1
|
Kuki I, Inoue T, Fukuoka M, Nukui M, Okuno H, Amo K, Otsuka Y, Ishikawa J, Rinka H, Ujiro A, Togawa M, Shiomi M, Okazaki S. Efficacy and safety of ketamine for pediatric and adolescent super-refractory status epilepticus and the effect of cerebral inflammatory conditions. J Neurol Sci 2024; 459:122950. [PMID: 38461760 DOI: 10.1016/j.jns.2024.122950] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/22/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To investigate the short-term benefits and adverse effects of ketamine in the treatment of pediatric and adolescent super-refractory status epilepticus (SRSE), with a focus on the inflammatory etiology. METHODS This retrospective observational cohort study included a consecutive series of 18 pediatric to adolescent patients with SRSE admitted between 2008 and 2023 and treated with ketamine. Seizure frequency per hour before and after ketamine administration and response rate were calculated. Neurological decline, catecholamine administration, and adverse effects were also assessed. The patients were divided into inflammatory and non-inflammatory etiology groups. RESULTS The median age at SRSE onset was 1 year 5 months (range: 11 days-24 years), and 78% of the patients were male individuals. The median duration of treatment was 7.5 days (interquartile range: 2.8-15.5 days). Fifteen (83%) patients achieved >50% seizure reduction. The median seizure frequency before and after ketamine treatment was 5.9 and 0.9, respectively, showing a significant reduction in seizure frequency (p < 0.0001). Ten patients had inflammatory etiologies including bacterial meningitis (n = 2), viral encephalitis (n = 3), and febrile infection related epilepsy syndrome (n = 5). The inflammatory etiology group required a longer treatment duration (p = 0.0453) and showed lower seizure reduction (p = 0.0264), lower response rate (p = 0.0044), and higher neurological decline (p = 0.0003) than the non-inflammatory etiology group. Three (17%) patients experienced transient adverse events requiring intervention within 24 h of initiating ketamine administration. CONCLUSIONS Ketamine administration was associated with fewer serious adverse events and a reduced seizure frequency. Additionally, inflammatory conditions may weaken the efficacy of ketamine in patients with SRSE.
Collapse
Affiliation(s)
- Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masataka Fukuoka
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hideo Okuno
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Yasunori Otsuka
- Department of Intensive Care Medicine, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan; Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Atushi Ujiro
- Department of Pediatrics, Medical Corporation ISEIKAI, ISEIKAI International General Hospital
| | - Masao Togawa
- Department of Pediatrics, Medical Corporation ISEIKAI, ISEIKAI International General Hospital
| | - Masashi Shiomi
- Department of Pediatrics, Aizenbashi Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| |
Collapse
|
2
|
Ishikawa J, Suto A, Abe K, Hayashi Y, Suga K, Tanaka S, Kageyama T, Iwata A, Suzuki K, Suzuki K, Nakajima H. IL-21 is required for the maintenance and pathogenesis of murine Vγ4 + IL-17-producing γδT cells. Front Immunol 2023; 14:1211620. [PMID: 37662923 PMCID: PMC10473412 DOI: 10.3389/fimmu.2023.1211620] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
Murine IL-17-producing γδT (γδT17) cells are divided into two subsets: natural γδT17 (nγδT17) cells, whose development is restricted to the fetal thymus, and inducible γδT17 cells, which require antigen exposure for their IL-17 production and are presumed to develop from Rorc + Il17a - CCR9 + immature γδT17 cells in the adult thymus and whose T cell receptor (TCR) is biased toward Vγ4. Although IL-23 is known to be involved in developing γδT17 cells, the roles of other cytokines, such as IL-21, which is involved in developing Th17 cells like IL-23, in the development, maintenance, and pathophysiology of γδT17 cells remain unknown. Here, we show that IL-21 is dispensable for the fetal thymic development of nγδT17 cells but is required for the peripheral maintenance of Vγ4+nγδT17 cells. Upon stimulation with γδTCR, IL-1 plus IL-21 induces the proliferation of Vγ4+nγδT17 cells via STAT3 as effectively as IL-1 plus IL-23. Using bone marrow chimeric mice, we demonstrated that immature γδT17 cells are produced de novo in the adult mice from donor adult bone marrow cells and that IL-21 is dispensable for their development. Instead, IL-21 is required to expand newly induced Vγ4+γδT17 cells in the periphery upon immunization. Finally, using adoptive transfer experiments of γδT17 cells, we found that IL-21 receptors on γδT17 cells are involved in maintaining Vγ4+γδT17 cells, subsequent infiltration of Th17 cells into the spinal cord, and exacerbation of experimental autoimmune encephalomyelitis. Collectively, IL-21 plays a vital role in the maintenance and pathogenesis of Vγ4+γδT17 cells.
Collapse
Affiliation(s)
- Junichi Ishikawa
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akira Suto
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Institute for Advanced Academic Research, Chiba University, Chiba, Japan
| | - Kazuya Abe
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuki Hayashi
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kensuke Suga
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shigeru Tanaka
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahiro Kageyama
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Institute for Advanced Academic Research, Chiba University, Chiba, Japan
| | - Arifumi Iwata
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazumasa Suzuki
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kotaro Suzuki
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroshi Nakajima
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Chiba University Synergy Institute for Futuristic Mucosal Vaccine Research and Development (cSIMVa), Chiba, Japan
| |
Collapse
|
3
|
Suga K, Suto A, Tanaka S, Sugawara Y, Kageyama T, Ishikawa J, Sanayama Y, Ikeda K, Furuta S, Kagami SI, Iwata A, Hirose K, Suzuki K, Ohara O, Nakajima H. TAp63, a methotrexate target in CD4+ T cells, suppresses Foxp3 expression and exacerbates autoimmune arthritis. JCI Insight 2023; 8:164778. [PMID: 37212280 PMCID: PMC10322677 DOI: 10.1172/jci.insight.164778] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 08/25/2022] [Accepted: 04/07/2023] [Indexed: 05/23/2023] Open
Abstract
Methotrexate (MTX) is a standard, first-line therapy for rheumatoid arthritis (RA); however, its precise mechanisms of action other than antifolate activity are largely unknown. We performed DNA microarray analyses of CD4+ T cells in patients with RA before and after MTX treatment and found that TP63 was the most significantly downregulated gene after MTX treatment. TAp63, an isoform of TP63, was highly expressed in human IL-17-producing Th (Th17) cells and was suppressed by MTX in vitro. Murine TAp63 was expressed at high levels in Th cells and at lower levels in thymus-derived Treg cells. Importantly, TAp63 knockdown in murine Th17 cells ameliorated the adoptive transfer arthritis model. RNA-Seq analyses of human Th17 cells overexpressing TAp63 and those with TAp63 knockdown identified FOXP3 as a possible TAp63 target gene. TAp63 knockdown in CD4+ T cells cultured under Th17 conditions with low-dose IL-6 increased Foxp3 expression, suggesting that TAp63 balances Th17 cells and Treg cells. Mechanistically, TAp63 knockdown in murine induced Treg (iTreg) cells promoted hypomethylation of conserved noncoding sequence 2 (CNS2) of the Foxp3 gene and enhanced the suppressive function of iTreg cells. Reporter analyses revealed that TAp63 suppressed the activation of the Foxp3 CNS2 enhancer. Collectively, TAp63 suppresses Foxp3 expression and exacerbates autoimmune arthritis.
Collapse
Affiliation(s)
- Kensuke Suga
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Akira Suto
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
- Institute for Advanced Academic Research, Chiba University, Chiba, Japan
| | - Shigeru Tanaka
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Yutaka Sugawara
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Takahiro Kageyama
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Junichi Ishikawa
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Yoshie Sanayama
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Kei Ikeda
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Shunsuke Furuta
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Shin-Ichiro Kagami
- Research Center for Allergy and Clinical Immunology, Asahi General Hospital, Asahi, Chiba, Japan
| | - Arifumi Iwata
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Koichi Hirose
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Kotaro Suzuki
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| | - Osamu Ohara
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu, Chiba, Japan
| | - Hiroshi Nakajima
- Department of Allergy and Clinical Immunology, Graduate School of Medicine, and
| |
Collapse
|
4
|
Hattori K, Tanaka S, Ishikawa J, Yabe Y, Iwamoto T, Furuta S, Ikeda K, Suzuki K, Nakajima H. Visceral disseminated varicella zoster virus infection during non-intensive maintenance therapy in a patient with systemic lupus erythematosus. Mod Rheumatol Case Rep 2023; 7:57-59. [PMID: 35781576 DOI: 10.1093/mrcr/rxac054] [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: 05/10/2022] [Revised: 06/19/2022] [Accepted: 06/26/2022] [Indexed: 01/07/2023]
Abstract
Visceral disseminated varicella zoster virus infection (VD-VZV) is a rare complication in immunocompromised patients. Although systemic lupus erythematosus (SLE) patients have a higher risk of VZV infection, only a few reports describe VD-VZV in SLE. Here, we report a 48-year-old woman with SLE who had received maintenance therapy. She was transferred to the hospital because of severe epigastric pain. There were no significant abnormalities in abdominal computed tomography and upper gastrointestinal endoscopy. On hospital day 4, she developed vesicular eruption on her face and abdomen. VZV antigen was detected in specimens obtained from skin lesions, and treatment with acyclovir was started. VZV DNA in blood turned out to be positive, and the epigastric pain was thought to be caused by VD-VZV. There is a risk of VD-VZV in patients with SLE, even in those receiving non-intensive maintenance therapy.
Collapse
Affiliation(s)
- Koto Hattori
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Shigeru Tanaka
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Junichi Ishikawa
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Yoko Yabe
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Taro Iwamoto
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Shunsuke Furuta
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Kei Ikeda
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Kotaro Suzuki
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| | - Hiroshi Nakajima
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan
| |
Collapse
|
5
|
Ida T, Furuta S, Takayama A, Tamura J, Hayashi Y, Abe K, Kurihara S, Ishikawa J, Iwamoto T, Ikeda K, Suzuki K, Nakajima H. Efficacy and safety of dose escalation of tofacitinib in refractory anti-MDA5 antibody-positive dermatomyositis. RMD Open 2023; 9:rmdopen-2022-002795. [PMID: 36593080 PMCID: PMC9809321 DOI: 10.1136/rmdopen-2022-002795] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023] Open
Abstract
Anti-melanoma differentiation-associated protein 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) is frequently complicated with rapidly progressive-interstitial lung disease (RP-ILD). The prognosis of MDA5-DM with RP-ILD is mostly poor despite intensive treatment with a combination of high-dose glucocorticoids and single conventional immunosuppressants. It was reported that the triple therapy (high-dose glucocorticoids, cyclophosphamide and tacrolimus) was more effective than a combination of high-dose glucocorticoids and stepwise addition of immunosuppressants. In addition, the efficacy of tofacitinib 10 mg/day for MDA5-DM with RP-ILD refractory to the triple therapy was suggested. However, the effect of those therapies was evaluated only in comparison to the historical control. Moreover, more importantly, there are still refractory patients even if treated with those therapies. In this case series, we report six MDA5-DM cases with RP-ILD in which the dose of tofacitinib was increased from 10 mg to 20 mg/day due to poor response to the triple therapy, followed by tofacitinib 10 mg/day. Four of six patients improved after dose escalation of tofacitinib, while two non-responders died. All six patients developed at least one infection including five cases of cytomegalovirus reactivation, one pulmonary aspergillosis, one herpes zoster and one herpes simplex keratitis. These cases suggest that the dose escalation of tofacitinib can be an option for MDA5-DM patients refractory to 10 mg/day of tofacitinib and other immunosuppressants although the risk of infection is a concern. The risk-benefit balance of the dose escalation of tofacitinib should be carefully assessed in each case.
Collapse
Affiliation(s)
- Tomoaki Ida
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Shunsuke Furuta
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Asuka Takayama
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Jun Tamura
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Yuki Hayashi
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Kazuya Abe
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Syunjiro Kurihara
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Junichi Ishikawa
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Taro Iwamoto
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Kei Ikeda
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Kotaro Suzuki
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| | - Hiroshi Nakajima
- Department of Allergy and Clinical Immunology, Chiba University, Chiba, Chiba, Japan
| |
Collapse
|
6
|
Kuki I, Inoue T, Nukui M, Okazaki S, Kawawaki H, Ishikawa J, Amo K, Togawa M, Ujiro A, Rinka H, Kunihiro N, Uda T, Shiomi M. Longitudinal electroencephalogram findings predict acute neurological and epilepsy outcomes in patients with hemorrhagic shock and encephalopathy syndrome. Epilepsy Res 2022; 181:106870. [PMID: 35149310 DOI: 10.1016/j.eplepsyres.2022.106870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/26/2021] [Revised: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Hemorrhagic shock and encephalopathy syndrome (HSES) is a severe subtype of acute encephalopathy with a poor prognosis. The association between electroencephalogram (EEG) findings and neurological outcomes in patients with HSES, including the onset of epilepsy, remains unclear. METHODS Thirty-two children with HSES registered in a database of Osaka City General Hospital between 2003 and 2018 were included in this study. The EEG findings which consisted of continuity, reactivity, state change, voltage, rhythmic and periodic patterns, and electrographic or electroclinical seizures, in the onset phase were evaluated for patient outcome. Patients who avoided acute death were investigated for epilepsy by a longitudinal EEG. Seizure types were determined by ictal video recordings. RESULTS We analyzed EEG findings in the onset phase of 30 patients. Severely to extremely abnormal EEG pattern (deteriorated continuity more than discontinuous pattern, presence of generalized abnormal low voltage slow wave, and presence of generalized rhythmic and periodic patterns) in the onset phase correlated with poor outcome (p = 0.0024). Subsequently, 9/23 patients (39%) developed epilepsy, of which a total of eight had epileptic spasms. A significant correlation between interictal epileptic discharges and the development of epilepsy was observed as early as within three months (p = 0.0003). CONCLUSIONS EEG pattern in the onset phase may be useful to predict the neurological prognosis in the acute stage. Moreover, this study demonstrated that longitudinal EEG findings after the acute phase of HSES were significantly related to the development of epilepsy. EEG findings are useful for predicting acute prognosis and epilepsy in patients with HSES.
Collapse
Affiliation(s)
- Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan.
| | - Takeshi Inoue
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Megumi Nukui
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Masao Togawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Atushi Ujiro
- Department of Intensive Care Medicine, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Department of Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Noritsugu Kunihiro
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takehiro Uda
- Department of Pediatric Neurosurgery, Osaka City General Hospital, Osaka, Japan; Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masashi Shiomi
- Department of Pediatrics, Aizenbashi Hospital, Osaka, Japan
| |
Collapse
|
7
|
Toyoshima K, Seino S, Tamura Y, Ishikawa J, Chiba Y, Ishizaki T, Fujiwara Y, Shinkai S, Kitamura A, Araki A. Difference between "Physical Fitness Age" Based on Physical Function and Chronological Age Is Associated with Obesity, Hyperglycemia, Depressive Symptoms, and Low Serum Albumin. J Nutr Health Aging 2022; 26:501-509. [PMID: 35587763 DOI: 10.1007/s12603-022-1786-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to (1) develop the physical fitness age, which is the biological age based on physical function, (2) evaluate the validity of the physical fitness age for the assessment of sarcopenia, and (3) examine the factors associated with the difference between physical fitness age and chronological age. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Community-dwelling older adults and outpatients. MEASUREMENTS A formula for calculating the physical fitness age was created based on the usual walking speed, handgrip strength, one-leg standing time, and chronological age of 4,076 older adults from the pooled data of community-dwelling and outpatients using the principal component analysis. For the validation of the physical fitness age, we also used pooled data from community-dwelling older adults (n = 1929) and outpatients (n = 473). Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. The association of D-age (the difference between physical and chronological ages) with cardiovascular risk factors, renal function, and cardiac function was examined. RESULTS The receiver operating characteristic analysis, with sarcopenia as the outcome, showed that the area under the curve (AUC) of physical fitness age was greater than that of chronological age (AUC 0.87 and 0.77, respectively, p < 0.001). Binomial logistic regression analysis revealed that the D-age was significantly associated with sarcopenia after adjustment for covariates (odds ratio 1.22, 95% confidence interval 1.19-1.26; p <0.001). In multivariate linear regression analysis with D-age as the dependent variable, D-age was independently associated with a history of diabetes mellitus (or hemoglobin A1c as a continuous variable), obesity, depression, and low serum albumin level. D-age was also correlated with estimated glomerular filtration rate derived from serum cystatin C, brain natriuretic peptide, and ankle-brachial index, reflecting some organ function and arteriosclerosis. CONCLUSIONS Compared to chronological age, physical fitness age calculated from handgrip strength, one-leg standing time, and usual walking speed was a better scale for sarcopenia. D-age, which could be a simple indicator of physical function, was associated with modifiable factors, such as poor glycemic control, obesity, depressive symptoms, and malnutrition.
Collapse
Affiliation(s)
- K Toyoshima
- Kenji Toyoshima, Department of Diabetes, Metabolism, and Endocrinology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan, E-mail:
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Aomatsu N, Shigemitsu K, Nakagawa H, Morooka T, Ishikawa J, Yamashita T, Tsuruoka A, Fuke A, Motoyama K, Kitagawa D, Ikeda K, Maeda K, Shirano M, Rinka H. Efficacy of Ninjin'yoeito in treating severe coronavirus disease 2019 in patients in an intensive care unit. Neuropeptides 2021; 90:102201. [PMID: 34753072 PMCID: PMC8484001 DOI: 10.1016/j.npep.2021.102201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 02/08/2023]
Abstract
Coronavirus Disease-2019 (COVID-19), an infectious disease associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global emergency with high mortality. There are few effective treatments, and many severe patients are treated in an intensive care unit (ICU). The purpose of this study was to evaluate whether the Japanese Kampo medicine ninjin'yoeito (NYT) is effective in treating ICU patients with COVID-19. Nine patients with confirmed SARS-CoV-2 infection admitted to the ICU were enrolled in this study. All patients underwent respiratory management with invasive mechanical ventilation (IMV) and enteral nutrition. Four patients received NYT (7.5 g daily) from an elemental diet tube. We retrospectively examined the prognostic nutritional index (PNI), length of IMV, length of ICU stay, length of hospital stay, rate of tracheostomy, and mortality rate. The median age of the enrolled participants was 60.0 years (4 men and 5 women). The median body mass index was 27.6. The most common comorbidity was diabetes (4 patients, 44%), followed by hypertension (3 patients, 33%) and chronic kidney disease (2 patients, 22%). The median length of IMV, ICU stay, and hospital stay were all shorter in the NYT group than in the non-NYT group (IMV; 4.0 days vs 14.3 days, ICU; 5.3 days vs 14.5 days, hospital stay; 19.9 days vs 28.2 days). In the NYT and non-NYT groups, the median PNI at admission was 29.0 and 31.2, respectively. One week after admission, the PNI was 30.7 in the NYT group and 24.4 in non-NYT group. PNI was significantly (p = 0.032) increased in the NYT group (+13.6%) than in the non-NYT group (-22.0%). The Japanese Kampo medicine NYT might be useful for treating patients with severe COVID-19 in ICU. This study was conducted in a small number of cases, and further large clinical trials are necessary.
Collapse
Affiliation(s)
- Naoki Aomatsu
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan; Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan.
| | - Kazuaki Shigemitsu
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Hidenori Nakagawa
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan
| | - Takaya Morooka
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Tomoya Yamashita
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Ayumu Tsuruoka
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Akihiro Fuke
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Koka Motoyama
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Daiki Kitagawa
- Department of Emergency and Critical Care Medical center, Osaka City General Hospital, Osaka, Japan
| | - Katsumi Ikeda
- Department of Breast Surgical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Kiyoshi Maeda
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| | - Michinori Shirano
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan
| |
Collapse
|
9
|
Yoshihiro S, Hongo T, Ohki S, Kaneko T, Ishikawa J, Ihara S, Taito S, Sakaguchi M, Yatabe T. Steroid treatment in patients with acute respiratory distress syndrome: a systematic review and network meta-analysis. J Anesth 2021; 36:107-121. [PMID: 34757498 PMCID: PMC8579727 DOI: 10.1007/s00540-021-03016-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/18/2021] [Accepted: 10/20/2021] [Indexed: 12/14/2022]
Abstract
Purpose Although the most recent systematic review and meta-analyses on acute respiratory distress syndrome (ARDS) have shown that the use of steroids decreases mortality in adult patients, its benefits and risks may differ depending on the type and dosage of the steroid. Therefore, we conducted a network meta-analysis (NMA) to compare the differences in the efficacy among different doses and types of steroids. Methods We searched MEDLINE, CENTRAL, ICHUSHI, ClinicalTrials.gov, and WHO ICTRP databases from the earliest records to March 2021 for randomized control trials, which compared steroids with placebo or conventional therapy for ARDS. Using the random-effects model, we compared various categories of steroids (high-dose methylprednisolone, low-dose methylprednisolone, hydrocortisone, dexamethasone, and no steroid) concerning hospital mortality, incidence of infection, and ventilator-free days (VFD). Results We analyzed nine studies involving adult patients (n = 1212). Although there were no significant differences between the groups in terms of the mortality and incidence of infection, the number of VFD were greater when using low-dose methylprednisolone than when not using any steroids (Mean difference: 6.06; 95% confidence intervals: [2.5, 10.5]). Moreover, the rank probability showed that low-dose methylprednisolone might be the optimal treatment, whereas using no steroid or high-dose methylprednisolone may be inferior to other treatments in terms of mortality, infection, and VFD. Conclusion This NMA suggested that the effect of steroids on the outcome in patients with ARDS might depend on the type of the steroid drug administered. Moreover, further studies are needed to identify the optimal type and dosage. Supplementary Information The online version contains supplementary material available at 10.1007/s00540-021-03016-5.
Collapse
Affiliation(s)
- Shodai Yoshihiro
- Pharmaceutical Department, JA General Hospital, Hiroshima, Japan
| | - Takashi Hongo
- Department of Emergency, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Shingo Ohki
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tadashi Kaneko
- Emergency and Critical Care Center, Mie University Hospital, Tsu, Japan
| | - Junichi Ishikawa
- Emergency and Critical Care Medical Center and Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Shoichi Ihara
- Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan
| | - Shunsuke Taito
- Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Masahiko Sakaguchi
- Department of Engineering Informatics, Osaka Electro-Communication University, Neyagawa, Japan
| | - Tomoaki Yatabe
- Department of Anesthesiology and Intensive Care Medicine, Nishichita General Hospital, 3-1, Nakanoike, Tokai-shi, Tokai, Aichi, 477-8522, Japan.
| |
Collapse
|
10
|
Tamura E, Ishikawa J, Yasuda Y, Yamamoto T. The efficacy of synthetic pseudo-ceramide for dry and rough lips. Int J Cosmet Sci 2021; 43:158-164. [PMID: 33258166 PMCID: PMC8252384 DOI: 10.1111/ics.12677] [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: 09/30/2020] [Revised: 11/09/2020] [Accepted: 11/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Lips can easily become dry and rough, one reason being the characteristics of their ceramide (CER) profile. Lips have lower levels of total ceramides, higher percentages of CER[NS] and CER[AS], and lower percentages of CER[NP] and CER[NH] than skin in other regions of the body. The purpose of this study was to clarify the effects of synthetic pseudo‐ceramide (pCer; Cetyl‐PG hydroxyethyl palmitamide) to improve the dryness and roughness of the lips of healthy subjects in a formulation that exclude an occlusive effect. METHODS Thirty‐one Japanese female subjects with normal skin (age range 21–37 years; mean 28.6) were enrolled in this study. A four‐week continuous use test was conducted using samples with or without 0.5% or 2.0% pCer. The degree of lip roughness was scored, and values of capacitance, transepidermal water loss (TEWL) and lip surface elasticity were measured. Endogenous CER profiles and absorption levels of pCer in the stratum corneum (SC) were analysed in tape‐stripped skin specimens. RESULTS Treatment with the pCer‐2.0% sample significantly improved the visual roughness score after 2 and 4 weeks compared to 0 weeks and compared to the Blank. Moreover, an improvement in TEWL was observed after 4 weeks of treatment with the pCer‐2.0% sample. CER[NP] showed a significant increase in pCer‐2.0% treated lips after 4 weeks compared to the Blank. Both pCer‐0.5% and pCer‐2.0% were significantly absorbed after 2 weeks compared with the Blank. CONCLUSION The effect of the synthetic pseudo‐ceramide pCer to improve the roughness of lips was shown excluding the effect of occlusiveness derived from the formulation for the first time. Since the improvement of TEWL and absorption of pCer was observed, we concluded that pCer was first absorbed in rough lip areas, improved the ceramide profile and consequently restored the barrier function.
Collapse
Affiliation(s)
- E Tamura
- Make-up Product Research Laboratory, Kao Corporation, Odawara, Japan
| | - J Ishikawa
- Biological Science Laboratory, Kao Corporation, Odawara, Japan
| | - Y Yasuda
- Analytical Science Laboratory, Kao Corporation, Odawara, Japan
| | - T Yamamoto
- Make-up Product Research Laboratory, Kao Corporation, Odawara, Japan
| |
Collapse
|
11
|
Horino A, Kuki I, Inoue T, Nukui M, Okazaki S, Kawawaki H, Togawa M, Amo K, Ishikawa J, Ujiro A, Shiomi M, Sakuma H. Intrathecal dexamethasone therapy for febrile infection-related epilepsy syndrome. Ann Clin Transl Neurol 2021; 8:645-655. [PMID: 33547757 PMCID: PMC7951105 DOI: 10.1002/acn3.51308] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/12/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Increasing reports suggest a role for immunological mechanisms in febrile infection-related epilepsy syndrome (FIRES). The objective of this study was to elucidate the efficacy and safety of intrathecal dexamethasone therapy (IT-DEX). METHODS We assessed six pediatric patients with FIRES who were administered add-on IT-DEX in the acute (n = 5) and chronic (n = 1) phases. We evaluated clinical courses and prognosis. We measured cytokines/chemokines in cerebrospinal fluid (CSF) from FIRES patients at several points, including pre- and post-IT-DEX, and compared them with control patients with chronic epilepsy (n = 12, for cytokines/chemokines) or with noninflammatory neurological disease (NIND, n = 13, for neopterin). RESULTS Anesthesia was weaned after a median of 5.5 days from IT-DEX initiation (n = 6). There was a positive correlation between the duration from the disease onset to the introduction of IT-DEX and the length of ICU stay and the duration of mechanical ventilation. No patient experienced severe adverse events. Seizure spreading and background activities on electroencephalography were improved after IT-DEX in all patients. The levels of CXCL10, CXCL9, IFN-γ, and neopterin at pre-IT-DEX were significantly elevated compared to levels in epilepsy controls, and CXCL10 and neopterin were significantly decreased post-IT-DEX, but were still higher compared to patients with chronic epilepsy. IL-6, IL-8, and IL-1β were significantly elevated before IT-DEX compared to epilepsy controls, though there was no significant decrease post-treatment. INTERPRETATION IT-DEX represents a therapeutic option for patients with FIRES that could shorten the duration of the critical stage of the disease. The effect of IT-DEX on FIRES might include cytokine-independent mechanisms.
Collapse
Affiliation(s)
- Asako Horino
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
- Department of Brain and NeuroscienceTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| | - Ichiro Kuki
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Takeshi Inoue
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Megumi Nukui
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Shin Okazaki
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Hisashi Kawawaki
- Department of Pediatric NeurologyChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Masao Togawa
- Department of Pediatric Emergency MedicineChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Kiyoko Amo
- Department of Pediatric Emergency MedicineChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Junichi Ishikawa
- Department of Pediatric Emergency MedicineChildren's Medical CenterOsaka City General HospitalOsakaJapan
| | - Atsushi Ujiro
- Department of Intensive Care MedicineOsaka City General HospitalOsakaJapan
| | | | - Hiroshi Sakuma
- Department of Brain and NeuroscienceTokyo Metropolitan Institute of Medical ScienceTokyoJapan
| |
Collapse
|
12
|
Abe K, Ishikawa Y, Ishikawa J, Fujiwara M, Kita Y. Successful treatment of a patient with refractory immune thrombocytopenic purpura in systemic lupus erythematosus with rituximab. Immunol Med 2019; 42:185-188. [PMID: 31794352 DOI: 10.1080/25785826.2019.1696644] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Immune thrombocytopenic purpura (ITP) is one of the complications of systemic lupus erythematosus (SLE). Although corticosteroids are usually selected for initial therapy, some patients are corticosteroid-resistant and, therefore, require other immunosuppressants or splenectomy. However, the best treatment approach in such patients remains unknown, and there is little evidence regarding which immunosuppressive agent can provide best results. We report the case of a patient with corticosteroid-resistant SLE-associated ITP (SLE-ITP) who was successfully treated with rituximab (RTX). RTX might be a therapeutic option for corticosteroid-resistant SLE-ITP.
Collapse
Affiliation(s)
- Kazuya Abe
- Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yuichi Ishikawa
- Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Junichi Ishikawa
- Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Michio Fujiwara
- Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Yasuhiko Kita
- Department of Rheumatology, Yokohama Rosai Hospital, Yokohama, Japan
| |
Collapse
|
13
|
|
14
|
Oboshi M, Oka T, Yasui T, Shioyama W, Tada Y, Ishikawa J, Fujita M. P1570Cardiac strain detects subclinical decline of cardiac function after hematopoietic stem cell transplantation in patients with hematologic malignancies. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0330] [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
Hematopoietic stem cell transplantation (HSCT) has been established as a treatment of various hematologic malignancies and improved their prognoses. HSCT includes intensive chemotherapy and systemic radiation, which occasionally induces cardiac dysfunction. However, early predictor of cardiac dysfunction associated with HSCT is still elusive. Recently, left ventricular (LV) global longitudinal strain (GLS) has been recognized as an early detector of cardiotoxicity. In this study, we retrospectively analyzed GLS and cardiac parameters in patients with hematologic malignancies before and after HSCT to explore HSCT-induced cardiac dysfunction.
Methods
Thirty-one consecutive patients undergone HSCT were enrolled and reviewed their cardiac comorbidities, medications, chemotherapy, and radiotherapy before HSCT. Transthoracic echocardiographic variables including GLS, cardiac troponin-I, and B-type natriuretic peptide were analyzed prior to and 1 month after HSCT.
Results
The patients were 49.7±13.5 years of age, 61% were male, and 52% had cardiovascular risk factors. Cardiac troponin-I was significantly increased following HSCT from 0.010±0.002 ng/ml to 0.016±0.014 ng/ml (P=0.02), indicating that HSCT should have certain impact on cardiac myocytes. Echocardiographic analyses revealed that LV GLS was significantly decreased after HSCT from −19.4±0.8% to −18.8±0.8% (P<0.001), whereas there was no significant difference in LV ejection fraction between these time points of HSCT (63.6±5.5% vs. 64.7±4.6%; P=0.13). Although there was no correlation between the decline of GLS and the increase of troponin-I in this cohort, these results clearly indicated that GLS, but not LVEF, predicted HSCT-induced early and subclinical cardiac dysfunction at 1 month after the HSCT.
Conclusion
GLS detected early decline of cardiac function after HSCT in the patients with hematologic malignancies. Further follow-up investigations will reveal relationship between GLS, troponin-I and prognosis of cardiac function after HSCT in patients with hematologic malignancies.
Collapse
Affiliation(s)
- M Oboshi
- Osaka International Cancer Institute, Osaka, Japan
| | - T Oka
- Osaka International Cancer Institute, Osaka, Japan
| | - T Yasui
- Osaka International Cancer Institute, Osaka, Japan
| | - W Shioyama
- Osaka International Cancer Institute, Osaka, Japan
| | - Y Tada
- Osaka International Cancer Institute, Osaka, Japan
| | - J Ishikawa
- Osaka International Cancer Institute, Osaka, Japan
| | - M Fujita
- Osaka International Cancer Institute, Osaka, Japan
| |
Collapse
|
15
|
Nomura T, Ishikawa J, Ohki M, Ohata A, Araki R, Kikuchi S. Multifactorial analysis of local control and survival in patients with early glottic cancer. Laryngoscope 2019; 130:1701-1706. [PMID: 31397901 DOI: 10.1002/lary.28240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/17/2019] [Accepted: 07/26/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The purpose of this study is to determine the effects of various prognostic factors for early glottic cancer patients who underwent radiotherapy. METHODS We retrospectively reviewed the all patients who were treated at our hospital for early glottic squamous cell carcinoma from 2004 to 2016. Data included patient's age, sex, T classification, tumor size, pathological grade, anterior commissure involvement, subglottic extension, laryngeal ventricle involvement, and restriction of vocal cord movement. RESULTS There were 74 patients with T1 tumors and 31 with T2 tumors. Recurrence was found in four patients with T1 and eight patients with T2. There were 99 males and six females enrolled, and the mean age was 67.5 ± 9.2 years for T1a, 67.3 ± 11.2 years for T1b, and 67.4 ± 7.9 years for T2. One patient with recurrence after 1 month was thought to have a residual tumor. The 5-year overall survival (OS) rate and the 5-year disease-specific survival (DSS) rate for T1-T2 patients were both 100%. The rate of larynx preservation was 94.6% for T1 and 74.2% for T2. A univariate analysis showed that the effective factors were age, T, size, SE. A multivariate logistic regression analysis showed that age influenced the recurrence status. Size is also suspected to be a prognostic factor. CONCLUSIONS This study revealed that the effective factors were age, T, size, and SE. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1701-1706, 2020.
Collapse
Affiliation(s)
- Tsutomu Nomura
- Division of Otolaryngology, Department of Comprehensive Medical Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Junichi Ishikawa
- Department of Otolaryngology, Saitama Medical University, Saitama, Japan
| | - Masafumi Ohki
- Department of Otolaryngology, Saitama Medical University, Saitama, Japan
| | - Atsushi Ohata
- Department of Otolaryngology, Saitama Medical University, Saitama, Japan
| | - Ryuichiro Araki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Sigeru Kikuchi
- Department of Otolaryngology, Saitama Medical University, Saitama, Japan
| |
Collapse
|
16
|
Abstract
RATIONALE It is known that 5% to 34% of Sjögren's syndrome (SS) cases are complicated by neuropathy in the form of myelitis. Although SS myelopathy (SSM) is often treated with glucocorticoid (GC) and immunosuppressants such as cyclophosphamide (CY), a therapeutic strategy for SSM has not been established. PATIENT CONCERNS A 65-year-old female was admitted with weakness and thermal hypoalgesia in the lower limbs. Four months before this admission, she showed weakness in her lower limbs and thermal hypoalgesia of bilateral upper and lower limbs. Magnetic resonance imaging (MRI) revealed that the cause of her neurological symptoms was cervical myelitis. She was diagnosed with SS because she tested positive for the ophthalmic test (Schirmer's test and fluorescent test) and for the anti-SS-A antibodies. Therefore, myelitis was thought to be a complication of SS. She was treated with GC and CY. Both neurological symptoms and MRI findings temporarily improved, and the GC dose was gradually decreased. One month before this admission, her neurological symptoms and MRI findings were exacerbated. Upon relapse of SSM, serum amyloid A protein (SAA) level was markedly elevated. DIAGNOSES Based on MRI findings, the diagnosis was SSM relapse. INTERVENTIONS Treatment by subcutaneous tocilizumab (TCZ) 162 mg every two weeks was introduced. OUTCOMES After introducing TCZ, her neurological symptoms and MRI findings gradually improved. SAA levels remained low. At eight months after the introduction of TCZ, the GC dose has been decreased and so far, the myelitis has not relapsed. LESSONS This case report is the first report suggesting the effectiveness of TCZ for refractory SSM. Subcutaneous TCZ might be an effective therapeutic option for treating refractory SSM when SAA levels are elevated.
Collapse
|
17
|
Suehiro K, Rinka H, Ishikawa J, Fuke A, Arimoto H, Miyaichi T. Stroke Volume Variation as a Predictor of Fluid Responsiveness in Patients Undergoing Airway Pressure Release Ventilation. Anaesth Intensive Care 2019; 40:767-72. [DOI: 10.1177/0310057x1204000503] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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]
Affiliation(s)
- K. Suehiro
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
- Department of Anesthesiology, Osaka City University Graduate School of Medicine
| | - H. Rinka
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - J. Ishikawa
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - A. Fuke
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - H. Arimoto
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - T. Miyaichi
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| |
Collapse
|
18
|
Ishikawa Y, Kasuya T, Ishikawa J, Fujiwara M, Kita Y. A case of developing progressive multifocal leukoencephalopathy while using rituximab and mycophenolate mofetil in refractory systemic lupus erythematosus. Ther Clin Risk Manag 2018; 14:1149-1153. [PMID: 29983569 PMCID: PMC6027819 DOI: 10.2147/tcrm.s167109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Indexed: 01/25/2023] Open
Abstract
Progressive multifocal leukoencephalopathy (PML) is a central nervous system infection caused by John Cunningham (JC) virus reactivation in an immunocompromised patient. PML has various neurologic symptoms and has very poor prognosis. A 36-year-old man developed transverse myelitis and had a psychiatric disorder at the age of 26. He was diagnosed with systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE), on the basis of leukopenia and presence of anti-DNA and anti-nuclear antibodies. Treatment with glucocorticoid (GC) was started, and remission was introduced. Six months before PML onset, his condition was complicated with hemophagocytic lymphohistiocytosis (HLH) due to exacerbation of SLE. Remission re-induction therapy by GC, cyclosporine-A, intravenous cyclophosphamide, and rituximab (RTX) was initiated and HLH improved. However, interleukin-6 levels of the cerebrospinal fluid (CSF) continued to rise. We thought that the disease activity of NPSLE worsened; thus, we introduced mycophenolate mofetil (MMF) 4 months before the PML onset. He developed progressive dysarthria and right hemiplegia. He was diagnosed with PML via magnetic resonance imaging and JC virus polymerase chain reaction in CSF. Considering that immunosuppressants, including RTX and MMF, are precipitating factors of PML, we discussed the RTX removal using plasma exchange (PEx), but we did not introduce PEx, because it was expected that the concentration of RTX was already lowered when he was diagnosed with PML. Treatment for PML with mefloquine and mirtazapine saved his life, but severe residual disabilities remained. This is the first report of a patient who developed PML during combination therapy with RTX and MMF.
Collapse
Affiliation(s)
- Yuichi Ishikawa
- Department of Rheumatology, Yokohama Rosai Hospital, Kohoku-ku, Yokohama, Kanagawa, Japan,
| | - Tadamichi Kasuya
- Department of Rheumatology, Yokohama Rosai Hospital, Kohoku-ku, Yokohama, Kanagawa, Japan,
| | - Junichi Ishikawa
- Department of Rheumatology, Yokohama Rosai Hospital, Kohoku-ku, Yokohama, Kanagawa, Japan,
| | - Michio Fujiwara
- Department of Rheumatology, Yokohama Rosai Hospital, Kohoku-ku, Yokohama, Kanagawa, Japan,
| | - Yasuhiko Kita
- Department of Rheumatology, Yokohama Rosai Hospital, Kohoku-ku, Yokohama, Kanagawa, Japan,
| |
Collapse
|
19
|
Tamura E, Ishikawa J, Sugata K, Tsukahara K, Yasumori H, Yamamoto T. Age-related differences in the functional properties of lips compared with skin. Skin Res Technol 2018; 24:472-478. [PMID: 29405429 DOI: 10.1111/srt.12456] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIMS Lips can easily become dry and rough and their biggest problems are drying and chapping. The cause of those problems is considered to be that the stratum corneum (SC) moisture is small and its barrier function is low. However, those problems decrease in subjects as they approach 40 years of age, after which problems due to their shape and color increase. The purpose of this study was to investigate relationships between SC properties of the lips during aging and to clarify the cause(s) of lip problems. METHODS One hundred and 38 Japanese female subjects with normal skin ranging in age from 16 to 78 years were enrolled in the study. The capacitance and transepidermal water loss (TEWL) values, viscoelasticity, and color of their lips were measured and compared with their cheeks. RESULTS The capacitance values for the lip and the cheek increased and TEWL values for both areas decreased with age. TEWL values for the lip decreased until ~30 years of age and this is considered to be related to the problem of drying. Although the maximum amplitude Uf of the lip increased with age, the Ur /Uf had no correlation with age. As for color, the L* and a* values decreased with age. CONCLUSION Age-related changes with regard to SC functions, viscoelasticity and color of the lips have been clarified for the first time, and it is clear that these changes are related to problems of the lips. Compared with the cheeks, differences with the lips are more apparent.
Collapse
Affiliation(s)
- E Tamura
- Kao Corporation, Make-up Product Research Laboratory, Odawara, Japan
| | - J Ishikawa
- Kao Corporation, Biological Science Laboratory, Tochigi, Japan
| | - K Sugata
- Kao Corporation, Biological Science Laboratory, Tochigi, Japan
| | - K Tsukahara
- Kao Corporation, Biological Science Laboratory, Tochigi, Japan
| | - H Yasumori
- Kao Corporation, Make-up Product Research Laboratory, Odawara, Japan
| | - T Yamamoto
- Kao Corporation, Make-up Product Research Laboratory, Odawara, Japan
| |
Collapse
|
20
|
Pellegrini M, Dolganov K, Herranz LE, Bonneville H, Luxat D, Sonnenkalb M, Ishikawa J, Song JH, Gauntt RO, Moguel LF, Payot F, Nishi Y. Benchmark Study of the Accident at the Fukushima Daiichi NPS: Best-Estimate Case Comparison. NUCL TECHNOL 2017. [DOI: 10.13182/nt16-63] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - K. Dolganov
- Nuclear Safety Institute of the Russian Academy of Sciences (IBRAE), Moscow, Russia
| | - L. E. Herranz
- Centro de Investigaciones Energéticas MedioAmbientales y Tecnológicas (CIEMAT), Madrid, Spain
| | - H. Bonneville
- Institut de Radioprotection et de Sùreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - D. Luxat
- Institut de Radioprotection et de Sùreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - M. Sonnenkalb
- Gesellschaft für Anlagen- und Reaktorsicherheit (GRS), Cologne, Germany
| | - J. Ishikawa
- Japan Atomic Energy Agency (JAEA), Tokyo, Japan
| | - J. H. Song
- Korea Atomic Energy Research Institute (KAERI), Daejeon, Korea
| | - R. O. Gauntt
- Sandia National Laboratories (SNL), Albuquerque, New Mexico
| | | | - F. Payot
- Korea Atomic Energy Research Institute (KAERI), Daejeon, Korea
| | - Y. Nishi
- Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
| |
Collapse
|
21
|
Kogashiwa Y, Yasuda M, Sakurai H, Nakahira M, Sano Y, Gonda K, Ikeda T, Inoue H, Kuba K, Oba S, Ishikawa J, Enoki Y, Matsumura S, Minami K, Ebihara Y, Sugasawa M. PD-L1 Expression Confers Better Prognosis in Locally Advanced Oral Squamous Cell Carcinoma. Anticancer Res 2017; 37:1417-1424. [PMID: 28314313 DOI: 10.21873/anticanres.11465] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Clinical trials with therapies targeting immune checkpoint molecules have shown promising results in several tumor types. However, the predictive and prognostic values of these immunological factors for locally advanced oral squamous cell carcinomas (LAOSCC) remain unclear. Our purpose was to evaluate the expression and prognostic value of programmed cell death-ligand1 (PD-L1) and PD-L2 and to correlate their expression with the degree of infiltration by CD8+ cells in LAOSCC. PATIENTS AND METHODS A total of 84 patients with LAOSCC were included. PD-L1, PD-L2 and CD8 expression was detected in the tumor tissue using immunohistochemistry and was tested for correlation with clinical outcome. RESULTS PD-L1 and PD-L2 were expressed in 52.4% and 23.8% of LAOSCC cases, respectively. PD-L1 positivity was significantly associated with superior disease-free (p=0.024) and overall (p=0.008) survival of the patients and retained significance in multivariate analysis. PD-L1 positivity was correlated with CD8 density. CONCLUSION PD-L1 expression was associated with CD8+ tumor-infiltrating lymphocytes and better outcome in patients with LAOSCC.
Collapse
Affiliation(s)
- Yasunao Kogashiwa
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Masanori Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Hiroyuki Sakurai
- Department of Pharmacology and Toxicology, Kyorin University School of Medicine, Mitaka, Japan
| | - Mitsuhiko Nakahira
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yoshie Sano
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kenji Gonda
- Department of Surgery, Japan Community Health Care Organization, Nihonmatsu, Japan
| | - Tetsuya Ikeda
- Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Mitaka, Japan
| | - Hitoshi Inoue
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kiyomi Kuba
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Susumu Oba
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Junichi Ishikawa
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yuichiro Enoki
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Satoko Matsumura
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kazuhiko Minami
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yasuhiro Ebihara
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Masashi Sugasawa
- Department of Head and Neck Surgery, and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Japan
| |
Collapse
|
22
|
Ishikawa J, Yamamoto A, Kano F, Asai H, Hagino H, Hideharu H. Sialic acid-binding immunoglobulin-like lectin-9 and monocyte chemoattractant protein-1 accelerate bone regeneration through altering macrophage polarity in the rat calvarial defects. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1163] [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: 10/19/2022]
|
23
|
Ohki M, Kikuchi S, Ohata A, Baba Y, Ishikawa J, Sugimoto H. Features of oral, pharyngeal, and laryngeal lesions in bullous pemphigoid. Ear Nose Throat J 2016; 95:E1-E5. [PMID: 27792825] [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] [Indexed: 06/06/2023] Open
Abstract
Bullous pemphigoid is an autoimmune bullous disease characterized by skin lesions, with or without oral lesions. The occurrence of pharyngolaryngeal lesions is very rare in affected patients. We conducted a study to investigate the characteristics of oral and pharyngolaryngeal lesions in bullous pemphigoid. Our study population was made up of 6 consecutively presenting outpatients-2 men and 4 women, aged 40 to 83 years (mean: 68.2)-who had been referred to our department over an 11-year period. Presenting symptoms included sore throat in all 6 patients and oral pain in 3. The sites of mucosal lesions included the soft palate, epiglottis, gingiva, hypopharynx, tongue, nasal cavity, and buccal mucosa. These lesions appeared as erosions, erosions with white coating, erythematous patches, and/or blisters. Mucosal lesions preceded skin lesions in 2 patients, appeared after skin lesions in 1 patient, and appeared simultaneously with skin lesions in 3 patients. We conclude that bullous pemphigoid sometimes involves the mucosa, such as that of the laryngopharynx and the oral cavity, and it can manifest as skin lesions. In the differential diagnosis of refractory pharyngolaryngeal lesions, bullous pemphigoid should be considered.
Collapse
Affiliation(s)
- Masafumi Ohki
- Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama 350-8550, Japan.
| | | | | | | | | | | |
Collapse
|
24
|
Arai Y, Kondo T, Shigematsu A, Tanaka J, Takahashi S, Kobayashi T, Uchida N, Onishi Y, Ishikawa J, Kanamori H, Sawa M, Yokota A, Kouzai Y, Takanashi M, Ichinohe T, Atsuta Y, Mizuta S. High-dose cytarabine added to CY/TBI improves the prognosis of cord blood transplantation for acute lymphoblastic leukemia in adults: a retrospective cohort study. Bone Marrow Transplant 2016; 51:1636-1639. [PMID: 27643870 DOI: 10.1038/bmt.2016.242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Y Arai
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Shigematsu
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - J Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - S Takahashi
- Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - T Kobayashi
- Division of Hematology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - N Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Y Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - J Ishikawa
- Department of Hematology and Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - H Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - M Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - A Yokota
- Department of Hematology, Chiba Aoba Municipal Hospital, Chiba, Japan
| | - Y Kouzai
- Department of Transfusion Medicine, Tokyo Metropolitan Tama Medical Center, Fuchu, Japan
| | - M Takanashi
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - T Ichinohe
- Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Y Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Mizuta
- Division of Hematology, Fujita Health University, Toyoake, Japan
| |
Collapse
|
25
|
Iwasaki N, Masuko T, Ishikawa J, Minami A. Surgical Efficacy of Carpal Tunnel Release for Carpal Tunnel Syndrome in Acromegaly: Report of Four Patients. ACTA ACUST UNITED AC 2016; 30:605-6. [PMID: 16095779 DOI: 10.1016/j.jhsb.2005.06.007] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Accepted: 06/09/2005] [Indexed: 11/25/2022]
Abstract
Although carpal tunnel syndrome is frequent in acromegaly, few acromegalics will be encountered by most hand surgeons. This paper considers the treatment of four cases of acromegaly in whom carpal tunnel syndrome arose, to discuss aspects of management of carpal tunnel syndrome in this patient group.
Collapse
Affiliation(s)
- N Iwasaki
- Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
| | | | | | | |
Collapse
|
26
|
Tamai S, Tanaka C, Abe T, Kuroki T, Ishikawa J. Preparation and Properties of Optically Clear Poly[(Arylenedioxy)(Diphenylsilylene)]s and Poly[(Alkylenedioxy)(Diphenylsilylene)]. HIGH PERFORM POLYM 2016. [DOI: 10.1177/0954008303015003011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several types of poly[(arylenedioxy)(diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] were synthesized from various diols and dichlorodiphenylsilane by the step polymerization method. The thermal properties, solubility in organic solvents and optical properties of the obtained polymers were investigated by focusing on the chemical structures of their repeating structural units. The weight-average molecular weight ( Mw) of the obtained polymers based on polystyrene ranged from 43000 to 194000. High molecular weight, ductile materials with a high degree of optical clarity were obtained. These polymers display glass transition temperatures ( Tg) between 96 and 130°C. The obtained poly[(arylenedioxy) (diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] were soluble in chloroform and toluene. The refractive index ( nd) was 1.64 for a biphenol-based poly[(arylenedioxy)(diphenylsilylene)] and 1.61 for a bisphenol-A based poly[(arylenedioxy)(diphenylsilylene)]. The poly[(arylenedioxy)(diphenylsilylene)]s and poly[(alkylenedioxy)(diphenylsilylene)] display very low birefringence (Δ n) between 0.0005 and 0.0022. The 70 μm thick film transmission of bicyclohexanol-based poly[(alkylenedioxy)(diphenylsilylene)] was 91% at a 350 nm wavelength.
Collapse
Affiliation(s)
- S. Tamai
- Advanced Materials Group Materials Science Laboratory, Mitsui Chemicals Inc., 580-32 Nagaura, Sodegaura-City, Chiba 229-0265, Japan
| | - C. Tanaka
- Advanced Materials Group Materials Science Laboratory, Mitsui Chemicals Inc., 580-32 Nagaura, Sodegaura-City, Chiba 229-0265, Japan
| | - T. Abe
- Advanced Materials Group Materials Science Laboratory, Mitsui Chemicals Inc., 580-32 Nagaura, Sodegaura-City, Chiba 229-0265, Japan
| | - T. Kuroki
- Advanced Materials Group Materials Science Laboratory, Mitsui Chemicals Inc., 580-32 Nagaura, Sodegaura-City, Chiba 229-0265, Japan
| | - J. Ishikawa
- Advanced Materials Group Materials Science Laboratory, Mitsui Chemicals Inc., 580-32 Nagaura, Sodegaura-City, Chiba 229-0265, Japan
| |
Collapse
|
27
|
Ito S, Ishikawa J, Naoe A, Yoshida H, Hachiya A, Fujimura T, Kitahara T, Takema Y. Ceramide synthase 4 is highly expressed in involved skin of patients with atopic dermatitis. J Eur Acad Dermatol Venereol 2016; 31:135-141. [PMID: 27358008 DOI: 10.1111/jdv.13777] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ceramide is a crucial lipid in the stratum corneum (SC) which maintains the barrier function and hydration of the skin. In atopic dermatitis (AD) patients who have defective skin barrier function, ceramide levels are altered. We previously reported that although the amount of total ceramide was lower in involved skin compared with uninvolved skin of AD patients and with healthy control skin, the amounts of smaller ceramide species of Cer[NS] (<40 total carbons, which are total carbons of both sphingoid base and amide-linked fatty acid), especially Cer[NS] with 34 total carbons (C34-Cer[NS]), were higher. However, the enzyme(s) that produces the higher levels of smaller ceramide species in involved skin of AD patients was unclear. OBJECTIVE To identify the enzyme(s) that produces higher levels of smaller ceramide species of Cer[NS] in the involved skin of AD patients. METHODS Eight female Caucasian subjects who were diagnosed with AD on their arms (age range: 21-45 years) were enroled in this study. We compared ceramide levels in the SC and the expression levels of enzymes involved in ceramide metabolism using real-time PCR and immunohistochemistry between involved and uninvolved skin of AD patients. RESULTS Level of mRNA encoding ceramide synthase 4 (CERS4), which is one of the enzymes that synthesize ceramide from a sphingoid base and an amide-linked fatty acid, was significantly higher in involved skin than in uninvolved skin (P < 0.01). Additionally, the protein expression level of CERS4 in the epidermis was also higher in involved skin compared with uninvolved skin. The expression level of CERS4 correlated with the amount of C34-Cer[NS] (P < 0.01) and the skin hydration value (P < 0.05). CONCLUSIONS The elevated expression level of CERS4 contributes to the increase of C34-Cer[NS] and the impaired SC barrier function in involved skin of AD patients.
Collapse
Affiliation(s)
- S Ito
- Kao Corporation, Tochigi, Japan
| | | | - A Naoe
- Kao Corporation, Tochigi, Japan
| | | | | | | | | | | |
Collapse
|
28
|
Tamura E, Ishikawa J, Naoe A, Yamamoto T. The roughness of lip skin is related to the ceramide profile in the stratum corneum. Int J Cosmet Sci 2016; 38:615-621. [PMID: 27090066 DOI: 10.1111/ics.12335] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 02/19/2016] [Accepted: 04/17/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The structure of skin on the lips is different from skin at other areas of the body; the water content of the stratum corneum (SC) and the barrier function there is low. Therefore, the lips can easily become dry and rough. The SC plays an important role in the barrier and water-holding functions of the skin. Above all, ceramides (CERs) are important SC lipids which maintain SC functions. The purpose of this study was to clarify the relationship between the degree of lip roughness and the CER profile. METHODS Forty-one Japanese female subjects with normal skin (age range 22-52 years; mean 34.1) were enrolled in this study. The degree of lip roughness was scored, the values of capacitance and transepidermal water loss (TEWL) were measured and CER profiles of the SC were analysed using tape-stripping. RESULTS The degree of lip roughness was related to the capacitance values but not the TEWL values. The roughness level correlated with the levels of CER[NH], CER[NP], CER[AH], CER[EOS] and CER[EOH] and the average carbon numbers of CER[NDS], CER[NH] and CER[NP] but not with the level of total CERs. The capacitance values of the lips were related not only with the levels of total CERs but also with the levels of CER[NH], CER[NP], CER[AH], CER[AP], CER[EOS], CER[EOH] and CER[EOP] and with the average carbon numbers of CER[NDS], CER[NS], CER[NH] and CER[NP]. The TEWL values of the lips were related not only with the levels of total CERs but also with the levels of CER[NH], CER[AH], CER[AP], CER[EOS] and CER[EOH]. CONCLUSION The relationship between lip roughness and the CER profile was clarified for the first time. The results suggest that not only the level of total CERs but also the specific CER species and their carbon numbers affect the maintenance of SC function.
Collapse
Affiliation(s)
- E Tamura
- Make-up Product Research Laboratory, Kao Corporation, Tokyo, Japan
| | - J Ishikawa
- Biological Science Laboratory, Kao Corporation, Tokyo, Japan
| | - A Naoe
- Analytical Science Laboratory, Kao Corporation, Tokyo, Japan
| | - T Yamamoto
- Make-up Product Research Laboratory, Kao Corporation, Tokyo, Japan
| |
Collapse
|
29
|
Tian ZM, Kohama Y, Tomita T, Ishikawa J, Mairo H, Kindo K, Nakatsuji S. Experimental exploration of novel semimetal state in strong anisotropic Pyrochlore iridate Nd2lr2O7under high magnetic field. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1742-6596/683/1/012024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
30
|
Arimoto H, Rinka H, Miyaichi T, Fuke A, Ishikawa J, Morooka T, Shigemitsu K, Morimoto T. Evaluation of complications of administration for tolvaptan after fluid resuscitation in critical care. Intensive Care Med Exp 2015. [PMCID: PMC4798141 DOI: 10.1186/2197-425x-3-s1-a545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
31
|
Ishikawa J, Yamamoto N, Nishikawa M, Furue H, Hagiwara S, Wakayama H, Yamaguchi S, Hibi H, Yamamoto A. A study of therapeutic effects of serum free conditioned media derived from stem cells from human exfoliated deciduous teeth for rheumatoid arthritis. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.142] [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: 10/22/2022]
|
32
|
Takano W, Ishikawa J, Nakamura Y. Using a human action database to recognize actions in monocular image sequences: recovering human whole body configurations. Adv Robot 2015. [DOI: 10.1080/01691864.2014.996604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
33
|
Ohki M, Baba Y, Kikuchi S, Ohata A, Tsutsumi T, Tanaka S, Tahara A, Urata S, Ishikawa J. Potentially lethal pharyngolaryngeal edema with dyspnea in adult patients with mumps: A series of 5 cases. Ear Nose Throat J 2015; 94:184-186. [PMID: 25923277] [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] [Indexed: 06/04/2023] Open
Abstract
In this article we describe 5 rare cases of mumps-associated pharyngolaryngeal edema. To the best of our knowledge, this report includes the first case of mumps-associated pharyngolaryngeal edema in a patient who had previously received mumps vaccination, and these cases represent the sixth report of mumps-associated pharyngolaryngeal edema in the English literature. All 5 of our patients with mumps infection were adults and manifested airway stenosis due to pharyngolaryngeal edema. This edema responded favorably to steroid treatment without tracheotomy. We conclude that a pharyngolaryngeal examination is recommended for patients with mumps infection. Steroid treatment is usually effective against pharyngolaryngeal edema; however, in certain cases tracheotomy may be inevitable.
Collapse
Affiliation(s)
- Masafumi Ohki
- Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama 350-8550, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Kuki I, Shiomi M, Okazaki S, Kawawaki H, Tomiwa K, Amo K, Togawa M, Ishikawa J, Rinka H. Characteristic neuroradiologic features in hemorrhagic shock and encephalopathy syndrome. J Child Neurol 2015; 30:468-75. [PMID: 25512363 DOI: 10.1177/0883073814558119] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 10/08/2014] [Indexed: 11/16/2022]
Abstract
Hemorrhagic shock and encephalopathy syndrome is a devastating disease, but the pathogenesis remains unclear. The aim of this study was to examine the usefulness of neuroimaging in establishing a diagnosis and elucidating the pathogenesis. We analyzed the neuroradiologic features of 22 patients who fulfilled the Levin criteria. All patients underwent brain computed tomography (CT), and 14 patients underwent brain magnetic resonance imaging (MRI) including diffusion-weighted imaging in 10 patients. Initial CT showed normal findings in 14 of 18 (78%) patients, but subsequently hypodensities appeared in bilateral watershed zones and progressed to whole brain edema. MRI revealed cytotoxic edema, showing hyperintensities in bilateral watershed zones on diffusion-weighted imaging with a low apparent diffusion coefficient. Serial neuroimaging showed characteristic features of a widespread brain ischemic event mainly in watershed zones in hemorrhagic shock and encephalopathy syndrome.
Collapse
Affiliation(s)
- Ichiro Kuki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Masashi Shiomi
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Shin Okazaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Hisashi Kawawaki
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyotaka Tomiwa
- Department of Pediatric Neurology, Osaka City General Hospital, Osaka, Japan
| | - Kiyoko Amo
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Masao Togawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka, Japan
| | - Junichi Ishikawa
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Hiroshi Rinka
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| |
Collapse
|
35
|
Murakoshi A, Takausu Y, Komada Y, Ishikawa J, Inoue Y. Factors associated with development of benzodiazepine dependence. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.516] [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] [Indexed: 10/25/2022]
|
36
|
Arimoto H, Rinka H, Miyaichi T, Fuke A, Ishikawa J, Morooka T. Evaluation of complication for therapeutic hypothermia with extra corporeal membrane oxygenation for out-of-hospital cardiac arrest. Resuscitation 2012. [DOI: 10.1016/j.resuscitation.2012.08.246] [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: 11/26/2022]
|
37
|
Kulić D, Ott C, Lee D, Ishikawa J, Nakamura Y. Incremental learning of full body motion primitives and their sequencing through human motion observation. Int J Rob Res 2011. [DOI: 10.1177/0278364911426178] [Citation(s) in RCA: 122] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper we describe an approach for on-line, incremental learning of full body motion primitives from observation of human motion. The continuous observation sequence is first partitioned into motion segments, using stochastic segmentation. Next, motion segments are incrementally clustered and organized into a hierarchical tree structure representing the known motion primitives. Motion primitives are encoded using hidden Markov models, so that the same model can be used for both motion recognition and motion generation. At the same time, the temporal relationship between motion primitives is learned via the construction of a motion primitive graph. The motion primitive graph can then be used to construct motions, consisting of sequences of motion primitives. The approach is implemented and tested during on-line observation and on the IRT humanoid robot.
Collapse
Affiliation(s)
- Dana Kulić
- Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Christian Ott
- Institute of Robotics and Mechatronics, DLR – German Aerospace Center, Wessling, Germany
| | - Dongheui Lee
- Department of Electrical Engineering and Information Technology, Technical University of Munich, Munich, Germany
| | - Junichi Ishikawa
- Department of Mechano-Informatics, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yoshihiko Nakamura
- Department of Mechano-Informatics, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
38
|
Matsuki H, Ishikawa J, Iwasaki N, Uchiyama S, Minami A, Kato H. Non-vascularized bone graft with Herbert-type screw fixation for proximal pole scaphoid nonunion. J Orthop Sci 2011; 16:749-55. [PMID: 21927984 DOI: 10.1007/s00776-011-0158-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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: 01/06/2011] [Accepted: 08/17/2011] [Indexed: 02/09/2023]
Abstract
BACKGROUND Since proximal pole fractures of the scaphoid are frequently overlooked, the poor vascularity in the proximal pole fragment often leads to nonunion. Vascularized bone grafts have been recently tested in cases with scaphoid proximal pole nonunion, but the indication for this treatment has not been well established. Alternatively, we have been treating such patients with a non-vascularized iliac bone graft and Herbert-type screw fixation with considerable success. The purpose of this investigation is to evaluate these cases retrospectively and clarify the surgical efficacy of our procedure. METHODS Between 1996 and 2009, 11 consecutive patients with proximal pole scaphoid nonunion were treated with a non-vascularized corticocancellous iliac bone graft and Herbert-type screw fixation. They were all male aged from 12 to 26 years. In two patients, avascular changes were recognized in the proximal pole in preoperative radiographs or MRI. Follow-up ranged from 12 to 76 months. RESULTS Bone union was radiographically confirmed in all patients, who returned to their former activities without any complications. The period from operation to union ranged from 12 to 24 weeks. The mean Mayo modified wrist score was 76.4 points preoperatively and 91.4 points postoperatively, and was improved in all cases. CONCLUSIONS A non-vascularized iliac bone graft with Herbert-type screw fixation obtained satisfactory clinical and radiographic results in cases with scaphoid proximal pole nonunion, regardless of the vascularity in the proximal fragment.
Collapse
Affiliation(s)
- Hiroyuki Matsuki
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
| | | | | | | | | | | |
Collapse
|
39
|
Ishikawa J, Shimotoyodome Y, Chen S, Ohkubo K, Takagi Y, Fujimura T, Kitahara T, Takema Y. Eucalyptus increases ceramide levels in keratinocytes and improves stratum corneum function. Int J Cosmet Sci 2011; 34:17-22. [DOI: 10.1111/j.1468-2494.2011.00675.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
40
|
Ishikawa J, Yamamuro M, Togawa M, Shiomi M. [Attempt of differentiation acute encephalopathy with febrile convulsive status epilepticus from febrile convulsive status epilepticus induced by human herpesvirus 6 at early stage]. No To Hattatsu 2010; 42:283-286. [PMID: 20666134] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
It is difficult for clinicians to predict the subsequent development of acute encephalopathy with febrile convulsive status epilepticus (AEFCSE), when febrile convulsive status epilepticus (FCSE) develops. Comparing clinical and laboratory characteristics between patients with AEFCSE and those with FCSE, we investigated the factors which predict the later development of febrile convulsive status caused by HHV6. The subjects of this study were patients treated for FCSE or AEFCSE due to HHV6 in our hospital between April 2004 and January 2008. The AEFCSE group included 5 patients, and the FCSE group included 6 patients. There were few differences in clinical characteristics or brain images on admission between the 2 groups. Disturbance of consciousness persisted for 24 hours or more in all patients in the AEFCSE group and in 2 patients in the FCSE group. The serum creatinine concentration was significantly higher in the AEFCSE group. Serum creatinine concentration could be a good indicator for the prediction of AEFCSE in patients with FCSE.
Collapse
Affiliation(s)
- Junichi Ishikawa
- Department of Pediatric Emergency Medicine, Osaka City General Hospital, Osaka
| | | | | | | |
Collapse
|
41
|
Eguchi K, Matsui Y, Shibasaki S, Hoshide S, Kabutoya T, Ishikawa J, Ishikawa S, Shimada K, Kario K. Controlling evening BP as well as morning BP is important in hypertensive patients with prediabetes/diabetes: the JMS-1 study. Am J Hypertens 2010; 23:522-7. [PMID: 20168303 DOI: 10.1038/ajh.2010.17] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The significance of home blood pressure (BP) measurement in type 2 diabetes (T2DM) has not been well investigated. We aimed to test the hypotheses that home BP is more closely associated with target-organ damage than clinic BP, and that the presence of prediabetes/T2DM enhances the impact of home BP measurement. METHODS We studied 551 hypertensives (99 diabetics and 452 nondiabetics) whose self-measured systolic BP (SBP) was >135 mm Hg while on medication. The subjects were followed for 6 months after allocation to either a control group or an active treatment group. The changes in clinic BP and home BP were analyzed in relation to the changes in the spot urine albumin-creatinine ratio (UAR). RESULTS The extent of clinic and home BP reduction was similar between the diabetic and nondiabetic groups. The change in UAR in nondiabetics was significantly associated with the extent of SBP reduction in the clinic (r = 0.19), morning (r = 0.33), and evening (r = 0.22, all P < 0.01). In contrast, in the diabetic group, the change in UAR was significantly associated with the changes in morning SBP (r = 0.23, P = 0.02) and evening SBP (r = 0.39, P < 0.001), but not with clinic BP. The correlation with evening SBP in the diabetic group tended to be stronger than the nondiabetic group. CONCLUSIONS In hypertensives with prediabetes/T2DM, changes in home BP were better than changes in clinic BP to predict changes in UAR. In particular, this suggests the hypothesis that aggressive control of evening home BP might be equally or more important to morning BP in hypertensives with prediabetes/T2DM.
Collapse
|
42
|
Awh E, Scolari M, Ishikawa J. Object-based biased competition during covert spatial orienting. J Vis 2010. [DOI: 10.1167/8.6.224] [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: 11/24/2022] Open
|
43
|
Sakamoto H, Ishikawa J, Osuga H, Doi K, Wada H. Highly silver ion selective fluorescence ionophore: Fluorescent properties of polythiazaalkane derivatives bearing 8-(7-hydroxy-4-methyl)coumarinyl moiety in aqueous solution and in liquid–liquid extraction systems. Analyst 2010; 135:550-8. [DOI: 10.1039/b920625f] [Citation(s) in RCA: 16] [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] [Indexed: 11/21/2022]
|
44
|
Hiratsuka T, Furihata K, Ishikawa J, Yamashita H, Itoh N, Seto H, Dairi T. An Alternative Menaquinone Biosynthetic Pathway Operating in Microorganisms. Science 2008; 321:1670-3. [DOI: 10.1126/science.1160446] [Citation(s) in RCA: 182] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
45
|
Ishikawa J, Furuta H, Ikawa Y. Mutation analysis of the base-pair connecting two functional modules in the DSL ribozyme. ACTA ACUST UNITED AC 2008:523-4. [DOI: 10.1093/nass/nrn265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
46
|
Sakakura K, Hoshide S, Ishikawa J, Momomura SI, Kawakami M, Shimada K, Kario K. Association of body mass index with cognitive function in elderly hypertensive Japanese. Am J Hypertens 2008; 21:627-32. [PMID: 18443570 DOI: 10.1038/ajh.2008.157] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND As hypertension, obesity, and leanness are reported to be associated with poor cognitive function, it is possible that obesity or leanness in hypertensive patients may also be associated strongly with poor cognitive function. METHODS We recruited 184 elderly hypertensive patients comprising 93 very elderly (aged >or=80 years) and 91 younger elderly (aged 61-79 years) subjects. A mini-mental state examination (MMSE) and 24-h ambulatory blood pressure monitoring (ABPM) were performed in all participants. Patients were classified as either lean, normal physique, or obese according to the body mass index (BMI) quartile. The prevalence of poor cognitive function, total MMSE score, and MMSE subscores were compared between the groups. RESULTS The prevalence of poor cognitive function, total MMSE score, and MMSE subscore attention/calculation were significantly different between the groups both in the total study population and in the very elderly patients. The multiple logistic regression model showed that leanness was a significant determinant of poor cognitive function in both the total study population (odds ratio (OR) 2.54, 95% confidence interval (CI) 1.13-5.73, P = 0.02) and the very elderly patients (OR 3.94, 95% CI 1.31-11.82, P = 0.01). Obesity was not a significant determinant in either the total study population, very elderly, or younger elderly groups. CONCLUSION While obesity in hypertensive elderly patients was not associated with poor cognitive function, leanness in hypertensive elderly patients was, especially in the very elderly.
Collapse
|
47
|
Moriwaki Y, Moriwaki Y, Taharav Y, Arata S, Toyoda H, Kosuge T, Iwahita J, Washita M, Ishikawa J, Matsuzaki S, Harunari N, Suzuki N, Sugiyama M. Who finds out-of-hospital cardiac arrest patients and where they are found in an urban city? Resuscitation 2008. [DOI: 10.1016/j.resuscitation.2008.03.161] [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: 10/22/2022]
|
48
|
Moriwaki Y, Tahara Y, Arata S, Toyoda H, Kosuge T, Iwashita M, Ishikawa J, Matsuzakis S, Harunarin N, Suzuki N, Sugiyama M. Out-of-hospital cardiac arrest due to non-cardiac causes. Resuscitation 2008. [DOI: 10.1016/j.resuscitation.2008.03.162] [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: 11/24/2022]
|
49
|
Eguchi K, Pickering TG, Hoshide S, Ishikawa J, Ishikawa S, Schwartz JE, Shimada K, Kario K. Ambulatory blood pressure is a better marker than clinic blood pressure in predicting cardiovascular events in patients with/without type 2 diabetes. Am J Hypertens 2008; 21:443-50. [PMID: 18292756 DOI: 10.1038/ajh.2008.4] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The prognostic significance of ambulatory blood pressure (ABP) has not been established in patients with type 2 diabetes (T2DM). METHODS In order to clarify the impact of ABP on cardiovascular prognosis in patients with or without T2DM, we performed ABP monitoring (ABPM) in 1,268 subjects recruited from nine sites in Japan, who were being evaluated for hypertension. The mean age of the patients was 70.4 +/- 9.9 years, and 301 of them had diabetes. The patients were followed up for 50 +/- 23 months. We investigated the relation between incidence of cardiovascular diseases (CVDs) and different measures of ABP, including three categories of awake systolic blood pressure (SBP <135, 135-150, and >150 mm Hg), sleep SBP (<120, 120-135, and >135 mm Hg), and dipping trends in nocturnal blood pressure (BP) (dippers, nondippers, and risers). Cox regression models were used in order to control for classic risk factors. RESULTS Higher awake and sleep SBPs predicted higher incidence of CVD in patients with and without diabetes. In multivariable analyses, elevated SBPs while awake and asleep predicted increased risk of CVD more accurately than clinic BP did, in both groups of patients. The relationships between ABP level and CVD were similar in both groups. In Kaplan-Meier analyses, the incidence of CVD in nondippers was similar to that in dippers, but risers experienced the highest risk of CVD in both groups (P < 0.01). The riser pattern was associated with a approximately 150% increase in risk of CVD, in both groups. CONCLUSIONS These findings suggest that ABPM is a better predictor of cardiovascular risk than clinic BP, and that this holds true for patients with or without T2DM.
Collapse
|
50
|
Shiomi M, Ishikawa J, Togawa M, Okazaki S, Kuki I, Kimura S, Kawawaki H. [A concept of acute encephalopathy with febrile convulsive status epilepticus (AEFCSE) and theophylline as one of its precipitating causes]. No To Hattatsu 2008; 40:122-127. [PMID: 18341050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
|