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Avoiding stoma creation due to super-morbid obesity: A report of two surgical cases of colorectal cancer. Int J Surg Case Rep 2024; 114:109171. [PMID: 38113563 PMCID: PMC10772238 DOI: 10.1016/j.ijscr.2023.109171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION A stoma is commonly created in patients with a high risk of anastomotic leakage. However, patients with obesity have a higher incidence of stoma-related complications, and the decision to create a stoma should be carefully considered. We report two cases of patients with colorectal cancer and super-morbid obesity wherein stoma creation was avoided. PRESENTATION OF CASES Case 1 involved a 52-year-old male patient with a body mass index (BMI) of 41.8 kg/m2 who underwent a robotic-assisted laparoscopic low anterior resection after neoadjuvant chemotherapy for lower rectal cancer. Although temporary diverting ileostomy was initially considered, stoma creation was skipped intraoperatively, considering the complication risk-benefit ratio. Case 2 involved a 42-year-old female patient with a BMI of 64 kg/m2 who underwent open partial non-curative colon resection for descending colon cancer complicated by colonic perforation and abscess formation. The patient was considered to be at high risk of stoma-related complications due to high mobility of the subcutaneous fat of abdominal wall; therefore, we decided not to create a stoma preoperatively. DISCUSSION Considering the high risk of stoma-associated complications, avoiding stoma creation and implementing preventive measures against potential complications are alternative options for patients with super-morbid obesity. CONCLUSION We present our experience two cases in which stoma creation was avoided for super-morbid obese patients with BMI over 40.
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559 Induction of tissue-specific premature stem cell aging promotes senescence-like phenotypes in remote multiple organs. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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[Perineal Wound Complications after Abdominoperineal Resection for Anorectal Lesions]. Gan To Kagaku Ryoho 2022; 49:1926-1928. [PMID: 36733046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Perineal wound complications(PWCs)are common after abdominoperineal resection(APR). We examined the incidence of PWCs after APR for anorectal lesions and their risk factors. METHODS Patients who underwent APR for anorectal lesions at our hospital from January 2011 to December 2021 were included. Complications of Clavien-Dindo Grade Ⅱ or higher were considered as PWCs. RESULTS Eighty-one patients were included; PWCs were observed in 24 patients (29.6%), and associated with a history of Crohn's disease(p=0.018), longer operation time(p=0.040), higher blood loss (p=0.011), extensive perineal resection(p=0.003), and closure with a skin flap(p=0.003). Forty-one patients underwent APR for initial rectal cancer without extended perineal resection, and PWCs were observed in 9 patients(22.0%). Prognostic nutritional index(PNI)<45(p=0.049), smoking(p=0.034), and alcohol consumption(p=0.021)were associated with PWCs. CONCLUSION We examined the incidence of PWCs after APR for anorectal lesions and their risk factors. Appropriate intervention in nutrition, smoking, and alcohol consumption may prevent PWCs.
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Three-month prostate-specific antigen level after androgen deprivation therapy predicts survival in patients with metastatic castration-sensitive prostate cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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First-line nivolumab plus ipilimumab versus chemotherapy in patients with unresectable malignant pleural mesothelioma: 3-year outcomes from CheckMate 743. Ann Oncol 2022; 33:488-499. [DOI: 10.1016/j.annonc.2022.01.074] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/24/2022] [Indexed: 12/11/2022] Open
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[A Case of Improvement by SOX Therapy for DIC Caused by Gastric Cancer]. Gan To Kagaku Ryoho 2021; 48:1892-1894. [PMID: 35045438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Disseminated intravascular coagulation(DIC)has a poor prognosis in gastric cancer. The patient was a 78-year-old man. He had been diagnosed with Stage Ⅳ gastric cancer. Before chemotherapy, thrombocytopenia and elevated D-dimer occurred, and we diagnosed DIC. We started SOX therapy to treat gastric cancer with DIC. DIC improved on the 10th day after the onset of DIC. But developed DIC again on the 21st day. We started SOX therapy again. However, the DIC did not improve. The patient died 32 days after the initial DIC. Oxaliplatin regimen may be a potential treatment for DIC.
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Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study). ESMO Open 2021; 6:100325. [PMID: 34839104 PMCID: PMC8633880 DOI: 10.1016/j.esmoop.2021.100325] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/14/2023] Open
Abstract
Background Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients. Patients and methods We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4. Results Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001). Conclusions First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events. Anti-PD-1 plus anti-CTLA-4 antibody therapy (PD1 + CTLA4) is an option for patients with advanced mucosal melanoma (MCM). Data on the efficacy of PD1 + CTLA4 compared with PD-1 monotherapy (PD1) for MCM, however, are limited. We retrospectively analyzed data from 329 Japanese patients with advanced MCM treated with PD1 or PD1 + CTLA4. No significant differences in objective response rate, progression-free survival, or overall survival were observed. Immune-related adverse events resulting in treatment cessation were higher in the PD1 + CTLA4 group.
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LBA65 First-line nivolumab (NIVO) plus ipilimumab (IPI) vs chemotherapy (chemo) in patients (pts) with unresectable malignant pleural mesothelioma (MPM): 3-year update from CheckMate 743. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2146] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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OA03.07 Pembrolizumab for Advanced Mesothelioma: Results from the Phase 2 KEYNOTE-158 Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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LBA1 First-line nivolumab (NIVO) plus ipilimumab (IPI) versus chemotherapy (chemo) for the treatment of unresectable malignant pleural mesothelioma (MPM): Patient-reported outcomes (PROs) from CheckMate 743. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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ID:2908 First-Line Nivolumab + Ipilimumab vs Chemotherapy in Unresectable Malignant Pleural Mesothelioma: CheckMate 743. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2020.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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1895MO Three-year follow-up results of the MERIT trial: A Japanese phase II study of nivolumab in malignant pleural mesothelioma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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1898P A phase II trial of first-line combination chemotherapy with cisplatin, pemetrexed, and nivolumab for unresectable malignant pleural mesothelioma: JME-001. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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[Pulmonary Metastases of Hepatocellular Carcinoma Treated with Repeated Pulmonary Resection-A Case Report]. Gan To Kagaku Ryoho 2019; 46:2527-2529. [PMID: 32156987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 65-year-old man visited our hospital for hepatocellular carcinoma(HCC)and underwent extended posterior sectionectomy. Eight months after the hepatic resection, follow-up computed tomography(CT)revealed a solitary, recurrent tumor in S4 of the liver, and transcatheter arterial chemoembolization and radiofrequency ablation were performed for the intrahepatic recurrence. After 12 postoperative months, follow-up CT demonstrated pulmonary metastases in S5 of the right lung and S10 of the left lung. Since there were no other metastases, the 2 metastatic lesions were resected using video-assisted thoracoscopic surgery(VATS). The resected tumors were histologically diagnosed as pulmonary metastases of HCC. Three years after the pulmonary resection, 3 additional pulmonary metastases were detected on CT in S3 and S10 of the right lung and S4 of the left lung. No other metastases were found. Bilateral VATSmetastasectomy was performed for the metastases. The tumors were diagnosed as pulmonary metastases of HCC on histological examination. One year and 8 months after the surgery, he was alive in a good condition, with no recurrences. The present case suggested that some patients with pulmonary metastasis of HCC can have long-term survival with surgical resection of the metastasis. Therefore, while systemic chemotherapy is generally considered the standard treatment for extrahepatic metastasis of HCC, surgical resection might be an option.
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[A Case of Resected Primary Hepatic Neuroendocrine Tumor]. Gan To Kagaku Ryoho 2019; 46:2081-2083. [PMID: 32157066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 70s man presented with a solitary liver tumor measuring 4.5 cm on CT. On contrast-enhanced CT, the tumor appeared partly well-enhanced in the late phase, and the remaining part was enhanced in the early phase and washed out in the late phase. Contrast-enhanced MRIshowed fused multiple nodules, and the enhancement/washout pattern was clearer than that of the contrast-enhanced CT. The tumor showed a defective image in the hepatobiliary phase and a high signal on diffusionweighted imaging. Then, the tumor was diagnosed as hepatocellular carcinoma, and thus, left liver lobectomy was performed. On histological examination of the resected specimen, the tumor was found to be composed of uniform and small tumor cells with solid or trabecular growth fashion. On immunohistochemical staining, synaptophysin and chromogranin A positivity was noted, and the Ki-67 index was 14%. Finally, the tumor was diagnosed as a NET G2. Postoperatively, somatostatin receptor scintigraphy was performed to identify the primary site; however, no obvious primary site could not be identified, and thus a diagnosis of primary hepatic NET was made. Eighteen months postoperatively, the patient is alive without relapse. Preoperative diagnosis of primary hepatic NETs is difficult because NETs present various imaging findings and are rare. Moreover, no accurate preoperative diagnosis was reached in our case, suggesting the difficulty in the preoperative diagnosis of NETs.
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Phase II trial of carboplatin, nab-paclitaxel and bevacizumab for advanced non-squamous non-small cell lung cancer (CARNAVAL study; TORG1424/OLCSG1402). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sézary syndrome involving the intestinal tract. Clin Exp Dermatol 2019; 45:466-469. [PMID: 31646657 DOI: 10.1111/ced.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
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P5007Acute natriuretic activity of sodium-glucose cotransporter 2 inhibitor in heart failure patients with type 2 diabetes mellitus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sodium-glucose cotransporter 2 (SGLT2) inhibitor promotes diuresis and reduces the risk of hospitalization for heart failure (HF). However, the mechanisms of diuretic effects of SGLT2 inhibitor in HF patients with type 2 diabetes mellitus (T2DM) remain under investigation.
Purpose
The purpose of this study was to investigate the mechanisms of acute diuretic effects of SGLT2 inhibitor and to identify its predictor in HF patients with T2DM.
Methods
We prospectively enrolled 40 hospitalized HF patients with T2DM (68±13 years, 63% male, and hemoglobin A1c 7.1±0.9%) between July 2014 and June 2018. All patients received ipragliflozin at a dose of 50 mg once daily after breakfast. They underwent 24-hour urine test and first-morning blood and urine tests before and after ipragliflozin therapy.
Results
Urine volume significantly increased from 1,365±511 ml/day on day 0 to 1,698±595 ml/day on day 3 (p<0.001). Multivariate linear regression analyses showed that the increase of 24-hour urine sodium but not urine sugarwas significantlyand independently associated with the increase of 24-hour urine volume (β-Coefficient=0.80; P<0.001). Univariate and multivariate logistic regression analyses showed that higher dosage of furosemide-equivalent loop diuretics and lower level of first-morning urine sodium concentration (per 1 mEq/L) at baseline were significantly associated with the diuretic effect of ipragliflozin therapy, and the latter independently predicted increase of 24-hour urine volume (Table).
Predictors for increase of urine volume Univariate Multivariate Odds ratio (95% CI) P value Odds ratio (95% CI) P value Dosage of furosemide, mg 1.09 (1.01–1.18) 0.04 – – HbA1c, % 1.45 (0.56–3.78) 0.44 Fasting blood glucose, mg/dL 1.02 (0.99–1.04) 0.24 eGFR, mL/min/1.73m2 1.01 (0.97–1.05) 0.65 Plasma BNP, pg/mL 1.00 (0.99–1.01) 0.12 Left ventricular ejection fraction, % 0.98 (0.94–1.02) 0.24 First-morning urine sugar, mg/dL 1.20 (0.96–1.50) 0.12 First-morning urine sodium, mEq/L 0.96 (0.93–0.99) 0.02 0.96 (0.93–0.99) 0.02 24-hour urine sugar, g/day 3.49 (0.13–93.40) 0.46 24-hour urine sodium, mEq/day 0.98 (0.96–1.01) 0.20 eGFR, estimated glomerular filtration rate; BNP, brain natriuretic peptide.
Conclusion
SGLT2 inhibitor has acute natriuretic activity and may restore loop-diuretic resistance in HF patients with T2DM.
Acknowledgement/Funding
None
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P4432Coronary microvascular dysfunction in inflammatory bowel disease: Restored after enterectomy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inflammatory bowel disease (IBD) is a complex multisystem disease characterized by chronic inflammation, which can lead to coronary microvascular dysfunction (CMD).
Purpose
We aimed to investigate the presence and the severity of CMD in Crohn's disease (CD) and ulcerative colitis (UC) by assessing coronary flow reserve (CFR) using transthoracic Doppler echocardiography, and to elucidate the influence of enterectomy on CMD.
Methods
Thirty-seven IBD patients (22 CD patients: 39±12 years, 15 UC patients: 52±17 years), and 30 age- and gender-matched control subjects (46±12 years) who have comparable risk factors for coronary artery disease were enrolled. Smokers were excepted from the present study. For CFR measurement, coronary flow velocity was recorded at rest and during hyperemia in the left anterior descending coronary artery induced by intravenous infusion of adenosine triphosphate (0.14 mg/kg/min), and a CFR ≤2.5 calculated as the ratio of hyperemic to basal peak and mean diastolic velocity defined CMD. CFR measurement was repeated before and within 1 year after enterectomy. Serum or plasma cytokines were also measured before and after enterectomy.
Results
The median disease duration of CD and UC patients were 12 and 6 years. Although none of control subjects had CMD, 38% in IBD patients (CD: 41%, UC: 33%) had CMD. CFR was similarly and significantly lower in CD and UC patients than Control subjects (CD: 2.92±1.03*, UC: 2.99±0.65*, and Control: 3.84±0.75, *p<0.05 vs. Control). Serum levels of TNF-α, IL-6 and hs-CRP were significantly higher in CD and UC patients than Control subjects. Multiple linear regression analysis showed that the presence of IBD and mean diastolic flow velocity at baseline were independently associated with reduced CFR among all study participants (β=−0.324 and −0.614, p=0.001, respectively). CFR in IBD patients with both CMD and non-CMD significantly improved after enterectomy, and the extent of CFR improvement was greater in patients with CMD than those with non-CMD (Figure). Serum levels of IL-6 and hs-CRP significantly reduced among all IBD patients.
Conclusion
IBD was associated with CMD, which improved after enterectomy.
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Updated analysis of a phase I trial of afatinib (Afa) and bevacizumab (Bev) in chemo-naïve patients (pts) with advanced non-small cell lung cancer (NSCLC) harboring EGFR-mutations: OLCSG1404. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Antihypertensive and Renoprotective Effects of Dietary Flaxseed and its Mechanism of Action in Deoxycorticosterone Acetate-Salt Hypertensive Rats. Pharmacology 2019; 105:54-62. [PMID: 31514180 DOI: 10.1159/000502789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Flaxseed contains alpha-linolenic acid (ALA), lignans, and dietary fiber, and its intake lowers blood pressure in hypertensive patients. Here, we examined the effects of flaxseed powder, which includes all flaxseed components, flaxseed oil, composed mainly of ALA, flaxseed lignan, and flaxseed fiber, on hypertension and renal damage induced by deoxycorticosterone acetate (DOCA)-salt. Then, we investigated the mechanisms of action associated with the effects of flaxseed. METHODS Flaxseed powder, oil, lignan, or fiber was administered to DOCA-salt rats. Systolic blood pressure (SBP), urinary protein excretion, renal angiotensin converting enzyme (ACE) activity, sympathetic nerve activity, and gene expression of inflammatory mediators in the kidney and hypothalamus were measured. RESULTS Flaxseed powder and oil reduced the increases in SBP and urinary protein excretion induced by DOCA-salt treatment, whereas lignan and fiber had no effects. Flaxseed oil suppressed the increase in renal ACE activity, sympathetic nerve activity, and gene expression of renal and hypothalamic inflammatory mediators. CONCLUSION Flaxseed has antihypertensive and renoprotective effects in DOCA-salt rats. These effects are likely principally exerted by ALA. Furthermore, the suppression of renal ACE activity, sympathetic nerve activity, and inflammation is partly involved in the effects of flaxseed.
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OA08.01 Long-Term Efficacy and Safety of Nivolumab in Second- or Third-Line Japanese Malignant Pleural Mesothelioma Patients (Phase II: MERIT Study). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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P1.01-40 Randomized Phase II Study of Docetaxel Plus Bevacizumab or Pemetrexed Plus Bevacizumab for Elderly pts with Untreated Advanced NSCLC: TORG1323. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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5971Predictors of the results of the confirmatory tests for the diagnosis of primary hyperaldosteronism in hypertensive patients with an aldosterone-to-renin ratio greater than 20. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P3196Anorexia coexisted in frailty predicts 1-year prognosis in patients with heart failure: a multicenter prospective cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P3660Clinical usefulness of instantaneous wave-free ratio for evaluation of coronary artery lesion with prior myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P5653Extracellular volume fraction measured by cardiac magnetic resonance imaging can help to evaluate left ventricular stiffness noninvasively by representing histological collagen volume fraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Early diagnosis of kidney transplant rejection and cyclosporin nephrotoxicity by urine cytology. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gene polymorphisms in antioxidant enzymes correlate with the efficacy of androgen-deprivation therapy for prostate cancer with implications of oxidative stress. Ann Oncol 2017; 28:569-575. [PMID: 27993795 DOI: 10.1093/annonc/mdw646] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background Oxidative stress mitigated by antioxidant enzymes is thought to be involved in the progression to castration-resistant prostate cancer (CRPC) during androgen-deprivation therapy (ADT). This study investigated the association between genetic variations in antioxidant enzymes and the efficacy of ADT as well as its biological background. Patients and methods The non-synonymous or promoter-locating polymorphisms of antioxidant enzymes were examined as well as the time to CRPC progression and overall survival in 104 and 92 patients treated with ADT for metastatic and non-metastatic prostate cancer, respectively. In addition, intracellular reactive oxygen species and expression levels of antioxidant enzymes were examined in castration-resistant and enzalutamide-resistant cells. Results In metastatic prostate cancer, the AG/GG allele in GSTM3 rs7483 and CT/TT allele in CAT rs564250 were associated with a significantly lower risk of progression to CRPC and all-cause death compared with homozygotes of the major AA allele (hazard ratio [HR]; [95% confidence interval (CI)], 0.55 [0.34-0.86], P = 0.0086) and CC allele (HR; [95% CI], 0.48 [0.24-0.88], P = 0.016), respectively. On multivariate analyses, only GSTM3 rs7483 was associated with significant progression risk (AG/GG versus AA; HR; [95% CI], 0.45 [0.25-0.79], P = 0.0047) even after Bonferroni adjustment. In non-metastatic prostate cancer, the AG/GG allele in GSTM3 rs7483 was associated with a significantly lower risk of progression to CRPC (HR; [95% CI], 0.35 [0.10-0.93], P = 0.034) and all-cause death (HR; [95% CI], 0.26 [0.041-0.96], P = 0.043) compared with the AA allele. Intracellular reactive oxygen species levels were increased, accompanied with augmented GSTM3 expression in both castration-resistant and enzalutamide-resistant cells. Conclusions Differential activity of antioxidant enzymes caused by the polymorphism in GSTM3 may contribute to resistance to hormonal therapy through oxidative stress. The GSTM3 rs7483 polymorphism may be a promising biomarker for prostate cancer patients treated with ADT.
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A phase II trial of carboplatin plus S-1 for elderly patients with advanced non-small cell lung cancer with wild-type EGFR: The Okayama Lung Cancer Study Group Trial 1202 (OLCSG1202). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MA 19.01 A Phase II Study of Nivolumab: A Multicenter, Open-Label, Single Arm Study in Malignant Pleural Mesothelioma (MERIT). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.634] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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A phase I trial of afatinib (Afa) and bevacizumab (Bev) in chemo-naïve patients (pts) with advanced non-small-cell lung cancer (NSCLC) harboring EGFR-mutations: OLCSG1404. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx671.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Monitoring of hemostatic abnormalities in major orthopedic surgery patients treated with edoxaban by APTT waveform. Int J Lab Hematol 2017; 40:49-55. [PMID: 28869359 DOI: 10.1111/ijlh.12727] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/11/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out. METHODS The APTT waveform was analyzed in the above patients to monitor edoxaban administration. RESULTS Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications. The peak times of acceleration, velocity, and 1/2 fibrin formation were significantly prolonged after the administration of edoxaban, especially in patients with massive bleeding, and were moderately correlated with the anti-Xa activity. While the heights of velocity and acceleration peak 2 were lower in patients receiving warfarin treatment than in those receiving edoxaban, the widths of these parameters were significantly longer. The height of 1/2 fibrin formation and the width of acceleration peaks 1 and 2 and the velocity were significantly increased after the administration of edoxaban. CONCLUSION The peak time of the APTT waveform was significantly prolonged after the administration of edoxaban. The analysis of the APTT waveform may therefore be useful for the prediction of the risk of massive bleeding.
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EFFECTS OF EXPOSURE TO RADIOACTIVE 56MnO2 POWDER ON HYALURONAN SYNTHASE 2 IN THE LUNGS OF RATS. GEORGIAN MEDICAL NEWS 2017:120-124. [PMID: 28972496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Manganese-56 (56Mn) is among the predominant radioisotopes produced in soil by neutrons from atomic bombs. Previously, we examined the effects of the internal exposure of this radioisotope in Wistar rats and reported significant pathological changes in the lung and small intestine. In the present study, we focused on its effects on hyaluronan synthase 2 (Has2) gene expression that may related to pathological changes in the lung. Ten-week-old male Wistar rats were exposed to neutron-activated 56MnO2 powder, non-radioactive MnO2 powder or external 60Co γ-rays (2 Gy, whole body). Animals were examined on days 3, 14, and 60 post-exposure. Absorbed doses in the lung of rats exposed to 56Mn were 55-110 mGy. Quantitative reverse transcription polymerase chain reaction analysis revealed that 56Mn exposure significantly reduced the expression of Has2 gene in the lung, while γ-rays did not change it. Our findings suggest that internal exposure to 56Mn, even at low doses, has a significant biological impact on the lung compared with external radiation.
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A large prospective cohort study of the clinical features of advanced lung cancer harboring HER2 aberrations (HER2-CS STUDY). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Phase I/II trial of weekly nab-paclitaxel as 2nd or 3rd line treatment in NSCLC without driver mutations. (OLCSG1303). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Evaluation of quality of life in survivors with malignant pleural mesothelioma in Japan. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx389.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P3324Clinical significance of higher extracellular volume in patients with apical and non- apical hypertrophic cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Decreased level of interleukin-10-producing B cells in patients with pemphigus but not in patients with pemphigoid. Br J Dermatol 2017; 176:1204-1212. [PMID: 27716906 DOI: 10.1111/bjd.15113] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND While the frequency of interleukin (IL)-10-producing B (B10) cells is reported to have an inverse correlation with disease activity in some human autoimmune diseases, the association between B10 cells and autoimmune blistering diseases (AIBD) has not been well evaluated. Although several phenotypes of human regulatory B cells have been proposed, the most appropriate one in AIBD has not been established. OBJECTIVE To evaluate B10 cells in AIBD including their phenotypes. METHODS Peripheral blood mononuclear cells were isolated from 39 patients with AIBD, including 14 with pemphigus and 25 with pemphigoid, and 10 healthy controls. We investigated the frequencies of B10 cells and CD19+ CD24hi CD38hi B cells using flow cytometry. RESULTS The frequencies of B10 cells and CD19+ CD24hi CD38hi B cells were significantly lower and higher, respectively, in patients with pemphigus compared with healthy controls. Comparing patients with pemphigoid and healthy controls, no significant difference in the frequencies of B10 cells and CD19+ CD24hi CD38hi B cells was observed. B10-cell level in pemphigus was not associated with disease severity but inversely correlated with the required dose of steroid for treatment. While no significant difference in the frequency of IL-10-producing cells among CD19+ CD24hi CD38hi B cells was observed, in CD9+ and CD27- B-cell subsets it was significantly decreased in patients with pemphigus compared with healthy controls. CONCLUSIONS Our results suggest the association of B10 cells with pemphigus but not with pemphigoid. The decrease in B10-cell level in pemphigus is partly caused by the lower production of IL-10 in CD9+ and CD27- B-cell subsets.
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Culture substrates made of elastomeric micro-tripod arrays for long-term expansion of human pluripotent stem cells. J Mater Chem B 2017; 5:236-244. [DOI: 10.1039/c6tb02246d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Elastomeric micro-tripod arrays were used as novel substrates for culturing and long-term expansion of human pluripotent stem cells.
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Erythrocyte deformability as measured with a newly developed nickel mesh. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1987-7608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Shock, acute disseminated intravascular coagulation, and microvascular thrombosis: is 'shock liver' the unrecognized provocateur of ischemic limb necrosis: comment. J Thromb Haemost 2016; 14:2315-2316. [PMID: 27541323 DOI: 10.1111/jth.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Indexed: 11/29/2022]
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[Resection of Hepatocellular Carcinoma with Synchronous Bilateral Adrenal Metastases]. Gan To Kagaku Ryoho 2016; 43:1770-1772. [PMID: 28133126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 59-year-old man was admitted to our hospital with liver dysfunction. Examinations revealed a huge liver tumor in the right hepatic lobe and a mass in each adrenal gland. The preoperative diagnosis was hepatocellular carcinoma(HCC)with synchronous bilateral adrenal metastases. The patient underwent right hepatic lobectomy, cholecystectomy, and bilateral adrenalectomy. Histopathological examination of the specimens confirmed the diagnosis of HCC with synchronous bilateral adrenal metastases. After surgery, he received steroid replacement therapy and had a favorable clinical course without complications. Six months after surgery, the patient has experienced no recurrence and is being followed up on an outpatient basis. Although further postoperative follow-up is necessary, the findings of this case suggested a positive oncological impact of surgical resection for HCC and synchronous bilateral adrenal metastases.
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Deposition of elafin in the involved vascular wall of neutrophil-mediated cutaneous vasculitis. J Eur Acad Dermatol Venereol 2016; 30:1544-9. [PMID: 27060697 DOI: 10.1111/jdv.13650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neutrophil elastase plays an important role in skin inflammation induced by neutrophil infiltration. Elafin is an inducible elastase inhibitor expressed by keratinocytes, and is known to be involved in pathogenesis of neutrophilic skin disorders such as psoriasis. METHODS Immunohistochemical studies of elafin expression in the cases of vasculitis were performed. Induction of elafin expression in cultured vascular cells and its effect on neutrophil migration were studied in vitro. RESULTS A positive immunoreactivity was detected in polyarteritis nodosa, giant cell arteritis and Schönlein-Henoch purpura, but no immunoreactivity was found in Churg-Strauss syndrome. Elafin expression in cultured venous endothelial cells and arterial smooth muscle cells was undetectable, but induced by interleukin-1β (IL-1β) and IL-8. Elafin inhibited the elastin peptide-induced neutrophil chemotaxis at the concentration of 10(-8) -10(-5) mol/L. CONCLUSION Elafin deposition induced by cytokines (IL-1β or IL-8) will be an important regulator for the progress of leucocytoclastic vasculitis by functioning as an inhibitor for neutrophil chemotaxis as well as for vascular elastin degradation.
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Cutaneous macroglobulinosis: successful treatment with rituximab. J Eur Acad Dermatol Venereol 2016; 31:e30-e31. [DOI: 10.1111/jdv.13613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cardiovascular response to exercise training in the systemic right ventricle of adults with transposition of the great arteries. J Physiol 2016; 593:2447-58. [PMID: 25809342 DOI: 10.1113/jp270280] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/09/2015] [Indexed: 12/25/2022] Open
Abstract
KEY POINTS Patients with transposition of the great arteries (TGA) and systemic right ventricles have premature congestive heart failure; there is also a growing concern that athletes who perform extraordinary endurance exercise may injure the right ventricle. Therefore we felt it essential to determine whether exercise training might injure a systemic right ventricle which is loaded with every heartbeat. Previous studies have shown that short term exercise training is feasible in TGA patients, but its effect on ventricular function is unclear. We demonstrate that systemic right ventricular function is preserved (and may be improved) in TGA patients with exercise training programmes that are typical of recreational and sports participation, with no evidence of injury on biomarker assessment. Stroke volume reserve during exercise correlates with exercise training response in our TGA patients, identifying this as a marker of a systemic right ventricle (SRV) that may most tolerate (and possibly even be improved by) exercise training. ABSTRACT We aimed to assess the haemodynamic effects of exercise training in transposition of the great arteries (TGA) patients with systemic right ventricles (SRVs). TGA patients have limited exercise tolerance and early mortality due to systemic (right) ventricular failure. Whether exercise training enhances or injures the SRV is unclear. Fourteen asymptomatic patients (34 ± 10 years) with TGA and SRV were enrolled in a 12 week exercise training programme (moderate and high-intensity workouts). Controls were matched on age, gender, BMI and physical activity. Exercise testing pre- and post- training included: (a) submaximal and peak; (b) prolonged (60 min) submaximal endurance and (c) high-intensity intervals. Oxygen uptake (V̇O2; Douglas bag technique), cardiac output (Q̇c, foreign-gas rebreathing), ventricular function (echocardiography and cardiac MRI) and serum biomarkers were assessed. TGA patients had lower peak V̇O2, Q̇c, and stroke volume (SV), a blunted Q̇c/V̇O2 slope, and diminished SV response to exercise (SV increase from rest: TGA = 15.2%, controls = 68.9%, P < 0.001) compared with controls. After training, TGA patients increased peak V̇O2 by 6 ± 8.5%, similar to controls (interaction P = 0.24). The magnitude of SV reserve on initial testing correlated with Q̇c training response (r = 0.58, P = 0.047), though overall, no change in peak Q̇c was observed. High-sensitivity troponin T (hs-TnT) and N-terminal prohormone of brain naturetic peptide (NT pro-BNP) were low and did not change with acute exercise or after training. Our data show that TGA patients with SRVs in this study safely participated in exercise training and improved peak V̇O2. Neither prolonged submaximal exercise, nor high-intensity intervals, nor short-term exercise training seem to injure the systemic right ventricle.
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Familial Mediterranean fever with onset in the 70s showing various neutrophilic dermatosis. J Eur Acad Dermatol Venereol 2015; 30:e129-e131. [PMID: 26448397 DOI: 10.1111/jdv.13407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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P05.12 Analysis of bacterial flora of the urine specimens from male patients with urethritis by the clone library method based on the 16s rrna gene. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Improvement of depth dose distribution using multiple-field irradiation in boron neutron capture therapy. Appl Radiat Isot 2015; 106:134-8. [PMID: 26282566 DOI: 10.1016/j.apradiso.2015.07.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/10/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022]
Abstract
It is important that improvements are made to depth dose distribution in boron neutron capture therapy, because the neutrons do not reach the innermost regions of the human body. Here, we evaluated the dose distribution obtained using multiple-field irradiation in simulation. From a dose volume histogram analysis, it was found that the mean and minimum tumor doses were increased using two-field irradiation, because of improved dose distribution for deeper-sited tumors.
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A one-step sandwich enzyme immunoassay for tissue inhibitor of metalloproteinases-2. CONTRIBUTIONS TO NEPHROLOGY 2015; 107:116-23. [PMID: 8004957 DOI: 10.1159/000422969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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