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2. Association of red blood cell and platelet transfusions with persistent inflammation, immunosuppression, and catabolism syndrome in critically ill patients

Author

Suzuki, Ginga, Ichibayashi, Ryo, Masuyama, Yuka, Yamamoto, Saki, Serizawa, Hibiki, Nakamichi, Yoshimi, Watanabe, Masayuki, and Honda, Mitsuru

Subjects
Multidisciplinary, Science, Immunology, Health care, Medicine, Platelet Transfusion, Article
Abstract

The objective of this single-center retrospective cohort study was to investigate the relationship between blood transfusion and persistent inflammation, immunosuppression, and catabolism syndrome (PIICS). The study was conducted at the Critical Care Center at Toho University Omori Medical Center, Japan. We included 391 patients in the PIICS group (hospitalization for > 15 days, C-reactive protein > 3.0 mg/dL or albumin 15 days and not meeting the PIICS criteria). We performed univariate and multivariate logistic regression analyses using PIICS as the objective variable and red blood cell (RBC) or fresh frozen plasma or platelet (PLT) transfusion and other confounding factors as explanatory variables. In addition, we conducted sensitivity analysis using propensity score matching analysis. The multivariate and propensity score analyses showed that RBC and PLT transfusions were significantly associated with PIICS. This is the first study to report an association between RBC and PLT transfusions and PIICS. Our findings have contributed to better understanding the risk factors of PIICS and suggest that physicians should consider the risk of PIICS occurrence when administering blood transfusions in intensive care unit (ICU) patients.

Published
2022
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3. Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

Author

Butler, Amy, Elmersson, Micael, Egilsson, Arnor, Borjesson, Ulf, Svard, Gunnar, Liu, Bo, Lindh, Anders, Olsson, Lars-Bertil, Gustaysson, Mikael, Andersson, Lars, Benson, Lars, Bothin, Claes, Hajimirsadeghi, Ali, Martinsson, Bjorn, Ericsson, Marianne, Ohlsson, Ake, Lindvall, Hakan, Svensson, Peter, Thorne, Katarina, Handel, Hans, Platonov, Pyotr, Bernsten, Fredrik, Timberg, Ingar, Crisby, Milita, Karlsson, Jan-Erik, Andersson, Agneta, Malmqvist, Lennart, Engdahl, Johan, Thulin, Jorgen, Hot-Bjelak, Aida, Jensen, Steen, Debrunner, Johann, Beer, Juerg H., Shah, Dipen, Rudyk, Iurii, Tseluyko, Vira, Karpenko, Oleksandr, Zhurba, Svitlana, Kraiz, Igor, Parkhomenko, Oleksandr, Kupnovytska, Iryna, Seredyuk, Nestor, Mostovoy, Yuriy, Ushakov, Oleksiy, Koval, Olena, Kovalskiy, Igor, Svyshchenko, Yevgeniya, Sychov, Oleg, Stanislavchuk, Mykola, Tykhonova, Susanna, Fushtey, Ivan, Murdoch, Will, Chauhan, Naresh, Goodwin, Daryl, Lumley, Louise, Patel, Ramila, Saunders, Philip, Wong, Bennett, Patel, Niranjan, Jhittay, P., Ross, Andrew, Kainth, M. S., Ladha, Karim, Douglas, Kevin, Pickavance, Gill, McDonnell, Joanna, Handscombe, Laura, Gooding, Trevor, Wagner, Helga, Bradshaw, Colin, Bromham, Catherine, Jones, Kevin, Suryani, Shoeb, Coates, Richard, Sarai, Bhupinder, Willcock, W., Sircar, S., Cairns, John, Gilliand, A., Bilas, Roman, Strieder, E., Hutchinson, Peter, Wakeman, Anne, Stokes, Michael, Kirby, Graham, Vishwanathan, Bhaskhar, Vormann, Reinhold, Mueller, Thomas, Mayer, Peter, Horstmeier, Uwe, Eissing, Volker, Hey, Heinz, Leuchtgens, Heinz, Lilienweiss, Volker, Mueller, Heiner, Schubert, Christian, Lauer, Hellmann, Buchner, Thomas, Brauer, Gunter, Kamin, Susanne, Mueller, Karsten, Baumbach, Sylvia, Abdel-Qader, Muwafeg, Ebert, Hans-Holger, Schwencke, Carsten, Bernhardt, Peter, Karolyi, Laszlo, Sievers, Britta, Haverkamp, Wilhelm, Roehnisch, Jens-Uwe, Vertes, Andras, Szantai, Gabor, Menke, Holger, Matoltsy, Andras, Kanakaridisz, Nikosz, Boda, Zoltan, Kis, Erno, Gaszner, Balazs, Juhasz, Ferenc, Kamogawa, Yasuyuki, Fournier, Pierre-Yves, Muller, Jean-Joseph, Marquand, Andre, Delarche, Nicolas, Bantwal, Ganapathi, Faes, Dirk, Verstraete, Stefan, Dominguez, Helena, Topsakal, Ramazan, Centurion, Nestor, Alfredo Sinisi, Victor, Minc, Piotr, Nagy, Andras, Bilo, Grzegorz, Bongiorni, Maria Grazia, Bird, Nigel, Paul, Carolyn, Wadeson, Paul, Hargreaves, Nick, Kostenko, Victor, Tercedor Sanchez, Luis, Tranche Iparraguirre, Salvador, Jimenez Gonzalez, Mercedes, Herreros Melenchon, Juan, Stalby, Per, Yagensky, Andriy, Cameron, Alex, Jacobs, Polly, Juhasz, Gizella, Kancz, Sandor, Laszlo, Zoltan, May, Zsolt, Astridge, Penny, Loghdey, Rehana, Quick, Annette, Yang, Ping, Chen, Yingmin, He, Shenghu, Wang, Yong, Fu, Guosheng, Li, Xin, Wu, Tongguo, Cheng, Xiaoshu, Yan, Xiaowei, Zhao, Ruiping, Chen, Moshui, Xiong, Longgen, Chen, Ping, Jiao, Yang, Guo, Ying, Xue, Li, Yang, Zhiming, Jadhavm, Praveen, Merkely, Bela, Noon, Ebrahim, Habon, Tamas, Polgar, Peter, Szalai, Gabriella, Vangel, Sandor, Sarma, Raghava, Kulkarni, Govind, Engelthaler, Gabriella, Ferenczi, Judit, Chandwani, Prakash, Pothiwala, Rasesh Atulbhai, Purayil, Mohanan Padinhare, Chawla, Kamaldeep, Verheugt, Freek W. A., Ambrosio, Giuseppe, Atar, Dan, Bassand, Jean-Pierre, Costabel, Juan Pablo, Goldhaber, Samuel Z., Goto, Shinya, Egyutt, Mihaly, Martini, Giuliana, Cristina, Leone Maria, Tirafern, Eros, Santoro, Rita, Testa, Sophie, Di Minno, Giovanni, Moia, Marco, Caimi, Teresa Maria, Tessitori, Maria, Cappelli, Roberto, Accogli, Michele, Mariani, Antonio, Feola, Mauro, Raisaro, Arturo, Fattore, Luciano, Mauric, Andrea, Germini, Fabrizio, Tedeschi, Luca, Settimi, Maria, Nicoli, Sergio, Ricciarini, Paolo, Argena, Antonio, Ronchini, Paolo, Bulla, Claudio, Tradati, Filippo, Volpe, Massimo, Avino, Maria D., Seven, Silva, Capucci, Alessandro, Lodigiani, Corrado, Salomone, Enrico, Serviddio, Gaetano, Tondo, Claudio, Golino, Paolo, Mazzone, Carmine, Iacopino, Saverio, Ruiter, J. H., Lucassen, Andreas, Adriaansen, Henk, Bongaerts, Maarten, Pieterse, Mathijs, van Guldener, Coen, Herrman, Johannes, Nierop, S. H. K. P. R., Hoogslag, Pieter, Hermans, Walter, Groenemeijer, B. 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Michael, Sharma, Niraj, Wilson, Vance, Miller, Stephen, Alberts, Mark, Blumberg, Edwin, Canosa, Roddy, Gutowski, Ted, Ison, Rodney, Garcia, Jorge, Mullen, Paul, Noveck, Howard, Rama, Pamela, Reddy, Rajneesh, Williams, Marcus, Nishijima, Daniel, Ferdinand, Keith, Hague, Ihsan, Mendelson, Robert, Pitta, Sridevi, Theodoro, Daniel, Treasure, Charles, Moustafa, Moustafa, Cader, Cas, Pharr, Walter, Oropallo, Alisha, Platt, George, Gujral, Jaspal, Welker, James, Koura, Firas, Lesnik, Jozef, Eltishcheva, Vera, Libis, Roman, Kamalov, Gadel, Belenky, Dmitry, Egorova, Liudmila, Khokhlov, Alexander, Yakupov, Eduard, Zateyshchikov, Dmitry, Barbarash, Olga, Miller, Olga, Mazur, Evgeniy, Zrazhevskiy, Konstantin, Novikova, Tatyana, Moiseeva, Yulia, Polkanova, Elena, Sobolev, Konstantin, Rossovskaya, Maria, Shapovalova, Yulia, Kolesnikova, Alla, Nikolaev, Konstantin, Zemlianskaia, Oksana, Zateyshchikova, Anna, Popov, Sergey, Poltayskaya, Maria, Edin, Anton, Aleksandrova, Elena, Drapkina, Oksana, Vishnevsky, Alexander, Nagibovich, Oleg, Chizhov, Petr, Rachkova, Svetlana, Sergeev, Mikhail, Kurylo, Borys, Ushakov, Alexey, Alvarez Garcia, Pere, Lopez Fernandez, Maria Fernanda, Toran Monserrat, Pere, Marquez Contreras, Emilio, Isart Rafecas, Jordi, Motero Carrasco, Juan, Garcia Pavia, Pablo, Gomez Pajuelo, Casimiro, Rincon Diaz, Luis Miguel, Iglesias Alonso, Luis Fernando, Grande Ruiz, Angel, Merce Klein, Jordi, Gonzalez Juanatey, Jose Ramon, Monte Collado, Ines, Palacin Piquero, Herminia, Brotons Cuixart, Carles, Fernandez Escobar, Esther, Bayo i Llibre, Joan, Corros Vicente, Cecilia, Vida Gutierrez, Manuel, Evans, Paul, Clark, M., Bisatt, John, Litchfield, Jennifer, Fisher, E., Fooks, Tim, Kelsall, Richard, Paul, Neil, Alborough, Elizabeth, Aziz, Michael, Ramesh, C., Wilson, Pete, Franklin, Simon, Fairhead, Sue, Thompson, Julian, Chowan, Hasan, Taylor, Gary, Tragen, Dawn, Parfitt, Matt, Seamark, Claire, Richardson, Mark, Jefferies, Angus, Sharp, Helen, Jones, Hywel, Giles, Claire, Bramley, Matthew, Williams, Philip, Aldegather, Jehad, Wetherell, Simon, Lumb, William, Evans, Phil, Scouller, Frances, Macey, Neil, Rogers, Stephen, Stipp, Yvette, West, Richard, Pinney, Philip, Matthews, John, Pandya, Preeti, Gallagher, Andrew, Railton, T., Davies, Emyr, McClure, Jonathan, Jacobs, Marc, Hutton, Claire, Thompson, R., Sinha, Bijoy, Butter, Keith, Barrow, Susan, Little, Helen, Russell, David, Choudhary, Ulka, Haq, Ikram, Ainsworth, Paul, Jones, Claire, Weeks, Phil, Eden, Jane, Gibbons, Lisa, Glencross, Janet, MacLeod, Alison, Poland, K., Mulolland, Conor, Warke, A., Conn, Paul, Burns, D., Smith, R., Kamath, R., Webster, Jonathan, Hodgins, Ian, Vercoe, Stephen, Roome, Paul, Pinnock, Hilary, Patel, Jayesh, Ali, Amar, Hart, Nigel, Davies, Richard, De-Sousa, Nigel, Neden, Catherine, Danielsen, Mark, Sharma, Purnima, Galloway, Sophia, Hawkins, Charlotte, Oliver, Raife, Aylward, Martin, Pattni, Mira, Irvine, Gordon, Ahmad, Shahid, Rothwell, Catherine, Choudhary, Fiaz, Khalaque, Sabrina, Short, Stephanie, Peters, Sharon, Coulson, Warwick, Roberts, Neil, Coates, Steven, Ward, Ben, Jackson, Daniel, Walton, Steve, Shepherd, Diane, Wong, Toh, Boon, Mark, Deacon, Melanie, Cornelius, David, Davies, Sarah, Ben Frankel, Ben Frankel, Choi, Henry, Sumner, Jon, Myhill, Tim, Estifanos, Salah, Geatch, Diane, Wilkinson, Justin, Veale, Richard, Forshaw, Karen, Hirst, Rob, Zaman, Kashif, Liley, Catherine, Wastling, Rebecca, McEleny, Paul, Beattie, Andre, Cooke, Philip, Wong, Mike, Pugsley, Mark, Dooldeniya, Chaminda, Rogers, Greg, Bennett, James, Muvva, Rajesh, Adam, Matthew, Fox, Robin, Thomas, Nicolas, Cartwright, Simon, Reed, Rory, Randfield, Simon, ACourt, Christine, Flynn, Ann, Halpin, Andrew, Dobson, Simon, Lomax, Louise, Nadaph, Minnal, Goram, Jane, Stoddart, Helen, Simmons, Phil, Shewring, John, Bowen-Simpkins, Emma, Rickenbach, Mark, Munro, Iain, Blenkhorn, Adam, Singh, Bhuwanendu, van Gaal, William, Abhayaratna, Walter, Thomson, Philip, Lehman, Ron, Kilian, Jens, Coulshed, David, Camm, A. 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Yasuhide, Seta, Yukihiro, Miyaguchi, Shingo, Morishita, Kojuro, Samejima, Yasuko, Sasaki, Toyoshi, Iseki, Fumiko, Kobayashi, Toshiyuki, Kano, Hiroshi, Kim, Jaeyoung, Yamaguchi, Hiroshi, Takagi, Yoichi, Pearce, Yoko Onuki, Suzuki, Yasuyuki, Fukui, Takayuki, Nakayama, Toni, Kanai, Hideaki, Kawano, Yoshiyuki, Ino, Tetsuji, Miyoshi, Hironori, Miyamoto, Yasufumi, Shigekiyo, Masahito, Ono, Shimato, Okamoto, Yutaka, Ubukata, Satoshi, Kodera, Kojiro, Oriuchi, Tatsuo, Matsumoto, Naoki, Nagano, Shinjiro, Iwaki, Masaaki, Nakamura, Yuichiro, Miyamoto, Naomasa, Taguchi, Toshifumi, Ashida, Ko, Yoshizawa, Naoto, Agata, Jun, Matsukawa, Seishiro, Arasaki, Osamu, Fukuoka, Shuji, Murakami, Hirofumi, Mishima, Kazuya, Hata, Yoshiki, Sakuma, Ichiro, Obunai, Kotaro, Takamura, Ichiro, Akutsu, Mitsuyuki, Unoki, Toshihide, Go, Yoshinori, Ikemura, Makoto, Morii, Shoji, Marusaki, Shigem, Doi, Hideo, Tanaka, Mitsuru, Kusu-moto, Takaaki, Kakinoki, Shigeo, Ogurusu, Chiga, Murata, Kazuya, Shimoyama, Masaki, 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Sasaki, Akitoshi, Tsuchiya, Yoshihiro, Bet-suyaku, Tetsuo, Higuchi, Koji, Honda, Masaaki, Hasegawa, Koichi, Baba, Takao, Mineoi, Kazuaki, Koeda, Toshihiko, Hirasawa, Kunihiko, Kumazaki, Toshihide, Nakagomi, Akira, Otaki, Eiji, Shindo, Takashi, Hirayama, Hiroyoshi, Sugimoto, Chikako, Yamagishi, Takashi, Mizuguchi, Ichiro, Sezaki, Kazunori, Niwa, Isamu, Takenaka, Ken, Iiji, Osamu, Taya, Koichi, Kitazawa, Hitoshi, Ueda, Samu, Kakuda, Hirokazu, Ono, Takuya, Oriso, Seizo, Kamata, Junya, Nanke, Toshihiko, Maeda, Itaru, Matsuura, Yoshifusa, Teragawa, Hiroki, Maruyama, Yasuyuki, Takei, Kazuo, Hone, Hajime, Kito, Tetsu-taro, Asano, Hiroshi, Matsushita, Koji, Nakamura, Masaichi, Washizuka, Takashi, Yoshida, Tomoki, Sawano, Masato, Arima, Shinichi, Arai, Hidekazu, Shinohara, Hisanori, Takai, Hiroyuki, Furukawa, Nobufusa, Ota, Akira, Yamamoto, Kentaro, Aoki, Kenji, Yamamoto, Taku, Kasai, Takeaki, Suzuki, Shunji, Suzuki, Shu, Shibata, Nitaro, Watanabe, Masayuki, Nishihata, Yosuke, Arino, Torn, Okuyama, Masaki, Wakiyama, Tetsushi, Kato, Tomoko, Sasagawa, Yasuo, Tana, Takeshi, Tumelero, Rogerio Tadeu, Maia, Lilia, de Almeida, Roberto Simoes, Carmo Borges, Ney Carter, Gomes Ferreira, Luis Gustavo, Stockins Fernandez, Benjamin Aleck Joseh, Montecinos, Humberto, Lanas, Fernando, Larico Gomez, Martin, Astudillo, Carlos, Conejeros, Carlos, Marin Cuevas, Patricio, Forero, Alejandro, Bugueno Gutierrez, Claudio, Aguilar, Juan, Potthoff Cardenas, Sergio, Eggers, German, Houzvic, Cesar, Rey, Carlos, Arriagada, German, Charme Vilches, Gustavo, Illescas Diaz, Jesus Jaime, Leal Cantu, Raul, Ramos Zavala, Maria Guadalupe, Cabrera Jardines, Ricardo, Espinola Zavaleta, Nilda, Lopez Rosas, Enrique, Llamas Esperon, Guillermo Antonio, Pozas, Gerardo, Cardona Munoz, Ernesto, Her-nandez, Norberto Matadamas, Leyva Rendon, Adolfo, Garcia Hernandez, Norberto, de los Rios Ibarra, Manuel, Virgen Carrillo, Luis Ramon, Lopez Villezca, David, Hernandez Herrera, Carlos, Lopez Prieto, Juan Jose, Gaona Rodriguez, Rodolfo, Villeda Espinosa, Efrain, Flores Martinez, David, Velasco Barcena, Jose, Fierro Fierro, Omar, Rodriguez Briones, Ignacio, Leiva Pons, Jose Luis, Alvarez Lopez, Humberto, Olvera Ruiz, Rafael, Cantu Brito, Carlos Gerardo, Chuquiure Valenzuela, Eduardo Julian Jose Roberto, Reyes Sanchez, Roxana, Bazzoni Ruiz, Alberto Esteban, Lopez Ruiz, Oscar Martin, Arriaga Nava, Roberto, Morales Cerda, Jesus David, Fajardo Campos, Pedro, Benavides Gonzalez, Mario, Lenz, Kurt, Hagn, Claus, Foechterle, Johannes, Drexel, Heinz, Huber, Kurt, Podczeck-Schweighofer, Andrea, Winkler, Michael, Schneeweiss, Bruno, Gegenhuber, Alfons, Lang, Wilfried, Eichinger-Hasenauer, Sabine, Kaserer, Peter, Sykora, Josef, Rasch, Heribert, Strohmer, Bernhard, Capiau, Luc, Vervoort, Geert, Wollaert, Bart, Hollanders, Geert, Vercammen, Jan, Balthazar, Yohan, Delforge, Marc, Xhaet, Olivier, Striekwold, Harry, Thoeng, John, Hermans, Kurt, Mairesse, Georges, Anne, Wim, Blankoff, Ivan, Beutels, Michel, Vandergoten, Peter, Purnode, Philippe, Godart, Pascal, Boussy, Tim, Desfontaines, Philippe, Heyse, Alex, Voet, Joeri, De Wolf, Axel, Zidkova, Eva, Spacek, Rudolf, Machova, Vilma, Ludka, Ondrej, Olsr, Josef, Kotik, Lubos, Racz, Blazej, Ferkl, Richard, Hubac, Jan, Kotik, Ilja, Monhart, Zdenek, Burianova, Hana, Jerabek, Ondrej, Pisova, Jana, Petrova, Iveta, Dedek, Vratislav, Honkova, Michaela, Podrazil, Petr, Reichert, Petr, Spinar, Jindrich, Novak, Miroslav, Durdil, Vaclav, Plocova, Katarina, Lastuvka, Jiri, Nielsen, Jorn, Hayashi, Yoshihito, Hirota, Shinichi, Abe, Yukihiko, Saito, Yoshihiro, Uchiyama, Hirohide, Takeda, Hiroshi, Ono, Hiroshi, Tohyo, Shuichi, Hanazono, Naoto, Miyajima, Seiichi, Shimono, Hisashi, Aoyama, Takuma, Shozawa, Yasunobu, Niijima, Yawara, Murai, Osamu, Inaba, Hideko, Nomura, Katsumasa, Nozoe, Masatsugu, Suzuki, Kazuo, Furukawa, Toshiyuki, Shiraiwa, Toshihiko, Ito, Nobuhisa, Nagai, Shunichi, Sato, Kiyoharu, Nakahara, Shiro, Shimoyama, Yujin, Ohara, Naoko, Kozuka, Teruhiko, Okita, Hideaki, Endo, Masato, Goto, Tsutomu, Hirose, Makoto, Nagata, Emiko, Nakanishi, Noriyuki, Mori, Toshizumi, Seki, Shuichi, Okamoto, Katsuhiro, Moriai, Osamu, Emura, Yoko, Fukuda, Tsuyoshi, Date, Haruhiko, Kawakami, Shuichi, Nagai, Sho, Ueyama, Yuya, Fudo, Tetsuro, Imaizumi, Mitsuru, Ogawa, Takuo, Take, Shunsuke, Ikeda, Hideo, Nishioka, Hiroaki, Sakamoto, Norihiko, Ikeoka, Kiyomitsu, Wakaki, Nobuo, Abe, Masatake, Doiuchi, Junji, Inagaki, Koichi, Iseki, Atsushi, Yoshida, Tomohiro, Goda, Toshihiro, Katsuki, Tsukasa, Sato, Atsushi, Mori, Etsuo, Tsubokura, Toshio, Shudo, Hiroshi, Fujimoto, Shunichi, Katsuya, Tomohiro, Furukawa, Yoshiyuki, Hosokawa, Hiroshi, Narumi, Jun, Yamamoto, Kiichiro, Owari, Masaki, Inakura, Takuya, Anno, Takafumi, Shirakawa, Kazuyuki, Ching, Chi Keong, Foo, David, Wong, Kelvin, Yuyang, Tan, Park, Hui Nam, Kim, Woo-Shik, Lee, HyeYoung, Jang, Sung-Won, Kim, Dae Hyeok, Kim, Jun, Ryu, DongRyeol, Shim, Jaemin, Kim, Dae-Kyeong, Choi, Dong Ju, Oh, Yong Seog, Cho, Myeong-Chan, Kim, Hack-Lyoung, Jeon, Hui-Kyung, Shin, Dong-Gu, Park, Sang Weon, Park, Hoon Ki, Han, Sang-Jin, Sung, Jung Hoon, Park, Hyung-Wook, Nam, Gi-Byoung, On, Young Keun, Lim, Hong Euy, Kwak, JaeJin, Cha, Tae-Joon, Hong, Taek Jong, Park, Seong Hoon, Yoon, Jung Han, Kim, Nam-Ho, Kim, Kee-Sik, Jung, Byung Chun, Hwang, Gyo-Seung, Kim, Chong-Jin, Rungaramsin, Sakda, Katekangplu, Peerapat, Khunrong, Porames, Bunyapipat, Thanita, Wongcharoen, Wanwarang, Kaewsuwanna, Pinij, Siriwattana, Khanchai, Tiyanon, Waraporn, Pattanaprichakul, Supalerk, Likittanasombat, Khanchit, Cholsaringkarl, Doungrat, Boonyapisit, Warangkana, Cheewatanakornkul, Sirichai, Silaruks, Songkwan, Hutayanon, Pisit, Chawanadelert, Seksan, Chattranukulchai, Pairoj, Chatlaong, Boonsert, Santanakorn, Yingsak, Kanokphatcharakun, Khompiya, Mongkolwongroj, Piya, Jai-Aue, Sasivimon, Komson, Ongkarn, Altun, Armagan, Aydinlar, Ali, Ongen, Zeki, Acikel, Sadik, Sahin, Durmus Yildiray, Yilmaz, Ozcan, Pekdemir, Hasan, Demir, Mesut, Sucu, Murat, Sahiner, Levent, Ersanli, Murat, Okuyan, Ertugrul, Aras, Dursun, Rolandi, Florencia, Cesar Ingaramo, Adrian, Alberto Sambadaro, Gustavo, Fernandez Caputi, Vanina, Luciardi, Hector, Graciela Berman, Sofia, Dragotto, Pablo, Poli, Daniela, Quintavalla, Roberto, Cosmi, Franco, Fanelli, Raffaele, Oriana, Vincenzo, Reggio, Raffaele, Anti, Roberto S., Pancaldi, Leonardo, De Cristofaro, Raimondo, Guazzaloca, Giuliana, De Blasio, Angelo, Uriate, Jorge Salerno, Lillo, Flavia, Pogliani, Enrico Maria, Javier Kleiban, Andres, Ahuad Guerrero, Rodolfo Andres, Adalberto Di Paola, Leonel, Dario Dran, Ricardo, Egido, Javier, Jose Fosco, Matias, Rodolfo Cartasegna, Luis, Gomez Vilamajo, Oscar, Luis Ramos, Jose, Sassone, Sonia, Zapata, Gerardo, Conde, Diego, Giacomi, Guillermo, Alfredo Fernandez, Alberto, Alberto Berli, Mario, Ferroni, Fabian, Sobral Filho, Dario Celestino, Jaber, Jefferson, Armaganijan, Luciana Vidal, Frack Costantini, Costantino Roberto, Steffens, Andre, Sebba Barroso de Souzaem, Weimar Kunz, de Souza Neto, Joao David, Ribeiro, Jose Marcio, Teixeira, Marcelo Silveira, Rossi, Paulo, Pires, Leonardo, Moreira, Daniel, Moura Jorge, Jose Carlos, Lorga Filho, Adalberto Menezes, Bodanese, Luiz, Montera, Marcelo Westerlund, Del Carlo, Carlos Henrique, Saad, Jamil Abdalla, Alves Costa, Fernando Augusto, Lopes, Renato, de Aranjo, Gilson Roberto, Manenti, Euler Roberto, Kerr Saraiva, Jose Francisco, Ferreira Braga, Joao Carlos, Negri, Alexandre, Moncada, Carlos, Precoma, Dalton, Roquette, Fernando, Reis, Gilmar, Ramos Filho, Roberto Alvaro, Figueiredo, Estevao Lanna, Botelho, Roberto Vieira, Fontoura Tavares, Claudio Munhoz, Finimundi, Helius Carlos, Kochi, Adriano, Broilo Franca, Cesar Cassio, Alban, Fabio, Aranha Rosito, Guido Bernardo, de Moura Xavier Moraes Junior, Joao Batista, Husted, Steen, Hintze, Ulrik, Rasmussen, Soren, Sygehus, Nwstved, Bremmelgaard, Arne, Markenvard, John, Borger, Jan, Solgaard, Jorgen, Eriksen, Ebbe, Lokkegaard, Thomas, Bruun, Michael, Mertz, Jacob, Schou, Morten, Olsen, Michael, Viitanen, Carmela, Paganelli, Franck, Ohayon, Joel, Casassus, Frederic, Galinier, Michel, Gottwalles, Yannick, Loiselet, Philippe, Koujan, Mohamed Bassel, Destrac, Sylvain, Piot, Olivier, Cebron, Jean-Pierre, Guenoun, Maxime, Guedj-Meynier, Dominique, Lokesh, A. G., Zuber, Mathieu, Amarenco, Pierre, Ellie, Emmanuel, Kadouch, James, Huberman, Jean-Pierre, Lemaire, Nestor, Rodier, Gilles, Vandamme, Xavier, Sibon, Igor, Neau, Jean-Philippe, Mahagne, Marie Helene, Mielot, Antoine, Bonnefoy, Marc, Churet, Jean-Baptiste, Navarre, Vincent, Sellem, Frederic, Monniot, Gilles, Boyes, Jean-Paul, Doucet, Bernard, Martelet, Michel, Obadia, Desire, Crousillat, Bernard, Mouallem, Joseph, Bearez, Etienne, Brugnaux, Jean Philippe, Fedorowsky, Alain, Nazeyrollas, Pierre, Berneau, Jean-Baptiste, Chemin, Frederic, Schellong, Sebastien, Koeniger, Georg, Kopf, Andreas, Gerbaulet, Uwe, Kellner, Bernd-Thomas, Schaefer, Thomas, Purr, Jan, Eissfeller, Enno, Zauzig, Heinz-Dieter, Riegel, Peter, Axthelm, Christoph, Heinz, Gerd-Ulrich, Pustelnik, Andreas, Zutz, Stefan, Eder, Wolfgang, Rehling, Guenter, Glatzel, Dirk, Ludwig, Norbert, Sandow, Petra, Wiswedel, Henning, Wildenauer, Cosmas, Schoen, Steffen, Schwarz, Toralf, Babyesiza, Adyeri, Kropp, Maximilian, Zimny, Hans-Hermann, Kahl, Friedhelm, Caspar, Andreas, Omankowsky, Sabine, Laessig, Torsten, Hartmann, Hermann-Josef, Lehmann, Gunter, Bindig, Hans-Walter, Hergdt, Gunter, Reimer, Dietrich, Hauk, Joachim, Michel, Holger, Dres, Praxis, Erdle, Werner, Dorsch, Wilfried, Dshabrailov, Janna, Rapp, Karl-Albrecht, Epelde Gonzalo, Francisco, Almeida Fernandez, Carlos Alexandre, Martinez Navarro, Encarnacion, Montero Alia, Juan Jose, Barreda Gonzalez, Maria, Moleiro Oliva, Maria Angels, Iglesias Sanmartin, Jose, Rodriguez Alvarez, Maria del Mar, Ripoll Vera, Tomas, Jimenez Navarro, Manuel, Vazquez Caamano, Maria, Arcocha Tones, Maria Fe, Marcos Gomez, Gonzalo, Iniguez Romo, Andres, Prieto Diaz, Miguel Angel, Wirdby, Alexander, Linden, Jan, and Henriksson, Kerstin

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Hemorrhage, 030204 cardiovascular system & hematology, antiplatelet therapy, Coronary artery disease, Anticoagulation, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cause of Death, Internal medicine, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, bleeding, mortality, stroke, Stroke, Aged, Proportional Hazards Models, business.industry, Hazard ratio, Anticoagulants, Atrial fibrillation, General Medicine, Prognosis, medicine.disease, Blood pressure, Cardiovascular Diseases, Heart failure, Cardiology, Female, Liver function, business, Platelet Aggregation Inhibitors, Follow-Up Studies
Abstract

Item does not contain fulltext BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes. METHODS: Adults with newly diagnosed atrial fibrillation and >/=1 investigator-defined stroke risk factor were enrolled in GARFIELD-AF between March 2010 and September 2015. The association between prior acute coronary syndromes and long-term outcomes was determined using a Cox proportional hazards model, adjusting for baseline risk factors, oral anticoagulation (OAC) +/- antiplatelet (AP) therapy, and usual care. RESULTS: Of 39,679 patients, 10.5% had a history of acute coronary syndromes. At 2-year follow-up, patients with prior acute coronary syndromes had higher adjusted risks of stroke/systemic embolism (hazard ratio [HR] 1.39; 95% confidence interval [CI], 1.08-1.78), major bleeding (HR 1.30; 95% CI, 0.95 -1.79), all-cause mortality (HR 1.34; 95% CI, 1.21 -1.49), cardiovascular mortality (HR 1.85; 95% CI, 1.51-2.26), and new acute coronary syndromes (HR 3.42; 95% CI, 2.62-4.45). Comparing antithrombotic therapy in the acute coronary syndromes vs no acute coronary syndromes groups, most patients received OAC +/- AP: 60.8% vs 66.1%, but AP therapy was more likely in the acute coronary syndromes group (68.1% vs 32.9%), either alone (34.9% vs 20.8%) or with OAC (33.2% vs 12.1%). Overall, 17.8% in the acute coronary syndromes group received dual AP therapy with (5.3%) or without OAC (12.5%). Among patients with moderate/high risk for stroke/systemic embolism, fewer in the acute coronary syndromes group received OAC with or without AP therapy (Congestive heart failure, Hypertension, Age 75 years, Diabetes mellitus, prior Stroke, TIA, or thromboembolism, Vascular disease, Age 65-74 years, Sex category [CHA2DS2-VASc] 2: 52.1% vs 64.6%; CHA2DS2-VASc >/=3: 62.0% vs 70.7%), and the majority with a Hypertension (uncontrolled systolic blood pressure >160 mm Hg), Abnormal renal or liver function, previous Stroke, Bleeding history or predisposition, Labile international normalized ratios, Elderly, and concomitant Drugs or alcohol excess (HAS-BLED) score >/=3 were on AP therapy (83.8% vs 65.5%). CONCLUSIONS: In GARFIELD-AF, previous acute coronary syndromes are associated with worse 2-year outcomes and a greater likelihood of under-treatment with OAC, while two-thirds of patients receive AP therapy. Major bleeding was more common with previous acute coronary syndromes, even after adjusting for all risk factors.

Published
2019
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5. SULFIDE CORE SAMPLE FROM THE DEEP-SEA ARTIFICIAL HYDROTHERMAL VENT AT THE IHEYA-NORTH KNOLL, OKINAWA TROUGH: NATURAL ANALOGUE OF SUB-SEAFLOOR MINERALIZATION ON A SEAFLOOR

Author

Takaya Yutaro, Watanabe Masayuki, Ishibashi Jun‐ichiro, Saruhashi Tomokazu, Shimada Kazuhiko, Torimoto Junji, Nozaki Tatsuo, Masaki Yuka, Kyo Masanori, and Nagase Toshiro

Subjects
chemistry.chemical_classification, Mineralization (geology), Oceanography, Sulfide, chemistry, Trough (geology), Core sample, Deep sea, Seafloor spreading, Geology, Natural (archaeology), Hydrothermal vent
Published
2017
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6. Design and Analysis of Robust SMES Controller for Stability Enhancement of Interconnected Power System Taking Coil Size Into Consideration

Author

Dechanupaprittha, Sanchai, Sakamoto, Naotoshi, Hongesombut, Komsan, Watanabe, Masayuki, Mitani, Y, Mitani, Yasunori, and Ngamroo, Issarachai

Subjects
Optimal design, Computer science, Superconducting magnetic energy storage, Condensed Matter Physics, Electronic, Optical and Magnetic Materials, law.invention, Electric power system, law, Control theory, Electromagnetic coil, Robustness (computer science), Electrical network, Control system, Electrical and Electronic Engineering, Robust control
Abstract

In power applications, efficiency and effectiveness of SMES with proper control are promising and highly remarkable, however, quite costly. Accordingly, optimum design and utilization are essentially needed. This paper presents the design and analysis of robust SMES controller for stability enhancement of interconnected power system taking coil size into consideration. With lead/lag controller structure, parameters of robust SMES controller can be optimized by a metaheuristic method; meanwhile, a multiplicative uncertainty is included in the design to cope with system uncertainties. Lastly, aiming at achieving optimum design and utilization, robust controllers for SMES with different coil sizes are examined to investigate performance and robustness under different situations via simulation studies.

Published
2009
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7. Additional file 1: Table S1. of Characteristics, treatments, and outcomes of severe sepsis of 3195 ICU-treated adult patients throughout Japan during 2011â 2013

Author

Mineji Hayakawa, Shinjiro Saito, Shigehiko Uchino, Yamakawa, Kazuma, Kudo, Daisuke, Iizuka, Yusuke, Sanui, Masamitsu, Takimoto, Kohei, Mayumi, Toshihiko, Azuhata, Takeo, Ito, Fumihito, Shodai Yoshihiro, Hayakawa, Katsura, Nakashima, Tsuyoshi, Ogura, Takayuki, Noda, Eiichiro, Nakamura, Yoshihiko, Sekine, Ryosuke, Yoshikawa, Yoshiaki, Sekino, Motohiro, Ueno, Keiko, Okuda, Yuko, Watanabe, Masayuki, Tampo, Akihito, Saito, Nobuyuki, Kitai, Yuya, Takahashi, Hiroki, Kobayashi, Iwao, Kondo, Yutaka, Matsunaga, Wataru, Nachi, Sho, Miike, Toru, Takahashi, Hiroshi, Takauji, Shuhei, Umakoshi, Kensuke, Todaka, Takafumi, Kodaira, Hiroshi, Kohkichi Andoh, Kasai, Takehiko, Iwashita, Yoshiaki, Arai, Hideaki, Murata, Masato, Yamane, Masahiro, Shiga, Kazuhiro, and Hori, Naoto

Abstract

Epidemiological information from previous reports after 2005. (DOC 48 kb)

Published
2016
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8. Evaluation of a transection method for distal pancreatectomy: A comparative study on the use of electrosurgical and stapling devices in swine

Author

Ikeda, Tetsuo, Akahoshi, Tomohiko, Kawanaka, Hirofumi, Uchiyama, Hideaki, Yamashita, Yo-ichi, Morita, Masaru, Oki, Eiji, Saeki, Hiroshi, Sugimachi, Keishi, Ikegami, Toru, Yoshizumi, Tomoharu, Soejima, Yuji, Shirabe, Ken, Mimori, Koshi, Watanabe, Masayuki, Hashizume, Makoto, and Maehara, Yoshihiko

Subjects
Swine, Anastomosis, Surgical, Distal pancreatectomy, Electrosurgery, Electrosurgical devices, Pancreatic Fistula, Stapling devices, Pancreatectomy, Postoperative Complications, Models, Animal, Surgical Stapling, Pressure, Animals, Female, Pancreas fistula, Pancreas, Bursting pressure
Abstract

Background : Despite marked improvements in pancreatic surgery, the high incidence of pancreatic fistula and high morbidity after resection persists. Purposes : The objective of this study was to evaluate the role of electrosurgical and stapling devices as an alternative to traditional methods of stump closure in an animal model of distal pancreatectomy. Methods : Four devices were used for transection of the pancreatic body : a bi-polar thermofusion system attached to an automatic irrigation function (BI, n = 3), a bi-polar tissue sealer (BS, n = 3), an ultrasonic scissor (US, n = 3), and an endoscopic stapling device (ES, n = 3). For each group, burst pressure was tested using an electronic manometer, with a focus on the location (s) of the first disruption (s). Histological examination was performed for the dissected surfaces. The transection line, including staples, was embedded in a polyester resin, and histological examination was performed for these polished sections of the resin. Results : Pressure was significantly higher for BI (P < 0.01) than that for the other devices. In contrast, thermal denaturation of the pancreas parenchyma was observed at a depth of approximately 1 mm from the dissected portion for BS, while it extended beyond 15 mm for BI. The staple line was the first disruption point for all of ES cases. Conclusions : The pellicle of the pancreas is likely to be deficient after a surgical operation. If the pellicle is preserved, the strength of the pellicle may be insufficient for complete closure with high stapling mechanical pressure or the protein coagulation of usually used electrosurgical devices., 【背景】膵臓に関する手術手技の進歩にも関わらず，膵切離後膵液瘻の発生頻度は減少しておらず，依然として最も重大な合併症である．【目的】この研究の目的は近年従来の膵管結紮，膵実質切離に変わって，鏡視下手術の普及と共に一般に行われるようになった，膵の高周波電気器機と吻合器での切離方法を動物実験によって評価し最適な切離方法を検討する事にある．【方法】4つの器機を用いて膵体部での切離を行った．使用した器具は①bi-polar thermofusion system(BiClamp®)に自動irrigation装置を装着した器機(BI)(n = 3)，②bi-polar tissue sealer(ENSEAL®)(BS)(n = 3)，③ultrasonic scissor(Harmonic ACE®)(US)(n = 3)，④endoscopic stapling device(ECHELON ENDOPATH®)(ES)(n = 3)である．ブタを用いて全麻下に，肝，膵，脾そして十二指腸を一回に摘出し膵体部の切断を4種の器具を用いて行った．十二指腸乳頭の膵管開口部より背側膵管にカニュレーションを行い膵切離断端の耐圧力を測定した．また高周波電気器機での切離断端のみではなく，吻合器での切離断端もpolyester resin樹脂化標本の研磨切片からStaplerでの切離線の組織学的評価を行った．【結果】切離断端の膵管耐圧力はBIで約10mmの膵をthermofusion後に尾側で切断する方法のみで高い耐圧能を認め，他の方法と比較して有意な差を認めた(P < 0.01)．組織学的にはBIでは15mm程度の熱変性を認めたのに対してBSやUSでは熱変性の深さは1mm程度であった．Staple切離線の組織所見では各々のstapleは正常に閉鎖した形となっていたが，stapleは膵実質に食い込んでおり切離面に開存した膵管を認めた．【結語】膵臓断端の十分な閉鎖は高周波電気器機や吻合器では得られなかった．適切な膵切離には膵の被膜の形態を考慮した閉鎖方法を検討する必要があると考えられた．

Published
2014

9. [Optimum hepatic parenchymal dissection to prevent bile leak: a comparative study using electrosurgical and stapling devices in swine]

Author

Ikeda, Tetsuo, Akahoshi, Tomohiko, Kawanaka, Hirofumi, Uchiyama, Hideaki, Yamashita, Yo-ichi, Morita, Masaru, Oki, Eiji, Saeki, Hiroshi, Sugimachi, Keishi, Ikegami, Toru, Yoshizumi, Tomoharu, Soejima, Yuji, Shirabe, Ken, Mimori, Koshi, Watanabe, Masayuki, Hashizume, Makoto, and Maehara, Yoshihiko

Subjects
Swine, Electrosurgery, Anastomotic Leak, Electrosurgical devices, Stapling devices, Burst pressure, Liver, Laparoscopic hepatectomy, Surgical Stapling, Animals, Bile, Hepatectomy, Bile leak, Female, Laparoscopy, Bile Ducts, Intraoperative Complications
Abstract

Background : Bile leakage is a serious complication of liver resection, and its treatment is very time-consuming. In open liver resection, Glisson's sheaths are usually disconnected by ligation to the extent possible during the parenchyma dissection. However, in laparoscopic surgery, the ligation, suture, and hemostasis are more difficult than in open surgery. For this reason, in laparoscopic liver resection, liver parenchyma dissection is generally accomplished using electrosurgical or stapling devices. Purpose : The purpose of this study was to verify the authenticity of electrosurgical devices attached an automatic irrigation function (AI) and stapling devices for laparoscopic liver parenchymal dissection. Methods : Four devices were used for liver parenchymal dissection in laparoscopic hepatic wedge resection, in pigs : monopolar high-frequency electric cautery attached AI (MCI) (n = 6), bipolar high-frequency electric cautery attached AI (BCI) (n = 6), bipolar tissue sealing system (LigaSure™) attached AI (BSI) and an endoscopic stapling device (ECHELON FLEX™ ENDOPATH®) (ES). In each group, burst pressures were tested using an electronic manometer, paying special attention to the location (s) of the first disruption (s). The dissected tissues were examined histologically. Results : Pressures used in electrosurgical devices attach AI were significantly higher compared to pressures used in a ES (P < 0.001). While thermal denaturation of the liver parenchyma occurred at approximately 2-3 mm of depth when bipolar high-frequency electric cautery was used for dissection, it reached up to more than 10 mm with monopolar high-frequency electric cautery. All of the first disruption points of stapling were at stapling line. Conclusions : Electrosurgical devices with an automatic irrigation function are useful devices to dissect the liver parenchyma., 【背景】術後胆汁漏は肝切除術の重大な合併症の一つであり，一旦発生すると治療に難渋する事も稀ではない．このため開腹下での肝切除においては，Glisson鞘は可能な限り結紮して閉鎖されている．しかし，腹腔鏡下では結紮，縫合の操作は開腹手術に比べ極めて時間を要する．このため腹腔鏡下では肝実質切離も電気手術器機による凝固あるいは吻合器によって行われているのが現状である．【目的】大動物(ブタ)を用いた肝切離において，電気手術器具あるいは吻合器での肝実質切離の安全性と胆汁漏の原因を検討する．【方法】4種類の器具①モノポラー高周波凝固器具に自動生理食塩水滴下装置を装着した器具(MCI)，②バイポーラ高周波凝固器具に自動生理食塩水滴下装置を装着した器具(BCI)，③バイポーラ血管シーリング装置(LigaSure™)に自動生理食塩水滴下装置を装着した器具(BSI)，④腹腔鏡下自動吻合器(ECHELON FLEX™ ENDOPATH®)(ES)をを用いて腹腔鏡下に楔状肝切除を行った．切離時間，術中出血量，胆管の耐圧力測定および組織学的に比較検討した．【結果】電気手術器機に比べ吻合器は切離時間は短く，出血量は多く，胆管耐圧力は低い結果であった．上記に関しては3種の電気手術器機間での違いは認められなかったが，組織学的にはモノポーラがボイポーラ電気手術器機に比べ，熱による肝実質障害が深い部分にまで及んでいた．【結語】電気手術器具に自動生理食塩水滴下装置を装着した器具での肝実質切離では高い胆管耐圧力が得られ結紮の必要はないと考えられる．

Published
2014

10. Successful treatment of primary jejunal cancer after esophageal and colon cancer resection

Author

Egashira, Akinori, Taguchi, Kenichi, To, Yasushi, Yamamoto, Manabu, Okamura, Takeshi, Saeki, Hiroshi, Oki, Eiji, Morita, Masaru, Ikeda, Tetsuo, Mimori, Koshi, Watanabe, Masayuki, and Maehara, Yoshihiko

Subjects
Male, Esophageal Neoplasms, Jejunal Neoplasms, Esophageal cancer, Jejunal cancer, Triple primary cancers, Neoplasms, Second Primary, Adenocarcinoma, Middle Aged, Esophagectomy, Treatment Outcome, Colonic Neoplasms, Humans, Lymph Node Excision, Digestive System Surgical Procedures
Abstract

Patients with esophageal cancer are susceptible to other primary cancers, but multiple primary cancers involving the esophagus and jejunum are rare. We herein report a case of primary jejunal cancer as a component of metachronous triple primary cancers including esophageal cancer and ascending colon cancer. A 63-year-old male patient with a history of surgery for esophageal cancer and ascending colon cancer was admitted to our hospital after experiencing 1 month of repeated vomiting and epigastric abdominal pain. Esophagogastroduodenoscopy, duodenography, and computed tomography revealed a jejunal tumor located 2 cm from the ligament of Treitz on the anal side. Partial resection of the jejunum with lymph node dissection was performed. The postoperative course was uneventful, and the patient remains well with no signs of recurrence 10 months after the operation. This is the first report of curative resection of triple primary cancers of the esophagus, jejunum, and colon. Patients with a history of esophageal cancer are susceptible to other primary cancers, and it is important to perform surveillance for the subsequent development of other cancers., 食道癌には他癌が合併し易いことが知られているが，空腸癌を合併することは稀である．我々は異時性三重複癌の一つとして，食道癌および上行結腸癌術後に発症した空腸癌の一例を経験したので報告する．症例は63 歳の男性であり，6年前に食道癌，8年前に上行結腸癌に対しての根治術を施行された．1ヶ月ほど続く繰り返す嘔吐と心窩部痛を主訴に受診され，上部消化管内視鏡，上部消化管造影およびCT 検査にて，トライツ靱帯から約2cm 肛門側の空腸に全周性腫瘍を認めた．手術はリンパ節郭清を伴う空腸部分切除術を施行し，術後経過は良好であり，術後10ヶ月経過した現在も再発は認めていない．根治的切除術が施行された食道癌，空腸癌および結腸癌の三重複癌の報告は初めてである．食道癌患者は他癌の合併が多くみられることより，異時性重複癌を念頭に置いた経過観察が重要である

Published
2014

11. Application of splenectomy to decompress portal pressure in left lobe living donor liver transplantation

Author

Ikegami, Toru, Yoshizumi, Tomoharu, Soejima, Yuji, Ikeda, Tetsuo, Kawanaka, Hirofumi, Uchiyama, Hideaki, Yamashita, Yo-ichi, Morita, Masaru, Oki, Eiji, Saeki, Hiroshi, Mimori, Koshi, Sugimachi, Keishi, Watanabe, Masayuki, Shirabe, Ken, and Maehara, Yoshihiko

Subjects
Adult, Male, Living donor liver transplantation, Graft Survival, Left lobe, Middle Aged, Liver Transplantation, End Stage Liver Disease, Treatment Outcome, Hypertension, Portal, Living Donors, Splenectomy, Feasibility Studies, Humans, Female, Primary Graft Dysfunction, Portal hypertension
Abstract

This study was conducted to evaluate the impact of splenectomy in living donor liver transplantation (LDLT) using left lobe grafts. The two hundred and fifty LDLT cases were divided into two groups : Group-S (n = 98, simultaneous splenectomy) and Group-NS (n = 152). Group-S had significantly increased recipient age (54.5 ± 10.9 years vs. 46.3 ± 17.0 years, p < 0.01), advanced liver diseases including Child class C (64.8% vs. 51.5%, p < 0.01), higher model for end-stage liver score (17.8 ± 8.1 vs. 15.4 ± 5.8, p < 0.01) and more patients with hospitalized status (67.4% vs. 48.0%, p < 0.01), and smaller graft volume/standard liver volume ratio (36.5 ± 6.1% vs. 40.2 ± 8.2%, p < 0.01). In Group-S, splenectomy decreased portal venous (PV) pressure decreased from 23.5 ± 5.2 mmHg to 19.2 ± 4.8 mmHg (p < 0.01). Group-S had significantly increased PV pressure at laparotomy (24.9±5.3 mmHg vs. 22.5 ± 6.3 mmHg, p < 0.01) and decreased PV pressure at closure (16.4 ± 3.5 mmHg vs. 18.0 ± 4.7 mmHg, p < 0.01), compared with Group-NS. On the 14th day after LDLT, Group-S had lower total bilirubin (5.7 ± 6.5 mg/dl vs. 8.7 ± 8.9 mg/dl, p < 0.01) and smaller ascites output (0.4 ± 0.7 L/day vs. 0.7 ± 0.4 L/day, p = 0.01) than Group-NS. The cumulative 5-year graft survival rate was 86.8% in Group-S and 76.2% in Group-NS (p = 0.03). In conclusion, splenectomy had beneficial impacts on graft outcomes in left-lobe LDLT., 【はじめに】生体肝移植に於いて, 左葉グラフトを使用することはドナーの安全性をより高める意味で重要であるが, グラフトサイズが小さいことによりグラフト機能不全そしてグラフト不全に繋がる可能性も秘めている. 我々は,摘脾を行うことで左葉グラフト移植をより安全に行う試みを行っている. 【対象および方法】対象は左葉グラフトを用いた生体肝移植250 例とした. 摘脾群（n=98）および非摘脾群（n=152）の二群に分類し, 背景因子, 手術・術後因子, そしてグラフト生存に関する比較検討を行った. 【結果】摘脾群は非摘脾に比し, 有意にレシピエント年齢が高齢（54.5 歳vs. 46.3 歳, p < 0.01）, Child C 症例が多く（64.8% vs. 51.5%, p < 0.01）, model for end-stage liver スコアが高値（17.8 ± 8.1 vs. 15.4 ± 5.8, p < 0.01）, そしてグラフト標準肝容積比が小さい（36.5 ± 6.1% vs. 40.2 ± 8.2%, p < 0.01）症例群であった. 摘脾群では摘脾により門脈圧が有意に低下（23.5 ± 5.2mmHg to 19.2 ± 4.8mmHg, < 0.01）した. また, 摘脾群は非摘脾群に比し有意に開腹時門脈圧が高値（24.9 ± 5.3mmHg vs. 22.5 ± 6.3mmHg, p < 0.01）であったが, 閉腹時門脈圧は低値（16.4 ± 3.5mmHg vs. 18.0 ± 4.7mmHg, p < 0.01）であった. そして術後14 日目の総ビリルビン値および腹水排出量は摘脾群が非摘脾群に比し, それぞれ有意に低値（5.7 ± 6.5mg/dl vs. 8.7 ± 8.9mg/dl, p < 0.01）, 少量（0.4 ± 0.7L/day vs. 0.7 ± 0.4L/day, p=0.01）であった. そしてグラフトの5年生存率は摘脾群（86.8%）が非摘脾群（76.2%）に比し有意に良好であった（p=0.03）. 【まとめ】左葉を用いた生体肝移植に於いて, 摘脾を行うことはグラフト機能を改善するうえで有用な手段であると考えられた.

Published
2013

12. Variability of carbon and nitrogen composition in body compartments of Strongylocentrotus nudus and Hemicentrotus pulcherrimus (Echinodermata: Echinoidea) associated with food availability

Author

AGATSUMA, Yukio, WATANABE, Masayuki, KINOSHITA, Junji, and INOMATA, Eri

Abstract

Little is known about the differences in elemental composition in body compartments of consumers in rocky subtidal bottom ecosystems. We conducted a series of feeding experiments to investigate differences in the carbon and nitrogen content in the body compartments of edible sea urchins, Strongylocentrotus nudus and Hemicentrotus pulcherrimus from three different macrophyte beds: the kelp Eisenia bicyclis; fucoid Sargassum yezoense, and crustose coralline algae. We also investigated various differences between urchins feeding on Saccharina japonica kelp ad libitum and those kept in starvation conditions. We found that the gonad index of S. nudus in kelp beds was higher than that of those in the fucoid bed. No significant difference was found in the gonad index of H. pulcherrimus from kelp and fucoid beds. The lantern indices of S. nudus in kelp beds and those fed with kelp were significantly lower than those in fucoid and coralline algal beds, and the starved ones and the carbon content of lantern in the kelp bed was also significantly lower than those in fucoid bed. Both species of sea urchins fed on kelp had increases in the gut index, carbon content and the C:N ratio of gut. The C:N ratios of the predominant algae in each bed were 1.2-6.0 times higher than those of the whole body of both species of sea urchin. There were no significant differences in the C:N ratios in the gonads among animals receiving the same treatment, and the C:N ratios in S. nudus were higher than those in H. pulcherrimus. These results suggest carbon and nitrogen compositions changed in the Aristotle¢s lantern of S. nudus and gut of S. nudus and H. pulcherrimus in an imbal- anced manner, while the composition of the gonads during the growth stage is stable and may be homeostatic for each species.

Published
2013
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13. Successful EUS-guided drainage of the abscess in the abdominal cavity consequent to the gastric surgery: Report of a case

Author

Nakamura Kazuhiko, Kimura Kazue, Endoh Shingo, Oya Masafumi, Motomura Yasuaki, Kubokawa Masaru, Akahoshi Kazuya, Honda Kuniomi, Matsui Noriaki, and Watanabe Masayuki

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Gastroenterology, Medicine, Abdominal cavity, business, Abscess, medicine.disease, Eus guided drainage, Surgery
Published
2011
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