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Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios alone or combined with prostate-specific antigen for the diagnosis of prostate cancer and clinically significant prostate cancer

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Asian Journal of Urology 2023年第2期10卷 158-165页

作者： Sat Prasad Nepal Takehiko Nakasato Takashi Fukagai Yoshio Ogawa Yoshihiro Nakagami Takeshi Shichijo Jun Morita Yoshiko Maeda Kazuhiko Oshinomi Tsutomu Unoki Tetsuo Noguchi Tatsuki Inoue Ryosuke Kato satoshi amano Moyuru Mizunuma Masahiro Kurokawa Yoshiki Tsunokawa Sou Yasuda Department of Urology Department of MedicineShowa University School of Medicine1-5-8 HatanodaiShinagawa-kuTokyoJapan

Objective:We evaluated whether the blood parameters before prostate biopsy can diagnose prostate cancer(PCa)and clinically significant PCa(Gleason score[GS]7)in our hospital.Methods:This study included patients with increased prostate-specific antigen(PSA)up to 20 ng/mL.The associations of neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)alone or with PSA with PCa and clinically significant PCa were analyzed.Results:We included 365 patients,of whom 52.9%(193)had PCa including 66.8%(129)with GS of≥7.PSA density(PSAD)and PSA had better the area under the curve(AUC)of 0.722 and 0.585,respectively with pZ0.001 for detecting PCa compared with other blood parameters.PSA combined with PLR(PsPLR)and PSA with NLR(PsNLR)had better AUC of 0.608 and 0.610,respectively with p<0.05,for diagnosing GS≥7 population,compared with PSA,free/total PSA,NLR,PLR,and PsNPLR(PSA combined with NLR and PLR).NLR and PLR did not predict PCa on multivariate analysis.For GS≥7 cancer detection,in the multivariate analysis,separate models with PSA and NLR(Model 1:PsNLRþbaseline parameters)or PSA and PLR(Moder 2:PsPLRþbaseline parameters)were made.Baseline parameters comprised age,digital rectal exam-positive lesions,PSA density,free/total PSA,and magnetic resonance imaging.Model 2 containing PsPLR was statistically significant(odds ratio:2.862,95% confidence interval:1.174-6.975,p=0.021)in finding aggressive PCa.The predictive accuracy of Model 2 was increased(AUC:0.734,p<0.001)than that when only baseline parameters were used(AUC:0.693,p<0.001).Conclusion:NLR or PLR,either alone or combined with PSA,did not detect PCa.However,the combined use of PSA with PLR could find the differences between clinically significant and insignificant PCa in our retrospective study limited by the small number of samples.

关键词： Blood parameter Gleason score Neutrophil-tolymphocyte ratio Platelet-tolymphocyte ratio Prostate cancer

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Evaluation of mitral chordae tendineae length using four-dimensional computed

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World Journal of Cardiology 2024年第5期16卷 274-281页

作者： Takuya Mori satoshi Matsushita Terumasa Morita Abulaiti Abudurezake Junji Mochizuki Atsushi amano Department of Cardiovascular Surgery Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of Cardiovascular Surgery JACCT Japan Animal Cardiovascular Care TeamOsaka 533-0033Japan Department of Radiology Minamino Cardiovascular HospitalTokyo 192-0918Japan

BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral regurgitation.Achieving precise measurements of artificial chordae tendineae length(CL)is an important factor in the procedure;however,no objective index currently exists to facilitate this measurement.Therefore,preoperative assessment of CL is critical for surgical planning and support.Four-dimensional x-ray micro-computed tomography(4D-CT)may be useful for accurate CL measurement considering that it allows for dynamic three-dimensional(3D)evaluation compared to that with transthoracic echocardiography,a conventional inspection method.AIM To investigate the behavior and length of mitral chordae tendineae during systole using 4D-CT.METHODS Eleven adults aged>70 years without mitral valve disease were evaluated.A 64-slice CT scanner was used to capture 20 phases in the cardiac cycle in electrocardiographic synchronization.The length of the primary chordae tendineae was measured from early systole to early diastole using the 3D image.The primary chordae tendineae originating from the anterior papillary muscle and attached to the A1-2 region and those from the posterior papillary muscle and attached to the A2-3 region were designated as cA and cP,respectively.The behavior and maximum lengths[cA(ma),cP(max)]were compared,and the correlation with body surface area(BSA)was evaluated.RESULTS In all cases,the mitral anterior leaflet chordae tendineae could be measured.In most cases,the cA and cP chordae tendineae could be measured visually.The mean cA(max)and cP(max)were 20.2 mm±1.95 mm and 23.5 mm±4.06 mm,respectively.cP(max)was significantly longer.The correlation coefficients(r)with BSA were 0.60 and 0.78 for cA(max)and cP(max),respectively.Both cA and cP exhibited constant variation in CL during systole,with a maximum 1.16-fold increase in cA and a 1.23-fold increase in cP from early to mid-systole.For cP,CL reached a plateau at 15%and remained elongated until end-systole,whereas for cA,aft

关键词： Mitral valve Chordae tendineae Computed tomography Four-dimensional Cardiac cycle

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Fragmented QRS complex with an additional R-wave attenuated by short RR interval in a patient with acute pulmonary embolism and cardiogenic shock

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Journal of Geriatric Cardiology 2022年第12期19卷 995-1000页

作者： Koji Takahashi Hiromasa Nakahara Eiji Arimitsu satoshi Imamine Yoshiyasu Obata Kimio Nakanishi Yoshiyasu Taniguchi Maiko amano Chika Omori Takafumi Okura Department of Community Emergency Medicine Ehime University Graduate School of MedicineEhimeJapan Department of Cardiology Yawatahama City General HospitalEhimeJapan Department of Internal Medicine Oozu City HospitalEhimeJapan Department of Clinical Laboratory Oozu City HospitalEhimeJapan

Registries and hospital discharge datasets of unselected patients with pulmonary embolism show 30-day all-cause mortality rates of approximately 10%.[1]Clinical findings from histories and physical examinations,such as age,systemic blood pressure,and respiratory rate at presentation,classify patients into risk classes of increasing risk of death and other adverse medical outcomes.

关键词： mortality patients Clinical

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Laparoscopic Kasai portoenterostomy can be a standard surgical procedure for treatment of biliary atresia

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World Journal of Gastrointestinal Surgery 2022年第1期14卷 56-63页

作者： Chiyoe Shirota Akinari Hinoki Takahisa Tainaka Wataru Sumida Fumie Kinoshita Kazuki Yokota satoshi Makita Hizuru amano Yoichi Nakagawa Hiroo Uchida Department of Pediatric Surgery Nagoya University Graduate School of MedicineNagoya 4668550AichiJapan Rare/Intractable Cancer Analysis Research Nagoya University Graduate School of MedicineNagoya 4668550AichiJapan Department of Advanced Medicine Nagoya University HospitalNagoya 466-8560AichiJapan

BACKGROUND Biliary atresia(BA)is a rare pediatric disease.AIM To compare the outcomes of laparoscopic portoenterostomy(Lap-PE)with those of laparotomy(Open-PE)at a single institution.METHODS The surgical outcomes of PE were retrospectively analyzed for patients with a non-correctable type of BA from 2003 to 2020.RESULTS Throughout the assessment period,119 patients received PE for BA treatment,including 66 Open-PE and 53 Lap-PE cases.Although the operation duration was longer(medians:for Open-PE,242 min;for Lap-PE,341 min;P80%for both groups for the first half year post surgery,followed by a gradual decrease with time;there were no statistically significant differences in the native liver survival rates for any durations assessed.CONCLUSION Lap-PE could be a standard therapy for BA.

关键词： Laparoscopic Kasai portoenterostomy Biliary atresia Native liver survival Pediatric Liver Transplantation

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Nutritional supplement drink reduces inflammation and postoperative depression in patients after off-pump coronary artery bypass surgery

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World Journal of Cardiology 2021年第8期13卷 348-360页

作者： satoshi Matsushita Akie Shimada Taira Yamamoto Kazuo Minematsu Hirotaka Inaba Kenji Kuwaki Atsushi amano Department of Cardiovascular Surgery Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of School Health Graduate School of EducationNagasaki UniversityNagasaki 852-8521Japan Department of Cardiovascular Surgery Juntendo University Urayasu HospitalChiba 279-0021Japan Department of Cardiovascular Surgery Tokai University Hachioji HospitalTokyo 192-0032Japan

BACKGROUND Coronary artery bypass grafting is a surgical treatment for ischemic heart disease.Although development in surgical technique and improvement of perioperative management reduced the postoperative complications,some patients still delayed in progress of postoperative rehabilitation.In this study,we aimed to investigate the effect of daily intake of an herbal medicine-containing drink for rehabilitation after surgery in patients with ischemic heart disease.AIM To investigate the effect of taking an herbal medicine-containing,commercially available drink for postoperative rehabilitation in those patients.METHODS Patients who underwent isolated off-pump coronary artery bypass(OPCAB)surgery were divided into two groups depend on the timing of the admission to the hospital:the Yunker(YKR)group,that consumed one bottle of a caffeine-free nutritional supplement drink on a daily basis and the control group(CTL)that underwent regular rehabilitation.RESULTS A total of 229 patients(CTL=130,YKR=99)were enrolled.No significant differences were observed in the baseline characteristics between the two groups.The YKR group had a significantly increased number of daily steps postoperatively(P<0.05)and had significantly lower postoperative serum tumor necrosis factor-alpha levels(P<0.01),while no significant differences were observed in the levels of other inflammatory or stress-related cytokines(interleukin-6,adiponectin,superoxide dismutase,and urine 8-hydroxy-2′-deoxyguanosine)between the two groups.Also,the YKR group showed a significant improvement in the Hospital Anxiety and Depression Score(P<0.05).Moreover,there were no differences in postoperative complications and the duration of postoperative hospital stay between the two groups.CONCLUSION Our results demonstrated that the daily intake of an herbal medicine-containing drink after OPCAB surgery may have beneficial effects on cardiac rehabilitation by reducing inflammation markers and depression.

关键词： Herbal medicine Inflammation Cardiac rehabilitation Moderate-to-vigorous intensity physical activity Off-pump coronary artery bypass

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Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy

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World Journal of Gastroenterology 2019年第4期25卷 457-467页

作者： Hideaki Harada satoshi Suehiro Daisuke Murakami Ryotaro Nakahara Takuya Nagasaka Tetsuro Ujihara Ryota Sagami Yasushi Katsuyama Kenji Hayasaka Yuji amano Department of Gastroenterology New Tokyo Hospital Department of Endoscopy New Tokyo Hospital

BACKGROUND Endoscopic submucosal dissection(ESD) for gastric neoplasms during continuous low-dose aspirin(LDA) administration is generally acceptable according to recent guidelines. This retrospective study aimed to investigate the effect of continuous LDA on the postoperative bleeding after gastric ESD in patients receiving dual antiplatelet therapy(DAPT).AIM To investigate the feasibility of gastric ESD with continuous LDA in patients with DAPT.METHODS A total of 597 patients with gastric neoplasms treated with ESD between January2010 and June 2017 were enrolled. The patients were categorized according to type of antiplatelet therapy(APT).RESULTS The postoperative bleeding rate was 6.9%(41/597) in all patients. Patients were divided into the following two groups: no APT(n = 443) and APT(n = 154). APT included single-LDA(n = 95) and DAPT(LDA plus clopidogrel, n = 59)subgroups. In the single-LDA and DAPT subgroups, 56 and 39 patients were received continuous LDA, respectively. The bleeding rate with continuous singleLDA(10.7%) was similar to that with discontinuous single-LDA(10.3%)(P >0.99). Although the bleeding rate with continuous LDA in patients receiving DAPT(23.1%) was higher than that with discontinuous LDA in patients receiving DAPT(5.0%), no significant difference was observed(P = 0.141).CONCLUSION The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT. Therefore, continuous LDA administration may be acceptable for ESD in patients receiving DAPT, although patients should be carefully monitored for possible bleeding.

关键词： Dual antiplatelet therapy Endoscopic submucosal dissection Low-dose aspirin Postoperative bleeding Thienopyridine

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Micro-Computed Tomography Provides Accurate Measurement for Cardiac Function in Infarcted Rat Heart

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Open Journal of Medical Imaging 2014年第2期4卷 72-79页

作者： satoshi Matsushita Mayuko Naito Atsushi amano Department of Cardiovascular Surgery School of Medicine Juntendo University Tokyo Japan

Objective: High resolution image is required for accurate measurement of cardiac function for the analysis of detailed regional function especially in a small animal. Methods: Left ventricular function of rat hearts was measured using micro-computed tomography (micro-CT) with administration of contrast agent in a rat with normal heart as well as rats with mild and severe myocardial infarction (MI). Following the CT acquisition, the hearts were sectioned for pathological evaluation. Results: The volume plot per each disk of the normal heart revealed that contraction force peaked at the middle of the heart. In the heart with mild infarction, the volume plot curve clearly demonstrated that infarction was located only at the apex of the heart, whereas severe infarction was disturbed in larger area. The left ventricular ejection fraction of the normal, mild MI, and severe MI hearts were 68.6%, 40.0%, and 16.4%, respectively. In addition, volume analysis in severe MI demonstrated ventricular dilatation, although that in mild MI did not show any change in the ventricular volume. Histological results were consistent with the CT measurement. Conclusions: Micro-CT provided accurate measurement of cardiac function in rats, which is especially useful for the analysis of small animals with heterogeneous dysfunction of the heart.

关键词： Regional Cardiac Function Small Animal Contrast Agent

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Results of aortic valve replacement for aortic stenosis in patients aged 80 years and older

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World Journal of Cardiovascular Diseases 2012年第3期2卷 220-226页

作者： Kenji Kuwaki Atsushi amano Hirotaka Inaba Taira Yamamoto Shizuyuki Dohi Takeshi Matsumura satoshi Matsushita Department of Cardiovascular Surgery Juntendo University Tokyo Japan

Purpose: The aim of this study was to investigate our clinical experience in a contemporary series of aortic valve replacement (AVR) for aortic stenosis (AS) with or without coronary artery bypass grafting (CABG), and compare the early and mid-term results between patients aged more than 80 years and those aged less than 80 years. Methods: A retrospective review was performed of 258 consecutive patients with aortic stenosis (AS) who underwent AVR between August 2002 and December 2010 at Juntendo University Hospital. Results: Operative mortality was 7.3% in patients aged 80 years and older, compared with 3.6% in younger patients. Thus, operative mortality was higher in the older patients compared with the younger patients, but was not statistically significant between the two groups. Age more than 80 years was not a predictor of operative mortality. Advanced NYHA class (p = 0.03;odds ratio [OR], 9.5) was found to be a multivariate independent predictor of operative mortality. Patients aged 80 years and older were significantly more likely to suffer from respiratory failure after surgery than younger patients, but there were no significant differences in any other complications between the two age groups. Non-home discharge rate was significantly higher in the patients aged 80 years and older (21.9%) than in the younger patients (5.5%). Three-year survival was 84% in patients aged more than 80 years, and 83% of these elderly patients were living at home at the last follow-up. Conclusions: Patients aged 80 years and older have acceptable results of AVR with slightly increased risk of early mortality and morbidity compared with younger patients.

关键词： Aortic Valve Replacement Octogenarians

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Evaluation of a New Formula for Calculating Heparin Dose for Cardiopulmonary Bypass Patients

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Open Journal of Thoracic Surgery 2014年第2期4卷 32-38页

作者： Aya Nakasuji satoshi Matsushita Hirotaka Inaba Taira Yamamoto Kenji Kuwaki Eiichi Inada Atsushi amano Department of Anesthesiology and Pain Medicine Faculty of Medicine Juntendo University Tokyo Japan Department of Cardiovascular Surgery Faculty of Medicine Juntendo University Tokyo Japan

Introduction: Anticoagulation is essential during CPB in cardiac surgery. It is generally performed using heparin;however the widely used formula for its dosing is based solely on body weight. Although the formula assumes activated clotting time (ACT) to be within normal range, baseline ACT varies in each patient. Thus, we developed an original formula, which takes into account baseline ACT in addition to body weight to calculate a more proper dose for initial administration of heparin. In this study, we monitored the ACT to examine if the dose of heparin calculated using our formula can prolong the ACT to the target range, and we determined the factors which interfere with the prolongation of ACT. Methods: Between October 2010 and April 2011, 141 consecutive patients underwent cardiac surgery requiring cardiopulmonary bypass at our hospital. We measured ACT 3 minutes after the initial administration of heparin and considered ACT values >400 seconds as appropriate for safe initiation of CPB. Results: Using the proposed formula, administered heparin dose was 241 ± 27 IU/kg and target ACT was achieved in 86.4% of patients. Multivariate analysis was performed to determine the effect of patient background factors on target ACT achievement. Body weight, age, and preoperative heparin therapy, which showed significant differences, were further analyzed. Conclusions: This study demonstrated that our newly developed formula could be used to properly calculate the optimal initial dose of heparin.

关键词： Anesthesia Cardiac Surgery Cardio Pulmonary Bypass

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Endovascular Repair for Abdominal Aortic Aneurysm Reduces Postoperative Blood Endotoxin Levels Assayed by the EAA Method Compared with Open Abdominal Surgery

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World Journal of Cardiovascular Surgery 2014年第6期4卷 87-94页

作者： Atsumi Ohishi satoshi Matsushita Shizuyuki Dohi Taira Yamamoto Hirotaka Inaba Kenji Kuwaki Atsushi amano Department of Cardiovascular Surgery Faculty of Medicine Juntendo University Tokyo Japan

Introduction: We hypothesized to demonstrate whether there are significant differences in blood endotoxin (Et) levels after abdominal aortic surgery between endovascular aortic repair (EVAR) and open abdominal surgery. Methods: The patients who underwent the surgical treatment for abdominal aortic aneurysm were divided into two groups according to the procedures: open abdomen surgery (OP) and EVAR (SG). The value of Endotoxin Activity Assay (EAA) was compared between groups. Results: After surgery, Et level was significantly higher in the OP group than in the SG group on postoperative day 3. Neutrophil count was significantly higher in the OP group immediately after treatment, but no significant difference was seen thereafter. There were no differences between the groups in other inflammatory markers. Conclusions: This study indicated that EVAR was less invasive compared to an open abdominal surgery from the standpoint of assessing postoperative endotoxin activity (EA) levels measured by EAA.

关键词： Inflammation Infection Stents Endovascular Aortic Repair

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