Publications by authors named "Yuya Ishikawa"

23 Publications

  • Page 1 of 1

Mid- to Long-Term Outcomes After Resection of Thoracic Dumbbell Tumors Managed by Laminectomy and Unilateral Total Facetectomy Without Instrumented Fusion.

Global Spine J 2021 May 11:21925682211008836. Epub 2021 May 11.

Department of Regenerative and Transplant Medicine, Division of Orthopaedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Study Design: Retrospective multicenter study.

Objective: To evaluate mid- to long-term surgical outcomes of thoracic dumbbell tumors managed by laminectomy and unilateral total facetectomy without instrumented fusion.

Methods: A total of 15 patients with thoracic dumbbell tumors who underwent primary resection by laminectomy and unilateral total facetectomy without spinal instrumented fusion between 2000 and 2015 were reviewed. Patient characteristics, surgical outcomes (including spinal alignment and stability), disc degeneration, pain, disability, and health-related quality of life were evaluated. Additionally, to analyze the impact of the affected levels on these outcomes, we divided the patients into 2 groups: a middle thoracic group and a thoracolumbar group.

Results: The mean duration of follow-up was 100.5 months (range, 36-190 months). The affected level was T3-T4 or below in all patients. Although the local kyphosis angle (8.1° to 12.7°), thoracic kyphosis angle (25.6° to 33.9°), and coronal Cobb angle (6.6° to 9.5°) significantly increased from preoperative to the final visit ( ≤ .02), no patient demonstrated spinal instability. From magnetic resonance imaging, no patient had a worse grade of disc degeneration in the affected level than those in the adjacent levels. The percentage of patients who presented with an Oswestry disability index ≤ 22% was 80%. Moreover, the surgical region did not adversely affect the outcomes. No patient required additional surgery due to spinal instability or deformity.

Conclusions: Unilateral total facetectomy without fusion to resect thoracic dumbbell tumors caused neither spinal deformity nor instability requiring additional surgery at the mid- to long-term follow-up.
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http://dx.doi.org/10.1177/21925682211008836DOI Listing
May 2021

Development and structural characterisation of human scFv targeting MDM2 spliced variant MDM2.

Mol Immunol 2021 Jul 27;135:191-203. Epub 2021 Apr 27.

Institute for Research in Molecular Medicine, Universiti Sains Malaysia, 11800, Penang, Malaysia; Analytical Biochemistry Research Centre, Universiti Sains Malaysia, 11800, Penang, Malaysia. Electronic address:

The murine double minute 2 (MDM2) protein is a major negative regulator of the tumour suppressor protein p53. Under normal conditions, MDM2 constantly binds to p53 transactivation domain and/or ubiquinates p53 via its role as E3 ubiquitin ligase to promote p53 degradation as well as nuclear export to maintain p53 levels in cells. Meanwhile, amplification of MDM2 and appearance of MDM2 spliced variants occur in many tumours and normal tissues making it a prognostic indicator for human cancers. The mutation or deletion of p53 protein in half of human cancers inactivates its tumour suppressor activity. However, cancers with wild type p53 have its function effectively inhibited through direct interaction with MDM2 oncoprotein. Here, we described the construction of a MDM2 spliced variant (rMDM2) consisting of SWIB/MDM2 domain and its central region for antibody generation. Biopanning with a human naïve scFv library generated four scFv clones specific to rMDM2. Additionally, the selected scFv clones were able to bind to the recombinant full length MDM2 (rMDM2-FL). Computational prediction showed that the selected scFv clones potentially bind to exon 7-8 of MDM2 while leaving the MDM2/SWIB domain free for p53 interaction. The developed antibodies exhibit good specificity can be further investigated for downstream biomedical and research applications.
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http://dx.doi.org/10.1016/j.molimm.2021.04.016DOI Listing
July 2021

Phosphorylation of GAP-43 T172 is a molecular marker of growing axons in a wide range of mammals including primates.

Mol Brain 2021 04 8;14(1):66. Epub 2021 Apr 8.

Departments of Neurochemistry and Molecular Cell Biology, School of Medicine and Graduate School of Medical/Dental Sciences, Niigata University, Niigata, 951-8510, Japan.

GAP-43 is a vertebrate neuron-specific protein and that is strongly related to axon growth and regeneration; thus, this protein has been utilized as a classical molecular marker of these events and growth cones. Although GAP-43 was biochemically characterized more than a quarter century ago, how this protein is related to these events is still not clear. Recently, we identified many phosphorylation sites in the growth cone membrane proteins of rodent brains. Two phosphorylation sites of GAP-43, S96 and T172, were found within the top 10 hit sites among all proteins. S96 has already been characterized (Kawasaki et al., 2018), and here, phosphorylation of T172 was characterized. In vitro (cultured neurons) and in vivo, an antibody specific to phosphorylated T172 (pT172 antibody) specifically recognized cultured growth cones and growing axons in developing mouse neurons, respectively. Immunoblotting showed that pT172 antigens were more rapidly downregulated throughout development than those of pS96 antibody. From the primary structure, this phosphorylation site was predicted to be conserved in a wide range of animals including primates. In the developing marmoset brainstem and in differentiated neurons derived from human induced pluripotent stem cells, immunoreactivity with pT172 antibody revealed patterns similar to those in mice. pT172 antibody also labeled regenerating axons following sciatic nerve injury. Taken together, the T172 residue is widely conserved in a wide range of mammals including primates, and pT172 is a new candidate molecular marker for growing axons.
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http://dx.doi.org/10.1186/s13041-021-00755-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034164PMC
April 2021

Irradiation effect of a submillimeter wave from 420 GHz gyrotron on amyloid peptides in vitro.

Biomed Opt Express 2020 Sep 31;11(9):5341-5351. Epub 2020 Aug 31.

Research Center for Development of Far-Infrared Region, University of Fukui, 3-9-1 Bunkyo, Fukui, Fukui 910-8507, Japan.

On using the far-infrared radiation system, whether the irradiation effect is thermal or non-thermal is controversial. We irradiated amyloid peptides that are causal factors for amyloidosis by using a submillimeter wave from 420 GHz gyrotron. Fluorescence reagent assay, optical and electron microscopies, and synchrotron-radiation infrared microscopy showed that the irradiation increased the fibrous conformation of peptides at room temperature for 30 min. The temperature increase on the sample was only below 5 K, and a simple heating up to 318 K hardly induced the fibril formation. Therefore, the amyloid aggregation was driven by the far-infrared radiation with little thermal effect.
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http://dx.doi.org/10.1364/BOE.395218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7510884PMC
September 2020

Iatrogenic bronchial injury findings during video-assisted thoracoscopic surgery.

Gen Thorac Cardiovasc Surg 2021 Feb 26;69(2):388-390. Epub 2020 Aug 26.

Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji, Hyogo, 670-8520, Japan.

Iatrogenic tracheobronchial injury detected during cardiothoracic surgery should be repaired intraoperatively to ensure safe of postoperative management and stable respiratory conditions. We report herein a patient with lung cancer who underwent video-assisted thoracoscopic surgery right lower lobectomy. During surgery, pneumomediastinum and air leakage from mediastinal fatty tissue were detected. Furthermore, bronchial injury to the membranous part of the left main bronchus was incidentally detected. Hence, we switched from video-assisted thoracoscopic surgery to posterolateral thoracotomy and repaired this bronchial injury using a continuous suture technique under right femoral venoarterial extracorporeal membrane oxygenation support. The intraoperative findings could offer a clue for early detection and development of therapeutic strategy for iatrogenic tracheobronchial injury.
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http://dx.doi.org/10.1007/s11748-020-01468-2DOI Listing
February 2021

Short- versus long-segment posterior spinal fusion with vertebroplasty for osteoporotic vertebral collapse with neurological impairment in thoracolumbar spine: a multicenter study.

BMC Musculoskelet Disord 2020 Aug 1;21(1):513. Epub 2020 Aug 1.

Department of Orthopaedic Surgery, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara City, Kanagawa, 252-0374, Japan.

Background: Vertebroplasty with posterior spinal fusion (VP + PSF) is one of the most widely accepted surgical techniques for treating osteoporotic vertebral collapse (OVC). Nevertheless, the effect of the extent of fusion on surgical outcomes remains to be established. This study aimed to evaluate the surgical outcomes of short- versus long-segment VP + PSF for OVC with neurological impairment in thoracolumbar spine.

Methods: We retrospectively collected data from 133 patients (median age, 77 years; 42 men and 91 women) from 27 university hospitals and their affiliated hospitals. We divided patients into two groups: a short-segment fusion group (S group) with 2- or 3-segment fusion (87 patients) and a long-segment fusion group (L group) with 4- through 6-segment fusion (46 patients). Surgical invasion, clinical outcomes, local kyphosis angle (LKA), and complications were evaluated.

Results: No significant differences between the two groups were observed in terms of neurological recovery, pain scale scores, and complications. Surgical time was shorter and blood loss was less in the S group, whereas LKA at the final follow-up and correction loss were superior in the L group.

Conclusion: Although less invasiveness and validity of pain and neurological relief are secured by short-segment VP + PSF, surgeons should be cautious regarding correction loss.
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http://dx.doi.org/10.1186/s12891-020-03539-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395972PMC
August 2020

Phosphoproteomic and bioinformatic methods for analyzing signaling in vertebrate axon growth and regeneration.

J Neurosci Methods 2020 06 8;339:108723. Epub 2020 Apr 8.

Departments of Laboratory of Bioinformatics, School and Medicine and Graduate School of Medical/Dental Sciences, Japan.

Phosphorylation is the most important post-translational modification of proteins in many cells, including neurons. Phosphoproteomics is a relatively new technique for comprehensively identifying phosphorylation sites in the whole proteome of a given system. We applied this method to developmental neurobiology research to understand the signaling pathways that regulate the mammalian growth cone, which is formed at the tips of developing neurites to ensure accurate neuronal network formation. Using this powerful technique, we identified at least four phosphorylation sites tightly associated with axon growth. Because phosphoproteomic results include relatively large numbers of phosphopeptides, the data are typically analyzed using bioinformatics. We utilized three bioinformatics tools to identify the responsible protein kinases, the putative functions of the phosphorylated protein groups, and the evolutional aspects of the phosphorylated proteins. Collectively, these data indicate phosphoproteomics is a cutting-edge tool for neuroscience research.
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http://dx.doi.org/10.1016/j.jneumeth.2020.108723DOI Listing
June 2020

The impact of surgical chest wall damage caused by classic thoracotomy on pulmonary function and morphology.

Gen Thorac Cardiovasc Surg 2020 May 14;68(5):508-515. Epub 2019 Nov 14.

Department of Thoracic Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Objectives: Postoperative changes in pulmonary function (PF) and morphology due to surgical chest wall damage by thoracotomy with rib resection are unclear. Therefore, we evaluated the effects of surgical damage on PF and morphology at > 6 months postoperatively by comparing different lung lobectomy approaches.

Methods: A total of 140 patients who underwent lobectomy for lung diseases between January 2006 and March 2016 were analyzed. Patients who underwent PF tests and computed tomography (CT) scans preoperatively and postoperatively were divided into posterolateral thoracotomy with one rib resection (PT) group and video-assisted thoracoscopic surgery (VATS) group. A 1:1 propensity score-matched (PSM) analysis was used to balance clinically important confounders between the groups. Regarding morphology, lung volume was measured semi-automatically using image analysis software and reconstructed three-dimensional (3D) images.

Results: After PSM, 31 patients in each group were compared. Perioperative reduction ratios in forced vital capacity (FVC) (- 23% vs. - 13%; P = 0.006) and forced expiratory volume in 1 s (FEV1) (- 19% vs. - 12%; P = 0.02) were significantly larger for the PT group. No significant differences in lung volume values based on 3D CT volumetry (PT vs. VATS; total lung volume: - 7.9% vs. - 7.2%, P = 0.82; non-resected ipsilateral lung volume: + 36% vs. + 40%, P = 0.69; contralateral lung volume: + 9.3% vs. + 9.4%, P = 0.98) were found in either group.

Conclusions: Among the patients underwent lobectomy, classic thoracotomy decreased PF by an additional FVC loss of 10% and FEV1 loss of 7% compared with VATS, without affecting residual lung volume.
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http://dx.doi.org/10.1007/s11748-019-01250-zDOI Listing
May 2020

Phosphorylation sites of microtubule-associated protein 1B (MAP 1B) are involved in axon growth and regeneration.

Mol Brain 2019 11 11;12(1):93. Epub 2019 Nov 11.

Department of Neurochemistry and Molecular Cell Biology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8510, Japan.

The growth cone is a specialized structure that forms at the tip of extending axons in developing and regenerating neurons. This structure is essential for accurate synaptogenesis at developmental stages, and is also involved in plasticity-dependent synaptogenesis and axon regeneration in the mature brain. Thus, understanding the molecular mechanisms utilized by growth cones is indispensable to understanding neuronal network formation and rearrangement. Phosphorylation is the most important and commonly utilized protein modification in signal transduction. We previously identified microtubule-associated protein 1B (MAP 1B) as the most frequently phosphorylated protein among ~ 1200 phosphorylated proteins. MAP 1B has more than 10 phosphorylation sites that were present more than 50 times among these 1200 proteins. Here, we produced phospho-specific antibodies against phosphorylated serines at positions 25 and 1201 of MAP 1B that specifically recognize growing axons both in cultured neurons and in vivo in various regions of the embryonic brain. Following sciatic nerve injury, immunoreactivity with each antibody increased compared to the sham operated group. Experiments with transected and sutured nerves revealed that regenerating axons were specifically recognized by these antibodies. These results suggest that these MAP 1B phosphorylation sites are specifically involved in axon growth and that phospho-specific antibodies against MAP 1B are useful markers of growing/regenerating axons.
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http://dx.doi.org/10.1186/s13041-019-0510-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849251PMC
November 2019

Early postoperative inflammatory response by procedure types: stapler-based segmentectomy versus lobectomy.

Gen Thorac Cardiovasc Surg 2020 Mar 26;68(3):280-286. Epub 2019 Sep 26.

Department of Thoracic Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Objective: Perioperative C-reactive protein (CRP) levels have become a contentious topic on the surgical outcome of lung cancer, but the influence of the procedure types has not been precisely investigated. From this viewpoint, we compared two types of thoracoscopic anatomical lung resection: segmentectomy and lobectomy.

Methods: This was a retrospective study involving patients who underwent standardized anatomical lung resection at a single institute from 2014 to 2017; CRP levels were routinely measured on postoperative days 1, 3, and 5. Changes in the CRP levels from the preoperative period were calculated (ΔCRP), and factors associated with a higher ΔCRP value were analyzed.

Results: Among 186 patients included, 91 (48.9%) patients underwent stapler-based segmentectomy and 95 (51.1%) patients underwent lobectomy. The segmentectomy group showed significantly higher ΔCRP values on every measurement day than the lobectomy group, in spite of shorter operation time, smaller blood loss, shorter drainage periods, shorter dissection time, and limited lymph node dissection. The number of stapler cartridges for the lung parenchyma was significantly larger in the segmentectomy group. Regression analyses indicated that procedure type and smoking history were associated with a higher ΔCRP value, whereas no significant difference was indicated in the smoking history between the groups.

Conclusion: In our cohort, stapler-based thoracoscopic segmentectomy was associated with an increase in acute inflammatory response despite favorable perioperative outcome compared to lobectomy. Local surgical stress and damage in the remaining segments might play a key role and warrants further investigation.
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http://dx.doi.org/10.1007/s11748-019-01214-3DOI Listing
March 2020

Lifesaving surgery for a ruptured invasive thymoma using the hemi-clamshell approach: a case report.

Surg Case Rep 2019 Feb 19;5(1):35. Epub 2019 Feb 19.

Department of Thoracic Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

Background: Among anterior mediastinal tumors, a teratoma is known to rupture with growth, but there have been few previous reports about thymoma rupture. We here report a rare case of an invasive thymoma with intrapulmonary and intrathoracic rupture requiring emergency life-saving surgery. To our knowledge, this is the first such case in the literature.

Case Presentation: A 56-year-old woman suddenly experienced right precordial pain and hemoptysis. Enhanced computed tomography revealed a large mediastinal tumor pressing against the pulmonary hilar vascularity, with extravasation of blood into the right lung. Tumor rupture into the lungs was suspected. Given the deterioration of her respiratory status and hemodynamics, thymomectomy with removal of the involved tissues was urgently performed using the hemi-clamshell approach and intrapericardial dissection, with veno-arterial extracorporeal membrane oxygenation on standby. She survived, and no recurrence has been noted for 2 years postoperatively.

Conclusions: A large thymoma can suddenly rupture into the thorax, similar to the rupture of a teratoma. Additionally, in cases with hemoptysis, an appropriate procedure should be selected to reach both the pulmonary hilum and thorax for complete resection, as hemoptysis might suggest tumor invasion into the lungs.
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http://dx.doi.org/10.1186/s40792-019-0594-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381200PMC
February 2019

Can posterior implant removal prevent device-related vertebral osteopenia after posterior fusion in adolescent idiopathic scoliosis? A mean 29-year follow-up study.

Eur Spine J 2019 06 19;28(6):1314-1321. Epub 2019 Feb 19.

Niigata Bone Science Institute, 761 Kizaki, Kitaku, Niigata City, 950-3304, Niigata, Japan.

Purpose: To determine whether posterior implant removal prevents stress-shielding-induced vertebral osteopenia within the posterior fusion area in surgically treated patients with adolescent idiopathic scoliosis (AIS).

Methods: Eighteen patients with major thoracic AIS (mean age, 43.3 years; range, 32-56 years; mean follow-up, 28.8 years, range, 20-39 years) who underwent posterior spinal fusion (PSF) alone between 1973 and 1994 were included. Participants were divided into implant removal (group R, n = 10, mean interval until implant removal, 50 months) and implant non-removal groups (group NR, n = 8). Bone mineral density was evaluated using the Hounsfield units (HU) of the computed tomography image of the full spine. The HU values of the UIV-1 (one level below the uppermost instrumented vertebra), apex, LIV+1 (one level above the lowermost instrumented vertebra), and LIV-1 (one level below the lowermost instrumented vertebra; as a standard value) were obtained. Stress-shielding-induced osteopenia was assessed as the UIV-1/LIV-1, apex/LIV-1, and LIV+1/LIV-1 HU ratios (× 100).

Results: Overall (median, 25th-75th percentile), the apex (144.7, 108.6-176.0) and LIV+1 (159.4, 129.7-172.3) demonstrated lower HU values than LIV-1 (180.3, 149.2-200.2) (both comparisons, p < .05). Comparison of groups R and NR showed no significant differences in the scoliosis correction rate, bone mineral density of the proximal femur, the HU absolute values of all investigated vertebrae, or in the HU ratios of the investigated vertebrae to LIV-1.

Conclusion: Instrumented PSF causes stress-shielding-induced osteopenia of the vertebral body within the fusion area in adulthood, which cannot be prevented by posterior implant removal, probably due to firm fusion mass formation. These slides can be retrieved under Electronic Supplementary Material.
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http://dx.doi.org/10.1007/s00586-019-05921-6DOI Listing
June 2019

Primary Synovial Sarcoma of the Mediastinum with Long-term Follow-up.

Intern Med 2019 May 10;58(10):1463-1465. Epub 2019 Jan 10.

Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Japan.

Chest radiography showed a right posterior mass on the mediastinum of an 84-year-old woman. The mass had been growing gradually for four years. Surgical excision was performed, and a pathological examination found the mass to be consistent with primary synovial sarcoma (SS) of the mediastinum. To our knowledge, this is a rare case in which follow-up imaging was able to be performed over a period of four years. This disease is aggressive, and its early diagnosis is key to achieving a cure. It is important to consider primary SS in the differential diagnosis of a primary intra-thoracic tumor, even if the tumor grows slowly.
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http://dx.doi.org/10.2169/internalmedicine.2199-18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548923PMC
May 2019

Relationship Between the Structure of Methoxylated and Hydroxylated Flavones and Their Antiproliferative Activity in HL60 Cells.

Anticancer Res 2018 Oct;38(10):5679-5684

Laboratory of Bio-organic Chemistry, Akita Prefectural University, Akita, Japan.

As part of our continuing investigation on flavonoid derivatives as potential anticancer substances, a series of methoxylated and hydroxylated flavones was synthesized, and their cytotoxic and anti-proliferative activity was evaluated in leukemic HL60 cells. Their structure-activity relationship was also investigated. The correlation between the methoxylation/hydroxylation pattern and antiproliferative activity revealed the importance of the 5,4'- and 3',4'-dihydroxyl moieties in flavone nucleus.
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http://dx.doi.org/10.21873/anticanres.12904DOI Listing
October 2018

Incidence of four major types of osteoporotic fragility fractures among elderly individuals in Sado, Japan, in 2015.

J Bone Miner Metab 2019 May 28;37(3):484-490. Epub 2018 Jun 28.

Department of Physical Therapy, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan.

The aim of this study was to survey the incidence of osteoporotic fragility fractures, which include vertebral, hip, distal radius, and proximal humerus fractures, in patients ≥ 50 years of age, from 2004 to 2015, in Sado City, Japan. We examined temporal changes in the incidence of these fractures from 2010 through 2015. The incidence of vertebral (p < 0.001) and radius fractures (p = 0.001) was lower in 2015 than in 2010, with only the incidence of hip fracture (p = 0.013) being lower in 2015 than in 2004. With regard to age-specific incidences, there was a sharp increase in vertebral and hip fractures among the segment of the population 70-89 years old, with no remarkable change in the incidence of radial and humeral fractures. Pre-existing vertebral fractures were identified in 69.6% of patients with a hip fracture, 35.6% of patients with a distal radius fracture, and 55% of patients with a humeral fracture. Among patients with pre-existing vertebral fractures, 42.5% had a single fracture, whereas 57.5% had 2 or more fractures. The proportion of patients on anti-osteoporotic agents before the occurrence of fractures increased to 14.5% in 2015, compared to 4% in 2004 and 7.6% in 2010. We speculate that the increase in the use of anti-osteoporotic agents is the main reason for the declining incidence of fractures. Therefore, considering the sharp increase in hip and vertebral fractures among individuals in their mid-1970s and older, judicious use of anti-osteoporotic agents among these individuals could be useful for lowering the occurrence of these fractures.
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http://dx.doi.org/10.1007/s00774-018-0937-9DOI Listing
May 2019

Chylothorax post thoracoscopic surgery for an anterior mediastinal tumor.

Gen Thorac Cardiovasc Surg 2018 Jun 16;66(6):372-375. Epub 2017 Nov 16.

Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

Chylothorax after anterior mediastinal surgery is rare. We treated a 39-year-old woman who presented with progressive dyspnea over 6 months. Chest computed tomography revealed a 12-cm round mass in the right anterior mediastinum. She underwent video-assisted thoracoscopic surgery for successful excision of the tumor; however, the surgery was complicated by the development of chylothorax. It was treated surgically with no recurrence of the tumor and/or chylothorax for 2 years. Chylothorax should be recognized as a postsurgical complication of anterior mediastinal tumors.
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http://dx.doi.org/10.1007/s11748-017-0865-yDOI Listing
June 2018

A novel model uses metabolic and volumetric parameters to predict less invasive lung adenocarcinomas†.

Eur J Cardiothorac Surg 2018 02;53(2):379-384

Department of Thoracic Surgery, St. Luke's International Hospital, Tokyo, Japan.

Objectives: This study aimed to develop a prediction model for less invasive lesions of pathological Stage IA adenocarcinomas.

Methods: We retrospectively evaluated 121 lesions from 114 patients with pathological Stage IA adenocarcinoma who underwent surgery after fluorodeoxyglucose positron emission tomography and high-resolution computed tomography. Less invasive lesions were adenocarcinoma in situ and minimally invasive adenocarcinoma. The 3D parameter, solid tumour ratio, was the volume ratio of the solid part to the whole tumour. The 2D parameter was the consolidation-to-tumour ratio. The maximum standardized uptake value (SUVmax) in fluorodeoxyglucose positron emission tomography was the metabolic parameter. A volumetric analysis programme semiautomatically measured these 3 parameters. The cut-off values were 0.5, 0.125 and 1.0 for the consolidation-to-tumour ratio, solid tumour ratio and SUVmax, respectively. Multivariable logistic regression analysis was used to select the prediction model parameters.

Results: There were 34 (28.1%) less invasive lesions. A consolidation-to-tumour ratio <0.5 was an insignificant predictive factor for less invasive lesions in the multivariable analysis. The prediction model had a total score of 3 points: 1 point for SUVmax <1.0 and 2 points for the solid tumour ratio <0.125. The area under the receiver operating characteristic curve in this model was 0.86 (95% confidence interval 0.78-0.94). The total score indicated 89.5% probability of possessing less invasive lesions.

Conclusions: The solid tumour ratio and SUVmax effectively predicted less invasive lesions in early-stage lung adenocarcinomas. The prediction model generated by volumetric and metabolic parameters showed higher predictive power in this clinical setting.
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http://dx.doi.org/10.1093/ejcts/ezx273DOI Listing
February 2018

Case report of nivolumab-related pneumonitis.

Immunotherapy 2017 03;9(4):313-318

Immunotherapy & Cell Therapy Service, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.

We report a case with suggestive antiprogrammed death-1 inhibitor-related pneumonitis in an endometrial cancer patient. This case presented with fever and cough after three dosages of nivolumab. Computed tomography initially showed centrilobular nodularities in a unilateral lung, which was compatible with aspiration pneumonia. However, diffuse ground-glass opacities (GGO) rapidly developed in the unilateral lung over 4 days despite the use of broad-spectrum antibiotics. Development of GGO was considered to be related to a nivolumab-mediated immune reaction. Corticosteroid was administered and the GGO subsequently disappeared. The present report focuses on the computed tomography diagnostic features of nivolumab-related pneumonitis. The accumulation of knowledge regarding various types of antiprogrammed death-1-related pneumonitis will lead to appropriate treatment for this newly emerging adverse event.
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http://dx.doi.org/10.2217/imt-2016-0129DOI Listing
March 2017

Radiation dose optimization for the bolus tracking technique in abdominal computed tomography: usefulness of real-time iterative reconstruction for monitoring scan.

Radiol Phys Technol 2017 Jun 30;10(2):155-160. Epub 2016 Sep 30.

Department of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Sunto, Shizuoka, 411-8777, Japan.

The purpose of this study was to optimize the monitoring dose, obtained using the conventional filtered back projection (FBP) method and iterative reconstruction algorithms, for the bolus tracking technique. A phantom study was performed to assess the effect of the scan start time in patients grouped according to different body weights. An oval torso phantom was used for simulating the time enhancement curve of the bolus tracking technique. To reproduce image noise levels in the two body weight groups, the phantom diameter was adjusted with a water-equivalent material. The tube currents were 10, 20, 30, and 50 mA. The monitoring scan was performed with the conventional FBP method and real-time adaptive iterative dose reduction by three-dimensional processing (AIDR 3D). The results at different doses were compared with those at 50 mA. The volume computed tomography dose index was 1.31, 2.65, 3.93, and 6.56 mGy at tube currents of 10, 20, 30, and 50 mA, respectively. The scan start time, reconstructed using FBP, was significantly faster at 10 and 20 mA in group A (50-59 kg) and at 20 mA in group B (≥80 kg). The CT values in the region of interest could not be measured at 10 mA because of artifacts. With real-time AIDR 3D, both groups showed no significant differences between the measurements obtained at 30 or 20 mA and those obtained at 50 mA. Our study demonstrated that the real-time AIDR 3D algorithm improved the accuracy of the CT measurements with the bolus tracking technique.
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http://dx.doi.org/10.1007/s12194-016-0378-xDOI Listing
June 2017

Mature Biofilm Degradation by Potential Probiotics: Aggregatibacter actinomycetemcomitans versus Lactobacillus spp.

PLoS One 2016 20;11(7):e0159466. Epub 2016 Jul 20.

Department of Biological Functions Engineering, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Wakamatsu-ku, Kitakyushu, Japan.

The biofilm degradation of Aggregatibacter actinomycetemcomitans is essential as a complete periodontal disease therapy, and here we show the effects of potential probiotic bacteria such as Lactobacillus spp. for the biofilm of several serotypes of A. actinomycetemcomitans strains. Eight of the 13 species showed the competent biofilm degradation of ≥ 90% reduction in biofilm values in A. actinomycetemcomitans Y4 (serotype b) as well as four of the seven species for the biofilm of A. actinomycetemcomitans OMZ 534 (serotype e). In contrast, the probiotic bacteria did not have a big impact for the degradation of A. actinomycetemcomitans SUNY 75 (serotype a) biofilm. The dispersed A. actinomycetemcomitans Y4 cells through the biofilm detachment were still viable and plausible factors for the biofilm degradation were not due to the lactic acid and low pH conditions. The three enzymes, protease, lipase, and amylase may be responsible for the biofilm degradation; in particular, lipase was the most effective enzyme for the biofilm degradation of A. actinomycetemcomitans Y4 along with the protease activity which should be also important for the other serotypes. Remarkable lipase enzyme activities were detected from some of the potential probiotics and a supporting result using a lipase inhibitor presented corroborating evidence that lipase activity is one of the contributing factors for biofilm degradation outside of the protease which is also another possible factor for the biofilm of the other serotype of A. actinomycetemcomitans strains. On the other hand, the biofilm of A. actinomycetemcomitans SUNY 75 (serotype a) was not powerfully degraded by the lipase enzyme because the lipase inhibitor was slightly functional for only two of potential probiotics.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159466PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4954673PMC
July 2017

Proposal for a new noncontact method for measuring tongue moisture to assist in tongue diagnosis and development of the tongue image analyzing system, which can separately record the gloss components of the tongue.

Biomed Res Int 2015 28;2015:249609. Epub 2015 Jan 28.

Center for Frontier Medical Engineering, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba 263-8522, Japan.

Tongue diagnosis is a noninvasive diagnosis and is traditionally one of the most important tools for physicians who practice Kampo (traditional Japanese) medicine. However, it is a subjective process, and its results can depend on the experience of the physician performing it. Previous studies have reported how to measure and evaluate the shape and color of the tongue objectively. Therefore, this study focused on the glossy component in order to quantify tongue moisture in tongue diagnosis. We hypothesized that moisture appears as a gloss in captured images and measured the amount of water on the tongue surface in 13 subjects. The results showed a high correlation between the degree of gloss and the amount of water on the tongue surface and suggested that the moisture on the tongue can be estimated by the degree of gloss in a captured image. Because the moisture level on the tongue changes during the course of taking photos, it became clear that we had to wait at least 3 minutes between photos. Based on these results, we established the tongue image analyzing system (TIAS), which can consistently record the gloss and color of the tongue surface simultaneously.
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http://dx.doi.org/10.1155/2015/249609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324740PMC
November 2015

Temporal changes in tongue color as criterion for tongue diagnosis in Kampo medicine.

Forsch Komplementmed 2012 19;19(2):80-5. Epub 2012 Apr 19.

Center for Kampo Medicine, School of Medicine, Keio University, Tokyo, Japan.

Background: In Kampo medicine (Japanese traditional herbal medicine), the appearance of the tongue contains a lot of useful information for diagnosis. However, an inspection of the tongue is not considered to be important in modern medical diagnosis, since the skills applied in the examination are difficult to understand. Thus, we developed an imaging system and algorithm for quantitative analysis of the tongue to provide the traditional techniques of Kampo with greater objectivity.

Materials And Methods: Tongue images were taken from 9 healthy subjects for 3 consecutive weeks (5 days/week), 12 times a day, with 300 images taken successively within 30 s each time. Then, the temporal color changes in 30 s, 1 day, and 3 weeks were measured in the device-independent International Commission on Illumination (CIE) 1976 L*a*b* color space.

Results: The tongue color change in 30 s varied between individuals, and it was mainly classified into 3 patterns. This image acquisition system and valid color management should help all tongue-related research, and the 30-s temporal color change might be an important target for further tongue analysis.

Conclusions: We were able to acquire tongue images without specular reflection and with valid color reproduction, and the color change in 30 s was found to vary. Tongue color changes have not been mentioned in the classics of Kampo medicine, since they were certainly impossible to discriminate by the naked eye. The change during 30 s is a new finding based on the electronic devices, and together they are expected to become a new criterion for tongue analysis.
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http://dx.doi.org/10.1159/000338516DOI Listing
October 2012

[Cardiogenic shock due to takotsubo cardiomyopathy during induction therapy for acute myeloid leukemia].

Rinsho Ketsueki 2011 Dec;52(12):1896-9

Department of Hematology, Niigata University Graduate School of Medical and Dental Sciences.

A 61-year-old man admitted for pancytopenia was diagnosed with acute myeloid leukemia. On day 26 of induction therapy, the patient suddenly developed cardiogenic shock. The ultrasound cardiogram showed imaging features typical of takotsubo cardiomyopathy. Cardiogenic shock caused by takotsubo cardiomyopathy is rare in patients with hematological malignancies but is a severe complication during chemotherapy.
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December 2011