka Kimura
- Department of Surgery, Sakai City Hospital, Osaka, Japan
| | | | - Makoto Yamada
- Department of Surgery, Gifu Municipal Hospital, Gifu, Japan
| | | | | | | | | | | | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Takeshi Sano
- Japanese Foundation for Cancer Research Cancer Institute Hospital, Tokyo, Japan
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Aoyama T, Nishikawa K, Fujitani K, Tanabe K, Ito S, Matsui T, Miki A, Nemoto H, Sakamaki K, Fukunaga T, Kimura Y, Hirabayashi N, Yoshikawa T. Early results of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of cisplatin/S-1 and docetaxel/cisplatin/S-1 as neoadjuvant chemotherapy for locally advanced gastric cancer. Ann Oncol 2018; 28:1876-1881. [PMID: 28486692 DOI: 10.1093/annonc/mdx236] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Neoadjuvant chemotherapy (NAC) is a promising method of improving the survival of resectable gastric cancer. Cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) are both effective against metastatic gastric cancer. This report clarified the impact of these regimens on early endpoints, including the pathological responses, chemotherapy-related toxicities, and surgical results. Methods Patients with M0 and either T4 or T3 in case of junctional cancer or scirrhous type received two or four courses of cisplatin (60 mg/m2 at day 8)/S-1 (80 mg/m2 for 21 days with 1 week rest) or docetaxel (40 mg/m2 at day 1)/cisplatin (60 mg/m2 at day 1)/S-1 (80 mg/m2 for 14 days with 2 weeks rest) as NAC. Patients then underwent D2 gastrectomy and adjuvant S-1 chemotherapy for 1 year. The primary endpoint was the 3-year overall survival. Results Between October 2011 and September 2014, 132 patients were assigned to receive CS (n = 66; 33 in 2 courses and 33 in 4 courses) or DCS (n = 66; 33 in 2 courses and 33 in 4 courses). The respective major grade 3 or 4 hematological toxicities (CS/DCS) were leukocytopenia (14.1%/26.2%), neutropenia (29.7%/47.7%), anemia (14.1%/12.3%), and platelet reduction (3.1%/1.5%). The rate of pathological response, defined as a complete response or < 10% residual cancer remaining, was 19.4% in the CS group and 15.4% in the DCS group, and 15.6% in the two-course group and 19.0% in the 4-course group. The R0 resection rate was 72.7% in the CS group and 81.8% in the DCS group and 80.3% in the two-course group and the 74.2% in the four-course group. No treatment-related deaths were observed. Conclusions Our results do not support three-drug therapy with a taxane over two-drug therapy, or any further treatment beyond two cycles as an attractive candidate for the test arm of NAC.
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Affiliation(s)
- T Aoyama
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama
| | - K Nishikawa
- Department of Surgery, Osaka National Hospital
| | - K Fujitani
- Osaka General Medical Center, Department of Surgery, Osaka, Japan
| | - K Tanabe
- Department of Gastrointestinal Surgery, Hiroshima University, Hiroshima
| | - S Ito
- Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya
| | - T Matsui
- Department of Surgery, Aichi Cancer Center Aichi Hospital, Okazaki
| | - A Miki
- Department of Surgery, Kobe City Medical Center General Hospital, Kobe
| | - H Nemoto
- Department of Surgery, Showa University Fujigaoka Hospital, Yokohama
| | - K Sakamaki
- Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama
| | - T Fukunaga
- Department of Surgery, Saint Marianna University, Kawasaki
| | - Y Kimura
- Department of Surgery, Sakai City Hospital, Sakai
| | - N Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - T Yoshikawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama
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Shimizu N, Oki E, Tanizawa Y, Suzuki Y, Aikou S, Kunisaki C, Tsuchiya T, Fukushima R, Doki Y, Natsugoe S, Nishida Y, Morita M, Hirabayashi N, Hatao F, Takahashi I, Choda Y, Iwasaki Y, Seto Y. Effect of early oral feeding on length of hospital stay following gastrectomy for gastric cancer: a Japanese multicenter, randomized controlled trial. Surg Today 2018; 48:865-874. [PMID: 29721714 DOI: 10.1007/s00595-018-1665-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/05/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE This multicenter, randomized controlled study evaluates the safety of early oral feeding following gastrectomy, and its effect on the length of postoperative hospital stay. METHODS The subjects of this study were patients who underwent distal gastrectomy (DG) or total gastrectomy (TG) for gastric cancer between January 2014 and December 2015. Patients were randomly assigned to the early oral feeding group (intervention group) or the conventional postoperative management group (control group) for each procedure. We evaluated the length of postoperative hospital stay and the incidence of postoperative complications in each group. RESULTS No significant differences in length of postoperative stay were found between the intervention and control groups of the patients who underwent DG. The incidence of postoperative complications was significantly greater in the DG intervention group. In contrast, the length of postoperative stay was significantly shorter in the TG intervention group, although the TG group did not attain the established target sample size. CONCLUSION Early oral feeding did not shorten the postoperative hospital stay after DG. The higher incidence of postoperative complications precluded the unselected adoption of early oral feeding for DG patients. Further confirmative studies are required to definitively establish the potential benefits of early oral feeding for TG patients.
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Affiliation(s)
- Nobuyuki Shimizu
- Department of Surgery, International University of Health and Welfare, Sanno Hospital, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yutaka Tanizawa
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan
| | - Yutaka Suzuki
- Department of Gastroenterological Surgery and General Surgery, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763, Japan
| | - Susumu Aikou
- Department of Gastroenterological Surgery, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Chikara Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, 232-0024, Japan
| | - Takashi Tsuchiya
- Department of Gastroenterological Surgery and General Surgery, Sendai Open Hospital, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan
| | - Ryoji Fukushima
- Department of Surgery, Teikyo University, School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8606, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shoji Natsugoe
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yasunori Nishida
- Department of Gastroenterological Surgery, Keiyukai Sapporo Hospital, Kita1-1 Hondori 14 cho-me, Shiroishi-ku, Sapporo, 003-0027, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asa, Kita-ku, Hiroshima, 731-0293, Japan
| | - Fumihiko Hatao
- Department of Surgery, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu-shi, 183-8524, Japan
| | - Ikuo Takahashi
- Department of Surgery, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, 790-8524, Japan
| | - Yasuhiro Choda
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yoshiaki Iwasaki
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Yasuyuki Seto
- Department of Gastroenterological Surgery, Graduate School of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Kitagawa H, Kaneko M, Kano M, Ibuki Y, Amatya VJ, Takeshima Y, Hirabayashi N, Hirota S. Coexistence of gastrointestinal stromal tumor and leiomyosarcoma of the stomach presenting as a collision tumor: A case report and review of literature. Pathol Int 2018; 68:313-317. [PMID: 29575341 DOI: 10.1111/pin.12662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 02/16/2018] [Indexed: 01/15/2023]
Abstract
Collision tumor of the stomach is rare. We report a rare case of a gastric collision tumor consisting of gastrointestinal stromal tumors (GISTs) and leiomyosarcoma (LMS). Computed tomography scan revealed a 15 cm sized mass in the posterior wall of the body of the stomach. Gross examination of the wedge resection specimen showed the tumor located in the muscularis propria with extramural protrusion into the peritoneal cavity and the gastric cavity with geographic necrosis, hemorrhage, and mucosal ulceration. Histologically, the majority of the tumor consisted of the GIST component and the minor area in the submucosal region consisted of the LMS component. The tumor showed an abrupt transition between GIST and LMS by histologically and immunohistochemically, suggesting a collision tumor. Furthermore, the GIST components exhibited a c-kit exon 11 mutation. On the other hand, LMS component exhibited neither c-kit nor platelet-derived growth factor receptor-alpha (PDGFRA) mutation. Here we describe a case of the collision tumor consisting of GIST and LMS and its literature review.
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Affiliation(s)
- Hiroki Kitagawa
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Mikihiro Kano
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Yuta Ibuki
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Vishwa Jeet Amatya
- Department of Pathology, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Yukio Takeshima
- Department of Pathology, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo Medical College of Medicine, Nishinomiya, Japan
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Kitagawa H, Yoshimitsu M, Kaneko M, Ibuki Y, Emi M, Kohashi T, Mukaida H, Matsuura H, Ohge H, Ohdan H, Hirabayashi N. Invasive micropapillary carcinoma component is an independent prognosticator of poorer survival in Stage III colorectal cancer patients. Jpn J Clin Oncol 2018; 47:1129-1134. [PMID: 29036423 DOI: 10.1093/jjco/hyx136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 02/10/2017] [Accepted: 09/03/2017] [Indexed: 01/10/2023] Open
Abstract
Background Invasive micropapillary carcinoma (IMPC) is an aggressive variant of adenocarcinoma found in several organs. Recent studies showed that IMPC in colorectal cancer leads to poorer prognosis than conventional colorectal cancer; however, the influence of IMPC on outcomes remains unclear. The present study aimed to identify the clinicopathological characteristics of colorectal cancers with IMPCs, and to evaluate the prognostic significance of IMPCs per se. Methods We retrospectively analyzed data from 837 patients with colorectal cancer who underwent surgical treatment. We compared the clinicopathological characteristics and survival outcomes of colorectal cancer patients with IMPCs to those without. Results Among 837 patients, 130 (16%) had an IMPC component, including 0 (0%) of 18, 9 (4.2%) of 215, 34 (13%) of 254, 59 (24%) of 249 and 28 (27%) of 101 patients with TNM Stages 0, I, II, III and IV, respectively. The 3-year disease-free survival (DFS) rates were significantly worse for Stage III patients with IMPC than for those without (55.3% vs. 78.7% respectively, P < 0.001), but not in patients with other stages. Multivariate analyses of patients with Stage III colorectal cancer found IMPC to be associated with significantly worse DFS (P = 0.026), as were high CEA levels, tumor budding and TNM staging. IMPC was only significantly associated with tumor invasion (P = 0.045) and venous invasion (P = 0.045) in Stage III tumors. Conclusions Identifying IMPC components in Stage III colorectal cancer is crucial, as their presence is significantly associated with poorer survival.
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Affiliation(s)
| | | | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital
| | - Yuta Ibuki
- Department of Surgery, Hiroshima City Asa Citizens Hospital
| | - Manabu Emi
- Department of Surgery, Hiroshima City Asa Citizens Hospital
| | | | | | - Hiroo Matsuura
- Department of Pathology, Hiroshima City Asa Citizens Hospital
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Makuuchi R, Yamaguchi T, Takashima A, Nagashima K, Yamada T, Kinoshita T, Hata H, Kawachi Y, Kawabata R, Tsuji T, Hirabayashi N, Sakamoto T, Inada T, Ishiyama K, Fukagawa T, Boku N, Katai H. The impact of pre-operative chemotherapy in patients with peritoneal lavage cytology positive or localized peritoneum metastasis for gastric cancer: A multicenter retrospective study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.95] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
95 Background: Peritoneal lavage cytology of positive and localized peritoneum metastasis of gastric cancer (GC) are defined as CY1 and P1 in the 14th edition of the Japanese Classification of GC. Patients (pts) with CY1 and/or P1 have poor prognosis after removing all macroscopically visible disease by standard gastrectomy followed by S1. The aim of this study was to investigate the efficacy of pre-operative chemotherapy (Pre-Cx) in patients with CY1 and/or P1. Methods: We retrospectively reviewed the GC pts who were diagnosed to have CY1 and/or P1 at 34 institutions participating in the Stomach Cancer Group of Japan Clinical Oncology Group between 2007 and 2012. Inclusion criteria were: no distant metastasis other than CY1 or P1, no prior treatment for GC. The subjects were divided to two groups according to treatment strategy with/without Pre-Cx before surgery. In the Pre-Cx group, status of CY and P was diagnosed by laparoscopy before and after Pre-Cx, and indication of surgical resection was decided by each physician. Results: A total of 824 pts were collected from 34 institutions. Of the 713 eligible pts, 150 pts received Pre-Cx (Pre-Cx group) and 563 pts underwent surgery followed by Cx (Post-Cx group). Proportions of P0CY1/P1CY0/P1CY1 were 69/12/19% and 69/17/14% in the Pre- and Post-Cx. Cx regimen for Pre-Cx were S1 plus cisplatin/ docetaxel and cisplatin plus S1/others (n=90/37/23). In the Pre-Cx, 57 (38%) pts who achieved P0CY0 after Pre-Cx showed better survival than the remaining 92 pts (overall survival (OS), 31.0 vs. 19.9 months (M), HR=1.99, 95% CI 1.32-2.93, p=0.001). OS was 24.8 and 24.0 M in the Pre- and Post-Cx (HR 1.07; 95% CI 0.87-1.32, p=0.502). In multivariate analysis, P1CY1, over 65 years old and clinical N3 lymph node metastasis were identified as the independent prognostic factor for OS (p<0.05). Conclusions: Although Pre-Cx showed favorable survival in case of achieving P0 and CY0, Pre-Cx did not show a survival benefit for GC pts with CY1 and /or P1.
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Affiliation(s)
- Rie Makuuchi
- Shizuoka General Hospital Cancer Center, Shizuoka, Japan
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Hihara J, Mukaida H, Hirabayashi N. Gastrointestinal stromal tumor of the esophagus: current issues of diagnosis, surgery and drug therapy. Transl Gastroenterol Hepatol 2018; 3:6. [PMID: 29441371 DOI: 10.21037/tgh.2018.01.06] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/09/2018] [Indexed: 12/14/2022] Open
Abstract
Gastrointestinal stromal tumors (GISTs) often arise in the stomach and small intestine, while esophageal GISTs are rare. Due to their rarity, clinicopathological data on esophageal GISTs are extremely limited, and this results in a lack of clear recommendations concerning optimal surgical management for esophageal GISTs. It is difficult to distinguish esophageal GIST from leiomyoma, the most frequent esophageal mesenchymal tumor, prior to resection, because the two types of tumors appear similar on computed tomography (CT), endoscopic ultrasound (EUS), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). Fine-needle aspiration biopsy (FNAB) under EUS enables definitive diagnosis, but it is often avoided because scarring could make enucleation more difficult and increase the risk of tumor dissemination by capsule destruction. Esophageal segmental and wedge resections are not usually performed due to the anatomical peculiarity of the esophagus, and the surgical options are limited to the highly invasive esophagectomy or the much less invasive surgical tumor enucleation. The decision as to which surgical procedure should be performed for esophageal GISTs is still under debate. Tumor enucleation may be permitted for smaller tumors, and esophagectomy may be recommended for larger GISTs or high-risk tumors with a high mitotic rate. The purpose of neoadjuvant imatinib administration is downsizing of the GIST to reduce the extent of resection and to reduce the risk of intraoperative complications, including tumor rupture. The efficacy of neoadjuvant/adjuvant imatinib therapy for esophageal GISTs is poorly understood, because the reports are limited to case reports or case series with small numbers. More clinicopathological data and clinical trials for esophageal GIST are expected.
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Affiliation(s)
- Jun Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Asakita-ku, Hiroshima, Japan
| | - Hidenori Mukaida
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Asakita-ku, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Asakita-ku, Hiroshima, Japan
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Kano M, Hihara J, Hirabayashi N. Treatment of gastric cancer with brain metastasis or leptomeningeal carcinomatosis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx660.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hakoda K, Yoshimitsu M, Emi M, Hirai Y, Kamigaichi A, Osawa M, Kuraoka N, Komo T, Tsubokawa N, Yamakita I, Miguchi M, Aoki Y, Nakashima A, Kano M, Oishi K, Kohashi T, Kaneko M, Funakoshi M, Hihara J, Mukaida H, Hirabayashi N. [Abdominoperineal Resection for Anal Metastasis of Rectal Cancer]. Gan To Kagaku Ryoho 2017; 44:1364-1366. [PMID: 29394635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Anal metastasis of colorectal cancer is rare, and no standardized effective therapeutic strategy exists. We report a case of abdominoperineal resection for anal metastasis of rectal cancer. A 65-year-old man underwent laparoscopic low anterior resection for rectal cancer in August 2013. Histopathological examination revealed a moderately differentiated adenocarcinoma( tub2, pSS, ly3, v2, pN1, H0, P0, M0, Stage III a, Cur A). In February 2015, he complained of anal discomfort, and tumor markers were elevated. Enhanced CT revealed a 15-mm high-density solid tumor in the anal canal. The results of needle biopsy indicated a moderately differentiated adenocarcinoma. This tumor was suspected to be metastasis from rectal cancer, and we performed abdominoperineal resection. Histopathological examination revealed a moderately differentiated adenocarcinoma, which was the same histological type as the primary rectal cancer and was covered with normal anal epithelium. Collectively, the findings indicated anal metastasis from rectal cancer. The patient is alive without recurrence for 18 months after resection. Anal metastasis should be considered as a differential diagnosis in patients with anal discomfort who have a history of colon/rectal cancer. Abdominoperineal resection may be an effective treatment modality for this condition.
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Affiliation(s)
- Keishi Hakoda
- Dept. of Surgery, Hiroshima City Asa Citizens Hospital
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Miguchi M, Yoshimitsu M, Hakoda K, Omori I, Kohashi T, Hihara J, Ohdan H, Hirabayashi N. Short-term outcomes of laparoscopic surgery in octogenarians with colorectal cancer: a single-institution analysis. Surg Today 2017; 48:292-299. [PMID: 28948374 DOI: 10.1007/s00595-017-1584-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 08/06/2017] [Indexed: 01/16/2023]
Abstract
PURPOSE The number of elderly patients with colorectal cancer (CRC) treated with surgery has gradually increased. The aim of this study was to evaluate the short-term outcomes in patients ≥80 years of age who underwent laparoscopic or open surgery for CRC using a propensity score-matched analysis to make uniform the patient background characteristics affecting the postoperative morbidity and mortality. METHODS We compared the short-term outcomes of open vs. laparoscopic surgery in patients with CRC ≥80 years of age between 2010 and 2015. Fifty-two patients undergoing laparoscopic colectomy for CRC were matched to 52 patients undergoing open colectomy with respect to gender, age, body mass index, performance status, prognostic nutritional index, Charlson Comorbidity Index score, tumor-node-metastasis stage, and tumor location. The operative time, blood loss, length of hospital stay, and postoperative complications were investigated. RESULTS Blood loss was less during laparoscopic surgery than during open surgery (40 vs. 140 ml, p < 0.001). In the laparoscopic surgery group, the hospital stay was shorter (11 vs. 14 days, p < 0.001) and the morbidity rate lower (21.2 vs. 40.4%) than in the open surgery group. The mortality for both groups was similar (0 vs. 1.9% for laparoscopic surgery vs. open surgery). CONCLUSION Laparoscopic surgery in octogenarians with CRC is a safe, low-invasive alternative to open surgery with less blood loss and a shorter hospital stay.
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Affiliation(s)
- Masashi Miguchi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan.
| | - Keishi Hakoda
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Ichiro Omori
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Jun Hihara
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Hirabayashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, 731-0293, Japan
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Komo T, Hihara J, Kanou M, Kohashi T, Ohmori I, Yoshimitsu M, Ikeda T, Nakashima A, Miguchi M, Yamakita I, Mukaida H, Hirabayashi N, Kaneko M. Splenic hamartoma associated with thrombocytopenia: A case report. Int J Surg Case Rep 2017; 39:172-175. [PMID: 28846949 PMCID: PMC5573780 DOI: 10.1016/j.ijscr.2017.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/04/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023] Open
Abstract
Few cases of splenic hamartomas associated with thrombocytopenia have been reported. Imaging findings in splenic hamartomas are non-specific, variable, and making definitive preoperative diagnosis difficult. Surgery is necessary for diagnosis when malignancy cannot be ruled out. Surgery may also improve symptoms of hypersplenism, including thrombocytopenia.
Introduction Hamartomas are rare, benign tumors of the spleen. Few cases of splenic hamartomas associated with thrombocytopenia have been reported. Presentation of case An asymptomatic 64-year-old man with myelodysplastic syndrome was found to have a splenic tumor. Laboratory tests were significant for thrombocytopenia, with a platelet count of 7.8 × 104/μL. Ultrasonography showed splenomegaly (10.8 × 6.6 cm), and a hypoechoic splenic mass (8.0 × 7.0 cm). Color doppler ultrasound revealed blood flow within the mass, and the mass density was homogeneous on abdominal computed tomography (CT). Contrast-enhanced CT showed heterogeneous enhancement of the splenic mass during the arterial phase. Positron emission tomography (PET)-CT showed no significant fludeoxyglucose (FDG) accumulation within the mass. The differential diagnosis included splenic hamartoma, splenic hemangioma, splenomegaly associated with extramedullary hematopoiesis, and malignant tumor, including solitary splenic metastasis. A laparoscopic splenectomy was performed due to the possibility of malignancy, the presence of thrombocytopenia, and the risk of splenic rupture. The resected specimen showed a localized, well-demarcated, 8.0 × 7.0 cm splenic mass. Histological examination revealed abnormal red pulp proliferation and the absence of normal splenic structures. The patient’s post-operative course was uneventful. His platelet count improved on post-operative day 1 and he was discharged on post-operative day 9. He remained in good health with a normal platelet count one month after surgery. Discussion Making definitive preoperative diagnosis is difficult in splenic hamartomas. Surgery is necessary for diagnosis when malignancy cannot be ruled out. Conclusions Surgery may also improve symptoms of hypersplenism, including thrombocytopenia.
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Affiliation(s)
- Toshiaki Komo
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Jun Hihara
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan.
| | - Mikihiro Kanou
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Toshihiko Kohashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Ichiro Ohmori
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Masanori Yoshimitsu
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Takuhiro Ikeda
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Akira Nakashima
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Masashi Miguchi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute Biomedical & Health Sciences, Hiroshima University, Japan
| | - Ichiko Yamakita
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Hidenori Mukaida
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Naoki Hirabayashi
- Department of Gastroenterological Surgery, Hiroshima City Asa Citizens Hospital, Japan
| | - Mayumi Kaneko
- Department of Pathology, Hiroshima City Asa Citizens Hospital, Japan
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