記述言語：英語   出版者・発行元：Jtcvs Techniques  

DOI： 10.1016/j.xjtc.2025.07.003

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記述言語：英語   出版者・発行元：Journal of Oral Rehabilitation  

Background: Several studies have examined the impact of tooth loss on nutrient intake, yielding mixed results. Objectives: This cross-sectional study aimed to investigate the association among the number of teeth present, nutrient intake and food group consumption in Japanese adults with no history of the four major diseases (diabetes, cancer, heart disease and stroke). Methods: Data were obtained from the baseline survey of the Japan Multi-Institutional Collaborative Cohort study conducted in the Shizuoka and Daiko areas. Participants completed a self-administered questionnaire on their number of teeth, medical history (diabetes, cancer, heart disease and stroke), education level, employment status and lifestyle factors, such as diet, smoking history and exercise habits. The number of teeth was classified into four groups: 0 teeth, 1–19 teeth, 20–27 teeth and 28–32 teeth. Results: A total of 8912 individuals included in the analysis had a mean age ± SD of 51.7 ± 9.5 years, with women accounting for 53.6% of the total. In adult men, the number of teeth was negatively associated with the intake of vitamin D, n-3 highly unsaturated fatty acid intake and seafood, while in women, bread consumption was positively associated with the number of teeth. Conclusions: These findings suggest that the number of teeth is independently associated with poor nutritional status in Japanese adults with no history of the four major diseases.

DOI： 10.1111/joor.14011

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Surgery Today  

Purpose: This study compared the peri- and postoperative outcomes of robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) lobectomy for primary lung cancer. Methods: This retrospective cohort study included patients who underwent RATS or VATS at Nagoya University Hospital between April 2018 and March 2022. Propensity score matching was used to balance patient characteristics between the two groups. The following long-term outcomes were assessed: the 3-year overall survival (OS), causes of death, 3-year disease-free survival (DFS), and recurrence patterns. Various peri- and postoperative outcomes were examined as short-term outcomes. Results: After propensity score-matching, 137 patients were included in each group. RATS was associated with a longer operative time (median 180 vs. 144 min, p < 0.001), less blood loss (median 5 vs. 12 ml, p = 0.005), and a lower rate of conversion to open thoracotomy (1 [0.7%] vs. 10 [7.4%], p = 0.010) than VATS. The 3-year OS and DFS were comparable between the groups. Conclusion: In lobectomy for lung cancer, RATS demonstrated long-term outcomes that were comparable to those of VATS. Although RATS has a longer operative time, it is associated with less blood loss and a lower conversion rate to open thoracotomy than VATS, suggesting that it is a beneficial surgical approach for patients.

DOI： 10.1007/s00595-025-03000-6

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記述言語：英語   出版者・発行元：Jtcvs Techniques  

DOI： 10.1016/j.xjtc.2025.05.018

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記述言語：英語   出版者・発行元：Journal of Thoracic Disease  

Background: Azithromycin (AZI) has proven effective in improving pulmonary function and survival in certain patients with established chronic lung allograft dysfunction (CLAD) following lung transplantation (LTx), but its prophylactic effects on CLAD remain controversial. This study aimed to assess the outcomes of prophylactic AZI for CLAD following LTx. Methods: A systematic review was conducted based on PubMed, Embase and Cochrane Library. All included studies reported the primary or secondary outcomes in the prophylactic azithromycin (pAZI) and control groups. The CLAD onset, disease-free survival and overall survival (OS) data were pooled using fixed-effect or random-effect models. Sensitivity analysis was employed to evaluate the robustness of the pooled results, while a funnel plot was utilized to assess the publication bias. Results: Six eligible studies involving 1,251 LTx recipients were included. The pooled analysis revealed a lower risk of CLAD onset in the pAZI group compared to the control group [relative risk (RR) 0.64, 95% confidence interval (CI): 0.51–0.81, P<0.001]. Moreover, the pAZI group exhibited superiority in the 3-year [hazard ratio (HR) 0.57, 95% CI: 0.39–0.83, P=0.003] and 5-year CLAD-free survival (HR 0.61, 95% CI: 0.43–0.86, P=0.005); but this superiority was not observed in the 3-year (HR 0.69, 95% CI: 0.31–1.54, P=0.36) and 5-year OS (HR 0.59, 95% CI: 0.30–1.14, P=0.12). Conclusions: Prophylactic AZI may reduce the risk of CLAD onset and improve 3- and 5-year CLAD-free survival, providing supporting evidence for its application in LTx community. More high-quality and well-designed studies are warranted to determine the prophylactic effects of AZI on CLAD and its phenotypes following LTx.

DOI： 10.21037/jtd-2025-365

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: Following the introduction of robot-assisted thoracoscopic surgery (RATS) as a health insurance-covered treatment in Japan, we investigated the current status and impact of the expansion of the indications for RATS for mediastinal tumors. Methods: Between 2018 and 2022, 209 cases of total mediastinal tumor resection were performed in our hospital. The study period was divided into the first half (January 2018 to June 2020) and the second half (July 2020 to December 2022), and perioperative parameters were compared between the two groups. Results: Ninety-six surgical procedures were performed in the first half and 113 in the second half. The percentage of RATS approach was significantly higher in the second half compared with the first half (P < 0.001). Indications for RATS in the second half compared with the first half were significantly increased in patients with stage II (P < 0.001) and stage III (P = 0.026) thymomas, tumor diameter ≥ 50 mm (P < 0.011), and patients undergoing extended thymectomy for myasthenia gravis (P < 0.009). In respect of short-term postoperative parameters, the estimated intraoperative blood loss (P < 0.035), postoperative drain duration (P < 0.037), and postoperative hospital stay (P < 0.011) were significantly lower in the second half than in the first half. Conclusions: RATS has recently been expanded for mediastinal tumors with improved short-term outcomes in our hospital after health insurance was applied in Japan. In the future, it will be necessary to discuss the further expansion of its indications by taking into account safety and long-term outcomes.

DOI： 10.1007/s11748-024-02093-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Surgery Today  

The increasing detection of small pulmonary nodules on computed tomography (CT) warrants simple and effective nodule localization methods. We describe our clinical experience using an experimental computer that displays virtual thoracoscopic images. This device constructs three-dimensional images from preoperative CT scans and simulates the deflated lung parenchyma in the lateral decubitus position. Five patients underwent lung resection using this technology. The device provided images that closely resembled actual thoracoscopic images in all cases. This method addresses the limitations of other localization techniques such as allergic reactions and mechanical marker-related complications. The method only requires preoperative CT images, and the process is semi-automatically performed by specifying the nodule location, thoracoscopic camera insertion site, and camera angle. This study is still in the preliminary phase and has several limitations. However, this method has the potential to accurately predict nodule locations and eliminate the many risks associated with other techniques.

DOI： 10.1007/s00595-024-02945-4

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記述言語：英語   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Purpose: This study aimed to evaluate the effectiveness of a cadaver surgical training program at the Clinical Anatomy Laboratory Nagoya (CALNA), focusing on its impact on procedural skills, confidence, and anatomical understanding among young and mid-career thoracic surgeons. Methods: From 2016 to 2024, 13 cadaver surgical training sessions were conducted, divided into basic, advanced, and specialized courses. The program included hands-on practice using cadavers preserved with Thiel or hypertonic saline methods. The surveys were administered post-training to assess confidence, satisfaction, and practical applicability. Statistical analysis was performed on the survey results. Results: A total of 100 participants attended the training sessions (mean: 12.5/session). The survey responses indicated that 92% of participants rated the training content as “good” or “excellent,” and 88% found the training “applicable” or “highly applicable” to clinical practice. Reflective discussions following each session facilitated iterative program refinement. The key improvements included enhanced surgical instrument availability and optimized trainee-to-instructor ratios. Conclusions: Our cadaver surgical training program was shown to significantly enhance surgical skills, boost confidence, and deepen thoracic anatomical understanding, demonstrating its value in advancing thoracic surgical education. Further development of standardized programs across institutions is needed to enable novice surgeons to acquire advanced skills efficiently.

DOI： 10.1007/s11748-025-02157-8

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記述言語：英語   出版者・発行元：International Journal of Molecular Sciences  

Mesothelioma is characterized by the inactivation of tumor suppressor genes, with frequent mutations in neurofibromin 2 (NF2), BRCA1-associated protein 1 (BAP1), and cyclin-dependent kinase inhibitor 2A (CDKN2A). These mutations lead to disruptions in the Hippo signaling pathway and histone methylation, thereby promoting tumor growth. NF2 mutations result in Merlin deficiency, leading to uncontrolled cell proliferation, whereas BAP1 mutations impair chromatin remodeling and hinder DNA damage repair. Emerging molecular targets in mesothelioma include mesothelin (MSLN), oxytocin receptor (OXTR), protein arginine methyltransferase (PRMT5), and carbohydrate sulfotransferase 4 (CHST4). MSLN-based therapies, such as antibody–drug conjugates and immunotoxins, have shown efficacy in clinical trials. OXTR, upregulated in mesothelioma, is correlated with poor prognosis and represents a novel therapeutic target. PRMT5 inhibition is being explored in tumors with MTAP deletions, commonly co-occurring with CDKN2A loss. CHST4 expression is associated with improved prognosis, potentially influencing tumor immunity. Immune checkpoint inhibitors targeting PD-1/PD-L1 have shown promise in some cases; however, resistance mechanisms remain a challenge. Advances in multi-omics approaches have improved our understanding of mesothelioma pathogenesis. Future research will aim to identify novel therapeutic targets and personalized treatment strategies, particularly in the context of epigenetic therapy and combination immunotherapy.

DOI： 10.3390/ijms26094299

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: This study analyzed the changes in health-related quality of life (HRQOL) and employment status of patients undergoing lung cancer surgery in Japan. Methods: This was a single-center, prospective study on patients who underwent lung anatomical resection. The eligible patients completed self-reported HRQOL and employment surveys at baseline and 6 and 12 months postoperatively. HRQOL was assessed using questionnaires including the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) and EORTC QLQ and Lung Cancer module and additional social engagement and work-related stress evaluation tools. Results: In total, 93 patients completed the baseline survey, and 80 provided survey data at 6 months postoperatively. The HRQOL scores of several factors significantly declined immediately after the surgery and then gradually improved. The EORTC global health score, which represents overall health status, returned to baseline levels at 12 months postoperatively. However, symptoms such as fatigue, dyspnea, and coughing did not return to baseline levels at 12 months postoperatively. Approximately 68% of the patients who were employed preoperatively continued to work at 12 months postoperatively. Conclusions: Lung cancer surgery significantly affected the HRQOL and employment status of the patients within the first 6 months after surgery. For patients who decide to return to work before full recovery of QOL, we consider the need for enhanced support to assist them as they can reintegrate into work and activities of daily living.

DOI： 10.1007/s11748-025-02144-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Jtcvs Techniques  

DOI： 10.1016/j.xjtc.2025.02.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research  

Background/Aim: The aim of the study was to describe the specific characteristics of patients with microscopic residual disease (R1) after surgical resection for non‑small cell lung cancer and to evaluate the effect of postoperative therapy in R1 patients. Patients and Methods: We retrospectively reviewed the clinical data of 3,296 patients. Enrolled R1 patients were divided into two groups: those who received postoperative therapy (PT) and those who did not receive postoperative therapy (NPT). Results: A total of 52 R1 patients were enrolled. Of those, 27 (51.9%) underwent extended resections in addition to the standard surgery, 37 patients were assigned to the PT group and 15 to the NPT group. The PT group exhibited significantly longer overall survival (OS) than the NPT group (p<0.01, 5‑year OS rate: 62.7% vs. 17.9%). There was no difference in progression‑free survival (PFS) between the two groups (p=0.34, 5‑year PFS rate: 38.7% vs. 22.2%). Age (<70 years old) and postoperative therapy positively impacted OS (p=0.03, and p=0.01, respectively). Conclusion: R1 resection after surgical resection for non‑small cell lung cancer was more likely to occur in the patients receiving extended surgical resection. The PT group demonstrated a significantly better prognosis than the NPT group.

DOI： 10.21873/anticanres.17506

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記述言語：英語   出版者・発行元：Respirology Case Reports  

In cases of thymoma with autoimmune disease, extended thymectomy may improve disease symptoms and medication effects. Myasthenia gravis (MG) is the most common complication, but thymoma with Stiff-Person syndrome (SPS) is rare, and there are few reports of surgery. In the present case, we performed robot-assisted extended thymectomy on a 74-year-old man with thymoma who had MG and SPS. At 6 months after surgery, his MG and SPS symptoms had improved and the dose of prednisolone had been reduced, confirming that surgical treatment contributed to disease control. Thus far, only two studies have been published on thymoma surgery in conjunction with MG and SPS, and both have documented the progression of neurological symptoms after surgery. To the best of our knowledge, this is the first report of a resected thymoma with MG and SPS, both of which were controlled after surgery.

DOI： 10.1002/rcr2.70149

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Background: There are few papers on three-dimensional (3D) images of the lungs using non-enhanced computed tomography (CT). This study aimed to investigate the accuracy of 3D images of the lungs using non-enhanced CT. Methods: The study included 10 consecutive cases for each lung lobe, totalling 50 cases between March and December 2022. The patients had both non-enhanced and contrast-enhanced CT taken within 2 months before surgery. A 3D image analysis system (SYNAPSE VINCENT) was used to obtain 3D images of the pulmonary artery (PA), pulmonary vein (PV), and bronchus (Br). The system automatically generated 3D images based on both non-enhanced and contrast-enhanced CTs, which were then compared with each other and also with actual surgical findings. Results: The coincidence rate of PA, PV, and Br between 3D images based on non-enhanced CT and enhanced CT was 70% for the right lung and 65% for the left lung. The coincidence rate of PA, PV, and Br between 3D images based on non-enhanced CT and actual surgical findings was 100% for the right middle, right lower, and left lower lobes, but 50% for the right upper lobe and 60% for the left upper lobe. Conclusions: The 3D images of the lungs based on non-enhanced CT showed that the right middle lobe and both lower lobes were correctly depicted. The right and left upper lobes were poorly visualized using non-enhanced CT, while the right upper lobe was poorly visualized using contrast-enhanced CT.

DOI： 10.21037/jtd-24-1406

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記述言語：英語   出版者・発行元：Asian Journal of Endoscopic Surgery  

We encountered a rare case of bilateral intralobar pulmonary sequestration presenting as horseshoe lung. A 44-year-old asymptomatic woman was referred to our hospital because of increased serum cancer antigen 125 and carbohydrate antigen 19-9, accompanied by an abnormal chest shadow. Preoperative imaging indicated a horseshoe-shaped bilateral intralobar pulmonary sequestration diagnosis. The surgery was initiated on the left side in a semiprone right lateral decubitus position. The aberrant vessels arising from the descending aorta were divided, and after indocyanine green administration, the boundary between the normal and sequestrated lungs was determined and stapled. The left and right pleural cavities were connected, and the left sequestrated lung was pushed into the right thoracic cavity. The right sequestrated lung was similarly resected via the right-sided approach, and both were resected en bloc. Both tumor markers were normalized 3 months postoperatively. We safely performed thoracoscopic surgery by formulating an appropriate surgical plan.

DOI： 10.1111/ases.70115

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記述言語：日本語   出版者・発行元：日本VR医学会  

DOI： 10.24764/jsmvr.2025.0_23

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Thoracic Surgery Short Reports  

We present a case of robot-assisted complex anatomical segmentectomy utilizing Resection Process Map (RPM) software. RPM enables the confirmation of internal structures obscured by lung parenchyma, thereby reducing the risk of injury or misidentification to essential structures. It facilitates an accurate understanding of anatomy beyond processed vessels, fostering collaboration among the surgical team and informed discussions. Preventing complications stemming from misidentification of bronchovascular structures is vital in complex segmentectomies. Robot-assisted complex segmentectomies can achieve precise anatomical resections through RPM's integration of real-time observations and virtual images. We are committed to further advancing this technology soon.

DOI： 10.1016/j.atssr.2024.06.019

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Peribronchiolar metaplasia is an uncommon lesion characterized by fibrosis and bronchiolar epithelial cell proliferation along the peribronchiolar alveolar walls, primarily in response to bronchiolar and peribronchiolar injuries. Peribronchiolar metaplasia usually appears as ground glass nodules or sub-solid nodules on computed tomography. However, we present an exceptional case of peribronchiolar metaplasia that appeared as a solitary solid nodule on computed tomography. A 62-year-old woman with conjunctival icterus was diagnosed with ampullary cancer and nodal metastasis. A solid predominant nodule (0.7 cm maximum diameter) in the left lower lobe was identified on computed tomography, requiring accurate differentiation between primary lung cancer and pulmonary metastasis. Due to the location, histological confirmation via transbronchial biopsy was not feasible. Hence, the patient underwent surgery for both diagnosis and treatment. The pathological findings revealed the growth of columnar epithelium containing ciliated cells replacing alveolar epithelium in the bronchioloalveolar wall with no malignant component. The final pathological diagnosis of the lesion was peribronchiolar metaplasia. This unique case highlights an atypical presentation of peribronchiolar metaplasia as a solitary solid nodule on computed tomography. Recognizing that peribronchiolar metaplasia can also manifest as solid nodules, as illustrated in our current case, is essential.

DOI： 10.18999/nagjms.86.4.720

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記述言語：英語   出版者・発行元：Surgery Today  

Purpose: To investigate the clinical characteristics of lung cancer that develops after kidney transplantation. Methods: The clinical data of patients with lung cancer diagnosed after kidney transplantation were collected retrospectively. The medical records were extracted from our database. All patients underwent routine chest examination after kidney transplantation. Results: In total, 17 lung tumors were detected in 15 (0.6%) of 2593 patients who underwent kidney transplantation at our institution. Eleven lung tumors were completely resected from a collective 10 patients (surgical group). The remaining five patients did not receive surgical treatment (nonsurgical group). The surgical group underwent wedge resection (n = 5), segmentectomy (n = 1), lobectomy (n = 3), and bilobectomy (n = 1). The pathological stages were 0 (n = 1), IA1 (n = 2), IA2 (n = 4), IA3 (n = 2), and IB (n = 1). The surgical group had a significantly better prognosis than the nonsurgical group. There were no perioperative complications related to kidney transplantation in either group. Conclusions: Routine chest examination would be useful for the early diagnosis and treatment of lung cancer after kidney transplantation. Moreover, surgical resection for early-stage lung cancer was associated with a better prognosis for kidney transplantation patients.

DOI： 10.1007/s00595-024-02819-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancers  

The widespread implementation of lung cancer screening and thin-slice computed tomography (CT) has led to the more frequent detection of small nodules, which are commonly referred to thoracic surgeons. Surgical resection is the final diagnostic and treatment option for such nodules; however, surgeons must perform preoperative or intraoperative markings for the identification of such nodules and their precise resection. Historically, hook-wire marking has been performed more frequently worldwide; however, lethal complications, such as air embolism, have been reported. Therefore, several surgeons have recently attempted to develop novel preoperative and intraoperative markers. For example, transbronchial markings, such as virtual-assisted lung mapping and intraoperative markings using cone-beam computed tomography, have been developed. This review explores various marking methods that have been practically applied for a better understanding of preoperative and intraoperative markings in thoracic surgery. Recently, several attempts have been made to perform intraoperative molecular imaging and dynamic virtual three-dimensional computed tomography for the localization, diagnosis, and margin assessment of small nodules. In this narrative review, the current status and future perspectives of preoperative and intraoperative markings in thoracic surgery are examined for a better understanding of these techniques.

DOI： 10.3390/cancers16193284

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記述言語：英語   出版者・発行元：Computerized Medical Imaging and Graphics  

Shape registration of patient-specific organ shapes to endoscopic camera images is expected to be a key to realizing image-guided surgery, and a variety of applications of machine learning methods have been considered. Because the number of training data available from clinical cases is limited, the use of synthetic images generated from a statistical deformation model has been attempted; however, the influence on estimation caused by the difference between synthetic images and real scenes is a problem. In this study, we propose a self-supervised offline learning framework for model-based registration using image features commonly obtained from synthetic images and real camera images. Because of the limited number of endoscopic images available for training, we use a synthetic image generated from the nonlinear deformation model that represents possible intraoperative pneumothorax deformations. In order to solve the difficulty in estimating deformed shapes and viewpoints from the common image features obtained from synthetic and real images, we attempted to improve the registration error by adding the shading and distance information that can be obtained as prior knowledge in the synthetic image. Shape registration with real camera images is performed by learning the task of predicting the differential model parameters between two synthetic images. The developed framework achieved registration accuracy with a mean absolute error of less than 10 mm and a mean distance of less than 5 mm in a thoracoscopic pulmonary cancer resection, confirming improved prediction accuracy compared with conventional methods.

DOI： 10.1016/j.compmedimag.2024.102418

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research  

Background/Aim: Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of non-small cell lung cancer (NSCLC), but specific outcomes of ICIs treatment among patients with postoperative recurrence of NSCLC remain unclear. The objective of the study was to compare the efficacy of ICIs and chemotherapy with conventional chemotherapy only in patients with postoperative recurrence of epidermal growth factor receptor (EGFR) wild-type NSCLC. Patients and Methods: A retrospective analysis was performed on patients who underwent anatomical lung resection at the Nagoya University Hospital and were treated for postoperative recurrence of wild-type EGFR NSCLC. This study evaluated the prognosis for postoperative recurrence, including ICIs treatment and other clinicopathological factors. Results: Of the 83 patients included in the analysis, 20 patients underwent chemotherapy and 63 patients underwent chemotherapy combined with ICIs. The combination of ICIs and chemotherapy significantly prolonged survival after recurrence (median survival: 33.1 months vs. 22.0 months, p=0.01). In the ICIs group, no significant differences in survival were detected between patients with different programmed death ligand 1 (PD-L1) status (Tumor Proportion Scores: <1%, 1%-49%, ≥50%, p=0.27). Multivariate analysis revealed that postoperative distant recurrence was a significant poor prognostic factor for survival after recurrence (HR=1.85, 95% CI=1.06-3.25, p=0.03), and combining ICIs with chemotherapy significantly improved survival after recurrence (HR=0.43, 95% CI=0.24-0.78, p<0.01). Conclusion: Combination of ICIs with chemotherapy significantly prolonged survival of postoperative recurrence with wild-type EGFR NSCLC regardless of PD-L1 status.

DOI： 10.21873/anticanres.17165

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Postoperative air leakage is the most common complication in surgery for malignant lung tumors, leading to extended hospital stays and substantial medical expenses. This study aimed to identify the incidence and characteristics of intraoperative and postoperative air leaks in both robotic-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS), as well as the causes of persistent air leakage following RATS. We conducted a retrospective analysis of patients who underwent lung resection for malignant lung tumors at our institution from October 2018 to August 2022. We compared the incidence rates of intraoperative air leak, postoperative air leak, and persistent air leak between patients who underwent RATS and those who underwent VATS. Background factors were adjusted using propensity score matching. A subanalysis was performed to compare unexpected air leaks, defined as air leaks not observed intraoperatively but confirmed postoperatively. The study included 295 cases of RATS and 227 cases of VATS. In both the overall population and the matched group (187 cases each for RATS and VATS), RATS demonstrated a significantly higher incidence of persistent air leaks compared to VATS (11% vs 3%, p < 0.01; 9% vs 3%, p = 0.02, respectively). RATS also had a significantly higher incidence of unexpected air leaks compared with VATS (29% vs 18%, p = 0.05). Although there was no statistically significant difference in hospital stays, RATS showed a higher incidence of postoperative persistent air leaks and unexpected postoperative air leaks than VATS.

DOI： 10.18999/nagjms.86.3.464

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Translational Lung Cancer Research  

Background: Nuclear protein in testis (NUT) carcinoma (NC) of the lung is a rare cancer that occurs mainly in young adolescents and adults. NC is genetically characterized by NUTM1 rearrangements, which usually take the form of BRD4-NUT fusions. The prognosis for NC is dismal, and treatment with conventional chemotherapeutic regimens is ineffective. Case Description: We herein describe the case of a 53-year-old woman with recurrent NC of the lung 14 years after surgery for nasal cavity cancer. Chest computed tomography revealed a 5.5-cm tumor in the lower lobe of the left lung. We completely resected the recurrent lung NC via thoracotomy. Immunohistochemistry (IHC) of the lung and nasal cavity cancers showed diffuse strong expression of NUT. RNA-seq of the lung NC revealed NUTM1 rearrangement, with a fusion of BRD4 exon 10 to NUTM1 exon 4. This breakpoint has never been reported before. In addition, IHC revealed elevated expression of parathyroid hormone-like hormone in the lung NC but not in the nasal cavity NC, indicating that the lung and nasal cavity NCs were metachronous multiple primary cancers. Conclusions: We experienced a rare recurrence of lung NC 14 years after the initial surgery. The BRD4-NUT fusion consisted of a new breakpoint. Furthermore, the expression pattern of parathyroid hormone-like hormone (PTHLH) suggested that the NCs in the nasal cavity and lung may be metachronous multiple lung cancers. This extremely rare case highlighted the possibility of identifying less malignant NCs in patients with poorly differentiated tumors via fusion gene analysis and the need to develop more effective treatment strategies for this malignancy.

DOI： 10.21037/tlcr-24-259

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s40792-024-01970-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Thoracic Surgery Short Reports  

A 55-year-old woman with no significant medical history or symptoms was incidentally diagnosed with a mediastinal tumor during a routine health checkup. The intraoperative findings of robot-assisted thoracoscopic surgery led to the diagnosis of extralobar pulmonary sequestration (EPS), with multiple vessels connecting to the pulmonary artery and superior pulmonary vein. EPS, an extremely rare condition, is typically supplied with blood from the aorta. Whereas it is uncommon for blood to be supplied from the pulmonary artery and to drain into the pulmonary vein in EPS, it is safely excised through robot-assisted thoracoscopic surgery.

DOI： 10.1016/j.atssr.2024.01.009

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Molecular Sciences  

Malignant pleural mesothelioma (MPM) develops primarily from asbestos exposures and has a poor prognosis. In this study, The Cancer Genome Atlas was used to perform a comprehensive survival analysis, which identified the CHST4 gene as a potential predictor of favorable overall survival for patients with MPM. An enrichment analysis of favorable prognostic genes, including CHST4, showed immune-related ontological terms, whereas an analysis of unfavorable prognostic genes indicated cell-cycle-related terms. CHST4 mRNA expression in MPM was significantly correlated with Bindea immune-gene signatures. To validate the relationship between CHST4 expression and prognosis, we performed an immunohistochemical analysis of CHST4 protein expression in 23 surgical specimens from surgically treated patients with MPM who achieved macroscopic complete resection. The score calculated from the proportion and intensity staining was used to compare the intensity of CHST4 gene expression, which showed that CHST4 expression was stronger in patients with a better postoperative prognosis. The median overall postoperative survival was 107.8 months in the high-expression-score group and 38.0 months in the low-score group (p = 0.044, log-rank test). Survival after recurrence was also significantly improved by CHST4 expression. These results suggest that CHST4 is useful as a prognostic biomarker in MPM.

DOI： 10.3390/ijms25042270

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記述言語：日本語   出版者・発行元：一般社団法人 日本移植学会  

<p>【背景】当院は2023年3月に国内11施設目の肺移植実施施設の認定を受け、同年8月より脳死肺移植の待機登録申請を開始した。肺移植適応評価入院の際に冠動脈疾患を新たに指摘された症例が複数認められたことから、そのリスク因子との関連を調べた。</p><p>【方法】2024年4月末時点で、肺移植を目的に紹介された患者28例のうち、今後の適応評価入院予定5例を除き、適応評価した13例を対象とし、患者背景および検査結果と冠動脈所見について調査した。</p><p>【結果】13例の原疾患は間質性肺疾患10例、造血幹細胞移植後肺障害1例、慢性閉塞性肺疾患1例、びまん性汎細気管支炎1例であった。冠動脈疾患のリスク因子とされている項目に関して調査した結果、喫煙歴あり7例、高血圧症4例、糖尿病6例、脂質異常症4例、CT画像上冠動脈石灰化あり3例認めた（重複あり）。上記リスク因子を3個以上認められた4例に冠動脈造影CT検査が施行され、うち2例で冠動脈狭窄が新規に指摘されたが、心筋シンチグラフィーで虚血性心疾患は否定的なことから移植適応について他科と協議し慎重に検討を行っている。</p><p>【結語】当院の肺移植適応評価13例のうち2例に新規の冠動脈狭窄が判明し、いずれも3個以上の冠動脈疾患リスク因子を有していた。冠動脈疾患の併存は肺移植周術期の重篤な合併症発生のリスクであるため、今後も慎重に適応評価を継続していく。</p>

DOI： 10.11386/jst.59.supplement_s373_2

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記述言語：日本語   出版者・発行元：一般社団法人 日本移植学会  

<p>【背景】当院は国内11施設目の肺移植実施施設の認定を受け、肺移植適応評価患者の受け入れを開始し、初回実施に向けて準備を進めている。実施施設への留学や見学を積極的に行っているが、移植医療の未経験者も多いため、本番を想定した修練が求められている。日頃のトレーニングのひとつを紹介する。【献体を用いた手術手技トレーニング】献体の固定方法は進化し、固定された状態は生体と類似しているため、手術トレーニングに有用である。臓器摘出やインプラントについて、心臓外科医と本番を想定し計12回トレーニングを継続し内容を定型化してきた。【トレーニング概要】開胸後に臓器評価し、心灌流液注入用と肺灌流液ドレナージ用のカテーテルを留置、大血管を遮断し心臓摘出、続いて肺摘出を学会が推奨する手順で施行する。左房の処理については、心臓外科・呼吸器外科の双方の考えを伝え、解剖を確認しながら行う。肺灌流液ドレナージ経路の方法や肺灌流のタイミングなど細やかな部分までシミュレーションしている。その後、別の献体でインプラント手技を修練する。【結語】本トレーニングは手技と順序確認に有用で、プログラムを定型化することで実践に役立つレベルに質を高め、繰り返し行っている。新規肺移植実施施設として、現実施施設のレベルに少しでも追いつくため、利用できるリソースを活用し工夫して準備している。</p>

DOI： 10.11386/jst.59.supplement_s297_1

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記述言語：日本語   出版者・発行元：一般社団法人 日本移植学会  

<p>背景：中部地方には長らく肺移植実施施設がなかったが、藤田医大に続き2023年3月に名古屋大学が肺移植実施施設となった。目的：新規肺移植実施施設の視点から肺移植後慢性期患者の管理について検討する。方法：肺移植非実施施設から、新規肺移植実施施設の申請、そして承認にいたる中で経験したことを基に、肺移植後慢性期患者の管理について、新規肺移植実施施設の立場から検討する。結果：2019年9月、名大病院で管理していた肺移植術の慢性期患者は4名で、全例、当院から肺移植実施施設に紹介し肺移植を受けた患者であった。その後、術後患者の紹介を受け入れ、肺移植実施施設としての申請を行うと決断した2021年4月には、その数は9名となった。2022年1月に申請を行い、2023年3月に肺移植実施施設として認定され、同年8月より脳死肺移植登録のための評価入院を開始し、2024年5月現在、10名の脳死肺移植登録を完了した。これまでに、のべ19名の肺移植術後患者の管理を行ったが、2名の死亡を経験した。死因は、CLAD１名、感染症1名であり、名大病院で最期を看取った。現在、HOTが必要なCLADを2名に認め、名大病院での入退院を繰り返しているが、移植を行った施設に連絡をとりながら管理している。他に、小児症例の管理、種々の合併症の管理や生体腎移植の施行なども経験した。結論：名古屋大学では、今後も、慢性期管理を通して、肺移植の経験をサステイナブルに積んでいく方針である。</p>

DOI： 10.11386/jst.59.supplement_s171_2

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancers  

Accurate identification of the intersegmental plane is essential in segmentectomy, and Indocyanine Green (ICG) assists in visualizing lung segments. Various factors, including patient-related, intraoperative, and technical issues, can influence boundary delineation. This study aims to assess the rate of unsuccessful intersegmental identification and identify the contributing factors. We analyzed cases of lung segmentectomy from April 2020 to March 2023, where intraoperative ICG was intravenously administered during robot-assisted or video-assisted thoracoscopic surgery. Cases where fluorescence extended beyond expected boundaries within 30 s were classified as the “unclear boundary group”. This group was then compared to the “clear boundary group”. The study encompassed 111 cases, 104 (94%) of which were classified under the “clear boundary group” and 7 (6%) under the “unclear boundary group”. The “unclear boundary group” had a significantly lower DLCO (15.7 vs. 11.8, p = 0.03) and DLCO/VA (4.3 vs. 3.0, p = 0.01) compared to the “clear boundary group”. All cases in the “unclear boundary group” underwent lower lobe segmentectomy. ICG administration effectively outlines pulmonary segments. Challenges in segment demarcation may occur in cases with low DLCO and DLCO/VA values, particularly during lower lobe segmentectomy.

DOI： 10.3390/cancers15245876

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Preoperative three-dimensional computed tomography (CT) facilitates accurate identification of aberrant systemic arteries in thoracic surgery for pulmonary sequestration (PS). Furthermore, the boundary between normal and sequestrated lungs can be visualized using the spread of fluorescent indocyanine green (ICG) when performing surgery for PS. This study aimed to determine how to completely visualize anatomical variations, safely treat aberrant arteries, remove only sequestrated lungs, and perform minimally invasive surgery for PS. Seventeen patients underwent lung resection for intralobar PS at our institution between 2009 and 2022. We retrospectively reviewed the surgical outcomes and intraoperative images using ICG to assess the efficacy and feasibility of near-infrared fluorescence imaging. Since 2019, intraoperative near-infrared fluorescence imaging with ICG has been used in six patients, including four females and two males (median age, 56 years), to visualize the boundary between normal and sequestrated lungs. Aberrant arteries were identified using preoperative three-dimensional CT, and the boundary between sequestrated and normal lungs could be clearly delineated intraoperatively using ICG in all cases. The median operative time was 145 min (range, 88–167 min), and the median blood loss was 5 mL (range, 1–191 mL). The overlay mode using near-infrared thoracoscopy, which merges visible light images with fluorescent images, was safer and more useful than conventional thoracoscopy for delineating boundaries with electrocautery. No intraoperative or postoperative complications occurred. The median postoperative hospital stay was 5 days (range, 3–7 days). Intraoperative identification of the boundary between normal and sequestrated lungs using ICG was simple and feasible. We suggested that this technique was effective for lesion resection and normal lung preservation during surgery for intralobar PS.

DOI： 10.21037/jtd-23-892

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Quantitative Imaging in Medicine and Surgery  

Background: Based on computed tomography (CT) findings of lung cancer, solid nodules have a much worse prognosis than subsolid nodules, even if the nodules are subcentimeter in size. There is, however, no systematic method for determining the prognosis of solid tumors on CT. This study aimed to discover the prognostic factor of early-stage solid lung adenocarcinoma using three-dimensional CT volumetry. Methods: Patients with pathological stage I solid lung adenocarcinoma who underwent complete resection between 2007 and 2012 were selected in this retrospective study. Clinicopathological data and preoperative multidetector CT findings, such as tumor size on the two-dimensional axial image, three-dimensional tumor volume between -600 and 199 HU, and three-dimensional solid volume between 0 and 199 HU, which corresponded to highly solid components, were compared between recurrence and non-recurrence. Furthermore, these radiological values were compared to pathological invasive volume (PIV). Results: During this time, 709 patients had their lung cancer completely removed. From this cohort, 90 patients with pathological stage I solid lung adenocarcinoma were selected. In addition, recurrence was found in 26 patients (28.9%). Although two-dimensional axial image, serum carcinoembryonic antigen (CEA) level, and SUVmax on 18F fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/ CT) did not differ statistically between recurrent and non-recurrent patients, three-dimensional tumor and solid tumor volume did. Multivariate analysis indicated that three-dimensional solid tumor volume [hazard ratio: 2.440; 95% confidence interval (CI): 1.110-5.361, P=0.026] and epidermal growth factor receptor (EGFR) mutation (hazard ratio: 4.307; 95% CI: 1.328-13.977, P=0.015) were significantly associated with disease-free survival (DFS). When three-dimensional tumor and solid tumor volume were compared to PIV, three-dimensional solid tumor volume (3,091 mm3 on average) showed a highly similar value with PIV (2,930 mm3 on average), whereas three-dimensional tumor volume (6,175 mm3 on average) was significantly larger than PIV (P<0.001). Conclusions: In patients with early-stage solid lung adenocarcinoma, the measurement of threedimensional solid tumor volume, which is correlated with PIV, accurately predicted the postoperative outcome.

DOI： 10.21037/qims-23-36

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Background: Preoperative three-dimensional (3D) computed tomography (CT) images have been widely used as surgical guides in lung surgery; however, the lungs tend to be deflated during surgery. Discrepancies between the preoperatively constructed 3D image and the intraoperative view of the deflated lungs often require preoperative and/or intraoperative marking methods for sublobar pulmonary resection. We have developed a lung deflation simulation algorithm in which 3D CT images of the deflated lungs can be predicted only based on the preoperative CT taken in an inflated phase of respiration. Using this system, we conducted a preliminary study to retrospectively compare the intersegmental line predicted by our lung deflation simulation algorithm with the intersegmental line delineated by the intravenous administration of indocyanine green. Methods: Sixteen patients who underwent unilateral segmentectomy between January 1, 2020, and June 30, 2022, were included in the study. The identified intersegmental lines were confirmed intraoperatively using indocyanine green. These actual intersegmental lines were compared with those delineated on 3D images using the lung deflation simulation algorithm. Results: Of the 16 patients who underwent pulmonary segmentectomy, the consistency of these intersegmental lines was in complete agreement in twelve patients, partial agreement in three patients, and disagreement in one patient. The concordance rate of the intersegmental lines was 75%. Conclusions: The lung deflation simulation algorithm provides a new surgical guide in addition to the currently utilized ones. Continuous innovation might lead to a less invasive surgical technique for delineating the intersegmental line.

DOI： 10.21037/jtd-23-421

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

This study aimed to clarify the association of daily physical activity and leisure-time exercise with the risk of dysphagia in community-dwelling Japanese older adults using a questionnaire-based survey. We analyzed 3070 participants (1657 men, 1413 women; age 66 ± 4 years [mean ± SD]) of the Shizuoka and Daiko studies within the Japanese Multi-Institutional Collaborative Cohort study. We used the Dysphagia Risk Assessment for the Community-dwelling Elderly questionnaire to assess dysphagia risk and the International Physical Activity Questionnaire to assess daily physical activity and leisure-time exercise. Logistic regression analyses were used to evaluate the independent association of the amount of physical activity and leisure-time exercise with dysphagia risk. The proportion of participants with dysphagia risk was 27.5% (n = 844) and the risk was significantly higher in women (29.8%, n = 421) than in men (25.5%, n = 423; P = 0.008). Daily physical activity was not associated with dysphagia risk. A greater amount of leisure-time exercise was associated with lower dysphagia risk (P for trend = 0.003) and individuals in the highest leisure-time exercise quartile had a significantly lower odds ratio (0.68, 95% CI 0.52–0.89) than those in the lowest quartile, even after adjusting for the covariates.

DOI： 10.1038/s41598-023-37605-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: This study aimed to demonstrate to the involved departments the goal of increasing the number of robotic-assisted thoracic surgery (RATS) cases/surgeons and acceptable surgery times. Methods: This retrospective study included 1572 patients who underwent thoracic surgery from fiscal year (FY) 2018 to FY 2021. The factors evaluated included the number of surgery cases and actual and scheduled surgery times. Results: The total number of RATS and total surgery cases increased after the quality indicator (QI) setting (n = 363, 360, 417, and 432 in FY 2018, 2019, 2020, and 2021, respectively). In FY 2020, 93.3% of the QI target was achieved, while in FY 2021, 88% was achieved. The number of RATS lobectomy/segmentectomy increased as the FY progressed (n = 31, 47, 58, and 116 in FY 2018, 2019, 2020, and 2021, respectively). The mean surgical time by RATS starters decreased in FY 2020 and 2021 (171.4 min.; 74 cases; seven RATS starters) compared with those in FY 2018 and 2019 (198.0 min.; 57 cases; six RATS starters) (P = 0.002). Conclusions: The goal of increasing the number of surgery cases and RATS cases/surgeons within the given framework was achieved by setting the QI.

DOI： 10.1007/s11748-022-01903-6

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記述言語：英語   出版者・発行元：Asian Journal of Endoscopic Surgery  

Lingular-segment torsion after left-upper division segmentectomy (LUDS) is a rare complication, and the cause remains unclear. Here we report the case of a patient who developed lingular-segment torsion after LUDS for multiple lung metastases of breast cancer. One lung nodule was located in the S1 + 2 segment and another between the upper lobe and S6 on an incomplete interlobar fissure. The lung metastases were resected by extended LUDS using video-assisted thoracic surgery with indocyanine green fluorescence imaging. The staple line on the lingular segment was vertically tilted against the interlobar line because of the atypical defect of the fluorescence plane and nodule position. Chest X-ray and contrast-enhanced computed tomography indicated ischemia and torsion of the lingular segment on the second postoperative day, and completion of lingular segmentectomy was performed. This case showed the vertical intersegment staple line during LUDS was one of the important causes of postoperative torsion of the lingular segment.

DOI： 10.1111/ases.13189

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記述言語：日本語   掲載種別：研究論文（学術雑誌）  

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記述言語：日本語   出版者・発行元：(株)南江堂  

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00349&link_issn=&doc_id=20230629040009&doc_link_id=issn%3D0021-5252%26volume%3D76%26issue%3D7%26spage%3D523&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0021-5252%26volume%3D76%26issue%3D7%26spage%3D523&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：英語  

DOI： 10.1186/s40792-023-01694-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Epidemiology  

Background: Little is known about whether insufficient moderate-to-vigorous physical activity (MVPA) and longer sedentary behavior (SB) are independently associated with estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), whether they interact with known risk factors for CKD, and the effect of replacing sedentary time with an equivalent duration of physical activity on kidney function. Methods: We examined the cross-sectional association of MVPA and SB with eGFR and CKD in 66,603 Japanese cohort study in 14 areas from 2004 to 2013. MVPA and SB were estimated using a self-reported questionnaire, and CKD was defined as eGFR <60 mL/min/1.73 m². Multiple linear regression analyses, logistic regression analyses, and an isotemporal substitution model were applied. Results: After adjusting for potential confounders, higher MVPA and longer SB were independently associated with higher eGFR (P for trend MVPA <0.0001) and lower eGFR (P for trend SB <0.0001), and a lower odds ratio (OR) of CKD (adjusted OR of MVPA ≥20 MET·h/day, 0.76; 95% confidence interval [CI], 0.68–0.85 compared to MVPA <5 MET·h/day) and a higher OR of CKD (adjusted OR of SB ≥16 h/day, 1.81; 95% CI, 1.52–2.15 compared to SB <7 h/day), respectively. The negative association between MVPA and CKD was stronger in men, and significant interactions between sex and MVPA were detected. Replacing 1 hour of SB with 1 hour of physical activity was associated with about 3 to 4% lower OR of CKD. Conclusion: These findings indicate that replacing SB with physical activity may benefit kidney function, especially in men, adding to the possible evidence on CKD prevention.

DOI： 10.2188/jea.JE20210155

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本呼吸器外科学会  

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記述言語：英語   出版者・発行元：Asian Journal of Endoscopic Surgery  

Here we report the cases of five patients on continuous ambulatory peritoneal dialysis (CAPD) who developed hydrothorax because of pleuroperitoneal communication. Preoperative computed tomography (CT) peritoneography revealed penetrated sites on the diaphragm in all patients. All patients underwent video-assisted thoracoscopic surgery (VATS), and a dialysate containing indigo carmine was injected intraperitoneally through a CAPD catheter to confirm the fistula. In all patients, a thinned bleb was found at the center of the diaphragmatic tendon consistent with that noted on preoperative CT peritoneography. The bleb was resected using a surgical stapler in four patients, and the pleuroperitoneal communication did not recur. However, in one patient, the bleb was only covered with reinforcement agents and the hydrothorax recurred after CAPD. This study demonstrates that VATS treatment for pleuroperitoneal communication is safe and effective but that lesion resection would be more useful for preventing hydrothorax recurrence in patients undergoing CAPD.

DOI： 10.1111/ases.13127

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of surgical oncology  

DOI： 10.1245/s10434-022-12860-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Surgical Oncology  

Objectives: The rates of postoperative mortality and morbidity are high in patients with malignant pleural mesothelioma (MPM). Therefore, it is important to identify variables that increase the risk of postoperative complications. Pleural thickness has recently been identified as a prognostic indicator in patients with MPM. The aim of this study was to investigate clinical variables, including pleural thickness, that contribute to postoperative complications in patients with MPM. Patients and Methods: A total of 47 patients who underwent surgical excision of MPM between 2005 and 2021 were enrolled in this study. Correlations between postoperative complications within 90 days of surgery and preoperative clinical factors were investigated. Results: A total of 27 patients underwent extrapleural pneumonectomy (EPP), and the remaining 20 underwent pleurectomy/decortication (P/D). Macroscopic complete resections were obtained in all but three patients. Of the 47 patients, 23 (49%) experienced postoperative complications of grade 3 or worse. The major complication in patients with EPP was respiratory failure (n = 6), whereas the major complication in patients with P/D was prolonged air leakage (n = 7). Univariate logistic regression analysis found a correlation between postoperative complications and age, surgical side, and pleural thickness, while multivariate logistic regression analysis found surgical side (p = 0.04, 95% Cl 1.10–21.71, OR 4.90) and pleural thickness (p = 0.03, 95% Cl 1.21–23.00, OR 5.26) to significantly influence the occurrence of postoperative complications. Conclusions: Pleural thickness has a significant effect on the occurrence of postoperative complications. Patients with thick pleura on the right side are at greater risk of postoperative complications.

DOI： 10.1245/s10434-022-12790-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Background: The COVID-19 pandemic has affected the clinical practice of lung cancer surgery in Japan, but few studies have revealed the real situation of surgical practice for lung cancer in this country. This latest information will help us to decide the future direction of lung cancer surgery under pandemic circumstances. Methods: We collected data from patients with primary lung cancer who underwent thoracic surgery between 2018 and 2021. To investigate the impact of the COVID-19 pandemic on lung cancer surgery, we compared between 2018–2019 (prepandemic group) and 2020–2021 (pandemic group) in the respect of patient characteristics, pathological findings, and short-term outcome after lung cancer resection by Mann-Whitney and Fisher’s exact tests. Moreover, the monthly number of surgeries for lung cancer in our institution during 2020–2021 was compared with the number of newly diagnosed COVID-19 patients in Japan by Spearman correlation analysis. Results: From 2018 through 2021, 936 patients with primary lung cancer underwent surgical intervention in our institute and were included in this study. The number of surgeries did not decrease in the pandemic group (n=443) compared with that in the prepandemic group (n=493). Tumor and invasive size in stage I which was measured by pathologist were significantly larger in the pandemic group than in the prepandemic group (tumor size: P=0.031, invasive size: P<0.001). In terms of postoperative short-term outcome, the median hospital stay was 6 days, 30-day mortality was 2, and morbidity was around 20% in both groups. Only one patient suffered from COVID-19 infection 5 months after right upper lobectomy. An increased ratio of newly diagnosed COVID-19 cases in Japan was negatively correlated with the number of surgeries for lung cancer in our institution in the next month (r=−0.393, P=0.007), although there was no correlation in the present or the month after next. Conclusions: Even during the COVID-19 pandemic period, lung cancer surgery could be performed safely and in a sustainable manner. However, pathological findings of lung cancer tended to be progressive in early-stage lung cancer.

DOI： 10.21037/jtd-22-1289

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Mediastinum  

Background: Taste disorders in patients with thymoma accompanied by myasthenia gravis (MG) is rare. Case Description: The first case was a male in his 50s who underwent surgery for Masaoka stage III type B3 thymoma. He experienced a loss of taste before surgery, which showed no improvement after surgery. Due to a MG crisis 44 days after surgery, the patient underwent intensive treatment with mechanical ventilation, steroid pulse therapy, and intravenous immunoglobulin (IVIG) therapy. The patient recovered taste when he started oral food intake after the treatment for the MG crisis (about 3 months after surgery). Despite the recovery of taste after steroid pulse therapy and IVIG therapy, taste disorder gradually worsened about 1 year and 9 months after surgery, resulting in an almost complete loss of sweet taste 2 years after surgery. The second case was a male in his 60s who underwent surgery for Masaoka stage II type B1 thymoma. He experienced loss of taste before surgery, which showed no improvement after surgery. Five years and two months after surgery, the patient was diagnosed with a MG crisis and underwent steroid pulse therapy. Along with improvements in MG symptoms, taste disorders gradually improved. After 6 years and 10 months of surgery, the patient is still alive without MG symptoms (only pyridostigmine, 180 mg/body/day), taste disorder, and thymoma recurrence. Conclusions: The autoimmune mechanism may contribute to taste disorders in patients with thymoma, which can be recovered by immunosuppressive treatment in our cases.

DOI： 10.21037/med-23-8

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research  

Background/Aim: Multidisciplinary treatment including anatomical pulmonary and chest wall resection is recommended for lung cancer complicated by chest wall invasion. The present study aimed to investigate the survival benefit and safety of preoperative therapy followed by surgery for non-small cell lung cancer with chest wall invasion. Patients and Methods: Sixty-five patients who underwent surgical excision of lung cancer complicated with chest wall invasion between 2009 and 2020 were enrolled in this study. Results: The median age was 65 (37-81) years old, with 59 males and 6 females. Histological types included squamous cell carcinoma (n=32) and adenocarcinoma (n=21). The median tumor diameter was 5.5 cm (2.3-12.5 cm). The clinical nodal status was N0 in 49 cases and N positive in 16 cases. Of the 65 eligible patients, 5- and 10-year overall survival (OS) rates were 58.4% and 46.0%, respectively, and 5- and 10-year progression-free survival (PFS) rates were 54.2% and 41.7%, respectively. For patients receiving preoperative therapy followed by surgery (Pre-Tx), 5- and 10-year OS survival rates were 69.2% and 62.9%, and among patients receiving up-front surgery (UFS) were 48.5% and 29.1%, respectively (p=0.03). The 5- and 10-year PFS rates for pre-Tx were 65.8% and 59.2%, respectively, and 44.7% and 26.8% for UFS, respectively (p=0.02). Cox regression analysis preoperative therapy was significantly associated with OS and PFS. Conclusion: We demonstrate the survival benefit of preoperative therapy followed by surgery for patients with lung cancer and chest wall invasion.

DOI： 10.21873/anticanres.16059

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic Disease  

Background: Sarcopenia and its marker, the psoas muscle index (PMI), have attracted attention as prognostic factors for various types of cancers. The fragile X-related 1 (FXR1) gene is highly expressed in myocytes, and FXR1 overexpression is a candidate biomarker for poor survival in several types of cancers. Thymic squamous cell carcinoma (TSQCC) is rare, and no studies assessing its prognostic factors, particularly in terms of skeletal muscle mass and FXR1 expression, are available. Methods: We retrospectively investigated the prognostic significance of PMI in 34 patients who underwent TSQCC resection, considering the status of FXR1 and tumor programmed death-ligand 1 (PD-L1). PMI was calculated from the bilateral psoas muscle using preoperative computed tomography (CT). Patients were divided into two groups: low PMI (<58.2%, n=17) and normal PMI (≥58.2%, n=17). Immunohistochemical analysis was performed to determine the FXR1 and PD-L1 expression levels. Results: Low PMI was significantly associated with worse overall survival (OS) (5-year survival rate; 86% vs. 100%; P=0.026) and marginally associated with worse disease-free survival (DFS) (5-year survival rate; 39% vs. 66%; P=0.090) compared with normal PMI. The immunohistochemical analysis revealed that the FXR1 intensity score (0–1+: 6% vs. 0%; 2+–3+: 94% vs. 100%; P=0.31), median FXR1 distribution (95% vs. 90%; P=0.63), and PD-L1 status (high: 47% vs. 59%; P=0.49) were not significantly different between the two groups. Conclusions: Our findings suggest that PMI might be considered as a potential prognostic factor in TSQCC and that FXR1 is widely expressed regardless of the PMI status. Skeletal muscle mass may play a role in the prognosis of TSQCC.

DOI： 10.21037/jtd-22-385

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Thoracic and Cardiovascular Surgery  

DOI： 10.1016/j.jtcvs.2021.01.083

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s40792-022-01492-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Hypertension Research  

Previous studies have reported that the number of pregnancies and childbirths affected the risk of cardiovascular diseases (CVDs). However, the influence of reproductive history on hypertension and obesity, which are important risk factors for CVDs, is still unclear. Moreover, this association may vary depending on menopausal status. We evaluated the association of reproductive history with hypertension and obesity using a large cross-sectional dataset from the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). At the baseline survey, physical data, blood samples, and self-reported health questionnaires were collected. Participants with insufficient data were excluded, and 24,558 women from eight study regions were included in this study. Logistic regression analysis was conducted to evaluate the association of reproductive history with hypertension and obesity using multivariable-adjusted odds ratios. In premenopausal women, childbirth showed a generally protective effect on hypertension but not on obesity. In postmenopausal women, childbirth was positively associated with obesity and hypertension but not with hypertension after adjusting for BMI. In conclusion, reproductive history was associated with hypertension and obesity in a large Japanese population, and this association differed between premenopausal and postmenopausal women.

DOI： 10.1038/s41440-021-00820-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：World Journal of Surgery  

Background: Considering advances in current post-recurrence treatment, we examined the prognostic significance of the number of risk factors for loss-of-exercise capacity (LEC) after lung cancer surgery, which were identified by our previous prospective observational study. Methods: Risk factors for LEC were defined as a short baseline 6-min walk distance (<400 m), older age (≥75 years), and low predicted postoperative diffusing capacity for carbon monoxide (<60%). Patients were classified as Risk 0/I/II/III according to the number of risk factors. The survival data were retrospectively analyzed. Results: Between 2014 and 2017, 564 patients (n = 307, 193, 57, 7; Risk 0/I/II/III) who underwent lung cancer surgery were included in the study. The number of risk factors was associated with smoking status, predicted postoperative forced expiratory volume in 1 s, histology, pathological stage, and adjuvant therapy. In a multivariate Cox regression analysis, compared to Risk 0, Risk I/II/III showed significant associations with overall survival (hazard ratios: 1.92, 3.35, 9.21; 95% confidence interval: 1.27–2.92, 2.01–5.58, 3.64–23.35; Risk I/II/III, respectively). In 141 patients with recurrence, molecular targeted therapies (MTTs) or immune checkpoint inhibitors (ICIs) were included in 58%, 47%, 32%, and 0% (Risk 0/I/II/III) during the course of treatment. In patients with MTT/ICI treatment, the estimated 1-year and 3-year post-recurrence survival rates were 88% and 58%, respectively. Conclusions: Risk classification for LEC was associated with survival after lung cancer surgery, as well as post-recurrence treatment. The concept of physical performance-preserving surgery may contribute to improving the outcomes of current lung cancer treatment.

DOI： 10.1007/s00268-021-06427-3

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of Surgical Oncology  

Background: Thymoma patients with pleural dissemination are difficult to manage, and their treatment strategy remains undefined. This study aimed to investigate the clinicopathologic features of these patients, focusing on the association between the depth of pleural invasion and prognosis. Methods: Between 2003 and 2019, the study identified 120 disseminated lesions in 20 thymoma patients. Seven patients had de novo stage IVa thymoma and 13 were recurrent cases. Extrapleural pneumonectomy was performed for 8 patients and debulking surgery for 12 patients. Invasion depth of pleural tumors was classified into two groups: when the disseminated tumors invaded the pleura beneath the elastic layer, the tumor was diagnosed as Da, and when the disseminated tumors invaded the pleura beyond the elastic layer, the tumor was diagnosed as Db. Results: Of 120 nodules, 31 (26%), found in eight patients with recurrent malignancies, were classified as Db. The pathologic status of the surgical margin (PSM) was positive in eight patients, seven of whom had Db nodules. The 5-year overall survival (OS) rate was 100% in the Da group and 75% in the Db group (P = 0.02). The 5-year progression-free survival (PFS) rate was 66.7% in the Da group and 25% in the Db group (P = 0.02). Cox univariate analysis showed that PFS was significantly influenced by the depth of invasion (P = 0.04) and PSM (P = 0.03). Conclusion: Depth of pleural invasion may influence survival outcomes for thymoma patients with pleural dissemination. The patients in this study with Da-disseminated nodules had an increased probability of a longer OS and PFS and tended to achieve negative PSM compared with the patients with Db.

DOI： 10.1245/s10434-021-10888-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Annals of surgical oncology  

DOI： 10.1245/s10434-021-10969-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Plos One  

Objective The aim of the present study was to investigate the associations between breastfeeding and the prevalence of metabolic syndrome in community-dwelling parous women and to clarify whether the associations depend on age. Methods The present cross-sectional study included 11,118 women, aged 35–69 years. Participants’ longest breastfeeding duration for one child and their number of breastfed children were assessed using a self-administered questionnaire, and their total breastfeeding duration was approximated as a product of the number of breastfed children and the longest breastfeeding duration. The longest and the total breastfeeding durations were categorized into none and tertiles above 0 months. Metabolic syndrome and cardiovascular risk factors (obesity, hypertension, dyslipidemia, and hyperglycemia) were defined as primary and secondary outcomes, respectively. Associations between breastfeeding history and metabolic syndrome or each cardiovascular risk factor were assessed using multivariable unconditional logistic regression analysis. Results Among a total of 11,118 women, 10,432 (93.8%) had ever breastfed, and 1,236 (11.1%) had metabolic syndrome. In participants aged <55 years, an inverse dose–response relationship was found between the number of breastfed children and the prevalence of metabolic syndrome; multivariable-adjusted odds ratios for 1, 2, 3, and ?4 breastfed children were 0.60 (95% confidence interval [CI]: 0.31 to 1.17), 0.50 (95% CI: 0.29 to 0.87), 0.44 (95% CI: 0.24 to 0.84), and 0.35 (95% CI: 0.14 to 0.89), respectively. The longest and total breastfeeding durations of longer than 0 months were also associated with lower odds of metabolic syndrome relative to no breastfeeding history in participants aged <55 years. In contrast, all measures of breastfeeding history were not significantly associated with metabolic syndrome and cardiovascular risk factors in participants aged ?55 years old. Conclusions Breastfeeding history may be related to lower prevalence of metabolic syndrome in middleaged parous women.

DOI： 10.1371/journal.pone.0262252

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記述言語：日本語   出版者・発行元：(一社)日本疫学会  

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記述言語：日本語   出版者・発行元：日本小児呼吸器学会  

本邦における肺移植は、世界の肺移植の成功から15年遅れて行われ、その後20余年が経過した。本邦における肺移植は、800例を超え、その生存率は世界屈指のレベルである。しかし、肺は、気道によって外界と直接通ずる臓器であり、肺移植において感染と拒絶のバランスを長期に維持することは難しく、グラフトの生着率は低い。また、小児肺移植数は少なく、慢性呼吸不全に罹患する小児患者の治療の一つとして、肺移植が定着し、将来的に増加していくことを期待し、今回、肺移植の現状と未来について概説する。肺移植は、世界的には今後も増加する医療であり、とくに脳死ドナーが今後増加する可能性が高い本邦では、小児ドナーの増加とともに、小児肺移植数も増加することが予想される。また、本邦では、小児に対する生体肺移植も必須の治療オプションであることから、小児呼吸器領域における肺移植の知識の共有は、今後さらに重要なものとなると考えられる。(著者抄録)

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Epidemiology  

Background: The Japan Multi-institutional Collaborative Cohort (J-MICC) study was launched in 2005 to examine gene–environment interactions in lifestyle-related diseases, including cancers, among the Japanese. This report describes the study design and baseline profile of the study participants. Methods: The participants of the J-MICC Study were individuals aged 35 to 69 years enrolled from respondents to study announcements in specified regions, inhabitants attending health checkup examinations provided by local governments, visitors at health checkup centers, and first-visit patients at a cancer hospital in Japan. At the time of the baseline survey, from 2005 to 2014, we obtained comprehensive information regarding demographics, education, alcohol consumption, smoking, sleeping, exercise, food intake frequency, medication and supplement use, personal and family disease history, psychological stress, and female reproductive history and collected peripheral blood samples. Results: The baseline survey included 92,610 adults (mean age: 55.2 [standard deviation, 9.4] years, 44.1% men) from 14 study regions in 12 prefectures. The participation rate was 33.5%, with participation ranging from 19.7% to 69.8% in different study regions. The largest number of participants was in the age groups of 65–69 years for men and 60–64 years for women. There were differences in body mass index, educational attainment, alcohol consumption, smoking, and sleep duration between men and women. Conclusions: The J-MICC Study collected lifestyle and clinical data and biospecimens from over 90,000 participants. This cohort is expected to be a valuable resource for the national and international scientific community in providing evidence to support longer healthy lives.

DOI： 10.2188/jea.JE20200147

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記述言語：英語   出版者・発行元：BMJ Open  

Introduction Thoracoscopic surgery is performed for refractory or recurrent primary spontaneous pneumothorax (PSP). To reduce postoperative recurrence, additional treatment is occasionally adopted during surgery after bulla resection. However, the most effective method has not been fully elucidated. Furthermore, the preference for additional treatment varies among countries, and its efficacy in preventing recurrence must be evaluated based on settings tailored for the conditions of a specific country. The number of registries collecting detailed data about PSP surgery is limited. Therefore, to address this issue, a prospective multicentre observational study was performed. Methods and analysis This multicentre, prospective, observational study will enrol 450 participants aged between 16 and 40 years who initially underwent PSP surgery. Data about demographic characteristics, disease and family history, surgical details, and CT scan findings will be collected. Follow-up must be conducted until 3 years after surgery or in the event of recurrence, whichever came first. Patients without recurrence will undergo annual follow-up until 3 years after surgery. The primary outcome is the rate of recurrence within 2 years after surgery. A multivariate analysis will be performed to compare the efficacy of different surgical options. Then, adverse outcomes correlated with various treatments and the feasibility of treatment methods will be compared. Ethics and dissemination This study was approved by the local ethics committee of all participating centres. The findings will be available in 2025, and they can be used as a basis for clinical decision-making regarding appropriate options for the initial PSP surgery. Trial registration number NCT04758143.

DOI： 10.1136/bmjopen-2021-052045

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s40792-021-01323-3

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BMC Cancer  

Background: The aim of this study was to assess the diagnostic utility of metabolic parameters on fluorine-18-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) for predicting lymph node (LN) metastasis in patients with cN2 non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed patients who underwent surgery for cN2 NSCLC between 2007 and 2020. Those who had clinically diagnosed positive hilar and mediastinal LNs by routine CT and PET/CT imaging were investigated. To measure the metabolic parameters of LNs, the data according to maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN-to-primary tumor ratio of SUVmax (LPR) were examined. The diagnosis of each retrieved LN was confirmed based on histopathological examination of surgical tissue specimens. Receiver operating characteristics (ROC) curves with area under the curve (AUC) calculations and multivariate analysis by logistic regression were performed. Results: Forty-five patients with 84 clinically diagnosed positive hilar or mediastinal LNs were enrolled in the present study. Of the 84 LNs, 63 LNs were pathologically proven as positive (75%). The SUVmax, MTV, TLG, and LPR of LN metastasis were significantly higher than those of benign nodes. In the ROC analysis, the AUC value of LPR [AUC, 0.776; 95% confidence interval (CI), 0.640–0.913] was higher than that of LN SUVmax (AUC, 0.753; 95% CI, 0.626–0.880) or LN TLG3.5 (AUC, 0.746; 95% CI, 0.607–0.885). Using the optimal LPR cutoff value of 0.47, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 84.1, 66.7, 88.3, 58.3, and 79.8%, respectively. Multivariate analysis by logistic regression showed that LPR was an independent predictor for LN metastasis (odds ratio, 6.45; 95% CI, 1.785–23.301; P = 0.004). In the subgroup analysis of adenocarcinoma patients (n = 18; 32 LNs), TLG3.5 was a better predictor (AUC, 0.816; 95% CI, 0.639–0.985) than LPR (AUC, 0.792; 95% CI, 0.599–0.986) or LN SUVmax (AUC, 0.792; 95% CI, 0.625–0.959). Conclusions: Our findings suggest that LPR on FDG-PET is a useful predictor for LN metastasis in patients with cN2 NSCLC. TLG can be a good predictor for LN metastasis in patients with adenocarcinoma.

DOI： 10.1186/s12885-021-08688-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: The aim of this study was to investigate the effects of inflammatory respiratory complications on long-term survival in patients with resected non-small cell lung cancer. We defined inflammatory respiratory complications to include the following six conditions: pneumonia, empyema, bronchial fistula, respiratory dysfunction, acute interstitial pneumonia, and atelectasis. Methods: Part of the National Clinical Database was linked to our prospective database from 2014 to 2017. Linkage was achieved for 866 patients. The Kaplan–Meier method was used to evaluate the overall, relapse-free, and cancer-related survival. The Cox proportional hazard model was used to analyze the impact of each complication. Results: Of the 736 patients included in the study, 149 had complications. The 5-year overall and cancer-specific survival rates were significantly lower in patients with inflammatory respiratory complications. The Cox proportional hazard model showed that the inflammatory respiratory complications had a significant impact on overall survival (hazard ratio 2.48, 95% confidence interval 1.41–4.38) but not air leak (hazard ratio 1.38, 95% confidence interval 0.70–2.70). Conclusions: Our study shows the differential impact of each complication on the survival of patients with non-small cell lung cancer. The presence of inflammatory respiratory complications was the only predictor of poor overall survival.

DOI： 10.1007/s11748-021-01619-z

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：日本語   出版者・発行元：(一社)日本移植学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：European Journal of Clinical Nutrition  

Background/Objectives: Individual eating habits may be influenced by genetic factors, in addition to environmental factors. Previous studies suggested that adherence to Japanese food patterns was associated with a decreased risk of all-cause and cardiovascular disease mortality. We conducted a genome-wide association study (GWAS) in a Japanese population to find genetic variations that affect adherence to a Japanese food pattern. Subjects/Methods: We analyzed GWAS data using 14,079 participants from the Japan Multi-Institutional Collaborative Cohort study. We made a Japanese food score based on six food groups. Association of the imputed variants with the Japanese food score was performed by linear regression analysis with adjustments for age, sex, total energy intake, alcohol intake (g/day), and principal components 1–10 omitting variants in the major histocompatibility region. Results: We found one SNP in the 14q11.2 locus that was significantly associated with the Japanese food score with P values <5 × 10⁻⁸. Functional annotation revealed that the expression levels of two genes (BCL2L2, SLC22A17) were significantly inversely associated with this SNP. These genes are known to be related to olfaction and obesity. Conclusion: We found a new SNP that was associated with the Japanese food score in a Japanese population. This SNP is inversely associated with genes link to olfaction and obesity.

DOI： 10.1038/s41430-020-00823-z

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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担当区分：筆頭著者   記述言語：英語  

DOI： 10.1007/s11748-021-01619-z.

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s40792-021-01148-0

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記述言語：英語  

DOI： 10.1186/s40792-021-01148-0.

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

The coverage technique using absorbable mesh was first described in a European guideline published in 2015 as a preventive method for the recurrence of spontaneous pneumothorax. We performed a meta-analysis based on a literature search of primary studies that compared the postoperative recurrence rate of primary spontaneous pneumothorax between the use and nonuse of polyglycolic acid sheet coverage. Two reviewers independently selected and evaluated the quality of the relevant studies. The risk ratio in each study was calculated in a random-effect meta-analysis. Statistical heterogeneity among the included studies was quantitatively evaluated using the I² index, and publication bias was assessed using a funnel plot. A total of 19 retrospective cohort studies were analyzed: 1524 patients who underwent wedge resection alone (the control group) and 1579 who received additional sheet coverage. Polyglycolic acid sheet coverage was associated with a lower recurrence rate than that in the control group (risk ratio: 0.27, 95% confidence interval 0.20–0.37, P < 0.001; I² 0%). The funnel plot suggested possible publication bias. The covering technique reduced the recurrence rate of pneumothorax after thoracoscopic surgery to one-fourth.

DOI： 10.1038/s41598-021-83103-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Prostate cancer is emerging as a significant global public health burden. The incidence and prevalence of prostate cancer has increased in Japan, as westernized lifestyles become more popular. Recent advances in genetic epidemiology, including genome-wide association studies (GWASs), have identified considerable numbers of human genetic factors associated with diseases. Several GWASs have reported significant loci associated with serum prostate-specific antigen (PSA) levels. One GWAS, which was based on classic GWAS microarray measurements, has been reported for Japanese so far. In the present study,we conducted a GWAS of serum PSA using 1000Genomes imputed GWAS data (n =1,216) from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study, to detect candidate novel genetic loci that influence serum PSA levels in Japanese. The association of SNPs/genetic variants with serum PSA as a continuous variable was tested using the linear Wald test. SNP rs10000006 in SGMS2 (sphingomyelin synthase 2) on chromosome 4 had genome-wide significance (P <5×10∑8), and eight variants on three chromosomes (chromosomes 12, 14, 15) had genome-wide suggestive levels of significance (P <1×10∑6). With an independent data set from the J-MICC Shizuoka Study (n = 2,447), the association of the SGMS2 SNP with blood PSA levels was not replicated. Although our GWAS failed to detect novel loci associated with serum PSA levels in the Japanese cohort, it confirmed the significant effects of previously reported genetic loci on PSA levels in Japanese. Importantly, our results confirmed the significance of KLK3 SNPs also in Japanese, implying that consideration of individual genetic information in prostate cancer diagnosis may be possible in the future.

DOI： 10.18999/nagjms.83.1.183

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Epidemiology  

Background: While duodenal ulcer (DU) and gastric cancer (GC) are both H. pylori infection-related diseases, individuals withDU are known to have lower risk for GC. Many epidemiological studies have identified the PSCA rs2294008 T-allele as a risk factor of GC, while others have found an association between the rs2294008 C-allele and risk of DU and gastric ulcer (GU). Following these initial reports, however, few studies have since validated these associations. Here, we aimed to validate the association between variations in PSCA and the risk of DU=GU and evaluate its interaction with environmental factors in a Japanese population. Methods: Six PSCA SNPs were genotyped in 584 DU cases, 925 GU cases, and 8,105 controls from the Japan Multi-Institutional Collaborative Cohort (J-MICC). Unconditional logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the SNPs and risk of DU=GU. Results: PSCA rs2294008 C-allele was associated with per allele OR of 1.34 (95% CI, 1.18-1.51; P = 2.28 × 10^-6) for the risk of DU. This association was independent of age, sex, study site, smoking habit, drinking habit, and H. pylori status. On the other hand, we did not observe an association between the risk of GU and PSCA SNPs. Conclusions: Our study confirms an association between the PSCA rs2294008 C-allele and the risk of DU in a Japanese population.

DOI： 10.2188/jea.JE20190184

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: According to the tumor-node-metastasis classification for thymic malignancies, the proportion of patients diagnosed with stage I is expected to increase significantly. However, whether those patients have homogenous clinicopathological features and survival has not been fully evaluated. Methods: We reviewed 153 consecutive patients with stage I thymic epithelial tumors (133 thymomas, 15 thymic carcinomas, and 5 neuroendocrine tumors) who underwent complete resection at our institution between 2001 and 2016 and evaluated the prognostic significance of their clinicopathological factors. Results: The stage I patients accounted for 78% of all thymic epithelial tumors. The 5-year overall survival and recurrence-free survival rates of the 153 patients were 94% and 80%, respectively. The patients with the histology of thymic carcinoma or neuroendocrine tumor and with a tumor larger than 5.0 cm showed significantly worse recurrence-free survival in multivariate analysis (p = 0.027 and 0.038, respectively). Only the tumor size was revealed as a significant prognostic factor for recurrence-free survival when limited in the 133 cases of thymoma (p = 0.048). Conclusions: Patients with large tumors showed significantly worse recurrence-free survival than those with small tumors both in stage I thymic epithelial tumors and thymomas.

DOI： 10.1007/s11748-020-01427-x

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記述言語：日本語   出版者・発行元：(一社)日本疫学会  

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記述言語：日本語   出版者・発行元：一般社団法人 日本移植学会  

<p>【背景】脳死ドナー臓器摘出では、外科医だけでなく臨床工学技士（ME）・看護師・コーディネーター等多職種が関わる医療で、実際の手技を知っていればよりよい連携が可能かもしれない。献体されたご遺体の固定方法は進化しており、特殊な保存液で固定された状態は生体と類似しているため、手術トレーニングに用いることが可能となった。肺移植実施施設でない当院での実施施設へのとり組みの一貫として、心臓外科医・ME・医学生と合同で臓器摘出トレーニングを実行したので報告する。</p><p>【トレーニング概要】開胸・心嚢切開し臓器評価方法を全員で確認した後、心灌流液注入用と肺灌流液ドレナージ用のカテーテルを各留置し、大血管を遮断し心臓摘出、続いて肺摘出を行った。続いてバックテーブルにて肺の植え込みができる状態にまで処理を行いトレーニング終了とした。心肺摘出に際して重要となる左房の処理については、操作を止め指導医にポイントを解説してもらいつつ、心臓外科・呼吸器外科の双方の考えを伝え、解剖を確認しながら行った。また、MEと肺灌流液ドレナージ経路の方法や肺灌流のタイミングなど細やかな部分まで共有できた。</p><p>【結語】本トレーニングは多職種での手技と順序の確認に有用で、臓器摘出の際互いに心がけているポイントや考えも共有・理解できた。今後はプログラムを定型化し、実践に対応できるレベルに質を高めつつ、看護師やコーディネーターも含めて行う予定である。</p>

DOI： 10.11386/jst.56.supplement_s105

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Gene  

Dyslipidemia is a well-established risk factor for cardiovascular disease. Experimental studies have reported that peroxisome proliferator-activated receptor γ (PPAR-γ) regulates adipocyte differentiation, lipid storage, and glucose metabolism. Therefore, we examined the associations between PPAR-γ polymorphisms (rs1801282, rs3856806, rs12497191, rs1151999, and rs1152003) and serum lipids in two cross-sectional studies. In the Shizuoka area of the Japan Multi-Institutional Collaborative Cohort Study, we examined 4,952 participants (3,356 men and 1,596 women) in a baseline survey and 2,245 participants (1,550 men and 695 women) in a second survey 5 years later. Outcome measures were the prevalence of dyslipidemia (low-density lipoprotein-cholesterol [LDL-C] ≥ 140 mg/dl, high-density lipoprotein-cholesterol < 40 mg/dl, triglycerides ≥ 150 mg/dl, and/or use of cholesterol-lowering drugs) and the prevalence of high LDL-C (LDL-C ≥ 140 mg/dl and/or use of cholesterol-lowering drugs). Multivariate odds ratios (ORs) were estimated by using unconditional logistic regression models. A total of 2,114 and 1,431 individuals (42.7% and 28.9%) had dyslipidemia and high LDL-C in the baseline survey, respectively, as did 933 and 716 (41.6% and 31.9%), respectively, in the second survey. In the baseline study, compared with major allele homozygotes, minor allele homozygotes of rs3856806 and rs12497191 had a 42% (OR, 0.58; 95% confidence interval (CI), 0.39–0.85) and 23% (OR, 0.77; 95% CI, 0.60–0.99) lower risk of dyslipidemia, respectively, after adjustment for potential confounding factors. In addition, minor allele homozygotes of rs3856806 had a 45% (OR, 0.55; 95% CI, 0.35–0.86) lower risk of high LDL-C. Similar risk reductions were found in the second survey. In conclusion, rs3856806 and rs12497191 polymorphisms may be related to a lower risk of dyslipidemia and high LDL-C.

DOI： 10.1016/j.gene.2020.145019

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Scientific Reports  

There are few studies examining the association between homocysteine (Hcy) level and the risk of hypertension with consideration for folate and vitamin B<inf>12</inf> as related to Hcy level. We simultaneously examined the associations of plasma levels of Hcy, folate, and vitamin B<inf>12</inf>, and dietary folate intake with the prevalence of hypertension. Participants included 1046 men and 1033 women (mean age ± standard deviation: 56.0 ± 8.9 years) in the Japan Multi-Institutional Collaborative Cohort Study. Dietary folate intake was estimated using a validated food frequency questionnaire. Hypertension was defined based on measured blood pressure and use of antihypertensive medication. A total of 734 participants (35.3%) had hypertension. Multivariate-adjusted odds ratios of hypertension for the highest quartile group of Hcy were 2.36 (95% CI 1.41–3.96) in men and 1.86 (95% CI 1.11–3.11) in women, as compared with the lowest group (P for trend = 0.014 and 0.005, respectively). Dietary folate intake was not correlated with hypertension in both men and women (P for trend = 0.099 and 0.703, respectively). Plasma vitamin B<inf>12</inf> was positively associated with hypertension only in women (P for trend = 0.027). Plasma Hcy level was positively linked with hypertension after controlling for covariates, including folate and vitamin B<inf>12</inf>.

DOI： 10.1038/s41598-020-75267-3

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本胸部外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：英語  

記述言語：日本語   出版者・発行元：(一社)日本呼吸器学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器内視鏡学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, imageguided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and ex vivo lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

DOI： 10.18999/nagjms.82.2.161

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Human Hypertension  

The aim of this study is to show the combined effect of weight gain within normal weight range in adulthood and parental HT on the prevalence of HT. The study subjects were 44,998 individuals (19,039 men and 25,959 women) with normal weight (body mass index [BMI] 18.5–24.9) aged 35–69 years who participated in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. They were categorized into six groups by weight gain from age 20 years (<10 kg, and ≥10 kg) and by the number of parents having HT (no parent, one parent, and both parents). Odds ratios for HT were estimated after adjustment for age, sex, current BMI, estimated daily sodium intake, and other confounding factors. The prevalence of HT (31.5% in total subjects) gradually increased with greater weight gain from age 20 years and with greater number of parents with HT. Subjects who gained weight ≥10 kg and having both parents with HT showed the highest risk of having HT compared with those who gained weight <10 kg without parental HT (59.8% vs. 24.9%, odds ratio 4.25, 95% CI 3.53–5.13 after adjustment). This association was similarly observed in any category of age, sex, and BMI. Subjects who gained weight within normal range of BMI and having one or both parent(s) with HT showed the higher risk of having HT independent of their attained BMI in their middle ages. Thus, subjects having parent(s) with HT should avoid gaining their weight during adulthood, even within normal range of BMI, to reduce the risk of having HT.

DOI： 10.1038/s41371-019-0230-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nutrition Journal  

Background: Mental health has become a major public health issue worldwide. Biological and epidemiological studies suggest diet has a role in the prevention or cure of mental disorders. However, further research is required to elucidate the relationship between diet and mental health. This study aimed to investigate associations between dietary intake of nutrients (macronutrients, vitamins, calcium, and fatty acids) and food groups (fish, meat and chicken, dairy products, and vegetables) and mental health among middle-aged Japanese in cross-sectional and prospective studies. Methods: In total, 9298 men and women that participated in two areas of the Japan Multi-Institutional Collaborative Cohort Study were eligible for analysis at the baseline (cross-sectional) survey. Of these, 4701 participants were followed for about 5 years and included in the follow-up (prospective) analysis. The 12-item General Health Questionnaire (GHQ) was used to assess participants' general mental health status over the past several weeks. The average intake of 46 foods over the past year was assessed by a validated food frequency questionnaire. We also evaluated lifestyle and medical factors using a self-administered questionnaire. A cross-sectional logistic regression analysis was performed to estimate odds ratios for a GHQ score ≥ 4 (poor mental health) according to dietary intake of foods/nutrients at baseline. The prospective study used baseline dietary and lifestyle factors and GHQ scores at follow-up. Results: The cross-sectional logistic regression analysis showed vegetables, protein, calcium, vitamin D, carotene and n-3 highly-polyunsaturated fatty acids were inversely associated with a GHQ score ≥ 4. On the other hand, mono-unsaturated fatty acids showed a positive association with higher GHQ score. The prospective logistic regression analysis found dairy products, calcium, vitamin B<inf>2</inf>, and saturated fatty acids were inversely correlated with a GHQ score ≥ 4. Calcium was associated with GHQ scores in both the cross-sectional and follow-up studies. In the follow-up study, the multivariable-adjusted odds ratio for a GHQ score ≥ 4 was 0.71 (95% confidence interval, 0.55-0.92) for the highest versus lowest quartiles of calorie-adjusted dietary calcium intake. Conclusion: Consuming particular nutrients and foods, especially calcium and dairy products, may lead to better mental health in Japanese adults.

DOI： 10.1186/s12937-019-0515-6

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Lipid Research  

Few studies have investigated the interactions between HDL-C-related SNPs identified by genome-wide association (GWA) study and physical activity (PA) on HDL-C. First, we conducted a sex-stratified GWA study in a discovery sample (2,231 men and 2,431 women) and replication sample (2,599 men and 3,109 women) to identify SNPs influencing log-transformed HDL-C in Japanese participants in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. We also replicated previously reported HDLC- related SNPs in a combined (discovery plus replication) sample (4,830 men and 5,540 women). We then analyzed the interactions of the HDL-C-related SNPs with PA on HDL-C. The sex-stratified GWA analyses identified 11 and 10 HDL-Crelated SNPs in men and women as targets for an interaction analysis. Among these, only one interaction of ABCA1 rs1883025 with PA was statistically significant in men, after Bonferroni correction [P-interaction = 0.001 (α = 0.05/21 = 0.002)]. The per-major-allele (C allele) increase in log-transformed HDL-C was lost in men with low PA (β = 0.008) compared with those with medium (β= 0.032) or high PA (β= 0.034). These findings suggest that the benefit of carrying a C allele of ABCA1 rs1883025 on enhancing HDL-C may be attenuated in inactive men.

DOI： 10.1194/jlr.P091546

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Atherosclerosis and Thrombosis  

Aim: Accumulating evidence reveals that sedentary behavior is associated with mortality and cardiometabolic disease; however, there are potential age and sex differences in sedentary behavior and health outcomes that have not been adequately addressed. This study aimed to determine the association of sedentary behavior with cardiometabolic diseases such as hypertension, dyslipidemia, diabetes mellitus, and its risk factors in a large Japanese population according to age and sex. Methods: Using data from the Japan Multi-Institutional Collaborative Cohort Study obtained from baseline surveys, data of 62,754 participants (27,930 males, 34,824 females) were analyzed. This study uses a cross-sectional design and self-administered questionnaires to evaluate sedentary time and anamnesis. For the logistic regression analysis, sedentary time ＜5 h/day was used as the reference and then adjusted for age, research areas, leisure-time metabolic equivalents, and alcohol and smoking status. From the analysis of anthropometric and blood examinations, 35,973 participants (17,109 males, 18,864 females) were analyzed. Results: For hypertension and diabetes, sedentary time was associated with a significantly higher proportion of male participants. Both sexes were associated with a significantly higher proportion of participants with dyslipidemia. Participants who had longer sedentary time tended to have increased levels of blood pressure, triglycerides, and non-high-density lipoprotein cholesterol (HDL-C), and decreased levels of HDL-C, especially in the 60–69 years group. Conclusions: Independent of leisure-time physical activity, sedentary time was associated with cardiometabolic diseases in a large Japanese population classified by age and sex. Our findings indicate that regularly interrupting and replacing sedentary time may contribute to better physical health-related quality of life.

DOI： 10.5551/jat.54320

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Human Hypertension  

The prevention of hypertension starts with the awareness of risk. Our aim was to construct a simple and well-validated risk model for nonhypertensive people in Japan consisting of basic clinical variables, using a dataset for two areas derived from the Japan Multi-Institutional Collaborative Cohort Study. We constructed a continuous-value model using data on 5105 subjects participating in both the baseline survey and a second survey conducted after 5 years. The area under the receiver operating characteristic curve (AUC) and the Hosmer–Lemeshow χ² statistic for the entire cohort were 0.826 and 7.06, respectively. For validation, the entire cohort was randomly divided 100 times into derivation and validation sets at a ratio of 6:4. The summarized median AUC and the Hosmer–Lemeshow χ² statistic were 0.83 and 12.2, respectively. The AUC of a point-based model consisting of integer scores assigned to each variable was 0.826 and showed no difference, compared with the continuous-value model. This simple risk model may help the general population to assess their risks of new-onset hypertension.

DOI： 10.1038/s41371-019-0226-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nagoya Journal of Medical Science  

Forest walking or Shinrin-yoku is a health promotion activity in Japan. Although some studies have reported the acute effects of walking a few hours in forested areas in reducing blood pressure level compared to other environments, studies investigating whether successive walking has long-term effects in lowering blood pressure levels or lowering prevalence of hypertension are rare. This study aimed to reconfirm the presence or absence of an association between the frequency of forest walking and prevalence of hypertension in a Japanese population. This J-MICC Daiko Study was conducted targeting residents in Nagoya City. A total of 5,109 participants (1,452 men and 3,657 women; age, mean ± standard deviation: 52.5 ± 10.3 years) were included in the analysis. Age-adjusted blood pressure level by frequency of forest walking was not significant. After adjusting for age and lifestyle, the adjusted odds ratios (aORs) of the most frequent group (n=88, 1.7%; once a week or more group) relative to the less than once a month group (n=4,558, 89.2%) for prevalence of hypertension were not also significant [0.80 (95% CI: 0.40-1.62) for men and 1.48 (95% CI: 0.73-3.00) for women]. This study reconfirmed that either lowering blood pressure level or lowering the prevalence of hypertension is not associated with frequency of forest walking, similar to the results of our previous J-MICC Shizuoka Study. Given that these two studies were cross-sectional studies, cohort studies investigating the causal relationship are required to evaluate the effect of frequent forest walking on the prevention of hypertension.

DOI： 10.18999/nagjms.81.3.489

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nutrients  

The association between nutrient patterns and metabolic syndrome (MetS) has not been examined in a Japanese population. A cross-sectional study was performed on 30,108 participants (aged 35-69 years) in the baseline survey of the Japan Multi-Institutional Collaborative Cohort Study. Dietary intake was assessed using a 46-item food frequency questionnaire. MetS was diagnosed according to the Joint Interim Statement Criteria of 2009, using body mass index instead of waist circumference. Factor analysis was applied to energy-adjusted intake of 21 nutrients, and three nutrient patterns were extracted: Factor 1 (fiber, potassium and vitamins pattern); Factor 2 (fats and fat-soluble vitamins pattern); and Factor 3 (saturated fatty acids, calcium and vitamin B2 pattern). In multiple logistic regression analysis adjusted for sex, age, and other potential confounders, Factor 1 scores were associated with a significantly reduced odds ratio (OR) of MetS and all five components. Factor 2 scores were associated with significantly increased prevalence of MetS, obesity, and high blood pressure. Factor 3 scores were significantly associated with lower OR of MetS, high blood pressure, high serum triglycerides and low HDL cholesterol levels. Analysis of nutrient patterns may be useful to assess the overall quality of diet and its association with MetS.

DOI： 10.3390/nu11050990

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medicine United States  

Brief exposure to passive smoking immediately elevates blood pressure. However, little is known about the association between exposure to passive smoking and chronic hypertension. We aimed to examine this association in a cross-sectional study, after controlling multiple potential confounders. Participants included 32,098 lifetime nonsmokers (7,216 men and 24,882 women) enrolled in the Japan Multi-Institutional Collaborative Cohort Study. Passive smoking was assessed using a self-administered questionnaire. The single question about exposure to passive smoking had five response options: Ågsometimes or almost never,Åh Ågalmost every day, 2 hours/day or less,Åh Ågalmost every day, 2 to 4 hours/day,Åh Ågalmost every day, 4 to 6 hours/day,Åh and Ågalmost every day, 6 hours/day or longer.Åh Hypertension was defined as any of the following: systolic blood pressure ≥140mmHg, diastolic blood pressure ≥90mmHg, or use of antihypertensive medication. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for hypertension were estimated by exposure level to passive smoking using unconditional logistic regression models. The multivariate-adjusted OR for hypertension in those exposed almost every day was 1.11 (95% CI: 1.03.1.20) compared with those exposed sometimes or almost never. The OR for a 1-hour per day increase in exposure was 1.03 (95% CI: 1.01.1.06, Pfor trend=.006). This association was stronger in men than in women; the ORs were 1.08 (95% CI: 1.01.1.15, P<inf>for trend</inf>=.036) and 1.03 (95% CI: 1.00.1.05, P<inf>for trend</inf>=.055), respectively. Our findings suggest importance of tobacco smoke control for preventing hypertension.

DOI： 10.1097/MD.0000000000013241

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記述言語：英語   出版者・発行元：General Thoracic and Cardiovascular Surgery  

Objective: Clinical evidence comparing paravertebral (PVB) and continuous intercostal nerve (ICB) blocks for pain management post video-assisted thoracic surgery (VATS) is limited. This study confirms the analgesic effect of ICB using two catheters is not inferior to that of PVB under direct vision. Methods: Fifty patients who underwent VATS lobectomy from July 2015 to March 2016 were prospectively recruited and randomly assigned to PVB and ICB groups. Postoperative pain was assessed using the visual analog scale (VAS). VAS score at rest at 24 h was the primary endpoint. Data on time required for catheter insertion, adverse effects, and frequency of additional analgesics as secondary endpoints were also collected. Noninferiority was assessed by adding a VAS margin of 15 mm to the PVB group. Results: No significant differences were observed between the VAS scores of the two groups except at 48 h after surgery, with a margin noted for the PVB group. No significant differences were detected in the frequency of additional analgesics and occurrence of adverse effects. Conclusions: Our results could not clearly establish noninferiority of ICB to PVB. Improvements in ICB may be necessary for it to be used as an alternative method to PVB.

DOI： 10.1007/s11748-018-0936-8

Web of Science

Scopus

PubMed

記述言語：日本語   出版者・発行元：日本呼吸器外科学会  

<p>症例は60歳男性．繰り返す喀血を主訴に前医を受診した．重症肺炎の既往があり，左肺機能の低下を指摘されていた．胸部CTで左肺全体の囊胞状変化と容積低下，気管支拡張を認めた．複数の気管支動脈が高度に拡張し大動脈弓下と左肺門部を蛇行していた．標的血管が多く著明な拡張を伴っていたため気管支動脈塞栓術は不可能と判断し手術を施行した．手術は肺動静脈の処理を先行し，異常血管の集簇切離を行うことで時間を短縮し出血を最小限にとどめた．左肺全摘術後，広背筋弁にて気管支断端を被覆した．出血量は1,040 mLであった．術後経過は良好で以降は喀血を認めていない．気管支動脈蔓状血管腫の手術では異常血管の脆弱性と易出血性のため出血コントロールに苦慮する事がある．我々は，手術時の異常血管切離の手順と方法に工夫を加えることで高度に拡張した続発性気管支動脈蔓状血管腫の手術を比較的少ない出血量で手術を終えることができた．</p>

DOI： 10.2995/jacsurg.32.458

CiNii Research

記述言語：日本語   出版者・発行元：日本呼吸器外科学会  

<p>目的：呼吸器外科手術において上大静脈や腕頭静脈の合併切除と血行再建を行った症例について，手術方法，周術期管理および再建血管の開存性について検討した．</p><p>方法：2005年から2014年までに上大静脈および腕頭静脈の切除と再建を施行した15例を対象とした．患者背景，再建術式，使用した人工血管の種類，抗凝固療法および再建血管の閉塞の有無および閉塞時の症状等を調査した．</p><p>結果：対象疾患は胸腺上皮性腫瘍11例，胚細胞性腫瘍2例，肺癌・悪性リンパ腫各1例で，切除した血管は上大静脈13例，右腕頭静脈12例，左腕頭静脈14例であった．全例で，血行再建には径10 mm以上の人工血管が使用され，周術期に抗凝固療法が行われていた．再建血管の閉塞が確認されたのは6例で，左右腕頭静脈再建例では人工血管閉塞時の症状出現が少なかった．</p><p>結論：大血管の切除を伴う手術は現在においても困難な術式であるが，今回検討した症例では周術期死亡や術後急性期の人工血管閉塞は認められなかった．また，人工血管閉塞に伴う症状が出現しない場合には血管閉塞時にも経過観察が可能であると考えられた．</p>

DOI： 10.2995/jacsurg.31.446

CiNii Research

記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本肺癌学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本呼吸器外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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開催年月日： 2022年4月

記述言語：日本語  

開催地：熊本  

開催年月日： 2020年8月

記述言語：日本語   会議種別：ポスター発表  

開催地：横浜