Publications by authors named "Hirokawa M"

Purpose: Parathyroid lipoadenomas are difficult to recognize preoperatively; hence, they may remain undetected. Difficulty in recognition is thought to be due to the adipocytes present in the tumor. This study aimed to clarify the impact of adipocytes as a component of parathyroid adenomas on ultrasound evaluation.

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Objective: Cyanoacrylate closure (CAC) is a minimally invasive technique for treating axial venous reflux. However, the incidence of serious adverse events (AEs) related to CAC is concerning. With an increasing number of patients receiving CAC and insufficient safety data in Japan, this study aimed to investigate the safety profile of CAC, focusing on the types and incidence of AEs.

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Managing thyroid nodules diagnosed cytologically as follicular neoplasms (FN) is challenging for patients and clinicians. Gene panel testing was recently introduced to determine the management strategy for FN; however, it is unavailable in Japan. In this study, we assessed FN management.

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  • KEAP1 is a protein that usually promotes the degradation of NRF2, a factor that helps cells respond to oxidative stress, but mutations in KEAP1 can lead to diseases like familial multinodular goiter.
  • This study analyzed 39 patients with this goiter, identifying five with specific KEAP1 mutations that did not correlate with any other mutations related to goiter.
  • Results showed that these mutations led to increased activity of NRF2, causing thyroid hyperplasia and a protective response against oxidative stress, indicated by the upregulation of antioxidant and detoxification genes.
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  • The study focuses on establishing reference values for the tricuspid annulus (TA) geometry in a Japanese population, which is important for tricuspid valve surgery related to tricuspid regurgitation (TR).
  • Using 3D echocardiography, researchers analyzed data from 96 healthy Japanese subjects and found that TA area and circumference strongly correlate with body surface area, while age has a weaker correlation.
  • Gender differences in TA geometry were significant in younger subjects, with males showing larger TA area and smaller diameters compared to females, but these differences lessened with age.
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  • The study investigates factors that can predict the recurrence of papillary thyroid carcinoma (PTC) after patients undergo airway resection, with a focus on a group of 149 patients monitored for an average of 93 months.
  • Out of these patients, 11 (6.7%) experienced tracheal excision site recurrence (ESR), with significant predictors identified as a Ki-67 labeling index of 5% or higher and a thyroglobulin doubling rate greater than 0.33/year.
  • The findings suggest that patients with high Ki-67 LI and high Tg-DR should receive careful monitoring post-surgery, and adjuvant treatments like external beam radiotherapy could be
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Objectives: We evaluated the efficacy and safety of cyanoacrylate closure (CAC) for endovascular treatment of varicose veins with cyanoacrylate adhesive (VenaSeal® closure system) in Japan.

Methods: A multicenter prospective consecutive registry study was conducted at 12 centers in Japan on 125 patients with primary varicose veins who underwent CAC. The patients were evaluated on target vein occlusion, postoperative complications, Visual Analogue Scale (VAS) for pain, revised Venous Clinical Severity Score (rVCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), and EuroQol 5 dimensions 5-level (EQ-5D-5L) for 1-year after the surgery.

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Anti-PD immunotherapy is currently under investigation in anaplastic thyroid carcinoma (ATC). Tumor cell surface PD-L1 expression is considered predictive of therapeutic response. Although papillary thyroid carcinoma has been widely studied for PD-L1 expression, there are limited data on ATC.

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Background: Fine-needle aspiration cytology serves as an important preoperative diagnostic tool for thyroid nodules. Despite its excellent diagnostic accuracy, diagnoses based solely on morphological observation can be challenging. Therefore, various ancillary diagnostic techniques have been applied, including immunocytochemistry (ICC).

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  • A study examined the relationship between changes in arterial stiffness and left ventricular (LV) remodeling over time in 317 participants without cardiovascular disease.
  • Results indicated that increased arterial stiffness, measured by cardio-ankle vascular index (CAVI), was linked to impaired LV global longitudinal strain (LVGLS), an important indicator of heart function.
  • Notably, this association was observed primarily in women, highlighting that vascular health may significantly influence heart function even in early stages, contributing to heart failure risk.
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  • - The study explored how body fat distribution affects left atrial (LA) size and its potential to reverse in nonobese atrial fibrillation (AF) patients, revealing a link between central fat and LA remodeling.
  • - A total of 116 nonobese AF patients underwent catheter ablation, and measures like body mass index (BMI) and waist-to-hip (W/H) ratio were analyzed alongside fat percentages to see their impact on LA volume changes over six months.
  • - Results showed that higher W/H ratios and central fat percentages were associated with ongoing LA enlargement post-ablation, emphasizing the need to evaluate body fat distribution, even in patients who are not obese.
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Objective: The simplest way to determine the adequacy of aspirated materials is the on-site gross visual assessment of aspirated materials. However, few studies have examined the gross findings of thyroid aspirates. This study aimed to clarify the diagnostic significance of clay-like material aspirated from thyroid nodules.

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Methotrexate (MTX) is a well-known agent that can potentially cause lymphoproliferative disorder (LPD), known as MTX-related LPD (MTX-LPD). Only two cases of thyroid MTX-LPD have been reported to date. This study aimed to report 11 cases of MTX-LPDs arising in the thyroid gland and discuss their clinicopathological characteristics.

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Oligonucleotides are short nucleic acids that serve as one of the most promising classes of drug modality. However, attempts to establish a physicochemical evaluation platform of oligonucleotides for acquiring a comprehensive view of their properties have been limited. As the chemical stability and the efficacy as well as the solution properties at a high concentration should be related to their higher-order structure and intra-/intermolecular interactions, their detailed understanding enables effective formulation development.

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Although the development of prosocial behavior has been widely studied from the behavioral aspect, the neural mechanisms underlying prosocial behavior in the early stages of development remain unclear. Therefore, this study investigated the neural mechanisms underlying the emergence of prosocial behavior in 3-year-old children. Brain activity in the medial pFC and right TPJ (rTPJ) and facial expression activity, which are related to the ability to infer others' mental states (mentalizing), during the observation of prosocial and antisocial scenes were measured using functional near-infrared spectroscopy and electromyography, respectively.

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Backgruound: Hashimoto thyroiditis (HT) is suspected to correlate with papillary thyroid carcinoma (PTC) development. While some HT cases exhibit histologic features of immunoglobulin G4 (IgG4)-related disease, the relationship of HT with PTC progression remains unestablished.

Methods: This cross-sectional study included 426 adult patients with PTC (≥1 cm) undergoing thyroidectomy at an academic thyroid center.

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Introduction: Thyroglobulin (Tg) is a very sensitive and specific marker in patients who have undergone total thyroidectomy for papillary thyroid carcinoma (PTC). However, the presence of a Tg antibody (TgAb) interferes with Tg immunometric assays, making Tg levels unreliable indicators. There are currently no other tumor markers to monitor in patients with PTC whose serum is TgAb-positive.

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Purpose: Multiple punctate echogenic foci (MPEF) on thyroid ultrasonography reflects psammoma bodies in papillary thyroid carcinomas. However, MPEF is also observed in benign thyroid lesions. The aim of this study was to determine the origin of MPEF in patients with benign thyroid lesions.

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  • * The CAC-AE survey collected data from 1,030 authorized institutions, reporting 16 cases of proximal deep vein thrombosis, 3 cases of pulmonary embolism, and various other complications.
  • * The findings highlighted a total of 299 cases of localized phlebitis or allergic reactions, with one postoperative death linked to pulmonary embolism, aiming to present real-world data on CAC-related AEs in Japan.
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Papillary thyroid carcinoma (PTC) with marked cystic formation (CPTC) is not a subtype of PTC, and its clinical characteristics have not been fully investigated. This study aimed to clarify the clinical and pathological characteristics of CPTC and propose important indicators for its clinical management. Thirty-three CPTC nodules with cystic areas occupying >50% of their volume were examined.

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Differentiating BRAF V600E- and RAS-altered encapsulated follicular-patterned thyroid tumors based on morphology remains challenging. This study aimed to validate an 8-score scale nuclear scoring system and investigate the importance of nuclear pseudoinclusions (NPIs) in aiding this differentiation. A cohort of 44 encapsulated follicular-patterned tumors with varying degrees of nuclear atypia and confirmed BRAF V600E or RAS alterations was studied.

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Background: Follicular tumors include follicular thyroid adenomas and carcinomas; however, it is difficult to distinguish between the two when the cytology or biopsy material is obtained from a portion of the tumor. The presence or absence of invasion in the resected material is used to differentiate between adenomas and carcinomas, which often results in the unnecessary removal of the adenomas. If nodules that may be follicular thyroid carcinomas are identified preoperatively, active surveillance of other nodules as adenomas is possible, which reduces the risk of surgical complications and the expenses incurred during medical treatment.

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  • The study evaluates how well next-generation sequencing (NGS) works for detecting RET proto-oncogene changes in thyroid cancer tissue samples from Japanese hospitals.
  • Factors like sample age, processing methods, and DNA/RNA quality were analyzed to determine their impact on NGS success rates, which were found to be high overall (90% for DNA, 93% for RNA).
  • Key findings highlighted that newer samples and specific fixation conditions improved NGS success, and the quality of extracted nucleic acids from older samples (≥3 years) was crucial for reliable results.
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