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51.
Rahul S. Loungani Marat Fudim Dave Ranney Ajar Kochar Marc D. Samsky Desiree Bonadonna Akinobu Itoh Hiroo Takayama Koji Takeda Daniel Wojdyla Adam D. DeVore Mani Daneshmand 《Journal of cardiac failure》2021,27(3):327-337
BackgroundVenoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used as a life-saving therapy for patients with cardiovascular collapse, but identifying patients unlikely to benefit remains a challenge.Methods and ResultsWe created the RESCUE registry, a retrospective, observational registry of adult patients treated with VA-ECMO between January 2007 and June 2017 at 3 high-volume centers (Columbia University, Duke University, and Washington University) to describe short-term patient outcomes. In 723 patients treated with VA-ECMO, the most common indications for deployment were postcardiotomy shock (31%), cardiomyopathy (including acute heart failure) (26%), and myocardial infarction (17%). Patients frequently suffered in-hospital complications, including acute renal dysfunction (45%), major bleeding (41%), and infection (33%). Only 40% of patients (n = 290) survived to discharge, with a minority receiving durable cardiac support (left ventricular assist device [n = 48] or heart transplantation [n = 7]). Multivariable regression analysis identified risk factors for mortality on ECMO as older age (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.12–1.42) and female sex (OR, 1.44; 95% CI, 1.02–2.02) and risk factors for mortality after decannulation as higher body mass index (OR 1.17; 95% CI, 1.01-1.35) and major bleeding while on ECMO support (OR, 1.92; 95% CI, 1.23–2.99).ConclusionsDespite contemporary care at high-volume centers, patients treated with VA-ECMO continue to have significant in-hospital morbidity and mortality. The optimization of outcomes will require refinements in patient selection and improvement of care delivery. 相似文献
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Manabu Fujimoto Jun Asai Yoshihide Asano Takayuki Ishii Yohei Iwata Tamihiro Kawakami Masanari Kodera Masatoshi Abe Masahiro Amano Ryuta Ikegami Taiki Isei Zenzo Isogai Takaaki Ito Yuji Inoue Ryokichi Irisawa Masaki Ohtsuka Yoichi Omoto Hiroshi Kato Takafumi Kadono Sakae Kaneko Hiroyuki Kanoh Masakazu Kawaguchi Ryuichi Kukino Takeshi Kono Monji Koga Keisuke Sakai Eiichi Sakurai Yasuko Sarayama Yoichi Shintani Miki Tanioka Hideaki Tanizaki Jun Tsujita Naotaka Doi Takeshi Nakanishi Akira Hashimoto Minoru Hasegawa Masahiro Hayashi Kuninori Hirosaki Hideki Fujita Hiroshi Fujiwara Takeo Maekawa Koma Matsuo Naoki Madokoro Sei-Ichiro Motegi Hiroshi Yatsushiro Osamu Yamasaki Yuichiro Yoshino Andres James LE Pavoux Takao Tachibana Hironobu Ihn Japanese Dermatological Association Guidelines 《The Journal of dermatology》2020,47(10):1071-1109
The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS. 相似文献
54.
Akio Akagi Yasushi Iwasaki Akihiro Yamamoto Hiroshi Matsuura Toshimasa Ikeda Maya Mimuro Yuichi Riku Hiroaki Miyahara Tetsuyuki Kitamoto Mari Yoshida 《Neuropathology》2020,40(4):399-406
We report a case of early-phase sporadic Creutzfeldt–Jakob disease (sCJD) complicated by intracerebral hemorrhage (ICH), classified as MM1 + 2C-type based on autopsy. A 61-year-old Japanese man presented to our hospital with speaking difficulties including repeated usage of the same words. He was hospitalized on the seventh day after symptom onset, and diffusion-weighted images on magnetic resonance imaging showed hyperintense regions in the frontal cortex and caudate nucleus. On the 11th day after symptom onset, head computed tomography revealed ICH in the right occipital and parietal lobes. Routine laboratory evaluations and angiography revealed no cause of ICH. Myoclonus of the extremities and drowsiness were observed on the 15th day after symptom onset. He reached the state of akinetic mutism approximately two months after symptom onset. The cerebrospinal fluid test revealed positive real-time quaking-induced conversion and 14-3-3 protein. Electroencephalography revealed periodic sharp wave complexes. A clinical diagnosis of probable Creutzfeldt–Jakob disease was made according to the diagnostic criteria. After a relapse of pneumonia, he passed away on the 103rd day after symptom onset. Postmortem examination revealed ICH in the right posterior cingulate gyrus. No pathological change that might have caused ICH was obtained. Although the effect of sCJD on the onset of ICH is undeniable, the cause of ICH was unknown. Prion protein immunohistochemistry revealed the following results: (1) weak synaptic-type deposits in the tissue rarefacted by ICH; (2) synaptic-type deposits in the cerebral cortex, which showed fine vacuoles; and (3) perivacuolar-type deposits in the inferior temporal gyrus and lingual gyrus, which showed frequent large confluent vacuoles. Although it could be considered MM1-type sCJD clinically, this case was neuropathologically diagnosed as having MM1 + 2C-type sCJD. It was shown that ICH may occur in early-phase sCJD. To improve sCJD prognosis, treatment of complications and careful follow up are important. Furthermore, pathological diagnosis is indispensable for sCJD type diagnosis. 相似文献
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Tatsuki Ueda Ayako Kumagai Shoichi Iriguchi Yutaka Yasui Tadayo Miyasaka Kengo Nakagoshi Kazuki Nakane Keigo Saito Mari Takahashi Aki Sasaki Shinsuke Yoshida Naoko Takasu Hiroshi Seno Yasushi Uemura Koji Tamada Tetsuya Nakatsura Shin Kaneko 《Cancer science》2020,111(5):1478-1490
The use of allogeneic, pluripotent stem‐cell‐derived immune cells for cancer immunotherapy has been the subject of recent clinical trials. In Japan, investigator‐initiated clinical trials will soon begin for ovarian cancer treatment using human leukocyte antigen (HLA)‐homozygous‐induced pluripotent stem cell (iPSC)‐derived anti–glypican‐3 (GPC3) chimeric antigen receptor (CAR)‐expressing natural killer/innate lymphoid cells (NK/ILC). Using pluripotent stem cells as the source for allogeneic immune cells facilitates stringent quality control of the final product, in terms of efficacy, safety and producibility. In this paper, we describe our methods for the stable, feeder‐free production of CAR‐expressing NK/ILC cells from CAR‐transduced iPSC with clinically relevant scale and materials. The average number of cells that could be differentiated from 1.8‐3.6 × 106 iPSC within 7 weeks was 1.8‐4.0 × 109. These cells showed stable CD45/CD7/CAR expression, effector functions of cytotoxicity and interferon gamma (IFN‐γ) production against GPC3‐expressing tumor cells. When the CAR‐NK/ILC cells were injected into a GPC3‐positive, ovarian‐tumor‐bearing, immunodeficient mouse model, we observed a significant therapeutic effect that prolonged the survival of the animals. When the cells were injected into immunodeficient mice during non–clinical safety tests, no acute systemic toxicity or tumorigenicity of the final product or residual iPSC was observed. In addition, our test results for the CAR‐NK/ILC cells generated with clinical manufacturing standards are encouraging, and these methods should accelerate the development of allogeneic pluripotent stem cell‐based immune cell cancer therapies. 相似文献
58.
Nanami Gotoh Yusuke Minato Takayuki Saitoh Noriyuki Takahashi Tetsuhiro Kasamatsu Kana Souma Tsukasa Oda Takumi Hoshino Toru Sakura Takuma Ishizaki Hiroaki Shimizu Makiko Takizawa Akihiko Yokohama Norifumi Tsukamoto Hiroshi Handa Hirokazu Murakami 《European journal of haematology》2020,104(6):526-537
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60.
David J. Seiffge MD Gian Marco De Marchis MD Masatoshi Koga MD PhD Maurizio Paciaroni MD Duncan Wilson PhD Manuel Cappellari MD Kosmas Macha MD Georgios Tsivgoulis MD Gareth Ambler PhD Shoji Arihiro MD Leo H. Bonati MD Bruno Bonetti MD Bernd Kallmünzer MD Keith W. Muir MD PhD Paolo Bovi MD Henrik Gensicke MD Manabu Inoue MD Stefan Schwab MD Shadi Yaghi MD Martin M. Brown MD PhD FRCP Philippe Lyrer MD Masahito Takagi MD PhD Monica Acciarrese MD Hans Rolf Jager MD FRCP Alexandros A. Polymeris MD Kazunori Toyoda MD PhD Michele Venti MD Christopher Traenka MD Hiroshi Yamagami MD PhD Andrea Alberti MD Sohei Yoshimura MD PhD Valeria Caso MD Stefan T. Engelter MD David J. Werring MD PhD FRCP the RAF RAF-DOAC CROMIS- SAMURAI NOACISP Erlangen and Verona registry collaborators 《Annals of neurology》2020,87(5):677-687