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Shinoda M, Nishimura A, Sugiyama E, Sato H, Iijima T. Optimal Timing of Intravenous Acetaminophen Administration for Postoperative Analgesia. Anesth Prog 2022; 69:3-10. [PMID: 35849812 DOI: 10.2344/anpr-69-02-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/16/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Acetaminophen (APAP) is widely used as an analgesic for postoperative pain relief. However, the pharmacokinetic-pharmacodynamic (PK-PD) properties of intravenous APAP administration remain unclear. We developed a PK-PD model in adult volunteers. METHODS APAP (1 g) was intravenously administered to 15 healthy volunteers. The pain equivalent current (PEC) was then measured using the pulse current, corresponding to the quantitative value of pain perception. The PK model was developed using a 2-compartment model, and the PD model was developed using a linear model and an effect compartment model. RESULTS APAP plasma concentration peaked just administration, whereas PEC significantly increased at 90 minutes and lasted through the experimental period (300 minutes). APAP plasma concentrations and PEC were processed for use in the PK-PD model. The developed PK-PD model delineates the analgesic effect profile, which peaked at 188 minutes and lasted until 327 minutes. CONCLUSION We developed the PK/PD model for APAP administered intravenously. The analgesic effect can be expected ∼90 minutes after administration and to last >5 hours. It is suggested that APAP be administered ∼90 minutes prior to the onset of anticipated postoperative pain.
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Affiliation(s)
- Maho Shinoda
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan
| | - Erika Sugiyama
- Department of Pharmacology, Toxicology and Therapeutics, Division of Pharmacokinetics and Pharmacodynamics, Showa University School of Pharmacy, Japan
| | - Hitoshi Sato
- Department of Pharmacology, Toxicology and Therapeutics, Division of Pharmacokinetics and Pharmacodynamics, Showa University School of Pharmacy, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan
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Nishimura A, Kawahara M, Kawachi Y, Hasegawa J, Makino S, Kitami C, Nakano T, Otani T, Nemoto M, Hattori S, Nikkuni K. Totally laparoscopic resection of right-sided colon cancer using transvaginal specimen extraction with a 10-mm-long abdominal incision. Tech Coloproctol 2022; 26:755-760. [DOI: 10.1007/s10151-022-02636-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/01/2022] [Indexed: 11/24/2022]
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Togao O, Obara M, Kikuchi K, Helle M, Arimura K, Nishimura A, Wada T, Murazaki H, Van Cauteren M, Hiwatashi A, Ishigami K. Vessel-Selective 4D-MRA Using Superselective Pseudocontinuous Arterial Spin-Labeling with Keyhole and View-Sharing for Visualizing Intracranial Dural AVFs. AJNR Am J Neuroradiol 2022; 43:368-375. [PMID: 35241425 PMCID: PMC8910818 DOI: 10.3174/ajnr.a7426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/11/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE An accurate assessment of the hemodynamics of an intracranial dural AVF is necessary for treatment planning. We aimed to investigate the utility of 4D-MRA based on superselective pseudocontinuous arterial spin-labeling with CENTRA-keyhole and view-sharing (4D-S-PACK) for the vessel-selective visualization of intracranial dural AVFs. MATERIALS AND METHODS We retrospectively analyzed the images of 21 patients (12 men and 9 women; mean age, 62.2 [SD,19.2] years) with intracranial dural AVFs, each of whom was imaged with DSA, 4D-S-PACK, and nonselective 4D-MRA based on pseudocontinuous arterial spin-labeling combined with CENTRA-keyhole and view-sharing (4D-PACK). The shunt location, venous drainage patterns, feeding artery identification, and Borden classification were evaluated by 2 observers using both MRA methods on separate occasions. Vessel selectivity was evaluated on 4D-S-PACK. RESULTS Shunt locations were correctly evaluated in all 21 patients by both observers on both MRA methods. With 4D-S-PACK, observers 1 and 2 detected 76 (80.0%, P < .001) and 73 (76.8%, P < .001) feeding arteries of the 95 feeding arteries identified on DSA but only 39 (41.1%) and 46 (48.4%) feeding arteries with nonselective 4D-PACK, respectively. Both observers correctly identified 10 of the 11 patients with cortical venous reflux confirmed by DSA with both 4D-S-PACK and 4D-PACK (sensitivity = 90.9%, specificity = 90.9% for each method), and they made accurate Borden classifications in 20 of the 21 patients (95.2%) on both MRA methods. Of the 84 vessel territories examined, vessel selectivity was graded 3 or 4 in 73 (91.2%) and 66 (88.0%) territories by observers 1 and 2, respectively. CONCLUSIONS 4D-S-PACK is useful for the identification of feeding arteries and accurate classifications of intracranial dural AVFs and can be a useful noninvasive clinical tool.
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Affiliation(s)
- O. Togao
- From the Departments of Molecular Imaging & Diagnosis (O.T.)
| | - M. Obara
- Philips Japan (M.O., M.V.C.), Tokyo, Japan
| | | | - M. Helle
- Philips Research (M.H.), Hamburg, Germany
| | - K. Arimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A. Nishimura
- Neurosurgery (K.A., A.N.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T. Wada
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
| | - H. Murazaki
- Division of Radiology (T.W., H.M.), Department of Medical Technology, Kyushu University Hospital, Fukuoka, Japan
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Teshima R, Nishimura A, Hara A, Ubukata Y, Chizuwa S, Wakatsuki M, Iijima T. Anesthesia Management of a Patient With Familial Cold Autoinflammatory Syndrome: A Case Report. Anesth Prog 2022; 69:38-39. [PMID: 36223190 PMCID: PMC9552617 DOI: 10.2344/anpr-69-02-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 03/03/2023] Open
Abstract
Familial cold autoinflammatory syndrome (FCAS) is a rare phenotype of cryopyrin-associated periodic syndrome (CAPS) and is characterized by repetitive systemic inflammation triggered by cold stimulation. Recently, we treated a 13-year-old female with FCAS/CAPS scheduled to undergo removal of an impacted tooth. To minimize perioperative heat loss, a forced-air warming system was utilized to prewarm the patient for 10 minutes before induction of general anesthesia. The patient's core and peripheral temperatures were monitored with axillary, superficial temporal artery, and rectal thermometers. The difference in temperatures at these 3 locations decreased to 0.4° C within 60 minutes as a result of the forced-air warming system before induction. Perioperative use of the warming system successfully prevented the occurrence any significant redistribution hypothermia and any symptoms of FCAS/CAPS.
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Affiliation(s)
- Ruri Teshima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Akira Hara
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Yuhei Ubukata
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Sayaka Chizuwa
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Mone Wakatsuki
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
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Kajiwara R, Nakamura S, Ikeda K, Onimaru H, Yoshida A, Tsutsumi Y, Nakayama K, Mochizuki A, Dantsuji M, Nishimura A, Tachikawa S, Iijima T, Inoue T. Intrinsic properties and synaptic connectivity of Phox2b-expressing neurons in rat rostral parvocellular reticular formation. Neurosci Res 2021; 178:41-51. [PMID: 34973291 DOI: 10.1016/j.neures.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
The paired-like homeobox 2b gene (Phox2b) is critical for the development of the autonomic nervous system. We have previously demonstrated the distinct characteristics of Phox2b-expressing (Phox2b+) neurons in the reticular formation dorsal to the trigeminal motor nucleus (RdV), which are likely related to jaw movement regulation. In this study, we focused on Phox2b+ neurons in the rostral parvocellular reticular formation (rPCRt), a critical region for controlling orofacial functions, using 2-11-day-old Phox2b-EYFP rats. Most Phox2b+ rPCRt neurons were glutamatergic, but not GABAergic or glycinergic. Approximately 65 % of Phox2b+ rPCRt neurons fired at a low frequency, and approximately 24 % of Phox2b+ rPCRt neurons fired spontaneously, as opposed to Phox2b+ RdV neurons. Stimulation of the RdV evoked inward postsynaptic currents in more than 50 % of Phox2b+ rPCRt neurons, while only one Phox2b+ rPCRt neuron responded to stimulation of the nucleus of the solitary tract. Five of the 10 Phox2b+ neurons sent their axons that ramified within the trigeminal motor nucleus (MoV). Of these, the axons of the two neurons terminated within both the MoV and rPCRt. Our findings suggest that Phox2b+ rPCRt neurons have distinct electrophysiological and synaptic properties that may be involved in the motor control of feeding behavior.
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Affiliation(s)
- Risa Kajiwara
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan; Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Shiro Nakamura
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Keiko Ikeda
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Hiroshi Onimaru
- Department of Physiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Atsushi Yoshida
- Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
| | - Yumi Tsutsumi
- Department of Oral Anatomy and Neurobiology, Osaka University Graduate School of Dentistry, 1-8 Yamada-Oka, Suita, Osaka, 565-0871, Japan
| | - Kiyomi Nakayama
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Ayako Mochizuki
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Masanori Dantsuji
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Satoshi Tachikawa
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Tomio Inoue
- Department of Oral Physiology, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
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Abstract
BACKGROUND Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation. RESEARCH QUESTION/AIM/OBJECTIVES This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice. RESEARCH DESIGN/PARTICIPANTS AND RESEARCH CONTEXT We surveyed the basic attributes of and used the Ode's Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors. ETHICAL CONSIDERATIONS This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors' permission. FINDINGS/RESULTS Significant differences were found in the mean "ethical behavior" scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the "justice" subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without. DISCUSSION Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience. CONCLUSION Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences.
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Komatsu T, Chen-Yoshikawa TF, Ikeda M, Takahashi K, Nishimura A, Harashima SI, Date H. Impact of diabetes mellitus on postoperative outcomes in individuals with non-small-cell lung cancer: A retrospective cohort study. PLoS One 2020; 15:e0241930. [PMID: 33166327 PMCID: PMC7652320 DOI: 10.1371/journal.pone.0241930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/22/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Studies showing that individuals with non-small cell lung cancer (NSCLC) and diabetes mellitus (DM) have reported poor outcomes after pulmonary resection with varying results. Therefore, we investigated the clinical impact of preoperative DM on postoperative morbidity and survival in individuals with resectable NSCLC. PATIENTS AND METHODS Data of individuals who underwent pulmonary resection for NSCLC from 2000 to 2015 were extracted from the database of Kyoto University Hospital. The primary endpoint was the incidence of postoperative complications, and secondary endpoints were postoperative length of hospital stay and overall survival. The survival rate was analyzed using the Kaplan-Meier method. RESULTS A total of 2,219 patients were eligible for the study. The median age of participants was 67 years. Among them, 39.5% were women, and 259 (11.7%) presented with DM. The effect of DM on the incidence of postoperative complications and postoperative length of hospital stay was not significant. Although the 5-year survival rates were similar in both patients with and without DM (80.2% versus 79.4%; p = 0.158), those with DM who had a hemoglobin A1c level ≥ 8.0% had the worst survival. CONCLUSIONS In individuals with resectable NSCLC, preoperative DM does not influence the acute phase postoperative recovery. However, poorly controlled preoperative DM could lead to low postoperative survival rates.
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Affiliation(s)
- Teruya Komatsu
- Division of Thoracic Surgery, National Hospital Organization Nagara Medical Center, Gifu, Japan.,Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Masaki Ikeda
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Takahashi
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Faculty of Nursing, School of Medicine, Nara Medical University, Nara, Japan
| | - Shin-Ichi Harashima
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Goshominami Harashima Clinic, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Harada M, Nomura Y, Nishimura A, Motoike Y, Koshikawa M, Watanabe E, Izawa H, Ozaki Y. Factors associated with silent cerebral events during catheter ablation for atrial fibrillation in the era of uninterrupted oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A silent cerebral event (SCE), detected by brain magnetic resonance imaging (MRI), is defined as an acute new brain lesion without clinically apparent neurological deficit, and is frequently observed after catheter ablation in atrial fibrillation (AF) patients. Although the small number of SCEs does not cause neurocognitive dysfunction, the greater volume and/or larger number of SCE lesions are reportedly related to neuropsychological decline; SCE incidence may be a surrogate marker for the potential thromboembolic risk. Thus, strategies to reduce SCEs would be beneficial. Uninterrupted oral anticoagulation strategy for peri-procedural period reportedly reduced the risk of SCEs, but the incidence hovers at 10% to 30%. We sought factors associated with SCEs during catheter ablation for AF in patients with peri-procedural uninterrupted oral anticoagulation (OAC) therapy.
Methods
AF patients undergoing catheter ablation were eligible (n=255). All patients took non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for peri-procedural OAC (>4 weeks) without interruption during the procedure. Brain MRI was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure-related parameters were compared between patients with and without SCEs.
Results
SCEs were detected in 59 patients (23%, SCE[+]) but not in 196 patients (77%, SCE[-]). Average age was higher in SCE[+] than SCE[-] (66±10 years vs. 62±12 years, p<0.05). Persistent AF prevalence, CHADS2/CHA2DS2-VASc scores, and serum NT-ProBNP levels increased in SCE[+] vs. SCE[-]. In transthoracic/transesophageal echocardiography, left-atrial dimension (LAD) was larger and AF rhythm/spontaneous echo contrast were more frequently observed in SCE[+] than SCE[-]. SCE[+] had lower initial activated clotting time (ACT) before unfractionated heparin (UFH) injection and longer time to reach optimal ACT (>300 sec) before trans-septal puncture than SCE [-]. In multivariate analysis, LAD, initial ACT before UFH injection, and time to reach optimal ACT were predictors for SCEs.
Conclusions
LAD and intra-procedural ACT kinetics affect SCEs during the procedure in patients with uninterrupted OAC for AF ablation. Shortening time to achieve optimal ACT during the procedure may reduce the risk of SCEs.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | | | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Nishimura A, Harashima SI, Hosoda K, Honda I. Overeating Risk in Overweight Young Women Is Divided into Two Types According to Appetite and Eating Behavior. Metab Syndr Relat Disord 2020; 18:435-442. [PMID: 32667840 DOI: 10.1089/met.2020.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The problem of obesity in young women leads to future chronic diseases, effects on reproductive health, and next-generation obesity. Thus, it is necessary to provide effective support for these women's behavioral change. The purpose of this study was to evaluate dietary-related indicators to clarify the appetite and eating behavior problems among young women. Methods: Healthy women 18-39 years of age were enrolled. Interoceptive awareness (IA) was quantified using a heartbeat perception task score. Eating behavior was examined in three ways: Three-Factor Eating Questionnaire (TFEQ), visual analog scales of subjective appetite sensations, and a food consumption test. Results: In all, 15 participants who were overweight and 50 with normal weight were analyzed. The overweight women were clustered into two groups according to the heartbeat perception task score: a low-score group (women with overweight who have low IA [OW-LOW]) and high-score group (women with overweight who have high IA [OW-HIGH]). The OW-LOW group had significantly smaller intermeal changes in hunger score compared with women with normal weight. The disinhibition score on the TFEQ for the OW-HIGH group was significantly higher than the normal-weight women, and the prospective consumption score in the fasting condition was significantly higher in women with normal weight and a high heartbeat perception task score. Conclusions: Overweight young women were characterized into two groups with different appetite and eating behavior, which is connected to the risk of overeating. An appetite characteristic is associated with a high risk of obesity among the normal-weight population. Individualized interventions tailored to the IA levels may help in improving and preventing obesity.
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Affiliation(s)
- Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Faculty of Nursing, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Shin-Ichi Harashima
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Internal Medicine, Goshominami Harashima Clinic, Kyoto, Japan
| | - Kiminori Hosoda
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Division of Diabetes and Lipid Metabolism, Department of Lifestyle-Related Diseases, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ikumi Honda
- Department of Nursing, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Ohara S, Nishimura A, Tachikawa S, Iijima T. Effect of remifentanil on intraoperative fluid balance: a retrospective statistical examination of factors contributing to fluid balance. J Dent Anesth Pain Med 2020; 20:129-135. [PMID: 32617407 PMCID: PMC7321735 DOI: 10.17245/jdapm.2020.20.3.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/25/2020] [Accepted: 06/08/2020] [Indexed: 11/15/2022] Open
Abstract
Background Postoperative fluid retention is a factor that causes delay in recovery and unexpected adverse events. It is important to prevent intraoperative fluid retention, which is putatively caused by intraoperative release of stress hormones, such as ADH (anti-diuretic hormone) or others. We hypothesized that intraoperative analgesia may prevent pathological fluid retention. We retrospectively explored the relationship between analgesics and in-out balance in surgical patients from anesthesia records. Methods Anesthetic records of 80 patients who had undergone orthognathic surgery were checked in this study. Patients were anesthetized with either TIVA (propofol and remifentanil) or inhalational anesthesia (sevoflurane and remifentanil). During surgery, acetated Ringer's solution was infused for maintenance at a rate of 3-5 ml/kg/h at the discretion of the anesthetist. The perioperative parameters, including the amount of crystalloid and colloid infused, and the amount of urine and bleeding were checked. Furthermore, we checked the amount and administration rate of remifentanil during the surgical procedure. The correlation coefficient between the remifentanil dose and the in-out balance or the urinary output was analyzed using the Pearson correlation coefficient. The contributing factor to fluid retention, including urinary output, was statistically examined by means of multivariate logistic regression analysis. Results A significant positive correlation was found between remifentanil dose and urinary output. Urinary output less than 0.04 ml/kg/min was suggested to cause positive fluid balance. Although in-out balance approaches zero balance with increase in remifentanil administration rate, no contributing factor for near-zero fluid balance was statistically picked up. The remifentanil administration rate was statistically picked up as the significant factor for higher urinary output (> 0.04 ml/kg/min) (OR, 2,644; 95% CI, 3.2-2.2 × 106) among perioperative parameters. Conclusions In conclusion, remifentanil contributes in maintaining the urinary output during general anesthesia. Although further prospective study is needed to confirm this hypothesis, it was suggested that fluid retention could be avoided through suppressing intraoperative stress response by means of appropriate maintenance of remifentanil infusion rate.
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Affiliation(s)
- Sayaka Ohara
- Department of Perioperative Medicine, Division of Anesthesiology, School of Dentistry, Showa University, Ohta City, Tokyo, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, School of Dentistry, Showa University, Ohta City, Tokyo, Japan
| | - Satoshi Tachikawa
- Department of Perioperative Medicine, Division of Anesthesiology, School of Dentistry, Showa University, Ohta City, Tokyo, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, School of Dentistry, Showa University, Ohta City, Tokyo, Japan
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Kansaki H, Konno R, Fujii K, Nishimura A. Nurses' experience in providing care at shelters following natural hazards and disasters: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:1070-1076. [PMID: 32813361 DOI: 10.11124/jbisrir-d-19-00271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The review will synthesize current evidence regarding the experiences of nurses who care for people living in shelters following natural hazards and disasters. INTRODUCTION Over the last decade, due to climate change and global warming, the damage caused by natural hazards and disasters like hurricanes, floods and heavy rainfall has been steadily growing. Following natural hazards and disasters, many who lose their homes reside in evacuation shelters for prolonged periods. The loss of medical infrastructure in disaster-stricken areas can result in evacuees' health being compromised and the spread of disease and/or infection. Under such circumstances, disaster relief nurses can play a critical role in supporting these victims. This review aims to provide useful information for nurses who are working in disaster shelters. INCLUSION CRITERIA The review will include qualitative studies examining experiences of nurses caring for people living in shelters following natural hazards and disasters, published in either English or Japanese. Studies published from 2000 to the present will be considered. METHODS The review will follow the meta-aggregation approach developed by JBI. Published and unpublished studies will be searched using major international databases and other relevant databases for gray literature in either English or Japanese. Two reviewers will independently appraise studies and extract qualitative data using the JBI standardized critical appraisal and extraction instruments. Findings from the review will be categorized according to their similarity in meaning and their categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. The final synthesized findings will be graded according to the ConQual approach.
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Affiliation(s)
- Hatsumi Kansaki
- School of Nursing, Hyogo University of Health Sciences, Hyogo, Japan
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12
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Tatebayashi K, Yamamoto K, Tomida T, Nishimura A, Takayama T, Oyama M, Kozuka-Hata H, Adachi-Akahane S, Tokunaga Y, Saito H. Osmostress enhances activating phosphorylation of Hog1 MAP kinase by mono-phosphorylated Pbs2 MAP2K. EMBO J 2020; 39:e103444. [PMID: 32011004 PMCID: PMC7049814 DOI: 10.15252/embj.2019103444] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/22/2019] [Accepted: 01/08/2020] [Indexed: 12/21/2022] Open
Abstract
The MAP kinase (MAPK) Hog1 is the central regulator of osmoadaptation in yeast. When cells are exposed to high osmolarity, the functionally redundant Sho1 and Sln1 osmosensors, respectively, activate the Ste11‐Pbs2‐Hog1 MAPK cascade and the Ssk2/Ssk22‐Pbs2‐Hog1 MAPK cascade. In a canonical MAPK cascade, a MAPK kinase kinase (MAP3K) activates a MAPK kinase (MAP2K) by phosphorylating two conserved Ser/Thr residues in the activation loop. Here, we report that the MAP3K Ste11 phosphorylates only one activating phosphorylation site (Thr‐518) in Pbs2, whereas the MAP3Ks Ssk2/Ssk22 can phosphorylate both Ser‐514 and Thr‐518 under optimal osmostress conditions. Mono‐phosphorylated Pbs2 cannot phosphorylate Hog1 unless the reaction between Pbs2 and Hog1 is enhanced by osmostress. The lack of the osmotic enhancement of the Pbs2‐Hog1 reaction suppresses Hog1 activation by basal MAP3K activities and prevents pheromone‐to‐Hog1 crosstalk in the absence of osmostress. We also report that the rapid‐and‐transient Hog1 activation kinetics at mildly high osmolarities and the slow and prolonged activation kinetics at severely high osmolarities are both caused by a common feedback mechanism.
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Affiliation(s)
- Kazuo Tatebayashi
- Laboratory of Molecular Genetics, Frontier Research Unit, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Katsuyoshi Yamamoto
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Taichiro Tomida
- Department of Physiology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Akiko Nishimura
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Tomomi Takayama
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Masaaki Oyama
- Medical Proteomics Laboratory, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroko Kozuka-Hata
- Medical Proteomics Laboratory, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Satomi Adachi-Akahane
- Department of Physiology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yuji Tokunaga
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Haruo Saito
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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13
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Abstract
An estimation of the appropriate tubing depth for fixation is helpful to prevent inadvertent endobronchial intubation and prolapse of cuff from the vocal cord. A feasible estimation formula should be established. We measured the anatomical length of the upper-airway tract through the oral and nasal pathways on cephalometric radiographs and tried to establish the estimation formula from the height of the patient. The oral upper-airway tract was measured from the tip of the incisor to the vocal cord. The nasal upper-airway tract was measured from the tip of the nostril to the vocal cord. The tracts were smoothly traced by using software. The length of the oral upper-airway tract was 13.2 ± 0.8 cm, and the nasal upper-airway tract was 16.1 ± 0.9 cm. We found no gender difference ( p > .05). The correlations between the patients' height and the length of the oral and nasal upper-airway tracts were 0.692 and 0.760, respectively. We found that the formulas (height/10) - 3 (in cm) for oral upper-airway and (height/10) + 1 (in cm) for nasal upper-airway tract are the simple fit estimation formulas. The average error and standard deviation of the estimated values from the measured values were 0.50 ± 0.66 cm for the oral tract and 0.39 ± 0.63 cm for the nasal tract. Thus, considering the length of the intubation marker of each product (DM), we would like to propose the length of tube fixation as (height/10) + 1 + DM for nasal intubation and (height/10) - 3 + DM for oral intubation. In conclusion, the estimation formulas of (height/10) - 3 + DM and (height/10) + 1 + DM for oral and nasal intubation, respectively, are within almost 1 cm error in most cases.
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Affiliation(s)
- Keiko Yao
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Kinuko Goto
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Reina Shimazu
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Satoshi Tachikawa
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
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14
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Dóka É, Ida T, Dagnell M, Abiko Y, Luong NC, Balog N, Takata T, Espinosa B, Nishimura A, Cheng Q, Funato Y, Miki H, Fukuto JM, Prigge JR, Schmidt EE, Arnér ESJ, Kumagai Y, Akaike T, Nagy P. Control of protein function through oxidation and reduction of persulfidated states. Sci Adv 2020; 6:eaax8358. [PMID: 31911946 PMCID: PMC6938701 DOI: 10.1126/sciadv.aax8358] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 11/05/2019] [Indexed: 05/17/2023]
Abstract
Irreversible oxidation of Cys residues to sulfinic/sulfonic forms typically impairs protein function. We found that persulfidation (CysSSH) protects Cys from irreversible oxidative loss of function by the formation of CysSSO1-3H derivatives that can subsequently be reduced back to native thiols. Reductive reactivation of oxidized persulfides by the thioredoxin system was demonstrated in albumin, Prx2, and PTP1B. In cells, this mechanism protects and regulates key proteins of signaling pathways, including Prx2, PTEN, PTP1B, HSP90, and KEAP1. Using quantitative mass spectrometry, we show that (i) CysSSH and CysSSO3H species are abundant in mouse liver and enzymatically regulated by the glutathione and thioredoxin systems and (ii) deletion of the thioredoxin-related protein TRP14 in mice altered CysSSH levels on a subset of proteins, predicting a role for TRP14 in persulfide signaling. Furthermore, selenium supplementation, polysulfide treatment, or knockdown of TRP14 mediated cellular responses to EGF, suggesting a role for TrxR1/TRP14-regulated oxidative persulfidation in growth factor responsiveness.
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Affiliation(s)
- É. Dóka
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
| | - T. Ida
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - M. Dagnell
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Abiko
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
| | - N. C. Luong
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
- Faculty of Pharmacy, Hue University of Medicine and Pharmacy, Hue University, 06 Ngo Quyen, Hue, Vietnam
| | - N. Balog
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
| | - T. Takata
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - B. Espinosa
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - A. Nishimura
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - Q. Cheng
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Funato
- Department of Cellular Regulation, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - H. Miki
- Department of Cellular Regulation, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - J. M. Fukuto
- Department of Chemistry, Sonoma State University, Rohnert Park, Sonoma, CA 94928, USA
| | - J. R. Prigge
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - E. E. Schmidt
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - E. S. J. Arnér
- Department of Medical Biochemistry and Biophysics, Division of Biochemistry, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Y. Kumagai
- Environmental Biology Section, Faculty of Medicine, University of Tsukuba, 305-8575 Tsukuba, Japan
| | - T. Akaike
- Department of Environmental Medicine and Molecular Toxicology, Tohoku University Graduate School of Medicine, 980-8575 Sendai, Japan
| | - P. Nagy
- Department of Molecular Immunology and Toxicology, National Institute of Oncology, 1122 Budapest, Hungary
- Corresponding author.
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15
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Saito Y, Shiraishi K, Nishimura A, Kirinaka T, Sakurai Y, Tomida T. Fluorescence Database of Aerosol-Candidate-Substances for Fluorescence Lidar Application. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202023707016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A database containing spectrum and cross-section of the fluorescence of substances has been made. In test of forest environment monitoring by our Laser-Induced Fluorescence Spectrum (LIFS) lidar, the database showed that the origin substance of the aerosol observed by the lidar was cedar pollen, and the concentration was calculated using the cross-section. In the urban atmosphere monitoring, three substances stored in the database were proposed to be the origins of the aerosol. Based on these experiments, we discuss the usefulness of the fluorescence database in lidar observations.
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16
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Harada M, Motoike Y, Nomura Y, Nishimura A, Nagasaka R, Koshikawa M, Ichikawa T, Watanabe E, Ozaki Y. P1901Use of direct thrombin inhibitor on the day of atrial fibrillation ablation decreases incidence of silent cerebral ischemia detected by magnetic resonance imaging. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is increasing evidence to use direct oral anticoagulants (DOACs) in atrial fibrillation (AF) ablation. Uninterrupted use of DOACs is recommended for peri-procedural anticoagulation; the ways of choosing and/or using DOACs depend on physicians' decisions and preferences. Uninterrupted dabigatran (DAB), a direct thrombin inhibitor, reportedly decreased the risk of major bleeding (MB) in AF ablation, compared to uninterrupted warfarin (NEJM 2017; 376:1627). Among DOACs, only regular-dose of DAB (150 mg b.i.d.), showed superiority to warfarin for preventing ischemic thromboembolism (TE) in patients with non-valvular AF, implicating the powerful anti-thrombotic agent. DAB may decrease the potential risk of procedure-related TE.
Purpose
To evaluate whether use of DAB on the day of AF ablation decreases the prevalence of silent cerebral ischemia (SCI) detected by magnetic resonance imaging (MRI).
Methods
414 AF patients on DOACs were enrolled and admitted on the day before AF ablation. Among 354 patients on factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), the original DOACs were switched to DAB (150 mg b.i.d.) on the day of the procedure in 172 patients (Group D); the treatment remained unchanged in 182 patients (Group non-D). In both groups, DOACs were continuously used throughout the procedure. After propensity-score matching, procedure-related parameters/events and the incidence of MRI-detected SCI were compared between Group D (n=134) and Group non-D (n=134). These parameters in patients originally taking DAB, used without interruption during the procedure (uninterrupted DAB, n=55), were also compared to Group D (n=55) after propensity-score matching.
Results
Baseline activated clotting time (ACT) before initial heparin injection was increased in Group D vs. Group-non-D (179±25* vs. 146±23 sec, *p<0.05 vs. Group non-D). The time to achieve optimal ACT (>300 sec) was shorter in Group D (34±29* vs. 43±32 min). The amounts of heparin needed to achieve optimal ACT and the total amount of heparin used during the procedure were unchanged between Group D and Group non-D. The incidence of SCI decreased in Group D (13.1%* vs. 21.9%), suggesting the potential anti-thrombotic efficacy of DAB. No MB or symptomatic TE events were observed in either group. Baseline ACT, the time to achieve ACT >300 sec, and the incidence of SCI in Group D were comparable to those in uninterrupted DAB (183±38 vs. 181±32 sec, 39±31 vs. 42±28 min, and 14.5% vs. 16.4%, respectively). No MB or symptomatic TE events were observed either in Group D or uninterrupted DAB.
Conclusions
Temporarily switching to DAB from the other DOACs and using it on the day of procedure enable us to achieve optimal ACT quickly and decrease the incidence of SCI, showing similar potential anti-thrombotic efficacy to uninterrupted DAB. Use of DAB on the day of AF ablation also benefits from the availability of its antidote in the case of MB during the procedure.
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - R Nagasaka
- Fujita Health University, Toyoake, Japan
| | | | - T Ichikawa
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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17
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Oshima A, Nishimura A, Chen-Yoshikawa T, Harashima SI, Komatsu T, Handa T, Aoyama A, Takahashi K, Ikeda M, Oshima Y, Ikezoe K, Sato S, Isomi M, Shide K, Date H, Inagaki N. Nutrition-related factors associated with waiting list mortality in patients with interstitial lung disease: a retrospective cohort study. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Oshima A, Nishimura A, Chen-Yoshikawa TF, Harashima SI, Komatsu T, Handa T, Aoyama A, Takahashi K, Ikeda M, Oshima Y, Ikezoe K, Sato S, Isomi M, Shide K, Date H, Inagaki N. Nutrition-related factors associated with waiting list mortality in patients with interstitial lung disease: A retrospective cohort study. Clin Transplant 2019; 33:e13566. [PMID: 31002178 DOI: 10.1111/ctr.13566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/22/2019] [Accepted: 04/01/2019] [Indexed: 12/15/2022]
Abstract
Japanese patients with interstitial lung disease (ILD) sometimes die waiting for lung transplantation (LTx) because it takes about 2 years to receive it in Japan. We evaluated nutrition-related factors associated with waiting list mortality. Seventy-six ILD patients were hospitalized in Kyoto University Hospital at registration for LTx from 2013 to 2015. Among them, 40 patients were included and analyzed. Patient background was as follows: female, 30%; age, 50.3 ± 6.9 years; body mass index, 21.1 ± 4.0 kg/m2 ; 6-minute walk distance (6MWD), 356 ± 172 m; serum albumin, 3.8 ± 0.4 g/dL; serum transthyretin (TTR), 25.3 ± 7.5 mg/dL; and C-reactive protein, 0.5 ± 0.5 mg/dL. Median observational period was 497 (range 97-1015) days, and median survival time was 550 (95% CI 414-686) days. Survival rate was 47.5%, and mortality rate was 38.7/100 person-years. Cox analyses showed that TTR (HR 0.791, 95% CI 0.633-0.988) and 6MWD (HR 0.795, 95% CI 0.674-0.938) were independently correlated with mortality and were influenced by body fat mass and leg skeletal muscle mass, respectively. It is suggested that nutritional markers and exercise capacity are important prognostic markers in waitlisted patients, but further study is needed to determine whether nutritional intervention or exercise can change outcomes.
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Affiliation(s)
- Ayako Oshima
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan
| | - Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Shin-Ichi Harashima
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan.,Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Teruya Komatsu
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiro Aoyama
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Takahashi
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Ikeda
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yohei Oshima
- Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Kohei Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Maki Isomi
- Nursing Department, Kyoto University Hospital, Kyoto, Japan
| | - Kenichiro Shide
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuya Inagaki
- Department of Metabolism and Clinical Nutrition, Kyoto University Hospital, Kyoto, Japan.,Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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19
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Nishimura A, Harashima SI, Hosoda K, Arai H, Inagaki N. Sex-related differences in frailty factors in older persons with type 2 diabetes: a cross-sectional study. Ther Adv Endocrinol Metab 2019; 10:2042018819833304. [PMID: 30858966 PMCID: PMC6402070 DOI: 10.1177/2042018819833304] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/01/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This cross-sectional study aimed to describe sex-related differences in diabetes-specific factors underlying the development of frailty in older persons with type 2 diabetes. METHODS Older persons aged 60-80 years were sequentially enrolled. Frailty and sarcopenia were evaluated using the validated Kihon checklist (KCL) and Asian Working Group for Sarcopenia algorithm, respectively. Physical function and characteristics were measured by trained nurses independently. RESULTS This study included 213 participants. The mean age, body mass index (BMI), and glycated hemoglobin (HbA1c) level were 70.4 years, 24.3 kg/m2, and 7.4%, respectively. Prevalence of frailty was higher in women. Social and cognitive functions were lower in the prefrailty stage, while physical function was lower in the frailty stage, although there was no decrease in skeletal muscle mass. After adjustment for age, the KCL score was significantly associated with peripheral neuropathy, diet score, and coronary artery disease (CAD); frailty, with CAD and inoccupation; prefrailty, with diet score; and sarcopenia, with living alone in men. Meanwhile, the KCL score was significantly associated with living alone and skeletal muscle percentage; prefrailty, with peripheral neuropathy; and sarcopenia, with diabetes duration, LDL-cholesterol level, diet score, and irregular lifestyle in women. CONCLUSIONS Sex differences in the risk factors of frailty should be considered when selecting preventive strategies for older persons with type 2 diabetes, early in the prefrailty stage. In particular, it is important to evaluate social participation and diet therapy in men and skeletal muscle mass and psychosocial function in women.
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Affiliation(s)
- Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kiminori Hosoda
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto-city, Kyoto, Japan
- Division of Endocrinology and Metabolism, Department of Lifestyle-Related Diseases, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hidenori Arai
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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20
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Mizuguchi Y, Maruta M, Moriyama S, Yamashita N, Okada C, Nishimura A, Fujiwara Y, Tahakashi A. P5434Evaluation of the determinant factors on the capacity for self-care in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - M Maruta
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - S Moriyama
- Sakurakai Takahashi Hospital, Kobe, Japan
| | | | - C Okada
- Sakurakai Takahashi Hospital, Kobe, Japan
| | | | - Y Fujiwara
- Sakurakai Takahashi Hospital, Kobe, Japan
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21
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Nishimura A, Harashima SI, Hosoda K, Inagaki N. Long-Term Effect of the Color Record Method in Self-Monitoring of Blood Glucose on Metabolic Parameters in Type 2 Diabetes: A 2-Year Follow-up of the Color IMPACT Study. Diabetes Ther 2018; 9:1501-1510. [PMID: 29949015 PMCID: PMC6064598 DOI: 10.1007/s13300-018-0457-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION This article evaluates the potential long-term effect of two different color indication methods for self-monitoring of blood glucose (SMBG), the color record (CR) and color display (CD), on metabolic parameters in insulin-treated type 2 diabetes in a post-intervention period. METHODS 101 participants with type 2 diabetes who completed the Color IMPACT study were enrolled in a 2-year comparison follow-up study. Participants continued SMBG with their usual diabetes care. The study outcomes were differences in change in HbA1c levels, blood pressure (BP), body weight and lipid profiles between the CR and non-CR arms and the CD and non-CD arms during a 1- and 2-year period of the study. RESULTS 98 participants were analyzed. Reductions in HbA1c levels, systolic BP and low-density lipoprotein cholesterol levels were maintained in the CR arm by - 0.40% (95% CI: - 0.73 to - 0.06, p = 0.020), -1 3.2 mmHg (95% CI: - 24.1 to - 2.3, p = 0.019), - 11.4 mg/dl (95% CI: - 18.1 to - 4.6, p = 0.001), respectively, in a 1-year period. However, HbA1c and BP returned to the baseline levels during an additional 1-year period. In contrast, there were no significant changes in outcome in the CD arm during the study period. CONCLUSION Intervention promoting self-action such as the color record method in SMBG sustains a beneficial effect on metabolic parameters after the intervention. This long-term effect is helpful for people with type 2 diabetes to manage their diabetes ABCs (HbA1c, BP, cholesterol) and to prevent diabetic complications. TRIAL REGISTRATION UMIN clinical trials registry identifier, UMIN000006865.
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Affiliation(s)
- Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shin-Ichi Harashima
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Kiminori Hosoda
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Division of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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22
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Jangland E, Mirza N, Conroy T, Merriman C, Suzui E, Nishimura A, Ewens A. Nursing students' understanding of the Fundamentals of Care: A cross-sectional study in five countries. J Clin Nurs 2018. [PMID: 29526052 DOI: 10.1111/jocn.14352] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVE To explore the accuracy with which nursing students can identify the fundamentals of care. BACKGROUND A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. DESIGN Cross-sectional descriptive design. METHODS A total of 398 nursing students (pre- and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. RESULTS The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre- and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. CONCLUSIONS Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. RELEVANCE TO CLINICAL PRACTICE To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients.
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Affiliation(s)
- Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Noeman Mirza
- School of Nursing, Thompson Rivers University, Kamloops, BC, Canada
| | - Tiffany Conroy
- Adelaide Nursing School, University of Adelaide, Adelaide, South Australia, Australia
| | - Clair Merriman
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Emiko Suzui
- New Department Preparatory Office, Otemae University, Kobe, Japan
| | - Akiko Nishimura
- Department of Nursing School of Nursing, Hyogo University of Health Sciences, Kobe, Japan
| | - Ann Ewens
- Centre of Excellence in Healthcare Education, Staffordshire University, Stoke-on-Trent, UK
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Otsubo Y, Matsuo T, Nishimura A, Yamamoto M, Yamashita A. tRNA production links nutrient conditions to the onset of sexual differentiation through the TORC1 pathway. EMBO Rep 2018; 19:embr.201744867. [PMID: 29330317 DOI: 10.15252/embr.201744867] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/30/2017] [Accepted: 12/14/2017] [Indexed: 12/14/2022] Open
Abstract
Target of rapamycin (TOR) kinase controls cell growth and metabolism in response to nutrient availability. In the fission yeast Schizosaccharomyces pombe, TOR complex 1 (TORC1) promotes vegetative growth and inhibits sexual differentiation in the presence of ample nutrients. Here, we report the isolation and characterization of mutants with similar phenotypes as TORC1 mutants, in that they initiate sexual differentiation even in nutrient-rich conditions. In most mutants identified, TORC1 activity is downregulated and the mutated genes are involved in tRNA expression or modification. Expression of tRNA precursors decreases when cells undergo sexual differentiation. Furthermore, overexpression of tRNA precursors prevents TORC1 downregulation upon nitrogen starvation and represses the initiation of sexual differentiation. Based on these observations, we propose that tRNA precursors operate in the S. pombe TORC1 pathway to switch growth mode from vegetative to reproductive.
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Affiliation(s)
- Yoko Otsubo
- Laboratory of Cell Responses, National Institute for Basic Biology, Okazaki, Aichi, Japan
| | - Tomohiko Matsuo
- Department of Biophysics and Biochemistry, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Akiko Nishimura
- Department of Biophysics and Biochemistry, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - Masayuki Yamamoto
- Laboratory of Cell Responses, National Institute for Basic Biology, Okazaki, Aichi, Japan.,Department of Biophysics and Biochemistry, Graduate School of Science, The University of Tokyo, Tokyo, Japan.,Department of Basic Biology, School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi, Japan
| | - Akira Yamashita
- Laboratory of Cell Responses, National Institute for Basic Biology, Okazaki, Aichi, Japan .,Department of Basic Biology, School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), Okazaki, Aichi, Japan
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24
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Mitsuishi S, Nishimura R, Harashima SI, Kawamura T, Tsujino D, Koide K, Nishimura A, Utsunomiya K, Inagaki N, Atsumi Y. The Effect of Novel Glucose Monitoring System (Flash Glucose Monitoring) on Mental Well-being and Treatment Satisfaction in Japanese People with Diabetes. Adv Ther 2018; 35:72-80. [PMID: 29273859 DOI: 10.1007/s12325-017-0649-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION FreeStyle Libre (Abbot Diabetes Care Ltd) has been launched as a novel glucose monitoring system called flash glucose monitoring (FGM) in Europe. Several reports are becoming available on its usefulness and safety. To date, however, reports from Asian countries have not been made available. In this study, we evaluated its usefulness in Japanese people with diabetes in terms of its mental well-being and patient satisfaction outcomes. METHODS Individuals with type 1 and 2 diabetes treated with insulin were enrolled, and they performed self-monitoring of blood glucose. All participants were subjected to FGM for 14 days and compared for changes in mental well-being using the WHO-Five Well-Being Index (WHO-5) (1998 version) as well as in patient satisfaction using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) before and after implementation of FGM. RESULTS The study included a total of 80 subjects (type 1/2 diabetes, 57/23). The WHO-5 scores were significantly improved from 15.5 ± 4.1 at baseline to 17.2 ± 4.5 after implementation of FGM (P < 0.001); the DTSQ scores also were significantly improved from 24.8 ± 6.0 to 26.7 ± 5.2 (P = 0.001). In type 1 diabetes, both the WHO-5 and DTSQ scores were significantly improved from baseline (P = 0.001, P = 0.001), while neither the WHO-5 scores nor the DTSQ scores were improved in type 2 diabetes. CONCLUSIONS The study results suggest that FGM has the potential to improve mental well-being and treatment satisfaction among individuals with type 1 diabetes.
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Affiliation(s)
- Sumie Mitsuishi
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Shin-Ichi Harashima
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoyuki Kawamura
- Department of Pediatrics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Daisuke Tsujino
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Keiko Koide
- Diabetes Center, Eiju General Hospital, Tokyo, Japan
| | - Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazunori Utsunomiya
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Matsui Y, Ohno K, Nishimura A, Shirota T, Kim S, Miyashita H. Long-Term Study of Dental Implants Placed into Alveolar Cleft Sites. Cleft Palate Craniofac J 2017; 44:444-7. [PMID: 17608551 DOI: 10.1597/06-095.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate the long-term prognosis of dental implants placed into cleft sites after bone grafting in a relatively large number of cases in order to clarify the usefulness of the modality. Patients: Forty-seven patients with unilateral (dental, n = 32) or bilateral (n = 15) clefts of the alveolar process were included in this study. Interventions: A total of 71 implants, including smooth- or rough-surface titanium, and hydroxyapatite (HA)-coated implants, were placed after bone grafting from the anterior iliac crest and/or mandible. The placed implants were 13 to 15 mm in length. Main outcome: The follow-up period was from 21 to 120 months (average = 60 months). Implant survival rates were calculated as cumulative survival. Marginal bone loss (MBL) from the implant shoulder was examined, with statistical analyses performed on the influence of simultaneous bone graft and surface characteristics. Results: At the end of the clinical follow-up period, all implants except one were in situ and stable. Thus, the overall survival rate was 98.6% at the end of the first year and remained the same until the end of observation. Titanium implants with smooth surfaces had the lowest MBL with almost negligible regression slope, although some implants had relatively high MBL by the end of the first year. Conclusions: Implant therapy in the cleft site offers a reliable option for patients. Particular attention should be focused preoperatively on whether bone volume can provide primary implant stability.
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Affiliation(s)
- Yoshiro Matsui
- Department of Oral and Maxillofacial Surgery, Yokohama City Graduate School of Medicine, Japan.
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26
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Nagao Y, Masuda R, Ando A, Nonaka M, Nishimura A, Goto K, Maruoka Y, Iijima T. Whole Blood Platelet Aggregation Test and Prediction of Hemostatic Difficulty After Tooth Extraction in Patients Receiving Antiplatelet Therapy. Clin Appl Thromb Hemost 2017; 24:151-156. [PMID: 28511553 DOI: 10.1177/1076029617709086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
When patients on antiplatelet therapy (APT) require minor invasive surgery, APT is usually continued to limit the risk of thrombosis. However, the possibility of hemostatic difficulties necessitates the monitoring of platelet aggregation to prevent unexpected bleeding. We examined whether whole blood aggregometry as a point-of-care testing (POCT) could be useful as a tool for predicting hemostatic difficulties. Sixty-five patients receiving APT and 15 patients who were not receiving APT were enrolled in the present study; all patients were scheduled to undergo a tooth extraction. Whole blood samples were obtained and were examined using multiple electrode aggregometry. The aggregometry was performed using arachidonic acid (AA), adenosine diphosphate (ADP), and thrombin receptor activating peptide. Hemostatic difficulty was defined as a need for more than 10 minutes of compression to achieve hemostasis. The AA test results were significantly lower in patients treated with aspirin (control: 97.7 [29.0] U, aspirin: 14.5 [7.2] U, P < .001). The ADP test results were also significantly lower in patients treated with a P2Y12 inhibitor (control: 77.7 [21.7] U, P2Y12 inhibitor: 37.3 [20.4] U, P < .01). Six of the examined cases exhibited hemostatic difficulties. The cutoff values for the prediction of hemostatic difficulty were 16.5 U for the AA test (sensitivity, 0.833; specificity, 0.508) and 21 U for the ADP test (sensitivity, 0.847; specificity, 0.500). Our study showed that whole blood aggregometry was useful as a POCT for the prediction of hemostatic difficulties after tooth extraction in patients receiving APT.
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Affiliation(s)
- Yasushi Nagao
- 1 Division of Community-Based Comprehensive Dentistry, Department of Special Needs Dentistry, Showa University, Shinagawa, Japan
| | - Rikuo Masuda
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
| | - Akane Ando
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
| | - Mutsumi Nonaka
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
| | - Akiko Nishimura
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
| | - Kinuko Goto
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
| | - Yasubumi Maruoka
- 1 Division of Community-Based Comprehensive Dentistry, Department of Special Needs Dentistry, Showa University, Shinagawa, Japan
| | - Takehiko Iijima
- 2 Division of Anesthesiology, Department of Perioperative Medicine, School of Dentistry, Showa University, Shinagawa, Japan
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Nishimura A, Harashima SI, Fukushige H, Wang Y, Liu Y, Hosoda K, Inagaki N. A Large Difference in Dose Timing of Basal Insulin Introduces Risk of Hypoglycemia and Overweight: A Cross-Sectional Study. Diabetes Ther 2017; 8:385-399. [PMID: 28236272 PMCID: PMC5380500 DOI: 10.1007/s13300-017-0238-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Basal insulin should be injected at the same time each day, but people with diabetes sometimes mistime their injections. It is not known whether irregular daily dose timing affects diabetes-related factors. We report here our evaluation of the effects of deviations from a regular dosing schedule on glycemic control and hypoglycemia on patients treated with long-acting insulin (insulin glargine U100). We also consider the effects of ultra-long-acting insulin (insulin degludec) in this context. METHODS Nineteen individuals with type 1 diabetes and 58 with type 2 diabetes were enrolled. Demographic data on all participants were retrieved from their medical records. Variation in dose timing was determined as the difference between the time of the earliest mistimed dose and the time of the latest mistimed dose, for each participant, over a 2-week period. All participants completed the Summary of Diabetes Self-Care Activities questionnaire, Problem Areas in Diabetes scale and 5-Item World Health Organization Well-being Index. Glargine U100 was switched to degludec in those individuals with type 2 diabetes who achieved inadequate glycemic control or suffered from frequent hypoglycemic episodes or who required two injections per day, and changes in hemoglobin A1c level and frequency of hypoglycemic episodes during the 12-week period were compared. RESULTS A greater difference in dose timing was related to a higher frequency of hypoglycemic episodes and overweight in persons with type 2 diabetes. Smoking, drinking and living alone were independently associated with a greater difference in dose timing. Insulin degludec decreased the frequency of hypoglycemia and improved glycemic control in participants whose dose mistiming was >120 min. CONCLUSION Fixed dose timing should be employed for basal insulin, as a larger difference in dose timing worsens diabetes-related factors. Insulin degludec improved glycemic control and lowered the hypoglycemia rate in persons with more irregular dose timing.
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Affiliation(s)
- Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shin-Ichi Harashima
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Haruna Fukushige
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Foundation of Nursing, Kobe City College of Nursing, Kobe, Japan
| | - Yu Wang
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yanyan Liu
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiminori Hosoda
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Division of Endocrinology and Metabolism, Department of Lifestyle-Related Diseases, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Masuda R, Nonaka M, Nishimura A, Gotoh K, Oka S, Iijima T. Optimal and safe standard doses of midazolam and propofol to achieve patient and doctor satisfaction with dental treatment: A prospective cohort study. PLoS One 2017; 12:e0171627. [PMID: 28182732 PMCID: PMC5300152 DOI: 10.1371/journal.pone.0171627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/23/2017] [Indexed: 11/22/2022] Open
Abstract
Background The incidences of morbidity and mortality caused by pharmacosedation for dental treatment have not yet reached zero. Adverse events are related to inappropriate respiratory management, mostly originating from an overdose of sedatives. Since sedation is utilized for the satisfaction of both the dentist and the patient, the optimal dose should be minimized to prevent adverse events. We attempted to define the optimal doses of midazolam and propofol required to achieve high levels of patient and dentist satisfaction. Methods One thousand dental patients, including those undergoing third molar extractions, were enrolled in this study. A dose of 1 mg of midazolam was administered at 1-minute intervals until adequate sedation was achieved. Propofol was then infused continuously to maintain the sedation level. Both the patients and the dentists were subsequently interviewed and asked to complete a questionnaire. A multivariate logistic regression analysis was used to examine the factors that contributed to patient and dentist satisfaction. Results The peak midazolam dose resulting in the highest percentage of patient satisfaction was 3 mg. Both a lower dose and a higher dose reduced patient satisfaction. Patient satisfaction increased with an increasing dosage of propofol up until 4 mg/kg/hr, reaching a peak of 78.6%. The peak midazolam dose resulting in the highest percentage of dentist satisfaction (78.8%) was 2 mg. Incremental propofol doses reduced dentist satisfaction, in contrast to their effect on patient satisfaction. The strongest independent predictors of patient satisfaction and dentist satisfaction were no intraoperative memory (OR, 5.073; 95% CI, 3.532–7.287; P<0.001) and unintentional movements by the patient (OR, 0.035; 95% CI, 0.012–0.104; P<0.001), respectively. No serious adverse events were reported. Conclusion We found that 3 mg of midazolam and 3 mg/kg/hr of propofol may be the optimal doses for maximizing both patient and dentist satisfaction. Although this level of sedation is relatively light, memory loss and an absence of unintentional patient movements can be expected without adverse events.
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Affiliation(s)
- Rikuo Masuda
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
- * E-mail:
| | - Mutsumi Nonaka
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Kinuko Gotoh
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Shuichirou Oka
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan
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Miwa H, Uedo N, Watari J, Mori Y, Sakurai Y, Takanami Y, Nishimura A, Tatsumi T, Sakaki N. Randomised clinical trial: efficacy and safety of vonoprazan vs. lansoprazole in patients with gastric or duodenal ulcers - results from two phase 3, non-inferiority randomised controlled trials. Aliment Pharmacol Ther 2017; 45:240-252. [PMID: 27891632 PMCID: PMC6680291 DOI: 10.1111/apt.13876] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 06/14/2016] [Accepted: 11/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vonoprazan is a new potassium-competitive acid blocker for treatment of acid-related diseases. AIM To conduct two randomised-controlled trials, to evaluate the non-inferiority of vonoprazan vs. lansoprazole, a proton pump inhibitor, for treatment of gastric ulcer (GU) or duodenal ulcer (DU). METHODS Patients aged ≥20 years with ≥1 endoscopically-confirmed GU or DU (≥5 mm white coating) were randomised 1:1 using double-dummy blinding to receive lansoprazole (30 mg) or vonoprazan (20 mg) for 8 (GU study) or 6 (DU study) weeks. The primary endpoint was the proportion of patients with endoscopically confirmed healed GU or DU. RESULTS For GU, 93.5% (216/231) of vonoprazan-treated patients and 93.8% (211/225) of lansoprazole-treated patients achieved healed GU; non-inferiority of vonoprazan to lansoprazole was confirmed [difference = -0.3% (95% CI -4.750, 4.208); P = 0.0011]. For DU, 95.5% (170/178) of vonoprazan-treated patients and 98.3% (177/180) of lansoprazole-treated patients achieved healed DU; non-inferiority to lansoprazole was not confirmed [difference = -2.8% (95% CI -6.400, 0.745); P = 0.0654]. The incidences of treatment-emergent adverse events were slightly lower for GU and slightly higher for DU with vonoprazan than with lansoprazole. There was one death (subarachnoid haemorrhage) in the vonoprazan group (DU). The possibility of a relationship between this unexpected patient death and the study drug could not be ruled out. In both studies, increases in serum gastrin levels were greater in vonoprazan-treated vs. lansoprazole-treated patients; levels returned to baseline after treatment in both groups. CONCLUSIONS Vonoprazan 20 mg has a similar tolerability profile to lansoprazole 30 mg and is non-inferior with respect to GU healing and has similar efficacy for DU healing.
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Affiliation(s)
- H. Miwa
- Hyogo College of MedicineHyogoJapan
| | - N. Uedo
- Osaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
| | | | - Y. Mori
- Takeda Pharmaceutical Company LtdOsakaJapan
| | - Y. Sakurai
- Takeda Pharmaceutical Company LtdOsakaJapan
| | | | | | - T. Tatsumi
- Osaka University Graduate School of MedicineOsakaJapan
| | - N. Sakaki
- Foundation for Detection of Early Gastric CarcinomaTokyoJapan
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Nishimura A, Harashima SI, Fujita Y, Tanaka D, Wang Y, Liu Y, Inagaki N. Effects of structured testing versus routine testing of blood glucose in diabetes self-management: A randomized controlled trial. J Diabetes Complications 2017; 31:228-233. [PMID: 27653670 DOI: 10.1016/j.jdiacomp.2016.08.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/03/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
AIMS To compare the effects of structured and routine testing regimens used in self-monitoring of blood glucose (SMBG) on glycemic control and diabetes self-management in insulin-naïve type 2 diabetes patients. METHODS Sixty-two outpatients with insulin-naïve type 2 diabetes were randomly allocated into two less-frequent SMBG usage groups: a structured testing group (STG) and a routine testing group (RTG). Subjects in STG measured 7-points on SMBG for 3 consecutive days once every two months without daily testing; subjects in RTG measured SMBG 3 times each week before breakfast on Monday and Friday and before dinner on Wednesday. The primary endpoint was HbA1c reduction. The secondary endpoints were change in body weight, blood pressure, treatment change, and self-management performance change. RESULTS HbA1c levels were significantly decreased by 0.32% (3.50mmol/mol) in STG, partly because physicians changed medications more actively. In contrast, body weight and systolic/diastolic blood pressure were significantly reduced by 0.94kg and 6.8/4.7mmHg, respectively, in RTG, possibly related to the increased diet and exercise score in RTG. CONCLUSIONS Structured testing without daily testing is beneficial for glycemic control; routine testing 3 times a week is more helpful for daily self-management. In low SMBG frequency usage, these two regimens can be utilized according to individual diabetic conditions.
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Affiliation(s)
- Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
| | - Shin-Ichi Harashima
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan.
| | - Yoshihito Fujita
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
| | - Daisuke Tanaka
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
| | - Yu Wang
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
| | - Yanyan Liu
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto-city, Kyoto 606-8507, Japan
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Harashima SI, Nishimura A, Inagaki N. Attitudes of patients and physicians to insulin therapy in Japan: an analysis of the Global Attitude of Patients and Physicians in Insulin Therapy study. Expert Opin Pharmacother 2016; 18:5-11. [DOI: 10.1080/14656566.2016.1260547] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Shin-ichi Harashima
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Nishimura A, Tabuchi Y, Kikuchi M, Masuda R, Goto K, Iijima T. The Amount of Fluid Given During Surgery That Leaks Into the Interstitium Correlates With Infused Fluid Volume and Varies Widely Between Patients. Anesth Analg 2016; 123:925-32. [DOI: 10.1213/ane.0000000000001505] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Asanuma K, Yoshikawa T, Yoshida K, Okamoto T, Asanuma Y, Hayashi T, Akita N, Oi T, Nishimura A, Hasegawa M, Sudo A. Argatroban more effectively inhibits the thrombin activity in synovial fluid than naturally occurring thrombin inhibitors. Cell Mol Biol (Noisy-le-grand) 2016; 62:27-32. [PMID: 27262798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/03/2016] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to clarify the precise effect of argatroban on the inhibition of cytokine secretion induced by thrombin on synovial cells. The efficiency of thrombin inactivation by thrombin inhibitors was evaluated in human synovial fluids (SFs). In SFs from 13 osteoarthritis (OA) and 11 rheumatoid arthritis (RA) patients, thrombin, Factor Xa (FXa), plasmin activity, IL-6, MMP-3, VEGF, and D-dimer concentrations were measured. Tissue factor (TF) activity or IL-6, MMP-3, and VEGF secretion of human synovial cells with or without thrombin and argatroban were measured. The efficiency of thrombin inactivation in SFs was compared for thrombin inhibitors: argatroban, antithrombin III (ATIII), or heparin cofactor II (HCII). In SFs, thrombin, FXa, plasmin, D-dimer, IL-6, and MMP-3 were significantly higher in RA than in OA. In synovial cell experiments, TNF-alpha and thrombin enhanced TF activity on the cell surface, and IL-6, MMP-3, and VEGF secretion were enhanced by thrombin. Increased TF activity, and IL-6, MMP-3, and VEGF secretion induced by thrombin were inhibited by argatroban. In SFs, argatroban inactivated thrombin more effectively than ATIII or HCII. Since thrombin plays an important role in the disease activity of OA and RA, it is a potential therapeutic molecular target. Argatroban was the most effective anticoagulant to inhibit thrombin activity in SF. Intra-articular injection is ideal administration because it can deliver high dose of argatroban without high risk of systematic complication.
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Affiliation(s)
- K Asanuma
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - T Yoshikawa
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - K Yoshida
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - T Okamoto
- Mie University School of Medicine Department of Molecular Pathobiology Tsu City, Mie Japan
| | - Y Asanuma
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - T Hayashi
- Mie Prefecture Collage of Nursing Department of Biochemistry Tsu City, Mie Japan
| | - N Akita
- Suzuka University of Medical Science Department of Medical Engineering Suzuka City, Mie Japan
| | - T Oi
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - A Nishimura
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - M Hasegawa
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
| | - A Sudo
- Mie University School of Medicine Department of Orthopedic Surgery Tsu City, Mie Japan
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Konno A, Nishimura A, Nakamura S, Mochizuki A, Yamada A, Kamijo R, Inoue T, Iijima T. Continuous monitoring of caspase-3 activation induced by propofol in developing mouse brain. Int J Dev Neurosci 2016; 51:42-9. [PMID: 27126009 DOI: 10.1016/j.ijdevneu.2016.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/20/2016] [Indexed: 01/15/2023] Open
Abstract
The neurotoxicity of anesthetics on the developing brain has drawn the attention of anesthesiologists. Several studies have shown that apoptosis is enhanced by exposure to anesthesia during brain development. Although apoptosis is a physiological developmental step occurring before the maturation of neural networks and the integration of brain function, pathological damage also involves apoptosis. Previous studies have shown that prolonged exposure to anesthetics causes apoptosis. Exactly when the apoptotic cascade starts in the brain remains uncertain. If it starts during the early stage of anesthesia, even short-term anesthesia could harm the brain. Therefore, apoptogenesis should be continuously monitored to elucidate when the apoptotic cascade is triggered by anesthesia. Here, we describe the development of a continuous monitoring system to detect caspase-3 activation using an in vivo model. Brain slices from postnatal days 0-4 SCAT3 transgenic mice with a heterozygous genotype (n=20) were used for the monitoring of caspase-3 cleavage. SCAT3 is a fusion protein of ECFP and Venus connected by a caspase-3 cleavable peptide, DEVD. A specimen from the hippocampal CA1 sector was mounted on a confocal laser microscope and was continuously superfused with artificial cerebrospinal fluid, propofol (2,6-diisopropylphenol, 1μM or 10μM), and dimethyl sulfoxide. Images were obtained every hour for five hours. A pixel analysis of the ECFP/Venus ratio images was performed using a histogram showing the number of pixels with each ratio. In the histogram of the ECFP/Venus ratio, an area with a ratio>1 indicated the number of pixels from caspase-3-activated CA1 neurons. We observed a shift in the histogram toward the right over time, indicating caspase-3 activation. This right-ward shift dramatically changed at five hours in the propofol 1μM and 10μM groups and was obviously different from that in the control group. Thus, real-time fluorescence energy transfer (FRET) imaging was capable of identifying the onset of apoptosis triggered by propofol in neonatal brain slices. This model may be a useful tool for monitoring apoptogenesis in the developing brain.
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Affiliation(s)
- Ayumi Konno
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan
| | - Akiko Nishimura
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan.
| | - Shiro Nakamura
- Department of Physiology, Showa University School of Dentistry, Japan
| | - Ayako Mochizuki
- Department of Physiology, Showa University School of Dentistry, Japan
| | - Atsushi Yamada
- Department of Biochemistry, Showa University School of Dentistry, Japan
| | - Ryutaro Kamijo
- Department of Biochemistry, Showa University School of Dentistry, Japan
| | - Tomio Inoue
- Department of Physiology, Showa University School of Dentistry, Japan
| | - Takehiko Iijima
- Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Japan
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Ashida K, Sakurai Y, Hori T, Kudou K, Nishimura A, Hiramatsu N, Umegaki E, Iwakiri K. Randomised clinical trial: vonoprazan, a novel potassium-competitive acid blocker, vs. lansoprazole for the healing of erosive oesophagitis. Aliment Pharmacol Ther 2016; 43:240-51. [PMID: 26559637 PMCID: PMC4738414 DOI: 10.1111/apt.13461] [Citation(s) in RCA: 160] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 08/06/2015] [Accepted: 10/16/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vonoprazan is a novel potassium-competitive acid blocker which may provide clinical benefit in acid-related disorders. AIM To verify the non-inferiority of vonoprazan vs. lansoprazole in patients with erosive oesophagitis (EE), and to establish its long-term safety and efficacy as maintenance therapy. METHODS In this multicentre, randomised, double-blind, parallel-group comparison study, patients with endoscopically confirmed EE (LA Classification Grades A-D) were randomly allocated to receive vonoprazan 20 mg or lansoprazole 30 mg once daily after breakfast. The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy up to week 8. In addition, subjects who achieved healed EE in the comparison study were re-randomised into a long-term study to investigate the safety and efficacy of vonoprazan 10 or 20 mg as maintenance therapy for 52 weeks. RESULTS Of the 409 eligible subjects randomised, 401 completed the comparison study, and 305 entered the long-term maintenance study. The proportion of patients with healed EE up to week 8 was 99.0% for vonoprazan (203/205) and 95.5% for lansoprazole (190/199), thus verifying the non-inferiority of vonoprazan (P < 0.0001). Vonoprazan was also effective in patients with more severe EE (LA Classification Grades C/D) and CYP2C19 extensive metabolisers. In the long-term maintenance study, there were few recurrences (<10%) of EE in patients treated with vonoprazan 10 or 20 mg. Overall, vonoprazan was well-tolerated. CONCLUSIONS The non-inferiority of vonoprazan to lansoprazole in EE was verified in the comparison study, and vonoprazan was well-tolerated and effective during the long-term maintenance study.
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Affiliation(s)
| | - Y. Sakurai
- Takeda Pharmaceutical Company Ltd.OsakaJapan
| | - T. Hori
- Takeda Pharmaceutical Company Ltd.OsakaJapan
| | - K. Kudou
- Takeda Pharmaceutical Company Ltd.OsakaJapan
| | | | - N. Hiramatsu
- Osaka University Graduate School of MedicineOsakaJapan
| | - E. Umegaki
- Kobe University Graduate School of MedicineKobeJapan
| | - K. Iwakiri
- Nippon Medical School Graduate School of MedicineTokyoJapan
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Harashima SI, Nishimura A, Ikeda K, Wang Y, Liu Y, Inagaki N. Once Daily Self-Monitoring of Blood Glucose (SMBG) Improves Glycemic Control in Oral Hypoglycemic Agents (OHA)-Treated Diabetes: SMBG-OHA Follow-Up Study. J Diabetes Sci Technol 2015; 10:378-82. [PMID: 26428934 PMCID: PMC4773965 DOI: 10.1177/1932296815608869] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to compare glycemic control between SMBG-continued and -discontinued subjects with type 2 diabetes in the SMBG-OHA study. METHOD Of the 96 subjects from the SMBG-OHA study, 59 were recruited for the 24-week, comparison follow-up study. The study outcomes were the differences in change in HbA1c levels at 24 weeks between the 2 groups, and change in SMBG frequency in SMBG-continued subjects. RESULTS Although health insurance does not cover the cost of SMBG, 22.0% of subjects continued SMBG of their own will after the SMBG-OHA study was completed. HbA1c levels were maintained from 6.81 ± 0.55% to 6.64 ± 0.53% in SMBG-continued subjects. Conversely, HbA1c levels were increased from 7.18 ± 0.63% to 7.48 ± 0.84% in SMBG-discontinued subjects. HbA1c levels were significantly different by 0.83 ± 0.25% (95% CI: -1.33 to -0.36). The difference in change in HbA1c between the groups was -0.46% (95% CI: -0.78 to -0.15). SMBG frequency was decreased from 2.02 ± 1.06 to 1.53 ± 0.86 times a day. CONCLUSIONS HbA1c levels were maintained in SMBG-continued subjects but increased in SMBG-discontinued subjects. The study implied that almost once daily SMBG is helpful to maintain glycemic control in non-insulin-treated type 2 diabetes.
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Affiliation(s)
- Shin-Ichi Harashima
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Nishimura
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yu Wang
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yanyan Liu
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Ashida K, Sakurai Y, Nishimura A, Kudou K, Hiramatsu N, Umegaki E, Iwakiri K, Chiba T. Randomised clinical trial: a dose-ranging study of vonoprazan, a novel potassium-competitive acid blocker, vs. lansoprazole for the treatment of erosive oesophagitis. Aliment Pharmacol Ther 2015; 42. [PMID: 26201312 PMCID: PMC5014135 DOI: 10.1111/apt.13331] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The potassium-competitive acid blocker vonoprazan (VPZ) has potent acid-inhibitory effects and may offer clinical advantages over conventional therapy for acid-related disorders. AIM To investigate the efficacy and safety of VPZ in patients with erosive oesophagitis (EO). METHODS In this multicentre, randomised, double-blind, parallel-group, dose-ranging study, patients ≥20 years with endoscopically confirmed EO [Los Angeles (LA) grades A-D] received VPZ 5, 10, 20 or 40 mg, or lansoprazole (LPZ) 30 mg once daily for 8 weeks. The primary endpoint was the proportion of healed EO subjects as shown by endoscopy at week 4. RESULTS A total of 732 subjects received VPZ or LPZ. The proportion of healed EO subjects at week 4 was 92.3%, 92.5%, 94.4%, 97.0% and 93.2%, respectively, with VPZ 5, 10, 20 and 40 mg and LPZ 30 mg. All VPZ doses were non-inferior to LPZ when adjusted for baseline LA grades A/B and C/D. Among those with LA grades C/D, the proportions of healed EO subjects were 87.3%, 86.4%, 100%, 96.0% and 87.0%, respectively, with VPZ 5, 10, 20 and 40 mg and LPZ 30 mg. The incidence of adverse events was similar across the groups. CONCLUSIONS Vonoprazan was effective and non-inferior to LPZ in healing EO. VPZ 20 mg or higher was highly efficacious for severe EO (LA grades C/D). VPZ was associated with no safety concern during this 8-week study, while there was a dose-dependent increase in serum gastrin. Once-daily VPZ 20 mg is the recommended clinical dose for treating EO.
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Affiliation(s)
| | - Y. Sakurai
- Takeda Pharmaceutical Company Ltd.OsakaJapan
| | | | - K. Kudou
- Takeda Pharmaceutical Company Ltd.OsakaJapan
| | - N. Hiramatsu
- Osaka University Graduate School of MedicineOsakaJapan
| | - E. Umegaki
- Kobe University Graduate School of MedicineKobeJapan
| | - K. Iwakiri
- Nippon Medical School Graduate School of MedicineTokyoJapan
| | - T. Chiba
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
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Sakurai Y, Mori Y, Okamoto H, Nishimura A, Komura E, Araki T, Shiramoto M. Acid-inhibitory effects of vonoprazan 20 mg compared with esomeprazole 20 mg or rabeprazole 10 mg in healthy adult male subjects--a randomised open-label cross-over study. Aliment Pharmacol Ther 2015; 42:719-30. [PMID: 26193978 DOI: 10.1111/apt.13325] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 02/12/2015] [Accepted: 06/29/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Proton pump inhibitors (PPIs) are widely used for the treatment of acid-related diseases. Vonoprazan is a member of a new class of acid suppressants; potassium-competitive acid blockers. Vonoprazan may thus be an alternative to PPIs. AIM To evaluate efficacy, rapidity and duration of acid-inhibitory effects of vonoprazan vs. two control PPIs, esomeprazole and rabeprazole, in 20 healthy Japanese adult male volunteers with CYP2C19 extensive metaboliser genotype. METHODS In this randomised, open-label, two-period cross-over study, vonoprazan 20 mg and esomeprazole 20 mg (Study V vs. E) or rabeprazole 10 mg (Study V vs. R) were orally administered daily for 7 days. Primary pharmacodynamic endpoint was gastric pH over 24 h measured as percentage of time pH ≥3, ≥4 and ≥5 (pH holding time ratios; HTRs) and mean gastric pH. RESULTS Acid-inhibitory effect (pH4 HTR) of vonoprazan was significantly greater than that of esomeprazole or rabeprazole on both Days 1 and 7; Day 7 difference in pH4 HTR for vonoprazan vs. esomeprazole was 24.6% [95% confidence interval (CI): 16.2-33.1] and for vonoprazan vs. rabeprazole 28.8% [95% CI: 17.2-40.4]. The Day 1 to Day 7 ratio of 24-h pH4 HTRs was >0.8 for vonoprazan, compared with 0.370 for esomeprazole and 0.393 for rabeprazole. Vonoprazan was generally well tolerated. One vonoprazan subject withdrew due to a rash which resolved after discontinuation. CONCLUSIONS This study demonstrated a more rapid and sustained acid-inhibitory effect of vonoprazan 20 mg vs. esomeprazole 20 mg or rabeprazole 10 mg. Therefore, vonoprazan may be a potentially new treatment for acid-related diseases.
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Affiliation(s)
- Y Sakurai
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - Y Mori
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - H Okamoto
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - A Nishimura
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - E Komura
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - T Araki
- Takeda Pharmaceutical Company Ltd., Osaka, Japan
| | - M Shiramoto
- Medical Co. LTA Hakata Clinic, Fukuoka, Japan
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Nishimura A, Fujita Y, Katsuta M, Ishihara A, Ohashi K. Paternal postnatal depression in Japan: an investigation of correlated factors including relationship with a partner. BMC Pregnancy Childbirth 2015; 15:128. [PMID: 26026489 PMCID: PMC4449521 DOI: 10.1186/s12884-015-0552-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 05/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A negative effect of paternal depression on child development has been revealed in several previous studies. The aims of this study were to examine the prevalence and relevant factors associated with paternal postnatal depression at four months postpartum, including age, part-time work or unemployment, experience of visiting a medical institution due to a mental health problem, economic anxiety, unexpected pregnancy, pregnancy with infertility treatment, first child, partner's depression, and lower marital relationship satisfaction. METHODS We distributed 2032 self-report questionnaires to couples (one mother and one father) with a 4-month old infant between January and April 2013. Data from 807 couples (39.7 %) were analyzed. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS). In order to clarify the factors related with paternal depression, a logistic regression analysis was conducted. RESULTS One hundred and ten fathers (13.6 %) and 83 mothers (10.3 %) were depressed. According to the logistic regression analysis, paternal depression was positively associated with partner's depression (adjusted odds ratio (AOR) 1.91, 95 % confidence interval (CI) 1.05-3.47), and negatively with marital relationship satisfaction (AOR 0.83, 95 % CI 0.77-0.89). History of infertility treatment (AOR 2.37, 95 % CI 1.32-4.24), experience of visiting a medical institution due to a mental health problem (AOR 4.56, 95 % CI 2.06-10.08), and economic anxiety (AOR 2.15, 95 % CI 1.34-3.45) were also correlated with paternal depression. CONCLUSIONS This study showed that the prevalence of paternal depression at four months after childbirth was 13.6 % in Japan. The presence of partner's depression and low marital relationship satisfaction were significantly correlated with paternal postpartum depression, suggesting that health professionals need to pay attention to the mental status of both fathers and mothers, and to their relationship.
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Affiliation(s)
- Akiko Nishimura
- Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan.
| | - Yuichi Fujita
- Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan.
| | - Mayumi Katsuta
- Department of Nursing, Japan Red Cross Hiroshima College of Nursing, 1-2 Ajinadaihigashi, Hatsukaichi, 738-0052, Hiroshima, Japan.
| | - Aya Ishihara
- Department of Nursing, School of Nursing, Hyogo University of Health Sciences, 1-3-6 Minatojima, Chuo-ku, Kobe, 650-8530, Japan.
| | - Kazutomo Ohashi
- Department of Children and Women's Health, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, 565-0871, Osaka, Japan.
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Abstract
OBJECTIVES Salubrinal is a synthetic agent that elevates phosphorylation of eukaryotic translation initiation factor 2 alpha (eIF2α) and alleviates stress to the endoplasmic reticulum. Previously, we reported that in chondrocytes, Salubrinal attenuates expression and activity of matrix metalloproteinase 13 (MMP13) through downregulating nuclear factor kappa B (NFκB) signalling. We herein examine whether Salubrinal prevents the degradation of articular cartilage in a mouse model of osteoarthritis (OA). METHODS OA was surgically induced in the left knee of female mice. Animal groups included age-matched sham control, OA placebo, and OA treated with Salubrinal or Guanabenz. Three weeks after the induction of OA, immunoblotting was performed for NFκB p65 and p-NFκB p65. At three and six weeks, the femora and tibiae were isolated and the sagittal sections were stained with Safranin O. RESULTS Salubrinal suppressed the progression of OA by downregulating p-NFκB p65 and MMP13. Although Guanabenz elevates the phosphorylation level of eIF2α, it did not suppress the progression of OA. CONCLUSIONS Administration of Salubrinal has chondroprotective effects in arthritic joints. Salubrinal can be considered as a potential therapeutic agent for alleviating symptoms of OA. Cite this article: Bone Joint Res 2015;4:84-92.
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Affiliation(s)
- K Hamamura
- Indiana University, Purdue University, Indianapolis, 723 West Michigan Street, Indianapolis, Indiana 46202, USA
| | - A Nishimura
- Indiana University, Purdue University, Indianapolis, 723 West Michigan Street, Indianapolis, Indiana 46202, USA. Mie University Graduate School of Medicine, Mie 514, Japan
| | - T Iino
- Mie University Graduate School of Medicine, Mie 514, Japan
| | - S Takigawa
- Indiana University, Purdue University, Indianapolis, 723 West Michigan Street, Indianapolis, Indiana 46202, USA
| | - A Sudo
- Mie University Graduate School of Medicine, Mie 514, Japan
| | - H Yokota
- Indiana University, Purdue University, Indianapolis, 723 West Michigan Street, Indianapolis, Indiana 46202, USA
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Tatebayashi K, Yamamoto K, Nagoya M, Takayama T, Nishimura A, Sakurai M, Momma T, Saito H. Osmosensing and scaffolding functions of the oligomeric four-transmembrane domain osmosensor Sho1. Nat Commun 2015; 6:6975. [PMID: 25898136 PMCID: PMC4411306 DOI: 10.1038/ncomms7975] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 03/18/2015] [Indexed: 11/09/2022] Open
Abstract
The yeast high osmolarity glycerol (HOG) pathway activates the Hog1 MAP kinase, which coordinates adaptation to high osmolarity conditions. Here we demonstrate that the four-transmembrane (TM) domain protein Sho1 is an osmosensor in the HKR1 sub-branch of the HOG pathway. Crosslinking studies indicate that Sho1 forms planar oligomers of the dimers-of-trimers architecture by dimerizing at the TM1/TM4 interface and trimerizing at the TM2/TM3 interface. High external osmolarity induces structural changes in the Sho1 TM domains and Sho1 binding to the cytoplasmic adaptor protein Ste50, which leads to Hog1 activation. Besides its osmosensing function, the Sho1 oligomer serves as a scaffold. By binding to the TM proteins Opy2 and Hkr1 at the TM1/TM4 and TM2/TM3 interface, respectively, Sho1 forms a multi-component signalling complex that is essential for Hog1 activation. Our results illuminate how the four TM domains of Sho1 dictate the oligomer structure as well as its osmosensing and scaffolding functions.
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Affiliation(s)
- Kazuo Tatebayashi
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Katsuyoshi Yamamoto
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Miho Nagoya
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Tomomi Takayama
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Akiko Nishimura
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Megumi Sakurai
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - Takashi Momma
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Haruo Saito
- Division of Molecular Cell Signaling, Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan.,Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
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Abstract
Proliferation and differentiation of the epidermis in organ culture of adult human skin by the sponge matrix method were studied histologically and autoradiographically, and the following results were obtained: 1) On the first day of culture, mitotic figures were already observable in the epidermis. The outgrowth of epidermal cells at the margins of the explants started. On the second day, there was transformation to a zone that will be referred to as the newly formed stratum corneum in the upper epidermis. 2) On the third and fourth days, the increased growth of epidermal cells caused thickening of the epidermis. Simultaneously, Malpighian cells progressively differentiated into a cornified layer. 3) On and after the fifth day, the basospinous cell layer was reduced in thickness in most of explants. On the ninth and tenth days, DNA synthesis in the basal layer was still obvious, although the epidermis showed a thickness of only one or two cells overlaid with a large number of horny layers. 4) In the culture medium supplemented with corticosteroid, the epidermal growth was slightly depressed with lessened formation of stratum corneum in the early stages of culture as compared with the explants cultured in the basic medium. The reduction of the basospinous layer was scarcely notable after the fifth day. Even after 10-11 days, epidermal cells were well preserved and their stratified squamous architecture was less disorganized. It seemed that corticosteroid could prolong the survival of adult human skin in vitro. These findings indicate that this culture technique could be used as a model for organ culture of adult human skin.
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Affiliation(s)
- H Yasuno
- Department of Dermatology, Kyoto Prefectural University of Medicine, Kawara-machi, Hirokoji, Kamikyo-ku, Kyoto, Japan
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Jenkins H, Sakurai Y, Nishimura A, Okamoto H, Hibberd M, Jenkins R, Yoneyama T, Ashida K, Ogama Y, Warrington S. Randomised clinical trial: safety, tolerability, pharmacokinetics and pharmacodynamics of repeated doses of TAK-438 (vonoprazan), a novel potassium-competitive acid blocker, in healthy male subjects. Aliment Pharmacol Ther 2015; 41:636-48. [PMID: 25707624 PMCID: PMC4654261 DOI: 10.1111/apt.13121] [Citation(s) in RCA: 184] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 09/25/2014] [Accepted: 01/26/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND TAK-438 (vonoprazan) is a potassium-competitive acid blocker that reversibly inhibits gastric H(+) , K(+) -ATPase. AIM To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of TAK-438 in healthy Japanese and non-Japanese men. METHODS In two Phase I, randomised, double-blind, placebo-controlled studies, healthy men (Japan N = 60; UK N = 48) received TAK-438 10-40 mg once daily at a fixed dose level for 7 consecutive days. Assessments included safety, tolerability, pharmacokinetics and pharmacodynamics (intragastric pH). RESULTS Plasma concentration-time profiles of TAK-438 at all dose levels showed rapid absorption (median Tmax ≤2 h). Mean elimination half-life was up to 9 h. Exposure was slightly greater than dose proportional, with no apparent time-dependent inhibition of metabolism. There was no important difference between the two studies in AUC0-tau on Day 7. TAK-438 caused dose-dependent acid suppression. On Day 7, mean 24-h intragastric pH>4 holding time ratio (HTR) with 40 mg TAK-438 was 100% (Japan) and 93.2% (UK), and mean night-time pH>4 HTR was 100% (Japan) and 90.4% (UK). TAK-438 was well tolerated. The frequency of adverse events was similar at all dose levels and there were no serious adverse events. There were no important increases in serum alanine transaminase activity. Serum gastrin and pepsinogen I and II concentrations increased with TAK-438 dose. CONCLUSIONS TAK-438 in multiple rising oral dose levels of 10-40 mg once daily for 7 days was safe and well tolerated in healthy men and caused rapid, profound and sustained suppression of gastric acid secretion throughout each 24-h dosing interval. Clinicaltrials.gov identifiers: NCT02123953 and NCT02141711.
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Affiliation(s)
- H Jenkins
- Takeda Development Centre Europe LtdLondon, UK
| | - Y Sakurai
- Takeda Pharmaceutical Company LtdOsaka, Japan
| | - A Nishimura
- Takeda Pharmaceutical Company LtdOsaka, Japan
| | - H Okamoto
- Takeda Pharmaceutical Company LtdOsaka, Japan
| | - M Hibberd
- Takeda Development Centre Europe LtdLondon, UK
| | - R Jenkins
- Takeda Development Centre Europe LtdLondon, UK
| | - T Yoneyama
- Takeda Pharmaceutical Company Ltd, FujisawaJapan
| | - K Ashida
- Department of Gastroenterology and Hepatology, Saiseikai Nakatsu HospitalOsaka, Japan
| | - Y Ogama
- Medical Co. LTA Honjo Clinic (current Sumida Hospital)Tokyo, Japan
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Harashima SI, Nishimura A, Osugi T, Wang Y, Liu Y, Takayama H, Inagaki N. Restless legs syndrome in patients with type 2 diabetes: effectiveness of pramipexole therapy. BMJ Support Palliat Care 2014; 6:89-93. [DOI: 10.1136/bmjspcare-2014-000691] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Accepted: 08/31/2014] [Indexed: 11/03/2022]
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Nishimura A, Harashima SI, Honda I, Shimizu Y, Harada N, Nagashima K, Hamasaki A, Hosoda K, Inagaki N. Color record in self-monitoring of blood glucose improves glycemic control by better self-management. Diabetes Technol Ther 2014; 16:447-53. [PMID: 24506479 DOI: 10.1089/dia.2013.0301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Color affects emotions, feelings, and behaviors. We hypothesized that color used in self-monitoring of blood glucose (SMBG) is helpful for patients to recognize and act on their glucose levels to improve glycemic control. Here, two color-indication methods, color record (CR) and color display (CD), were independently compared for their effects on glycemic control in less frequently insulin-treated type 2 diabetes. SUBJECTS AND METHODS One hundred twenty outpatients were randomly allocated to four groups with 2×2 factorial design: CR or non-CR and CD or non-CD. Blood glucose levels were recorded in red or blue pencil in the CR arm, and a red or blue indicator light on the SMBG meter was lit in the CD arm, under hyperglycemia or hypoglycemia, respectively. The primary end point was difference in glycated hemoglobin (HbA1c) reduction in 24 weeks. Secondary end points were self-management performance change and psychological state change. RESULTS HbA1c levels at 24 weeks were significantly decreased in the CR arm by -0.28% but were increased by 0.03% in the non-CR arm (P=0.044). In addition, diet and exercise scores were significantly improved in the CR arm compared with the non-CR arm. The exercise score showed significant improvement in the CD arm compared with the non-CD arm but without a significant difference in HbA1c reduction. Changes in psychological states were not altered between the arms. CONCLUSIONS CR has a favorable effect on self-management performance without any influence on psychological stress, resulting in improved glycemic control in type 2 diabetes patients using less frequent insulin injection. Thus, active but not passive usage of color-indication methods by patients is important in successful SMBG.
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Affiliation(s)
- Akiko Nishimura
- 1 Department of Human Health Science, Graduate School of Medicine, Kyoto University , Kyoto, Japan
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Tanaka K, Tatebayashi K, Nishimura A, Yamamoto K, Yang HY, Saito H. Yeast osmosensors Hkr1 and Msb2 activate the Hog1 MAPK cascade by different mechanisms. Sci Signal 2014; 7:ra21. [PMID: 24570489 DOI: 10.1126/scisignal.2004780] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To cope with environmental high osmolarity, the budding yeast Saccharomyces cerevisiae activates the mitogen-activated protein kinase (MAPK) Hog1, which controls an array of osmoadaptive responses. Two independent, but functionally redundant, osmosensing systems involving the transmembrane sensor histidine kinase Sln1 or the tetraspanning membrane protein Sho1 stimulate the Hog1 MAPK cascade. Furthermore, the Sho1 signaling branch itself also involves the two functionally redundant osmosensors Hkr1 and Msb2. However, any single osmosensor (Sln1, Hkr1, or Msb2) is sufficient for osmoadaptation. We found that the signaling mechanism by which Hkr1 or Msb2 stimulated the Hog1 cascade was specific to each osmosensor. Specifically, activation of Hog1 by Msb2 required the scaffold protein Bem1 and the actin cytoskeleton. Bem1 bound to the cytoplasmic domain of Msb2 and thus recruited the kinases Ste20 and Cla4 to the membrane, where either of them can activate the kinase Ste11. The cytoplasmic domain of Hkr1 also contributed to the activation of Ste11 by Ste20, but through a mechanism that involved neither Bem1 nor the actin cytoskeleton. Furthermore, we found a PXXP motif in Ste20 that specifically bound to the Sho1 SH3 (Src homology 3) domain. This interaction between Ste20 and Sho1 contributed to the activation of Hog1 by Hkr1, but not by Msb2. These differences between Hkr1 and Msb2 may enable differential regulation of these two proteins and provide a mechanism through Msb2 to connect regulation of the cytoskeleton with the response to osmotic stress.
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Affiliation(s)
- Keiichiro Tanaka
- 1Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
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Moroto M, Nishimura A, Morimoto M, Isoda K, Morita T, Yoshida M, Morioka S, Tozawa T, Hasegawa T, Chiyonobu T, Yoshimoto K, Hosoi H. Altered somatosensory barrel cortex refinement in the developing brain of Mecp2-null mice. Brain Res 2013; 1537:319-26. [DOI: 10.1016/j.brainres.2013.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 09/13/2013] [Accepted: 09/16/2013] [Indexed: 12/13/2022]
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Shintaku H, Nakajima T, Sawada Y, Hase Y, Fujioka M, Nishimura A, Isshiki G, Oura T, Hsiao ΚJ, Chen RG. Prenatal Diagnosis of Tetrahydrobiopterin (BH4) Synthase Deficiency. Pteridines 2013. [DOI: 10.1515/pteridines.1991.3.12.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- H. Shintaku
- Dept. of Osaka City Univ. Medical School, Osaka 545, Japan
| | - T. Nakajima
- Dept. of Osaka City Univ. Medical School, Osaka 545, Japan
| | - Y. Sawada
- Dept. of Pediatrics Juso Citizens' Hospital, Osaka 532, Japan
| | - Y. Hase
- First Division of Pediatrics Children's Medical Center of Osaka City, Osaka 537, Japan
| | - M. Fujioka
- Dept. of Pediatrics PL Hospital, Tondabayashi 584, Japan
| | - A. Nishimura
- Dept. of Pediatrics PL Hospital, Tondabayashi 584, Japan
| | - G. Isshiki
- Dept. of Osaka City Univ. Medical School, Osaka 545, Japan
| | - T. Oura
- Osaka Municipal Rehabilitation Center for the Disabled, Osaka 547, Japan
| | - Κ. J. Hsiao
- Veterans General Hospital, Taipei 11216, Republic of China
| | - R. G. Chen
- Shanghai Institute for Pediatric Research, Shanghai, China
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Azechi T, Kanehira D, Kobayashi T, Sudo R, Nishimura A, Sato F, Wachi H. Trichostatin A, an HDAC class I/II inhibitor, promotes Pi-induced vascular calcification via up-regulation of the expression of alkaline phosphatase. J Atheroscler Thromb 2013; 20:538-47. [PMID: 23518467 DOI: 10.5551/jat.15826] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Vascular calcification, a major complication of chronic kidney disease (CKD), refers to the mineralization of vascular smooth muscle cells (VSMCs), resulting from a phenotypic change towards osteoblast-like cells. Histone deacetylase inhibitors (HDIs), potential therapeutic agents for CKD, are known to promote the differentiation and mineralization of osteoblasts. In this study, we aimed to determine the effects of an HDI on the phenotypic change of VSMCs and the development of vascular calcification. METHODS The effect of trichostatin A (TSA), an HDI, on human aortic smooth muscle cells (HASMCs) was determined. The mineralization of HASMCs was induced by inorganic phosphorus (Pi), and was confirmed by quantitation of Ca levels and by von Kossa staining. Furthermore, we examined the effect of alkaline phosphatase (ALP) suppression using siRNA on Pi-induced vascular calcification in the presence or absence of TSA. RESULTS TSA increased the expression and activity of ALP in HASMCs at a concentration which showed an inhibitory effect of histone deacetylase (HDAC) activity but not on cell viability. Moreover, TSA promoted the Pi-induced mineralization of HASMCs. In addition, both phosphonoformic acid (PFA), which is a sodium-dependent phosphate transporter inhibitor, and suppression of ALP expression by siRNA markedly inhibited the TSA-promoted mineralization of HASMCs. CONCLUSION These data show that inhibition of HDAC activity promotes Pi-induced vascular calcification via the up-regulation of ALP expression. Taken together, HDIs may increase the risk of vascular calcification in CKD patients.
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Affiliation(s)
- Takuya Azechi
- Department of Clinical Chemistry, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo 142-8501, Japan
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Sakaue S, Chiyonobu T, Moroto M, Morita T, Yoshida M, Morioka S, Tokuda S, Nishimura A, Morimoto M, Hosoi H. [A case with recurrent asystole due to breath-holding spells: successful treatment with levetiracetam]. No To Hattatsu 2012; 44:496-498. [PMID: 23240534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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