1
|
Abe S, Sakata J, Hirose Y, Nomura T, Takano K, Kitami C, Yokoyama N, Aono T, Minagawa M, Tsukahara A, Ohashi T, Takizawa K, Miura K, Ichikawa H, Shimada Y, Kobayashi T, Wakai T. Extent of regional lymphadenectomy and number-based nodal classification for non-ampullary duodenal adenocarcinoma. Eur J Surg Oncol 2023; 49:107122. [PMID: 37897834 DOI: 10.1016/j.ejso.2023.107122] [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: 06/03/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND This study aimed to evaluate the adequate extent of regional lymphadenectomy according to tumor location and the impact of number-based nodal classification on survival in patients with non-ampullary duodenal adenocarcinoma (NADAC). METHODS A total of 85 patients with NADAC who underwent surgery were enrolled. The frequency of metastasis was calculated for each node group in the respective tumor locations for 63 patients who underwent lymphadenectomy for pT2-pT4 tumor. RESULTS The frequency of metastasis in the pancreaticoduodenal (nos. 13 and 17) and superior mesenteric artery (no. 14) nodes was high (16.7 %-52.3 %) regardless of tumor location. Metastasis in the perigastric (nos. 3 and 4d) and right celiac artery (no. 9) nodes was not uncommon (14.3 %-22.2 %) for tumors in the first portion. The frequency of metastasis in the pyloric (nos. 5 and 6) and the other peripancreaticoduodenal (nos. 8 and 12) nodes varied depending on tumor location but could not be ignored for staging. When these nodes were classified as regional nodes, the 5-year survival in patients with pN0, pN1 (1-2 positive nodes), and pN2 (≥3 positive nodes) were 82.9 %, 51.7 %, and 19.2 %, respectively (p < 0.001). pN classification independently predicted survival (pN1, p = 0.022; pN2, p < 0.001). CONCLUSIONS Nos. 5, 6, 8, 12, 13, 14, and 17 nodes in all advanced NADAC and nos. 3, 4d, and 9 nodes in advanced NADAC in the first portion should be considered as regional nodes for accurate staging. The number-based nodal classification allows good patients' prognostic stratification.
Collapse
Affiliation(s)
- Shun Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tatsuya Nomura
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Kabuto Takano
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
| | | | - Akihiro Tsukahara
- Department of Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Taku Ohashi
- Department of Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| |
Collapse
|
2
|
Watanabe Y, Osaki A, Yamazaki S, Yokoyama H, Takaku K, Sato M, Sato D, Yokoyama N, Waguri N, Terai S. Two Cases of Gastric Varices with Left-sided Portal Hypertension Due to Essential Thrombocythemia Treated with Gastric Devascularization or Partial Splenic Embolization. Intern Med 2023; 62:2839-2846. [PMID: 36823082 PMCID: PMC10602822 DOI: 10.2169/internalmedicine.1273-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/10/2023] [Indexed: 02/25/2023] Open
Abstract
Left-sided portal hypertension (LSPH) is a condition of extrahepatic portal hypertension that often results in bleeding from isolated gastric varices (GVs). LSPH is sometimes caused by myeloproliferative diseases, such as essential thrombocythemia (ET). We herein report two cases of GVs with LSPH due to ET that were successfully controlled by gastric devascularization (GDS) or partial splenic embolization (PSE). Since each patient with LSPH due to ET has a different pathology, optimal treatment should be performed depending on the patient's condition, such as platelet counts, hemodynamics, or the prognosis. We believe that these cases will serve as a reference for future cases.
Collapse
Affiliation(s)
- Yusuke Watanabe
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
- Division of Preemptive Medicine for Digestive Disease and Healthy Active Life, School of Medicine, Niigata University, Japan
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan
| | - Akihiko Osaki
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Shun Yamazaki
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Hanako Yokoyama
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Kenichi Takaku
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Munehiro Sato
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Daisuke Sato
- Department of Surgery, Niigata City General Hospital, Japan
| | | | - Nobuo Waguri
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan
| |
Collapse
|
3
|
Inoue K, Chieh JTW, Yeh LC, Chiang SJ, Phrommintikul A, Suwanasom P, Kasim S, Ahmad B, Idrose AM, Salleh FM, Oyamada S, Hirano Y, Ouchi S, Terakura M, Yokoyama N, Kozuma K, Nanasato M, Higuchi R, Yumoto K, Fukuzawa T, Shimada I, Giannitsis E, Twerenbold R, Minamino T. Correction: An international, stepped wedge, cluster-randomized trial investigating the 0/1-h algorithm in suspected acute coronary syndrome in Asia: the rational of the DROP-Asian ACS study. Trials 2023; 24:335. [PMID: 37198646 DOI: 10.1186/s13063-023-07342-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Affiliation(s)
- Kenji Inoue
- Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, Tokyo, Japan.
| | - Jack Tan Wei Chieh
- Department of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore
| | - Lim Chiw Yeh
- Department of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore
| | - Shuo-Ju Chiang
- Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan
| | - Arintaya Phrommintikul
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | - Pannipa Suwanasom
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | - Sazzli Kasim
- Division of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia
| | - Bakhtiar Ahmad
- Division of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia
| | | | | | | | - Yohei Hirano
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Shohei Ouchi
- Department of Cardiovascular Biology and Medicine, Juntendo Urayasu Hospital, Chiba, Japan
| | - Moriyuki Terakura
- Department of Emergency, Teikyo University School of Medicine, Tokyo, Japan
| | - Naoyuki Yokoyama
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Ken Kozuma
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Mamoru Nanasato
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Ryosuke Higuchi
- Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Kazuhiko Yumoto
- Department of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan
| | | | | | | | - Raphael Twerenbold
- Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Hioki H, Watanabe Y, Kawashima H, Otsuka T, Omiya J, Kito K, Katayama T, Kataoka A, Yokoyama N, Kozuma K. Predictors of bioprosthetic valve dysfunction after transcatheter aortic valve implantation. AsiaIntervention 2023; 9:87-94. [PMID: 36936107 PMCID: PMC10018288 DOI: 10.4244/aij-d-22-00067] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/18/2022] [Indexed: 03/16/2023]
Abstract
Background Recently, the Valve Academic Research Consortium (VARC)-3 criteria redefined bioprosthetic valve dysfunction (BVD) after transcatheter aortic valve implantation (TAVI). However, the rate of BVD is scarcely reported in current practice. Aims We aimed to evaluate the rate and predictors of BVD after TAVI based on the VARC-3 criteria. Methods We retrospectively analysed patients who had undergone TAVI using single-centre data. BVD was reported as exposure-adjusted event rates with a patient-year unit (per 100 patient-years). Predictors of BVD after TAVI were analysed using Fine-Gray competing risk regression to account for the competing risk of death. Results Among 514 patients, the rate of BVD was 7.5 events per 100 patient-years (n=74) at a median follow-up of 1.9 years. The main cause of BVD was moderate or severe prosthesis-patient mismatch (PPM; n=59). The Fine-Gray model demonstrated that predilatation was associated with a lower rate of BVD, mainly moderate or severe PPM (adjusted subdistribution hazard ratio [sub-HR] 0.42, 95% confidence interval [CI]: 0.21-0.88). In a subgroup analysis, the patients with a small aortic annulus (area <400 mm2 or perimeter <72 mm) tended to benefit from predilatation (p for interaction=0.03). The same regression model also demonstrated that a small balloon-expandable valve (BEV; ≤23 mm) was associated with a higher rate of BVD (adjusted sub-HR 2.46, 95% CI: 1.38-4.38). Conclusions Our study suggested that the rate of BVD in patients undergoing TAVI is relatively low at midterm follow-up. Predilatation, particularly in small annuli and small BEV might have an impact on BVD, mainly caused by moderate or severe PPM, after TAVI.
Collapse
Affiliation(s)
- Hirofumi Hioki
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Yusuke Watanabe
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | | | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan and Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan
| | - Jo Omiya
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Kento Kito
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Taiga Katayama
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Akihisa Kataoka
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Naoyuki Yokoyama
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Ken Kozuma
- Division of Cardiology, Teikyo University Hospital, Tokyo, Japan
| |
Collapse
|
5
|
Furuse J, Ikeda M, Ueno M, Furukawa M, Morizane C, Takehara T, Nishina T, Todaka A, Okano N, Hara K, Nakai Y, Ohkawa K, Sasaki T, Sugimori K, Yokoyama N, Yamamoto K. Nanvuranlat, an L-type amino acid transporter (LAT1) inhibitor for patients with pretreated advanced refractory biliary tract cancer (BTC): Primary endpoint results of a randomized, double-blind, placebo-controlled phase 2 study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.494] [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: 02/05/2023] Open
Abstract
494 Background: LAT1 is a transporter ( SLC7A5) of L-type amino acid. Overexpression in cancer cells supports aggressive proliferation. High expression of LAT1 in tumor specimens has been identified as a predictor of poor prognosis in patients with various cancer types, including BTC. The efficacy and safety of nanvuranlat (JPH203), a first-in-class, single agent that selectively inhibits LAT1, was evaluated in patients with pretreated, advanced, refractory BTC in a placebo-controlled randomized trial. Methods: Patients with four different subtypes of advanced BTC were enrolled: intrahepatic (IHC), extrahepatic (EHC), gallbladder (GBC) and ampulla of Vater (AVC). All were refractory to or intolerant of standard chemotherapy and other investigational medicines. Patients were pre-classified as non-rapid acetylators via N-acetyltransferase 2 ( NAT2), to maximize efficacy/safety by minimizing the metabolism of nanvuranlat. The primary endpoint was progression-free survival (PFS), assessed by blinded independent center review (BICR), using RECIST 1.1. Results: At data cut-off (February 28, 2022), 211 BTC patients were consented at 14 centers in Japan. Using NAT2 testing for classification, a total of 106 patients were randomized (2:1) to nanvuranlat (n = 70) or placebo (n = 36). Nanvuranlat met its primary endpoint and demonstrated a statistically significant improvement in PFS by BICR in comparison with the placebo group (Hazard Ratio = 0.557; 95% CI, 0.3435 – 0.9029; one-sided p = 0.0164). The disease control rate (DCR) in the nanvuranlat group was approximately 25% (average = 24.6%) across all BTC subtypes, while it was 11.4% in the placebo group. Grade 3 adverse events were reported in 30.0% for nanvuranlat vs 22.9% for placebo. Treatment-related adverse event rates were respectively 41.4% and 57.1% in the nanvuranlat and placebo groups. No patient had adverse events leading to nanvuranlat treatment discontinuation, dose reduction, or death. Conclusions: The study met the primary endpoint. LAT1 inhibitor monotherapy with nanvuranlat demonstrated useful clinical efficacy in patients with four different subtypes of pre-treated, advanced, refractory BTC. Safe and highly tolerated profile was also documented. Clinical trial information: UMIN000034080 .
Collapse
Affiliation(s)
- Junji Furuse
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | | | | | - Tetsuo Takehara
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomohiro Nishina
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akiko Todaka
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Kazuo Hara
- Aichi Cancer Center, Aichi Hospital, Nagoya, Japan
| | - Yousuke Nakai
- Department of Urology, Faculty of Medicine, The University of Tokyo, Bunkyo-Ku, Japan
| | | | - Takashi Sasaki
- The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto-Ku, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | | | - Kouji Yamamoto
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| |
Collapse
|
6
|
Komatsu M, Yokoyama N, Katada T, Sato D, Otani T, Harada R, Utsumi S, Hirai M, Kubota A, Uehara H. Learning curve for the surgical time of laparoscopic cholecystectomy performed by surgical trainees using the three-port method: how many cases are needed for stabilization? Surg Endosc 2023; 37:1252-1261. [PMID: 36171452 DOI: 10.1007/s00464-022-09666-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/17/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND The assessment of laparoscopic cholecystectomy (LC) skills using operating times has not been well reported. We examined the total and partial operating times for LC procedures performed by surgical trainees to determine the required number of surgeries until the surgical time stabilizes. METHODS We reviewed the video records of 514 consecutive LCs using the three-port method, performed by 16 surgical trainees. The total and partial surgical times were calculated and correlated to the surgeons' experience. RESULTS The median total surgical time for a trainee's first LC was 112 (range 71-226) minutes. It reduced rapidly after the first 20 LCs and plateaued to its minimum after approximately 60 cases. A statistically significant time decrease was observed between the first 10 (median, range 112, 46-252 min) and the next 50-59 cases (64, 34-198 min), but not between the 50-59 and the subsequent 100-109 cases (71, 33-127 min). The total times taken by trainees who had performed > 50 operations were not significantly different from those taken by instructors during the study period. Surgery for 125 patients with acute cholecystitis took a significantly longer time (median 99 vs. 74 min with non-acute cholecystitis); however, the abovementioned time reduction findings showed similar results regardless of the patient's acute inflammation status. The partial operating times around the cervical/cystic duct and gallbladder bed reduced uniformly between the first 10 and the following 50-59 cases. Although time variations in total and cervical/cystic duct operating times were not correlated to the surgical experience, time fluctuation of gallbladder bed procedures reduced after 60 cases. CONCLUSION The time required to perform an LC was inversely correlated with the experience of surgical trainees and halved after the first 60 cases. The surgical experience required for LC time stabilization is approximately 60 cases.
Collapse
Affiliation(s)
- Masaru Komatsu
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan.
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tomohiro Katada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Rina Harada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shiori Utsumi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Motoharu Hirai
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hiroaki Uehara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
7
|
Yokoyama N, Sato D, Katada T, Otani T, Furukawa K, Hashidate H. Gastrointestinal: Melanotic schwannoma of the pancreas associated with Carney complex: A cause of acute neoplastic symptom. J Gastroenterol Hepatol 2023; 38:7. [PMID: 35615762 DOI: 10.1111/jgh.15888] [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] [Received: 04/05/2022] [Accepted: 05/07/2022] [Indexed: 01/19/2023]
Affiliation(s)
- N Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - D Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - T Katada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - T Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - K Furukawa
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - H Hashidate
- Department of Pathology, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
8
|
Inoue K, Chieh JTW, Yeh LC, Chiang SJ, Phrommintikul A, Suwanasom P, Kasim S, Ahmad B, Idrose AM, Salleh FM, Oyamada S, Hirano Y, Ouchi S, Terakura M, Yokoyama N, Kozuma K, Nanasato M, Higuchi R, Yumoto K, Fukuzawa T, Shimada I, Giannitsis E, Twerenbold R, Minamino T. An international, stepped wedge, cluster-randomized trial investigating the 0/1-h algorithm in suspected acute coronary syndrome in Asia: the rational of the DROP-Asian ACS study. Trials 2022; 23:986. [PMID: 36476401 PMCID: PMC9727900 DOI: 10.1186/s13063-022-06907-4] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND More than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data. METHODS The DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2022 and Apr 2024 were included. Initially, all clusters will apply "usual care" according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED. CONCLUSIONS This study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.
Collapse
Affiliation(s)
- Kenji Inoue
- grid.482668.60000 0004 1769 1784Department of Cardiovascular Biology and Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Jack Tan Wei Chieh
- grid.419385.20000 0004 0620 9905Department of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore
| | - Lim Chiw Yeh
- grid.419385.20000 0004 0620 9905Department of Cardiology, National Heart Centre Singapore and Sengkang General Hospital, Singapore, Singapore
| | - Shuo-Ju Chiang
- grid.410769.d0000 0004 0572 8156Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan
| | - Arintaya Phrommintikul
- grid.7132.70000 0000 9039 7662Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | - Pannipa Suwanasom
- grid.7132.70000 0000 9039 7662Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiangmai, Thailand
| | - Sazzli Kasim
- grid.412259.90000 0001 2161 1343Division of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia
| | - Bakhtiar Ahmad
- grid.412259.90000 0001 2161 1343Division of Cardiology, Hospital Al-Sultan Abdullah, University Teknologi MARA, Kuala Lumpur, Malaysia
| | - Alzamani Mohammad Idrose
- grid.412516.50000 0004 0621 7139Division of Emergency, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Farina Mohd Salleh
- grid.419388.f0000 0004 0646 931XDivision of Emergency, Institut Jantung Negara, Kuala Lumpur, Malaysia
| | | | - Yohei Hirano
- grid.482669.70000 0004 0569 1541Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Shohei Ouchi
- Department of Cardiovascular Biology and Medicine, Juntendo Urayasu Hospital, Chiba, Japan
| | - Moriyuki Terakura
- grid.264706.10000 0000 9239 9995Department of Emergency, Teikyo University School of Medicine, Tokyo, Japan
| | - Naoyuki Yokoyama
- grid.264706.10000 0000 9239 9995Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Ken Kozuma
- grid.264706.10000 0000 9239 9995Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Mamoru Nanasato
- grid.413411.2Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Ryosuke Higuchi
- grid.413411.2Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan
| | - Kazuhiko Yumoto
- grid.410819.50000 0004 0621 5838Department of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Tomoyuki Fukuzawa
- grid.410819.50000 0004 0621 5838Department of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan
| | | | - Evangelos Giannitsis
- grid.5253.10000 0001 0328 4908Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Raphael Twerenbold
- grid.13648.380000 0001 2180 3484Department of Cardiology and University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Tohru Minamino
- grid.258269.20000 0004 1762 2738Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
9
|
Enoki Y, Kameyama H, Uehara H, Iwaya A, Yamazaki T, Ishii S, Takamatsu Y, Tomizawa G, Sudo N, Katada T, Kobayashi K, Sato D, Sakata E, Yokoyama N, Kuwabara S. [A Case of Suspected Lynch Syndrome Due to Radical Resection for Descending Colon Cancer and Renal Pelvic Cancer]. Gan To Kagaku Ryoho 2022; 49:1547-1549. [PMID: 36733130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A 60-year-old woman was admitted on account of presenting with bloody stools. She had a history of endometrial cancer surgery. Family history revealed 3 colorectal cancer cases among the first or second relatives. Colonoscopy and contrast- enhanced computed tomography revealed descending colon cancer and left renal pelvic cancer. We performed partial resection of the descending/transverse colon with D3 lymph node dissection and total resection of the left kidney and ureter with curative intent. Postoperative pathological diagnosis revealed descending colon cancer(pT4bN0M1c, pStage Ⅳc)and left renal pelvic cancer (T1N0M0, Stage Ⅰ). In this case, Lynch syndrome was suspected based on the family history and medical history. The clinical findings were consistent with Amsterdam Criteria Ⅱ. The microsatellite instability(MSI)test result was MSI-H and the BRAF genetic test result showed a wild type. Immunohistochemical staining of descending colon cancer tissue showed loss of expression of MSH2 and MSH6 proteins. Genetic counseling was provided because Lynch syndrome was strongly suspected. Capecitabine plus oxaliplatin therapy was performed for 6 months for descending colon cancer. Nine months postoperatively, the patient remained recurrence-free for both colon cancer and renal pelvic cancer. We report a case of suspected Lynch syndrome triggered by double cancer of the descending colon and renal pelvis.
Collapse
Affiliation(s)
- Yuya Enoki
- Dept. of Digestive Surgery, Niigata City General Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Kubota A, Yokoyama N, Sato D, Hashidate H, Nojiri S, Taguchi C, Otani T. Treatment for Appendicitis With Appendicolith by the Stone Size and Serum C-Reactive Protein Level. J Surg Res 2022; 280:179-185. [PMID: 35987167 DOI: 10.1016/j.jss.2022.06.009] [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: 04/17/2021] [Revised: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Appendicolith causes acute appendicitis. However, surgical indications for appendicolith-related acute appendicitis have not been established. We aimed to clarify the clinical features of appendicolith-associated appendicitis and determine an appropriate treatment strategy based on the initial presentation. MATERIALS AND METHODS We retrospectively reviewed the records of 479 consecutive patients with acute appendicitis and verified the therapeutic strategy as per the appendicolith and clinical status. RESULTS Appendicoliths were identified in 214 of 479 patients (44.6%) using computed tomography. Surgery was more frequently required in patients with appendicolith than in patients without appendicolith (82.7 versus 64.9%; P < 0.001). The stones were smaller and serum C-reactive protein (CRP) concentration was lower among patients with appendicoliths treated with medication alone than among those surgically treated (both P < 0.001). An appendicolith measuring ≤5 mm in diameter and CRP concentration ≤5.36 mg/dL were predictive of completion of nonsurgical therapy. CRP concentration >10 mg/dL and stone diameter of 10 mm were significantly associated with appendiceal perforation. CONCLUSIONS Nonsurgical therapy could be considered for patients with appendicoliths measuring ≤5 mm in diameter and in cases where the serum CRP concentration is ≤5 mg/dL. An appendicolith measuring >10 mm in diameter or CRP concentration >10 mg/dL is an indication for surgery.
Collapse
Affiliation(s)
- Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan; Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, Tokyo, Japan.
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hideki Hashidate
- Department of Pathology, Niigata City General Hospital, Niigata, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University Hospital, Tokyo, Japan
| | - Chie Taguchi
- Department of Industrial Engineering and Economics, Tokyo Institute of Technology, Tokyo, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
11
|
Uehara H, Kameyama H, Iwaya A, Yamazaki T, Ishii S, Tomizawa G, Takamatsu Y, Gohda Y, Enoki Y, Sudo N, Katada T, Kobayashi K, Sato D, Yokoyama N, Kuwabara S, Otani T. Laparoscopic transabdominal preperitoneal hernioplasty for bilateral obturator hernias and left inguinal hernia with emaciation caused by anorexia nervosa: A case report. Asian J Endosc Surg 2022; 15:629-632. [PMID: 35052013 DOI: 10.1111/ases.13027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
A 55-year-old woman receiving treatment for anorexia nervosa presented with abdominal pain and right thigh pain. Her body mass index was 12.9 kg/m2 . Computed tomography showed fluid storage in the distal side of the right obturator foramen and revealed a dilated small bowel without a starting point of obstruction. We diagnosed a naturally reduced incarcerated right obturator hernia and performed elective surgery with a laparoscopic approach for hernia repair the next day. Intraperitoneal observation revealed bilateral obturator hernias and a left direct-type inguinal hernia. Transabdominal preperitoneal hernioplasty was performed using two self-gripping polyester meshes for bilateral obturator hernia repair and a lightweight 3D-shaped mesh for left inguinal hernia repair. Women with emaciation caused by anorexia nervosa may be more likely to have complex hernias, including obturator hernia, and laparoscopic approaches may be useful for preoperatively diagnosed nonstrangulated obturator hernias.
Collapse
Affiliation(s)
- Hiroaki Uehara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Iwaya
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Toshiyuki Yamazaki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shota Ishii
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Gen Tomizawa
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Yuki Takamatsu
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Yousuke Gohda
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Yuya Enoki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Natsuru Sudo
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tomohiro Katada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Kazuaki Kobayashi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shirou Kuwabara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
12
|
Iinuma Y, Yokoyama N, Saikusa N, Hashidate H, Naito SI, Hirayama Y, Nakaya K, Nitta K. A long-term survivor after radical surgery in early childhood for biliary tract cancer associated with congenital biliary dilatation despite a positive margin for epithelial carcinoma. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102211] [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: 02/07/2023] Open
|
13
|
Yukimitsu N, Yokoyama N, Ikeda Y, Ishibashi R, Takamura S, Kozuma K, Hatsuno M. ONE-YEAR OUTCOME IN HYPOKINETIC NON-DILATED CARDIOMYOPATHY DETECTED BY CARDIAC MAGNETIC RESONANCE: IDIOPATHIC DILATED CARDIOMYOPATHY COMPARISON. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01350-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Tominaga M, Morikawa K, Ogawa Y, Kamimura N, Tsuneki I, Tamura M, Yanase T, Kobayashi K, Sato D, Kameyama H, Iwaya A, Yokoyama N, Kuwabara S, Yamazaki T, Otani T, Kurabayashi T. Laparoscopic surgery for a hydrocele of the canal of Nuck with an ovarian tumor: An extremely rare clinical finding. Clin Case Rep 2022; 10:e05320. [PMID: 35140943 PMCID: PMC8813580 DOI: 10.1002/ccr3.5320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/14/2022] [Indexed: 11/09/2022] Open
Abstract
This clinical image presents an unusual report of simultaneous laparoscopic resection of a hydrocele of the canal of Nuck and an ovarian tumor. Laparoscopic treatment with a proper approach is a useful technique in some cases.
Collapse
Affiliation(s)
- Marie Tominaga
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Kyoko Morikawa
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Yutaro Ogawa
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Naomi Kamimura
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Ikunosuke Tsuneki
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Masaki Tamura
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Toru Yanase
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| | - Kazuaki Kobayashi
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Daisuke Sato
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Hitoshi Kameyama
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Akira Iwaya
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Naoyuki Yokoyama
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Shiro Kuwabara
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Toshiyuki Yamazaki
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Tetsuya Otani
- Department of Digestive and General Surgery Niigata City General Hospital Niigata Japan
| | - Takumi Kurabayashi
- Department of Obstetrics & Gynecology Niigata City General Hospital Niigata Japan
| |
Collapse
|
15
|
Kameyama H, Yamazaki T, Iwaya A, Uehara H, Utsumi S, Hirai M, Komatsu M, Kubota A, Katada T, Kobayashi K, Sato D, Yokoyama N, Kuwabara S, Otani T. Surgical approach for right-sided colonic diverticular bleeding: A single-center review of 43 consecutive cases. Asian J Endosc Surg 2021; 14:717-723. [PMID: 33595203 DOI: 10.1111/ases.12929] [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: 01/07/2021] [Revised: 01/28/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION While Asian populations develop colonic diverticular disease predominantly in the right colon, Western populations mainly present with left-sided disease. The present study aimed to clarify the outcomes of surgical treatment for right-sided colonic diverticular bleeding. METHODS Medical records of 43 patients who underwent surgery for right-sided colonic diverticular bleeding between 2010 and 2019 were reviewed. Those whose general condition became unstable underwent open surgery at our institution. Patients were then divided into two groups, the open surgery group (n = 17) and laparoscopic surgery group (n = 26), after which operative outcomes between both groups were compared. RESULTS This study included 36 men and seven women with a median age of 76 (range: 37-91) years. Laparoscopic surgery had a significantly longer operative time (183.5 minutes vs 110 minutes; P < .001) and significantly lower intraoperative blood transfusion rate (19.2% vs 82.4%; P < .001) than open surgery. The laparoscopic surgery group had earlier resumption of postoperative meals than open surgery group (postoperative day 3 vs postoperative day 4; P = .010). No significant difference in postoperative complications was observed between both groups. With regard to long-term outcomes, none of the cases exhibited rebleeding from the right-sided colon. CONCLUSION The present study revealed that laparoscopic surgery promoted lower intraoperative blood transfusion rates and earlier resumption of postoperative meals compared to open surgery for right-sided colonic diverticular bleeding. Hence, laparoscopic surgery can be feasible for right-sided colonic diverticular bleeding provided that the patient's general condition is stable.
Collapse
Affiliation(s)
- Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Toshiyuki Yamazaki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Iwaya
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hiroaki Uehara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shiori Utsumi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Motoharu Hirai
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Masaru Komatsu
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tomohiro Katada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Kazuaki Kobayashi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shirou Kuwabara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
16
|
Nagura F, Kataoka A, Ishibashi R, Mitsui M, Hioki H, Kuwabara M, Uno K, Watanabe Y, Yokoyama N, Kozuma K. Effect of oral tolvaptan for 1 year in patients with functional mitral regurgitation. Heart Vessels 2021; 37:434-442. [PMID: 34476570 DOI: 10.1007/s00380-021-01934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
The effect of the oral selective vasopressin V2-receptor antagonist tolvaptan for chronic phase therapy on patients with FMR remains unclear. We aimed to determine the efficacy of oral tolvaptan in patients with significant functional mitral regurgitation (FMR) to reduce the mortality and rehospitalization due to worsening heart failure (HF). We enrolled 219 patients (mean age 76 ± 9 years, 59.4% men) who were admitted at our hospital due to congestive HF during different two 1-year periods. The patients were divided into 2 groups: those who had significant FMR (MR ≥ grade 2 [n = 76]) and those who did not (MR < grade 2 [n = 143]) at discharge. The patients were further divided into a study group that received tolvaptan during follow-up and a control group that did not receive tolvaptan. We used an inverse probability of treatment weighting method with the primary end point defined as overall all-cause mortality and rehospitalization due to worsening HF within 1 year. Of the 76 patients with significant FMR at discharge, 2 of 20 (10%) who were administered tolvaptan died and 8 (40%) were readmitted to a hospital. Of the 56 patients who did not receive tolvaptan, 2 (3.5%) died and 18 (27.5%) required rehospitalization. After multiple adjustments, there were no significant differences for overall survival and rehospitalization between the groups (log-rank p = 0.700 and 0.510, respectively). Our results suggest that oral tolvaptan administration in addition to conventional diuretics had less impact on outcomes in patients with significant FMR.
Collapse
Affiliation(s)
- Fukuko Nagura
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Akihisa Kataoka
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan.
| | - Ruri Ishibashi
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Miho Mitsui
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Hirofumi Hioki
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Masanari Kuwabara
- Teikyo Academic Research Center, Teikyo University School of Medicine, Tokyo, Japan
| | - Kiyoko Uno
- Teikyo Academic Research Center, Teikyo University School of Medicine, Tokyo, Japan
| | - Yusuke Watanabe
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Naoyuki Yokoyama
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Ken Kozuma
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| |
Collapse
|
17
|
Sakata J, Nomura T, Aono T, Kitami C, Yokoyama N, Minagawa M, Takizawa K, Miura K, Hirose Y, Ichikawa H, Nagahashi M, Shimada Y, Kobayashi T, Wakai T. Oncological outcomes of surgery for recurrent biliary tract cancer: who are the best candidates? HPB (Oxford) 2021; 23:1371-1382. [PMID: 33558069 DOI: 10.1016/j.hpb.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/05/2020] [Accepted: 01/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to investigate the impact of surgery on outcomes in patients with recurrent biliary tract cancer (BTC) and elucidate factors affecting survival after surgery for this disease. METHODS A single-center study was undertaken in 178 patients with recurrent BTC, of whom 24 underwent surgery for recurrence, 85 received chemotherapy, and 69 received best supportive care. Then, we carried out a multicenter study in 52 patients undergoing surgery for recurrent BTC (gallbladder cancer, 39%; distal cholangiocarcinoma, 27%; perihilar cholangiocarcinoma, 21%; intrahepatic cholangiocarcinoma, 13%). RESULTS In the single-center study, 3-year survival after recurrence was 53% in patients who underwent surgery, 4% in those who received chemotherapy, and 0% in those who received best supportive care (p < 0.001). Surgery was an independently prognostic factor (p < 0.001). In the multicenter series, the respective 3-year and 5-year survival after surgery for recurrence was 50% and 29% in the 52 patients. Initial site of recurrence was the only independent prognostic factor (p = 0.019). Five-year survival after surgery for recurrence in patients with single distant, multifocal distant, and locoregional recurrence was 51%, 0%, and 0%, respectively (p = 0.002). Sites of single distant recurrence included the liver (n = 13, 54%), distant lymph nodes (all from gallbladder cancer, n = 7, 29%), lung (n = 2, 9%), peritoneum (n = 1, 4%), and abdominal wall (n = 1, 4%). CONCLUSION Surgery may be an effective option for patients with less aggressive tumor biology characterized by single distant recurrence in recurrent BTC.
Collapse
Affiliation(s)
- Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Tatsuya Nomura
- Department of Gastrointestinal Surgery, Niigata Cancer Center Hospital, Niigata, Japan.
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan.
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan.
| | - Naoyuki Yokoyama
- Department of Gastrointestinal Surgery, Niigata City General Hospital, Niigata, Japan.
| | | | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| |
Collapse
|
18
|
Otsuki S, Yamakawa T, Ishibashi R, Watari Y, Yokoyama N, Kozuma K. Noncontrast transcatheter pacing system implantation guided by trans-internal jugular vein approach intracardiac echocardiography. HeartRhythm Case Rep 2021; 7:283-285. [PMID: 34026516 PMCID: PMC8134754 DOI: 10.1016/j.hrcr.2021.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Shuji Otsuki
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan.,Department of Cardiology, Sonoda Daiichi Hospital, Tokyo, Japan
| | | | - Ruri Ishibashi
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Yuji Watari
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Naoyuki Yokoyama
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan
| | - Ken Kozuma
- Department of Cardiology, Teikyo University Hospital, Tokyo, Japan
| |
Collapse
|
19
|
Katayama T, Yokoyama N, Watanabe Y, Takahashi S, Hioki H, Kawasugi K, Kozuma K. Blood Coagulation Changes With or Without Direct Oral Anticoagulant Therapy Following Transcatheter Aortic Valve Implantation. Am J Cardiol 2021; 147:88-93. [PMID: 33617810 DOI: 10.1016/j.amjcard.2021.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
Thromboembolic events remain clinically unresolved after transcatheter aortic valve implantation (TAVI). The use of direct oral anticoagulant (DOAC) to reduce thrombosis associated with TAVI remains controversial. This study aimed at investigating the periprocedural change in blood coagulation and thrombolysis parameters in 199 patients undergoing transfemoral TAVI. Prothrombin activation fragment 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), soluble fibrin monomer complex (SFMC), and fibrin/fibrinogen degradation product (FDP) levels were measured before and 1 hour after TAVI and 1, 2, and 7 days postoperatively. Of the 199 patients, 49 were treated with DOAC (apixaban in 32, edoxaban in 10, and rivaroxaban in 7). The F1 + 2 and TAT levels immediately increased 1 hour after TAVI and then gradually decreased in both groups. The SFMC level also significantly increased with a peak on day 1. The FDP level gradually increased, peaking on day 2. The values of F1 + 2, TAT, SFMC, and FDP in patients who used DOAC were significantly lower than those who did not use DOAC at 1 hour after TAVI in F1 + 2 (600 [452 to 765] vs 1055 [812 to 1340] pmol/L; p < 0.001), TAT (21.4 [16.2 to 37.0] vs 38.7 [26.4 to 58.7] μg/mL; p < 0.001) and on day 1 in SFMC (18.2 [9.4 to 57.9] vs 113.4 [70.9 to 157.3] μg/mL; p < 0.001) and day 2 in FDP (6.0 [4.7 to 10.0] vs 12.6 [8.2 to 17.4] μg/mL; p < 0.001). Ischemic stroke within 30 days after TAVI occurred in 3 patients (1.5%), who were not treated with DOAC. Coagulation cascade activation was observed after TAVI. DOAC could reduce transient hypercoagulation following TAVI.
Collapse
|
20
|
Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, Wakai T. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. World J Surg 2021; 45:1613-1615. [PMID: 33575825 DOI: 10.1007/s00268-021-05991-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Pankaj Prasoon
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Chie Kitami
- Department of Surgery, Nagaoka Chuo General Hospital, 2041 Kawasaki-cho, Nagaoka, Niigata, 940-0861, Japan
| | - Masahiro Minagawa
- Department of Surgery, Nagaoka Red Cross Hospital, 2-297-1 Senshu, Nagaoka, Niigata, 940-2085, Japan
| | - Tatsuya Nomura
- Department of Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata, 951-8566, Japan
| | - Naoyuki Yokoyama
- Department of Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Takashi Aono
- Department of Surgery, Niigata Prefectural Central Hospital, 205 Shinnan-cho, Joetsu, Niigata, 943-0192, Japan
| | - Kizuki Yuza
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kohei Miura
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Tomohiro Katada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kazuyasu Takizawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takashi Kobayashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| |
Collapse
|
21
|
Iwaya A, Yamazaki T, Kameyama H, Uehara H, Hirai M, Komatsu M, Kubota A, Katada T, Kobayashi K, Sato D, Yokoyama N, Kuwabara S. Influence of Suture Materials on Incisional Hernia Rate after Laparoscopic Colorectal Cancer Surgery: A Propensity Score Analysis. J Anus Rectum Colon 2021; 5:46-51. [PMID: 33537500 PMCID: PMC7843141 DOI: 10.23922/jarc.2020-066] [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] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/25/2020] [Indexed: 11/30/2022]
Abstract
Objectives Incisional hernia is a common problem after colorectal surgery, and a laparoscopic approach does not reduce the incisional hernia rate. Previous reports have described the risk factors for incisional hernia; however, the impact of suture materials remains unclear. As such, this study compared the incisional hernia rate using different suture materials for abdominal wall closure after laparoscopic colorectal cancer surgery. Methods Patients undergoing laparoscopic colorectal cancer surgery between January 2014 and December 2016 were included in this study. We separated patients into the following two groups based on the suture materials used for abdominal wall closure: (1.) fast-absorbable group and (2.) non-absorbable group. The primary outcome was incisional hernia rate that was diagnosed using computed tomography. We compared outcomes between these two groups using propensity score matching. Results Before matching, 394 patients were included (168 in the fast-absorbable group and 226 in the non-absorbable group). After one-to-one matching, patients were stratified into the fast-absorbable group (n = 158) and the non-absorbable group (n = 158). The incisional hernia rate was higher in the fast-absorbable group than in the non-absorbable group (13.9% vs. 6.3%; P = 0.04). The median time to develop an incisional hernia was significantly shorter in the fast-absorbable group (6.7 months vs. 12.3 months; P < 0.01). The incidence of surgical site infection was not different between the two groups, but the incidence of suture sinus was lower in the fast-absorbable group (0% vs. 5.1%; P < 0.01). Conclusions The use of fast-absorbable sutures may increase the risk of incisional hernia after laparoscopic colorectal cancer surgery.
Collapse
Affiliation(s)
- Akira Iwaya
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Toshiyuki Yamazaki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hiroaki Uehara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Motoharu Hirai
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Masaru Komatsu
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tomohiro Katada
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Kazuaki Kobayashi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shirou Kuwabara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
22
|
Katayama T, Yokoyama N, Hirofumi H, Kataoka A, Watanabe Y, Kozuma K. Blood coagulation status after transcatheter aortic valve implantation between the patients with vitamin k antagonist and direct oral anticoagulants. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Ischemic stroke after transchatheter aortic valve implantation (TAVI) was recognized. Previous study showed that the median time of a stroke was 2.0 days (IQR, 1.0–5.0) after TAVI. One of the main mechanisms for ischemic stroke after TAVI was hyper-coagulation activity associated with TAVI procedure. However, the change of coagulation status in patients with oral anticoagulant (OAC) therapy was not investigated fully.
Purpose
We investigated the difference of blood coagulation parameters between the patients with vitamin K antagonist (VKA) and those with direct oral anticoagulants (DOAC).
Methods
We enrolled 253 patients underwent transfemoral TAVI between February 2017 and March 2019 in our hospital. Of 253 patients, 71 patients (age: 85, male: 20%) took OAC therapy (VKA: 21 patients, DOAC: 50 patients). Patients who took apixaban was 32 patients, rivaroxaban was 7, edoxaban was 11. Prothrombin activation fragment 1+2 (F1+2) as a molecular marker of thrombin generation, thrombin-anti-thrombin complex (TAT) as a marker of thrombin neutralization, soluble fibrin monomer complex (SFMC) as a marker of thrombophilia and fibrin/fibrinogen degradation product (FDP) as a marker of fibrinolysis were measured before and immediately after TAVI, and on 1 and 2 day postoperatively. We also assessed ischemic stroke after TAVI between 2 groups according to BARC-2 criteria.
Results
In patients with VKA, the value of PT-INR the day before TVAI was 1.2 (1.1–1.4). The level of F1+2 in patients with VKA was significantly greater on day 0 postoperatively than those with DOAC [855 pmol/l (595–1135) vs 614 pmol/l (452–774) P=0.003]. The level of SFMC in patients with VKA was significantly greater on day 0 postoperatively than those with DOAC [37.4 μg/ml (17.3–64.5) vs. 15.7 μg/ml (8.8–27.3) P=0.002]. The level of FDP in patients with VKA was significantly greater on day 0 postoperatively than those with DOAC [VKA: 5.8 μg/ml (3.8–7.9), DOAC: 4.0 μg/ml (3.1–5.3) P=0.023]. There were no patients with ischemic stroke among 2 groups.
Conclusion
This study revealed that coagulation activity was increased after TAVI. Furthermore, the coagulation activity in patients with VKA was significantly higher than that with DOAC at especially immediately after TAVI. Careful attention should be paid to hyper-coagulation status after TAVI in patients with VKA.
Funding Acknowledgement
Type of funding source: None
Collapse
|
23
|
Uehara H, Yamazaki T, Kameyama H, Iwaya A, Gohda Y, Chinen I, Kubota A, Aoki M, Kobayashi K, Sato D, Yokoyama N, Kuwabara S, Otani T. Internal hernia beneath the obturator nerve after robot-assisted lateral lymph node dissection for rectal cancer: A case report and literature review. Asian J Endosc Surg 2020; 13:578-581. [PMID: 32180365 DOI: 10.1111/ases.12795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 12/28/2022]
Abstract
A 63-year-old man who underwent robot-assisted laparoscopic low anterior resection and right lateral lymph node dissection (LLND) for rectal cancer presented with right thigh pain, nausea, vomiting, and abdominal pain on postoperative day 17. CT revealed dilated small bowel in the pelvis, and a small bowel loop was detected outside the internal iliac artery branch. Emergent laparoscopic surgery revealed the migration of the small bowel into the space beneath the right obturator nerve. The herniated bowel was reduced, and the obturator nerve was sharply dissected from the herniated bowel and preserved. The hernial orifice was left unrepaired. Postoperative recovery was uneventful, and the right thigh pain disappeared. It is important to consider the possibility of internal herniation beneath the obturator nerve after minimally invasive lateral lymph node dissection for rectal cancer.
Collapse
Affiliation(s)
- Hiroaki Uehara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Toshiyuki Yamazaki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Iwaya
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Yousuke Gohda
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Itaru Chinen
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Makoto Aoki
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Kazuaki Kobayashi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shirou Kuwabara
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
24
|
Nakaya H, Yokoyama N, Watanabe Y, Kataoka A, Konno K, Kozuma K. Prevalence and Predictors of Atherosclerotic Peripheral Arterial Obstructive Disease in Severe Heart Valve Diseases. Int Heart J 2020; 61:727-733. [PMID: 32684599 DOI: 10.1536/ihj.20-009] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Despite witnessing an upsurge in heart valve diseases (HVDs), the correlation between HVDs and atherosclerotic peripheral arterial obstructive disease (PAOD) remains unclear. This study aims to investigate the prevalence and predictors of PAOD in HVDs.In this study, a total of 245 consecutive patients were examined: 153 with severe aortic valve stenosis (AS), 66 with severe primary mitral valve regurgitation (MR), and 26 with severe pure native aortic valve regurgitation (AR). All patients underwent ultrasound scan of the carotid artery to ascertain the presence of internal carotid artery stenosis (ICAS). ICAS was defined as a peak systolic velocity ≥ 125 cm/second and/or ≥ 50% reduction in diameter. In addition, we measured the ankle-brachial index in each leg using a volume plethysmograph. A result of ≤ 0.9 was considered lower extremity artery disease (LEAD).The presence of ICAS was statistically more frequent in patients with severe AS than in patients with severe MR and AR (11.1% versus 1.5% versus 3.8%; P = 0.038). LEAD was present in patients with severe AS (17.6%) and MR (10.6%) but not in patients with severe AR (P = 0.037). The multivariate analysis revealed that the presence of severe AS (OR, 5.6 [1.3-24.9]; P = 0.023) was an independent predictor for ICAS, while history of coronary artery disease (OR, 4.8 [2.2-10.5]; P < 0.001) was an independent predictor for LEAD.The prevalence of PAOD varies depending on each valvular disease. Individual screening should be considered on the basis of atherosclerotic risk factors, especially for patients with severe AS.
Collapse
Affiliation(s)
- Hiroaki Nakaya
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| | - Naoyuki Yokoyama
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| | - Yusuke Watanabe
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| | - Akihisa Kataoka
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| | - Kumiko Konno
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| | - Ken Kozuma
- Department of Cardiology, Division of Cardiology, Teikyo University School of Medicine
| |
Collapse
|
25
|
Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, Wakai T. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. World J Surg 2020; 44:3875-3883. [PMID: 32577824 DOI: 10.1007/s00268-020-05656-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
26
|
Takahashi S, Yokoyama N, Watanabe Y, Katayama T, Hioki H, Yamamoto H, Kawasugi K, Kozuma K. Predictor and Mid-Term Outcome of Clinically Significant Thrombocytopenia After Transcatheter Aortic Valve Selection. Circ J 2020; 84:1020-1027. [PMID: 32336739 DOI: 10.1253/circj.cj-19-0875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND The frequency and predictors of thrombocytopenia after transcatheter aortic valve implantation (TAVI) are unclear.Methods and Results:This study enrolled 342 patients undergoing TAVI (245 with a percutaneous transfemoral approach, 65 with transfemoral surgical cutdown, and 32 with a non-transfemoral approach). Balloon-expandable and self-expanding valves were implanted in 235 and 107 patients, respectively. Platelet counts started to drop immediately, reaching a nadir 2-4 days after TAVI. Clinically significant thrombocytopenia (CSTP) was defined as a platelet count ≤50×109/L at the time of the nadir or both a platelet count between 80 and 51×109/L and a decrease in platelet count ≥50%. CSTP occurred in 16.7% patients. Approach site and TAVI valve selection significantly predicted CSTP. In multivariate analysis, independent predictors of CSTP were liver cirrhosis (odds ratio [OR] 7.22; 95% confidence interval [CI] 1.05-49.82), baseline platelet count ≤120×109/L (OR 2.98; 95% CI 1.20-7.38), multiple blood transfusions (OR 4.03; 95% CI 1.72-9.41), and the use of balloon-expandable valves (OR 2.38; 95% CI 1.04-5.46). Kaplan-Meier survival analysis with a generalized Wilcoxon test revealed that mid-term (2 years) mortality was greater for patients with than without CSTP (31.4% vs. 15.5%; P=0.008). CONCLUSIONS TAVI-related CSTP was not rare and was associated with poor mid-term outcomes. CSTP was not only caused by patients' comorbidities and TAVI complications, but also related to TAVI procedural factors.
Collapse
Affiliation(s)
| | | | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine
| | - Taiga Katayama
- Department of Cardiology, Teikyo University School of Medicine
| | - Hirofumi Hioki
- Department of Cardiology, Teikyo University School of Medicine
| | | | | | - Ken Kozuma
- Department of Cardiology, Teikyo University School of Medicine
| |
Collapse
|
27
|
Shioi I, Yokoyama N, Hirai M, Komatsu M, Kubota A, Aoki M, Sato D, Otani T. Perforation of anastomotic peptic ulcer following pancreaticoduodenectomy: a report of three cases. BMC Surg 2020; 20:79. [PMID: 32306934 PMCID: PMC7168954 DOI: 10.1186/s12893-020-00743-6] [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: 07/11/2019] [Accepted: 04/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Perforation of a marginal peptic ulcer after pancreaticoduodenectomy (PD) can lead to severe conditions, although its clinical features have not been well reported. In this article, we present three cases of marginal peptic ulcer perforation after PD that we experienced in our institute and attempt to clarify its appropriate treatment and prevention. CASE PRESENTATION Marginal ulcer perforation confirmed with computed tomography and/or surgical exploration occurred in 3 (1.8%) of 163 consecutive patients who underwent PD (including 160 patients who underwent a total or subtotal stomach-preserving procedure) at our institution. The three patients (one man and two women) had a median age of 77 (65-79) years. Two of these patients had a medical history of duodenal peptic ulcer. All three patients had biliary neoplasms. Two of the patients underwent subtotal stomach-preserving PD with antro-jejunal anastomosis, and the other patient underwent pylorus-preserving PD with duodenal jejunostomy. The perforation occurred with a sudden and severe onset of abdominal pain 34, 94, and 1204 days, respectively, after the PDs. At the time of the perforation, all of the patients had been withdrawn from postoperative prophylactic antipeptic ulcer agents, with the cessation periods ranging from 12 to 1008 days. In addition, all the patients were in fasting conditions for 1 to 13 days just before the perforation. Surgical treatment with direct suturing of the perforated ulcer was performed for two patients, while conservative therapy was performed for one patient. Their primary treatment courses were satisfactory. Chronic antisecretory agent therapy was prescribed for 562, 271, and 2370 days, respectively, from marginal ulcer perforation, and no ulcer recurrence was noted in any of the patients. CONCLUSIONS Lack of antisecretory therapy and fasting were considered an essential cause of marginal peptic ulcer perforation after PD. In addition, unlike the native duodenum, the jejunal limb used for reconstruction to a preserved stomach may be at increased risk of ulceration. Chronic permanent administration of antisecretory agents and fasting avoidance are desirable for patients who have undergone stomach-preserving PD to prevent marginal ulcer perforation.
Collapse
Affiliation(s)
- Ikuma Shioi
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan.
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Motoharu Hirai
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Masaru Komatsu
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Akira Kubota
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Makoto Aoki
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chou-ku, Niigata City, 950-1197, Japan
| |
Collapse
|
28
|
Mitsui M, Kataoka A, Nara Y, Nagura F, Kawashima H, Hioki H, Nakashima M, Watanabe Y, Yokoyama N, Kozuma K. P2621Clinical safety and efficacy of tolvaptan for acute phase therapy in patients with low-flow severe aortic stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Conventional diuretic therapy for low-flow (LF) severe aortic stenosis (SAS) often has an inadequate effect or causes hemodynamic instability. Tolvaptan is used for acute heart failure in addition to conventional diuretics in Japan, and it does not cause intravascular dehydration.
Purpose
This study aimed to retrospectively investigate the safety and efficacy of tolvaptan in the acute phase patients with SAS and compared LF-SAS with normal-flow (NF) SAS.
Methods
56 consecutive SAS patients are analyzed. The primary endpoints were adverse clinical events (death, worsening heart failure, worsening renal failure, fatal arrhythmia, cardiogenic or hypovolemic shock, and use of inotropic agents) and the volume of urine and fluid balance within 48 hours of tolvaptan administration (Figure).
Results
Among 56 patients, 16 had LF-SAS (29%), and 40 had NF-SAS (71%). Severe adverse clinical events were not observed 48 hours after tolvaptan administration. In both groups, the urine volume significantly increased after tolvaptan administration in comparison to 24 hours before tolvaptan administration (both, p<0.01). There were no changes in the urine volume during the initial 24 and 48 hours. In the LF-SAS group, tolvaptan resulted in a significant decrease in fluid balance during the initial 24 and 48 hours compared to 24 hours before tolvaptan administration (p<0.05).
Treatment and data collection protocols
Conclusion
Adding tolvaptan to conventional treatment leads to an increase in urine output and a decreased fluid balance without hemodynamic instability in patients with LF-SAS.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
| | | | - Y Nara
- Teikyo University, Tokyo, Japan
| | | | | | - H Hioki
- Teikyo University, Tokyo, Japan
| | | | | | | | | |
Collapse
|
29
|
Ikeda T, Iida M, Yokoyama N, Shimokawa T. Mitral valve perforation due to coexisting severe aortic regurgitation. Eur J Cardiothorac Surg 2019; 56:815. [PMID: 31220234 DOI: 10.1093/ejcts/ezz109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tsukasa Ikeda
- Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan
| | - Mitsuru Iida
- Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan
| | | | - Tomoki Shimokawa
- Department of Cardiovascular Surgery, Teikyo University, Tokyo, Japan
| |
Collapse
|
30
|
Ohara Y, Yabuki A, Nakamura R, Ichii O, Mizukawa H, Yokoyama N, Yamato O. Renal Infiltration of Macrophages in Canine and Feline Chronic Kidney Disease. J Comp Pathol 2019; 170:53-59. [PMID: 31375159 DOI: 10.1016/j.jcpa.2019.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 02/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 12/21/2022]
Abstract
During the progression of chronic kidney disease (CKD), macrophage infiltration is a crucial event leading to tubulointerstitial fibrosis. In the present study, macrophages infiltrating renal tissue in dogs and cats with CKD were analysed immunohistochemically. Iba-1 was used as a pan-macrophage marker, CD204 was used as a marker of M2 macrophages and tumour necrosis factor (TNF)-α was used as a marker of M1 macrophages. Signals for Iba1 and CD204 were observed in the interstitium of all tested kidney samples. In dogs, the signals were diffusely scattered. In cats, both diffuse and focal signals were observed. Cells that were positive for Iba1 and CD204 were also observed in the tubular lumina in cats. Co-expression of Iba1 and CD204 was also observed in the infiltrating cells by immunofluorescence labelling, and these cells were negative for TNF-α. By quantitative analysis, the indices for Iba1- and CD204-positive cells were significantly correlated with the concentrations of plasma creatinine and/or urea and the extent of interstitial fibrosis in both dogs and cats. These results demonstrated that renal infiltration of M2 macrophages plays an important role in the progression of CKD in dogs and cats. The distribution pattern of the kidney-infiltrating macrophages was unique in cats and may be associated with a cat-specific renal fibrotic process.
Collapse
Affiliation(s)
- Y Ohara
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - A Yabuki
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima.
| | - R Nakamura
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| | - O Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo
| | - H Mizukawa
- Laboratory of Environmental Analytical Chemistry, Department of Science and Technology for Biological Resources and Environment, Graduate School of Agriculture, Ehime University, Matsuyama
| | - N Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Clinical Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - O Yamato
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima
| |
Collapse
|
31
|
Mitsui M, Kataoka A, Nara Y, Nagura F, Kawashima H, Hioki H, Nakashima M, Watanabe Y, Yokoyama N, Kozuma K. Clinical safety and efficacy of tolvaptan for acute phase therapy in patients with low-flow and normal-flow severe aortic stenosis. Heart Vessels 2019; 34:1684-1691. [PMID: 30993439 DOI: 10.1007/s00380-019-01411-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/10/2019] [Accepted: 04/12/2019] [Indexed: 01/17/2023]
Abstract
Conventional diuretic therapy for low-flow (LF) severe aortic stenosis (SAS) often has an inadequate effect or causes hemodynamic instability. Tolvaptan is used for acute heart failure in addition to conventional diuretics, and it does not cause intravascular dehydration. This study aimed to retrospectively investigate the safety and efficacy of tolvaptan in the acute phase in 56 consecutive patients with SAS and compared LF-SAS with normal-flow (NF) SAS. The primary endpoints were adverse clinical events (death, worsening heart failure, worsening renal failure, fatal arrhythmia, cardiogenic or hypovolemic shock, and use of inotropic agents) and the volume of urine within 48 h of tolvaptan administration. Among 56 patients, 16 had LF-SAS (29%), and 40 had NF-SAS (71%). Severe adverse clinical events were not observed 48 h after tolvaptan administration. In both groups, the urine volume significantly increased after tolvaptan administration in comparison to 24 h before tolvaptan administration (both, p < 0.01). There were no changes in the urine volume during the initial 24 and 48 h. In the LF-SAS group, tolvaptan resulted in a significant decrease in fluid balance during the initial 24 and 48 h compared to 24 h before tolvaptan administration (p < 0.05). Adding tolvaptan to conventional treatment is safe and effective without renal dysfunction and hypotension in patients with SAS, including those with LF.
Collapse
Affiliation(s)
- Miho Mitsui
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Akihisa Kataoka
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan.
| | - Yugo Nara
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Fukuko Nagura
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Hideyuki Kawashima
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Hirofumi Hioki
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Makoto Nakashima
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Yusuke Watanabe
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Naoyuki Yokoyama
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| | - Ken Kozuma
- Division of Cardiology, Department of Internal Medicine, Teikyo University, 2-11-1 Kaga, Tokyo, 173-8606, Japan
| |
Collapse
|
32
|
Yokoyama N. Novel Echocardiographic Parameter in Heart Failure Is Born. Circ J 2019; 83:279-280. [DOI: 10.1253/circj.cj-18-1372] [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: 11/09/2022]
Affiliation(s)
- Naoyuki Yokoyama
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| |
Collapse
|
33
|
Nara Y, Watanabe Y, Kataoka A, Nakashima M, Hioki H, Nagura F, Kawashima H, Konno K, Kyono H, Yokoyama N, Kozuma K. Incidence, Predictors, and Midterm Clinical Outcomes of Myocardial Injury After Transcatheter Aortic-Valve Implantation. Int Heart J 2018; 59:1296-1302. [DOI: 10.1536/ihj.17-645] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/18/2022]
Affiliation(s)
- Yugo Nara
- Department of Medicine, Teikyo University School of Medicine
| | - Yusuke Watanabe
- Department of Medicine, Teikyo University School of Medicine
| | - Akihisa Kataoka
- Department of Medicine, Teikyo University School of Medicine
| | | | - Hirofumi Hioki
- Department of Medicine, Teikyo University School of Medicine
| | - Fukuko Nagura
- Department of Medicine, Teikyo University School of Medicine
| | | | - Kumiko Konno
- Department of Medicine, Teikyo University School of Medicine
| | - Hiroyuki Kyono
- Department of Medicine, Teikyo University School of Medicine
| | | | - Ken Kozuma
- Department of Medicine, Teikyo University School of Medicine
| |
Collapse
|
34
|
Yokoyama N, Ishimura T, Oda T, Ogawa S, Yamamoto K, Fujisawa M. Association of the PCK2 Gene Polymorphism With New-onset Glucose Intolerance in Japanese Kidney Transplant Recipients. Transplant Proc 2018; 50:1045-1049. [PMID: 29731064 DOI: 10.1016/j.transproceed.2018.01.042] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/22/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND New-onset diabetes mellitus after transplantation (NODAT) is a risk factor for both cardiovascular disease and poor graft survival after kidney transplantation (KTx). In this study, we identified single-nucleotide polymorphisms (SNPs) in genes involved in glucose metabolism and examined the correlation between these SNPs and glucose intolerance after KTx. METHODS Thirty-eight patients with normal glucose tolerance before KTx were included in this study. Patients with plasma glucose levels of >140 mg/dL at 120 minutes on the 75-g oral glucose tolerance test at 1 year after KTx were classified as having new-onset impaired glucose tolerance (NIGT). We identified 8 SNPs in 7 genes that are involved in glucose metabolism among the patients included in this study, and compared the prevalence rate of NIGT among SNPs in each gene. RESULTS Of the 38 patients, 11 (28.9%) were diagnosed with NIGT. For rs4982856 in the PCK2 gene, the distribution of genotypes among the total patient population was as follows: T/T, 12 (31.6%); T/C, 22 (57.9%); and C/C, 4 (10.5%). Seven of 11 patients with NIGT had the T/T genotype of rs4982856, whereas only 5 of 27 patients with normal glucose tolerance had this genotype. The T allele frequency of the rs4982856 was significantly higher in the NIGT group than in the normal group (81.8 vs 52.8%, respectively; P = .015). CONCLUSION Our study indicates that the T allele of the rs4982856 SNP in the PCK2 gene may be a risk factor for glucose intolerance after KTx.
Collapse
Affiliation(s)
- N Yokoyama
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - T Ishimura
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - T Oda
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Ogawa
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Yamamoto
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - M Fujisawa
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
35
|
Katayama T, Yokoyama N, Watanabe Y, Takahashi S, Kawamura H, Nakashima M, Kawasugi K, Kozuma K. P6316Differences of blood coagulation parameters and platelet counts in patients undergoing transcatheter aortic valve implantation with Edwards SAPIEN 3 or Corevalve Evolut R. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Katayama
- Teikyo University School of Medicine, Tokyo, Japan
| | - N Yokoyama
- Teikyo University School of Medicine, Tokyo, Japan
| | - Y Watanabe
- Teikyo University School of Medicine, Tokyo, Japan
| | - S Takahashi
- Teikyo University School of Medicine, Tokyo, Japan
| | - H Kawamura
- Teikyo University School of Medicine, Tokyo, Japan
| | - M Nakashima
- Teikyo University School of Medicine, Tokyo, Japan
| | - K Kawasugi
- Teikyo University School of Medicine, Tokyo, Japan
| | - K Kozuma
- Teikyo University School of Medicine, Tokyo, Japan
| |
Collapse
|
36
|
Nakaya H, Yokoyama N, Kataoka A, Watanabe Y, Kumiko K, Furukawa T, Kozuma K. P5442Prevalence and predictors of atherosclerotic peripheral arterial obstructive disease in heart valve disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Nakaya
- Teikyo University School of Medicine, Tokyo, Japan
| | - N Yokoyama
- Teikyo University School of Medicine, Tokyo, Japan
| | - A Kataoka
- Teikyo University School of Medicine, Tokyo, Japan
| | - Y Watanabe
- Teikyo University School of Medicine, Tokyo, Japan
| | - K Kumiko
- Teikyo University School of Medicine, Tokyo, Japan
| | - T Furukawa
- Teikyo University Hospital, Laboratory Medicine, Tokyo, Japan
| | - K Kozuma
- Teikyo University School of Medicine, Tokyo, Japan
| |
Collapse
|
37
|
Sasaoka K, Nakamura K, Osuga T, Morita T, Yokoyama N, Morishita K, Sasaki N, Ohta H, Takiguchi M. Transcranial Doppler Ultrasound Examination in Dogs with Suspected Intracranial Hypertension Caused by Neurologic Diseases. J Vet Intern Med 2017; 32:314-323. [PMID: 29265506 PMCID: PMC5787153 DOI: 10.1111/jvim.14900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 10/23/2017] [Accepted: 11/15/2017] [Indexed: 11/30/2022] Open
Abstract
Background Transcranial Doppler ultrasound examination (TCD) is a rapid, noninvasive technique used to evaluate cerebral blood flow and is useful for the detection of intracranial hypertension in humans. However, the clinical usefulness of TCD in diagnosing intracranial hypertension has not been demonstrated for intracranial diseases in dogs. Objectives To determine the association between the TCD variables and intracranial hypertension in dogs with intracranial diseases. Animals Fifty client‐owned dogs with neurologic signs. Methods Cross‐sectional study. All dogs underwent TCD of the basilar artery under isoflurane anesthesia after magnetic resonance imaging (MRI). Dogs were classified into 3 groups based on MRI findings: no structural diseases (group I), structural disease without MRI evidence of intracranial hypertension (group II), and structural disease with MRI evidence of intracranial hypertension (group III). The TCD vascular resistance variables (resistive index [RI], pulsatility index [PI], and the ratio of systolic to diastolic mean velocity [Sm/Dm]) were measured. Results Fifteen, 22, and 13 dogs were classified into groups I, II, and III, respectively. Dogs in group III had significantly higher Sm/Dm (median, 1.78; range, 1.44–2.58) than those in group I (median, 1.63; range, 1.43–1.75) and group II (median, 1.62; range, 1.27–2.10). No significant differences in RI and PI were identified among groups. Conclusions and Clinical Importance Our findings suggest that increased Sm/Dm is associated with MRI findings of suspected intracranial hypertension in dogs with intracranial diseases and that TCD could be a useful tool to help to diagnose intracranial hypertension.
Collapse
Affiliation(s)
- K Sasaoka
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - K Nakamura
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - N Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - K Morishita
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - N Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - H Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - M Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| |
Collapse
|
38
|
Nakashima M, Watanabe Y, Hioki H, Nara Y, Nagura F, Hosogoe N, Kawashima H, Kataoka A, Otsuki S, Konno K, Kyono H, Yokoyama N, Kozuma K. Efficacy and safety of transcatheter aortic valve implantation with Edwards SAPIEN 3 and XT in smaller Asian anatomy. Cardiovasc Interv Ther 2017; 33:384-390. [PMID: 29185181 DOI: 10.1007/s12928-017-0502-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 01/13/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022]
Abstract
We aimed to compare the efficacy and safety of transcatheter aortic valve implantation (TAVI) using Edwards SAPIEN 3 (S3) valve and SAPIEN XT) in smaller anatomy. The new generation S3 TAVI device has been used worldwide; however, its efficacy and safety in smaller Asian anatomy remain unknown. Between February 2014 and March 2017, 166 consecutive patients (S3, 54; XT, 112) were treated with balloon-expandable TAVI in a single center and their outcomes were analyzed. Median patient age was 85 (range: 81-88) years and mean body surface area was 1.41 ± 0.15 m2. A 23-mm size valve was used in S3 and XT groups (70 vs. 62%, p = 0.224). The transfemoral approach was more frequently used in the S3 than in the XT group (96 vs. 72%, p < 0.001). Although, the minimal luminal diameter of the femoral artery was smaller in the S3 group (5.9 vs. 6.4 mm, p = 0.001), the rates of major (2 vs. 11%, p = 0.226) and minor (11 vs. 5%, p = 0.107) vascular complications did not increase. The frequency of paravalvular leaks (PVL) ≥ 2 was significantly reduced in the S3 group (11 vs. 61%, p < 0.001); however, pre- (24 vs. 91%, p < 0.001) and post- (4 vs. 19%, p < 0.001) dilatations were less frequently performed. Pacemaker implantation incidence did not increase (4 vs. 5%, p = 1.0) and peak velocity of the transcatheter heart valve was significantly higher in the S3 group (2.3 vs. 2.2 m/s, p = 0.046). Device success was high (89 vs. 93%, p = 0.387) while the 30-day all-cause mortality was low (2 vs. 1%, p = 0.583) in both groups. TAVI with the S3 device was safe and effective, with low incidence of vascular complications and reduced PVL, in smaller body-sized Asians.
Collapse
Affiliation(s)
- Makoto Nakashima
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan.
| | - Yusuke Watanabe
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Hirofumi Hioki
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Yugo Nara
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Fukuko Nagura
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Naoyoshi Hosogoe
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Hideyuki Kawashima
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Akihisa Kataoka
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Shuji Otsuki
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Kumiko Konno
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Hiroyuki Kyono
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Naoyuki Yokoyama
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| | - Ken Kozuma
- Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-0003, Japan
| |
Collapse
|
39
|
Cho T, Higaki H, Hirata M, Hojo H, Ichimura M, Ishii K, Islam K, Itakura A, Katanuma I, Kohagura J, Nakashima Y, Numakura T, Saito T, Tatematsu Y, Yoshikawa M, Tokioka S, Yokoyama N, Miyake Y, Tomii Y, Kojima Y, Takemura Y, Imai T, Yoshida M, Sakamoto K, Pastukhov VP, Miyoshi S. Recent Progress in the GAMMA 10 Tandem Mirror. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Cho
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - H. Higaki
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - M. Hirata
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - H. Hojo
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - M. Ichimura
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - K. Ishii
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - K. Islam
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - A. Itakura
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - I. Katanuma
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - J. Kohagura
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Nakashima
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Numakura
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Saito
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Tatematsu
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - M. Yoshikawa
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - S. Tokioka
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - N. Yokoyama
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Miyake
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Tomii
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Kojima
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - Y. Takemura
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - T. Imai
- Plasma Research Centre, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - M. Yoshida
- JAERI, Naka Fusion Research Establishment, Ibaraki, Japan
| | - K. Sakamoto
- JAERI, Naka Fusion Research Establishment, Ibaraki, Japan
| | | | | | | |
Collapse
|
40
|
Kyono H, Nakashima M, Takamura S, Nakaya H, Nishide S, Nara Y, Sasaki K, Katayama T, Nagura F, Kawashima H, Hioki H, Watanabe Y, Konno K, Yokoyama N, Kozuma K. P4289The impact of transient slow flow/no-reflow during rotational atherectomy on clinical outcomes. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4289] [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: 11/12/2022] Open
|
41
|
Otani T, Yokoyama N, Sato D, Kobayashi K, Iwaya A, Kuwabara S, Yamazaki T, Matsuzawa N, Saito H, Katayanagi N. Safety and efficacy of a novel continuous incision technique for laparoscopic transcystic choledocholithotomy. Asian J Endosc Surg 2017; 10:282-288. [PMID: 28176466 DOI: 10.1111/ases.12363] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/20/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the safety and efficacy of a novel continuous incision technique for the cystic duct and the bile duct over the orifice for laparoscopic transcystic choledocholithotomy (LTCL). METHODS LTCL was attempted in 103 consecutive patients from January 1998 to March 2015 and was successful in 96 patients. The cystic duct confluence was made by cutting upward from the orifice in 19 patients. The cystic duct was incised downward beyond the orifice to the bile duct in the other 77 patients. Both of these procedures involved LTCL. RESULTS LTCL was successful in 96 patients. It failed in seven patients because of large bile duct stones (BDS), left lateral entry of the cystic duct, or the cystic duct's small diameter. The success rates of LTCL were 98% (47/48), 96% (42/44), and 64% (7/11) for patients with BDS <10 mm, 10-20 mm, and ≥20 mm, respectively. The success rate for removing BDS <20 mm was significantly higher than the removal rate for BDS ≥20 mm (P < 0.0001). There was no significant difference between the incidences of complications associated with BDS ≥10 mm and with BDS <10 mm (P = 0.49). In those who underwent successful LTCL, complications occurred in 3 of 23 patients with failed preoperative duodenoscopic sphincterotomy and in 9 of the other 73 patients; the incidence of complications did not significantly differ between these groups (P = 0.93). CONCLUSION LTCL is safe and feasible for exploration of the bile duct and removal of BDS <20 mm.
Collapse
Affiliation(s)
- Tetsuya Otani
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Naoyuki Yokoyama
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Daisuke Sato
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Kazuaki Kobayashi
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Akira Iwaya
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Shirou Kuwabara
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | | | - Natsumi Matsuzawa
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Hideki Saito
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| | - Norio Katayanagi
- Department of Surgery, Niigata City General Hospital, Niigata, Japan
| |
Collapse
|
42
|
Shiratori Y, Obana R, Tamura M, Kubo E, Iino R, Miyazawa A, Yokoyama N, Maruyama Y. P5182Five-year clinical outcome after angioplasty for symptomatic lower-limb ischemia in hemodialysis patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Hosogoe N, Ishikawa S, Yokoyama N, Kozuma K, Isshiki T. Add-on Antiplatelet Effects of Eicosapentaenoic Acid With Tailored Dose Setting in Patients on Dual Antiplatelet Therapy. Int Heart J 2017; 58:481-485. [PMID: 28717113 DOI: 10.1536/ihj.16-430] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to investigate the antiplatelet effects of eicosapentaenoic acid (EPA) at a sufficient dose following coronary stent implantation. Thirty-one patients on dual antiplatelet therapy with aspirin and clopidogrel were treated with highly purified EPA-E (Epadel®) for 12 weeks. Based on our previous study, patients with a high baseline EPA/arachidonic acid (AA) ratio (≥ 0.37; n = 11) were given a standard dose (1800 mg daily) of EPA-E, whereas those with a low EPA/AA ratio (< 0.37; n = 20) were given a high dose (2700 mg daily) to reach the target value of > 0.92. Platelet function was then evaluated with agonist-induced aggregation using light transmittance aggregometry and VerifyNow®. After EPA-E treatment, the EPA/AA ratio significantly increased from 0.28 to 1.31 (P < 0.001). Collagen (1, 2, and 4 μg/mL)-induced maximal platelet aggregation (MPA) was significantly suppressed after EPA-E administration (from 28.0 to 24.0, P = 0.033; from 44.0 to 40.0, P = 0.016; from 60.0 to 56.0, P = 0.010; respectively). However, there were no changes in MPA induced by adenosine diphosphate and AA and in P2Y12 reaction units (PRU) and aspirin reaction units. After EPA-E treatment, PRU was significantly suppressed in 8 patients showing high on-treatment platelet reactivity (HTPR) (baseline 305; 266-321 versus on-treatment 256; 233-261, P = 0.012), but not in those without HTPR (201; 156-220 versus 183; 159-233, P = 0.212). In conclusion, EPA treatment at a sufficient dose suppressed platelet aggregation and showed possible add-on effects in patients with clopidogrel hyporesponsiveness.
Collapse
Affiliation(s)
- Naoyoshi Hosogoe
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Shuichi Ishikawa
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Naoyuki Yokoyama
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Ken Kozuma
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| | - Takaaki Isshiki
- Division of Cardiology, Department of Internal Medicine, Teikyo University School of Medicine
| |
Collapse
|
44
|
Oda T, Ishimura T, Yokoyama N, Ogawa S, Miyake H, Fujisaw M. Hypoxia-Inducible Factor-1α Expression in Kidney Transplant Biopsy Specimens After Reperfusion Is Associated With Early Recovery of Graft Function After Cadaveric Kidney Transplantation. Transplant Proc 2017; 49:68-72. [PMID: 28104162 DOI: 10.1016/j.transproceed.2016.10.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ischemia/reperfusion injury during kidney transplantation (KTx) delays allograft recovery. Hypoxia-inducible factor-1α (HIF-1α) is the key regulator of the protective response to ischemia/reperfusion injury. We evaluated the impact of the HIF-1α signaling pathway on allograft recovery during cadaveric KTx. METHODS Between 1996 and 2015, 46 patients underwent cadaveric KTx. The expression levels of HIF-1α-related proteins, including phosphoinositide 3-kinase, phosphorylated (p)-Akt, p-mammalian target of rapamycin, p-Eukaryotic translation initiation factor 4E, p-S6 ribosomal protein, and HIF-1α, were immunohistochemically evaluated and semi-quantitatively scored in graft biopsy specimens after 1 hour of revascularization. Ten kidney biopsy specimens collected during donor nephrectomy for living KTx were used as controls. Delayed graft function (DGF) was defined as the need for dialysis within 1 week of KTx. We compared the staining scores of each protein and several clinical parameters between patients with and those without DGF. RESULTS Expression levels of all six proteins in specimens after revasculization were elevated compared with those in controls. Thirty-five patients had DGF. Expression levels of PI3K, p-AKT, p-mTOR, p-eIF4E, and HIF-1α were significantly higher in patients without DGF than in those with DGF. Univariate analysis identified expression levels of p-Akt, p-S6, and HIF-1α, in addition to donor type (heart beating/non-heart beating), cold ischemic time, and donor age as significant predictors of DGF. Of these, only expression levels of HIF-1α and donor type were independently associated with DGF in multivariate analysis. CONCLUSIONS Up-regulation of HIF-1α in allografts after reperfusion may be a predictor of early recovery after cadaveric KTx.
Collapse
Affiliation(s)
- T Oda
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - T Ishimura
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Yokoyama
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Ogawa
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Miyake
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Fujisaw
- Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
45
|
Ohta H, Morita T, Yokoyama N, Osuga T, Sasaki N, Morishita K, Nakamura K, Takiguchi M. Serial measurement of pancreatic lipase immunoreactivity concentration in dogs with immune-mediated disease treated with prednisolone. J Small Anim Pract 2017; 58:342-347. [DOI: 10.1111/jsap.12652] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/28/2016] [Accepted: 01/02/2017] [Indexed: 12/21/2022]
Affiliation(s)
- H. Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - T. Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - N. Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - T. Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - N. Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - K. Morishita
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - K. Nakamura
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| | - M. Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine; Hokkaido University; Sapporo 060-0818 Japan
| |
Collapse
|
46
|
Takahashi Y, Yokoyama N, Sato D, Otani T, Mitsuma K, Hashidate H. Diagnosis of autoimmune pancreatitis with cholesterol granuloma mimicking intraductal papillary-mucinous carcinoma: A case report. Int J Surg Case Rep 2017; 33:62-66. [PMID: 28278438 PMCID: PMC5342982 DOI: 10.1016/j.ijscr.2017.02.053] [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: 11/08/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Pancreatic cysts are often observed incidentally on abdominal computed tomography (CT). For cysts involving intracystic nodules, malignant neoplasms such as intraductal papillary-mucinous carcinoma (IPMC) should be suspected. In contrast, cholesterol granuloma (CG) rarely occurs in the pancreas, and CG-associated autoimmune pancreatitis (AIP) has not yet been reported. To our knowledge, this is the first reported case of AIP with CG mimicking IPMC. PRESENTATION OF CASE A 56-year-old woman underwent abdominal CT for preoperative breast cancer screening. Asymptomatic polycystic lesions were detected in the pancreatic tail (maximum diameter, 5cm). Magnetic resonance cholangiopancreatography and endoscopic ultrasonography revealed main pancreatic duct obstruction and a lesion with intracystic nodules (maximum diameter, 10mm). Serum levels of pancreatic cancer tumor markers and IgG4 were within normal ranges. Because IPMC was suspected, distal pancreatectomy and splenectomy with regional lymphadenectomy were performed after surgery for breast cancer. Pathological examination of the specimen revealed no epithelial neoplasm; however, cholesterol crystals with foreign body giant cells were observed. Moreover, IgG4-positive plasma cells, diffuse lymphocyte infiltration, storiform fibrosis, and obliterative phlebitis were identified in the non-cystic pancreatic parenchyma. The final diagnosis was AIP with CG. DISCUSSION CG in the pancreas is rare and its pathogenesis remains unclear. The findings of the present case suggest that chronic inflammation due to AIP may cause local bleeding, and that a reaction to the leaked blood cells causes CG. CONCLUSIONS Although preoperative diagnosis may be difficult, AIP with CG should be considered as a differential diagnosis in pancreatic cysts involving nodular lesions.
Collapse
Affiliation(s)
- Yusuke Takahashi
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, 950-1197, Japan.
| | - Naoyuki Yokoyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, 950-1197, Japan
| | - Daisuke Sato
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, 950-1197, Japan
| | - Tetsuya Otani
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, 950-1197, Japan
| | - Koko Mitsuma
- Department of Pathology, Niigata City General Hospital, Niigata, 950-1197, Japan
| | - Hideki Hashidate
- Department of Pathology, Niigata City General Hospital, Niigata, 950-1197, Japan
| |
Collapse
|
47
|
Yokoyama N, Sugiyama D, Itakura M. Development of Aged Erythrocytes Separation Device using Lorentz Force. Biophys J 2017. [DOI: 10.1016/j.bpj.2016.11.1519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
48
|
Yokoyama N, Sugimoto T, Hashizume S, Kagami E. High Resolution Ketone Measuring Method using Enzyme Reactions and Electrical Chemical Analysis. Biophys J 2017. [DOI: 10.1016/j.bpj.2016.11.2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
49
|
Yokoyama N, Ohta H, Yamazaki J, Kagawa Y, Ichii O, Khoirun N, Morita T, Osuga T, Lim SY, Sasaki N, Morishita K, Nakamura K, Takiguchi M. Localization of Toll-like Receptor (TLR) 2 and TLR4 mRNA in the Colorectal Mucosa of Miniature Dachshunds with Inflammatory Colorectal Polyps. J Comp Pathol 2017; 156:183-190. [PMID: 28089357 DOI: 10.1016/j.jcpa.2016.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 09/30/2016] [Accepted: 10/22/2016] [Indexed: 01/03/2023]
Abstract
Inflammatory colorectal polyps (ICRPs) are characterized by the formation of multiple or solitary polyps with marked neutrophil infiltration in the colorectal area, and are speculated to be a novel form of breed-specific canine idiopathic inflammatory bowel disease (IBD). In human IBD, toll-like receptor (TLR) 2 and TLR4 have been reported to be involved in the pathogenesis of the disease. The aim of this study was to evaluate the expression of TLR2 and TLR4 mRNA in the colorectal mucosa of dogs with ICRPs by in-situ hybridization using an RNAscope assay. Samples of inflamed colorectal mucosa (n = 5) and non-inflamed mucosa (n = 5) from miniature dachshunds (MDs) with ICRPs and colonic mucosa from healthy beagles (n = 5) were examined. TLR2 and TLR4 hybridization signals were localized to the colorectal epithelium, inflammatory cells and fibroblasts in the inflamed colorectal mucosa of affected dogs. The signals were significantly greater in inflamed colorectal epithelium compared with non-inflamed epithelium of MDs with ICRPs and healthy beagles (P <0.05). These results suggest that increased expression of TLR2 and TLR4 mRNA in the inflamed colorectal mucosa results from not only inflammatory cell infiltration, but also the upregulation of TLR2 and TLR4 mRNA in the colonic epithelium.
Collapse
Affiliation(s)
- N Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - H Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - J Yamazaki
- Laboratory of Molecular Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - Y Kagawa
- Department of Diagnostic Pathology, Sapporo, Japan
| | - O Ichii
- Laboratory of Anatomy, Department of Biomedical Science, Sapporo, Japan
| | - N Khoirun
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - T Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - T Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - S Y Lim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - N Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan
| | - K Morishita
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - K Nakamura
- Veterinary Teaching Hospital, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - M Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Sapporo, Japan.
| |
Collapse
|
50
|
Krill L, Jandial D, Blair C, Ji T, Eskander R, Yokoyama N, Bristow R, Randall L, Zi X. Inhibition of the Wnt Pathway in Ovarian Cancer Tumorigenesis. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|