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1.
Tetsuo Yamaguchi Daisuke Ueshima Makoto Utsunomiya Akihiro Matsui Toru Miyazaki Masaaki Matsumoto Tsukasa Shimura Naotaka Murata Yasushi Komatsu Kazuki Tobita Yo Fujimoto Takahide Kodama Kenji Suzuki Hitoshi Anzai Kentaro Jujo Michiaki Higashitani 《Journal of cardiology》2021,77(2):109-115
BackgroundMalnutrition measured by the geriatric nutritional risk index (GNRI) was reported to be associated with poor prognosis for patients with peripheral artery disease (PAD). However, the optimal cut-off value of preprocedural GNRI for critical limb ischemia (CLI) and intermittent claudication (IC) is unknown. We aimed to determine its optimal cut-off value for CLI or IC patients requiring endovascular revascularization.MethodsWe explored data of 2246 patients (CLI: n = 1061, IC: n = 1185) registered in the Tokyo-taMA peripheral vascular intervention research COmraDE (TOMA-CODE) registry, which prospectively enrolled consecutive PAD patients who underwent endovascular revascularization in 34 hospitals in Japan from August 2014 to August 2016. The optimal cut-off values of GNRI were assessed by the survival classification and regression tree (CART) analyses, and the survival curve analyses for major adverse cardiovascular and limb events (MACLEs) were performed for these cut-off values.ResultsIn addition to the first cut-off value of 96.2 in CLI and 85.6 in IC, the survival CART provided an additional cut-off value of 78.2 in CLI and 106.0 in IC for further risk stratification. The survival curve was significantly stratified by the GNRI-based malnutrition status in both CLI [high risk: 47.7% (51/107), moderate: 30.1% (118/392), and low: 10.2% (53/520), log–rank p < 0.001] and IC [high risk: 14.3% (7/49), moderate: 4.5% (29/646), and low: 0.5% (2/407), log–rank p < 0.001]. The multivariate Cox-proportional hazard analysis showed that a higher GNRI was significantly associated with a better outcome in both CLI [hazard ratio (HR) per 1-point increase: 0.97, 95% CI: 0.96–0.98, p < 0.001] and IC (HR: 0.94, 95% CI: 0.91–0.97, p < 0.001).ConclusionsPreprocedural nutritional status significantly stratified future events in patients with PAD. Given that the optimal cut-off value of GNRI in CLI was almost 10-points lower than that of IC, using a disease-specific cut-off value is important for risk stratification. 相似文献
2.
3.
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
4.
ObjectivesWe sought to evaluate whether the cutaneous silent period (CSP) could be an electrophysiological indicator reflective of the effects of therapy for Parkinson's disease (PD), including anti-PD medications or deep brain stimulation (DBS).Material and MethodsWe recorded the CSP in 43 patients with PD prior to and following the administration of medication during a pre-DBS evaluation (30 cases) and the “on” and “off” states of subthalamic nucleus DBS (13 cases). The CSP was elicited from the abductor pollicis brevis muscle by an electrical stimulation of the index finger that was 2, 4, and 15 times stronger than the sensory threshold (ST). We measured changes in latencies, including the onset, duration, and end of CSP, and waveform scores from 0 to 3. The correlation between the CSP score and unified PD rating score part III (UPDRS-III) also was assessed.ResultsThe onset latency and duration of CSP were significantly different between high- (15ST) and low-strength stimulations (2ST and 4ST). However, there were no significant latency changes (onset, duration, end of CSP) before and after receiving medication, or during the on and off state of the DBS. Anti-PD medications substantially increased the CSP waveform score only in the 4ST state. However, the waveform score significantly increased in all stimuli states during the DBS-on state. Both medication and the DBS-on state decreased the UPDRS-III. Nevertheless, there was no statistically significant correlation between the UPDRS-III and CSP waveform scores.ConclusionDifferent onset latencies and the duration of CSP between low- and high-strength stimuli support the hypotheses proposing two different reflex pathways. Despite being independent from the UPDRS-III, the CSP may be an electrophysiological indicator reflective of the changes in inhibitory activity to the spinal α-motoneuron in response to anti-PD medications and DBS. 相似文献
5.
Masahiro Waza Keisuke Maeda Chihiro Katsuragawa Atsuko Sugita Ryotarou Tanaka Asako Ohtsuka Tomo Matsui Keiko Kitagawa Taiki Kishimoto Hiroko Fukui Katsuhisa Kawai Masahiko Yamamoto Michio Isono 《Journal of the American Medical Directors Association》2019,20(4):426-431
Objective
To determine the influence of the Kuchi-kara Taberu (KT) index on rehabilitation outcomes during hospitalized convalescent rehabilitation.Design
A historical controlled study.Setting and Participants
A rehabilitation hospital.Participants
Patients who were admitted to a convalescent rehabilitation ward from June 2014 to May 2017.Measures
Patients’ background characteristics included age, sex, nutritional status, activities of daily living (ADL) assessed using the Functional Impedance Measure (FIM), dysphagia assessed using the Functional Oral Intake Scale (FOIS), and reasons for rehabilitation. The following values before (control group) and after initiation of the KT index intervention period (intervention group) were compared: gain of FIM, length of stay, accumulated rehabilitation time, discharge destination, gain of FOIS, gain of body weight (BW), and nutritional intake (energy and protein).Results
Mean age was 76.4 ± 12.3 years (n = 233). There were no significant differences in the baseline characteristics of the patients at admission between the control and intervention groups, except for reason of rehabilitation. The intervention group demonstrated statistically higher values for the total (P = .004) and motor FIM gain (P = .003), total (P = .018) and motor FIM efficiency (P = .016), and FOIS gain (P < .001), compared with values in the control group. The proportion of patients returning home was statistically more frequent in the intervention group compared with that in the control group (73.4% vs 85.5%, odds ratio 2.135, 95% confidence interval [CI] 1.108-4.113, P = .022). Multivariate analyses indicated that intervention using the KT index was a significant independent factor for increased FIM gain (β coefficient = 0.163, 95% CI 1.379-8.329, P = .006) and returning home (adjusted odds ratio 2.570, 95% CI 1.154-5.724, P = .021).Conclusions/Implications
A rehabilitation program using the KT index may lead to improvement of inpatient outcomes in post-acute care. Further prospective research is warranted to confirm the efficacy of this program. 相似文献6.
Hiroshi Watanabe Aya Miyagawa‐Hayashino Tatsuya Imabayashi Mitsuo Kishimoto Masanori Shimomura Kohei Honda Ikoi Omatsu Eri Shimada Masayoshi Inoue Koichi Takayama Eiichi Konishi 《Pathology international》2019,69(12):721-726
We herein describe a rare case of low‐grade endobronchial tumor that exhibited two distinct features of typical carcinoid and acinic cell carcinoma (ACC) by immunohistochemical and ultrastructure study. ACC was suspected on transbronchial biopsy. The resected specimen showed that the tumor surface comprised an acinic cell component (40% of the tumor), and the central area comprised typical carcinoid (60% of the tumor). The acinic cell component was positive for chromogranin A, synaptophysin and alpha‐1‐antichymotrypsin. Additionally, this component showed focal apical membranous staining for DOG1 and weak positivity for BCL10 and SOX10. Conversely, the carcinoid component was negative for all proteins except for chromogranin A and synaptophysin. Electron microscopy indicated zymogen‐type granules (600–800 nm in diameter) in the acinic cell component, whereas neuroendocrine‐type granules (200–300 nm in diameter) were observed in the carcinoid component. Nuclear NR4A3 immunostaining, which is highly specific for ACC of the salivary gland, was negative in this case. We conclude that the pulmonary carcinoid tumor with true zymogen‐type granules could be seen but showed superficial similarities to ACC based on negative nuclear staining for NR4A3. Pulmonary carcinoids encompass a wide morphological spectrum and may exhibit prominent acinic cell differentiation. 相似文献
7.
Masaya Sekimizu Akihiko Yoshida Sachiyo Mitani Naofumi Asano Makoto Hirata Takashi Kubo Fumito Yamazaki Hiromi Sakamoto Mamoru Kato Naohiro Makise Taisuke Mori Naoya Yamazaki Shigeki Sekine Ichiro Oda Shun‐ichi Watanabe Hiroaki Hiraga Tsukasa Yonemoto Teruya Kawamoto Norifumi Naka Yuki Funauchi Yoshihiro Nishida Kanya Honoki Hirotaka Kawano Hiroyuki Tsuchiya Toshiyuki Kunisada Koichi Matsuda Katsunori Inagaki Akira Kawai Hitoshi Ichikawa 《Genes, chromosomes & cancer》2019,58(6):373-380
Granular cell tumors (GCTs) are rare mesenchymal tumors that exhibit a characteristic morphology and a finely granular cytoplasm. The genetic alterations responsible for GCT tumorigenesis had been unknown until recently, when loss‐of‐function mutations of ATP6AP1 and ATP6AP2 were described. Thus, we performed whole‐exome sequencing, RNA sequencing, and targeted sequencing of 51 GCT samples. From these genomic analyses, we identified mutations in genes encoding vacuolar H+‐ATPase (V‐ATPase) components, including ATP6AP1 and ATP6AP2, in 33 (65%) GCTs. ATP6AP1 and ATP6AP2 mutations were found in 23 (45%) and 2 (4%) samples, respectively, and all were truncating or splice site mutations. In addition, seven other genes encoding V‐ATPase components were also mutated, and three mutations in ATP6V0C occurred on the same amino acid (isoleucine 136). These V‐ATPase component gene mutations were mutually exclusive, with one exception. These results suggest that V‐ATPase function is impaired in GCTs not only by loss‐of‐function mutations of ATP6AP1 and ATP6AP2 but also through mutations of other subunits. Our findings provide additional support for the hypothesis that V‐ATPase dysfunction promotes GCT tumorigenesis. 相似文献
8.
Influence of preparation features on retention and resistance. Part II: three-quarter crowns 总被引:2,自引:0,他引:2
Four three-quarter crown variations were tested for retention and resistance and compared with results of a previous study.15 Preparations with boxes or four grooves are the most retentive of the three-quarter crown designs used in the study. Lingual placement of proximal grooves enhanced the retention. Three-quarter crowns with V-shaped grooves are the least resistant of the preparation designs with retention/resistance features. 相似文献
9.
Kishimoto H Urade M Noguchi K Sakurai K 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2001,91(1):85-88
A case of common variable immunodeficiency with unusual vegetative lesions of the tongue and lower lip in a 28-year-old man is presented. The vegetative lesions developed over the preceding 10 months and clinically were suggestive of malignancy. The biopsy specimens showed no malignancy, and a bacterial culture of the tongue detected abundant Staphylococcus aureus. Combined treatment with a corticosteroid antibiotic ointment and povidone iodine rinse produced remarkable resolution of the lesions. Laboratory examination showed markedly decreased levels of serum immunoglobulins. Intravenous gamma globulin replacement therapy resulted in good control of infection and disappearance of the lesions. 相似文献
10.
Sano T Westesson PL Yamamoto M Okano T 《Cranio : the journal of craniomandibular practice》2004,22(4):283-288
This study investigated the differences of age distribution and temporomandibular joint (TMJ) pain between marrow edema and osteonecrosis in the mandibular condyle. Subjects consisted of 35 TMJs in 35 patients with abnormal bone marrow on MR images who were selected from a consecutive series of 527 patients with TMJ disorders. Proton density and T2-weighted MR images taken in the oblique sagittal and coronal planes were used to diagnose condylar marrow abnormalities and divide them into either edema or osteonecrosis. The differences in TMJ pain and age distribution for these two abnormalities were assessed with the one-sided Wilcoxon rank sum test with 0.05 alpha level. The degree of pain was higher in joints with marrow edema than in joints with osteonecrosis (p = 0.033). The mean age was higher in joints with osteonecrosis (p < 0.001). Our results suggest that there is more severe pain in TMJs with marrow edema of the mandibular condyle than in those with osteonecrosis. Since the patients with marrow edema have lower age, it also appears that marrow edema may be a precursor condition for osteonecrosis of the TMJ. 相似文献