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Uemura T, Kimura A, Matsuda W, Yamamoto H, Sasaki R. Reverse Shock Index multiplied by Glasgow Coma Scale score as a point-of-care severity assessment for initial trauma management: A nationwide cohort study. Injury 2024; 55:111267. [PMID: 38129233 DOI: 10.1016/j.injury.2023.111267] [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: 07/25/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Severe trauma patients often require emergent interventions, such as massive transfusion, resuscitative procedures, and surgical procedures, and consume considerable human and medical resources. However, few practical indices can be easily used for emergent interventions. In recent years, it has become clear that rSIG (Reverse Shock Index multiplied by Glasgow Coma Scale [GCS] score), which can be easily calculated from vital signs, is a promising predictor of mortality. However, it is unclear whether rSIG is useful for emergent interventions. METHODS Data collected by the Japan Trauma Data Bank for adult patients admitted directly from the scene of trauma between April 2019 and December 2020 were analysed. The outcomes were massive transfusion, resuscitative procedures, surgical procedures and emergent interventions. Emergent interventions were defined as the composite outcome of massive transfusion, resuscitative procedures, and surgical procedures. The ability of rSIG to predict massive transfusion was compared with that of the ABC score and FASILA score by receiver-operating characteristic curve analysis. The ability of rSIG to predict resuscitative and surgical procedures was compared with that of the Shock Index (SI), GCS, Triage Revised Trauma score (T-RTS), and Previous Simple Prediction (PSP) score. The ability of rSIG to predict emergent interventions was compared with that of T-RTS, PSP, ABC, and FASILA. In addition to rSIG, rSIM (Reverse Shock Index multiplied by best motor response score) was also analysed as a supplement. RESULTS The study included 32,201 patients, 6,371 of whom required emergent interventions. The area under the receiver-operating characteristic curve (AUROC) for massive transfusion was highest for rSIG (0.846 [95 % confidence interval 0.832-0.859]) and significantly higher for rSIG than for rSIM, ABC and FASILA (all p < 0.0001). AUROCs for resuscitative and surgical procedures were highest for rSIG (0.777 [0.769-0.785] and 0.731 [0.720-0.741], respectively) and significantly higher than those for rSIM, SI, GCS, T-RTS, and PSP (all p < 0.0001). The AUROC for emergent interventions was highest for rSIG (0.760 [0.753-0.768]) and significantly higher for rSIG than for rSIM, T-RTS, PSP, ABC, or FASILA (all p < 0.0001). CONCLUSIONS rSIG is a simple and effective point-of-care predictor of emergent interventions during initial management of trauma.
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Affiliation(s)
- Tatsuki Uemura
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan.
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Wataru Matsuda
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hiroki Yamamoto
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
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Honda Y, Takahashi A, Tanaka N, Kajiwara Y, Sasaki R, Kataoka H, Sakamoto J, Okita M. Electrical Stimulation-Based Twitch Exercise Suppresses Progression of Immobilization-Induced Muscle Fibrosis via Downregulation of PGC-1?/VEGF Pathway. Physiol Res 2024; 73:285-294. [PMID: 38710059 PMCID: PMC11081190] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/16/2023] [Indexed: 05/08/2024] Open
Abstract
This study aimed to determine whether electrical stimulation-based twitch exercise is effective in inhibiting the progression of immobilization-induced muscle fibrosis. 19 Wistar rats were randomly divided into a control group (n=6), an immobilization group (n=6; with immobilization only), and a Belt group (n=7; with immobilization and twitch exercise through the belt electrode device, beginning 2 weeks after immobilization). The bilateral soleus muscles were harvested after the experimental period. The right soleus muscles were used for histological analysis, and the left soleus muscles were used for biochemical and molecular biological analysis. As a result, in the picrosirius red images, the perimysium and endomysium were thicker in both the immobilization and Belt groups compared to the control group. However, the perimysium and endomysium thickening were suppressed in the Belt group. The hydroxyproline content and alpha-SMA, TGF-beta1, and HIF-1alpha mRNA expressions were significantly higher in the immobilization and belt groups than in the control group. These expressions were significantly lower in the Belt group than in the immobilization group. The capillary-to-myofiber ratio and the mRNA expressions of VEGF and PGC-1alpha were significantly lower in the immobilization and belt groups than in the control group, these were significantly higher in the Belt group than in the immobilization group. From these results, Electrical stimulation-based twitch exercise using the belt electrode device may prevent the progression of immobilization-induced muscle fibrosis caused by downregulating PGC-1alpha/VEGF pathway, we surmised that this intervention strategy might be effective against the progression of muscle contracture. Keywords: Immobilization, Skeletal muscle, Fibrosis, Electrical stimulation-based twitch exercise, PGC-1alpha/VEGF pathway.
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Affiliation(s)
- Y Honda
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan.
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Esteller D, Schiava M, Verdú-Díaz J, Villar-Quiles RN, Dibowski B, Venturelli N, Laforet P, Alonso-Pérez J, Olive M, Domínguez-González C, Paradas C, Vélez B, Kostera-Pruszczyk A, Kierdaszuk B, Rodolico C, Claeys K, Pál E, Malfatti E, Souvannanorath S, Alonso-Jiménez A, de Ridder W, De Smet E, Papadimas G, Papadopoulos C, Xirou S, Luo S, Muelas N, Vilchez JJ, Ramos-Fransi A, Monforte M, Tasca G, Udd B, Palmio J, Sri S, Krause S, Schoser B, Fernández-Torrón R, López de Munain A, Pegoraro E, Farrugia ME, Vorgerd M, Manousakis G, Chanson JB, Nadaj-Pakleza A, Cetin H, Badrising U, Warman-Chardon J, Bevilacqua J, Earle N, Campero M, Díaz J, Ikenaga C, Lloyd TE, Nishino I, Nishimori Y, Saito Y, Oya Y, Takahashi Y, Nishikawa A, Sasaki R, Marini-Bettolo C, Guglieri M, Straub V, Stojkovic T, Carlier RY, Díaz-Manera J. Correction to: Analysis of muscle magnetic resonance imaging of a large cohort of patient with VCP‑mediated disease reveals characteristic features useful for diagnosis. J Neurol 2024; 271:2147-2148. [PMID: 38349561 PMCID: PMC10973025 DOI: 10.1007/s00415-023-12178-z] [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: 03/28/2024]
Affiliation(s)
- Diana Esteller
- Neurology Department, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Marianela Schiava
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - José Verdú-Díaz
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Rocío-Nur Villar-Quiles
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Boris Dibowski
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Nadia Venturelli
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Pascal Laforet
- Département de Neurologie Hôpital Raymond-Poincaré Garches France Inserm U1179, Garches, France
| | - Jorge Alonso-Pérez
- Servicio de Neurología. Hospital Virgen de la Candelaria, Tenerife, Spain
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Montse Olive
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Domínguez-González
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, Spain
| | - Carmen Paradas
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Beatriz Vélez
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Anna Kostera-Pruszczyk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Carmelo Rodolico
- UOC di Neurologia e Malattie Neuromuscolari, AOU Policlinico "G. Martino", Rome, Italy
| | - Kristl Claeys
- Neurologie, Neuromusculair Referentiecentrum, Universitaire Ziekenhuizen, Leuven, Belgium
| | - Endre Pál
- Neurology Department, University of Pécs, Pécs, Hungary
| | - Edoardo Malfatti
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | - Sarah Souvannanorath
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | | | - Willem de Ridder
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - Eline De Smet
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - George Papadimas
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | | | - Sofia Xirou
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | - Sushan Luo
- Neurology Department, Huashan Hospital, Fudan University, Shangai, China
| | - Nuria Muelas
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Juan J Vilchez
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Alba Ramos-Fransi
- Unitat de Malalties Neuromusculars, Servei de Neurologia, Hospital Germans Tries I Pujol, Badalona, Spain
| | - Mauro Monforte
- UOC di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Bjarne Udd
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Johanna Palmio
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Srtuhi Sri
- Sree Chitra Tirunal Insitute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Sabine Krause
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Roberto Fernández-Torrón
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Adolfo López de Munain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Elena Pegoraro
- Department of Neurosciences, University of Padova, Padua, Italy
| | - Maria Elena Farrugia
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Mathias Vorgerd
- Heimer Institut for Muscle Research, Klinikum Bergmannsheil Ruhr, University Bochum, Bochum, Germany
| | | | - Jean Baptiste Chanson
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Aleksandra Nadaj-Pakleza
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Hakan Cetin
- Neurology Department, Medical University of Vienna, Vienna, Austria
| | | | | | - Jorge Bevilacqua
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Nicholas Earle
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Mario Campero
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Jorge Díaz
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Chiseko Ikenaga
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Thomas E Lloyd
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yukako Nishimori
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | - Yoshiaki Takahashi
- Department of Neurology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | | | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Michela Guglieri
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Tanya Stojkovic
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Robert Y Carlier
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Jordi Díaz-Manera
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom.
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
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Okamoto M, Sasaki R, Ikeda K, Doi K, Tatsumi F, Oshima K, Kojima T, Mizushima S, Ikegami K, Yoshimura T, Furukawa K, Kobayashi M, Horio F, Murai A. FcRY is a key molecule controlling maternal blood IgY transfer to yolks during egg development in avian species. Front Immunol 2024; 15:1305587. [PMID: 38487530 PMCID: PMC10938909 DOI: 10.3389/fimmu.2024.1305587] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
Maternal immunoglobulin transfer plays a key role in conferring passive immunity to neonates. Maternal blood immunoglobulin Y (IgY) in avian species is transported to newly-hatched chicks in two steps: 1) IgY is transported from the maternal circulation to the yolk of maturing oocytes, 2) the IgY deposited in yolk is transported to the circulation of the embryo via the yolk sac membrane. An IgY-Fc receptor, FcRY, is involved in the second step, but the mechanism of the first step is still unclear. We determined whether FcRY was also the basis for maternal blood IgY transfer to the yolk in the first step during egg development. Immunohistochemistry revealed that FcRY was expressed in the capillary endothelial cells in the internal theca layer of the ovarian follicle. Substitution of the amino acid residue in Fc region of IgY substantially changed the transport efficiency of IgY into egg yolks when intravenously-injected into laying quail; the G365A mutant had a high transport efficiency, but the Y363A mutant lacked transport ability. Binding analyses of IgY mutants to FcRY indicated that the mutant with a high transport efficiency (G365A) had a strong binding activity to FcRY; the mutants with a low transport efficiency (G365D, N408A) had a weak binding activity to FcRY. One exception, the Y363A mutant had a remarkably strong binding affinity to FcRY, with a small dissociation rate. The injection of neutralizing FcRY antibodies in laying quail markedly reduced IgY uptake into egg yolks. The neutralization also showed that FcRY was engaged in prolongation of half-life of IgY in the blood; FcRY is therefore a multifunctional receptor that controls avian immunity. The pattern of the transport of the IgY mutants from the maternal blood to the egg yolk was found to be identical to that from the fertilized egg yolk to the newly-hatched chick blood circulation, via the yolk sac membrane. FcRY is therefore a critical IgY receptor that regulates the IgY uptake from the maternal blood circulation into the yolk of avian species, further indicating that the two steps of maternal-newly-hatched IgY transfer are controlled by a single receptor.
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Affiliation(s)
- Mayuko Okamoto
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Ryo Sasaki
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Koki Ikeda
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Kasumi Doi
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Fumiya Tatsumi
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Kenzi Oshima
- Laboratory of Molecular Bioregulation, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Takaaki Kojima
- Laboratory of Molecular Biotechnology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Shusei Mizushima
- Department of Biological Sciences, Faculty of Science, Hokkaido University, Sapporo, Japan
| | - Keisuke Ikegami
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Takashi Yoshimura
- Laboratory of Animal Integrative Physiology, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
- Institute of Transformative Bio-Molecules (WPI-ITbM), Nagoya University, Nagoya, Japan
| | - Kyohei Furukawa
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Misato Kobayashi
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Fumihiko Horio
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
| | - Atsushi Murai
- Laboratory of Animal Nutrition, Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Japan
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Sasaki R, Asami T, Takaishi M, Nakamura R, Roppongi T, Yoshimi A, Hishimoto A. Smaller hypothalamic subregion with paraventricular nucleus in patients with panic disorder. Brain Imaging Behav 2024:10.1007/s11682-023-00834-x. [PMID: 38376715 DOI: 10.1007/s11682-023-00834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 02/21/2024]
Abstract
In panic disorder (PD), functional disturbance of the hypothalamus-pituitary-adrenal (HPA) axis has been considered. However, in neuroimaging studies of PD, the hypothalamus and pituitary gland are poorly studied.We investigated the volume of PD patients' hypothalamus and pituitary gland, enrolling 38 PD patients and 38 healthy controls. Severity of PD was mild to moderate according to the Panic Disorder Severity Scale, and the illness duration was relatively short (median = 2.8 years). The hypothalamus' gray matter was automatically extracted and segmented, whereas the pituitary gland was manually traced. Regarding the hypothalamus, the paraventricular nucleus (PVH), which produces the corticotropin-releasing hormone, was of interest.The volumes of the pituitary and the bilateral anterior-superior hypothalamic subunits, where the PVH would be located, were compared by the multiple regression analyses controlling for age and intracranial content volume. To compensate for limitation in the abovementioned segmentation and analyses, the voxel-based morphometry with small volume correction (VBM-SVC) targeting the whole hypothalamus was also performed.The multiple regression analyses did not find significant effect of PD diagnosis on the volumes. However, in the VBM-SVC analysis, volume reduction of the PVH was suggested in PD even when patients who experienced PD for ≥ 3 years were excluded [peak coordinate (x, y, z = -2, 3, -8), FWE-corrected P = .022 (cluster-level) and 0.003 (peak-level), voxel size = 63]. Our results suggested structural alteration of the PVH in PD patients for the first time, indicating importance of the HPA-axis in PD pathology.
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Affiliation(s)
- Ryo Sasaki
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takeshi Asami
- Department of Psychiatry, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan.
| | - Masao Takaishi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ryota Nakamura
- Department of Psychiatry, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Tomohide Roppongi
- Psychiatric Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Asuka Yoshimi
- Psychiatric Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Akitoyo Hishimoto
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
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Sato L, Iwamoto N, Kakumoto Y, Tsuzuki S, Togano T, Ishikane M, Okumura N, Yamada G, Inada M, Suzuki T, Hojo M, Takasaki J, Sasaki R, Kimura A, Teruya K, Okamoto T, Hayakawa K, Hara H, Iseki K, Ohmagari N. Unfractionated Heparin Safety in COVID-19: Incidence and Risks of Bleeding Complications in Japan. J Atheroscler Thromb 2024:64448. [PMID: 38355124 DOI: 10.5551/jat.64448] [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] [Indexed: 02/16/2024] Open
Abstract
AIM Several studies have shown the efficacy and safety of low-molecular-weight heparin use in coronavirus disease 2019 (COVID-19), but that of unfractionated heparin (UFH) has not been investigated. We investigated the prevalence of bleeding complications during UFH administration, its impact on mortality, and the risk factors of bleeding outcomes associated with UFH. METHODS This retrospective cohort study was conducted at a single-center tertiary care hospital, including hospitalized patients with COVID-19. The primary outcomes were measured as the prevalence of bleeding complications during hospitalization, and the secondary outcomes were thromboembolic events and 60-day mortality rates. Logistic regression analysis and propensity score matching were used to assess risk factors for bleeding complications and their impact on mortality. RESULTS Among 1035 included patients, 516 patients were treated with UFH. Twelve (2.3%) patients in the UFH group experienced major bleeding. The prevalence of major bleeding in patients treated with therapeutic-dose UFH was 9.2%. Logistic regression analysis showed that age ≥ 60 years (adjusted odds ratio [aOR], 3.89; 95% confidence interval [CI], 1.01-15.0; P<.05) and COVID-19 severity (aOR, 35.9; 95% CI, 4.57-282; P <.05) were associated with major bleeding complications. After propensity score matching, 11 major and 11 non-major bleeding cases (including minor bleeding) were matched. The 60-day cumulative mortality rate between the two groups did not differ significantly (P=.13, log-rank test). CONCLUSIONS The incidence of major bleeding in COVID-19 patients using therapeutic-dose UFH was relatively high. Critical COVID-19 and older age were risk factors for bleeding complications.
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Affiliation(s)
- Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Yuko Kakumoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Nobumasa Okumura
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Hisao Hara
- Department of Cardiology, National Center for Global Health and Medicine
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
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Yamauchi Y, Saeki I, Fujisawa K, Egusa M, Nishiyama N, Fujioka T, Kawamoto D, Sasaki R, Nishimura T, Tanabe N, Hisanaga T, Matsumoto T, Ishikawa T, Yamasaki T, Takami T. Varying impact of lenvatinib or sorafenib therapy on skeletal muscle loss in patients with hepatocellular carcinoma. Oncology 2024:000536501. [PMID: 38286117 DOI: 10.1159/000536501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Lenvatinib and sorafenib are key therapeutic agents for hepatocellular carcinoma. However, there are no useful biomarkers for selecting molecular-targeted agents (MTAs). Skeletal muscle volume is associated with the clinical outcomes in these patients. We investigated the effects of lenvatinib and sorafenib on the skeletal muscles of patients with HCC. METHODS We evaluated the impact of skeletal muscle changes over a 3-month period for each MTA (n = 117; lenvatinib/sorafenib, 45/72). The skeletal muscle mass index (SMI) was measured at the third lumbar vertebra. Furthermore, we evaluated the direct effect of each MTA on primary human skeletal muscle cells by estimating muscle protein synthesis using western blot analysis. RESULTS The median change in SMI was -0.7% (p = 0.959) and -5.9% (p <0.001) for the lenvatinib and sorafenib groups, respectively. Sorafenib had a greater effect on skeletal muscle loss than lenvatinib (p < 0.001). Additionally, SMI significantly decreased in the sorafenib group regardless of initial skeletal muscle volume (p < 0.001), whereas no significant differences were observed in the lenvatinib group. Sorafenib therapy (odds ratio [OR], 2.98; p = 0.023) and non-muscle depletion (OR, 3.31; p = 0.009) were associated with a decreased SMI. In vitro analysis showed that sorafenib negatively affected muscle synthesis compared to lenvatinib. CONCLUSIONS Sorafenib may have a more negative effect on skeletal muscle than lenvatinib.
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Ueda S, Yoshida Y, Kebede B, Kitamura C, Sasaki R, Shinohara M, Fukuda I, Shirai Y. New Implications of Metabolites and Free Fatty Acids in Quality Control of Crossbred Wagyu Beef during Wet Aging Cold Storage. Metabolites 2024; 14:95. [PMID: 38392987 PMCID: PMC10890485 DOI: 10.3390/metabo14020095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/30/2023] [Accepted: 01/11/2024] [Indexed: 02/25/2024] Open
Abstract
Efficient cold-chain delivery is essential for maintaining a sustainable global food supply. This study used metabolomic analysis to examine meat quality changes during the "wet aging" of crossbred Wagyu beef during cold storage. The longissimus thoracic (Loin) and adductor muscles (Round) of hybrid Wagyu beef, a cross between the Japanese Black and Holstein-Friesian breeds, were packaged in vacuum film and refrigerated for up to 40 days. Sensory evaluation indicated an increase in the umami and kokumi taste owing to wet aging. Comprehensive analysis using gas chromatography-mass spectrometry identified metabolite changes during wet aging. In the Loin, 94 metabolites increased, and 24 decreased; in the Round, 91 increased and 18 decreased. Metabolites contributing to the umami taste of the meat showed different profiles during wet aging. Glutamic acid increased in a cold storage-dependent manner, whereas creatinine and inosinic acid degraded rapidly even during cold storage. In terms of lipids, wet aging led to an increase in free fatty acids. In particular, linoleic acid, a polyunsaturated fatty acid, increased significantly among the free fatty acids. These results provide new insight into the effects of wet aging on Wagyu-type beef, emphasizing the role of free amino acids, organic acids, and free fatty acids generated during cold storage.
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Affiliation(s)
- Shuji Ueda
- Department of Agrobioscience, Graduate School of Agricultural Science, Kobe University, Hyogo 657-8501, Japan
| | - Yuka Yoshida
- Japan Meat Science and Technology Institute, Tokyo 150-0013, Japan
| | - Biniam Kebede
- Department of Food Science, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Chiaki Kitamura
- Department of Agrobioscience, Graduate School of Agricultural Science, Kobe University, Hyogo 657-8501, Japan
| | - Ryo Sasaki
- Food Oil and Fat Research Laboratory, Miyoshi Oil & Fat Co., Ltd., Tokyo 124-8510, Japan
| | - Masakazu Shinohara
- The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, Hyogo 650-0017, Japan
| | - Itsuko Fukuda
- Department of Agrobioscience, Graduate School of Agricultural Science, Kobe University, Hyogo 657-8501, Japan
| | - Yasuhito Shirai
- Department of Agrobioscience, Graduate School of Agricultural Science, Kobe University, Hyogo 657-8501, Japan
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9
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Sasaki R, Ohta Y, Onoe H, Yamaguchi R, Miyamoto T, Tokuda T, Tamaki Y, Isa K, Takahashi J, Kobayashi K, Ohta J, Isa T. Balancing risk-return decisions by manipulating the mesofrontal circuits in primates. Science 2024; 383:55-61. [PMID: 38175903 DOI: 10.1126/science.adj6645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/06/2023] [Indexed: 01/06/2024]
Abstract
Decision-making is always coupled with some level of risk, with more pathological forms of risk-taking decisions manifesting as gambling disorders. In macaque monkeys trained in a high risk-high return (HH) versus low risk-low return (LL) choice task, we found that the reversible pharmacological inactivation of ventral Brodmann area 6 (area 6V) impaired the risk dependency of decision-making. Selective optogenetic activation of the mesofrontal pathway from the ventral tegmental area (VTA) to the ventral aspect of 6V resulted in stronger preference for HH, whereas activation of the pathway from the VTA to the dorsal aspect of 6V led to LL preference. Finally, computational decoding captured the modulations of behavioral preference. Our results suggest that VTA inputs to area 6V determine the decision balance between HH and LL.
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Affiliation(s)
- Ryo Sasaki
- Division of Physiology and Neurobiology, Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
| | - Yasumi Ohta
- Division of Materials Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma-shi, Nara 630-0192, Japan
| | - Hirotaka Onoe
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8507, Japan
| | - Reona Yamaguchi
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
| | - Takeshi Miyamoto
- Division of Physiology and Neurobiology, Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo 102-0083, Japan
| | - Takashi Tokuda
- Institute of Innovative Research, Tokyo Institute of Technology, Meguro-Ku, Tokyo 152-8550, Japan
| | - Yuki Tamaki
- Division of Physiology and Neurobiology, Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
| | - Kaoru Isa
- Division of Physiology and Neurobiology, Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
| | - Jun Takahashi
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto-shi, Kyoto 606-8507, Japan
| | - Kenta Kobayashi
- Section of Viral Vector Development, National Institute for Physiological Sciences, Okazaki-shi, Aichi 444-8585, Japan
| | - Jun Ohta
- Division of Materials Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma-shi, Nara 630-0192, Japan
| | - Tadashi Isa
- Division of Physiology and Neurobiology, Department of Neuroscience, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto 606-8507, Japan
- Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto-shi, Kyoto 606-8501, Japan
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10
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Sasaki R, Sakamoto J, Honda Y, Motokawa S, Kataoka H, Origuchi T, Okita M. Low-intensity pulsed ultrasound phonophoresis with diclofenac alleviated inflammation and pain via downregulation of M1 macrophages in rats with carrageenan-induced knee joint arthritis. Neurobiol Pain 2024; 15:100148. [PMID: 38174056 PMCID: PMC10758990 DOI: 10.1016/j.ynpai.2023.100148] [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: 09/24/2023] [Revised: 11/27/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
Objective This study aimed to investigate the effects of low-intensity pulsed ultrasound (LIPUS) phonophoresis with diclofenac on inflammation and pain in the acute phase of carrageenan-induced arthritis in rats. Design 60 male Wistar rats were randomly divided into the arthritis, diclofenac, LIPUS, phonophoresis, and sham-arthritis control groups. LIPUS and transdermal diclofenac gel were applied to the lateral side of the inflamed knee for 7 days, initiated postinjection day 1. In the phonophoresis group, diclofenac gel was rubbed onto the skin, followed by LIPUS application over the medication. Knee joint transverse diameters, pressure pain thresholds (PPTs), and paw withdrawal thresholds (PWT) were evaluated. The number of CD68-, CD11c-, and CD206-positive cells, and IL-1β and COX-2 mRNA expression were analyzed 8 days after injection. Results In the phonophoresis group, the transverse diameter, PPT, PWT significantly recovered at the day 8 compared to those in the LIPUS and diclofenac groups. The number of CD68- and CD11c-positive cells in the phonophoresis group was significantly lower than that in the LIPUS and diclofenac groups, but no significant differences were observed among three groups in CD206-positive cells. IL-1β and COX-2 mRNA levels were lower in the phonophoresis group than in the arthritis group, although there were no differences among the LIPUS, diclofenac, and phonophoresis groups. Conclusion LIPUS phonophoresis with diclofenac is more effective to ameliorate inflammation and pain compared to diclofenac or LIPUS alone, and the mechanism involves the decrease of M1 macrophages.
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Affiliation(s)
- Ryo Sasaki
- Department of Rehabilitation, Juzenkai Hospital, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yuichiro Honda
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Satoko Motokawa
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Hideki Kataoka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Tomoki Origuchi
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Minoru Okita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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11
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Esteller D, Schiava M, Verdú-Díaz J, Villar-Quiles RN, Dibowski B, Venturelli N, Laforet P, Alonso-Pérez J, Olive M, Domínguez-González C, Paradas C, Vélez B, Kostera-Pruszczyk A, Kierdaszuk B, Rodolico C, Claeys K, Pál E, Malfatti E, Souvannanorath S, Alonso-Jiménez A, de Ridder W, De Smet E, Papadimas G, Papadopoulos C, Xirou S, Luo S, Muelas N, Vilchez JJ, Ramos-Fransi A, Monforte M, Tasca G, Udd B, Palmio J, Sri S, Krause S, Schoser B, Fernández-Torrón R, López de Munain A, Pegoraro E, Farrugia ME, Vorgerd M, Manousakis G, Chanson JB, Nadaj-Pakleza A, Cetin H, Badrising U, Warman-Chardon J, Bevilacqua J, Earle N, Campero M, Díaz J, Ikenaga C, Lloyd TE, Nishino I, Nishimori Y, Saito Y, Oya Y, Takahashi Y, Nishikawa A, Sasaki R, Marini-Bettolo C, Guglieri M, Straub V, Stojkovic T, Carlier RY, Díaz-Manera J. Analysis of muscle magnetic resonance imaging of a large cohort of patient with VCP-mediated disease reveals characteristic features useful for diagnosis. J Neurol 2023; 270:5849-5865. [PMID: 37603075 PMCID: PMC10632218 DOI: 10.1007/s00415-023-11862-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND The diagnosis of patients with mutations in the VCP gene can be complicated due to their broad phenotypic spectrum including myopathy, motor neuron disease and peripheral neuropathy. Muscle MRI guides the diagnosis in neuromuscular diseases (NMDs); however, comprehensive muscle MRI features for VCP patients have not been reported so far. METHODS We collected muscle MRIs of 80 of the 255 patients who participated in the "VCP International Study" and reviewed the T1-weighted (T1w) and short tau inversion recovery (STIR) sequences. We identified a series of potential diagnostic MRI based characteristics useful for the diagnosis of VCP disease and validated them in 1089 MRIs from patients with other genetically confirmed NMDs. RESULTS Fat replacement of at least one muscle was identified in all symptomatic patients. The most common finding was the existence of patchy areas of fat replacement. Although there was a wide variability of muscles affected, we observed a common pattern characterized by the involvement of periscapular, paraspinal, gluteal and quadriceps muscles. STIR signal was enhanced in 67% of the patients, either in the muscle itself or in the surrounding fascia. We identified 10 diagnostic characteristics based on the pattern identified that allowed us to distinguish VCP disease from other neuromuscular diseases with high accuracy. CONCLUSIONS Patients with mutations in the VCP gene had common features on muscle MRI that are helpful for diagnosis purposes, including the presence of patchy fat replacement and a prominent involvement of the periscapular, paraspinal, abdominal and thigh muscles.
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Affiliation(s)
- Diana Esteller
- Neurology Department, Hospital Clinic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Marianela Schiava
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - José Verdú-Díaz
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Rocío-Nur Villar-Quiles
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Boris Dibowski
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Nadia Venturelli
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Pascal Laforet
- Département de Neurologie Hôpital Raymond-Poincaré Garches France Inserm U1179, Garches, France
| | - Jorge Alonso-Pérez
- Servicio de Neurología. Hospital Virgen de la Candelaria, Tenerife, Spain
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Montse Olive
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Domínguez-González
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Instituto de Investigación imas12, Hospital 12 de Octubre, Madrid, Spain
| | - Carmen Paradas
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Beatriz Vélez
- Unidad de Enfermedades Neuromusculares, Servicio de Neurología, Hospital Virgen del Rocio, Seville, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Anna Kostera-Pruszczyk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, ERN EURO NMD, Warsaw, Poland
- Neuromuscular Reference Centre, ERN-EURO-NMD, Warsaw, Poland
| | - Carmelo Rodolico
- UOC di Neurologia e Malattie Neuromuscolari, AOU Policlinico "G. Martino", Rome, Italy
| | - Kristl Claeys
- Neurologie, Neuromusculair Referentiecentrum, Universitaire Ziekenhuizen, Leuven, Belgium
| | - Endre Pál
- Neurology Department, University of Pécs, Pécs, Hungary
| | - Edoardo Malfatti
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | - Sarah Souvannanorath
- Université Paris Est, U955 INSERM, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, EURO-NMD, 94010, Creteil, France
| | | | - Willem de Ridder
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - Eline De Smet
- Neurology Department, Universitary Hospital Antwerpen, Edegem, Belgium
| | - George Papadimas
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | | | - Sofia Xirou
- Department of Neurology, Eginition Hospital, Medical School, NKUA, ERN, EURO NMD, Athens, Greece
| | - Sushan Luo
- Neurology Department, Huashan Hospital, Fudan University, Shangai, China
| | - Nuria Muelas
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Juan J Vilchez
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Neuromuscular and Ataxias Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Department of Medicine, Universitat de València, Valencia, Spain
| | - Alba Ramos-Fransi
- Unitat de Malalties Neuromusculars, Servei de Neurologia, Hospital Germans Tries I Pujol, Badalona, Spain
| | - Mauro Monforte
- UOC di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Bjarne Udd
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Johanna Palmio
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
- Folkhalsan Genetic Institute, Helsinki University, Helsinki, Finland
| | - Srtuhi Sri
- Sree Chitra Tirunal Insitute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Sabine Krause
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Benedikt Schoser
- Department of Neurology, Friedrich-Baur-Institute, LMU Clinics, Munich, Germany
| | - Roberto Fernández-Torrón
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Adolfo López de Munain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Neurology Department, Biodonostia Health Research Institute, Donostia, Spain
| | - Elena Pegoraro
- Department of Neurosciences, University of Padova, Padua, Italy
| | - Maria Elena Farrugia
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - Mathias Vorgerd
- Heimer Institut for Muscle Research, Klinikum Bergmannsheil Ruhr, University Bochum, Bochum, Germany
| | | | - Jean Baptiste Chanson
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Aleksandra Nadaj-Pakleza
- Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France and ERN-EURO-NMD, Neurology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Hakan Cetin
- Neurology Department, Medical University of Vienna, Vienna, Austria
| | | | | | - Jorge Bevilacqua
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Nicholas Earle
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Mario Campero
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Jorge Díaz
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile
| | - Chiseko Ikenaga
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Thomas E Lloyd
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yukako Nishimori
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yoshihiko Saito
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology, Tokyo, Japan
| | - Yasushi Oya
- Department of Neurology, National Center Hospital, NCNP, Tokyo, Japan
| | - Yoshiaki Takahashi
- Department of Neurology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | | | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Michela Guglieri
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom
| | - Tanya Stojkovic
- APHP, Centre de Référence des Maladies Neuromusculaires, Institut de Myologie, Centre de Recherche en Myologie, Sorbonne Université, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Robert Y Carlier
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (AP-HP), DMU Start Imaging, Raymond Poincaré Teaching Hospital, Garches, France
| | - Jordi Díaz-Manera
- John Walton Muscular Dystrophy Research Centre, Newcastle University Translational and Clinical Research Institute and Newcastle Hospitals NHS Foundation Trust, Center for Life, Central Parkway, Newcastle Upon Tyne, NE13BZ, United Kingdom.
- Neuromuscular Diseases Unit, Neurology Department, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
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Tadokoro K, Nakada Y, Sasaki R, Nakano Y, Yunoki T, Shin K, Taoka M, Ninomiya K, Nomura E, Takemoto M, Morihara R, Yamashita T. A Unique Case of Sarcoid-associated Myelopathy Accompanied by Lung Cancer. Intern Med 2023; 62:3531-3535. [PMID: 37062734 PMCID: PMC10749799 DOI: 10.2169/internalmedicine.0943-22] [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: 09/10/2022] [Accepted: 02/26/2023] [Indexed: 04/18/2023] Open
Abstract
The differential diagnosis of myelopathy in patients with malignancies may be challenging, as a spinal biopsy is not always applicable. A 66-year-old woman who had shown transient double vision and nausea developed spasticity and impaired deep sensation in both feet. Magnetic resonance imaging showed abnormal gadolinium enhancement of the brainstem, spinal meninges, and nerve root. Cerebrospinal fluid (CSF) revealed mild pleocytosis and elevated protein and decreased glucose levels, although CSF cytology was normal. Lung carcinoma was simultaneously detected, and noncaseating granuloma was detected from the hilar and axillary lymph nodes, so she was diagnosed with sarcoid-associated myelopathy. Her symptoms were kept stable by intravenous methylprednisolone, oral prednisolone, and methotrexate. This is the first case of sarcoid-associated myelopathy accompanied by lung cancer, suggesting the importance of clinical course, repetitive CSF cytology, and a biopsy of the lymph nodes to distinguish sarcoid-associated myelopathy from meningeal metastasis in patients with malignancies.
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Affiliation(s)
- Koh Tadokoro
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yumi Nakada
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yumiko Nakano
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Taijun Yunoki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Kotaro Shin
- Center for Graduate Medical Education, Okayama University, Japan
| | - Masataka Taoka
- Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan
| | - Kiichiro Ninomiya
- Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan
| | - Emi Nomura
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
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Sasaki R, Kaneda K, Yamada Y, Niki Y, Nakamura M, Nagura T, Jinzaki M. Extra-articular location of the three-dimensional mechanical axis in advanced knee osteoarthritis: an upright computed tomography study. Jpn J Radiol 2023; 41:1405-1413. [PMID: 37440161 DOI: 10.1007/s11604-023-01468-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE One of the most widely used benchmarks of lower-limb alignment is the mechanical axis (MA), which passes through the centers of the femoral head and the ankle in the weight-bearing position. However, where the MA passes through three-dimensionally (3D) is unclear. We investigated the MA in 3D (3D-MA) in knee osteoarthritis (OA) using upright computed tomography (CT). MATERIALS AND METHODS This study included 66 varus OA knees from 38 patients [age 70.0 (64.8-77.0) years; median (interquartile range)]. The 3D-MA was determined using upright CT data and compared among Kellgren-Lawrence (KL) grades. Further, correlations between the 3D-MA and other parameters were evaluated. RESULTS The 3D-MA was located at 5.3 (1.3-14.4)% medially and 7.1 (0.7-15.3)% posteriorly on the tibial plateau in KL-1, and was translated medioposteriorly with increased KL grade. The 3D-MA in KL-3 [30.6 (22.6-42.6)% medially and 50.9 (45.8-80.2)% posteriorly] and KL-4 [56.7 (48.5-62.9)% medially and 92.3 (50.2-127.1)% posteriorly] was located extra-articularly. The mediolateral position of the 3D-MA correlated with the femorotibial angle [correlation coefficient (CC) = - 0.85, p < 0.001], and the anteroposterior position of the 3D-MA correlated with the knee flexion angle (CC = - 0.93, p < 0.001). CONCLUSION Our analysis demonstrated that the 3D-MA in low-grade OA knees passes slightly medial and posterior to the knee center, and the 3D-MA is translated medioposteriorly with the progression of knee OA. Further, the 3D-MA is translated medially with varus progression and posteriorly with the progression of knee flexion contracture.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kazuya Kaneda
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Yasuo Niki
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
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Sasaki R, Nagashima M, Tanaka K, Okada Y, Komatsu S, Takeshima K. Accessory fragment migration in a professional baseball player with bipartite patella: A case report. Int J Surg Case Rep 2023; 112:108933. [PMID: 37856973 PMCID: PMC10667769 DOI: 10.1016/j.ijscr.2023.108933] [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: 08/21/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Bipartite patella (BP) is usually recognized as an incidental radiographic finding. Therefore, no reports have observed the process of accessory fragment migration. We present the case of a professional baseball pitcher with significant migration of the fragment during follow-up. PRESENTATION OF CASE A 26-year-old man was diagnosed with symptomatic BP and underwent conservative therapy. Eleven months later, he was unable to play baseball because of gradually worsening knee pain without obvious trauma. On radiographs, the accessory fragment which had located at the superolateral pole 11 months earlier migrated posterolaterally. The diagnosis of Saupe's type III BP was established, and open excision of the accessory fragment was performed. Postoperatively, full-weight-bearing walking and range-of-motion exercises were started the day after surgery. Three months after surgery, he could pitch with all his power without pain. DISCUSSION Since our patient was a professional baseball right-handed pitcher who needed to step strongly on his left knee during pitching, strong traction force from the vastus lateralis was likely to have been repeatedly applied to the accessory fragment. It might lead to migration of the accessory fragment. The open excision of the accessory fragment was performed because the accessory fragment had migrated away from the patella body. CONCLUSION We report a case of professional baseball player with symptomatic BP, in which case the chronological migration of the accessory fragment was observed without obvious trauma. When the accessory fragment is identified without obvious trauma, one of the differential diseases could be a BP.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan.
| | - Kentaro Tanaka
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan
| | - Yoshifumi Okada
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
| | - Shuro Komatsu
- Institute for Integrated Sports Medicine, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8642, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan; Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita city, Chiba 286-8520, Japan
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Nagashima M, Sasaki R, Tanaka K, Takeshima K. The use of tourniquet is useful in terms of blood loss and soft tissue damage in arthroscopic anterior cruciate ligament reconstruction: a retrospective study. Sci Rep 2023; 13:17798. [PMID: 37853067 PMCID: PMC10584916 DOI: 10.1038/s41598-023-45159-3] [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: 03/05/2023] [Accepted: 10/17/2023] [Indexed: 10/20/2023] Open
Abstract
Whether a tourniquet should be used for anterior cruciate ligament reconstruction (ACLR) when the operative field is secured remains controversial. Little is known about the influence of not using a tourniquet on total perioperative blood loss and soft tissue damage. The aim of this study was to compare total perioperative blood loss and soft tissue damage with and without tourniquet use during ACLR. Seventy-seven consecutive ACLRs in 76 patients were performed without tourniquet use at our hospital and enrolled in this study (T- group) between November 2018 and September 2021. The control group (T + group) comprised 55 historical ACLRs in 55 patients performed with tourniquet use at our hospital between April 2017 and September 2018. Total perioperative blood loss, calculated from the change in hemoglobin between that preoperatively and on postoperative day (POD) 1, and indicators of soft tissue damage including serum white blood cell (WBC) counts, creatine phosphokinase (CPK), and C-reactive protein (CRP) values measured on POD 1 and POD 7 were compared between groups. Total blood loss was significantly higher in the T- group (339 ± 216 mL) than in the T + group (258 ± 199 mL; P = 0.030). On POD 1, WBC counts were significantly higher in the T- group (9.7 ± 2.4 × 103 cells/µL) than in the T + group (9.1 ± 2.5 × 103 cells/µL; P = 0.043), CPK levels were significantly higher in the T- group (294 ± 417 U/L) than in the T + group (255 ± 88 U/L; P = 0.046), and CRP levels were also significantly higher in the T- group (1.40 ± 1.12 mg/dL) than in the T + group (0.91 ± 0.76 mg/dL; P = 0.016). No significant differences in WBC counts or CPK or CRP levels were seen between groups on POD 7. Total blood loss and soft tissue damage were significantly increased without tourniquet use during ACLR. No advantage was found for not using a tourniquet in terms of blood loss or soft tissue damage.
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Affiliation(s)
- Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-Ku, Tokyo, 108-8329, Japan.
| | - Ryo Sasaki
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-Ku, Tokyo, 108-8329, Japan
| | - Kentaro Tanaka
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-Ku, Tokyo, 108-8329, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan
- Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita City, Chiba, 286-8520, Japan
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Sasaki R, Taneda S, Okamoto T. Tatouage d’amalgame sur les gencives. CMAJ 2023; 195:E1390-E1391. [PMID: 37844927 PMCID: PMC10581712 DOI: 10.1503/cmaj.230584-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Affiliation(s)
- Ryo Sasaki
- Département de chirurgie buccale et maxillo-faciale (Sasaki, Okamoto), Université de médecine des femmes de Tokyo, Faculté de médecine; Département de chirurgie plastique et reconstructive (Sasaki), Hôpital de la police métropolitaine de Tokyo; Département d'anatomopathologie chirurgicale (Taneda), Université de médecine des femmes de Tokyo, Faculté de médecine, Tokyo, Japon.
| | - Sekiko Taneda
- Département de chirurgie buccale et maxillo-faciale (Sasaki, Okamoto), Université de médecine des femmes de Tokyo, Faculté de médecine; Département de chirurgie plastique et reconstructive (Sasaki), Hôpital de la police métropolitaine de Tokyo; Département d'anatomopathologie chirurgicale (Taneda), Université de médecine des femmes de Tokyo, Faculté de médecine, Tokyo, Japon
| | - Toshihiro Okamoto
- Département de chirurgie buccale et maxillo-faciale (Sasaki, Okamoto), Université de médecine des femmes de Tokyo, Faculté de médecine; Département de chirurgie plastique et reconstructive (Sasaki), Hôpital de la police métropolitaine de Tokyo; Département d'anatomopathologie chirurgicale (Taneda), Université de médecine des femmes de Tokyo, Faculté de médecine, Tokyo, Japon
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Kawahara D, Nishioka R, Murakami Y, Emoto Y, Iwashita K, Kubota H, Sasaki R, Nagata Y. A Nomogram Based on Pretreatment Radiomics and Dosiomics Features for Predicting Overall Survival for Esophageal Squamous Cell Cancer: Multi-Institutional Study. Int J Radiat Oncol Biol Phys 2023; 117:e470-e471. [PMID: 37785496 DOI: 10.1016/j.ijrobp.2023.06.1678] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The current study aims to propose a nomogram-based 2- and 3-years survival prediction model for esophageal squamous cell carcinoma treated by definitive radiotherapy using pretreatment computed tomography (CT), positron emission tomography (FDG PET) radiomic features and dosiomics features in addition to the common clinical factors using multi-institution data. MATERIALS/METHODS Data of 112 patients from one institution and 28 patients from the other institution were retrospectively collected. Radiomics and dosiomics features were extracted using five segmentations on CT and PET images and dose distribution. The least absolute shrinkage and selection operator (LASSO) with logistic regression was used to select radiomics and dosiomics features by calculating the radiomics and dosiomics scores (Rad-score and Dos-score), respectively, in the training model. The predictive clinical factors, Rad-score, and Dos-score were identified to develop a nomogram model. RESULTS We extracted 15219 features from the radiomics and dosiomics analysis. By LASSO Cox regression analysis, 13 CT-based radiomics features, 11 PET-based radiomics features, and 19 dosiomics features were selected. Clinical factors of T-stage, N-stage, and clinical stage were selected as significant prognostic factors by univariate Cox regression analysis. A predictive nomogram for prognosis in was established using these factors. In the external validation cohort, the C-index of the combined model of CT-based radiomics, PET-based radiomics, and dosiomics features with clinical factors were 0.74, 0.82, and 0.92, respectively. Moreover, we divided the cohort into high-risk and low-risk groups using the median nomogram score. Significant differences in overall survival (OS) in the combine model of CT-based radiomics, PET-based radiomics, and dosiomics features with clinical factors were observed between the high-risk and low-risk groups (P = 0.019, P = 0.038, and 0.014, respectively). CONCLUSION The current study established and validated 2- and 3-year survival prediction models based on radiomics and dosiomics features with clinical factors. The prediction model with dosiomics analysis could better predict OS than CT- and PET-based radiomics analysis in esophageal cancer patients treated with radiotherapy.
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Affiliation(s)
- D Kawahara
- Department of Radiation Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - R Nishioka
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Murakami
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Emoto
- Department of Radiation Oncology, Hyogo Cancer Center, Kobe, Japan
| | - K Iwashita
- Kobe Minimally invasive Cancer Center, Kobe, Japan
| | - H Kubota
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - R Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Nagata
- Department of Radiation Oncology, Graduate School of Biomedical Health Sciences, Hiroshima University, Hiroshima, Japan
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18
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Doi Y, Nagata Y, Matsumo Y, Numata K, Sasaki R, Yamada T, Igaki H, Imagumbai T, Katoh N, Yoshitake T, Shimizuguchi T, Fujioka D, Inoue M, Koide Y, Kimura T, Ito Y. Multicenter Retrospective Study of Stereotactic Body Radiotherapy for Patients with Previously Untreated Initial Small Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e293. [PMID: 37785079 DOI: 10.1016/j.ijrobp.2023.06.1290] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The effectiveness of stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) has been shown in many studies and its therapeutic effect is similar to radiofrequency ablation (RFA). However, many of these studies were done in combination with transcatheter chemoembolization (TACE), for recurrent HCC, or on a small scale. To better understand the specific outcomes of SBRT for HCC, we conducted a multicenter retrospective analysis of SBRT for previously untreated initial HCC at Japanese Society of Clinical Oncology (JCOG) member hospitals. MATERIALS/METHODS Patientswho underwent SBRT for HCC at JCOG member hospitals between July 2013 and December 2017 and met the following eligibility criteria were included: (1) initial HCC; (2) ≤ 3 nodules, ≤ 5 cm in diameter; (3) a Child-Pugh (CP) score of A or B; and (4) unsuitability for or refusal of standard treatment, such as surgery, transplantation, RFA and TACE. We evaluated the overall survival (OS), recurrence-free survival (RFS) which was defined as the first instance of intra-hepatic recurrence after SBRT, disease-specific survival (DSS) using Kaplan-Meier analysis. Using Grey's test, patients who died of other diseases were analyzed as competing risks to estimate the cumulative incidence of local recurrence (CLR). Adverse events directly related to SBRT also analyzed using Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). RESULTS Seventy-three patients with 79 lesions from 14 hospitals were analyzed. The median age was 77 years (range; 50-89 years), and the median tumor size was 23 mm (range; 6-50 mm). The median radiation dose was 40 Gy (range; 35-60 Gy) in five fractions (range; 4-8). The median follow-up period was 45 months (range; 0-103 months). There were three cases where follow-up was not possible due to unexpected events unrelated to SBRT, while the remaining 70 patients were successfully followed for at least six months. The 2 and 3year OS, RFS, DSS, and CLR rates were 84.3% (95% CI: 75.8-92.8%) and 69.9% (95% CI: 58.7-81%), 67.5% (95% CI: 56.0-79.0%) and 57.9% (95% CI: 45.2-70.5%), 95.1% (95% CI:89.7-100%)/87.6% (95% CI:78.8-96.3%), and 11.4% (95% CI: 5.3-20.0%) and 20.0% (95% CI: 11.2-30.5%), respectively. Four cases (5.5%) of adverse events of grade 3 or higher were reported: one case of grade 3 laboratory toxicities, one case of grade 3 liver failure, one case of grade 3 portal tumor thrombosis, and one case of grade 4 duodenal ulcer. No grade 5 toxicities were observed. CONCLUSION The results of our study demonstrate that SBRT for HCC is highly effective in achieving local control and is safe to administer. In addition, survival outcomes are favorable. SBRT is a promising treatment modality, especially for small HCCs for that is not suitable for standard treatment.
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Affiliation(s)
- Y Doi
- Department of Radiation Oncology, Hiroshima High-precision Radiotherapy Cancer Center, Hiroshima, Japan
| | - Y Nagata
- Department of Radiation Oncology, Hiroshima University, Hiroshima, Japan
| | - Y Matsumo
- Department of Radiation oncology, Niigata cancer center hospital, Niigata, Japan
| | - K Numata
- Department of Gastroenterology, Yokohama City University Medical Center, Yokohama, Japan
| | - R Sasaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Yamada
- University of Yamanashi, Chuo, Japan
| | - H Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T Imagumbai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - N Katoh
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yoshitake
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Shimizuguchi
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - D Fujioka
- Department of Radiation Oncology, Tsukuba University Hospital, Ibaraki, Japan
| | - M Inoue
- Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Y Koide
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Kimura
- Department of Radiation Oncology, Kochi University Hospital, Kochi, Japan
| | - Y Ito
- Department of Radiation Oncology, Showa University Hospital, Tokyo, Japan
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Sasaki R, Taneda S, Okamoto T. Gingival amalgam tattoo. CMAJ 2023; 195:E1083-E1084. [PMID: 37604524 PMCID: PMC10442241 DOI: 10.1503/cmaj.230584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Affiliation(s)
- Ryo Sasaki
- Department of Oral and Maxillofacial Surgery (Sasaki, Okamoto), Tokyo Women's Medical University, School of Medicine; Department of Plastic and Reconstructive Surgery (Sasaki), Tokyo Metropolitan Police Hospital; Department of Surgical Pathology (Taneda), Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
| | - Sekiko Taneda
- Department of Oral and Maxillofacial Surgery (Sasaki, Okamoto), Tokyo Women's Medical University, School of Medicine; Department of Plastic and Reconstructive Surgery (Sasaki), Tokyo Metropolitan Police Hospital; Department of Surgical Pathology (Taneda), Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
| | - Toshihiro Okamoto
- Department of Oral and Maxillofacial Surgery (Sasaki, Okamoto), Tokyo Women's Medical University, School of Medicine; Department of Plastic and Reconstructive Surgery (Sasaki), Tokyo Metropolitan Police Hospital; Department of Surgical Pathology (Taneda), Tokyo Women's Medical University, School of Medicine, Tokyo, Japan
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Sakamoto J, Miyahara S, Motokawa S, Takahashi A, Sasaki R, Honda Y, Okita M. Regular walking exercise prior to knee osteoarthritis reduces joint pain in an animal model. PLoS One 2023; 18:e0289765. [PMID: 37561757 PMCID: PMC10414568 DOI: 10.1371/journal.pone.0289765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
We investigated the effect of regular walking exercise prior to knee osteoarthritis (OA) on pain and synovitis in a rat monoiodoacetic acid (MIA)-induced knee OA model. Seventy-one male Wistar rats were divided into three groups: (i) Sedentary + OA, (ii) Exercise + OA, and (iii) Sedentary + Sham groups. The Exercise + OA group underwent a regular treadmill walking exercise at 10 m/min (60 min/day, 5 days/week) for 6 weeks, followed by a 2-mg MIA injection in the right knee. The right knee joint was removed from rats in this group at the end of the 6-week exercise period and at 1 and 6 weeks after the MIA injection. After the 6 weeks of treadmill exercise but before MIA injection, there were no significant differences among the three groups in the pressure pain threshold, whereas at 1 week post-injection, the Exercise + OA group's pressure pain threshold was significantly higher than that in the Sedentary + OA group, and this difference persisted until the end of the experimental period. The histological changes in articular cartilage and subchondral bone revealed by toluidine blue staining showed no difference between the Sedentary + OA and EX + OA groups. The expression levels of interleukin (IL)-4 and IL-10 mRNA in the infrapatellar fat pad and synovium were significantly increased by the treadmill exercise. Significant reductions in the number of CD68-, CD11c-positive cells and IL-1β mRNA expression and an increase in the number of CD206-positive cells were observed at 1 week after the MIA injection in the Exercise + OA group compared to the Sedentary + OA group. These results suggest that regular walking exercise prior to the development of OA could alleviate joint pain through increases in the expressions of anti-inflammatory cytokines in the rat infrapatellar fat pad and synovium.
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Affiliation(s)
- Junya Sakamoto
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Syouta Miyahara
- Department of Rehabilitation Medicine, Japan Organization of Occupational Health and Safety, Spinal Injuries Center, Fukuoka, Japan
| | - Satoko Motokawa
- Department of Clinical Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Ayumi Takahashi
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryo Sasaki
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Juzenkai Hospital, Nagasaki, Japan
| | - Yuichiro Honda
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Minoru Okita
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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21
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Sasaki R, Niki Y, Kaneda K, Yamada Y, Nagura T, Nakamura M, Jinzaki M. Three-dimensional joint surface orientation does not correlate with two-dimensional coronal joint line orientation in knee osteoarthritis: Three-dimensional analysis of upright computed tomography. Knee 2023; 43:10-17. [PMID: 37207557 DOI: 10.1016/j.knee.2023.05.001] [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: 08/25/2022] [Revised: 03/23/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Two-dimensional (2D) coronal joint line orientation on radiography under weight-bearing conditions has been widely used in evaluating knee osteoarthritis (OA). However, the effects of tibial rotation remain unknown. The present study aimed to newly define three-dimensional (3D) joint surface orientation relative to the floor as an unchangeable 3D angle unaffected by tibial rotation using upright computed tomography (CT), and to investigate correlations between 3D and 2D parameters in knee OA. METHODS Sixty-six knees in 38 patients with varus knee OA underwent standing hip-to-ankle digital radiography and upright CT. The 2D parameters measured on radiographs included femorotibial angle (FTA), tibial joint line angle (TJLA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA). The 3D inner product angle between vectors of the tibial joint surface and the floor from CT was defined as the 3D joint surface-floor angle. RESULTS Mean 3D joint surface-floor angle was 6.0 ± 3.6°. No correlation was identified between 3D joint surface-floor angle and 2D joint line parameters, even though FTA correlated substantially with 2D joint line parameters. No significant differences in 3D joint surface-floor angle were identified among Coronal Plane Alignment of the Knee (CPAK) types. CONCLUSIONS The 3D joint surface orientation did not correlate with 2D coronal joint line orientation and was unaffected by CPAK classification types. This finding suggests that current 2D evaluations should be reconsidered for a better understanding of true knee joint line orientation.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasuo Niki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Kazuya Kaneda
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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22
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Sasaki R, Katsuhara M, Yoshifuji K, Komoriya Y. Novel dry EEG electrode with composite filler of PEDOT:PSS and carbon particles. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083429 DOI: 10.1109/embc40787.2023.10341103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
We have developed a novel composite filler with Poly(3,4-ethylenedioxythiophene) : poly(styrenesulfonic acid) (PEDOT:PSS), a biocompatible organic conductive polymer, adsorbed on carbon particles for biological electrodes. This composite filler enables to fabricate high-performance biological electrodes simply by adding it to resin in the same way as conventional conductive fillers. The fabricated electrodes achieve ion exchange properties similar to those of PEDOT:PSS polymers and therefore low skin and electrode contact impedance. Electroencephalogram (EEG) measurements show that these electrodes capture various brain activities and exhibit high correlation (≥ 0.9) to commercially available wet and AgCl electrodes. Additionally, each electrode can be molded into various shapes and structures while retaining its electrode characteristics. Therefore, the proposed electrode is promising for EEG measurement, which requires high comfort and signal quality.
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23
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Sasaki R, Watanabe Y, Miyamoto NS, Agawa K, Okamoto T. Innsbruck-style Retromandibular Anterior Trans-parotid Approach for Condylar Fractures: A Retrospective Review of 39 Fractures. Plast Reconstr Surg Glob Open 2023; 11:e5091. [PMID: 37351120 PMCID: PMC10284331 DOI: 10.1097/gox.0000000000005091] [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: 03/13/2023] [Accepted: 05/05/2023] [Indexed: 06/24/2023]
Abstract
The retromandibular anterior trans-parotid (RAT) approach and a triangular-positioned double mini-plate osteosynthesis (TDO) technique have been reported from Innsbruck Medical University. This minimally invasive technique involves direct visualization of the condyle and is associated with lower incidence of facial palsy. Methods A retrospective review was performed on the RAT approach and TDO technique conducted by a surgeon and team at two hospitals in Tokyo during a period of 3 years and 10 months. Results This technique was performed on 35 patients with 39 condylar fractures. Sixty-nine percent of cases were due to accidental fall, 17% to traffic accidents, and 9% to sports. Furthermore, 92% cases were condylar base fractures. Nighty-seven percent of cases achieved good occlusion. The mean maximum mouth opening was 49 ± 1.3 mm. Postoperatively, facial palsy developed in three patients (7.7%), and two of them developed Frey syndrome at approximately 2.5 years postoperatively (5.1%). All patients completely recovered within 3 months postoperatively. One case each of salivary fistula, visible scar, and condylar resorption was found (2.6%). No case of massive bleeding during surgery, hematoma, or TMJ pain after surgery was found. Conclusion This technique could achieve good occlusion with low incidence of complications and could contribute to early social reintegration among patients.
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Affiliation(s)
- Ryo Sasaki
- From the Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, School of Medicine, Tokyo, Japan
- Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Yorikatsu Watanabe
- Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Noriko Sangu Miyamoto
- From the Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, School of Medicine, Tokyo, Japan
| | - Kaori Agawa
- Department of Plastic and Reconstructive Surgery, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Toshihiro Okamoto
- From the Department of Oral and Maxillofacial Surgery, Tokyo Women’s Medical University, School of Medicine, Tokyo, Japan
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24
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Tanabe N, Saeki I, Aibe Y, Matsuda T, Hanazono T, Nishi M, Hidaka I, Kuwashiro S, Shiratsuki S, Matsuura K, Egusa M, Nishiyama N, Fujioka T, Kawamoto D, Sasaki R, Nishimura T, Oono T, Hisanaga T, Matsumoto T, Ishikawa T, Yamasaki T, Takami T. Early Prediction of Response Focused on Tumor Markers in Atezolizumab plus Bevacizumab Therapy for Hepatocellular Carcinoma. Cancers (Basel) 2023; 15:cancers15112927. [PMID: 37296889 DOI: 10.3390/cancers15112927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Despite the promising efficacy of atezolizumab plus bevacizumab (atezo/bev), some patients with unresectable hepatocellular carcinoma (HCC) experience disease progression. This retrospective study, which included 154 patients, aimed to evaluate predictors of treatment efficacy of atezo/bev for unresectable HCC. Factors associated with treatment response were examined, focusing on tumor markers. In the high-alpha-fetoprotein (AFP) group (baseline AFP ≥ 20 ng/mL), a decrease in AFP level > 30% was an independent predictor of objective response (odds ratio, 5.517; p = 0.0032). In the low-AFP group (baseline AFP < 20 ng/mL), baseline des-gamma-carboxy prothrombin (DCP) level < 40 mAU/mL was an independent predictor of objective response (odds ratio, 3.978; p = 0.0206). The independent predictors of early progressive disease were an increase in AFP level ≥ 30% at 3 weeks (odds ratio, 4.077; p = 0.0264) and the presence of extrahepatic spread (odds ratio, 3.682; p = 0.0337) in the high-AFP group and up-to-seven criteria, OUT (odds ratio, 15.756; p = 0.0257) in the low-AFP group. In atezo/bev therapy, focusing on early AFP changes, baseline DCP, and tumor burden of up-to-seven criteria are useful in predicting response to treatment.
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Affiliation(s)
- Norikazu Tanabe
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Issei Saeki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Yuki Aibe
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Kokura Memorial Hospital, Kitakyushu 802-8555, Fukuoka, Japan
| | - Takashi Matsuda
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Shimonoseki Medical Center, Shimonoseki 750-0061, Yamaguchi, Japan
| | - Tadasuke Hanazono
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Saiseikai Shimonoseki General Hospital, Shimonoseki 759-6603, Yamaguchi, Japan
| | - Maiko Nishi
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Yamaguchi Rosai Hospital, Sanyo-Onoda 756-0095, Yamaguchi, Japan
| | - Isao Hidaka
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Saiseikai Yamaguchi General Hospital, Yamaguchi 753-0078, Yamaguchi, Japan
| | - Shinya Kuwashiro
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Yamaguchi Prefectural Grand Medical Center, Hofu 747-8511, Yamaguchi, Japan
| | - Shogo Shiratsuki
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Tokuyama Central Hospital, Syunan 745-8522, Yamaguchi, Japan
| | - Keiji Matsuura
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Gastroenterology, Shuto General Hospital, Yanai 742-0032, Yamaguchi, Japan
| | - Maho Egusa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Natsuko Nishiyama
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Tsuyoshi Fujioka
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Daiki Kawamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Ryo Sasaki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Tatsuro Nishimura
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Takashi Oono
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Takuro Hisanaga
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Toshihiko Matsumoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Tsuyoshi Ishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
| | - Takahiro Yamasaki
- Division of Laboratory, Yamaguchi University Hospital, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
- Department of Oncology and Laboratory Medicine, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Yamaguchi, Japan
- Yamaguchi Clinical Research Group-Hepatology (YCR-H), Ube 755-8505, Yamaguchi, Japan
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Sasaki R, Matsuoka C, Yamashita T, Kinomura M, Abe K. A Case of Drug-Resistant Myoclonus Improved by Only Slight Adjustment to the Hemodialysis Setting. Cureus 2023; 15:e36104. [PMID: 37065285 PMCID: PMC10098026 DOI: 10.7759/cureus.36104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Myoclonus, a rare complication in patients with end-stage renal disease, is typically ameliorated through hemodialysis. The present case concerns an 84-year-old male with chronic renal failure undergoing hemodialysis, presenting involuntary movements in his limbs, which gradually worsened from the initiation of hemodialysis without constant elevation of serum blood urea nitrogen and electrolytes levels. Surface electromyography revealed characteristic findings consistent with myoclonus. He was diagnosed with subcortical-nonsegmental myoclonus related to hemodialysis, and the myoclonus was significantly alleviated after slightly increasing the post-dialysis target weight even though drug treatment was ineffective. This case suggests that drug-resistant myoclonus in patients with renal failure may be improved by adjusting hemodialysis settings, even in cases of atypical dialysis disequilibrium syndrome.
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Sasaki R, Nagashima M, Aibara N, Aomatsu S, Aida S, Takeshima K, Ishii K. Simultaneous bilateral quadriceps tendon rupture in a healthy young male: a case report. J Med Case Rep 2023; 17:85. [PMID: 36879269 PMCID: PMC9990254 DOI: 10.1186/s13256-023-03802-7] [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: 03/03/2022] [Accepted: 02/01/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Simultaneous bilateral quadriceps tendon rupture is rare, particularly in young individuals with no prior medical history. We present the case of a young man who presented with bilateral quadriceps tendon rupture. CASE PRESENTATION A 27-year-old Japanese man missed a step while descending a flight of stairs, stumbled, and became aware of severe pain in both knees. He had no past medical history, but was severely obese, with a body mass index of 43.7 kg/m2 (height 177 cm, weight 137 kg). Five days after injury, he was referred to our hospital for examination and treatment. Bilateral quadriceps tendon rupture was diagnosed based on magnetic resonance imaging, and quadriceps tendon repair with suture anchor was performed on both knees 14 days after injury. The postoperative rehabilitation protocol was to immobilize both knees in extension for 2 weeks, then to gradually proceed with weight-bearing and gait training using hinged knee braces. Both knees obtained a range of motion from 0° to 130° without any extension lag by 3 months postoperatively. One year postoperatively, tenderness was evident at the suture anchor in the right knee. That suture anchor was therefore removed in a second operation, and histological evaluation of the tendon of the right knee revealed no pathological changes. As of 19 months after the primary surgery, the patient showed a range of motion from 0° to 140° in both knees, did not complain of any disability, and had fully returned to normal daily activities. CONCLUSIONS We experienced simultaneous bilateral quadriceps tendon rupture in a 27-year-old man with no past medical history other than obesity. Suture anchor repair was performed for both quadriceps tendon ruptures and achieved a favorable postoperative outcome.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan.
| | - Noriyuki Aibara
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Shuji Aomatsu
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Shinsuke Aida
- Department of Pathology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
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Ishikawa Y, Sasaki R, Ishiwata A, Hatakeyama S, Matsumura M, Sato T. A case of Behçet's-like disease associated with trisomy 8-positive myelodysplastic syndrome presented periodic fever with MEFV E148Q variant. Mod Rheumatol Case Rep 2023:7070601. [PMID: 36881672 DOI: 10.1093/mrcr/rxad015] [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: 11/02/2022] [Revised: 02/03/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
Behçet's-like disease, which incompletely fulfils the criteria of Behçet's disease, is often associated with trisomy 8-positive myelodysplastic syndrome (MDS). We report a case of an 82-year-old man with these conditions carrying E148Q variant of MEFV gene who presented with periodic fever. The patient presented with joint pain, muscle pain, and episodes of periodic fever every two weeks for the past three months. On admission, painful erythema and fever were observed. Colonoscopy revealed erosion in the cecum and ascending colon. The patient had bicytopenia, and a bone marrow biopsy showed findings compatible with trisomy 8-positive unclassifiable MDS. Because the patient incompletely fulfilled the criteria for Behçet's disease, he was diagnosed with Behçet's-like disease associated with trisomy 8-positive MDS. Positron emission tomography-computed tomography performed during the fever revealed multiple muscle lesions consistent with the sites of pain. To examine the cause of the periodic fever attacks, MEFV gene was analysed, and the results revealed E148Q variant. Steroids were ineffective against periodic fever attacks. A daily dose of 0.5 mg colchicine was prescribed, but the effect was minimal, probably because of the insufficient dose due to renal dysfunction. Based on the diagnosis of atypical familial Mediterranean fever, canakinumab was added, which partially mitigated the periodic fever. This case suggests the importance of ruling out MDS when physicians see an elderly patient who present with Behçet-like disease. Although the significance of E148Q variant in the pathogenesis of periodic fever remains controversial, it may act as a disease modifier in accordance with trisomy 8-positive MDS.
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Affiliation(s)
- Yukiko Ishikawa
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Ryo Sasaki
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Akira Ishiwata
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Shuji Hatakeyama
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Masami Matsumura
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Takeo Sato
- Division of Rheumatology and Clinical Immunology, Jichi Medical University, Tochigi, Japan
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Ishikawa T, Egusa M, Fujioka T, Nishiyama N, Kawamoto D, Sasaki R, Nishimura T, Tanabe N, Oono T, Saeki I, Takami T. A combination of liver stiffness and international normalized ratio is an ideal prognostic predictor of portosystemic shunt occlusion in patients with portal hypertension. J Gastroenterol 2023; 58:246-256. [PMID: 36583759 DOI: 10.1007/s00535-022-01947-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND We previously reported liver stiffness (LS) as a prognostic predictor of portosystemic shunt (PSS) occlusion. This study aims to reinvestigate the predictive factors of the model for end-stage liver disease-sodium (MELD-Na) score amelioration following balloon-occluded retrograde transvenous obliteration (BRTO) and to evaluate the postoperative prognoses of patients with portal hypertension by using newly identified factors. METHODS Seventy-five patients who underwent BRTO between 2008 and 2021 were retrospectively enrolled. The MELD-Na scores were calculated preoperatively and one month postoperatively. We monitored long-term outcomes and analyzed postoperative survival. RESULTS At one month postoperatively, the MELD-Na score decreased in 46 (61.3%) patients. Univariate analyses revealed a significant association of the score amelioration with nine factors, including lower LS levels and a higher international normalized ratio (INR). A multivariate logistic regression analysis with receiver operating characteristic curve analyses identified preoperative LS levels and INR as significant independent predictors of the postoperative MELD-Na score amelioration, with optimal cutoffs of 28.1 kPa and 1.06, respectively. The combination of LS < 28.1 kPa and INR ≥ 1.06 showed a sensitivity and specificity of 84.8% and 75.9% for the prediction of the score amelioration, respectively. For the propensity score model, we matched 24 patients with similar age, sex, MELD-Na score, and concomitant hepatocellular carcinoma. Kaplan-Meier analysis determined significantly higher cumulative survival rates in patients with LS < 28.1 kPa and INR ≥ 1.06 than in other populations. CONCLUSIONS A combination of LS and INR can predict the MELD-Na score amelioration and prognosis improvement following PSS occlusion.
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Affiliation(s)
- Tsuyoshi Ishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan.
| | - Maho Egusa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Tsuyoshi Fujioka
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Natsuko Nishiyama
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Daiki Kawamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Ryo Sasaki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Tatsuro Nishimura
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Norikazu Tanabe
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Takashi Oono
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Issei Saeki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 7558505, Japan
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Sasaki R, Yunoki T, Nakano Y, Fukui Y, Takemoto M, Morihara R, Katsuyama E, Nishino I, Yamashita T. A young female case of asymptomatic immune-mediated necrotizing myopathy: a potential diagnostic option of antibody testing for rhabdomyolysis. Neuromuscul Disord 2023; 33:183-186. [PMID: 36652875 DOI: 10.1016/j.nmd.2022.12.012] [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: 09/20/2022] [Revised: 12/09/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) immune-mediated necrotizing myopathy (IMNM) is a neuromuscular disorder that presents muscle weakness in proximal extremities and/or the trunk with an elevation of creatine kinase (CK). Young and asymptomatic anti-HMGCR IMNM patients are very rare and a treatment regimen has not been established. The present case, a 17-year-old woman without any muscular symptoms, only showed hyperCKemia that was detected by chance. After close examinations, including a muscle biopsy and antibody search, she was diagnosed as anti-HMGCR IMNM, and initial treatment with methotrexate and continuous intravenous immunoglobulin seemed to be effective. The present case is the unusually young asymptomatic case of anti-HMGCR IMNM. The diagnosis was successfully made, leading to the early introduction of a treatment. Given the course of this case, we believe that the preceding antibody testing is one of the diagnostic option for rhabdomyolysis.
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Affiliation(s)
- Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Taijun Yunoki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yumiko Nakano
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yusuke Fukui
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Eri Katsuyama
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8502, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
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Sasaki R, Yunoki T, Nakano Y, Fukui Y, Takemoto M, Morihara R, Abe K, Yamashita T. Actual Telemedicine Needs of Japanese Patients with Neurological Disorders in the COVID-19 Pandemic. Intern Med 2023; 62:365-371. [PMID: 36418105 PMCID: PMC9970807 DOI: 10.2169/internalmedicine.9702-22] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective During the coronavirus disease 2019 (COVID-19) pandemic, many social activities have moved online using applications for digital devices (e.g. computers, smartphones). We investigated the needs of telemedicine and trends in medical status and social care situations of Japanese patients with neurological disorders in order to estimate their affinity for an online telemedicine application. Methods We designed an original questionnaire for the present study that asked participants what problems they had with hospital visits, how the COVID-19 pandemic had affected their lives, and whether or not they would like to receive telemedicine. Patients The present study included volunteer caregivers, participants with Parkinson's disease (PD), epilepsy, stroke, dementia, immune-mediated neurological disease (IMMD), spinocerebellar degeneration (SCD), amyotrophic lateral sclerosis (ALS), headache, myopathy, and other neurological diseases from Okayama University Hospital. Results A total of 29.6% of patients wanted to use telemedicine. Patients with headaches (60.0%) and epilepsy (38.1%) were more likely to want to use telemedicine than patients with PD (17.8%) or stroke (19.0%). Almost 90% of patients had access to a digital device, and there was no association between favoring telemedicine, ownership of a digital device, hospital visiting time, or waiting time at the hospital, although age was associated with motivation to telemedicine use (52.6 vs. 62.2 years old, p<0.001). Conclusion We can contribute to the management of the COVID-19 pandemic and the medical economy by promoting telemedicine, especially for young patients with headaches or epilepsy.
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Affiliation(s)
- Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Taijun Yunoki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yumiko Nakano
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yusuke Fukui
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
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Okita S, Sasaki R, Kondo Y, Sakamoto J, Honda Y, Okita M. Effects of low-level laser therapy on inflammatory symptoms in an arthritis rat model. J Phys Ther Sci 2023; 35:55-59. [PMID: 36628144 PMCID: PMC9822828 DOI: 10.1589/jpts.35.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/19/2022] [Indexed: 01/01/2023] Open
Abstract
[Purpose] This study evaluated the effect of low-level laser therapy on inflammatory signs in an arthritis rat model as a foundation for elucidating the mechanism of the anti-inflammatory effect. [Materials and Methods] Eigteen Wistar rats were divided into three groups: group I (arthritis without low-level laser therapy), group II (arthritis with low-level laser therapy), and the control group (sham arthritis control). Arthritis was induced in the right knee by injecting a mixture of kaolin and carrageenan. Low-level laser therapy was continued for seven days after the onset of arthritis by 60 times of repeated irradiation for 10 seconds in the right knee joint area. The joint transverse diameter, pressure pain threshold in the affected knee joint, and mechanical paw withdrawal threshold at the distant site were evaluated the day before the injection and one, three, and seven days after the injection. Pathological changes were observed. [Results] Group II showed better improvement in swelling and pain in the affected knee joint and secondary hyperalgesia at the distance site when compared to group I. In group II, there was only mild infiltration of synovial cells, and the progression of arthritis was suppressed compared with that of group I. [Conclusion] Low-level laser therapy can mitigate swelling and inflammatory pain in the affected knee joint and prevent secondary hyperalgesia.
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Affiliation(s)
- Seima Okita
- Department of Rehabilitation, The Japanese Red Cross
Nagasaki Genbaku Hospital, Japan, Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan
| | - Ryo Sasaki
- Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan, Department of Rehabilitation, Juzenkai Hospital,
Japan
| | - Yasutaka Kondo
- Department of Rehabilitation, The Japanese Red Cross
Nagasaki Genbaku Hospital, Japan, Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan
| | - Junya Sakamoto
- Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan, Institute of Biomedical Sciences, Health Sciences, Nagasaki
University, Japan
| | - Yuichiro Honda
- Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan, Institute of Biomedical Sciences, Health Sciences, Nagasaki
University, Japan
| | - Minoru Okita
- Laboratory of Locomotive Rehabilitation Science, Nagasaki
University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki-shi, Nagasaki
852-8520, Japan, Institute of Biomedical Sciences, Health Sciences, Nagasaki
University, Japan,Corresponding author. Minoru Okita (E-mail: )
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Yamashita T, Nakano Y, Sasaki R, Tadokoro K, Omote Y, Yunoki T, Kawahara Y, Matsumoto N, Taira Y, Matsuoka C, Morihara R, Abe K. Safety and Clinical Effects of a Muse Cell-Based Product in Patients With Amyotrophic Lateral Sclerosis: Results of a Phase 2 Clinical Trial. Cell Transplant 2023; 32:9636897231214370. [PMID: 38014622 PMCID: PMC10686030 DOI: 10.1177/09636897231214370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by progressive loss of motor neurons. Multilineage-differentiating stress-enduring (Muse) cells are unique endogenous stem cells that show therapeutic effects on motor function in ALS mouse models. We conducted a single-center open phase II clinical trial to evaluate the safety and clinical effects of repeated intravenous injections of an allogenic Muse cell-based product, CL2020, in patients with ALS. Five patients with ALS received CL2020 intravenously once a month for a total of six doses. The primary endpoints were safety and tolerability, and the secondary endpoint was the rate of change in the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) score. In addition, serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), sphingosine-1-phosphate (S1P), cerebrospinal fluid chitotriosidase-1 (CHIT-1), and neurofilament light chain (NfL) levels were evaluated. The CL2020 treatment was highly tolerated without serious side effects. The ALSFRS-R score change trended upward at 12 months post-CL2020 treatment compared with that at 3 months pre-administration, but the difference was not statistically significant. Among five patients diagnosed with ALS, three exhibited a decrease in the rate of ALSFRS-R score change, one demonstrated an increase, and another showed no change. In addition, the patients' serum IL-6 and TNF-α levels and cerebrospinal fluid CHIT-1 and NfL levels increased for up to 6 months post-treatment; however, their serum S1P levels continuously decreased over 12 months. These findings indicate a favorable safety profile of CL2020 therapy. In the near future, a double-blind study of a larger number of ALS patients should be conducted to confirm the efficacy of ALS treatment with CL2020.
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Affiliation(s)
- Toru Yamashita
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yumiko Nakano
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryo Sasaki
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koh Tadokoro
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshio Omote
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Taijun Yunoki
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuko Kawahara
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Namiko Matsumoto
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Taira
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Chika Matsuoka
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Ryuta Morihara
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
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Sun H, Morihara R, Feng T, Bian Z, Yu H, Hu X, Hu X, Bian Y, Sasaki R, Fukui Y, Takemoto M, Yunoki T, Nakano Y, Abe K, Yamashita T. Human Cord Blood-Endothelial Progenitor Cells Alleviate Intimal Hyperplasia of Arterial Damage in a Rat Stroke Model. Cell Transplant 2023; 32:9636897231193069. [PMID: 37615293 PMCID: PMC10467372 DOI: 10.1177/09636897231193069] [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: 03/26/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
Human cord blood-endothelial progenitor cells (hCB-EPCs) isolated from the human umbilical cord can be used to repair damaged arteries. In this study, we used an animal model with pathological changes that mimics artery wall damage caused by stent retrievers in humans. We injected hCB-EPCs to investigate their effect on endothelial hyperplasia and dysfunction during intimal repair. Four groups were established based on the length of reperfusion (3 and 28 days), as well as the presence or absence of hCB-EPC therapy. Damage to the internal carotid artery was evaluated by hematoxylin-eosin and immunohistochemical staining. Stroke volume was not significantly different between non-EPC and EPC groups although EPC treatment alleviated intimal hyperplasia 28 days after intimal damage. Vascular endothelial growth factor (VEGF) and eNOS expression were significantly higher in the EPC-treated group than in the non-EPC group 3 days after intimal damage. In addition, MMP9 and 4HNE expression in the EPC-treated group was significantly lower than in the non-EPC group. Ultimately, this study found that venous transplantation of hCB-EPCs could inhibit neointimal hyperplasia, alleviate endothelial dysfunction, suppress intimal inflammation, and reduce oxidative stress during healing of intimal damage.
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Affiliation(s)
- Hongming Sun
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Tian Feng
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Zhihong Bian
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Haibo Yu
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Xiao Hu
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Xinran Hu
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yuting Bian
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yusuke Fukui
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Taijun Yunoki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yumiko Nakano
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Koji Abe
- National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Sasaki R, Honda Y, Oga S, Fukushima T, Tanaka N, Kajiwara Y, Nakagawa K, Takahashi A, Sakamoto Y, Morita H, Kondo Y, Okita S, Kondo Y, Goto K, Kataoka H, Sakamoto J, Okita M. Effect of exercise and/or educational interventions on physical activity and pain in patients with hip/knee osteoarthritis: A systematic review with meta-analysis. PLoS One 2022; 17:e0275591. [PMID: 36409668 PMCID: PMC9678259 DOI: 10.1371/journal.pone.0275591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the effectiveness of exercise and/or educational intervention on physical activity and pain in patients with hip/knee osteoarthritis (OA) using systematic review and meta-analysis. METHODS We searched randomized controlled trials that investigated physical activity and pain and compared exercise and/or educational intervention with usual care in patients with hip/knee OA in MEDLINE (PubMed), ProQuest, Scopus, and the Physiotherapy Evidence Database (PEDro), including all those published by April 30, 2022 and written in English. Studies that newly applied analgesics after onset of the intervention were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological qualities. The random-effects model was used for meta-analysis with standard mean differences using RevMan version 5.4. The body of evidence for each study was synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Twenty studies including 2,350 patients were included (7 exercise studies, 8 educational intervention studies and 5 combination studies). The meta-analysis demonstrated that there is very low evidence that combination therapy of exercise and educational intervention improve the physical activity level at the endpoint (4 articles; SMD 0.33, 95% CI 0.04 to 0.51, P = 0.03). Low evidence was observed for combination therapy reducing pain (4 articles; SMD -0.15, 95% CI -0.29 to -0.02, P = 0.03). DISCUSSION The current evidence indicated that combination therapy of exercise and educational intervention leads to improved physical activity and pain reduction in hip/knee OA patients, but the risk of bias in each study, especially in allocation concealment, downgraded the evidence level. These findings support the use of a combination therapy of exercise and educational intervention to promote physical activity levels in patients with hip/knee OA. TRAIL REGISTRATION There was no financial support for this research. The protocol was registered at the International Prospective Register of Systematic Reviews (registration code: CRD42020205804).
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Affiliation(s)
- Ryo Sasaki
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Juzenkai Hospital, Nagasaki, Japan
| | - Yuichiro Honda
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
| | - Satoshi Oga
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Hyogo, Japan
| | - Takuya Fukushima
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Natsumi Tanaka
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Shizuoka, Japan
| | - Yasuhiro Kajiwara
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Nakagawa
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Ayumi Takahashi
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Yukinori Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Hinako Morita
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Yutaro Kondo
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Seima Okita
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Yasutaka Kondo
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kyo Goto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Hideki Kataoka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
- * E-mail:
| | - Minoru Okita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
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Nishimura T, Ishikawa T, Kawamoto D, Sasaki R, Matsuda T, Takami T. Drastic Improvement in Hepatitis B/C Virus-induced Decompensated Liver Cirrhosis Treated by Total Management Consisting of Interventional Radiology, Endoscopy, and Pharmacotherapy. Intern Med 2022; 61:3217-3223. [PMID: 35342139 PMCID: PMC9683805 DOI: 10.2169/internalmedicine.9240-21] [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] [Indexed: 11/06/2022] Open
Abstract
Recent advances in antiviral therapy have enabled control of the hepatitis virus; however, these do not completely eliminate the pathological condition of liver disease, and portal hypertension remains a clinical problem. We herein report a case of hepatitis B virus/hepatitis C virus (HBV/HCV)-induced decompensated liver cirrhosis for which total management consisting of interventional radiology and endoscopy, based on the evidence of our clinical studies, followed by antiviral therapy for co-infection with HBV and HCV was successful. This case clearly indicates the effective timing of total management, suggesting that it prolongs the vital prognosis in addition to improving the hepatic function.
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Affiliation(s)
- Tatsuro Nishimura
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
| | - Tsuyoshi Ishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
| | - Daiki Kawamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
| | - Ryo Sasaki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
| | - Takashi Matsuda
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Japan
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Asada T, Takenoshita S, Senda M, Yamamoto K, Sasaki R, Otsuka F, Terada S, Yamada N. Secondary autoimmune hypothalamitis with severe memory impairment 7 years after the onset of diabetes insipidus due to lymphocytic hypophysitis: a case report. BMC Neurol 2022; 22:371. [PMID: 36175850 PMCID: PMC9520890 DOI: 10.1186/s12883-022-02891-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autoimmune hypothalamitis is a very rare neuroendocrine disorder that causes central diabetes insipidus, headache, visual impairment, and sometimes cognitive impairment. Autoimmune hypothalamitis may occur in association with autoimmune hypophysitis, including lymphocytic hypophysitis, or in isolation. It is not known whether autoimmune hypothalamitis and autoimmune hypophysitis are consecutive diseases. CASE PRESENTATION A 52-year-old woman developed autoimmune hypothalamitis 7 years after developing central diabetes insipidus due to lymphocytic hypophysitis, resulting in severe memory impairment. High-dose intravenous methylprednisolone therapy improved her cognitive function and decreased the size of the lesion. CONCLUSION This case presented a unique clinical course, with a long period of time between the onset of autoimmune hypopituitaritis and the development of autoimmune hypothalamitis.
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Affiliation(s)
- Takahiro Asada
- Department of Neuropsychiatry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shintaro Takenoshita
- Department of Neuropsychiatry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Mayuko Senda
- Department of Neuropsychiatry, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Ryo Sasaki
- Department of Neurology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Seishi Terada
- Department of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Honda Y, Takahashi A, Tanaka N, Kajiwara Y, Sasaki R, Okita S, Sakamoto J, Okita M. Muscle contractile exercise through a belt electrode device prevents myofiber atrophy, muscle contracture, and muscular pain in immobilized rat gastrocnemius muscle. PLoS One 2022; 17:e0275175. [PMID: 36149919 PMCID: PMC9506634 DOI: 10.1371/journal.pone.0275175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/12/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose
Immobilization of skeletal muscles causes muscle atrophy, muscle contracture, and muscle pain, the mechanisms of which are related to macrophage accumulation. However, muscle contractile exercise through a belt electrode device may mitigate macrophage accumulation. We hypothesized that such exercise would be effective in preventing myofiber atrophy, muscle contracture, and muscular pain. This study tested this hypothesis in immobilized rat gastrocnemius muscle.
Materials and methods
A total of 32 rats were divided into the following control and experimental groups: immobilization (immobilized treatment only), low-frequency (LF; immobilized treatment and muscle contractile exercise with a 2 s (do) /6 s (rest) duty cycle), and high-frequency (HF; immobilized treatment and muscle contractile exercise with a 2 s (do)/2 s (rest) duty cycle). Electrical stimulation was performed at 50 Hz and 4.7 mA, and muscle contractile exercise was applied to the lower limb muscles for 15 or 20 min/session (once daily) for 2 weeks (6 times/week). After the behavioral tests, the bilateral gastrocnemius muscles were collected for analysis.
Results
The number of macrophages, the Atrogin-1 and MuRF-1 mRNA expression, and the hydroxyproline content in the HF group were lower than those in the immobilization and LF groups. The cross-sectional area (CSA) of type IIb myofibers in the superficial region, the PGC-1α mRNA expression, and the range of motion of dorsiflexion in the HF group were significantly higher than those in the immobilization and LF groups. The pressure pain thresholds in the LF and HF groups were significantly higher than that in the immobilization group, and the nerve growth factor (NGF) content in the LF and HF groups was significantly lower than that in the immobilization group.
Conclusion
Muscle contractile exercise through the belt electrode device may be effective in preventing immobilization-induced myofiber atrophy, muscle contracture, and muscular pain in the immobilized rat gastrocnemius muscle.
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Affiliation(s)
- Yuichiro Honda
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Ayumi Takahashi
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Natsumi Tanaka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Shizuoka, Japan
| | - Yasuhiro Kajiwara
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Nagasaki, Japan
| | - Ryo Sasaki
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- Department of Rehabilitation, Jyuzenkai Hospital, Nagasaki, Nagasaki, Japan
| | - Seima Okita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- Department of Rehabilitation, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Nagasaki, Japan
| | - Junya Sakamoto
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Minoru Okita
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Nagasaki, Japan
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- * E-mail:
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Kakizoe M, Nagata K, Sasaki R, Ozawa E, Nakao K. Hepatobiliary and Pancreatic: Ruptured pseudoaneurysm after endoscopic biliary stenting using the novel double-pit-type plastic stent. J Gastroenterol Hepatol 2022; 37:1653. [PMID: 35761482 DOI: 10.1111/jgh.15913] [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: 04/03/2022] [Revised: 05/17/2022] [Accepted: 06/13/2022] [Indexed: 12/09/2022]
Affiliation(s)
- M Kakizoe
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Nagata
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - R Sasaki
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - E Ozawa
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kobayashi K, Kimura A, Sasaki R, Hayakawa K, Ohmagari N, Sugiura Y, Sugiyama H, Kokudo N. Actual situation of handling Tokyo 2020 Games-related patients at a designated hospital during COVID-19 pandemic. Glob Health Med 2022; 4:230-232. [PMID: 36119786 PMCID: PMC9420326 DOI: 10.35772/ghm.2022.01009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/17/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
In preparation for the Tokyo 2020 Olympic and Paralympic Games, our hospital was responsible for accepting mainly media representatives, marketing partners, and other Games staff. Given that restricting our regular capacity to treat certain groups of patients could potentially result in social losses, to avoid this we made rigorous preparations for the entire hospital to accept Games-related patients. It was rational to set up a single 24-h contact point at the Emergency Department for making the decision on whether to accept the patient or not and for coordinating the patient's medical care. With respect to language support, International Health Care Center staffs were made available as interpreters on weekdays. Multilingual support was available all day via an application run on tablet devices. During a 67-day period, the hospital accepted 31 Games-related patients (mean age 43.4 years, male: female ratio 25:6). Eighteen patients were from Europe, 4 patients each were from North America and Asia, 2 each were from Central America, South America, and Africa, and 1 was from Oceania. The most common cause of visits was COVID-19, but none were severe cases. Other causes were diverse and included moderate and severe conditions. We summarized the challenges and experiences in handling Tokyo 2020 Games-related patients at a designated hospital during the COVID-19 pandemic.
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Affiliation(s)
- Kentaro Kobayashi
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuo Sugiura
- International Health Care Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan
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Sato K, Sasaki R, Matsuda R, Nakagawa M, Ekimoto T, Yamane T, Ikeguchi M, Tabata KV, Noji H, Kinbara K. Correction to "Supramolecular Mechanosensitive Potassium Channel Formed by Fluorinated Amphiphilic Cyclophane". J Am Chem Soc 2022; 144:13983-13984. [PMID: 35861320 DOI: 10.1021/jacs.2c07339] [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: 11/30/2022]
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Sasaki R, Nagashima M, Otani T, Okada Y, Aibara N, Takeshima K, Ishii K. Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty. J Orthop Surg Res 2022; 17:349. [PMID: 35841041 PMCID: PMC9284780 DOI: 10.1186/s13018-022-03204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/02/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction In cemented total knee arthroplasty (TKA), pressurized carbon dioxide (CO2) lavage prior to cement fixation can eliminate debris at the bone-cement interface and is considered effective for increasing cement penetration and preventing aseptic loosening. Regarding the risk of a preliminary diagnosis of implant loosening, a radiolucent line (RLL) is a valuable sign. The purpose of this study was to compare the incidence of a tibial RLL at 2 years after TKA with and without pressurized CO2 lavage. Methods This is a retrospective study. One hundred knees from 98 patients were enrolled in this study. TKA was performed without pressurized CO2 lavage (CO2− group) for the first 47 knees, and with pressurized CO2 lavage (CO2+ group) for the next 53 knees. The depth of cement penetration was measured just after surgery, and the incidence of tibial RLL > 2 mm at 2 years after TKA was determined. Results Significant differences between groups were not seen regarding pre- and postoperative clinical factors. The depth of cement penetration in each area was significantly higher in the CO2+ group. The frequency of knees with RLL > 2 mm was significantly lower in the CO2+ group than in the CO2− group (p < 0.001). Conclusions Pressurized CO2 lavage improved cement penetration and decreased the incidence of tibial RLL > 2 mm at 2 years after TKA.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan.
| | - Toshiro Otani
- Department of Orthopaedic Surgery, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kōnodai, Ichikawa City, Chiba, 272-0827, Japan
| | - Yoshifumi Okada
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Noriyuki Aibara
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
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Sato K, Sasaki R, Matsuda R, Nakagawa M, Ekimoto T, Yamane T, Ikeguchi M, Tabata KV, Noji H, Kinbara K. Supramolecular Mechanosensitive Potassium Channel Formed by Fluorinated Amphiphilic Cyclophane. J Am Chem Soc 2022; 144:11802-11809. [PMID: 35727684 DOI: 10.1021/jacs.2c04118] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Inspired by mechanosensitive potassium channels found in nature, we developed a fluorinated amphiphilic cyclophane composed of fluorinated rigid aromatic units connected via flexible hydrophilic octa(ethylene glycol) chains. Microscopic and emission spectroscopic studies revealed that the cyclophane could be incorporated into the hydrophobic layer of the lipid bilayer membranes and self-assembled to form a supramolecular transmembrane ion channel. Current recording measurements using cyclophane-containing planer lipid bilayer membranes successfully demonstrated an efficient transmembrane ion transport. We also demonstrated that the ion transport property was sensitive to the mechanical forces applied to the membranes. In addition, ion transport assays using pH-sensitive fluorescence dye revealed that the supramolecular channel possesses potassium ion selectivity. We also performed all-atom hybrid quantum-mechanical/molecular mechanical simulations to assess the channel structures at atomic resolution and the mechanism of selective potassium ion transport. This research demonstrated the first example of a synthetic mechanosensitive potassium channel, which would open a new door to sensing and manipulating biologically important processes and purification of key materials in industries.
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Affiliation(s)
- Kohei Sato
- School of Life Science and Technology, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8501, Japan
| | - Ryo Sasaki
- School of Life Science and Technology, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8501, Japan
| | - Ryoto Matsuda
- School of Life Science and Technology, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8501, Japan
| | - Mayuko Nakagawa
- Graduate School of Medical Life Science, Yokohama City University, 1-7-29 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Toru Ekimoto
- Graduate School of Medical Life Science, Yokohama City University, 1-7-29 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Tsutomu Yamane
- Graduate School of Medical Life Science, Yokohama City University, 1-7-29 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Mitsunori Ikeguchi
- Graduate School of Medical Life Science, Yokohama City University, 1-7-29 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Kazuhito V Tabata
- Department of Applied Chemistry, School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Hiroyuki Noji
- Department of Applied Chemistry, School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Kazushi Kinbara
- School of Life Science and Technology, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8501, Japan.,World Research Hub Initiative, Institute of Innovative Research, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama, Kanagawa 226-8501, Japan
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Sasaki R, Hand BJ, Liao WY, Rogasch NC, Fernandez L, Semmler JG, Opie GM. Utilising TMS-EEG to Assess the Response to Cerebellar-Brain Inhibition. Cerebellum 2022:10.1007/s12311-022-01419-y. [PMID: 35661100 DOI: 10.1007/s12311-022-01419-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Cerebellar-brain inhibition (CBI) is a transcranial magnetic stimulation (TMS) paradigm indexing excitability of cerebellar projections to motor cortex (M1). Stimulation involved with CBI is often considered to be uncomfortable, and alternative ways to index connectivity between cerebellum and the cortex would be valuable. We therefore sought to assess the utility of electroencephalography in conjunction with TMS (combined TMS-EEG) to record the response to CBI. A total of 33 volunteers (25.7 ± 4.9 years, 20 females) participated across three experiments. These investigated EEG responses to CBI induced with a figure-of-eight (F8; experiment 1) or double cone (DC; experiment 2) conditioning coil over cerebellum, in addition to multisensory sham stimulation (experiment 3). Both F8 and DC coils suppressed early TMS-evoked EEG potentials (TEPs) produced by TMS to M1 (P < 0.05). Furthermore, the TEP produced by CBI stimulation was related to the motor inhibitory response to CBI recorded in a hand muscle (P < 0.05), but only when using the DC coil. Multisensory sham stimulation failed to modify the M1 TEP. Cerebellar conditioning produced changes in the M1 TEP that were not apparent following sham stimulation, and that were related to the motor inhibitory effects of CBI. Our findings therefore suggest that it is possible to index the response to CBI using TMS-EEG. In addition, while both F8 and DC coils appear to recruit cerebellar projections, the nature of these may be different.
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Affiliation(s)
- R Sasaki
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - B J Hand
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - W Y Liao
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - N C Rogasch
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - L Fernandez
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - J G Semmler
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - G M Opie
- Discipline of Physiology, School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
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Sasaki R, Niki Y, Kaneda K, Yamada Y, Nagura T, Nakamura M, Jinzaki M. A novel anteroposterior axis of the tibia for total knee arthroplasty: An upright weight-bearing computed tomography analysis. Knee 2022; 36:80-86. [PMID: 35561561 DOI: 10.1016/j.knee.2022.04.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/13/2022] [Accepted: 04/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The traditional anteroposterior (AP) axis (i.e., Akagi's line) has been widely used as the tibial component AP axis during total knee arthroplasty (TKA). However, this AP axis has been defined based on computed tomography (CT) in a non-weight-bearing supine position. In this study, AP axes of the tibial plateau from upright CT in weight-bearing and non-weight-bearing positions were determined and compared. METHODS This study included 43 knees from 23 healthy volunteers. CT images were obtained in weight-bearing and non-weight-bearing standing positions using a 320-detector row upright CT scanner. The line perpendicular to surgical transepicondylar axis projected onto the tibia plateau was determined as the AP axis in upright weight-bearing and non-weight-bearing conditions. Angular differences between these two conditions were measured. RESULTS The upright weight-bearing AP axis was positioned in a mean of 7.4 ± 4.3° of internal rotation relative to the traditional AP axis. Distance between the traditional and upright weight-bearing AP axis was 2.9 ± 1.6 mm at the edge of the tibial plateau. The upright non-weight-bearing AP axis was positioned in a mean of 3.5 ± 4.1° of internal rotation relative to the traditional AP axis. Mean angular difference between weight-bearing and non-weight-bearing conditions was 3.9 ± 4.1°. CONCLUSIONS The upright weight-bearing AP axis was positioned in 7.4° of internal rotation relative to the traditional AP axis, showing one-seventh of the tibial tuberosity away from the medial border of the tibial tubercle, which represents a practical landmark for the tibial component AP axis during TKA.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Yasuo Niki
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
| | - Kazuya Kaneda
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Yoshitake Yamada
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan
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Mino S, Hinotsu K, Fujiwara M, Sakamoto S, Sasaki R, Yada Y, Yamada Y, Fukao T, Takaki M, Yamada N. Inconsistency of antibody testing in a patient with anti-N-methyl-D-aspartate receptor encephalitis. Asian J Psychiatr 2022; 72:103124. [PMID: 35421625 DOI: 10.1016/j.ajp.2022.103124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/16/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Shori Mino
- Department of Neuropsychiatry, Okayama University Hospital, Okayama 700-8558, Japan.
| | - Kenji Hinotsu
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Shinji Sakamoto
- Department of Neuropsychiatry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Ryo Sasaki
- Department of Neurology, Okayama University Hospital, Okayama 700-8558, Japan
| | - Yuji Yada
- Okayama Psychiatric Medical Center, Okayama 700-0915, Japan
| | - Yuto Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Takashi Fukao
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Manabu Takaki
- Department of Neuropsychiatry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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Sekihara K, Shibasaki T, Okamoto T, Matsumoto C, Ito K, Fujimoto K, Kato F, Matsuda W, Kobayashi K, Sasaki R, Uemura T, Kimura A, Sugiyama H, Kokudo N. Poor prognosis of patients with severe COVID-19 admitted to an infectious disease intensive care unit during the pandemic caused by the Delta variant in Japan. Glob Health Med 2022; 4:122-128. [PMID: 35586761 PMCID: PMC9066459 DOI: 10.35772/ghm.2021.01121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 05/15/2023]
Abstract
During the surge of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) delta variant, our institution operated an intensive care unit (ICU) for patients with severe COVID-19. The study aim was to determine the survival rate and treatment outcomes of patients with severe COVID-19 treated in the ICU during the surge. A total of 23 consecutive patients with severe COVID-19 were admitted to the ICU between August 5 and October 6, 2021. Patients received multidrug therapy consisting of remdesivir, tocilizumab, heparin, and methylprednisolone. The patients were divided into two groups based on the ordinal scale (OS): a non-invasive oxygen therapy (OS-6) group, and an invasive oxygen therapy (OS-7) group. There were 13 (57%) and 10 (43%) patients in the OS-7 and OS-6 groups, respectively. All patients were unvaccinated. Sixteen patients (70%) were male. The median age was 53 years; the median body mass index (BMI) was 30.3 kg/m2; and the median P/F ratio on admission was 96. The 30-day survival rate was 69% and was significantly poorer in the OS-7 group (54%) than in the OS-6 group (89%; p = 0.05). The prevalence of obesity (p = 0.05) and the Sequential Organ Failure Assessment (SOFA) score on admission (p < 0.01) were significantly higher in the OS-7 group. Seven patients in the OS-7 group (54%) developed bacteremia. A low P/F ratio on admission was a significant unfavorable prognostic factor (hazard ratio: 10.9; p = 0.03). The survival rate was poor, especially in patients requiring invasive oxygen therapy. More measures are needed to improve the treatment outcomes of patients with severe COVID 19.
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Affiliation(s)
- Keigo Sekihara
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Address correspondence to:Keigo Sekihara, Department of Intensive Care Medicine, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo 162-8655, Japan. E-mail:
| | - Takatoshi Shibasaki
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Chihiro Matsumoto
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Kuniaki Ito
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Kana Fujimoto
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Fumito Kato
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Matsuda
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Kentaro Kobayashi
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Tatsuki Uemura
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Akio Kimura
- Department of Intensive Care Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Department of Emergency Medicine and Critical Care, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Department of Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- Department of Surgery, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
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Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. J Int Med Res 2022; 50:3000605221084865. [PMID: 35272510 PMCID: PMC8921757 DOI: 10.1177/03000605221084865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Magnetic resonance imaging (MRI) findings of a tram-track appearance and celery stalk appearance in mucoid degeneration of the cruciate ligament are valuable; however, their pathological basis is unclear. Because these appearances are generally seen throughout the entire ligament, the association between MRI findings and pathological findings must be verified in specimens of the whole degenerated ligament, including the ligamentous attachments to bone. We herein report two cases of mucoid degeneration of the posterior cruciate ligament with osteoarthritis of the knee requiring total knee arthroplasty. The entire degenerated ligament, including the ligamentous attachments to bone, was removed and pathologically evaluated. On pathological examination, the central portion of the lesion showed typical mucoid degeneration, whereas the marginal and adherent portions showed normal ligament tissue, consistent with a tram-track appearance on T2-weighted MRI. The fibrous normal ligament tissues in the longitudinal direction in regions of mucoid degeneration were consistent with a celery stalk appearance on T2-weighted MRI. No mucoid degeneration was found in the attachment area. The tram-track appearance and celery stalk appearance of mucoid degeneration on MRI can be explained by the pathological findings.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan.,Department of Orthopaedic Surgery, 36767International University of Health and Welfare Mita Hospital, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita city, Chiba 286-8520, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan.,Department of Orthopaedic Surgery, 36767International University of Health and Welfare Mita Hospital, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita city, Chiba 286-8520, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita city, Chiba 286-8520, Japan
| | - Toshiro Otani
- Department of Orthopaedic Surgery, 38259International University of Health and Welfare Ichikawa Hospital, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kōnodai, Ichikawa city, Chiba 272-0827, Japan
| | - Yoshifumi Okada
- Department of Orthopaedic Surgery, 36767International University of Health and Welfare Mita Hospital, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
| | - Shinsuke Aida
- Department of Pathology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba 286-8686, Japan.,Department of Orthopaedic Surgery, 36767International University of Health and Welfare Mita Hospital, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852, Hatakeda, Narita city, Chiba 286-8520, Japan
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Ishikawa T, Egusa M, Kawamoto D, Nishimura T, Sasaki R, Saeki I, Sakaida I, Takami T. Screening for portopulmonary hypertension using computed tomography-based measurements of the main pulmonary artery and ascending aorta diameters in patients with portal hypertension. Hepatol Res 2022; 52:255-268. [PMID: 34822208 DOI: 10.1111/hepr.13735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 12/12/2022]
Abstract
AIM This study aimed to demonstrate the feasibility of identifying candidates of portopulmonary hypertension (PoPH) from general portal hypertension patients based on chest computed tomography (CT) results. METHODS One hundred and thirty patients with portal hypertension who had undergone interventional radiology therapies at our hospital between August 2011 and July 2021 were included, and preoperative clinical data were collected. Suspicious PoPH was defined as main pulmonary artery diameter (mPA-D) ≥ 29 mm or the ratio of mPA-D to ascending aorta diameter (mPA-D/aAo-D) ≥ 1.0, and probable PoPH as mPA-D ≥ 33 mm based on the chest CT. Prevalence of suspicious and probable PoPH was evaluated, and the differences in clinical characteristics of each population were compared. RESULTS Overall, 29 (22.3%) and 5 (3.8%) patients were categorized as suspicious and probable PoPH, respectively. Univariate analyses revealed that female sex, higher shortest diameter of inferior vena cava, presence of portosystemic shunts ≥ 5 mm, and lower blood urea nitrogen levels were significantly associated with suspicious PoPH (p < 0.05). Multivariate analyses identified all four factors as significantly independent determinants of suspicious PoPH (p < 0.05). In addition, among the population of suspicious PoPH, there were significant differences in seven parameters, including total bilirubin levels and spleen volume between patients with and without probable PoPH (p < 0.05). However, no significant independent indicators of probable PoPH were found. CONCLUSIONS CT-based measurements of mPA-D and mPA-D/aAo-D have the potential to screen patients with suspicious PoPH in clinical practice focused on portal hypertension.
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Affiliation(s)
- Tsuyoshi Ishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Maho Egusa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Daiki Kawamoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Tatsuro Nishimura
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Ryo Sasaki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Issei Saeki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Isao Sakaida
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
| | - Taro Takami
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube-Yamaguchi, Japan
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Matsuda T, Ishikawa T, Oono T, Sasaki R, Hidaka I, Okada M, Sakaida I. Rendezvous therapy with endoscopic and endovascular treatments for rectal arteriovenous malformation: A case report. Endoscopy 2022; 54:E77-E78. [PMID: 33723845 DOI: 10.1055/a-1388-6021] [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: 12/10/2022]
Affiliation(s)
- Takashi Matsuda
- Department of Liver Regenerative Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Tsuyoshi Ishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takashi Oono
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Ryo Sasaki
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Isao Hidaka
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Munemasa Okada
- Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Isao Sakaida
- Department of Liver Regenerative Medicine, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Nagashima M, Otani T, Harato K, Sasaki R, Seki H, Takeshima K, Ishii K. Lateral Patellar Facetectomy Reduces the Incidence of Anterior Knee Pain in Patellar Resurfaced Total Knee Arthroplasty. J Knee Surg 2022; 36:773-778. [PMID: 35189663 DOI: 10.1055/s-0042-1743226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lateral patellar facet impingement (LPFI) can cause anterior knee pain (AKP) after patellar resurfaced total knee arthroplasty (TKA). Recently, lateral patellar facetectomy (LPF), which has been used for LPFI, has been performed during primary TKA, providing good clinical outcomes. However, the effect of LPF on AKP in primary patellar resurfaced TKA has not been sufficiently studied. The purpose of this study was to examine the effect of LPF on the development of AKP in patellar resurfaced TKAs with minimum follow-up of 3 years. This retrospective cohort study included 84 knees of 66 consecutive patients who underwent patellar resurfaced TKA between April 2007 and November 2014 in our hospital. The subjects were divided into two groups: TKA with LPF (LPF group; 47 knees) and TKA without LPF (no-LPF group; 37 knees). Postoperative AKP, the primary outcome, the Japanese Orthopaedic Association (JOA) score, and range of motion were investigated at the final visit and compared between the two groups. Six knees (16.2%) had AKP in the no-LPF group, whereas none of the knees had AKP in the LPF group at the final visit. The incidence of AKP was significantly lower in the LPF group (p = 0.004). The postoperative JOA score and flexion angle were significantly higher in the LPF group than in the no-LPF group. LPF correlated with less incidence of postoperative AKP and improved the JOA score and knee flexion angle. In patellar resurfaced TKA, LPF may be considered an additional maneuver to avoid postoperative AKP.
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Affiliation(s)
- Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Toshiro Otani
- Department of Orthopaedic Surgery, International University of Health and Welfare Ichikawa Hospital, Ichikawa City, Chiba, Japan
| | - Kengo Harato
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryo Sasaki
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Hiroyuki Seki
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita City, Chiba, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Chiba, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, Narita City, Chiba, Japan
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