Faculty Profiles - CHEN-YOSHIKAWA Toyofumi

Papers - CHEN-YOSHIKAWA Toyofumi

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Long agonal period deteriorates cardiac death donor lung function in a rat EVLP model.

Hijiya K, Chen-Yoshikawa TF, Motoyama H, Ohsumi A, Nakajima D, Sakamoto J, Aoyama A, Date H

General thoracic and cardiovascular surgery Vol. 67 ( 5 ) page： 457-463 2019.5

Survival outcomes after minimally invasive thymectomy for early-stage thymic carcinoma.

Miyata R, Hamaji M, Omasa M, Nakagawa T, Sumitomo R, Huang CL, Ikeda M, Fujinaga T, Shoji T, Katakura H, Motoyama H, Nakajima D, Ohsumi A, Menju T, Aoyama A, Chen-Yoshikawa TF, Sato T, Sonobe M, Date H

Surgery today Vol. 49 ( 4 ) page： 357-360 2019.4

In Vitro Disease Modeling of Hermansky-Pudlak Syndrome Type 2 Using Human Induced Pluripotent Stem Cell-Derived Alveolar Organoids. Reviewed International journal

Yohei Korogi, Shimpei Gotoh, Satoshi Ikeo, Yuki Yamamoto, Naoyuki Sone, Koji Tamai, Satoshi Konishi, Tadao Nagasaki, Hisako Matsumoto, Isao Ito, Toyofumi F Chen-Yoshikawa, Hiroshi Date, Masatoshi Hagiwara, Isao Asaka, Akitsu Hotta, Michiaki Mishima, Toyohiro Hirai

Stem cell reports Vol. 12 ( 3 ) page： 431 - 440 2019.3

Language：English Publishing type：Research paper (scientific journal)

It has been challenging to generate in vitro models of alveolar lung diseases, as the stable culture of alveolar type 2 (AT2) cells has been difficult. Methods of generating and expanding AT2 cells derived from induced pluripotent stem cells (iPSCs) have been established and are expected to be applicable to disease modeling. Hermansky-Pudlak syndrome (HPS) is an autosomal recessive disorder characterized by dysfunction of lysosome-related organelles, such as lamellar bodies (LBs), in AT2 cells. From an HPS type 2 (HPS2) patient, we established disease-specific iPSCs (HPS2-iPSCs) and their gene-corrected counterparts. By live cell imaging, the LB dynamics were visualized and altered distribution, enlargement, and impaired secretion of LBs were demonstrated in HPS2-iPSC-derived AT2 cells. These findings provide insight into the AT2 dysfunction in HPS patients and support the potential use of human iPSC-derived AT2 cells for future research on alveolar lung diseases.

DOI： 10.1016/j.stemcr.2019.01.014

PubMed

Low incidence of and mortality from a second malignancy after resection of thymic carcinoma†.

Hamaji M, Kawaguchi A, Omasa M, Nakagawa T, Sumitomo R, Huang CL, Fujinaga T, Ikeda M, Shoji T, Katakura H, Motoyama H, Menju T, Aoyama A, Sato T, Chen-Yoshikawa TF, Sonobe M, Date H

Interactive cardiovascular and thoracic surgery Vol. 28 ( 3 ) page： 375-379 2019.3

Dual approach for large mediastinal tumors in the thoracic outlet: transmanubrial osteomuscular sparing approach and video-assisted thoracoscopic surgery. International journal

Kayawake H, Chen-Yoshikawa TF, Date H

Journal of cardiothoracic surgery Vol. 14 ( 1 ) page： 42 - 42 2019.2

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Selecting the proper surgical approach for mediastinal tumors in the thoracic outlet is difficult. Video-assisted thoracoscopic surgery is ideal because of the less invasiveness; however, it is often difficult to resect tumors only by video-assisted thoracoscopic surgery due to the poor visualization of the cranial side of tumors. We report two successfully treated cases by using a dual approach consisting of the transmanubrial osteomuscular sparing technique and video-assisted thoracoscopic surgery for aiming both the less invasiveness and the good visualization of the cranial side of tumors. CASE PRESENTATIONS: We present two resected cases of the mediastinal tumor in the thoracic outlet. The first case was a 28-year-old woman and the second case was a 37-year-old man. They had a mediastinal tumor in the thoracic outlet which was detected on the roentgenogram. A definitive preoperative diagnosis was unavailable. The surgical resection was started with video-assisted thoracoscopic surgery in the both cases. After the dissection of the caudal side of the tumor, the dissection of the cranial side was judged to be difficult and risky because the tumor was located adjacent to major vessels and the good visualization of this side couldn't be acquired. Therefore, the transmanubrial approach was sequentially performed and complete resection was safely achieved. Postoperatively, although transient Horner syndrome appeared in both cases, they recovered from this syndrome and were discharged. The final diagnosis was schwannoma for both cases. Neither of the cases had any functional restriction of the upper extremity. CONCLUSIONS: This dual approach for mediastinal tumors in the thoracic outlet is useful in terms of safety and lower invasiveness.

DOI： 10.1186/s13019-019-0863-5

PubMed

Impact of flat chest on cadaveric lung transplantation: postoperative pulmonary function and survival.

Miyahara S, Chen-Yoshikawa TF, Motoyama H, Nakajima D, Hamaji M, Aoyama A, Date H

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Vol. 55 ( 2 ) page： 316-322 2019.2

Prognostic impact of microscopic vessel invasion and visceral pleural invasion and their correlations with epithelial-mesenchymal transition, cancer stemness, and treatment failure in lung adenocarcinoma. Reviewed International journal

Shinya Neri, Toshi Menju, Terumasa Sowa, Yojiro Yutaka, Daisuke Nakajima, Masatsugu Hamaji, Akihiro Ohsumi, Toyofumi F Chen-Yoshikawa, Toshihiko Sato, Makoto Sonobe, Akihiko Yoshizawa, Hironori Haga, Hiroshi Date

Lung cancer (Amsterdam, Netherlands) Vol. 128 page： 13 - 19 2019.2

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: Microscopic vessel invasion (MVI) and visceral pleural invasion (VPI) have been recently reported as poor prognostic factors of non-small cell lung cancer. Epithelial-mesenchymal transition (EMT) and cancer stemness (CS) are known malignant phenotypes that induce resistance to cancer therapy. We aimed to assess the prognostic significance of MVI and the correlations among VPI/MVI, EMT, CS, and treatment failure for recurrent tumor. MATERIALS AND METHODS: From 2002 to 2013, 1034 consecutive patients with pathological T1-4N0-2M0 lung adenocarcinoma underwent complete resection. Moreover, we established 206 tissue microarray (TMA) samples from 2002 to 2007. We then evaluated the prognostic impact of MVI, including conventional clinicopathological factors, and analyzed the VPI/MVI, EMT, CS, and treatment failure by TMA immunohistochemical staining. RESULTS: Among the 1034 cases, the proportion of patients with a 5-year overall survival (OS) period was 63.9% and 88.2% (MVI: +/-; p < .001). Multivariate analysis revealed that both MVI and VPI were independent predictors of OS (HR 1.57 and 1.47, respectively). Significant separation of the OS rate curves was observed among the 3 groups [VPI/MVI: both positive (2), either positive (1), and both negative (0)]. Among the 206 TMA cases, these 3 groups of VPI/MVI were significantly correlated with EMT and CS. The median time to progression after recurrence were 3.8, 8.9, and 15.9 months, respectively (VPI/MVI: 2/1/0; p = 0.016). CONCLUSION: MVI and VPI are significant prognostic factors of lung cancer, and they are correlated with EMT, CS, and treatment failure for recurrent tumor.

DOI： 10.1016/j.lungcan.2018.12.001

PubMed

Native upper lobe-sparing living-donor lobar lung transplantation maximizes respiratory function of the donor graft.

Takahagi A, Chen-Yoshikawa TF, Saito M, Okabe R, Gochi F, Yamagishi H, Hamaji M, Motoyama H, Nakajima D, Ohsumi A, Aoyama A, Sonobe M, Date H

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Vol. 38 ( 1 ) page： 66-72 2019.1

Novel insights into lung regenerative medicine.

Chen-Yoshikawa TF, Okabe R

The Journal of thoracic and cardiovascular surgery Vol. 157 ( 1 ) page： 421-422 2019.1

Statins may have double-edged effects in patients with lung adenocarcinoma after lung resection. International journal

Nishikawa S, Menju T, Takahashi K, Miyata R, Chen-Yoshikawa TF, Sonobe M, Yoshizawa A, Sabe H, Sato T, Date H

Cancer management and research Vol. 11 page： 3419-3432 - 3432 2019

Language：English Publishing type：Research paper (scientific journal)

Purpose: The epithelial to mesenchymal transition (EMT) is pivotal for driving metastasis and recurrence in lung cancer. Some in vitro reports have shown that statins suppress EMT by inactivating mutant p53 functions. Several clinical trials of conventional treatments with statins have been performed, but the effect of these drugs on prognosis is still uncertain. The purpose of this study is to examine the impact of statins on EMT and the prognosis of patients with lung adenocarcinoma. Materials and methods: Morphological changes were evaluated and EMT markers (E-cadherin, vimentin) were analyzed by Western blotting in p53-overexpressing H1650 and mutant p53-harboring H1975 lung adenocarcinoma cells, with and without simvastatin administration. The invasive ability of these cells was analyzed in a Matrigel chemoinvasion assay. A total of 250 lung adenocarcinoma specimens were also collected from patients who underwent surgery in our institute. EMT markers in these tumor specimens were evaluated by immunostaining and p53 mutation status was determined by direct sequencing. Associations among EMT status, p53 mutation status, and statin use were evaluated, and prognosis was analyzed using a marginal structural model. Results: Mutant p53 induced EMT and increased the invasive ability of H1650 cells. Simvastatin restored the epithelial phenotype and decreased the invasive ability of both H1650 and H1975 cells. Statin administration was associated with inactivation of EMT only in patients with mutant p53, which was consistent with the in vitro results. Moreover, in patients with mutant p53, statin users had significantly better survival than non-statin users. In contrast, statins significantly worsened the prognosis of patients with wild type p53 (HR 2.10, 95% CI 1.14-3.85). Conclusion: Statins suppress EMT and change the prognosis of patients with lung adenocarcinoma in a p53 mutation-dependent manner.

DOI： 10.2147/CMAR.S200819

PubMed

Near-Infrared Imaging Using Intravenous Indocyanine Green at a Conventional Dose to Locate Pulmonary Metastases: A Pilot Study.

Hamaji M, Chen-Yoshikawa TF, Minami M, Date H

The Thoracic and cardiovascular surgeon 2018.11

Prognostic impact of preoperative comorbidities in geriatric patients with early-stage lung cancer: Significance of sublobar resection as a compromise procedure.

Yutaka Y, Sonobe M, Kawaguchi A, Hamaji M, Nakajima D, Ohsumi A, Menju T, Chen-Yoshikawa TF, Sato T, Date H

Lung cancer (Amsterdam, Netherlands) Vol. 125 page： 192-197 2018.11

Unilateral Chronic Lung Allograft Dysfunction Assessed by Biphasic Computed Tomographic Volumetry in Bilateral Living-donor Lobar Lung Transplantation. International journal

Saito M, Chen-Yoshikawa TF, Nakamoto Y, Kayawake H, Tokuno J, Ueda S, Yamagishi H, Gochi F, Okabe R, Takahagi A, Hamaji M, Motoyama H, Aoyama A, Date H

Transplantation direct Vol. 4 ( 11 ) page： e398 2018.11

Language：English Publishing type：Research paper (scientific journal)

Background: Early diagnosis of unilateral chronic lung allograft dysfunction (CLAD) is difficult because the unaffected contralateral lung functions as a reservoir in bilateral living-donor lobar lung transplantation (LDLLT). We previously reported the usefulness of 133Xe ventilation scintigraphy for detection of unilateral change, but the supply of 133Xe has been stopped globally. The present study aimed to examine the usefulness of inspiratory and expiratory computed tomography (I/E CT) volumetry for detection of unilateral change in CLAD patients. Methods: This was a retrospective single-center, observational study using prospectively collected data. A total of 58 patients who underwent bilateral LDLLT from August 2008 to February 2017 were analyzed. Respiratory function tests, I/E CT were prospectively conducted. ΔLung volume was defined as the value obtained by subtracting expiratory lung volume from inspiratory lung volume. Results: Fourteen (24%) cases were clinically diagnosed with CLAD, of which 10 (71%) were diagnosed as unilateral CLAD. ΔLung volume of bilateral lungs strongly correlated with forced vital capacity (r = 0.92, P < 0.01) and forced expiratory volume in 1 second (r = 0.80, P < 0.01). Regardless the phenotypes (bronchiolitis obliterans syndrome or restrictive allograft syndrome) of CLAD, Δlung volume onset/baseline significantly decreased compared with that in the non-CLAD group. Among the 10 unilateral CLAD patients, 3 with clinically suspected unilateral rejection yet did not show a 20% decline in forced expiratory volume in 1 second. In 2 of these, Δlung volume of unilateral lungs on the rejection side decreased by 20% or more. Conclusions: Our findings suggest that I/E CT volumetry may be useful for assessment and early diagnosis of unilateral CLAD after bilateral LDLLT.

DOI： 10.1097/TXD.0000000000000839

PubMed

Thoracoscopic rebiopsy to detect the T790M mutation after postoperative recurrence. Reviewed

Hamaji M, Motoyama H, Menju T, Chen-Yoshikawa TF, Sonobe M, Kim YH, Date H

Interactive cardiovascular and thoracic surgery Vol. 27 ( 4 ) page： 606 - 608 2018.10

Gastrointestinal complications after lung transplantation in Japanese patients.

Kayawake H, Chen-Yoshikawa TF, Motoyama H, Hamaji M, Nakajima D, Aoyama A, Date H

Surgery today Vol. 48 ( 9 ) page： 883-890 - 890 2018.9

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Gastrointestinal complications after lung transplantation (LTx) are an important postoperative morbidity associated with malnutrition and the malabsorption of drugs. We reviewed our experience of managing gastrointestinal complications after LTx. METHODS: Between June, 2008 and April, 2017, 160 lung transplants were performed at our institution, as living-donor lobar lung transplants in 77 patients, and as deceased-donor lung transplants in 83. We reviewed, retrospectively, the incidence, type and management of gastrointestinal complications. RESULTS: Among the 160 LTx recipients, 58 (36.3%) suffered a collective 70 gastrointestinal complications, the most frequent being gastroparesis, followed by gastroesophageal reflux disease. Two complications were managed surgically, by Nissen fundoplication for gastroesophageal reflux disease in one recipient and Hartmann's operation for sigmoid colon perforation in one. The other 68 complications were managed medically. Two patients died of complications: one, of aspiration pneumonia caused by gastroparesis; and one, of panperitonitis caused by a gastric ulcer. There were no significant differences in overall survival or chronic lung allograft dysfunction-free survival between the patients with and those without gastrointestinal complications. CONCLUSIONS: Gastrointestinal complications are not uncommon in LTx recipients and may be serious; therefore, early detection and appropriate treatment are imperative. Surgical management is required for some complications, but most can be managed medically.

DOI： 10.1007/s00595-018-1666-3

PubMed

Clinical significance of radiological pleuroparenchymal fibroelastosis pattern in interstitial lung disease patients registered for lung transplantation: a retrospective cohort study. Reviewed International journal

Kiminobu Tanizawa, Tomohiro Handa, Takeshi Kubo, Toyofumi F Chen-Yoshikawa, Akihiro Aoyama, Hideki Motoyama, Kyoko Hijiya, Akihiko Yoshizawa, Yohei Oshima, Kohei Ikezoe, Shinsaku Tokuda, Yoshinari Nakatsuka, Yuko Murase, Sonoko Nagai, Shigeo Muro, Toru Oga, Kazuo Chin, Toyohiro Hirai, Hiroshi Date

Respiratory research Vol. 19 ( 1 ) page： 162 - 162 2018.8

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Radiological pleuroparenchymal fibroelastosis (PPFE) lesion is characterized by pleural thickening with associated signs of subpleural fibrosis on high-resolution computed tomography (HRCT). This study evaluated the clinical significance of radiological PPFE as an isolated finding or associated with other interstitial lung diseases (ILDs) in patients having fibrotic ILDs and registered for cadaveric lung transplantation (LT). METHODS: This retrospective study included 118 fibrotic ILD patients registered for LT. Radiological PPFE on HRCT was assessed. The impact of radiological PPFE on clinical features and transplantation-censored survival were evaluated. RESULTS: Radiological PPFE was observed in 30/118 cases (25%): definite PPFE (PPFE concentrated in the upper lobes, with involvement of lower lobes being less marked) in 12 (10%) and consistent PPFE (PPFE not concentrated in the upper lobes, or PPFE with features of coexistent disease present elsewhere) in 18 (15%). Of these, 12 had late-onset non-infectious pulmonary complications after hematopoietic stem-cell transplantation and/or chemotherapy (LONIPCs), 9 idiopathic PPFE, and 9 other fibrotic ILDs (idiopathic pulmonary fibrosis, IPF; other idiopathic interstitial pneumonias, other IIPs; connective tissue disease-associated ILD, CTD-ILD, and hypersensitivity pneumonia, HP). Radiological PPFE was associated with previous history of pneumothorax, lower body mass index, lower percentage of predicted forced vital capacity (%FVC), higher percentage of predicted diffusion capacity of carbon monoxide, less desaturation on six-minute walk test, and hypercapnia. The median survival time of all study cases was 449 days. Thirty-seven (28%) received LTs: cadaveric in 31 and living-donor lobar in six. Of 93 patients who did not receive LT, 66 (71%) died. Radiological PPFE was marginally associated with better survival after adjustment for age, sex, %FVC, and six-minute walk distance < 250 m (hazard ratio 0.51 [0.25-1.05], p = 0.07). After adjustment for covariates, idiopathic PPFE and LONIPC with radiological PPFE was associated with better survival than fibrotic ILDs without radiological PPFE (hazard ratio 0.38 [0.16-0.90], p = 0.03), and marginally better survival than other fibrotic ILDs with radiological PPFE (hazard ratio, 0.20 [0.04-1.11], p = 0.07). CONCLUSIONS: idiopathic PPFE and LONIPC with radiological PPFE has better survival on the wait list for LT than fibrotic ILDs without radiological PPFE, after adjustment for age, sex, %FVC, and six-minute walk distance.

DOI： 10.1186/s12931-018-0860-6

PubMed

Adjuvant vinorelbine and cisplatin after complete resection of stage II and III non-small cell lung cancer: long-term follow-up of our study of Japanese patients Reviewed

Makoto Sonobe, Masatsugu Hamaji, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toyofumi F. Chen-Yoshikawa, Toshihiko Sato, Hiroshi Date

Surgery Today Vol. 48 ( 7 ) page： 687 - 694 2018.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Tokyo

Purpose: We reported previously a phase II study of adjuvant chemotherapy consisting of four cycles of vinorelbine (25 mg/m2) and cisplatin (40 mg/m2), given on days 1 and 8, every 4 weeks, to Japanese patients with completely resected stage II or III non-small cell lung cancer (NSCLC
UMIN 000005055). However, the follow-up was too short for us to evaluate a definitive 5-year overall survival rate and after-effects. Methods: Between December 2006 and January 2011, 60 patients were enrolled in this study. We analyzed relapse-free and overall survival, long-lasting adverse effects, the influence of treatment on recurrent tumors, and the development of a second primary cancer, in relation with the regimen. Results: After a median follow-up period of 95.8 months, the 5-year relapse-free and overall survival rates were 51.7 and 76.7%, respectively. Neuralgia developed in one patient and this was the only case of a long-lasting adverse effect. Recurrence developed in 31 patients, 29 of whom received intensive treatment. Although 16 s (or more) primary neoplasms developed among 13 patients, these were common carcinomas in Japan and did not include sarcoma or hematologic malignancies. Conclusion: Adjuvant vinorelbine and cisplatin chemotherapy showed encouraging relapse-free and overall survival rates, and long-term safety in Japanese patients with resected NSCLC.

DOI： 10.1007/s00595-018-1646-7

Scopus

PubMed

GATA6-positive lung adenocarcinomas are associated with invasive mucinous adenocarcinoma morphology, hepatocyte nuclear factor 4α expression, and KRAS mutations Reviewed

Naoki Nakajima, Akihiko Yoshizawa, Tomoyuki Nakajima, Masahiro Hirata, Ayako Furuhata, Shinji Sumiyoshi, Mariyo Rokutan-Kurata, Makoto Sonobe, Toshi Menju, Ei Miyamoto, Toyofumi F. Chen-Yoshikawa, Hiroshi Date, Hironori Haga

Histopathology Vol. 73 ( 1 ) page： 38 - 48 2018.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Blackwell Publishing Ltd

Aims: GATA6 is known to play a role in lung development. However, its role in the carcinogenesis of lung cancer is not well studied. The aim of this study was to analyse GATA6 expression in lung adenocarcinomas (LAs) by immunohistochemistry (IHC) in order to define its association with clinicopathological characteristics. Methods and results: IHC analysis of GATA6 was performed with tissue microarray slides containing 348 LAs. The association between GATA6 expression and clinicopathological parameters was evaluated. GATA6 expression in epithelial tumours other than lung cancer was also evaluated. GATA6 expression was found in 47 LAs (13.5%). This occurred more frequently in younger patients (P = 0.005), and was associated with the absence of lymph node metastasis (P =0.024), well-differentiated to moderately differentiated tumours (P &lt
0.001), the absence of lymphatic invasion (P = 0.020), and the absence of vascular invasion (P = 0.011). GATA6 expression was associated with mucin production (P &lt
0.001), the invasive mucinous adenocarcinoma subtype (P &lt
0.001), KRAS mutations (P = 0.026), expression of MUC2 (P &lt
0.001), CDX2 (P = 0.049), and MUC5AC (P &lt
0.001), and absence of expression of TTF-1 (P = 0.002). GATA6 expression was also associated with hepatocyte nuclear factor 4α (HNF4α) expression (P &lt
0.001). GATA6 expression tended to indicate better prognoses, whereas patients with HNF4α expression had significantly worse prognoses (P = 0.033). Of 270 tumours other than lung cancer, 110 expressed GATA6. Conclusions: These findings suggest that GATA6 might interact with HNF4α and contribute to the development of mucinous-type LAs.

DOI： 10.1111/his.13500

Scopus

PubMed

Surgical management of bronchial stumps in lobar lung transplantation Reviewed

Hidenao Kayawake, Toyofumi F. Chen-Yoshikawa, Akihiro Aoyama, Hideki Motoyama, Masatsugu Hamaji, Kyoko Hijiya, Hiroshi Date

Journal of Thoracic and Cardiovascular Surgery Vol. 156 ( 1 ) page： 451 - 460 2018.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Mosby Inc.

Background: The validity of lobar lung transplantation (LT) has been established in both living-donor lobar lung transplantation (LDLLT) and cadaveric-donor lung transplantation (CLT). However, bronchial stump management in lobar LT has not been precisely documented. Thus, we retrospectively analyzed our strategies for bronchial stump management in lobar LT. Methods: Between June 2008 and August 2016, 145 LTs (72 LDLLTs and 73 CLTs) were performed at our institution. Bronchial stumps were left in 14 LDLLTs. Eight patients underwent bilateral CLTs with downsizing lobectomy. We avoided leaving donor bronchial stumps by lobar-to-lobar bronchial anastomosis, and left recipient bronchial stumps if necessary. We retrospectively reviewed the bronchial stump management methods and outcomes in these 22 patients. Results: Among the 14 LDLLTs, right-to-left inverted lobar LT and right single-lobe LT with left pneumonectomy were performed in 12 and 2 patients, respectively. Among the 8 CLTs, 11 lobectomies were performed because of oversized grafts and/or localized pneumonia. Twenty-three lobar-to-lobar bronchial anastomoses were performed, and there were 21 recipient bronchial stumps in total. Three bronchial stumps were left in the donor graft, the middle bronchus in all cases. No complications related to lobar-to-lobar bronchial anastomoses were observed. All bronchial stumps healed well without developing a bronchopleural fistula. The 3-year overall survival rate was 88.1% (95% confidence interval, 58.8%-97.0%). Conclusions: We successfully avoided leaving bronchial stumps in the donor graft, except in the middle bronchus, by performing lobar-to-lobar bronchial anastomoses in lobar LTs. Excellent healing of lobar-to-lobar bronchial anastomoses and bronchial stumps was observed.

DOI： 10.1016/j.jtcvs.2017.10.150

Scopus

PubMed

Anterior mediastinal tissue volume is correlated with antiacetylcholine receptor antibody level in myasthenia gravis Reviewed

Akihiro Takahagi, Mitsugu Omasa, Toyofumi F. Chen-Yoshikawa, Masatsugu Hamaji, Akihiko Yoshizawa, Takashi Sozu, Makoto Sonobe, Hiroshi Date

Journal of Thoracic and Cardiovascular Surgery Vol. 155 ( 6 ) page： 2738 - 2744 2018.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Mosby Inc.

Objectives: Extended thymectomy is a treatment option for myasthenia gravis (MG), but the surgical indications are controversial. Pathologic features of the thymus can be used to predict surgical outcomes, but there is no reliable method for evaluating these characteristics preoperatively. The purpose of this study was to determine whether anterior mediastinal tissue volume, as measured via 3-dimensional computed tomography (3DCT) volumetry, correlates with serum anti-acetylcholine receptor antibody (AChRAb) levels in patients undergoing thymectomy for myasthenia gravis. Therefore, we investigated the relationships among anterior mediastinal tissue volume determined by 3DCT volumetry and AChRAb levels. Methods: The subjects were 28 patients who underwent extended thymectomy and were enrolled retrospectively. We measured volume of the anterior mediastinum and calculated the volumes of more than −30 Hounsfield units (V−30) by using 3DCT volumetry and compared them with perioperative AChRAb levels. The significance of their volumes in MG was examined by comparison with 53 patients without MG. Results: V−30 values were related to age and were significantly greater in patients with MG than in patients without MG (P &lt
.001). V−30 values were correlated positively with preoperative AChRAb levels (ρ = 0.505, P =.006) and inversely with the post/preoperative AChRAb ratio (ρ = −0.453, P =.018). The histologic nonadipose tissue ratio was correlated with the V−30/volume of the anterior mediastinum (ρ = 0.700, P &lt
.001). Conclusions: This method for evaluation of the anterior mediastinal tissue volume and AChRAb production may be helpful in establishing a treatment plan for MG.

DOI： 10.1016/j.jtcvs.2017.10.082

Scopus

PubMed

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Papers - CHEN-YOSHIKAWA Toyofumi