2,778 results on '"Satoshi Suzuki"'
Search Results
2. The Validation of the Japanese Version of the Scoliosis Research Society-30 Questionnaire for Adolescent Idiopathic Scoliosis Patients
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Hideyuki Arima, Yu Yamato, Yosuke Shibata, Hiroki Oba, Jun Takahashi, Kei Watanabe, Ryo Sugawara, Katsushi Takeshita, Takao Omura, Leah Carreon, Yasuhisa Arai, Tomoyuki Asada, Satoru Demura, Toru Doi, Akira Matsumura, Satoshi Suzuki, Shinji Takahashi, Takumi Takeuchi, Haruki Ueda, and Naobumi Hosogane
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scoliosis research society-30 ,questionnaire ,scoliosis research society-22 ,adolescent idiopathic scoliosis ,internal consistency ,external validity ,cronbach's α coefficient ,health-related quality of life ,Surgery ,RD1-811 - Abstract
Introduction: The Scoliosis Research Society-30 (SRS-30) is a questionnaire originally developed from the SRS-22r questionnaire and is used to evaluate adolescent idiopathic scoliosis (AIS). It comprised questions on five domains: function, pain, self-image, mental health, and satisfaction, with seven additional questions related to postoperative aspects. In addition to the original English version, translations in multiple languages have been effectively applied. Herein, we evaluated the internal consistency and external validity of the Japanese version of the SRS-30 for AIS patients. Methods: Among the 30 questions in SRS-30, the eight additional questions from SRS-22r were translated and back-translated to create a Japanese version of the SRS-30. This translated questionnaire was then used to survey patients with AIS who underwent corrective fusion surgery one year postoperatively. The internal consistency of the responses was evaluated using the Cronbach α coefficient. Additionally, the Spearman correlation analyses were conducted to assess the correlation between the scores obtained from the SRS-30 Japanese version and SRS-22r and the Oswestry Disability Index (ODI) for the overall scale and the five domains. Results: A total of 81 cases (eight males and 73 females; mean age at surgery 14.4 years) were enrolled. The mean preoperative Cobb angle was 51.0°. The Cronbach α coefficient for the overall SRS-30 was 0.861, indicating high internal consistency, while the coefficients for each domain were as follows: function/activity, 0.697; pain, 0.405; self-image/appearance, 0.776; mental health, 0.845; and satisfaction, 0.559. The SRS-30 total score significantly correlated with the SRS-22r total (r=0.945, P
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- 2024
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3. Development and Validation of Machine Learning-Based Predictive Model for Prolonged Hospital Stay after Decompression Surgery for Lumbar Spinal Canal Stenosis
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Mitsuru Yagi, Tatsuya Yamamoto, Takahito Iga, Yoji Ogura, Satoshi Suzuki, Masahiro Ozaki, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Hitoshi Kono, Jun Ogawa, Morio Matsumoto, Masaya Nakamura, Kota Watanabe, and Keio Spine Research Group
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degenerative lumbar spinal stenosis ,hospital stay ,predictive model ,machine learning ,surgery ,Surgery ,RD1-811 - Abstract
Introduction: Precise prediction of hospital stay duration is essential for maximizing resource utilization during surgery. Existing lumbar spinal stenosis (LSS) surgery prediction models lack accuracy and generalizability. Machine learning can improve accuracy by considering preoperative factors. This study aimed to develop and validate a machine learning-based model for estimating hospital stay duration following decompression surgery for LSS. Methods: Data from 848 patients who underwent decompression surgery for LSS at three hospitals were examined. Twelve prediction models, using 79 preoperative variables, were developed for postoperative hospital stay estimation. The top five models were chosen. Fourteen models predicted prolonged hospital stay (14 days), and the most accurate model was chosen. Models were validated using a randomly divided training sample (70%) and testing cohort (30%). Results: The top five models showed moderate linear correlations (0.576-0.624) between predicted and measured values in the testing sample. The ensemble of these models had moderate prediction accuracy for final length of stay (linear correlation 0.626, absolute mean error 2.26 days, standard deviation 3.45 days). The c5.0 decision tree model was the top predictor for prolonged hospital stay, with accuracies of 89.63% (training) and 87.2% (testing). Key predictors for longer stay included JOABPEQ social life domain, facility, history of vertebral fracture, diagnosis, and Visual Analogue Scale (VAS) of low back pain. Conclusions: A machine learning-based model was developed to predict postoperative hospital stay after LSS decompression surgery, using data from multiple hospital settings. Numerical prediction of length of stay was not very accurate, although favorable prediction of prolonged stay was accomplished using preoperative factors. The JOABPEQ social life domain score was the most important predictor.
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- 2024
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4. The significance of cerebrospinal fluid dynamics in adolescent idiopathic scoliosis using time-SLIP MRI
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Yusuke Tomita, Mitsuru Yagi, Fumiko Seki, Yuji Komaki, Satoshi Suzuki, Kota Watanabe, Morio Matsumoto, and Masaya Nakamura
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Time-SLIP MRI ,Cerebrospinal fluid ,Adolescent idiopathic scoliosis ,Medicine ,Science - Abstract
Abstract Adolescent idiopathic scoliosis (AIS) affects approximately 3% of the global population. Recent studies have drawn attention to abnormalities in the dynamics of the CSF as potential contributors. This research aims to employ the Time-Spatial Labeling Inversion Pulse (Time-SLIP) MRI to assess and analyze cerebrospinal fluid (CSF) dynamics in AIS patients. 101 AIS patients underwent Time-SLIP MRI. Images were taken at the mid-cervical and craniocervical junction regions. The sum of the maximum movement distances of CSF on the ventral and dorsal sides of the spinal canal within a single timeframe was defined and measured as Travel Distance (TD). Correlations between TD, age, Cobb angle, and Risser grade were analyzed. TD comparisons were made across Lenke classifications. TD for all patients was a weak correlation with the Cobb angle (r = − 0.16). Comparing TD between Lenke type 1 and 5, type 5 patients display significantly shorter TD (p
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- 2024
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5. Dynamic Cervical Spinal Canal Stenosis: Identifying Imaging Risk Factors in Extended Positions
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Shogo Matsumoto, Ryoma Aoyama, Junichi Yamane, Ken Ninomiya, Yuichiro Takahashi, Kazuya Kitamura, Satoshi Nori, Satoshi Suzuki, Ukei Anazawa, and Tateru Shiraishi
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magnetic resonance imaging ,canal stenosis ,cervical ,dynamic magnetic resonance imaging ,Medicine - Abstract
Study Design A retrospective study at a single academic institution. Purpose This study aimed to identify imaging risk factors for stenosis in extended neck positions undetectable in preoperative neutral magnetic resonance imaging (MRI) and improving decompression strategies for cervical spine disorders. Overview of Literature Cervical disorders are influenced by various dynamic factors, with spinal stenosis appearing during neck extension. Despite the diagnostic value of dynamic cervical MRI, standard practice often uses neutral-position MRI, potentially influencing surgical outcomes. Methods This study analyzed 143 patients who underwent decompression surgery between 2012 and 2014, who had symptomatic cervical disorders and MRI evidence of spinal cord or nerve compression but had no history of cervical spine surgery. Patient demographics, disease type, Japanese Orthopedic Association score, and follow-up periods were recorded. Spinal surgeons conducted radiological evaluations to determine stenosis levels using computed tomography myelography or MRI in neutral and extended positions. Measurements such as dural tube and spinal cord diameters, cervical alignment, range of motion, and various angles and distances were also analyzed. The residual space available for the spinal cord (SAC) was also calculated. Results During extension, new stenosis frequently appeared caudal to the stenosis site in a neutral position, particularly at C5/C6 and C6/C7. A low SAC was identified as a significant risk factor for the development of new stenosis in both the upper and lower adjacent disc levels. Each 1-mm decrease in SAC resulted in an 8.9- and 2.7-fold increased risk of new stenosis development in the upper and lower adjacent disc levels, respectively. A practical SAC cutoff of 1.0 mm was established as the threshold for new stenosis development. Conclusions The study identified SAC narrowing as the primary risk factor for new stenosis, with a clinically relevant cutoff of 1 mm. This study highlights the importance of local factors in stenosis development, advocating for further research to improve outcomes in patient with cervical spine disorders.
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- 2024
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6. Prevalence of thyroid diffuse goiter and its association with body mass index and the presence of cysts and nodules in children and adolescents: the Fukushima Health Management Survey
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Nana Nakahata, Mahiro Asano, Norikazu Abe, Haruka Ejiri, Hisashi Ota, Satoshi Suzuki, Ayako Sato, Rina Tazaki, Natsuki Nagamine, Chisato Takahashi, Yukie Yamaya, Manabu Iwadate, Takashi Matsuzuka, Tetsuya Ohira, Seiji Yasumura, Satoru Suzuki, Fumihiko Furuya, Hiroki Shimura, Shinichi Suzuki, Susumu Yokoya, Hitoshi Ohto, and Kenji Kamiya
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diffuse goiter ,body mass index ,child ,ultrasonography ,health survey ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
The main cause of diffuse thyroid goiter is autoimmune chronic thyroiditis, otherwise known as Hashimoto’s thyroiditis. Thyroid hormones play pivotal roles in growth and development during childhood. However, the prevalence of diffuse goiter and the relationships between diffuse goiter, thyroid volume, cysts and nodules, and anthropometric measurements in children are not well known. Among 789,459 participants who participated in thyroid ultrasound examinations, 320,206 participants (male: 161,728; female: 158,478) aged 1–23 years were analyzed. Logistic regression analyses were conducted to calculate the odds ratios of the standard deviation score of body mass index (BMI-SDS), the SDS of bilateral width multiplied thickness area (BWTAR-SDS) as a provisional determination of thyroid volume, and the presence of nodules or cysts for positive diffuse goiter compared with negative diffuse goiter after correction for sex and age. The prevalence of diffuse goiter increased in a female-dominant manner with aging. Compared with the absence of diffuse goiter, the age- and sex-adjusted odds ratios (95% confidence intervals) for BMI-SDS (1 SD), BWTAR-SDS (1 SD), cysts, and nodules were 1.24 (1.21–1.27), 3.21 (3.13–3.29), 0.53 (0.50–0.58), and 1.38 (1.17–1.64), respectively. The odds ratios of nodules for positive diffuse goiter were 4.18 (1.08–16.08), 1.76 (1.01–3.07), 1.80 (1.32–2.45), and 1.34 (1.08–1.67) in the age groups 1–7, 8–11, 12–15, and 16–23 years, respectively. The age-dependent increase in the prevalence of diffuse goiter was independently associated with increased BMI and positive prevalence of nodules in young individuals.
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- 2024
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7. Instrumentation failure following pediatric spine deformity growth-sparing surgery using traditional growing rods or vertical expandable prosthetic titanium ribs
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Noriaki Yokogawa, Satoru Demura, Tetsuya Ohara, Ryoji Tauchi, Kosuke Takimura, Haruhisa Yanagida, Toru Yamaguchi, Kota Watanabe, Satoshi Suzuki, Koki Uno, Teppei Suzuki, Kei Watanabe, Toshiaki Kotani, Keita Nakayama, Norihiro Oku, Yuki Taniguchi, Hideki Murakami, Takuya Yamamoto, Ichiro Kawamura, Katsushi Takeshita, Ryo Sugawara, Ichiro Kikkawa, and Noriaki Kawakami
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Growth-sparing surgery ,Instrumentation failure ,Pediatric spine deformity ,Traditional growing rods ,Vertical expandable prosthetic titanium ribs ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Instrumentation failure (IF) is a major complication associated with growth-sparing surgery for pediatric spinal deformities; however, studies focusing on IF following each surgical procedure are lacking. We aimed to evaluate the incidence, timing, and rates of unplanned return to the operating room (UPROR) associated with IF following each surgical procedure in growth-sparing surgeries using traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs). Methods We reviewed 1,139 surgical procedures documented in a Japanese multicenter database from 2015 to 2017. Of these, 544 TGR and 455 VEPTR procedures were included for evaluation on a per-surgery basis. IF was defined as the occurrence of an implant-related complication requiring revision surgery. Results The surgery-based incidences of IF requiring revision surgery in the TGR and VEPTR groups were 4.3% and 4.0%, respectively, with no significant intergroup difference. Remarkably, there was a negative correlation between IF incidence per surgical procedure and the number of lengthening surgeries in both groups. In addition, rod breakage in the TGR group and anchor-related complications in the VEPTR group tended to occur relatively early in the treatment course. The surgery-based rates of UPROR due to IF in the TGR and VEPTR groups were 2.0% and 1.5%, respectively, showing no statistically significant difference. Conclusions We found that IF, such as anchor related-complications and rod breakage, occurs more frequently earlier in the course of lengthening surgeries. This finding may help in patient counseling and highlights the importance of close postoperative follow-up to detect IF and improve outcomes.
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- 2024
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8. Study on deep learning-based detection of viable cell count in dialysis fluid images
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Michihiro Kawasaki, Toshiki Shimozawa, and Satoshi Suzuki
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CNN ,VGG-16 ,YOLO ,Deep learning ,Viable cell ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background and aims Control of dialysate fluid quality is critical to secure the safety of dialysis treatment. The number of colonies is manually counted when determining viable cell count in dialysis fluid, but errors and subjective interpretation on the part of the measurer can be problematic. This prompted us to examine the potential for using deep learning to detect viable cells and count their numbers. Methods In this study we prepared 5360 images for detecting viable cell count and classified them into four categories using the VGG-16 model. These images were resized to 224 × 224 px; 90% of them were used for learning, and 10% were used for validation. In an alternative approach, we also created 110 annotated images from images to detect viable cell count in dialysis fluid and subjected them to learning using the YOLOv5 model. Results VGG-model had a detection accuracy using the test data was 43%. YOLOv5 model had a mAP (Mean Average Precision) was 0.842. The detection accuracy using the test data was 90%. Conclusions The method using the VGG-16 model had problems with overfitting, suggesting that the model was not sufficiently expressive. The detection of viable cells using the YOLOv5 model showed high accuracy.
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- 2024
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9. MMW-AQA: Multimodal In-the-Wild Dataset for Action Quality Assessment
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Takasuke Nagai, Shoichiro Takeda, Satoshi Suzuki, and Hitoshi Seshimo
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Action quality assessment ,deep learning ,multimodal dataset ,multimodal learning ,Electrical engineering. Electronics. Nuclear engineering ,TK1-9971 - Abstract
Action quality assessment (AQA) is a task for assessing a specific action quality in videos. Since existing AQA datasets provide only two-dimensional (2D) video data captured from fewer viewpoints, existing AQA methods based on deep neural networks (DNNs) often struggle to assess complex three-dimensional (3D) actions accurately, and their robustness against diversified viewpoints remains unknown. We created a dataset called multimodal in-the-wild (MMW)-AQA in freestyle windsurfing that addresses these concerns. In addition to video data, MMW-AQA provides inertial measurement unit (IMU) and global positioning system (GPS) data. The 3D information of IMU data helps DNNs accurately assess complex 3D actions. Moreover, MMW-AQA provides wild video data captured by a single unmanned aerial vehicle (UAV). These wild video data enable us to evaluate whether AQA methods can work well on diversified viewpoints. Furthermore, we also present the baseline multimodalization framework with a transformer-based fusion module. These frameworks multimodalize existing unimodal DNN models easily to assess action quality using multimodal data. Our experimental results demonstrate that multimodal data improves the AQA accuracy compared with unimodal video data.
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- 2024
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10. Applicability of deep learning for blood pressure estimation during hemodialysis based on facial images
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Kosuke Oiwa, Satoshi Suzuki, Yoshitaka Maeda, and Hikohiro Jinnai
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Blood pressure estimation ,Deep learning ,Facial images ,Hemodialysis ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Back ground In hemodialysis, hypotension occurs due to dehydration and solute removal. Conventional blood pressure monitoring during dialysis is intermittent and relies on staff experience and intuition to predict patient blood pressure trends based on the amount of water removed on the day and previous trends, which requires hemodialysis operations that do not lead to hypotension. Our research group has attempted to estimate blood pressure based on the spatial features of facial visible images, including information on facial color, and facial infrared images, including information on skin temperature. It is expected to realize early detection of blood pressure decrease during treatment if the blood pressure of dialysis patients can be estimated from their facial visible and infrared images measured continuously and remotely. In this study, we verified the applicability of deep learning algorithms in blood pressure estimation based on facial visible and infrared images of hemodialysis patients. Methods Measured facial visible and infrared images and mean blood pressure (MBP) of hemodialysis patients were applied to a convolutional neural network to construct an MBP estimation model based on the spatial features of the facial images. Results Average blood pressure could be estimated with an error of less than 20 mmHg based on the spatial features of the facial images, and the blood pressure estimation accuracy based on the spatial features of the facial infrared images was higher than that of the facial visible images. Conclusion We found the possibility of applying the deep learning algorithm to blood pressure estimation based on the spatial features of facial images. Trial registration This study is not subject to enrollment in a clinical trial due to the absence of both intervention and invasion. The Ethics Review Committee of Jichi Medical University has approved the same interpretation.
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- 2024
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11. Familial Mediterranean fever with colonic lesions: A case report
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Hiroyuki Ariga, Reiko Kunisaki, Takeshi Ojima, Satoshi Suzuki, Kenta Okada, and Junya Kashimura
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familial Mediterranean fever ,prednisolone ,colchicine ,ulcerative colitis ,5‐aminosalicylate ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract A 26‐year‐old man with a history of ulcerative colitis treatment presented to our clinic with abdominal pain and fever. He had a history of bloody stools and abdominal pain at 19 years of age. A thorough examination by a medical practitioner, including lower gastrointestinal endoscopy, resulted in the diagnosis of ulcerative colitis. After induction of remission with prednisolone (PSL), the patient was treated with 5‐aminosalicylate. One year ago in September, his symptoms flared up again, and he was administered 30 mg/day of PSL until November of the same year. However, he was transferred to another hospital and referred to his previous doctor. During the follow‐up in December of the same year, flare‐ups of abdominal pain and diarrhea were reported. Upon review of the patient's medical history, familial Mediterranean fever was suspected because the patient had periodic fevers ≥38°C and symptoms that persisted even after oral steroid administration and were sometimes accompanied by joint pain. However, he was transferred again, and PSL was administered once more. The patient was referred to our hospital for further treatment. At the time of arrival, his symptoms did not improve with 40 mg/day of PSL, and endoscopy and computed tomography revealed thickening of the colon, with no abnormality in the small intestine. Suspecting familial Mediterranean fever‐associated enteritis, the patient was administered colchicine, resulting in an improvement in symptoms. Furthermore, an examination of the MEFV gene showed a mutation in Exon5 (S503C), and atypical familial Mediterranean fever was diagnosed. Endoscopy after colchicine treatment revealed that the ulcers improved remarkably.
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- 2024
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12. Bilateral Lumbar Pedicle Fracture in a Patient Receiving Long-Term Bisphosphonate Therapy: A Case Report
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Hiromune Karasawa, Satoshi Nori, Satoshi Suzuki, Masahiro Ozaki, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Mitsuru Yagi, Kota Watanabe, and Masaya Nakamura
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bilateral lumbar pedicle fractures ,osteoporosis ,bisphosphonate ,Surgery ,RD1-811 - Published
- 2023
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13. Comparison of taste characteristics between koji mold–ripened cheese and Camembert cheese using an electronic tongue system
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Sora Hayashida, Tatsuro Hagi, Miho Kobayashi, Ken-Ichi Kusumoto, Hideyuki Ohmori, Satoru Tomita, Satoshi Suzuki, Hideyuki Yamashita, Kaoru Sato, Takayuki Miura, and Masaru Nomura
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mold-ripened cheese ,Aspergillus oryzae ,Aspergillus sojae ,electronic tongue system ,Dairy processing. Dairy products ,SF250.5-275 ,Dairying ,SF221-250 - Abstract
ABSTRACT: Koji mold, classified in the genus Aspergillus, is used to produce traditional Japanese fermented foods such as miso, soy sauce, and sake. In recent years, the application of koji mold to cheese ripening has attracted attention, and cheese surface-ripened with koji mold (koji cheese) has been studied. In this study, to evaluate the taste characteristics of koji cheese, an electronic tongue system was employed to measure the taste values of cheese samples ripened using 5 strains of koji mold in comparison with commercial Camembert cheese. All koji cheese samples exhibited lower sourness and greater bitterness, astringency, saltiness, and umami richness than the Camembert cheese samples. The intensity of each taste characteristic differed depending on the koji mold strain. These results indicate that koji cheese has a different taste value than conventional mold-ripened cheese. Furthermore, the results also indicate that various taste characteristics can be achieved by selecting different koji molds.
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- 2023
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14. Helical peptides with disordered regions for measles viruses provide new generalized insights into fusion inhibitors
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Kazushige Hirata, Aoi Takahara, Satoshi Suzuki, Shumei Murakami, Kumi Kawaji, Akie Nishiyama, Mina Sasano, Mariko Shoji-Ueno, Emiko Usui, Kazutaka Murayama, Hironori Hayashi, Shinya Oishi, and Eiichi N. Kodama
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Virology ,Molecular biology ,Science - Abstract
Summary: Despite effective vaccines, measles virus (MeV) outbreaks occur sporadically. Therefore, developing anti-MeV agents remains important for suppressing MeV infections. We previously designed peptide-based MeV fusion inhibitors, M1 and M2, that target MeV class I fusion protein (F protein). Here, we developed a novel fusion inhibitor, MEK35, that exerts potent activity against M1/M2-resistant MeV variants. Comparing MEK35 to M1 derivatives revealed that combining disordered and helical elements was essential for overcoming M1/M2 resistance. Moreover, we propose a three-step antiviral process for peptide-based fusion inhibitors: (i) disordered peptides interact with F protein; (ii) the peptides adopt a partial helical conformation and bind to F protein through hydrophobic interactions; and (iii) subsequent interactions involving the disordered region of the peptides afford a peptide-F protein with a high-affinity peptide-F protein interaction. An M1-resistant substitution blocks the second step. These results should aid the development of novel viral fusion inhibitors targeting class I F protein.
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- 2024
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15. A homozygous structural variant of RPGRIP1 is frequently associated with achromatopsia in Japanese patients with IRD
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Akiko Suga, Kei Mizobuchi, Taiga Inooka, Kazutoshi Yoshitake, Naoko Minematsu, Kazushige Tsunoda, Kazuki Kuniyoshi, Yosuke Kawai, Yosuke Omae, Katsushi Tokunaga, Takaaki Hayashi, Shinji Ueno, Takeshi Iwata, Hatsue Ishibashi-Ueda, Tsutomu Tomita, Michio Noguchi, Ayako Takahashi, Yu-ichi Goto, Sumiko Yoshida, Kotaro Hattori, Ryo Matsumura, Aritoshi Iida, Yutaka Maruoka, Hiroyuki Gatanaga, Masaya Sugiyama, Satoshi Suzuki, Kengo Miyo, Yoichi Matsubara, Akihiro Umezawa, Kenichiro Hata, Tadashi Kaname, Kouichi Ozaki, Haruhiko Tokuda, Hiroshi Watanabe, Shumpei Niida, Eisei Noiri, Koji Kitajima, Reiko Miyahara, and Hideyuki Shimanuki
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Achromatopsia ,Genome sequencing ,RPGRIP1 ,Structural variant ,Genetics ,QH426-470 ,Medicine - Abstract
Purpose: Achromatopsia (ACHM) is an early-onset cone dysfunction caused by 5 genes with cone-specific functions (CNGA3, CNGB3, GNAT2, PDE6C, and PDE6H) and by ATF6, a transcription factor with ubiquitous expression. To improve the relatively low variant detection ratio in these genes in a cohort of exome-sequenced Japanese patients with inherited retinal diseases (IRD), we performed genome sequencing to detect structural variants and intronic variants in patients with ACHM. Methods: Genome sequencing of 10 ACHM pedigrees was performed after exome sequencing. Structural, non-coding, and coding variants were filtered based on segregation between the affected and unaffected in each pedigree. Variant frequency and predicted damage scores were considered in identifying pathogenic variants. Results: A homozygous deletion involving exon 18 of RPGRIP1 was detected in 5 of 10 ACHM probands, and variant inheritance from each parent was confirmed. This deletion was relatively frequent (minor allele frequency = 0.0023) in the Japanese population but was only homozygous in patients with ACHM among the 199 Japanese IRD probands analyzed by the same genome sequencing pipeline. Conclusion: The deletion involving exon 18 of RPGRIP1 is a prevalent cause of ACHM in Japanese patients and contributes to the wide spectrum of RPGRIP1-associated IRD phenotypes, from Leber congenital amaurosis to ACHM.
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- 2024
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16. No increase in translocated chromosomal aberrations, an indicator of ionizing radiation exposure, in childhood thyroid cancer in Fukushima Prefecture
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Akira Sakai, Naohiro Tsuyama, Tetsuya Ohira, Misaki Sugai-Takahashi, Takashi Ohba, Yusuke Azami, Yoshiko Matsumoto, Iwadate Manabu, Satoshi Suzuki, Maki Sato, Mitsuaki Hosoya, Tetsuo Ishikawa, and Shinichi Suzuki
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Medicine ,Science - Abstract
Abstract To investigate the effects of radiation exposure due to the Fukushima nuclear power plant accident, following the disaster Fukushima Prefecture launched thyroid ultrasound examinations of residents who were generally younger than 18 years at the time of the earthquake. As the rate of pediatric thyroid cancer was higher than expected, we conducted biological dose assessment based on the frequency of translocated chromosome (Tr) aberrations using peripheral blood lymphocytes. Tr formation frequency was compared among the thyroid cancer (n = 38, median age 18 years, age range 12–26 years), thyroid-related disease (n = 30, median age 21 years, age range 15–28 years), and healthy controls (n = 31, median age 22 years, age range 20–23 years) groups. Tr aberration frequency was initially significantly higher in the thyroid cancer than in the other two groups; however, differences among the groups disappeared after adjusting for history of CT scan, as 92%, 67%, and 28% of those in the thyroid cancer, thyroid-related disease, and control groups, respectively, had undergone CT previously. Therefore, the significant difference in the initial number of Tr formations is presumably due to radiation exposure from CT. Accordingly, the effects of medical exposure on the chromosomes of children and adolescents should be noted.
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- 2023
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17. Radiographical Results of Adolescent Idiopathic Scoliosis with Major Curve at Proximal Thoracic Spine
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Yosuke Horiuchi, Mitsuru Yagi, Satoshi Suzuki, Yohei Takahashi, Satoshi Nori, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, and Kota Watanabe
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adolescent idiopathic scoliosis ,posterior correction surgery ,major proximal thoracic curve ,Surgery ,RD1-811 - Abstract
Introduction: Adolescent idiopathic scoliosis (AIS) with a major curve at the main thoracic (MT) area is classified as Lenke type 1, 2, or 3 depending on the flexibility of the proximal thoracic (PT) curve and lumbar curve. No definite classification has been established for a major curve at the PT spine. The purpose of this study is to investigate the radiographic characteristics before and after correction surgery for AIS with a major curve at the PT area. Methods: This is a retrospective cohort study at a single academic institution. Twelve patients with a major curve at the PT spine participated in our study and followed for at least two years after surgery. We evaluated the pre- and postoperative Cobb angles of the curve, curve range, location of the apex, sagittal parameters, and shoulder balance-related parameters. All patients were treated by posterior correction and fusion surgery using pedicle screw constructs. Results: The patients were classified as having a double-curve (DC) type, in which the MT curve was structural, or a single-curve (SC) type, in which the MT curve was corrected to less than 25° on supine side-bending films. The mean correction rates for the PT curve were favorable in both groups (DC, 65.7%±9.6%; SC, 39.2%±4.9%). The mean Cobb angle of the lumbar curve improved in the DC group (preoperative, 17.1°±4.0°; postoperative, 5.0°±4.2°) but deteriorated in the SC group (preoperative, 7.1°±1.2°; postoperative, 12.4°±4.4°) after surgery. Conclusions: We illustrated the postoperative radiographical changes of 12 consecutive patients with the major curve at the PT curve. Although posterior correction and fusion surgery corrected the PT curve satisfactorily in both DC and SC patients, the Cobb angle of the lumbar curve deteriorated after surgery in all SC patients. Surgeons need to pay attention to the fusion area, especially LIV, when operating the SC curve type.
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- 2023
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18. Dysregulation of Inflammatory Pathways in Adult Spinal Deformity Patients with Frailty
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Tomohisa Tabata, Mitsuru Yagi, Satoshi Suzuki, Yohei Takahashi, Masahiro Ozaki, Osahiko Tsuji, Narihito Nagoshi, Morio Matsumoto, Masaya Nakamura, and Kota Watanabe
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frailty ,adult spinal deformity ,biomarker ,complication ,HRQOL ,Medicine - Abstract
Background/Objectives: An important aspect of the pathophysiology of frailty seems to be the dysregulation of inflammatory pathways and the coagulation system. However, an objective assessment of the impact of frailty on the recovery from surgery is not fully studied. This study sought to assess how frailty affects the recovery of adult spinal deformity (ASD) surgery using blood biomarkers. Methods: 153 consecutive ASD patients (age 64 ± 10 yr, 93% female) who had corrective spine surgery in a single institution and reached 2y f/u were included. The subjects were stratified by frailty using the modified frailty index-11 (robust [R] group or prefrail and frail [F] group). Results of commonly employed laboratory tests at baseline, 1, 3, 7, and 14 post-operative days (POD) were compared. Further comparison was performed in propensity-score matched-39 paired patients between the groups by age, curve type, and baseline alignment. A correlation between HRQOLs, major complications, and biomarkers was performed. Results: Among the propensity-score matched groups, CRP was significantly elevated in the F group at POD1,3(POD1; 5.3 ± 3.1 vs. 7.9 ± 4.7 p = 0.02, POD3; 6.6 ± 4.6 vs. 8.9 ± 5.2 p = 0.02). Transaminase was also elevated in the F group at POD3(ASD: 36 ± 15 vs. 51 ± 58 U/L, p = 0.03, ALT: 32 ± 16 vs. 47 ± 55 U/L, p = 0.04). Interestingly, moderate correlation was observed between transaminase at POD1 and 2 y SRS22 (AST; function r = −0.37, mental health r = −0.39, satisfaction −0.28, total r = −0.40, ALT; function r = −0.37, satisfaction −0.34, total r = −0.39). Conclusions: Frailty affected the serum CRP and transaminase differently following ASD surgery. Transaminase at early POD was correlated with 2 y HRQOLs. These findings support the hypothesis that there is a specific physiological basis to the frailty that is characterized in part by increased inflammation and that these physiological differences persist.
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- 2024
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19. Predicting dry weight change in Hemodialysis patients using machine learning
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Hiroko Inoue, Megumi Oya, Masashi Aizawa, Kyogo Wagatsuma, Masatomo Kamimae, Yusuke Kashiwagi, Masayoshi Ishii, Hanae Wakabayashi, Takayuki Fujii, Satoshi Suzuki, Noriyuki Hattori, Narihito Tatsumoto, Eiryo Kawakami, and Katsuhiko Asanuma
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Machine learning ,Random Forest classifier ,Importance analysis ,Dry Weight ,Hemodialysis ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Machine Learning has been increasingly used in the medical field, including managing patients undergoing hemodialysis. The random forest classifier is a Machine Learning method that can generate high accuracy and interpretability in the data analysis of various diseases. We attempted to apply Machine Learning to adjust dry weight, the appropriate volume status of patients undergoing hemodialysis, which requires a complex decision-making process considering multiple indicators and the patient’s physical conditions. Methods All medical data and 69,375 dialysis records of 314 Asian patients undergoing hemodialysis at a single dialysis center in Japan between July 2018 and April 2020 were collected from the electronic medical record system. Using the random forest classifier, we developed models to predict the probabilities of adjusting the dry weight at each dialysis session. Results The areas under the receiver-operating-characteristic curves of the models for adjusting the dry weight upward and downward were 0.70 and 0.74, respectively. The average probability of upward adjustment of the dry weight had sharp a peak around the actual change over time, while the average probability of downward adjustment of the dry weight formed a gradual peak. Feature importance analysis revealed that median blood pressure decline was a strong predictor for adjusting the dry weight upward. In contrast, elevated serum levels of C-reactive protein and hypoalbuminemia were important indicators for adjusting the dry weight downward. Conclusions The random forest classifier should provide a helpful guide to predict the optimal changes to the dry weight with relative accuracy and may be useful in clinical practice.
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- 2023
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20. Clinical Features of Recurrent Spinal Cord Tumors
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Osahiko Tsuji, Narihito Nagoshi, Satoshi Suzuki, Yohei Takahashi, Satoshi Nori, Mitsuru Yagi, Morio Matsumoto, Masaya Nakamura, and Kota Watanabe
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recurrent spinal cord tumor ,dumbbell-shaped tumor ,ventral meningioma ,intramedullary ependymoma ,spinal astrocytoma ,Surgery ,RD1-811 - Abstract
Introduction: Only a few reports have described the clinical features of recurrent spinal cord tumors. This study aimed to report the recurrence rates (RRs), radiographic imaging, and pathological features of various histopathological recurrent spinal cord tumors using a large sample size. Methods: This study adopted the retrospective observational study design using a single-center study setting. We retrospectively reviewed 818 consecutive individuals operated for spinal cord and cauda equina tumors between 2009 and 2018 in a university hospital. We first determined the number of surgeries and then the histopathology, duration to reoperation, number of surgeries, location, degree of tumor resection, and tumor configuration of the recurrent cases. Results: A total of 99 patients (46 men and 53 women) who underwent multiple surgeries were identified. The mean duration between the primary and second surgeries was 94.8 months. A total of 74 patients underwent surgery twice, 18 patients thrice, and 7 patients 4 or more times. The recurrence sites were broadly distributed over the spine, with mainly intramedullary (47.5%) and dumbbell-shaped (31.3%) tumors. The RRs for each histopathology were as follows: schwannoma, 6.8%; meningioma and ependymoma, 15.9%; hemangioblastoma, 15.8%; and astrocytoma, 38.9%. The RRs after total resection were significantly lower (4.4%) than that after partial resection. Neurofibromatosis-associated schwannomas had a higher RR than sporadic schwannomas (p
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- 2023
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21. Impact of pleural effusion at an early period after posterior spinal fusion for adolescent idiopathic scoliosis on future pulmonary function and lung volume
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Masahiro Ozaki, MD, PhD, Satoshi Suzuki, MD, PhD, Takehiro Michikawa, PhD, Yohei Takahashi, MD, PhD, Satoshi Nori, MD, PhD, Osahiko Tsuji, MD, PhD, Narihito Nagoshi, MD, PhD, Mitsuru Yagi, MD, PhD, Nobuyuki Fujita, MD, PhD, Morio Matsumoto, MD, PhD, Masaya Nakamura, MD, PhD, and Kota Watanabe, MD, PhD
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Pleural effusion ,Adolescent idiopathic scoliosis ,Posterior spinal fusion ,Pulmonary function ,Lung volume ,Low-dose computed tomography ,Orthopedic surgery ,RD701-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Background: Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) has a potential risk for postoperative pleural effusion. Although pleural effusion at an early period after PSF for AIS occurs with a relatively high frequency and occasionally requires some treatments, the impact of postoperative pleural effusion on future pulmonary function or lung volume (LV) has not been clarified to date. The aim of this study was to evaluate the effect of pleural effusion after PSF for AIS on the postoperative pulmonary function and LV. Methods: A total of 114 consecutive patients who underwent PSF for AIS followed up greater than 2 years at our institute were retrospectively reviewed. We evaluated postoperative pleural effusion by computed tomography (CT) at the 1-week follow-up and divided patients into the pleural effusion (PF) and non-pleural effusion (NP) groups. We investigated spirometry parameters recorded for testing included vital capacity (VC), forced expiratory volume in the first second (FEV1), %VC, and FEV1% and measured the LV using CT images and a workstation at baseline and 2 years after surgery. Results: A total of 87 (76.3%) patients with postoperative pleural effusion were identified, but all patients were asymptomatic and did not require additional treatment for postoperative pleural effusion. All pulmonary function parameters at the 2-year follow-up exhibited no significant differences between the two groups. Although preoperative left LV (1.21±0.30 L vs. 1.36±0.34 L; p=.022) and total LV (2.68±0.62 L vs. 2.99±0.73 L; p=.031) were significantly lower in the PF group than in the NP group, all postoperative LV parameters were similar between the two groups. Conclusions: Pleural effusion at an early period after PSF for AIS was a postoperative occurrence without an impact on future pulmonary function and LV.
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- 2023
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22. Autologous Platelet-Rich Plasma Improves Pregnancy Outcomes of Patients with Thin Endometrium Regardless Endometrial Thickening: Multicenter Retrospective Study with Elimination of Embryonic Confounders
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Satoshi Suzuki, Maki Kusumi, Tomoko Maeda, Kiyotaka Kawai, Toshihiro Kawamura, Eri Okamoto, Toushun Jo, Ryo Tsutsumi, Satoru Takamizawa, Takahiro Nakayama, Motowo Nabeta, Yukio Nishiyama, Mari Nomiyama, Kenji Furui, Yoshiharu Morimoto, and Osamu Tsutsumi
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Assisted Reproductive Technology ,Frozen Embryo Transfer ,Platelet-rich Plasma ,Preimplantation Genetic Testing for Aneuploidy ,Recurrent Implantation Failure ,Reproduction ,QH471-489 - Abstract
Objective: To determine whether endometrial thickening is an important factor for pregnancy outcomes in platelet-rich plasma (PRP) treatment for patients with thin endometrium. Methods: Data from the registry database of the Japan Gynecologic PRP Study Group from April 2019 to October 2021 were analyzed retrospectively. A total of 208 patients who underwent single blastocyst transfer (SBT) after PRP due to thin endometrium (¡8 mm) in their previous cycle were included in the study. Their pregnancy outcomes were compared with their own historical data before PRP infusion. The same patient group was then divided into 136 patients whose endometrium thickened after PRP and 72 patients whose endometrium did not, and the pregnancy outcomes of the two groups were compared. Furthermore, to eliminate embryonic confounding, 28 patients who had single euploid blastocyst transfer (SEBT) with preimplantation genetic testing for aneuploidy (PGT-A) were selected from the same patient group and divided into two groups of 22 patients whose endometrium thickened and 6 patients whose endometrium did not, and the pregnancy outcomes were compared in the same method. Results: After PRP administration, the clinical pregnancy rate, live birth rate, and miscarriage rate were all significantly improved compared with the historical controls (34.1 vs 20.0, [Formula: see text]; 22.6 vs 3.9, [Formula: see text]; 33.8 vs 73.4, [Formula: see text]). There were no statistically significant differences in the respective rates between the “thickened endometrium” group and the “unthickened endometrium” group in SBT group (36.0 vs [Formula: see text], [Formula: see text]; 25.7 vs [Formula: see text], [Formula: see text]; 28.5 vs [Formula: see text], [Formula: see text], respectively). Likewise, in the SEBT with PGT-A group, there were no statistically significant differences in results between the two groups (36.4 vs [Formula: see text], [Formula: see text]; 36.4 vs [Formula: see text], [Formula: see text]; 0 vs [Formula: see text], respectively). Conclusions: PRP administration to patients with thin endometrium improves pregnancy outcomes even when endometrial thickening is not achieved.
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- 2023
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23. Acute Calcium Pyrophosphate Deposition at the Surgical Site after Posterior Lumbar Decompression
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Ikko Koike, Satoshi Nori, Satoshi Suzuki, Yohei Takahashi, Osahiko Tsuji, Narihito Nagoshi, Mitsuru Yagi, Kota Watanabe, Morio Matsumoto, and Masaya Nakamura
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calcium pyrophosphate deposition disease ,pseudogout ,posterior lumbar decompression ,surgical site infection ,nonsteroidal anti-inflammatory drugs ,Surgery ,RD1-811 - Published
- 2023
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24. Disc Height Narrowing Could Not Stabilize the Mobility at the Level of Cervical Spondylolisthesis: A Retrospective Study of 83 Patients with Cervical Single-Level Spondylolisthesis
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Ryoma Aoyama, Junichi Yamane, Ken Ninomiya, Yuichiro Takahashi, Kazuya Kitamura, Satoshi Nori, Satoshi Suzuki, and Tateru Shiraishi
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spondylolisthesis ,degenerative cascade ,disc narrowing ,cervical ,instability ,Medicine - Abstract
Study Design A retrospective study at a single academic institution. Purpose We aimed to understand the pathogenesis of cervical spondylolisthesis by analyzing whether narrowing of the disc height stabilizes the slipped disc level according to the degenerative cascade. Overview of Literature According to Kirkaldy-Willis’ degenerative cascade, the narrowing of the disc height at slipped level contributes to intervertebral stability in lumbar spondylolisthesis. Conversely, the pathogenesis of cervical spondylolisthesis is unknown due to a scarcity of reports on the condition. Methods The images of 83 patients with cervical single-level spondylolisthesis were studied. We looked at 52 slipped levels for anterior slippage and 31 for posterior slippage. The imaging parameters included slippage in the neutral, flexed, and extended positions, axial facet joint orientation, sagittal facet slope, global cervical alignment, C2–C7 angle, C2–C7 sagittal vertical axis, range of motion (ROM), and slipped disc angle ROM. Results With the narrowing of the intervertebral disc height, slippage in the flexed position of both anterior and posterior spondylolisthesis increased. However, in both anterior and posterior spondylolisthesis, disc height narrowing did not show stability. The narrowing of the intervertebral disc height was found to be a risk factor for a translation of slippage of 1.8 mm or more in flexion-extension motion in anterior spondylolisthesis in multivariate regression analysis. Conclusions Narrowing the intervertebral disc height did not stabilize the translation of slippage in flexion-extension motion in cervical spondylolisthesis. Instead, narrowing of the disc height was associated with a translation of slippage of 1.8 mm or more in flexion-extension motion in cases of anterior slippage. Therefore, we discovered that degenerative cascade stabilization for cervical spondylolisthesis was difficult to achieve.
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- 2023
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25. Identification of SARS-CoV-2 Mpro inhibitors containing P1’ 4-fluorobenzothiazole moiety highly active against SARS-CoV-2
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Nobuyo Higashi-Kuwata, Kohei Tsuji, Hironori Hayashi, Haydar Bulut, Maki Kiso, Masaki Imai, Hiromi Ogata-Aoki, Takahiro Ishii, Takuya Kobayakawa, Kenta Nakano, Nobutoki Takamune, Naoki Kishimoto, Shin-ichiro Hattori, Debananda Das, Yukari Uemura, Yosuke Shimizu, Manabu Aoki, Kazuya Hasegawa, Satoshi Suzuki, Akie Nishiyama, Junji Saruwatari, Yukiko Shimizu, Yoshikazu Sukenaga, Yuki Takamatsu, Kiyoto Tsuchiya, Kenji Maeda, Kazuhisa Yoshimura, Shun Iida, Seiya Ozono, Tadaki Suzuki, Tadashi Okamura, Shogo Misumi, Yoshihiro Kawaoka, Hirokazu Tamamura, and Hiroaki Mitsuya
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Science - Abstract
Effective antivirals are critical for combatting SARS-CoV-2 infections. Here, the authors develop two orally available small molecules, which specifically inhibit the activity of the SARS-CoV-2 main protease and potently block the infectivity and replication of various SARS-CoV-2 strains in cells and mice.
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- 2023
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26. Lipopolysaccharide from Yoshino cedar trees (Cryptomeria japonica) induces high levels of human macrophage polarization
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Noriko Ouji-Sageshima, Masahiro Kitabatake, Satoki Fushimi, Satoshi Suzuki, Yuzu Fukui, Ryutaro Furukawa, and Toshihiro Ito
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Cryptomeria japonica ,Lipopolysaccharide ,Macrophage ,Allergy ,Forestry ,SD1-669.5 ,Building construction ,TH1-9745 - Abstract
Abstract Japanese cedar, Cryptomeria japonica, is an evergreen conifer native to Japan and is often used as a building material. The humidity control properties of wood are known, but there have been few detailed analyses of its effects on living organisms. Therefore, we investigated the effects of cedar water-soluble components on human macrophages, which are essential for maintaining biological homeostasis and innate immunity. In this study, we prepared aqueous extracts from Cryptomeria japonica in Yoshino, Nara prefecture (called as Yoshino cedar). Yoshino cedar aqueous extracts stimulated macrophages toward the classically activated phenotype and inhibited the macrophage phenotype thought to mediate allergic responses. Next, we measured the lipopolysaccharide (LPS) concentration in the Yoshino cedar aqueous extract and found it was present at a high concentration. The major receptor of LPS is Toll-like receptor 4 (TLR4). To confirm whether LPS in Yoshino cedar aqueous extracts activate macrophages through the LPS/TLR4 pathway, we analyzed its effects on TLR4-deficient mouse embryonic fibroblasts (MEF) and wild-type (WT) MEF. TLR4-deficient MEF did not produce the proinflammatory cytokines seen in WT MEF. This result showed that LPS in the Yoshino cedar aqueous extracts activate macrophages via TLR4. This information will help us better understand the benefits of cedar for human health, including allergies.
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- 2022
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27. Association between class of foundational medication for heart failure and prognosis in heart failure with reduced/mildly reduced ejection fraction
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Miyuki Ito, Daichi Maeda, Yuya Matsue, Yasuyuki Shiraishi, Taishi Dotare, Tsutomu Sunayama, Kazutaka Nogi, Makoto Takei, Tomoya Ueda, Maki Nogi, Satomi Ishihara, Yasuki Nakada, Rika Kawakami, Nobuyuki Kagiyama, Takeshi Kitai, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, Yuji Nagatomo, Takashi Kohno, Shintaro Nakano, Shun Kohsaka, Tsutomu Yoshikawa, Yoshihiko Saito, and Tohru Minamino
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Medicine ,Science - Abstract
Abstract We clarified the association between changes in the number of foundational medications for heart failure (FMHF) during hospitalization for worsening heart failure (HF) and post-discharge prognosis. We retrospectively analyzed a combined dataset from three large-scale registries of hospitalized patients with HF in Japan (NARA-HF, WET-HF, and REALITY-AHF) and patients diagnosed with HF with reduced or mildly reduced left ventricular ejection fraction (HFr/mrEF) before admission. Patients were stratified by changes in the number of prescribed FMHF classes from admission to discharge: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and mineralocorticoid receptor blockers. Primary endpoint was the combined endpoint of HF rehospitalization and all-cause death within 1 year of discharge. The cohort comprised 1113 patients, and 482 combined endpoints were observed. Overall, FMHF prescriptions increased in 413 (37.1%) patients (increased group), remained unchanged in 607 (54.5%) (unchanged group), and decreased in 93 (8.4%) (decreased group) at discharge compared with that during admission. In the multivariable analysis, the increased group had a significantly lower incidence of the primary endpoint than the unchanged group (hazard ratio 0.56, 95% confidence interval 0.45–0.60; P
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- 2022
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28. Cervical Spinous Process and Its Attached Muscles Maintain Lower Disk Lordosis: A Retrospective Study of 155 Patients Who Underwent Muscle-Preserving Double Laminectomies
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Ryoma Aoyama, Junichi Yamane, Ken Ninomiya, Yuichiro Takahashi, Kazuya Kitamura, Satoshi Nori, Satoshi Suzuki, and Tateru Shiraishi
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alignment ,laminectomy ,laminoplasty ,muscle-preserving ,double laminectomy ,Medicine - Abstract
Study Design A retrospective study conducted at a single academic institution. Purpose This study compared the postoperative alignment of consecutive double laminectomies according to their decompression levels and investigated the influence of the extension unit of the spinous process and its attached muscles on postoperative alignment. Overview of Literature Many reports have investigated bony and soft tissue factors as the causes of postoperative cervical alignment disorders. To-this-date, no other article has clarified the importance of the attached muscles between the spinous processes of C3 and C6 to maintain local cervical alignment. Methods In total, 155 consecutive patients who underwent muscle-preserving consecutive double laminectomies for cervical spondylotic myelopathy from 2005 to 2013 were included in this study. The imaging parameters included the C2–C7 angle, range of motion, C2–C7 sagittal vertical axis (SVA), C7 slope, C2–C5 angle, C5–C7 angle, local disk angle caudal to the decompression level, and the disk height between C2/C3 and C7/Th1. Results The caudal disk angle of the decompression level decreased after consecutive double laminectomies, thus suggesting that the extension unit maintained the local lordosis at the lower disk of the decompression level. Postoperatively, in the C3–4 decompression cases, the C2–C7 angle decreased by 7.3°, and the C2–C7 SVA increased by 8.6 mm, thus indicating the appearance of an alignment disorder. Multivariate logistic regression analysis showed that cephalad laminectomy was a risk factor for C2–C7 angle decreases >10°. However, the postoperative recovery rate of Japanese Orthopedic Association scores after consecutive double laminectomies was reasonable, and the overall cervical alignment was well maintained in all decompression levels except C3–C4. Conclusions The cervical extension unit maintained lordosis at the disk caudal to it. The extension unit was found to contribute more to the maintenance of lordosis of the entire cervical spine at the cephalad side.
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- 2022
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29. Lung cancer surgery after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment
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Hiroaki Komatsu, Nobuhiro Izumi, Takuma Tsukioka, Hidetoshi Inoue, Ryuichi Ito, Satoshi Suzuki, and Noritoshi Nishiyama
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Lung cancer ,Surgery ,COVID-19 ,Interstitial pneumonia ,Restrictive ventilatory impairment ,RD1-811 - Abstract
Abstract Background The spread of COVID-19 infection increased the number of patients who underwent pulmonary resection for lung cancer after COVID-19 infection. It is unclear how previous infection with COVID-19 affects perioperative complications and acute exacerbation of interstitial pneumonia after surgery in patients with interstitial pneumonia. Case presentation An 80-year-old man was referred to our hospital because of a tumor in his left lung. Chest computed tomography showed a 28-mm nodule in the lower lobe of the left lung and usual interstitial pneumonia in bilateral lungs. Bronchoscopic examination was performed, which diagnosed squamous cell carcinoma. Pulmonary function testing revealed restrictive ventilatory impairment, and we planned to perform basal segmentectomy of the left lung. However, before the planned surgery, the patient contracted symptomatic COVID-19. Chest computed tomography revealed ground-glass opacities owing to COVID-19. The patient was admitted for surgery 7 weeks after COVID-19 infection. Preoperatively, pulmonary function testing was repeated, which revealed decreased % vital capacity (%VC) and % diffusing capacity for carbon monoxide (%DLco). The 6-min walk test indicated a distance of 500 m, and the percutaneous oxygen saturation at the end of the test was 94%. Basal segmentectomy of the left lung was performed by video-assisted thoracoscopic surgery. The patient’s postoperative course was favorable, and he was discharged without the need for oxygen inhalational therapy 12 days after the surgery. Pathological examination of the resected specimen revealed usual interstitial pneumonia in the non-cancerous areas of the lung. Additionally, the infiltration of immature fibroblasts in the alveoli and perivascular infiltration of inflammatory cells were observed, which were consistent with fibrotic change after inflammation owing to COVID-19. Three months after the surgery, the patient was alive without recurrence or acute exacerbation of the interstitial pneumonia. Pulmonary function testing 6 weeks after surgery revealed decreased %VC and %DLco. Testing 12 weeks after surgery revealed persistently decreased %VC and improved %DLco (Table 1). Table 1 Pulmonary function test results before and after COVID-19 infection and 6 and 12 weeks after surgery VC (ml) %VC (%) %DLco (%) Before COVID-19 infection 2070 71.9 74.9 7 weeks after COVID-19 infection 1700 59.6 51.9 6 weeks after surgery 1500 52.6 53.1 12 weeks after surgery 1510 53.0 61.7 %VC % vital capacity, %DLco % diffusing capacity for carbon monoxide Conclusion We successfully performed basal segmentectomy of the left lung for lung cancer 7 weeks after COVID-19 infection in a patient with severe interstitial pneumonia and restrictive ventilatory impairment.
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- 2022
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30. Mutations in the nonstructural proteins of SARS-CoV-2 may contribute to adverse clinical outcome in patients with COVID-19
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Takaya Ichikawa, Shiho Torii, Hikoyu Suzuki, Akio Takada, Satoshi Suzuki, Masahide Nakajima, Akihito Tampo, and Yasutaka Kakinoki
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COVID-19 ,SARS-CoV-2 ,Nonstructural protein ,Mutation ,Clinical outcome ,Virulence ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background: From late March through April 2021, we experienced a cluster of patients with COVID-19, named “Cluster K”, with rapid severe illness compared with those who were infected before. Methods: Patients with COVID-19 who were enrolled in this study were divided into two groups: 66 patients from November 2020 to March 2021 (group A) and 37 patients whose infection links were traced from Cluster K (group B). The primary outcome was mortality rate, and the secondary outcome was maximal oxygen flow rate as the severity of the disease. Viral genome sequences were compared between the two groups. Results: Mortality rates were 6.1% in group A and 16.2% in group B (odds ratio: 2.97, 95% confidence interval: 0.65–15.38). The patients in group B required high oxygen flow rate (O2 ≥10 l/min) in the earlier clinical course (P = 0.029). Viral genome sequences revealed five amino acid mutations; of these, four were found on three nonstructural proteins (NSPs): one in nsp3 and nsp15, two in nsp6 (one of them is near the potential sites under positive selective pressure). Another one was on the S protein. Conclusion: This study suggests that mutations in NSPs, especially nsp6, are associated with adverse clinical outcome in patients with COVID-19.
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- 2022
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31. Apolipoprotein C3 and necrotic core volume are correlated but also associated with future cardiovascular events
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Takayuki Ohwada, Takayuki Sakamoto, Satoshi Suzuki, Yukiko Sugawara, Kazuya Sakamoto, Ayano Ikeda, Fumika Haga, Tomoki Sato, Kazuhiko Nakazato, Yasuchika Takeishi, and Kenichi Watanabe
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Medicine ,Science - Abstract
Abstract We aimed to clarify the relationship between apolipoprotein C3 (apo-C3) and the vascular composition of lesion plaque in stable coronary disease (SCD) before percutaneous coronary intervention (PCI), and to investigate major adverse cardiovascular events (MACEs) within 4 years. Data of 98 consecutive patients with SCD who underwent PCI between November 1, 2012, and March 10, 2015, were analyzed. Laboratory and virtual histology-intravascular ultrasound (VH-IVUS) examinations of culprit lesions were conducted before PCI. Patients were divided according to median apo-C3 into low apo-C3 (≤ 8.5 mg/dL) and high apo-C3 (> 8.5 mg/dL) groups. VH-IVUS data indicated that the percentage of necrotic core volume (%NC) was significantly higher in the high apo-C3 group than in the low apo-C3 group. Moreover, the %NC significantly correlated with the apo-C3 level (R = 0.2109, P = 0.037). Kaplan–Meier curve analysis revealed that freedom from MACEs exhibited a greater decrease in the high apo-C3 group than in the low apo-C3 group, and in the high %NC group than in the low %NC group. Multivariate Cox hazards analysis showed that the %NC and high apo-C3 were independent predictors of 4 year MACEs. Apo-C3 may be a useful marker of future MACEs in patients with SCD after PCI and contribute to %NC growth.
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- 2022
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32. Acute exacerbation of idiopathic hypereosinophilic syndrome following asymptomatic coronavirus disease 2019: a case report
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Satoshi Suzuki, Keiko Suzuki, Takaya Ichikawa, Kae Takahashi, Masako Minami-Hori, and Yoko Tanino
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COVID-19 ,Eosinophilic granulomatosis with polyangiitis ,Hypereosinophilic syndrome ,Hypereosinophilic asthma with systemic manifestations ,Autoimmune diseases ,Peripheral neuropathy ,Medicine - Abstract
Abstract Background Previous research has suggested that some autoimmune diseases develop after the occurrence of coronavirus disease 2019. Hypereosinophilic syndrome is a rare disease presenting with idiopathic eosinophilia and multiple organ involvement, including the skin, lungs, gastrointestinal tract, heart, and nervous system. The diagnosis of idiopathic hypereosinophilic syndrome poses a dilemma because clinical manifestation and serum biomarkers are similar to those of eosinophilic granulomatosis with polyangiitis. Only a few cases have been reported where coronavirus disease 2019 may have caused the new onset or exacerbation of eosinophilic granulomatosis with polyangiitis or idiopathic hypereosinophilic syndrome. Case presentation We present the case of a 48-year-old Japanese woman with history of asthma who developed deteriorating symptoms of insidiously developed idiopathic hypereosinophilic syndrome following asymptomatic coronavirus disease 2019. She developed acute-onset back pain, tachycardia, abdominal discomfort, loss of appetite, weight loss, skin rash on the back, and numbness of the extremities 3 days after the quarantine period. Extreme hypereosinophilia with multiple abnormal findings including pulmonary ground-glass opacity lesions and mononeuritis multiplex was consistent with hypereosinophilic syndrome. Normal cellularity with eosinophilic proliferation in the bone marrow and negative FIP1L1–PDGFRA raised the diagnosis of idiopathic hypereosinophilic syndrome. Although the patient tested negative for anti-neutrophilic cytoplasmic antibodies and skin biopsy was negative for vasculitis, eosinophilic granulomatosis with polyangiitis could not be excluded. Since glucocorticoids are a standard therapy for both idiopathic hypereosinophilic syndrome and eosinophilic granulomatosis with polyangiitis, we initiated glucocorticoids following a multidisciplinary discussion. Conclusion Although the relationship between asymptomatic coronavirus disease 2019 and acute idiopathic hypereosinophilic syndrome exacerbation was uncertain, the chronological order of the symptomatic development suggested a possible link. More clinical cases and population-based studies are needed to determine the potential effect of coronavirus disease 2019 on autoimmune diseases.
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- 2022
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33. Preoperative prediction of the pathological stage of advanced gastric cancer by 18F-fluoro-2-deoxyglucose positron emission tomography
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Kota Yamada, Naoki Urakawa, Shingo Kanaji, Hiroshi Hasegawa, Masashi Yamamoto, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Satoshi Suzuki, and Yoshihiro Kakeji
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Medicine ,Science - Abstract
Abstract In recent years, the usefulness of neoadjuvant chemotherapy for resectable advanced gastric cancer, particularly stage III, has been reported. Preoperative staging is mainly determined by computed tomography (CT), and the usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography/CT (FDG-PET/CT) for gastric cancer has been limited in usefulness. The study aimed to evaluate the usefulness of FDG-PET/CT in preoperative diagnosis of advanced gastric cancer. We retrospectively enrolled 113 patients with gastric cancer who underwent preoperative FDG-PET/CT. All patients underwent gastrectomy with lymph-node dissection. The maximum standardized uptake value (SUVmax) of the primary tumor (T-SUVmax) and lymph nodes (N-SUVmax) were measured for all patients. The cutoff values of T-SUVmax for pathological T3/4 from receiver operating characteristic analysis were 8.28 for differentiated and 4.32 for undifferentiated types. The T-SUVmax and N-SUVmax cutoff values for pathological lymph-node metastasis were 4.32 and 1.82, respectively. Multivariate analysis showed that T-SUVmax for differentiated types was a significant predictor of pathological T3/4, and N-SUVmax was a significant predictor of lymph-node metastasis. In conclusion, the SUVmax of FDG-PET/CT was a useful predictor of pathological T3/4 and lymph-node metastasis in gastric cancer. The diagnosis by preoperative FDG-PET/CT is promising to contribute a more accurate staging of gastric cancer than by CT scan alone.
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- 2022
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34. National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study
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Satoshi Suzuki, Kenji Yamamoto, Hiroaki Tanaka, Hiroshi Ozawa, Yuji Okamoto, Tatsuya Abe, Hidenori Suzuki, Akiko Kada, Shigeki Nishino, Nobuyuki Sakai, Kunihiro Nishimura, Tomoyoshi Oikawa, Takanari Kitazono, Hiroshi Tanaka, Daisuke Onozuka, Akihito Hagihara, Hiroshi Ooyama, Akira Watanabe, Shinichi Yoshimura, Toru Iwama, Hiroki Sato, Satoshi Ushikoshi, Kiyohiro Houkin, Nobuhiro Mikuni, Naoyuki Nakao, Michio Nakamura, Nanako Tamiya, Naofumi Isono, Koji Iihara, Yutaka Yamaguchi, Kuniaki Ogasawara, Osamu Onodera, Yusaku Nakamura, Naoki Hayashi, Akira Takada, Hiroyuki Arai, Masayuki Ezura, Akio Hyodo, Shigeru Miyachi, Susumu Miyamoto, Yuji Matsumaru, Ichiro Nakahara, Tomoaki Terada, Kazunari Yoshida, Ai Kurogi, Ataru Nishimura, Yoshiaki Shiokawa, Koichi Arimura, Kaoru Kurisu, Fusao Ikawa, Kenji Ohata, Kyoichi Nomura, Nobuhito Saito, Hiroaki Fujiwara, Susumu Suzuki, Masanori Isobe, Soshiro Ogata, Takeshi Matsuoka, Junichiro Satomi, Takashi Matsumoto, Hiroyuki Nakase, Yasunari Niimi, Manabu Kinoshita, Mamoru Murakami, Masaaki Uno, Junichi Iida, Takashi Matsuoka, Tatsuya Sasaki, Shinichi Wakabayashi, Hiroki Toda, Hideki Sakai, Hajime Ohta, Osamu Yamamura, Hideyuki Ohnishi, Hiroko Oyama, Junichi Ono, Izumi Nagata, Hiroharu Kataoka, Ryota Kurogi, Hajime Arai, Atsuo Yoshino, Tsuyoshi Ohta, Hiroshi Sugimori, Hidehiro Hirabayashi, Hiroyuki Masaoka, Satoshi Yamamoto, Hideki Murakami, Kazuhiko Nozaki, Hiroyuki Matsumoto, Yuichiro Tanaka, Takahisa Mori, Keizo Yasui, Akira Takahashi, Ichiro Suzuki, Sachio Suzuki, TAKASHI YOSHIDA, Masanori Morimoto, Tetsuya Ueba, Hiromu Hadeishi, Masaki Chin, Michihiro Kohno, Hitoshi Fukuda, Toru Nishi, Kazunari Koga, Toshihiko Wakabayashi, Hiroki Ohkuma, Kazuhiro Hongo, Hiroshi Nakane, Kazumi Nitta, Satoshi Utsuki, Toshihiko Iuchi, Nice Ren, Hidefuku Gi, Kensuke Kawai, Masayuki Ishihara, Eiji Kohmura, Yoshihiro Nishiura, Kazutaka Yatsushiro, Kensaku Yoshida, Atsushi Tominaga, Masayuki Sumida, Hidenori Yoshida, Atsushi Sato, Takashi Inoue, Hiroaki Shimizu, Eiichiro Kamatsuka, Makoto Ichinose, Naoya Takeda, Tsuyoshi Inoue, Hidekazu Takahashi, Satoshi Kuroda, Toshiaki Osato, Nobutaka Horie, Isao Date, Yoichiro Hashimoto, Haruhiko Hoshino, Takafumi Shimogawa, Koji Yoshimoto, Teiji Tominaga, Isao Sasaki, Kazuo Kitazawa, Minoru Saitoh, Hitoshi Saito, Minoru Asahi, Makoto Goda, Atsuhito Takemura, Masaaki Shibukawa, Isao Fuwa, Saburo Watanabe, Seiko Kataoka, Koji Takasaki, Kouji Shiga, Kensuke Hayashida, Ryunosuke Uranishi, Chiaki Ito, Kenji Wakui, Takashi Saegusa, Isao Kitahara, Yasushi Ejima, Satoru Hayashi, Kazuyoshi Hattori, Shinji Okita, Toshikazu Ichihashi, Tsugumichi Ichioka, Shinichi Shirakami, Teruo Kimura, Tomonori Kobayashi, Kanehisa Kohno, Kazunori Yamanaka, Akira Morooka, Nozomi Mori, Hideo Kunimine, Masahiro Satoh, Syougo Imae, Hirochiyo Wada, Masanori Kabuto, Katsuyuki Hirakawa, Isao Inoue, Kiyoshi Kazekawa, Masani Nonaka, Kouzou Fukuyama, Shigenari Kin, Kiyoshi Saito, Yoichi Watanabe, Tadashi Arisawa, Kou Takahashi, Tetsuya Tanigawara, Junki Ito, Kei Hisada, Makoto Takeda, Jun Niwa, Mikio Nishiya, Shuji Hayashi, Ichiro Fujishima, Teiji Nakayama, Yoshihiko Watanabe, Koichirou Matsukado, Takamichi Yuguchi, Tadahisa Shono, Hiroyuki Nishimura, Jyunya Hayashi, Keisuke Migita, Kazuhiro Yokoyama, Hirotoshi Ohtaka, Takata Hisashi, Takamitsu Uchizawa, Naoki Shinohara, Mitsunobu Kaijima, Junkoh Yamamoto, Yoshio Sakagami, Hideo Aihara, Takayuki Sakaki, Keishi Fujita, Sumio Kobayashi, Nobuaki Momozaki, Masahito Hara, Akazi Kazunori, Fumitaka Miya, Hisato Minamide, Shinichiro Kurokawa, Syuichi Ishikawa, Naohisa Miura, Shinya Noda, Shoji Mashiyama, Shinji Amano, Takayuki Sugawara, Yukihiko Shimizu, Keiichi Saito, Kazuyuki Miura, Akinori Yabuta, Tatumi Yamanome, Hiroshi Seto, Makoto Hasebe, Hikaru Mizobuchi, Junkoh Sasaki, Shin Tsuruoka, Keiichi Nishimaki, Katsumi Takizawa, Hitoshi Tsugu, Nozomi Suzuki, Takeshi Kohno, Shu Hasegawa, Ken Asakura, Masaki Miyatake, Hiromu Konno, Katsunobu Takenaka, Akira Ikeda, Keizou Yamamoto, Keigo Matsumoto, Satoshi Inoha, Masaki Morisige, Kunihiko Harada, Hirofumi Hiyama, Yasuaki Takeda, Taturou Mori, Takekazu Akiyama, Osamu Okuda, Kazuaki Awamori, Naoki Shirasaki, Kimihiro Yoshino, Atsushi Shindo, Kazuho Hirahara, Shunichi Tanaka, Teruaki Kawano, Kazunori Arita, Hiroaki Sawaura, Yoichi Uozumi, Masahiko Tanaka, Shunsuke Shiraga, Shuji Sato, Mitsutoshi Nakada, Kimihisa Kinoshita, Nakazawa Kazutomo, Yasuhiro Fujimoto, Kunikazu Yoshimura, Masaaki Iwase, Shinichi Yagi, Atsushi Tsuchiya, Junichi Harashina, Sadao Kaneko, Naoto Kuwayama, Junya Hayashi, Masayuki Sasou, Sotaro Higashi, Masakazu Kitahara, Sumio Suda, Amami Kato, Satoshi Magarisawa, Kenji Hashimoto, Hirotoshi Hamaguchi, Tomohiko Satou, Masaru Idei, Haruhisa Tsukamoto, Toshihiro Kumabe, Naoaki Sato, Yasuyuki Toba, Takashi Tominaga, Haruo Yamashita, Toyoaki Shinohara, Kazuyoshi Watanabe, Hidenori Endo, Kenjirou Hujiwara, Toshinori Hasegawa, Hisashi Nitta, Kuroyanagi Takayuki, Nobuhiko Mizutani, Akira Tsunoda, Fumio Suzuki, Tetsuya Morimoto, Takuya Kawai, Mitsuyuki Fujitsuka, Hiromasa Tsuiki, Junichi Kuratsu, Hidemichi Sasayama, Shigehiro Ohmori, Seiko Hasegawa, Kazuhiro Kikuchi, Motohiro Morioka, Masayuki Yokota, Nozomu Murai, Yasumasa Yamamoto, Nobuhito Mori, Minoru Kidooka, Hiroshi Tenjin, Yoshihiro Iwamoto, Hitonori Takaba, Sei Haga, Yoshinori Arai, Toshiyuki Tsukada, Hirohide Karasudani, Masakazu Suga, Kawamoto Yukihiko, Naoto Izumi, Youtarou Takeuchi, Motohiro Arai, Shinji Okumura, Hisashi Tanaka, Yasushi Shibata, Tetsuya Masaoka, Masahiko Kasai, Hitoshi Miyake, Osamu Hamasaki, Misao Nishikawa, Naohiko Kubo, Yosimasa Kinosita, Hiroyuki Kaidu, Tarou Komuro, Hiroaki Shigeta, Yoshikazu Kusano, Shigekazu Takeuchi, Takayuki Matsuo, Yoshiharu Tokunaga, Norimoto Nakahara, Nobukazu Hashimoto, Mitsuhito Mase, Junpei Yoshimoto, Jin Momoji, Kenji Kamiyama, Koji Oka, Hiromichi Koga, Kazuya Morimoto, Tsutomu Kadekaru, Naoki Tokumitsu, Yasuyuki Nagai, Hirokazu Tanno, Takato Kagawa, Masaaki Saiki, Kotaro Ogihara, Junichi Imamura, Katsuhiro Yamashita, Akira Nakamizo, Yoshinari Nakamura, Ei-Ichirou Urasaki, Noriyuki Suzaki, Chiaki Takahashi, Youichirou Namba, Kazuo Hashikawa, Tomonori Yamada, Kazuyuki Kuwayama, Keiichi Sakai, Katsuhiro Kuroda, Hideyuki Kurihara, Masayuki Miyazono, Kosuke Miyahara, Hideaki Takahashi, Akihiko Saito, Igarashi Michitoku, Mitsuo Kouno, Shiro Kobayashi, Shunichi Yoneda, Hiroshi Kusunoki, Hiroji Miyake, Toshio Yokoe, Tatsuya Nakamura, Takayuki Kubodera, Mitsuhiko Hokari, Yasunari Otawara, Cheho Park, Hidemitu Nakagawa, Souichi Obara, Haruki Takahashi, Masafumi Ohtaki, Atsuya Okubo, Katsuhiko Hayashi, Masahisa Kawakami, Yu Takeda, Akihiko Kaga, Ryoichi Hayashi, Koji Tokunaga, Hiroyuki Nakashima, Yasuyuki Miyoshi, Atusi Kimoto, Toshimitsu Uchihara, Tomoaki Nagamine, Masahiro Noha, Hiromichi Sadashima, Toshihiko Kinjo, Osamu Tao, Masayuki Nakajima, Akira Isoshima, Kouichi Kuramoto, Shigeru Daido, Yoshiyasu Iwai, Toshihiko Kuroiwa, Akatsuki Wakayama, Kohsuke Yamashita, Yasunobu Gotou, Kouich Iwatsuki, Yoshida Masahiro, Nobuaki Kobayasi, Yoshimasa Niiya, Syouji Mabuchi, Motohiro Takayama, Kazuo Yamamoto, Junta Moroi, Masato Sugitani, Akio Ookura, Naoko Fujimura, Osamu Nishizaki, Sumio Isimaru, Hiroshi Wanihuchi, Nobukuni Murakami, Hiroto Murata, Naoki Kitagawa, Katsuhiko Kono, Michiya Kubo, Masashi Nakatsukasa, Makoto Inaba, Hidetoshi Ooigawa, Atsuhiro Kojima, Takamitsu Fujimaki, Osamu Fukuda, Yoshikazu Nakajima, Kazuyuki Kouno, Takaaki Yoshida, Reizou Kanemaru, Yohei Kudoh, Toshitaka Nakamura, Masayoshi Takigami, Shogo Nishi, Rokuya Tanikawa, Seisaburo Sakamoto, Makio Kaminogo, Seiichiro Hoshi, Yoshinari Okumura, Shinichi Okabe, Haruhiko Sato, Shiro Miyata, Kotaro Tsumura, Hiroshi Karibe, Noriaki Watabe, Ryuji Nakamura, Norifumi Shimoeda, Tsutomu Hitotsumatsu, Tomoaki Kameda, Hiroshi Ishiguchi, Atsuo Shinoda, Masanobu Hokama, Akinori Yamamura, Takeshi Kondoh, Kenichi Murao, Takafumi Wataya, Seiji Fukazawa, Shinsuke Muraoka, Hirosuke Fujisawa, Tsuneo Shishido, Mayumi Mori, Arai Hiroaki, Shinjitsu Nishimura, Zenichiro Watanabe, Susumu Nakashima, Kazuhito Nakamura, Yukinari Kakizawa, Hiroki Takano, Norihito Shirakawa, Masahiro Kagawa, Eiichiro Mabuchi, Kazusige Maeno, Takayuki Koizumi, Warou Taki, Yusuke Nakagaki, Kazuyuki Tane, Hiromichi Ooishi, Katsuyuki Asaoka, Yoshinori Akiyama, Tadao Kawamura, Atumi Takenobu, Takehisa Tuji, Masami Shimoda, Mitsunori Matsumae, Shinji Noda, Koiti Moroki, Hirofumi Oka, Masahito Agawa, Hajimu Miyake, Masateru Katayama, Shinichi Numazawa, Taketoshi Maehara, Hiroyuki Jimbo, Satoshi Ihara, Koji Matuoka, Oikawa Akihiro, Takahiro Oota, Makoto Noguchi, Takakazu Kawamata, Youichi Hashimoto, Keiichirou Onitsuka, Masahiko Kitano, Jae-Hyun Son, Toru Masuoka, Naoki Koketsu, Keiichi Akatsuka, Masamichi Kurosaki, Miyamori Tadao, Hiroaki Hondo, Kazumasa Yamatani, Hirofumi Oyama, Junji Koyama, Ogura Koichiro, Shinji Yamamoto, Hitoshi Tabata, Kazuya Uemura, Kazuhiko Sato, Hideyuki Yoshida, Takafumi Nishizaki, Hiroshi Egami, Hideo Takeshima, Shogo Ishiuchi, Akira Matsumura, Hiroyuki Kinouchi, Susumu Mekaru, Mikihiko Takeshita, Hitoshi Ozawa, Kiichiro Zenke, Takeshi Matsuyama, Toshikazu Kuwata, Teruyuki Habu, Tomoyoshi Okumura, Seiya Takehara, Rei Kondo, Takashi Kumagai, Keiten So, Sunao Takemura, Sonoda Yukihiko, Manabu Urakawa, Yasuhiro Hamada, Michiyasu Suzuki, Mikito Uchida, Hidehito Koizumi, Masaru Yamada, Takashi Tsuruno, Gen Ishida, Ryouichi Masuda, Makoto Kimura, Shinichirou Ishihara, Masashi Morikawa, Hidetoshi Murata, Katsumi Sakata, Motohiro Nomura, Akihiro Nemoto, Sumio Endou, Nobuo Hirota, Kennji Itou, Hiroaki Minami, and Yoshihumi Teramoto
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Medicine - Abstract
Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era.
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- 2023
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35. Association between IRF6, TP63, GREM1 Gene Polymorphisms and Non-Syndromic Orofacial Cleft Phenotypes in Vietnamese Population: A Case–Control and Family-Based Study
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Loc Nguyen Gia Pham, Teruyuki Niimi, Satoshi Suzuki, Minh Duc Nguyen, Linh Cao Hoai Nguyen, Tuan Duc Nguyen, Kien Ai Hoang, Duc Minh Nguyen, Chisato Sakuma, Toko Hayakawa, Makino Hiyori, Nagana Natsume, Hiroo Furukawa, Hideto Imura, Junko Akashi, Tohru Ohta, and Nagato Natsume
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IRF6 ,TP63 ,GREM1 ,cleft lip and palate ,cleft lip with or without cleft palate ,Genetics ,QH426-470 - Abstract
This study aims to identify potential variants in the TP63–IRF6 pathway and GREM1 for the etiology of non-syndromic orofacial cleft (NSOFC) among the Vietnamese population. By collecting 527 case–parent trios and 527 control samples, we conducted a stratified analysis based on different NSOFC phenotypes, using allelic, dominant, recessive and over-dominant models for case–control analyses, and family-based association tests for case–parent trios. Haplotype and linkage disequilibrium analyses were also conducted. IRF6 rs2235375 showed a significant association with an increased risk for non-syndromic cleft lip and palate (NSCLP) and cleft lip with or without cleft palate (NSCL/P) in the G allele, with pallele values of 0.0018 and 0.0003, respectively. Due to the recessive model (p = 0.0011) for the NSCL/P group, the reduced frequency of the GG genotype of rs2235375 was associated with a protective effect against NSCL/P. Additionally, offspring who inherited the G allele at rs2235375 had a 1.34-fold increased risk of NSCL/P compared to the C allele holders. IRF6 rs846810 and a G-G haplotype at rs2235375–rs846810 of IRF6 impacted NSCL/P, with p-values of 0.0015 and 0.0003, respectively. In conclusion, our study provided additional evidence for the association of IRF6 rs2235375 with NSCLP and NSCL/P. We also identified IRF6 rs846810 as a novel marker associated with NSCL/P, and haplotypes G-G and C-A at rs2235375–rs846810 of IRF6 associated with NSOFC.
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- 2023
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36. Close-Range Transmission Line Inspection Method for Low-Cost UAV: Design and Implementation
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Qi Wang, Wei Wang, Ziran Li, Akio Namiki, and Satoshi Suzuki
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power line inspection ,low-cost sensor ,waypoint correction ,Science - Abstract
With the rapid development of microelectronics, unmanned aerial vehicles (UAVs) for electric inspection tasks have become popular. Among these tasks, transmission line inspections are more complicated than component and tower inspections owing to the small size, poor functionality, and severe magnetic field interference of transmission lines. Existing solutions invariably use high-precision devices and maintain safety distances during inspections. However, capturing detailed transmission line information over long distances is challenging. Moreover, sophisticated equipment implies high costs and considerable value risks. This work proposes a method using RGB cameras and mm-wave radar to accomplish close-range transmission line inspections. A heading correction and two correction modules address waypoint mission mismatch and wind interference during tracking. In addition, adaptive complementary fusion is designed to solve anomaly identification. Finally, the proposed method validated in a 10 kV transmission line environment demonstrates successful close-range inspection while acquiring high-definition (HD) images. The validation results prove the practical feasibility of the proposed low-cost transmission line inspection method, which is of great significance for reducing inspection costs and promoting the popularization of UAV inspections.
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- 2023
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37. A displaced bronchus branching from the left main bronchus and bifurcating into the apicoposterior and anterior bronchi of the left upper lobe in a healthy adult male: A case report
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Akira Katayama, MD, Jiro Sato, MD, Yosuke Kano, MD, Yoko Mise, MD, PhD, Satoshi Suzuki, MD, and Osamu Abe, MD, PhD
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Left upper lobe ,Displaced bronchus ,Eparterial bronchus ,Pulmonary artery ,Accessory fissure ,Anomaly ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
A displaced left upper bronchus is a rare anomaly. We report the case of a 45-year-old man with a displaced bronchus, branching from the left main bronchus and bifurcating into the apicoposterior and anterior segment bronchi of the left upper lobe. The displaced bronchus passed behind the left pulmonary artery. To our knowledge, 12 similar cases of displaced bronchi have been reported to date. Displaced bronchi are difficult to detect prospectively on computed tomography. However, evaluating the accessory fissures may help establish an accurate diagnosis.
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- 2022
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38. Coronal Plane Gap Increases Postoperative Pseudoarthrosis after Lateral Interbody Fusion for Adult Spinal Deformity
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Eijiro Okada, Mitsuru Yagi, Yusuke Yamamoto, Satoshi Suzuki, Satoshi Nori, Osahiko Tsuji, Narihito Nagoshi, Nobuyuki Fujita, Masaya Nakamura, Morio Matsumoto, and Kota Watanabe
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spinal fusion ,scoliosis ,pseudoarthrosis ,Medicine - Abstract
Study Design This is a retrospective study. Purpose This study aims to evaluate the risk factor associated with pseudoarthrosis after placement of lateral interbody fusion (LIF) cages for adult spinal deformity (ASD) treatment. Overview of Literature LIF technique is widely used for ASD correction. Furthermore, pseudoarthrosis is a major complication of fusion surgery required for revision surgery. Methods This study included 42 patients with ASD (two men and 40 women; 112 segments; mean, 68.5±8.4 years; and mean follow-up, 31.6±17.0 months) who underwent LIF and posterior correction surgery. The concave slot of the LIF cage was filled with an autologous iliac crest bone graft (IBG), and the convex slot with a porous hydroxyapatite/collagen (HAp/Col) composite was soaked with bone marrow aspirate. Endplate injury, the gap between vertebral endplate and cage in the coronal or sagittal plane, and fusion status were evaluated using computed tomography multiplanar reconstruction at 12 months after surgery. Moreover, the associated risk factors for pseudoarthrosis were analyzed. Results Fusion at LIF segments were observed in 71.4% segments at 12 months after surgery. Fusion on the concave slot (autologous IBG side), convex slot (porous HAp/Col composite side), and both concave and convex slots were observed in 66.1%, 37.5%, and 36.6% of patients, respectively. Moreover, pseudoarthrosis was observed in 28.6% at 12 months after surgery. Consequently, logistic regression analysis of the fusion at the LIF segment revealed that the gap between the LIF cage and endplate in the coronal plane (p=0.030; odds ratio, 0.183; 95% confidence interval, 0.030–0.183) was significantly associated with pseudoarthrosis at the LIF segments. Conclusions ASD surgery fusion rate using LIF cages was 71.4% at 12 months after surgery. The fusion rate was higher on the concave slot filled with autologous IBG than on the convex slot filled with a porous HAp/Col composite. The gap in the coronal plane was a risk factor for pseudoarthrosis at the LIF segment.
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- 2022
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39. Serine hydroxymethyltransferase as a potential target of antibacterial agents acting synergistically with one-carbon metabolism-related inhibitors
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Yuko Makino, Chihiro Oe, Kazuya Iwama, Satoshi Suzuki, Akie Nishiyama, Kazuya Hasegawa, Haruka Okuda, Kazushige Hirata, Mariko Ueno, Kumi Kawaji, Mina Sasano, Emiko Usui, Toshiaki Hosaka, Yukako Yabuki, Mikako Shirouzu, Makoto Katsumi, Kazutaka Murayama, Hironori Hayashi, and Eiichi N. Kodama
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Biology (General) ,QH301-705.5 - Abstract
Structural and biophysical studies of the inhibition of bacterial serine hydroxymethyltransferase (SHMT) by a human SHMT inhibitor used for cancer therapy, (+)-SHIN-1, identify SHMT as a potent antibacterial target.
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- 2022
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40. Effect of sake lees on cheese components in cheese ripened by Aspergillus oryzae and lactic acid bacteria
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Tatsuro Hagi, Atsushi Kurahashi, Yoshifumi Oguro, Kazuya Kodaira, Miho Kobayashi, Sora Hayashida, Hideyuki Yamashita, Yousuke Arakawa, Takayuki Miura, Kaoru Sato, Satoru Tomita, Satoshi Suzuki, Ken-Ichi Kusumoto, Naoko Moriya, and Masaru Nomura
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sake lees ,Aspergillus oryzae ,cheese ,Dairy processing. Dairy products ,SF250.5-275 ,Dairying ,SF221-250 - Abstract
ABSTRACT: More than 2,000 varieties of cheese currently exist in the world, and cheese manufacture continues to flourish. To develop the cheese ripening process, additional ingredients are used during cheese production. In this study, the effect of sake lees as an additional ingredient on the fermentation of cheese using Aspergillus oryzae (koji mold), known as koji cheese, was investigated. Aspergillus oryzae is used in the fermentation of Japanese traditional foods, such as sake and soy sauce, given its strong enzymatic activities, as well as in cheese production (i.e., koji cheese). Sake lees, a by-product of the fermentation of rice with A. oryzae and yeasts in the sake brewing process, contains various metabolites, such as amino acids. Here, supplementation with sake lees enhanced the activities of lactic acid bacteria and affected the color of the cheese. Metabolome analysis revealed that sake lees altered the balance of carbohydrates and fatty acids in the cheese. Remarkably, supplementation with sake lees enhanced the production of umami-enhancing γ-glutamyl (kokumi-active) peptides. This study suggests that a new type of cheese can be produced using A. oryzae and sake lees, and information on the synergistic effects of A. oryzae and sake lees will aid the development of cheese production.
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- 2022
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41. Effect of carperitide on the 1 year prognosis of patients with acute decompensated heart failure
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Kazutaka Nogi, Tomoya Ueda, Yuya Matsue, Maki Nogi, Satomi Ishihara, Yasuki Nakada, Rika Kawakami, Nobuyuki Kagiyama, Takeshi Kitai, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Keisuke Kida, Takahiro Okumura, and Yoshihiko Saito
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Acute heart failure ,Atrial natriuretic peptide ,Carperitide ,Dosing ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Acute heart failure (AHF) is a clinical syndrome with a poor prognosis and a major public health concern worldwide. The aim of this study was to investigate whether carperitide administration improves the 1 year prognosis of patients with AHF and to check whether there is an optimal dose of the drug. Methods and results We analysed the data of COOPERATE‐HF‐J (the Consortium for Pooled Data Analysis regarding Hospitalized Patients with Heart Failure in Japan), combining two cohorts (NARA‐HF and REALITY‐AHF), which included 2435 patients with acute decompensated heart failure. The patients were divided into no carperitide (NO‐ANP, n = 1098); very low‐dose carperitide (VLD‐ANP,
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- 2022
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42. Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for patients with COVID-19 in A Real-Life Setting: A Single Institute Analysis
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Yasutaka Kakinoki, Kazuki Yamada, Yoko Tanino, Keiko Suzuki, Takaya Ichikawa, Naoki Suzuki, Go Asari, Ai Nakamura, Shin Kukita, Akito Uehara, Seisuke Saito, Shohei Kuroda, Hidemitsu Sakagami, Yuuki Nagashima, Kae Takahashi, and Satoshi Suzuki
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COVID-19 ,SARS-CoV-2 ,Cocktail ,Ronapreve ,REGEN-COV ,Infectious and parasitic diseases ,RC109-216 - Abstract
ABSTRACT: Background: Recent data from clinical trials suggest that antibody cocktail therapy, which combined casirivimab and imdevimab, is linked to the reduction of the risk of hospitalization or death among high-risk patients with COVID-19. However, it remains unclear how effective the therapy is in a real-life clinical practice. Methods: We retrospectively analyzed patients with COVID-19 with high-risk factors who underwent the antibody cocktail therapy, compared with those who were not given the cocktail therapy while being isolated in nonmedical facilities during the same period. Results: Data from 55 patients who received the antibody cocktail therapy and 53 patients with initial isolation in nonmedical facilities were analyzed. A total of 22 (41.5 %) of 53 patients staying in isolation facilities were eventually hospitalized and received medical interventions. By contrast, 13 (23.6 %) of 55 patients who received the antibody cocktail therapy subsequently underwent further medical interventions. In multivariate analysis, the antibody cocktail therapy significantly reduced the need for further medical interventions by 70 % compared with isolation (odds ratio=0.30, 95%CI [0.10-0.87], p=0.027). Patients with percutaneous oxygen saturation 96% or higher were significantly favoured for the therapy and had an advantage. Conclusion: The results of this study indicate that the antibody cocktail therapy is associated with reducing burden on hospitals during the COVID-19 pandemic.
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- 2022
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43. Consistently low levels of histidine-rich glycoprotein as a new prognostic biomarker for sepsis: A multicenter prospective observational study.
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Naoya Kawanoue, Kosuke Kuroda, Hiroko Yasuda, Masahiko Oiwa, Satoshi Suzuki, Hidenori Wake, Hiroki Hosoi, Masahiro Nishibori, Hiroshi Morimatsu, and Okayama Research Investigation Organizing Network (ORION)
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Medicine ,Science - Abstract
BackgroundFew sepsis biomarkers accurately predict severity and mortality. Previously, we had reported that first-day histidine-rich glycoprotein (HRG) levels were significantly lower in patients with sepsis and were associated with mortality. Since the time trends of HRG are unknown, this study focused on the time course of HRG in patients with sepsis and evaluated the differences between survivors and non-survivors.MethodsA multicenter prospective observational study was conducted involving 200 patients with sepsis in 16 Japanese hospitals. Blood samples were collected on days 1, 3, 5, and 7, and 28-day mortality was used for survival analysis. Plasma HRG levels were determined using a modified quantitative sandwich enzyme-linked immunosorbent assay.ResultsFirst-day HRG levels in non-survivors were significantly lower than those in survivors (mean, 15.7 [95% confidence interval (CI), 13.4-18.1] vs 20.7 [19.5-21.9] μg/mL; P = 0.006). Although there was no time × survivors/non-survivors interaction in the time courses of HRG (P = 0.34), the main effect of generalized linear mixed models was significant (P < 0.001). In a univariate Cox proportional hazards model with each variable as a time-dependent covariate, higher HRG levels were significantly associated with a lower risk of mortality (hazard ratio, 0.85 [95% CI, 0.78-0.92]; P < 0.001). Furthermore, presepsin levels (P = 0.02) and Sequential Organ Function Assessment scores (P < 0.001) were significantly associated with mortality. Harrell's C-index values for the 28-day mortality effect of HRG, presepsin, procalcitonin, and C-reactive protein were 0.72, 0.70, 0.63, and 0.59, respectively.ConclusionsHRG levels in non-survivors were consistently lower than those in survivors during the first seven days of sepsis. Repeatedly measured HRG levels were significantly associated with mortality. Furthermore, the predictive power of HRG for mortality may be superior to that of other singular biomarkers, including presepsin, procalcitonin, and C-reactive protein.
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- 2023
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44. Genetic association of IL17 and the importance of ABO blood group antigens in saliva to COVID-19
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Nao Nishida, Masaya Sugiyama, Yosuke Kawai, Izumi Naka, Noriko Iwamoto, Tetsuya Suzuki, Michiyo Suzuki, Yusuke Miyazato, Satoshi Suzuki, Shinyu Izumi, Masayuki Hojo, Takayo Tsuchiura, Miyuki Ishikawa, Jun Ohashi, Norio Ohmagari, Katsushi Tokunaga, and Masashi Mizokami
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Medicine ,Science - Abstract
Abstract The outbreak of COVID-19 caused by infection with SARS-CoV-2 virus has become a worldwide pandemic, and the number of patients presenting with respiratory failure is rapidly increasing in Japan. An international meta-analysis has been conducted to identify genetic factors associated with the onset and severity of COVID-19, but these factors have yet to be fully clarified. Here, we carried out genomic analysis based on a genome-wide association study (GWAS) in Japanese COVID-19 patients to determine whether genetic factors reported to be associated with the onset or severity of COVID-19 in the international meta-GWAS are replicated in the Japanese population, and whether new genetic factors exist. Although no significant genome-wide association was detected in the Japanese GWAS, an integrated analysis with the international meta-GWAS identified for the first time the involvement of the IL17A/IL17F gene in the severity of COVID-19. Among nine genes reported in the international meta-GWAS as genes involved in the onset of COVID-19, the association of FOXP4-AS1, ABO, and IFNAR2 genes was replicated in the Japanese population. Moreover, combined analysis of ABO and FUT2 genotypes revealed that the presence of oral AB antigens was significantly associated with the onset of COVID-19. FOXP4-AS1 and IFNAR2 were also significantly associated in the integrated analysis of the Japanese GWAS and international meta-GWAS when compared with severe COVID-19 cases and the general population. This made it clear that these two genes were also involved in not only the onset but also the severity of COVID-19. In particular, FOXP4-AS1 was not found to be associated with the severity of COVID-19 in the international meta-GWAS, but an integrated analysis with the Japanese GWAS revealed an association with severity. Individuals with the SNP risk allele found between IL17A and IL17F had significantly lower mRNA expression levels of IL17F, suggesting that activation of the innate immune response by IL17F may play an important role in the severity of SARS-CoV-2 infection.
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- 2022
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45. Remnant Tumor Margin as Predictive Factor for Its Growth After Incomplete Resection of Cervical Dumbbell-Shaped Schwannomas
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Kazuya Kitamura, Narihito Nagoshi, Osahiko Tsuji, Satoshi Suzuki, Satoshi Nori, Eijiro Okada, Mitsuru Yagi, Morio Matsumoto, Masaya Nakamura, and Kota Watanabe
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cervical spinal cord tumor ,dumbbell ,schwannoma ,residual tumor ,surgical margin ,mib-1 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Objective The purpose of our study was to investigate the risk factors of remnant tumor growth after incomplete resection (IR) of cervical dumbbell-shaped schwannomas (DS). Methods Twenty-one patients with IR of cervical DS with at least 2 years of follow-up were included and were divided into 2 groups: the remnant tumor growth (G) (n = 10) and no growth (NG) (n = 11) groups. The tumor location in the axial plane according to Toyama classification, the location of the remnant tumor margin, and the tumor growth rate (MIB-1 index) index were compared. Results No significant differences in Toyama classification and MIB-1 index were found. Age was significantly higher in the G group (61.4 years vs. 47.6 years; p=0.030), but univariate logistic regression analysis revealed little correlation to the growth (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.001–1.166; p=0.047). Seventeen patients (9 in the G and 8 in the NG group) underwent the posterior one-way approach, and significant differences in the location of the remnant tumor margin were confirmed: within the spinal canal in 1 and 0 case, at the entrance of the intervertebral foramen in 7 and 1 cases, and in the foramen distal from the entrance in 1 and 7 cases, in the G and NG groups, respectively (p=0.007). The proximal margin was identified as a significant predictor of the growth (OR, 56.0; 95% CI, 2.93–1,072; p=0.008). Conclusion Remnant tumors with margins distally away from the entrance of the foramen were less likely to grow after IR of cervical DS.
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- 2022
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46. Adjacent Segment Stenosis after Muscle-Preserving Selective Laminectomy: A Retrospective Study of Patients with a Minimum 10-Year Follow-Up
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Ryoma Aoyama, Tateru Shiraishi, Junichi Yamane, Ken Ninomiya, Yuichiro Takahashi, Kazuya Kitamura, Satoshi Nori, and Satoshi Suzuki
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adjacent segment ,stenosis ,laminectomy ,laminoplasty ,muscle-preserving ,Surgery ,RD1-811 - Abstract
Introduction: The present study aimed to understand the characteristics of adjacent segment stenosis post-surgery by examining the status of adjacent segment stenosis in patients with long-term follow-up after muscle-preserving selective laminectomy (SL). Methods: We examined 43 patients who underwent muscle-preserving SL at a single academic institution and were followed up for >10 years. The C2-C7 angle, C2-C7 sagittal vertical axis, range of motion, and C7 slope were measured using an X-ray lateral view. The anterior-posterior diameter of the spinal cord (AP of SC) and anterior-posterior diameter of the dural tube (AP of dura) at adjacent segment were measured using magnetic resonance imaging T2-weighted sagittal section. Residual space for the spinal cord at the adjacent segment (SAC) was calculated as the difference between AP of SC and AP of dura. Results: Four cases had cephalad adjacent segment stenosis at the last follow-up (upper stenosis (US) group), 9 cases had caudal adjacent segment stenosis ( lower stenosis (LS) group), and 30 cases had no stenosis (none (N) group). AP of SC, AP of dura, and SAC at the upper adjacent segment were significantly lower in the US group. AP of dura and SAC at the lower adjacent segment were significantly lower in the LS group. Multivariate logistic regression analysis revealed that the small AP of dura in the upper adjacent segment and small SAC in the lower adjacent segment were risk factors for developing a new stenosis. Conclusions: Decompression should be considered beforehand in adjacent segments with small AP of SC and small AP of dura when performing cervical decompression.
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- 2022
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47. Clinical implication of initial intravenous diuretic dose for acute decompensated heart failure
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Kenji Yoshioka, Daichi Maeda, Takahiro Okumura, Keisuke Kida, Shogo Oishi, Eiichi Akiyama, Satoshi Suzuki, Masayoshi Yamamoto, Akira Mizukami, Shunsuke Kuroda, Nobuyuki Kagiyama, Tetsuo Yamaguchi, Tetsuo Sasano, Akihiko Matsumura, Takeshi Kitai, and Yuya Matsue
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Medicine ,Science - Abstract
Abstract Although intravenous diuretics is a cornerstone of acute heart failure treatment (AHF), its optimal initial dose is unclear. This is a post-hoc analysis of the REALITY-AHF, a prospective multicentre observational registry of AHF. The initial intravenous diuretic dose used in each patient was categorised into below, standard, or above the recommended dose groups according to guideline-recommended initial intravenous diuretic dose. The recommended dose was individualised based on the oral diuretic dose taken at admission. We compared the study endpoints, including 60-day mortality, diuretics response within six hours, and length of hospital stay (HS). Of 1093 patients, 429, 558, and 106 were assigned to the Below, Standard, and Above groups, respectively. The diuretics response and HS were significantly greater in the Below group than in the Standard group after adjusting for covariates. Kaplan–Meier analysis indicated a significantly higher incidence of 60-day mortality in the Above group than the Standard group. This difference was retained after adjusting for other prognostic factors. Treatment with a lower than guideline-recommended intravenous diuretic dose was associated with longer HS, whereas above the guideline-recommended dose was associated with a higher 60-day mortality rate. Our results reconfirm that the guideline-recommended initial intravenous diuretic dose is feasible for AHF.
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- 2022
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48. Knowledge Transferred Fine-Tuning: Convolutional Neural Network Is Born Again With Anti-Aliasing Even in Data-Limited Situations
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Satoshi Suzuki, Shoichiro Takeda, Naoki Makishima, Atsushi Ando, Ryo Masumura, and Hayaru Shouno
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Anti-aliasing ,convolutional neural network ,data-limited situation ,knowledge transfer ,Electrical engineering. Electronics. Nuclear engineering ,TK1-9971 - Abstract
Anti-aliased convolutional neural networks (CNNs) are models that introduce blur filters to intermediate representations of CNNs to achieve high accuracy in image recognition tasks. A promising way to prepare a new anti-aliased CNN is to introduce blur filters to the intermediate representations of pre-trained (non anti-aliased) CNNs, since many researchers have released them online. Although this scheme can build the new anti-aliased CNN easily, the blur filters drastically degrade the pre-trained representations. Therefore, to take full advantage of the benefits of introducing blur filters, fine-tuning using massive amounts of training data is often required. This can be problematic because the training data is often limited. In such a “data-limited” situation, the fine-tuning does not bring about a high performance because it induces overfitting to the limited training data. To tackle this problem, we propose “knowledge transferred fine-tuning.” Knowledge transfer is a technique that utilizes the representations of a pre-trained model to help ensure generalization in data-limited situations. Inspired by this concept, we transfer knowledge from intermediate representations in a pre-trained CNN to an anti-aliased CNN while fine-tuning. The key idea of our method is to transfer only the essential knowledge for image recognition in the pre-trained CNN using two types of loss: pixel-level loss and global-level loss. The former loss transfers the detailed knowledge from the pre-trained CNN, but this knowledge may contain “aliased” non-essential knowledge. The latter loss, on the other hand, is designed to increase when the pixel-level loss transfers non-essential knowledge while ignoring the essential knowledge, i.e., it penalizes the pixel-level loss. Experimental results demonstrate that the proposed method using just 25 training images per class on ImageNet 2012 can achieve higher accuracy than a conventional pre-trained CNN.
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- 2022
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49. Diagnostic error rates and associated factors for lower gastrointestinal perforation
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Taku Harada, Takashi Watari, Satoshi Watanuki, Juichi Hiroshige, Seiko Kushiro, Taiju Miyagami, Syunsuke Syusa, Satoshi Suzuki, Tetsuya Hiyoshi, Suguru Hasegawa, Shigeki Nabeshima, Hidetoshi Aihara, Shun Yamashita, Masaki Tago, Fumitaka Yoshimura, Kotaro Kunitomo, Takahiro Tsuji, Masanori Hirose, Tomoya Tsuchida, and Taro Shimizu
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Medicine ,Science - Abstract
Abstract Lower gastrointestinal perforation is rare and challenging to diagnose in patients presenting with an acute abdomen. However, no study has examined the frequency and associated factors of diagnostic errors related to lower gastrointestinal perforation. This large-scale multicenter retrospective study investigated the frequency of diagnostic errors and identified the associated factors. Factors at the level of the patient, symptoms, situation, and physician were included in the analysis. Data were collected from nine institutions, between January 1, 2015 and December 31, 2019. Timely diagnosis was defined as diagnosis at the first visit in computed tomography (CT)-capable facilities or referral to an appropriate medical institution immediately following the first visit to a non-CT-capable facility. Cases not meeting this definition were defined as diagnostic errors that resulted in delayed diagnosis. Of the 439 cases of lower gastrointestinal perforation identified, delayed diagnosis occurred in 138 cases (31.4%). Multivariate logistic regression analysis revealed a significant association between examination by a non-generalist and delayed diagnosis. Other factors showing a tendency with delayed diagnosis included presence of fever, absence of abdominal tenderness, and unavailability of urgent radiology reports. Initial misdiagnoses were mainly gastroenteritis, constipation, and small bowel obstruction. In conclusion, diagnostic errors occurred in about one-third of patients with a lower gastrointestinal perforation.
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- 2022
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50. Model-Free Guidance Method for Drones in Complex Environments Using Direct Policy Exploration and Optimization
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Hongxun Liu and Satoshi Suzuki
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drones ,reinforcement learning ,policy optimization ,model-free ,traverse complex environments ,Motor vehicles. Aeronautics. Astronautics ,TL1-4050 - Abstract
In the past few decades, drones have become lighter, with longer hang times, and exhibit more agile performance. To maximize their capabilities during flights in complex environments, researchers have proposed various model-based perception, planning, and control methods aimed at decomposing the problem into modules and collaboratively accomplishing the task in a sequential manner. However, in practical environments, it is extremely difficult to model both the drones and their environments, with very few existing model-based methods. In this study, we propose a novel model-free reinforcement-learning-based method that can learn the optimal planning and control policy from experienced flight data. During the training phase, the policy considers the complete state of the drones and environmental information as inputs. It then self-optimizes based on a predefined reward function. In practical implementations, the policy takes inputs from onboard and external sensors and outputs optimal control commands to low-level velocity controllers in an end-to-end manner. By capitalizing on this property, the planning and control policy can be improved without the need for an accurate system model and can drive drones to traverse complex environments at high speeds. The policy was trained and tested in a simulator, as well as in real-world flight experiments, demonstrating its practical applicability. The results show that this model-free method can learn to fly effectively and that it holds great potential to handle different tasks and environments.
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- 2023
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