T. Ebato, S. Ohta, Munehiro Yamaguchi, H. Mikuni, H. Ikeda, M. Jinno, K. Hirai, Y. Miyata, H. Inoue, T. Homma, Mayumi Yamamoto, S. Suzuki, A. Tanaka, H. Sagara
The cytokine interleukin-34 （ IL-34 ） was recently described. However, its role in the lungs is not well understood. IL-34 binds to the colony stimulating factor-1 receptor, thereby enhancing tissue macrophage maturation and differentiation. Macrophages are essential to the airway inflammation process and acute lung injury （ ALI ） . This study aimed to evaluate the role of IL-34 in ALI establishment. The bronchoalveolar lavage fluid （ BALF ） and lung tissues were collected. The cells of the human peripheral blood monocyte cell line THP-1 and the human airway epithelial cell line BEAS-2B were with LPS in vitro . The total in the than in the factor- α （ TNF- α） in THP-1 cells. Furthermore, TNF- α stimulation induced the IL-34 production in BEAS-2B cells. These results suggest that IL-34 induction in the epithelial cells may enhance pulmonary inflammation and fibrosis in the murine model of LPS-induced acute lung injury.
{"title":"Interleukin-34 induces pulmonary inflammation in a murine model of lipopolysaccharide-induced acute lung injury","authors":"T. Ebato, S. Ohta, Munehiro Yamaguchi, H. Mikuni, H. Ikeda, M. Jinno, K. Hirai, Y. Miyata, H. Inoue, T. Homma, Mayumi Yamamoto, S. Suzuki, A. Tanaka, H. Sagara","doi":"10.15369/sujms.33.124","DOIUrl":"https://doi.org/10.15369/sujms.33.124","url":null,"abstract":"The cytokine interleukin-34 （ IL-34 ） was recently described. However, its role in the lungs is not well understood. IL-34 binds to the colony stimulating factor-1 receptor, thereby enhancing tissue macrophage maturation and differentiation. Macrophages are essential to the airway inflammation process and acute lung injury （ ALI ） . This study aimed to evaluate the role of IL-34 in ALI establishment. The bronchoalveolar lavage fluid （ BALF ） and lung tissues were collected. The cells of the human peripheral blood monocyte cell line THP-1 and the human airway epithelial cell line BEAS-2B were with LPS in vitro . The total in the than in the factor- α （ TNF- α） in THP-1 cells. Furthermore, TNF- α stimulation induced the IL-34 production in BEAS-2B cells. These results suggest that IL-34 induction in the epithelial cells may enhance pulmonary inflammation and fibrosis in the murine model of LPS-induced acute lung injury.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84254414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We evaluated the treatment results and aortic remodeling of Stanford type B aortic dissection （ TBAD ） following thoracic endovascular aortic repair （ TEVAR ） to determine the optimal timing to operate. Based on the duration from the onset of TBAD to surgery, 17 patients who underwent TEVAR for TBAD were divided into early （ n ＝ 10, TEVAR ＜ 3 months from onset ） and late （ n ＝ 7, TEVAR≥3 months from onset ） groups. True- and false-lumen areas were measured at four levels （ A - D ） using contrast-enhanced computed tomography before and after TEVAR : A, immediately after the left subclavian artery branching ; B, descending aorta at the tracheal bifurcation ; C, aortic annulus ; and D, diaphragm. The durations from the onset of TBAD to TEVAR were 46 ± 25 days and 7.0 ± 5.3 years in the early and late groups, respectively. No major intraoperative complications were observed in either group. However, the early group had one case of retrograde type A aortic dissection 54 days after TEVAR. In the early group, true-lumen area increased at all levels, except at level A, whereas false-lumen areas decreased at all levels （ p ＜ 0.05 ） . The late group showed no tendencies, except for an increased true-lumen area at level B. A difference in early aortic remodeling was observed ― true-lumen area enlargement and false-lumen area decrease were more marked in the early group than the late group. TEVAR is useful when performed early after TBAD onset （ within 3 months ） and results in good aortic remodeling. In the late phase, the effect might be relatively smaller.
{"title":"Early outcomes of thoracic endovascular aortic repair in treating type B aortic dissection","authors":"H. Kataoka, Hiroyuki Tanaka, Y. Hori","doi":"10.15369/SUJMS.33.15","DOIUrl":"https://doi.org/10.15369/SUJMS.33.15","url":null,"abstract":"We evaluated the treatment results and aortic remodeling of Stanford type B aortic dissection （ TBAD ） following thoracic endovascular aortic repair （ TEVAR ） to determine the optimal timing to operate. Based on the duration from the onset of TBAD to surgery, 17 patients who underwent TEVAR for TBAD were divided into early （ n ＝ 10, TEVAR ＜ 3 months from onset ） and late （ n ＝ 7, TEVAR≥3 months from onset ） groups. True- and false-lumen areas were measured at four levels （ A - D ） using contrast-enhanced computed tomography before and after TEVAR : A, immediately after the left subclavian artery branching ; B, descending aorta at the tracheal bifurcation ; C, aortic annulus ; and D, diaphragm. The durations from the onset of TBAD to TEVAR were 46 ± 25 days and 7.0 ± 5.3 years in the early and late groups, respectively. No major intraoperative complications were observed in either group. However, the early group had one case of retrograde type A aortic dissection 54 days after TEVAR. In the early group, true-lumen area increased at all levels, except at level A, whereas false-lumen areas decreased at all levels （ p ＜ 0.05 ） . The late group showed no tendencies, except for an increased true-lumen area at level B. A difference in early aortic remodeling was observed ― true-lumen area enlargement and false-lumen area decrease were more marked in the early group than the late group. TEVAR is useful when performed early after TBAD onset （ within 3 months ） and results in good aortic remodeling. In the late phase, the effect might be relatively smaller.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78744799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Yamochi, Katsuhiko Yoshida, Yoshimi Nagakura, Yasuyuki Ohira, T. Yamochi, M. Takimoto, K. Fukuchi
We have reported the possibility of an outbreak of a plasmid-borne carbapenemase-producing Enterobacteriaceae at Showa University Hospital using conjugal transfer experiments ; however, we could not perform plasmid profiling and fingerprinting to identify the plasmid responsible for the outbreak in clinical isolates. Therefore, to distinguish whether the appearance of metallo- β -lactamase IMP-11 （ bla IMP-11 ） -producing Enterobacter cloacae （ E. cloacae ） was due to the same plasmid, we established a plasmid testing system involving plasmid isolation, typing, profiling, and fingerprinting, as well as DNA sequencing analysis of genes surrounding the carbapenemase-encoding gene. Plasmid fingerprinting is an essential tool for identifying plasmids when next-generation sequencing methods cannot be employed. Of note, an important step in fingerprinting is plasmid isolation, which is difficult when large plasmids are involved. In addition, plasmid profiling using S1 nuclease pulse-field gel electrophoresis （ PFGE ） Southern blotting important tool for profiling the size and number of plasmids in bacteria. study, we isolated an approximately 90-kb IncL/M plasmid by employing our plasmid analysis system. different MP-11 -producing of similar size and fingerprinting pattern, we suggest the IncL/M plasmid in
{"title":"Plasmid analysis of clinically isolated Enterobacter cloacae in Showa University Hospital","authors":"T. Yamochi, Katsuhiko Yoshida, Yoshimi Nagakura, Yasuyuki Ohira, T. Yamochi, M. Takimoto, K. Fukuchi","doi":"10.15369/sujms.33.97","DOIUrl":"https://doi.org/10.15369/sujms.33.97","url":null,"abstract":"We have reported the possibility of an outbreak of a plasmid-borne carbapenemase-producing Enterobacteriaceae at Showa University Hospital using conjugal transfer experiments ; however, we could not perform plasmid profiling and fingerprinting to identify the plasmid responsible for the outbreak in clinical isolates. Therefore, to distinguish whether the appearance of metallo- β -lactamase IMP-11 （ bla IMP-11 ） -producing Enterobacter cloacae （ E. cloacae ） was due to the same plasmid, we established a plasmid testing system involving plasmid isolation, typing, profiling, and fingerprinting, as well as DNA sequencing analysis of genes surrounding the carbapenemase-encoding gene. Plasmid fingerprinting is an essential tool for identifying plasmids when next-generation sequencing methods cannot be employed. Of note, an important step in fingerprinting is plasmid isolation, which is difficult when large plasmids are involved. In addition, plasmid profiling using S1 nuclease pulse-field gel electrophoresis （ PFGE ） Southern blotting important tool for profiling the size and number of plasmids in bacteria. study, we isolated an approximately 90-kb IncL/M plasmid by employing our plasmid analysis system. different MP-11 -producing of similar size and fingerprinting pattern, we suggest the IncL/M plasmid in","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78880651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazuo Kikuchi, N. Ohike, Tomoko Norose, Hitoshi Yoshida, Takashi Ogawa, T. Yamochi
This study is aimed at investigating the relationship between the polymeric immunoglobulin receptor (pIgR) expression and clinicopathological factors in advanced colorectal cancer (CRC) patients. The study involved 47 advanced CRC patients who were surgically resected and underwent KRAS gene test. The pIgR expression was analyzed by immunohistochemistry, and the patients were classified into high and low (pIgR-H and pIgR-L, respectively) groups based on the staining intensity and range. A total of 13 cases was classified under the pIgR-H group, and the remaining 34 were classified under the pIgR-L group. Results suggest no significant differences in most clinicopathological factors between the pIgR-H and pIgR-L groups, although the pIgR-L group had a significantly higher frequency of venous invasion than the pIgR-H group, whereas the frequency of KRAS gene mutation was significantly higher in the pIgR-H group than that in the pIgR-L group. The findings in this study showed little significant correlation between the pIgR expression and clinicopathological factors in advanced CRC patients. Further research on the biological behavior of pIgR as a drug treatment option for KRAS-mutated advanced CRCs is also warranted.
{"title":"Clinicopathological study on pIgR expression and tumor progression in advanced colorectal cancer","authors":"Kazuo Kikuchi, N. Ohike, Tomoko Norose, Hitoshi Yoshida, Takashi Ogawa, T. Yamochi","doi":"10.15369/SUJMS.33.41","DOIUrl":"https://doi.org/10.15369/SUJMS.33.41","url":null,"abstract":"This study is aimed at investigating the relationship between the polymeric immunoglobulin receptor (pIgR) expression and clinicopathological factors in advanced colorectal cancer (CRC) patients. The study involved 47 advanced CRC patients who were surgically resected and underwent KRAS gene test. The pIgR expression was analyzed by immunohistochemistry, and the patients were classified into high and low (pIgR-H and pIgR-L, respectively) groups based on the staining intensity and range. A total of 13 cases was classified under the pIgR-H group, and the remaining 34 were classified under the pIgR-L group. Results suggest no significant differences in most clinicopathological factors between the pIgR-H and pIgR-L groups, although the pIgR-L group had a significantly higher frequency of venous invasion than the pIgR-H group, whereas the frequency of KRAS gene mutation was significantly higher in the pIgR-H group than that in the pIgR-L group. The findings in this study showed little significant correlation between the pIgR expression and clinicopathological factors in advanced CRC patients. Further research on the biological behavior of pIgR as a drug treatment option for KRAS-mutated advanced CRCs is also warranted.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78420438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shun Fujiwara, Yuta Baba, Yohei Sasaki, S. Shimada, So Murai, N. Arai, Yukiko Kawaguchi, N. Hattori, E. Shiozawa, T. Yamochi, K. Fukuchi, T. Nakamaki
MYD88 L265P mutation causes constitutive activation of NF-κB and possible driver mutation in B-cell lymphoid malignancies. It is frequently detected in Waldenstrom’s macroglobulinemia (WM) (50%-100%), and its detection is important in diagnostic and therapeutic targets of this syndrome. Standard detection method of MYD88 L265P mutation in clinical practice has yet to be established. We developed semi-nested PCR-based restriction fragment length polymorphism (snPCR-RFLP) to detect the mutation. The snPCR-RFLP method is a modification of the PCR-RFLP method, which uses the restriction enzyme BsiEI that recognizes CGACT / CG, intending to increase detection sensitivity by amplification of mutated allele in the DNA sample using semi-nested PCR before enzyme digestion. The detection sensitivity of snPCR-RFLP was estimated as 0.1%, by detecting mutated allele in wild-type allele in the cloned plasmid DNA, which is comparable with allele-specific (AS) PCR method widely used as sensitive detection method. By analyzing 40 cases with IgM monoclonal gammopathy, snPCR-RFLP detected 29/40 (70%) of all cases, 22 / 31 (70.9%) of WM, and 6/9 (66.6%) of IgM-type monoclonal gammopathy with undetermined significance (IgMMGUS), including five cases (three cases of WM and two cases of IgMMGUS) in which the mutation was detected only by snPCR-RFLP but not by Sanger sequencing method. Regarding DNA sample status, particularly five cases, a case was extracted from formalin-fixed paraffin-embedded tissue and four cases were extracted from cells by Ficoll-Hypaque density gradient. In correlation with clinical features, the MYD88 mutation detected by snPCR-RFLP method was associated with the adverse prognostic index (WMIPSS) of WM using patient age, hemoglobin (Hb) level, platelet count, β2MG level, and serum IgM level (p=0.055). The snPCR-RFLP method is a clinically useful MYD88 mutation detection method that can be performed in general laboratories.
{"title":"Analysis of the MYD88 L265P mutation in IgM monoclonal gammopathy by semi-nested polymerase chain reaction-based restriction fragment length polymorphism method","authors":"Shun Fujiwara, Yuta Baba, Yohei Sasaki, S. Shimada, So Murai, N. Arai, Yukiko Kawaguchi, N. Hattori, E. Shiozawa, T. Yamochi, K. Fukuchi, T. Nakamaki","doi":"10.15369/SUJMS.33.47","DOIUrl":"https://doi.org/10.15369/SUJMS.33.47","url":null,"abstract":"MYD88 L265P mutation causes constitutive activation of NF-κB and possible driver mutation in B-cell lymphoid malignancies. It is frequently detected in Waldenstrom’s macroglobulinemia (WM) (50%-100%), and its detection is important in diagnostic and therapeutic targets of this syndrome. Standard detection method of MYD88 L265P mutation in clinical practice has yet to be established. We developed semi-nested PCR-based restriction fragment length polymorphism (snPCR-RFLP) to detect the mutation. The snPCR-RFLP method is a modification of the PCR-RFLP method, which uses the restriction enzyme BsiEI that recognizes CGACT / CG, intending to increase detection sensitivity by amplification of mutated allele in the DNA sample using semi-nested PCR before enzyme digestion. The detection sensitivity of snPCR-RFLP was estimated as 0.1%, by detecting mutated allele in wild-type allele in the cloned plasmid DNA, which is comparable with allele-specific (AS) PCR method widely used as sensitive detection method. By analyzing 40 cases with IgM monoclonal gammopathy, snPCR-RFLP detected 29/40 (70%) of all cases, 22 / 31 (70.9%) of WM, and 6/9 (66.6%) of IgM-type monoclonal gammopathy with undetermined significance (IgMMGUS), including five cases (three cases of WM and two cases of IgMMGUS) in which the mutation was detected only by snPCR-RFLP but not by Sanger sequencing method. Regarding DNA sample status, particularly five cases, a case was extracted from formalin-fixed paraffin-embedded tissue and four cases were extracted from cells by Ficoll-Hypaque density gradient. In correlation with clinical features, the MYD88 mutation detected by snPCR-RFLP method was associated with the adverse prognostic index (WMIPSS) of WM using patient age, hemoglobin (Hb) level, platelet count, β2MG level, and serum IgM level (p=0.055). The snPCR-RFLP method is a clinically useful MYD88 mutation detection method that can be performed in general laboratories.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87702313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Keiichiro Aoki, Hisayoshi Suzuki, Takeaki Miyata, T. Ogino, Akihiro Iguchi
To clarify predictors of outcomes that can indicate the appropriateness of discharging patients to their own homes following acute ischemic stroke and percutaneous mechanical thrombectomy (PMT). This study included 99 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at Hospital A and underwent PMT between April 2014 and December 2018. Of these, 32 and 67 patients were discharged to their own homes or to other hospitals, respectively. The following items were retrospectively collected from medical records within 3 days of PMT: age ; sex ; familial cohabitation and employment status ; serum albumin level ; consciousness disorders ; National Institutes of Health Stroke Scale (NIHSS), at the most severe time and at 24 hours postoperatively ; Brunnstrom recovery stage (BRS) in upper limbs, fingers, and lower limbs ; oral intake ; independence in activities of daily living such as eating, grooming, toileting, and walking ; and higher brain dysfunction. We identified significant differences between the groups in terms of consciousness disorders, both NIHSS scores, BRS, oral intake, independence in eating and grooming, and higher brain dysfunction (p<0.05). Multiple logistic regression analysis revealed the following significant predictors of outcomes : NIHSS score at 24 hours postoperatively (odds ratio [OR]: 1.35 ; 95% confidence interval [CI]: 0.1520.448) and oral intake (OR : 10.46, 95% CI : -2.252 to -0.095). NIHSS score at 24 hours postoperatively and oral intake are useful predictors of patient outcomes following PMT for acute ischemic stroke. These can be assessed even when bed rest levels are low.
{"title":"Predictors of discharge outcomes following percutaneous mechanical thrombectomy in patients with acute ischemic stroke: Comparisons between the home discharge group and hospital transfer group","authors":"Keiichiro Aoki, Hisayoshi Suzuki, Takeaki Miyata, T. Ogino, Akihiro Iguchi","doi":"10.15369/SUJMS.33.9","DOIUrl":"https://doi.org/10.15369/SUJMS.33.9","url":null,"abstract":"To clarify predictors of outcomes that can indicate the appropriateness of discharging patients to their own homes following acute ischemic stroke and percutaneous mechanical thrombectomy (PMT). This study included 99 patients with acute ischemic stroke who were hospitalized in the Department of Neurology at Hospital A and underwent PMT between April 2014 and December 2018. Of these, 32 and 67 patients were discharged to their own homes or to other hospitals, respectively. The following items were retrospectively collected from medical records within 3 days of PMT: age ; sex ; familial cohabitation and employment status ; serum albumin level ; consciousness disorders ; National Institutes of Health Stroke Scale (NIHSS), at the most severe time and at 24 hours postoperatively ; Brunnstrom recovery stage (BRS) in upper limbs, fingers, and lower limbs ; oral intake ; independence in activities of daily living such as eating, grooming, toileting, and walking ; and higher brain dysfunction. We identified significant differences between the groups in terms of consciousness disorders, both NIHSS scores, BRS, oral intake, independence in eating and grooming, and higher brain dysfunction (p<0.05). Multiple logistic regression analysis revealed the following significant predictors of outcomes : NIHSS score at 24 hours postoperatively (odds ratio [OR]: 1.35 ; 95% confidence interval [CI]: 0.1520.448) and oral intake (OR : 10.46, 95% CI : -2.252 to -0.095). NIHSS score at 24 hours postoperatively and oral intake are useful predictors of patient outcomes following PMT for acute ischemic stroke. These can be assessed even when bed rest levels are low.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86830244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this study was to establish a screening method for dysphagia using panoramic radiography. Seventy patients who had undergone panoramic radiography and videofluorographic swallowing study （ VF ） were selected. Exclusion criteria were surgery related to tumors, jaw deformity, and poor-quality panoramic radiograph images. Patients were diagnosed with dysphagia based on VF findings and accordingly categorized into Dysphagia （＋） or Dysphagia （−） groups. The control group consisted of 129 individuals who had undergone panoramic radiography for dental treatment. Exclusion criteria were the same as in the Dysphagia （＋） and Dysphagia （−） groups. Two maxillofacial radiologists assessed the vertical and horizontal position of the hyoid bone and measured the distance from the tongue to the palate. The vertical hyoid bone position was significantly lower in the Dysphagia （＋） group than in the control group. The distance from the tongue to the palate was significantly shorter in the control group, measuring 8.5 ± 5.9 mm as compared to 15.0 ± 9.5 in the Dysphagia （＋） group and 14.9 ± 10.0 in the Dysphagia （−） group. At least 77 ％ of patients were diagnosed with dysphagia or suspected of dysphagia because the hyoid body was below the mandibular line on panoramic radiography. Panoramic radiography may be a useful tool for predicting the risk of dysphagia as it reveals the vertical hyoid bone position and the distance from the tongue to the palate.
{"title":"A novel dysphagia screening method using panoramic radiography","authors":"Emi Ito, Y. Matsuda, Migiwa Kuroda, K. Araki","doi":"10.15369/sujms.33.74","DOIUrl":"https://doi.org/10.15369/sujms.33.74","url":null,"abstract":"The purpose of this study was to establish a screening method for dysphagia using panoramic radiography. Seventy patients who had undergone panoramic radiography and videofluorographic swallowing study （ VF ） were selected. Exclusion criteria were surgery related to tumors, jaw deformity, and poor-quality panoramic radiograph images. Patients were diagnosed with dysphagia based on VF findings and accordingly categorized into Dysphagia （＋） or Dysphagia （−） groups. The control group consisted of 129 individuals who had undergone panoramic radiography for dental treatment. Exclusion criteria were the same as in the Dysphagia （＋） and Dysphagia （−） groups. Two maxillofacial radiologists assessed the vertical and horizontal position of the hyoid bone and measured the distance from the tongue to the palate. The vertical hyoid bone position was significantly lower in the Dysphagia （＋） group than in the control group. The distance from the tongue to the palate was significantly shorter in the control group, measuring 8.5 ± 5.9 mm as compared to 15.0 ± 9.5 in the Dysphagia （＋） group and 14.9 ± 10.0 in the Dysphagia （−） group. At least 77 ％ of patients were diagnosed with dysphagia or suspected of dysphagia because the hyoid body was below the mandibular line on panoramic radiography. Panoramic radiography may be a useful tool for predicting the risk of dysphagia as it reveals the vertical hyoid bone position and the distance from the tongue to the palate.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74111840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moemi Fukuda, N. Kohyama, M. Maeda, T. Kawasaki, Toshinori Yamamoto, M. Kogo
Sulbactam/ampicillin (SBT / ABPC) and ceftriaxone (CTRX) are the initial antibiotics recommended for treating aspiration pneumonia without risk factors for drug-resistant pathogens. However, the condition of some patients does not improve with these antibiotics. Therefore, we investigated the new risk factors associated with failure of initial antibiotic treatment in patients with aspiration pneumonia. This study included 487 patients diagnosed with aspiration pneumonia who received initial antibiotic treatment with SBT / ABPC or CTRX, and were hospitalized at the Respiratory Medicine Department of the Yokohama City Minato Red Cross Hospital. The outcome was initial antibiotic treatment failure, which was defined as a change from initial to secondary antibiotic treatment. The characteristics of patients with and without antibiotic treatment failure were compared using univariate analyses, and significant independent risk factors for the initial antibiotic treatment failure were selected using multivariate analyses. The mean age of the patients was 84.1± 9.6 years; 302 (62%) of them were men and 93 patients experienced antibiotic treatment failure. Logistic regression analysis extracted no restriction of diet on admission (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.357.74), history of hospitalization due to aspiration pneumonia (OR, 1.81; 95%CI, 1.12-2.93), the severity of pneumonia (OR, 1.37; 95%CI, 1.01-1.86), and C-reactive protein (CRP) level (OR, 1.26; 95%CI, 1.09-1.45) as risk factors for initial antibiotic treatment failure. Our results suggested that no restriction of diet on admission, history of hospitalization due to aspiration pneumonia, severity of pneumonia, and increased CRP levels were the risk factors associated with failure of initial antibiotic treatment in patients with aspiration pneumonia. These factors will be useful for determining an effective initial treatment strategy for patients with aspiration pneumonia.
{"title":"Risk factors for initial antibiotic treatment failure in patients with aspiration pneumonia","authors":"Moemi Fukuda, N. Kohyama, M. Maeda, T. Kawasaki, Toshinori Yamamoto, M. Kogo","doi":"10.15369/SUJMS.33.55","DOIUrl":"https://doi.org/10.15369/SUJMS.33.55","url":null,"abstract":"Sulbactam/ampicillin (SBT / ABPC) and ceftriaxone (CTRX) are the initial antibiotics recommended for treating aspiration pneumonia without risk factors for drug-resistant pathogens. However, the condition of some patients does not improve with these antibiotics. Therefore, we investigated the new risk factors associated with failure of initial antibiotic treatment in patients with aspiration pneumonia. This study included 487 patients diagnosed with aspiration pneumonia who received initial antibiotic treatment with SBT / ABPC or CTRX, and were hospitalized at the Respiratory Medicine Department of the Yokohama City Minato Red Cross Hospital. The outcome was initial antibiotic treatment failure, which was defined as a change from initial to secondary antibiotic treatment. The characteristics of patients with and without antibiotic treatment failure were compared using univariate analyses, and significant independent risk factors for the initial antibiotic treatment failure were selected using multivariate analyses. The mean age of the patients was 84.1± 9.6 years; 302 (62%) of them were men and 93 patients experienced antibiotic treatment failure. Logistic regression analysis extracted no restriction of diet on admission (odds ratio [OR], 3.23; 95% confidence interval [CI], 1.357.74), history of hospitalization due to aspiration pneumonia (OR, 1.81; 95%CI, 1.12-2.93), the severity of pneumonia (OR, 1.37; 95%CI, 1.01-1.86), and C-reactive protein (CRP) level (OR, 1.26; 95%CI, 1.09-1.45) as risk factors for initial antibiotic treatment failure. Our results suggested that no restriction of diet on admission, history of hospitalization due to aspiration pneumonia, severity of pneumonia, and increased CRP levels were the risk factors associated with failure of initial antibiotic treatment in patients with aspiration pneumonia. These factors will be useful for determining an effective initial treatment strategy for patients with aspiration pneumonia.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79615780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Kataoka, Hiroyuki Tanaka, Ayumi Omura, Y. Takei, H. Sone, H. Mase, Hiroshi Suzuki
We performed aneurysm repair with double closure technique of sinus of Valsalva aneurysm （ SVA ） in a 59-year-old man who was revealed obstructing right ventricular outflow tract （ RVOT ） with moderate Aortic insufficiency （ AI ） by transthoracic echocardiography （ TTE ） . SVA plication was performed resection and suture trans tricuspid valve. Patch closure was performed with double-layer 30 mm × 30 mm bovine pericardial patch. Aortic valve cusps had no abnormalities such as prolapse and AI disappeared after aneurysm repair because the etiology of AI was enlargement of aortic valve annulus. He was discharged with good condition. Computed tomography confirmed disappearance of blood flow in SVA, and TTE showed released RVOT obstruction in follow-up. Double closure technique, which combines resection and suture and patch closure, is useful for treatment of SVA.
我们对一名59岁的男性患者，经胸超声心动图(TTE)发现右心室流出道梗阻(RVOT)并伴有中度主动脉不全(AI)，采用双闭术修复Valsalva动脉瘤窦(SVA)。经三尖瓣切除缝合SVA应用。膜片闭合采用双层30 mm × 30 mm牛心包膜片。主动脉瓣尖未见脱垂等异常，动脉瘤修复后AI消失，原因是AI的病因是主动脉瓣环扩大。他出院时情况良好。ct证实SVA血流消失，随访时TTE显示RVOT阻塞释放。双闭合技术，结合切除缝合和补片闭合，是治疗SVA的有效方法。
{"title":"A surgical case of unruptured giant sinus of Valsalva aneurysm with right ventricular outflow tract stenosis using double closure technique","authors":"H. Kataoka, Hiroyuki Tanaka, Ayumi Omura, Y. Takei, H. Sone, H. Mase, Hiroshi Suzuki","doi":"10.15369/sujms.33.154","DOIUrl":"https://doi.org/10.15369/sujms.33.154","url":null,"abstract":"We performed aneurysm repair with double closure technique of sinus of Valsalva aneurysm （ SVA ） in a 59-year-old man who was revealed obstructing right ventricular outflow tract （ RVOT ） with moderate Aortic insufficiency （ AI ） by transthoracic echocardiography （ TTE ） . SVA plication was performed resection and suture trans tricuspid valve. Patch closure was performed with double-layer 30 mm × 30 mm bovine pericardial patch. Aortic valve cusps had no abnormalities such as prolapse and AI disappeared after aneurysm repair because the etiology of AI was enlargement of aortic valve annulus. He was discharged with good condition. Computed tomography confirmed disappearance of blood flow in SVA, and TTE showed released RVOT obstruction in follow-up. Double closure technique, which combines resection and suture and patch closure, is useful for treatment of SVA.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80730979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Nakatani, A. Katagiri, N. Suzuki, Kazuo Kikuchi, F. Yanagisawa, Toshihiko Gocho, Kazuya Inoki, Kenichi Konda, F. Yamamura, E. Inoue, Hitoshi Yoshida
Surgical resection for colorectal cancer （ CRC ） that deeply invades the submucosa （ ≥1,000 µm ） （ T1b ） has been recommended to reduce the potential risk of lymph node metastasis. In clinical settings, cases of pathological T1b exist, and these cases are treated with endoscopic resection （ ER ） for various reasons. However, factors that influence the choice of ER to treat T1b CRC remain unknown. Therefore, in this study, we investigated the factors associated with the choice of endoscopic treatments in patients diagnosed with pathological T1b or a more deeply invading CRC. To achieve this aim, we conducted a case series investigation of the previously conducted endoscopic diagnoses, after which we selected treatments for colorectal lesions. The case series comprised 83 lesions endoscopically diagnosed as early CRC, which was subsequently reviewed by eight endoscopists with various levels of experience in magnifying colonoscopy at Showa University Hospital. Then, pathological T1b or T2 lesions were extracted from the case series. We also assessed factors related to ER selection for these lesions using multiple logistic regression and analyzed their contributions using decision tree analysis. Eighteen cases with pathological T1b or more deeply invading lesions were extracted, and the analyses were conducted using 144 data obtained from these 18 lesions as interpreted by the eight reviewers. With multivariate logistic regression, a low estimation level for T1b and high confidence to perform ER were identified as independent factors affecting the selection of ER for T1b. The decision further indicated that confidence levels to perform ER influenced treatment selection, especially in lesions diagnosed as probable T1b. Our study therefore demonstrated that factors affecting the selection of ER to treat T1b CRCs were low estimations during endoscopic diagnosis and high confidence to conduct the ER procedure.
{"title":"Factors associated with endoscopic treatment decisions for T1b or more deeply invading colorectal cancers","authors":"S. Nakatani, A. Katagiri, N. Suzuki, Kazuo Kikuchi, F. Yanagisawa, Toshihiko Gocho, Kazuya Inoki, Kenichi Konda, F. Yamamura, E. Inoue, Hitoshi Yoshida","doi":"10.15369/sujms.33.133","DOIUrl":"https://doi.org/10.15369/sujms.33.133","url":null,"abstract":"Surgical resection for colorectal cancer （ CRC ） that deeply invades the submucosa （ ≥1,000 µm ） （ T1b ） has been recommended to reduce the potential risk of lymph node metastasis. In clinical settings, cases of pathological T1b exist, and these cases are treated with endoscopic resection （ ER ） for various reasons. However, factors that influence the choice of ER to treat T1b CRC remain unknown. Therefore, in this study, we investigated the factors associated with the choice of endoscopic treatments in patients diagnosed with pathological T1b or a more deeply invading CRC. To achieve this aim, we conducted a case series investigation of the previously conducted endoscopic diagnoses, after which we selected treatments for colorectal lesions. The case series comprised 83 lesions endoscopically diagnosed as early CRC, which was subsequently reviewed by eight endoscopists with various levels of experience in magnifying colonoscopy at Showa University Hospital. Then, pathological T1b or T2 lesions were extracted from the case series. We also assessed factors related to ER selection for these lesions using multiple logistic regression and analyzed their contributions using decision tree analysis. Eighteen cases with pathological T1b or more deeply invading lesions were extracted, and the analyses were conducted using 144 data obtained from these 18 lesions as interpreted by the eight reviewers. With multivariate logistic regression, a low estimation level for T1b and high confidence to perform ER were identified as independent factors affecting the selection of ER for T1b. The decision further indicated that confidence levels to perform ER influenced treatment selection, especially in lesions diagnosed as probable T1b. Our study therefore demonstrated that factors affecting the selection of ER to treat T1b CRCs were low estimations during endoscopic diagnosis and high confidence to conduct the ER procedure.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90525831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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