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Harigai M, Fujii T, Sakai R, Igarashi A, Shoji A, Yamaguchi H, Iwasaki K, Makishima M, Yoshida A, Okada N, Yamashita K, Kawahito Y. Risk of hospitalized infections in older elderly patients with rheumatoid arthritis treated with tocilizumab or other biological/targeted synthetic disease-modifying antirheumatic drugs: Evaluation of data from a Japanese claims database. Mod Rheumatol 2024; 34:287-296. [PMID: 37039670 DOI: 10.1093/mr/road031] [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: 10/25/2022] [Accepted: 03/15/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE We compared the incidence rates of hospitalized infections (HIs) between tocilizumab (TCZ) and other biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults aged ≥75 years with rheumatoid arthritis (RA). METHODS We used a Japanese claims database from Medical Data Vision Co., Ltd (Tokyo, Japan) to perform a retrospective longitudinal population-based study in patients with RA who were prescribed b/tsDMARDs between 2014 and 2019. We calculated adjusted risk ratios (aRRs) for HIs in three age groups (<65, ≥65 and <75, and ≥75 years). RESULTS Of 5506 patients, 2265 (41.1%) were <65 years, 1709 (31.0%) were 65-74 years, and 1532 (27.8%) were ≥75 years. Crude incidence rates (/100 person-years) of HIs were 3.99, 7.27, and 10.77, respectively. In the oldest group, aRRs (95% confidence interval) for HIs (b/tsDMARDs versus TCZ) were as follows: etanercept, 2.40 (1.24-4.61); adalimumab, 1.90 (0.75-4.83); golimumab, 1.21 (0.66-2.23); and abatacept, 0.89 (0.49-1.62). In the other age groups, the noticeable difference was a lower aRR of etanercept versus TCZ in the youngest group (0.30, 0.11-0.85). CONCLUSION In patients with RA aged ≥75 years, b/tsDMARDs have a similar risk of HIs to tocilizumab except for etanercept.
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Affiliation(s)
- Masayoshi Harigai
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Takao Fujii
- Department of Rheumatology and Clinical Immunology, Wakayama Medical University, Wakayama, Japan
| | - Ryoko Sakai
- Department of Public Health and Epidemiology, Meiji Pharmaceutical University, Tokyo, Japan
| | - Ataru Igarashi
- Department of Health Economics & Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
- Unit of Public Health and Preventive Medicine, Yokohama City University of Medicine, Yokohama, Japan
| | - Ayako Shoji
- Medilead Inc., Tokyo Opera City Tower, Tokyo, Japan
| | | | | | | | | | | | | | - Yutaka Kawahito
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Ishimoto Y, Sotodate T, Namba Y, Uenishi T, Iwasaki K, Tomita H. Benefits of Working from Home During the COVID-19 Pandemic for Undiagnosed Workers with Attention-Deficit/Hyperactivity Disorder Symptoms. Neuropsychiatr Dis Treat 2023; 19:1607-1621. [PMID: 37484117 PMCID: PMC10356549 DOI: 10.2147/ndt.s414862] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/05/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose Our previous study suggested that working conditions might impact work productivity amid the COVID-19 pandemic. This study aimed to investigate the association between working from home (WFH) and depressive symptoms, work productivity, and quality of life (QOL), in undiagnosed workers with attention-deficit/hyperactivity disorder (ADHD) symptoms during the COVID-19 pandemic. Methods During the pandemic, the survey was conducted among eligible workers with (N = 904) and without (N = 900) ADHD symptoms based on the Adult ADHD Self-Report Scale [ASRS]. Each group was further stratified by working conditions (full working on-site [FWOS], hybrid, full WFH [FWFH]). Two-way ANOVA was performed to investigate the impact of WFH on depressive symptoms (Patient Health Questionnaire [PHQ-9] score), work productivity (Work Productivity and Activity Impairment scale [WPAI] scores), and QOL (EuroQol 5-Dimensions 5-Levels [EQ-5D-5L] score). The Tukey-Kramer test was used to assess differences between the stratified subgroups. Poisson and multiple regression analyses were also performed to assess the factors associated with these outcomes. Results Other than PHQ-9 score between FWOS and hybrid work in workers with ADHD symptoms (p < 0.05), no significant differences were observed in outcomes among the working condition subgroups in both workers with and without ADHD symptoms. In workers with ADHD symptoms, hybrid work and FWFH were significantly associated with a lower PHQ-9 score (hybrid, p < 0.001; FWFH, p < 0.05) but neither were significantly associated with WPAI score nor EQ-5D-5L. Annual income and discretionary work were significantly associated with a lower PHQ-9 score and a higher EQ-5D-5L score in workers with ADHD symptoms. Job type (manufacture/construction) was significantly associated with a lower presenteeism score. Conclusion WFH (hybrid and FWFH) may be associated with lower depressive symptoms compared with FWOS in undiagnosed workers with ADHD symptoms. The findings may be useful when considering suitable working environments for workers especially with ADHD symptoms.
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Affiliation(s)
| | - Takuma Sotodate
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Yuki Namba
- Medical Affairs Department, Shionogi & Co., Ltd., Tokyo, Japan
| | | | | | - Hiroaki Tomita
- Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan
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Iwasaki K, Okazaki A. Medication-related osteonecrosis of the jaw leading to sepsis in a patient with rheumatoid arthritis: A case report and clinical implications. Clin Case Rep 2023; 11:e7588. [PMID: 37334335 PMCID: PMC10276238 DOI: 10.1002/ccr3.7588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 06/20/2023] Open
Abstract
Key Clinical Message Chronic use of bisphosphonates, in combination with immunosuppressive therapy, increases the risk of jaw osteonecrosis. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection. Abstract Reports of medication-related osteonecrosis of the jaw (MRONJ) accompanied by sepsis are limited. A 75-year-old female patient with rheumatoid arthritis, receiving treatment with bisphosphonate and abatacept, developed sepsis secondary to MRONJ. When sepsis occurs in patients receiving bisphosphonate, osteonecrosis of the jaw should be considered a potential source of infection.
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Affiliation(s)
- K. Iwasaki
- Department of Internal MedicineKaga Medical CenterKagaJapan
- Department of Respiratory MedicineKanazawa University Graduate School of Medical SciencesKanazawaJapan
| | - A. Okazaki
- Department of Internal MedicineKaga Medical CenterKagaJapan
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4
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Kuwana M, Tamura N, Yasuda S, Fujio K, Shoji A, Yamaguchi H, Iwasaki K, Makishima M, Kawata Y, Yamashita K, Igarashi A. Cost-effectiveness analyses of biologic and targeted synthetic disease-modifying anti-rheumatic diseases in patients with rheumatoid arthritis: Three approaches with a cohort simulation and real-world data. Mod Rheumatol 2023; 33:302-311. [PMID: 35445720 DOI: 10.1093/mr/roac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/07/2022] [Accepted: 04/17/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) in rheumatoid arthritis. METHODS We conducted three analyses: a lifetime analysis with a cohort model (Study A) and two short-term analyses (Studies B and C). Study A evaluated the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained from costs of standard treatments. Study B evaluated yearly costs per person achieving American College of Rheumatology (ACR) response (ACR20, ACR50, and ACR70), and Study C evaluated costs per person achieving previously defined claims-based effectiveness (equivalent to 28-joint Disease Activity Score ≤ 3.2). The proportion of ACR responders to the drugs of interest were determined by mixed treatment comparisons. Studies B and C estimated costs using a claims database. RESULTS In Study A, ICERs of all b/tsDMARDs were lower than 5.0 million Japanese yen (JPY) per QALY. In Study B, yearly costs per person with ACR50 response were lower for subcutaneous tocilizumab (TCZ-SC; 1.9 million JPY) and SC abatacept (2.3 million JPY). In Study C, costs per person were lower for TCZ-SC (1.3 million JPY) and intravenous TCZ (1.6 million JPY) and effectiveness rates were higher for intravenous TCZ (45.3%) and infliximab (43.0%). CONCLUSION The b/tsDMARDs with lower prices showed higher cost-effectiveness.
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Affiliation(s)
- Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ayako Shoji
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Hiroko Yamaguchi
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | - Katsuhiko Iwasaki
- Medilead Inc., Tokyo Opera City Tower, Shinjuku-ku, Tokyo 163-1424, Japan
| | | | - Yuichi Kawata
- Chugai Pharmaceutical Co., Ltd., Chuo-ku, Tokyo 103-8324, Japan
| | | | - Ataru Igarashi
- Department of Health Economics & Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan.,Unit of Public Health and Preventive Medicine, Yokohama City University of Medicine, Yokohama 236-0004, Japan
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Kato M, Yoneyama-Hirozane M, Iwasaki K, Matsubayashi M, Igarashi A. Health-related quality of life in health states corresponding to different stages of perianal fistula associated with Crohn's disease: a quantitative evaluation of patients and non-patients in Japan. J Mark Access Health Policy 2023; 11:2166374. [PMID: 36684854 PMCID: PMC9848226 DOI: 10.1080/20016689.2023.2166374] [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] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 12/26/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Perianal fistula (PF), a complication of Crohn's disease (CD), affects health-related quality of life (QOL). OBJECTIVE To elucidate QOL of health states corresponding to different stages of PF associated with CD in Japan. METHOD This cross-sectional, observational, web-based questionnaire survey assessed eight different health states in patients with CD and PF and individuals without CD (non-patients) from the Medilead Healthcare Panel (MHP) and determined the utility values (QOL scores) in each health state by the time trade-off method. In patients, we determined also the utility value of the current health state associated with CD and the PF. The analysis excluded respondents with logical inconsistencies. RESULTS The analysis included 82 patients and 576 non-patients with the same sex and age distribution as the Japanese population. In both groups, mean utility values were higher in remission (patients, 0.78; non-patients, 0.51) than in non-remission states, with lowest values for poor prognosis after proctectomy (patients, 0.13; non-patients, -0.10) and highest values for the state with mild symptoms (patients, 0.60; non-patients, 0.30). In patients, the mean utility value of the current health state was 0.71. CONCLUSION QOL decreases with increasing severity of PF and is lower for good prognosis after proctostomy than for remission.
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Affiliation(s)
- Masafumi Kato
- Japan Pharma Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | - Mao Matsubayashi
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ataru Igarashi
- Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, Yokohama, Japan
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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Minami T, Tokiyasu AO, Kohri H, Abe Y, Iwasaki K, Taguchi T, Oda K, Suzuki S, Asai T, Tanaka SJ, Isayama S, Kanasaki M, Kodaira S, Fukuda Y, Kuramitsu Y. Mass-resolved ion measurement by particle counting analysis for characterizing relativistic ion beams driven by lasers. Rev Sci Instrum 2022; 93:113530. [PMID: 36461420 DOI: 10.1063/5.0101872] [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] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
Particle counting analysis is a possible way to characterize GeV-scale, multi-species ions produced in laser-driven experiments. We present a multi-layered scintillation detector to differentiate multi-species ions of different masses and energies. The proposed detector concept offers potential advantages over conventional diagnostics in terms of (1) high sensitivity to GeV ions, (2) realtime analysis, and (3) the ability to differentiate ions with the same charge-to-mass ratio. A novel choice of multiple scintillators with different ion stopping powers results in a significant difference in energy deposition between the scintillators, allowing accurate particle identification in the GeV range. Here, we report a successful demonstration of particle identification for heavy ions, performed at the Heavy Ion Medical Accelerator in Chiba. In the experiment, the proposed detector setup showed the ability to differentiate particles with similar atomic numbers, such as C6+ and O8+ ions, and provided an excellent energy resolution of 0.41%-1.2% (including relativistic effect, 0.51%--1.6%).
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Affiliation(s)
- T Minami
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - A O Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Miyagi 982-0826, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - Y Abe
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Iwasaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Oda
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Suzuki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Asai
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - S J Tanaka
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Isayama
- Faculty of Engineering Sciences, Kyushu University, 6-1 Kasuga-Koen, Kasuga, Fukuoka 816-8580, Japan
| | - M Kanasaki
- Graduate School of Maritime Sciences, Kobe University, Hyogo 658-0022, Japan
| | - S Kodaira
- National Institute of Radiological Sciences (NIRS), National Institutes for Quantum Science and Technology (QST), Chiba 263-8555, Japan
| | - Y Fukuda
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum Science and Technology (QST), Kyoto 619-0215, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
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Abe Y, Kohri H, Tokiyasu A, Minami T, Iwasaki K, Taguchi T, Asai T, Kanasaki M, Kodaira S, Fujioka S, Kuramitsu Y, Fukuda Y. A multi-stage scintillation counter for GeV-scale multi-species ion spectroscopy in laser-driven particle acceleration experiments. Rev Sci Instrum 2022; 93:063502. [PMID: 35778001 DOI: 10.1063/5.0078817] [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] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Particle counting analysis (PCA) with a multi-stage scintillation detector shows a new perspective on angularly resolved spectral characterization of GeV-scale, multi-species ion beams produced by high-power lasers. The diagnosis provides a mass-dependent ion energy spectrum based on time-of-flight and pulse-height analysis of single particle events detected through repetitive experiments. With a novel arrangement of multiple scintillators with different ions stopping powers, PCA offers potential advantages over commonly used diagnostic instruments (CR-39, radiochromic films, Thomson parabola, etc.) in terms of coverage solid angle, detection efficiency for GeV-ions, and real-time analysis during the experiment. The basic detector unit was tested using 230-MeV proton beam from a synchrotron facility, where we demonstrated its potential ability to discriminate major ion species accelerated in laser-plasma experiments (i.e., protons, deuterons, carbon, and oxygen ions) with excellent energy and mass resolution. The proposed diagnostic concept would be essential for a better understanding of laser-driven particle acceleration, which paves the way toward all-optical compact accelerators for a range of applications.
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Affiliation(s)
- Y Abe
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - A Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Miyagi 982-0826, Japan
| | - T Minami
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Iwasaki
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Asai
- Graduate School of Maritime Sciences, Kobe University, Kobe 658-0022, Japan
| | - M Kanasaki
- Graduate School of Maritime Sciences, Kobe University, Kobe 658-0022, Japan
| | - S Kodaira
- National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba 263-8555, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - Y Kuramitsu
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - Y Fukuda
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), Kyoto 619-0215, Japan
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Watanabe O, Ko Y, Tsujii N, Takase Y, Ejiri A, Shinohara K, Peng Y, Iwasaki K, Yamada I, Yatomi G, Moeller C, Peng YK. Design of a finline antenna for current drive in TST-2. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nakai T, Tsuji T, Tsuda H, Sotodate T, Namba Y, Uenishi T, Iwasaki K, Kokubo K, Tomita H. Working Conditions, Work Productivity, Quality of Life, and Depressive Symptoms in Undiagnosed Adults with and without Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms During the COVID-19 Pandemic. Neuropsychiatr Dis Treat 2022; 18:1561-1572. [PMID: 35937711 PMCID: PMC9346305 DOI: 10.2147/ndt.s358085] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aims to evaluate the impact of the COVID-19 pandemic on employment status, work productivity, quality of life (QOL), and depressive symptoms in undiagnosed adults with and without attention-deficit/hyperactivity disorder (ADHD) symptoms in Japan. METHODS An observational study used baseline data from a Japanese Medilead Healthcare Panel before the COVID-19 pandemic (October-December 2019). Eligible panel participants were then surveyed during the pandemic (March 2021). ADHD symptoms were screened using the Adult ADHD Self-Report Scale. Changes in QOL (EuroQol 5-Dimensions 5-Levels; EQ-5D-5L) and productivity impairment (Work Productivity and Activity Impairment scale; WPAI) from before to during the pandemic were analyzed in undiagnosed adults with and without ADHD symptoms. Unemployment rate and depressive symptoms (Patient Health Questionnaire; PHQ-9) during the pandemic were compared between groups. RESULTS Participants with (N=949) and without (N=942) ADHD symptoms completed the survey. The unemployment rate was not significantly different between participants with and without ADHD symptoms. Participants with ADHD symptoms were more likely to change jobs or employers during the pandemic. PHQ-9 scores in participants with ADHD symptoms were significantly higher than in those without ADHD symptoms (8.96 vs 3.57, respectively) during the pandemic. Before the pandemic, WPAI scores were significantly higher and EQ-5D-5L scores lower in participants with ADHD symptoms than in those without. Productivity improved and QOL was not altered during the pandemic in both groups, but productivity and QOL remained poorer among participants with ADHD symptoms than in those without. CONCLUSION Productivity was improved among all participants during the COVID-19 pandemic, contrary to expectations. However, adults with ADHD symptoms consistently had lower productivity, poorer QOL, and more depressive symptoms than those without ADHD symptoms.
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Affiliation(s)
- Toru Nakai
- Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan
| | - Toshinaga Tsuji
- Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan
| | - Hiroshi Tsuda
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan.,Department of Neurology, Faculty of Medicine, Juntendo University, Tokyo, Japan.,Department of Neurology, Faculty of Medicine, Toho University, Tokyo, Japan.,Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Takuma Sotodate
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Yuki Namba
- Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan
| | | | | | - Kinya Kokubo
- Medilead, Inc, Tokyo, Japan.,Department of International Business, Faculty of International Politics and Economics, Nishogakusha University, Tokyo, Japan
| | - Hiroaki Tomita
- Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Matsuoka K, Igarashi A, Sato N, Isono Y, Gouda M, Iwasaki K, Shoji A, Hisamatsu T. Trends in Corticosteroid Prescriptions for Ulcerative Colitis and Factors Associated with Long-Term Corticosteroid Use: Analysis Using Japanese Claims Data from 2006 to 2016. J Crohns Colitis 2020; 15:358-366. [PMID: 32845311 PMCID: PMC7944504 DOI: 10.1093/ecco-jcc/jjaa172] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Recent treatment guidelines for ulcerative colitis [UC] do not recommend long-term corticosteroid [CS] use. The present study aimed to capture the changes in CS use from 2006 to 2016 and to identify factors associated with long-term CS use after 2014, when the first two anti-tumour necrosis factor antibodies [infliximab and adalimumab] became available. METHODS A retrospective study using the JMDC Claims Database included UC patients who initiated UC medications in any year from January 2006 to December 2016, or after January 2014, who were under continuous observation from 6 months before to 12 months after initiation. Patients with Crohn's disease before initiation and those prescribed <8 days of CSs were excluded. RESULTS Among 7907 UC patients who initiated UC medications within the study period, 1555 were prescribed CSs. The proportion of patients using CSs in each year decreased from 2011 as use of thiopurines and biologics increased. The proportion of patients with a starting dose ≥30 mg/day of CSs and patients continuing CSs for <90 days increased from 2011, reaching 49.1% and 41.0%, respectively, in 2016. However, even in 2016, 34.3% continued to use CSs for ≥180 days. Among 1230 patients with CS use after January 2014, low initial CS dose [<10 mg/day] was most strongly associated with long-term CS use [≥180 days]. CONCLUSIONS CS use became more appropriate as use of thiopurine and biologics increased, although there were still many cases of inappropriate use. Long-term CS use was most strongly associated with low initial doses of CSs.
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Affiliation(s)
- Katsuyoshi Matsuoka
- Department of Gastroenterology and Hepatology, Toho University Sakura Medical Center, Sakura, Japan
| | - Ataru Igarashi
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan,Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | - Noriko Sato
- Ikuyaku Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Yuri Isono
- Ikuyaku Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Maki Gouda
- Ikuyaku Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | | | - Ayako Shoji
- Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan,Medilead, Inc., Tokyo, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan,Corresponding author: Tadakazu Hisamatsu, Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan. Tel: +81-422-47-5511; Fax: +81-422-44-0655;
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11
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Iwasaki K, Hamana H, Kishi H, Yamamoto T, Hiramitsu T, Okad M, Tomosugi T, Takeda A, Narumi S, Watarai Y, Miwa Y, Okumura M, Matsuoka Y, Horimi K, Muraguchi A, Kobayash T. The suppressive effect on CD4 T cell alloresponse against endothelial HLA-DR via PD-L1 induced by anti-A/B ligation. Clin Exp Immunol 2020; 202:249-261. [PMID: 32578199 DOI: 10.1111/cei.13482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/27/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022] Open
Abstract
While donor-specific human leukocyte antigen (HLA) antibodies are a frequent cause for chronic antibody-mediated rejection in organ transplantation, this is not the case for antibodies targeting blood group antigens, as ABO-incompatible (ABO-I) organ transplantation has been associated with a favorable graft outcome. Here, we explored the role of CD4 T cell-mediated alloresponses against endothelial HLA-D-related (DR) in the presence of anti-HLA class I or anti-A/B antibodies. CD4 T cells, notably CD45RA-memory CD4 T cells, undergo extensive proliferation in response to endothelial HLA-DR. The CD4 T cell proliferative response was enhanced in the presence of anti-HLA class I, but attenuated in the presence of anti-A/B antibodies. Microarray analysis and molecular profiling demonstrated that the expression of CD274 programmed cell death ligand 1 (PD-L1) increased in response to anti-A/B ligation-mediated extracellular signal-regulated kinase (ERK) inactivation in endothelial cells that were detected even in the presence of interferon-γ stimulation. Anti-PD-1 antibody enhanced CD4 T cell proliferation, and blocked the suppressive effect of the anti-A/B antibodies. Educated CD25+ CD127- regulatory T cells (edu.Tregs ) were more effective at preventing CD4 T cell alloresponses to endothelial cells compared with naive Treg ; anti-A/B antibodies were not involved in the Treg -mediated events. Finally, amplified expression of transcript encoding PD-L1 was observed in biopsy samples from ABO-I renal transplants when compared with those from ABO-identical/compatible transplants. Taken together, our findings identified a possible factor that might prevent graft rejection and thus contribute to a favorable outcome in ABO-I renal transplantation.
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Affiliation(s)
- K Iwasaki
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - H Hamana
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - H Kishi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Yamamoto
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Hiramitsu
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - M Okad
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - T Tomosugi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - A Takeda
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - S Narumi
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Watarai
- Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Y Miwa
- Department of Kidney Disease and Transplant Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - M Okumura
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Y Matsuoka
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - K Horimi
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - A Muraguchi
- Department of Immunology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - T Kobayash
- Department of Renal Transplant Surgery, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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12
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Takeuchi S, Watanabe T, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Mochizuki H, Iwasaki K, Nakajima S, Kuroda K, Seguchi O, Yanase M, Tadokoro N, Yajima S, Fukushima S, Fujita T, Ogawa H, Fukushima N. The Development of Cardiac Allograft Vasculopathy Occurs in Early Intimal Thickening and Constrictive Remodeling in Long-Term Period; Long-Term Serial Intravascular Ultrasound Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.532] [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: 10/24/2022] Open
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13
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Fukushima N, Yanase M, Watanabe T, Kuroda K, Nakajima S, Iwasaki K, Fujita T, Fukushima S, Tadokoro N, Kobayashi J. Mid-Term Effectiveness of Everolimus on Heart Transplant Recipients with Renal Dysfunction or Transplant Coronary Artery Atherosclerosis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.602] [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: 11/27/2022] Open
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14
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Watanabe T, Yanase M, Fujita T, Fukushima S, Nakajima S, Kuroda K, Iwasaki K, Yajima S, Tadokoro N, Mochizuki H, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Kobayashi J, Fukushima N. Donor-Transmitted Atherosclerosis and the Occurrence of Cardiac Antibody-Mediated Rejection Influenced on the Development of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.537] [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: 10/24/2022] Open
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15
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Iwasaki K, Yoshitake K, Yagi N, Sujino Y, Anegawa E, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Seguchi O, Yanase M, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Incidence, Factors and Prognostic Impact of Re-Exploration for Bleedings after Continuous Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.520] [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: 10/24/2022] Open
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16
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Nomoto M, Iwaki H, Tagawa M, Iwasaki K. Comparison of zonisamide with non-levodopa, anti-Parkinson’s disease drugs in the incidence of Parkinson’s disease-relevant symptoms. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.809] [Citation(s) in RCA: 1] [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: 10/25/2022]
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17
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. P1671Subclinical persistent hemolysis may affect late renal function deterioration after HeartMateII implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0428] [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
Late renal function dysfunction is an increasingly recognized complication in continuous flow left ventricular assist device (CF-LVAD) patients. Although hemolysis is prevalent in CF-LVAD patients and hemolysis may deteriorate renal function, the influence of persistent hemolysis on renal function in CF-LVAD patients remains to be investigated.
Purpose
To investigate the influence of persistent hemolysis on renal function in CF-LVAD patients, using lactate dehydrogenase (LDH) as a sensitive marker of hemolysis.
Methods
Excluding patients who died or underwent pump exchange for pump thrombosis, we retrospectively reviewed 65 consecutive adults who underwent HeartMateII implantation in our center from May 2011 to October 2017. Patient characteristics, chronotropic change of estimated glomerular filtration rate (eGFR) and LDH values weekly for 4 weeks and every 4 weeks between 4 and 48 weeks after implantation were collected. Then, calculating mean LDH during 48 weeks after implantation, study population was divided into low and high mean LDH groups at the median value of mean LDH.
Results
The median value of mean LDH was 304 U/l. Compared with low LDH patients, though high LDH patients were more likely female and had smaller body surface area, there were no significant difference in pre-operative eGFR between the groups (66.0±23.7 vs. 70.2±25.7 ml/min/1.73m2, p=0.495). After 40 weeks after implantation, high LDH patients had significantly lower eGFR than low LDH patients (71.0±23.7 vs. 87.1±31.4 ml/min/1.73m2, p=0.024). In multivariate linear regression analysis, mean LDH [parameter estimate: −0.10 (95% CI: −0.17 to −0.04), p=0.003] and post-operative pulse pressure [parameter estimate: 0.71 (95% CI: 0.05 to 1.37), p=0.036] were significantly associated with eGFR change during 48 weeks after HeartMateII implantation.
Univariate and multivariate linear regression analysis for eGFR change Univariate parameter estimate 95% CI p value Multivariate parameter estimate 95% CI p value Bilirubin, mg/dl 9.97 3.82 to 16.13 0.002 6.55 −0.43 to 13.53 0.065 BNP, pg/ml 0.01 0.00 to 0.02 0.044 0.00 −0.01 to 0.01 0.528 Mean LDH during 4 to 48 weeks, U/l −0.11 −0.18 to −0.05 <0.001 −0.10 −0.17 to −0.04 0.003 Pre-operative right atrial pressure, mmHg 1.43 0.35 to 2.51 0.010 −0.06 −1.52 to 1.40 0.935 Post-operative pulse pressure, mmHg 0.77 0.03 to 1.52 0.042 0.71 0.05 to 1.37 0.036
Conclusions
High mean LDH and low pulse pressure were associated with a significant decrease in eGFR late after HeartMateII implantation. Subclinical persistent hemolysis may be associated with late renal function deterioration in CF-LVAD patients.
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Affiliation(s)
- K Iwasaki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - O Seguchi
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - H Mochizuki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kimura
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kumai
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - K Kuroda
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - S Nakajima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - T Watanabe
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - M Yanase
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Matsumoto
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - S Fukushima
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - N Fukushima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
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18
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Kimura Y, Seguchi O, Mochizuki H, Iwasaki K, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Matsumoto Y, Fukushima S, Yanase M, Fujita T, Kobayashi J, Fukushima N. Role of Gallium-SPECT-CT in Predicting Outcomes of Patients with Ventricular Assist Device-Specific Percutaneous Driveline Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.800] [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: 11/30/2022] Open
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19
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Adjedj J, Picard F, Mogi S, Iwasaki K, Aoumeur H, Alansari O, Agudze E, Wijns W, Varenne O. In vitro flow and optical coherence tomography comparison of two bailout techniques after failed after provisional T-stenting for bifurcation percutaneous coronary interventions. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.044] [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: 11/27/2022]
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20
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Terminal Ileac Ulcers Mimicked Post-transplantation Lymphoproliferative Disorder in a Heart Recipient Treated With Everolimus: A Case Report. Transplant Proc 2018; 50:4053-4056. [PMID: 30577313 DOI: 10.1016/j.transproceed.2018.08.025] [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] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized and potentially fatal complication of cardiac transplantation that commonly involves the gastrointestinal tract. Herein, we report a case of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers mimicking PTLD in a heart recipient treated with everolimus (EVL). A 40-year-old man underwent heart transplantation for dilated cardiomyopathy 3 years prior to the current admission and was treated with tacrolimus and EVL. He was admitted to a local hospital because of fever, abdominal pain, and diarrhea. His symptoms persisted and, 3 weeks later, hematochezia occurred; thus, he was transferred to our hospital. As computed tomography and 18F-fluorodeoxyglucose positron emission tomography showed bowel-wall thickening of the terminal ileum, gastrointestinal PTLD was initially suspected. However, although colonoscopy- performed after switching EVL to mycophenolate mofetil (MMF)-showed terminal ileac ulcers, the histologic examination revealed no findings corresponding to PTLD. As EVL may delay ulcer healing, MMF was maintained for 3 months. After repeated colonoscopy showed ulcer healing, MMF was switched back to EVL for cardiac allograft vasculopathy prevention. Three weeks later, he was emergently admitted to a local hospital for life-threatening gastrointestinal bleeding from a recurrent terminal ileal ulcer, which required hemostatic forceps hemostasis. As EVL is suspected to be associated with recurrent ileal ulcers, EVL was again switched back to MMF. The ileal ulcers resolved, without recurrence in 3 months of clinical follow-up. This case demonstrates that cases of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers can mimic PTLD in a heart recipient treated with EVL.
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Affiliation(s)
- K Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - O Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - H Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - M Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - N Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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21
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Iwasaki K, Temin HM. Multiple sequence elements are involved in RNA 3' end formation in spleen necrosis virus. Gene Expr 2018; 2:7-18. [PMID: 1319783 PMCID: PMC6057358] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The function of the poly(A) signal in spleen necrosis virus (SNV) is dependent upon the distance between the cap site and the poly(A) site, while the function of the SV40 late poly(A) signal is independent of the distance. Deletions in the SNV poly(A) sequence do not alter the distance-dependent function. SNV/SV40 chimeric poly(A) signals show intermediate behavior between the SNV and SV40 poly(A) signals. These results indicate that multiple sequence elements are involved in the functions of either the SNV or SV40 poly(A) signals. This intermediate behavior is also observed with poly(A) signals from the mouse alpha-globin and herpes simplex virus thymidine kinase genes.
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Affiliation(s)
- K Iwasaki
- McArdle Laboratory for Cancer Research, University of Wisconsin, Madison 53706
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22
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Malchesky P, Takahashi T, Iwasaki K, Harasaki H, Nosé Y. Conjugated Human Hemoglobin as a Physiological Oxygen Carrier - Pyridoxalated Hemoglobin Polyoxyethylene Conjugate (PHP). Int J Artif Organs 2018. [DOI: 10.1177/039139889001300711] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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
Problems associated with specific physiological properties of Hb-based blood substitutes, such as a low P50, short plasma half-life and nephrotoxicity are still major issues to be addressed. Extensive investigations aimed at overcoming these problems have resulted in the preparation of pyridoxalated-hemoglobin-polyoxyethylene conjugate (PHP). PHP was developed from human hemoglobin by two major chemical modifications; pyridoxylation for the purpose of lowering the oxygen affinity (P50 of 19.5 ± 1.2 mmHg), and coupling with polyoxyethylene (POE) to increase its molecular weight (to approximately 90 kdaltons). The circulating half-life of PHP is about 40 hours in dogs. Toxicologicai and physiological studies including renal function assessments have demonstrated that PHP does not have untoward effects on major organ functions. Its efficacy in transporting oxygen has been shown in ET and intracoronary perfusion, and in in vitro studies with sickle cells. Studies to date suggest that PHP is a promising candidate as a physiological oxygen carrier. In this paper the properties of PHP, its safety and efficacy aspects, and its potential as a clinical oxygen carrier are reviewed based on studies conducted in the Author's laboratory.
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Affiliation(s)
- P.S. Malchesky
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - T. Takahashi
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - K. Iwasaki
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - H. Harasaki
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
| | - Y. Nosé
- Department of Artificial Organs, The Cleveland Clinic Foundation, Cleveland, Ohio - U.S.A
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23
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Iwasaki K, Kimura Y, Toda K, Kikuchi N, Kumai Y, Kuroda K, Seguchi O, Yanase M, Matsumoto Y, Fujita T, Kobayashi J, Fukushima N. Impact of Creatinine Excretion Rate, a Maker of Sarcopenia, on Prediction of Mortality and Neurological Events in Advanced Heart Failure Patients With Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.700] [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: 10/17/2022] Open
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Abstract
In a previous communication, we reported a leaflet fracture in a Jellyfish valve that was incorporated into a blood pump, after a 312-day animal implant duration. Subsequent finite element analysis revealed that the fracture location was consistent with an area of maximum strain concentration. Therefore, the aim of this study was to improve the durability in the light of these findings. Based on the engineering analysis results, a new valve seat having a concentric ring of 0.5mm width, located at a radius of 7.0 mm, was designed and fabricated. Accelerated fatigue tests, conducted under the conditions recommended by ISO 5840, demonstrated that the durability of this new prototype was extended by a factor of 10, as compared to the original valve. Moreover, further finite element analysis indicated that the maximum equivalent elastic strain of the proposed new valve was reduced by 52.3% as compared to the original valve. Accordingly, it has been confirmed that the modified Jellyfish valve is suitable for use in long-term artificial hearts.
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Affiliation(s)
- K. Iwasaki
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - M. Umezu
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - K. Imachi
- Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo - Japan
| | - K. Iijima
- Department of Mechanical Engineering, Waseda University, Tokyo - Japan
| | - T. Fujimoto
- Department of Mechanical Engineering, Shibaura Institute of Technology, Tokyo - Japan
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25
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Matsuo K, Takazawa Y, Ross MS, Elishaev E, Podzielinski I, Yunokawa M, Sheridan TB, Bush SH, Klobocista MM, Blake EA, Takano T, Matsuzaki S, Baba T, Satoh S, Shida M, Nishikawa T, Ikeda Y, Adachi S, Yokoyama T, Takekuma M, Fujiwara K, Hazama Y, Kadogami D, Moffitt MN, Takeuchi S, Nishimura M, Iwasaki K, Ushioda N, Johnson MS, Yoshida M, Hakam A, Li SW, Richmond AM, Machida H, Mhawech-Fauceglia P, Ueda Y, Yoshino K, Yamaguchi K, Oishi T, Kajiwara H, Hasegawa K, Yasuda M, Kawana K, Suda K, Miyake TM, Moriya T, Yuba Y, Morgan T, Fukagawa T, Wakatsuki A, Sugiyama T, Pejovic T, Nagano T, Shimoya K, Andoh M, Shiki Y, Enomoto T, Sasaki T, Fujiwara K, Mikami M, Shimada M, Konishi I, Kimura T, Post MD, Shahzad MM, Im DD, Yoshida H, Omatsu K, Ueland FR, Kelley JL, Karabakhtsian RG, Roman LD. Significance of histologic pattern of carcinoma and sarcoma components on survival outcomes of uterine carcinosarcoma. Ann Oncol 2016; 27:1257-66. [PMID: 27052653 DOI: 10.1093/annonc/mdw161] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To examine the effect of the histology of carcinoma and sarcoma components on survival outcome of uterine carcinosarcoma. PATIENTS AND METHODS A multicenter retrospective study was conducted to examine uterine carcinosarcoma cases that underwent primary surgical staging. Archived slides were examined and histologic patterns were grouped based on carcinoma (low-grade versus high-grade) and sarcoma (homologous versus heterologous) components, correlating to clinico-pathological demographics and outcomes. RESULTS Among 1192 cases identified, 906 cases were evaluated for histologic patterns (carcinoma/sarcoma) with high-grade/homologous (40.8%) being the most common type followed by high-grade/heterologous (30.9%), low-grade/homologous (18.0%), and low-grade/heterologous (10.3%). On multivariate analysis, high-grade/heterologous (5-year rate, 34.0%, P = 0.024) and high-grade/homologous (45.8%, P = 0.017) but not low-grade/heterologous (50.6%, P = 0.089) were independently associated with decreased progression-free survival (PFS) compared with low-grade/homologous (60.3%). In addition, older age, residual disease at surgery, large tumor, sarcoma dominance, deep myometrial invasion, lymphovascular space invasion, and advanced-stage disease were independently associated with decreased PFS (all, P < 0.01). Both postoperative chemotherapy (5-year rates, 48.6% versus 39.0%, P < 0.001) and radiotherapy (50.1% versus 44.1%, P = 0.007) were significantly associated with improved PFS in univariate analysis. However, on multivariate analysis, only postoperative chemotherapy remained an independent predictor for improved PFS [hazard ratio (HR) 0.34, 95% confidence interval (CI) 0.27-0.43, P < 0.001]. On univariate analysis, significant treatment benefits for PFS were seen with ifosfamide for low-grade carcinoma (82.0% versus 49.8%, P = 0.001), platinum for high-grade carcinoma (46.9% versus 32.4%, P = 0.034) and homologous sarcoma (53.1% versus 38.2%, P = 0.017), and anthracycline for heterologous sarcoma (66.2% versus 39.3%, P = 0.005). Conversely, platinum, taxane, and anthracycline for low-grade carcinoma, and anthracycline for homologous sarcoma had no effect on PFS compared with non-chemotherapy group (all, P > 0.05). On multivariate analysis, ifosfamide for low-grade/homologous (HR 0.21, 95% CI 0.07-0.63, P = 0.005), platinum for high-grade/homologous (HR 0.36, 95% CI 0.22-0.60, P < 0.001), and anthracycline for high-grade/heterologous (HR 0.30, 95% CI 0.14-0.62, P = 0.001) remained independent predictors for improved PFS. Analyses of 1096 metastatic sites showed that carcinoma components tended to spread lymphatically, while sarcoma components tended to spread loco-regionally (P < 0.001). CONCLUSION Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.
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Affiliation(s)
- K Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - Y Takazawa
- Department of Pathology, Cancer Institute Hospital, Tokyo, Japan
| | - M S Ross
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - E Elishaev
- Department of Pathology, MaGee-Womens Hospital, University of Pittsburgh, Pittsburgh
| | - I Podzielinski
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yunokawa
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T B Sheridan
- Department of Pathology, Mercy Medical Center, Baltimore
| | - S H Bush
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - M M Klobocista
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - E A Blake
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology; University of Colorado, Boulder, USA
| | - T Takano
- Department of Obstetrics and Gynecology, Tohoku University, Miyagi
| | - S Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - T Baba
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - S Satoh
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - M Shida
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - T Nishikawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - Y Ikeda
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - S Adachi
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Yokoyama
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - M Takekuma
- Department of Obstetrics and Gynecology, Shizuoka Cancer Center, Shizuoka
| | - K Fujiwara
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Hazama
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - D Kadogami
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - M N Moffitt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - S Takeuchi
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - M Nishimura
- Department of Obstetrics and Gynecology, Tokushima University, Tokushima
| | - K Iwasaki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - N Ushioda
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - M S Johnson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - M Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - A Hakam
- Department of Pathology, Moffitt Cancer Center, University of South Florida, Tampa
| | - S W Li
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx
| | - A M Richmond
- Department of Pathology, University of Colorado, Boulder
| | - H Machida
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
| | - P Mhawech-Fauceglia
- Department of Pathology, University of Southern California, Los Angeles, USA
| | - Y Ueda
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yoshino
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - K Yamaguchi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Oishi
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - H Kajiwara
- Department of Pathology, Tokai University, Kanagawa
| | - K Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Yasuda
- Department of Pathology, Saitama Medical University International Medical Center, Saitama
| | - K Kawana
- Departments of Obstetrics and Gynecology, The University of Tokyo, Tokyo
| | - K Suda
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T M Miyake
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - T Moriya
- Department of Pathology, Kawasaki Medical School, Okayama
| | - Y Yuba
- Department of Pathology, Kitano Hospital, Osaka, Japan
| | - T Morgan
- Department of Pathology, Oregon Health & Science University, Portland, USA
| | - T Fukagawa
- Department of Pathology, Iwate Medical University, Morioka
| | - A Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University, Aichi
| | - T Sugiyama
- Department of Obstetrics and Gynecology, Iwate Medical University, Morioka
| | - T Pejovic
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Portland, USA
| | - T Nagano
- Department of Obstetrics and Gynecology; Kitano Hospital, Osaka, Japan
| | - K Shimoya
- Department of Obstetrics and Gynecology, Kawasaki Medical School, Okayama
| | - M Andoh
- Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama
| | - Y Shiki
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka
| | - T Enomoto
- Department of Obstetrics and Gynecology, Niigata University, Niigata
| | - T Sasaki
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - K Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama
| | - M Mikami
- Department of Obstetrics and Gynecology, Tokai University, Kanagawa
| | - M Shimada
- Department of Obstetrics and Gynecology, Tottori University, Tottori
| | - I Konishi
- Department of Obstetrics and Gynecology, Kyoto University, Kyoto
| | - T Kimura
- Department of Obstetrics and Gynecology, Osaka University, Osaka
| | - M D Post
- Department of Pathology, University of Colorado, Boulder
| | - M M Shahzad
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of South Florida, Tampa
| | - D D Im
- Department of Gynecology, Mercy Medical Center, Baltimore
| | - H Yoshida
- Departments of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - K Omatsu
- Department of Gynecology, Cancer Institute Hospital, Tokyo
| | - F R Ueland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA
| | - J L Kelley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
| | - R G Karabakhtsian
- Department of Pathology, University of Kentucky, Lexington Department of Pathology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, USA
| | - L D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, USA
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Ishizaki H, Umemura K, Mineta H, Nozue M, Matsuoka I, Iwasaki K, Nishida Y. The examination of body sway in normal subjects and patients with Ménière's disease or cerebellar dysfunction. Adv Otorhinolaryngol 2015; 41:166-72. [PMID: 3265001 DOI: 10.1159/000416051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- H Ishizaki
- Department of Otorhinolaryngology, Hamamatsu University School of Medicine, Japan
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Iwasaki K, Kogo N, Dei M. Example Of Analysis Utilizing Real World Data: Medical Cost Reduction By Advising Untreated-Diabetes Patients To Visit Doctors. Value Health 2014; 17:A744. [PMID: 27202686 DOI: 10.1016/j.jval.2014.08.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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Iwasaki K, Kogo N, Dei M. Example of Analysis Utilizing Real World Data: Medical Cost Reduction of Combination Drugs. Value Health 2014; 17:A720-A721. [PMID: 27202550 DOI: 10.1016/j.jval.2014.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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Iwasaki K, Kogo N, Dei M. Example of Analysis Utilizing Real World Data: Medical Cost Reduction by Advising Untreated-Hypertension Patients to Visit Doctors. Value Health 2014; 17:A760. [PMID: 27202778 DOI: 10.1016/j.jval.2014.08.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - N Kogo
- Milliman Inc., Tokyo, Japan
| | - M Dei
- Milliman Inc., Tokyo, Japan
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Muroi C, Fujioka M, Mishima K, Irie K, Fujimura Y, Nakano T, Fandino J, Keller E, Iwasaki K, Fujiwara M. Effect of ADAMTS-13 on cerebrovascular microthrombosis and neuronal injury after experimental subarachnoid hemorrhage. J Thromb Haemost 2014; 12:505-14. [PMID: 24476338 DOI: 10.1111/jth.12511] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 09/08/2013] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Microthrombosis and reactive inflammation contribute to neuronal injury after subarachnoid hemorrhage (SAH). ADAMTS-13 cleaves von Willebrand factor multimers, and inhibits thrombus formation and, seemingly, inflammatory reactions. OBJECTIVE To investigate the effect of ADAMTS-13 in experimental SAH. METHODS A total of 100 male C57/BL6 mice were randomly assigned to four groups: sham (n = 15), SAH (n = 27), vehicle (n = 25), and ADAMTS-13 (n = 23; 100 μL per 10 g of body weight of 100 μg of ADAMTS-13 per 1 mL of 0.9% NaCl; 20 min after SAH). Neurologic performance was assessed on days 1 and 2 after SAH. Animals were killed on day 2. The amounts of subarachnoid blood, microthrombi, apoptosis and degenerative neurons were compared. The degree of neuronal inflammation and vasospasm was also compared. In five mice each (SAH and ADAMTS-13 groups), bleeding time was assessed 2 h after SAH. RESULTS Systemic administration of ADAMTS-13 achieved significant amelioration of microthrombosis and improvement in neurologic performance. ADAMTS-13 reduced the amount of apoptotic and degenerative neurons. A tendency for decreased neuronal inflammation was observed. ADAMTS-13 did not show any significant effect on vasospasm. The degree of systemic inflammation was not changed by ADAMTS-13 administration. ADAMTS-13 neither increased the amount of subarachnoid blood nor prolonged the bleeding time. CONCLUSIONS ADAMTS-13 may reduce neuronal injury after SAH by reducing microthrombosis formation and neuronal inflammation, thereby providing a new option for mitigating the severity of neuronal injury after SAH.
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Affiliation(s)
- C Muroi
- Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Institute of Aging and Brain Sciences, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan; Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland; Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
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Norimura D, Isomoto H, Fukuda E, Yamao T, Ozawa E, Iwasaki K, Ohnita K, Takeshima F, Shikuwa S, Nakao K. Cowden's disease manifested by esophageal polyposis with characteristic appearance on magnifying endoscopy using narrow band imaging. Endoscopy 2014; 45 Suppl 2 UCTN:E298. [PMID: 24008475 DOI: 10.1055/s-0032-1310022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- D Norimura
- Department of Gastroenterology and Hepatology, Sasebo Municipal General Hospital, Sasebo, Japan.
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Tokumine J, Lefor AT, Yonei A, Kagaya A, Iwasaki K, Fukuda Y. Three-step method for ultrasound-guided central vein catheterization. Br J Anaesth 2013; 110:368-73. [PMID: 23131458 DOI: 10.1093/bja/aes381] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The long-axis view and in-plane needle approach (LAX-IP) for ultrasound-guided central vein catheterization is considered ideal because of the quality of real-time imaging. We describe a novel technique, using a step-by-step procedure, to overcome the pitfalls associated with the LAX-IP. This study was undertaken to demonstrate the clinical utility of this approach. METHODS All operators underwent training before participation in this study. One hundred patients were enrolled in this study and underwent central venous catheterization using this method. Using a portable ultrasound and vein catheterization kit, patients were appropriately positioned and a straight portion of the vein identified (Step 1). A needle guide was used (Step 2) and the vein imaged in real time in two directions (Step 3), to identify the true long axis and prevent damage to surrounding tissues. RESULTS The overall success rate for catheterization was 100% with a median of one puncture for each patient. All catheterizations were performed within three punctures. Problems with the first puncture included difficult insertion of the guide-wire due to coiling, difficult anterior wall puncture, less experience with the procedure, and other reasons. There were no complications associated with the procedure. CONCLUSIONS This three-step method is not dependent on an operator's ability to proceed based on spatial awareness, but rather depends on logic. This method can prevent difficulties associated with a two-dimensional ultrasound view, and may be a safer technique compared with others. Further clinical trials are needed to establish the safety of this technique.
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Affiliation(s)
- J Tokumine
- Department of Anesthesia, Seikei-kai Chiba Medical Center, 1-11-12, Minami-cho, Chuo-ku, Chiba-shi 260-0842, Japan.
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Yip AK, Iwasaki K, Ursekar C, Machiyama H, Saxena M, Chen H, Harada I, Chiam KH, Sawada Y. Cellular response to substrate rigidity is governed by either stress or strain. Biophys J 2013; 104:19-29. [PMID: 23332055 DOI: 10.1016/j.bpj.2012.11.3805] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [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: 06/18/2012] [Revised: 11/19/2012] [Accepted: 11/26/2012] [Indexed: 12/18/2022] Open
Abstract
Cells sense the rigidity of their substrate; however, little is known about the physical variables that determine their response to this rigidity. Here, we report traction stress measurements carried out using fibroblasts on polyacrylamide gels with Young's moduli ranging from 6 to 110 kPa. We prepared the substrates by employing a modified method that involves N-acryloyl-6-aminocaproic acid (ACA). ACA allows for covalent binding between proteins and elastomers and thus introduces a more stable immobilization of collagen onto the substrate when compared to the conventional method of using sulfo-succinimidyl-6-(4-azido-2-nitrophenyl-amino) hexanoate (sulfo-SANPAH). Cells remove extracellular matrix proteins off the surface of gels coated using sulfo-SANPAH, which corresponds to lower values of traction stress and substrate deformation compared to gels coated using ACA. On soft ACA gels (Young's modulus <20 kPa), cell-exerted substrate deformation remains constant, independent of the substrate Young's modulus. In contrast, on stiff substrates (Young's modulus >20 kPa), traction stress plateaus at a limiting value and the substrate deformation decreases with increasing substrate rigidity. Sustained substrate strain on soft substrates and sustained traction stress on stiff substrates suggest these may be factors governing cellular responses to substrate rigidity.
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Affiliation(s)
- Ai Kia Yip
- Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore
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Iwasaki K, Obara W, Kato Y, Takata R, Tanji S, Fujioka T. Neoadjuvant Gemcitabine Plus Carboplatin for Locally Advanced Bladder Cancer. Jpn J Clin Oncol 2012; 43:193-9. [DOI: 10.1093/jjco/hys213] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shimizu T, Ueda J, Ho JC, Iwasaki K, Poellinger L, Harada I, Sawada Y. Dual inhibition of Src and GSK3 maintains mouse embryonic stem cells, whose differentiation is mechanically regulated by Src signaling. Stem Cells 2012; 30:1394-404. [PMID: 22553165 DOI: 10.1002/stem.1119] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Recent studies reveal that the mechanical environment influences the behavior and function of various types of cells, including stem cells. However, signaling pathways involved in the mechanical regulation of stem cell properties remain largely unknown. Using polyacrylamide gels with varying Young's moduli as substrates, we demonstrate that mouse embryonic stem cells (mESCs) are induced to differentiate on substrates with defined elasticity, involving the Src-ShcA-MAP kinase pathway. While the dual inhibition of mitogen-activated protein (MAP) kinase and glycogen synthase kinase 3 (GSK3), termed "2i," was reported to sustain the pluripotency of mESCs, we find it to be substrate elasticity dependent. In contrast, Src inhibition in addition to 2i allows mESCs to retain their pluripotency independent of substrate elasticity. The alternative dual inhibition of Src and GSK3 ("alternative 2i") retains the pluripotency and self-renewal of mESCs in vitro and is instrumental in efficiently deriving mESCs from preimplantation mouse embryos. In addition, the transplantation of mESCs, maintained under the alternative 2i condition, to immunodeficient mice leads to the formation of teratomas that include differentiation into three germ layers. Furthermore, mESCs established with alternative 2i contributed to chimeric mice production and transmitted to the germline. These results reveal a role for Src-ShcA-MAP kinase signaling in the mechanical regulation of mESC properties and indicate that alternative 2i is a versatile tool for the maintenance of mESCs in serum-free conditions as well as for the derivation of mESCs.
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Affiliation(s)
- Takeshi Shimizu
- Mechanobiology Institute, National University of Singapore, 5A Engineering Drive 1, Singapore
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Bhakta JN, Ohnishi K, Munekage Y, Iwasaki K, Wei MQ. Characterization of lactic acid bacteria-based probiotics as potential heavy metal sorbents. J Appl Microbiol 2012; 112:1193-206. [PMID: 22404232 DOI: 10.1111/j.1365-2672.2012.05284.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To isolate and characterize lactic acid bacteria (LAB) and determine whether they could potentially be used as heavy metal (cadmium and lead) absorbing probiotics. METHODS AND RESULTS The study used 53 environmental (mud and sludge) samples to isolate cadmium- and lead-resistant LAB, by following spared plate technique. A total of 255 cadmium- and lead-resistant LAB were isolated from these samples. The survival of 26 of the LAB was found after passing through sequential probiotic characterizations. These 26 probiotic LAB exhibited remarkable variations in their metal-resistant and metal-removal abilities. Of 26, seven (Cd54-2, Cd61-7, Cd69-12, Cd70-13, Pb82-8, Pb96-19 and Cd109-16) and four (Pb71-1, Pb73-2, Pb85-9 and Pb96-19) strains displayed relatively elevated cadmium- and lead-removal efficiencies from water, respectively, compare with that of the remaining strains. Strains Cd70-13 and Pb71-1 showed the highest cadmium (25%) and lead (59%) removal capacity from MRS (De Man, Rogosa and Sharpe) culture medium, respectively, amongst the selected strains and showed a good adhesive ability on fish mucus. A phylogenetic analysis of their 16S rDNA sequences revealed that the strains Cd70-13 and Pb71-1 belong to Lactobacillus reuteri. CONCLUSION Excellent probiotic, metal sorption and adhesive characteristics of newly identified Lact. reuteri strains Cd70-13 and Pb71-1 were isolated, which indicated their high potential abilities to survive in the intestinal milieu and to uptake the tested metals from the environment. SIGNIFICANCE AND IMPACT OF THE STUDY To our knowledge, this is the first study that has aimed to isolate, characterize and identify metal-resistant LAB strains that have potential to be a probiotic candidate for food and in vivo challenge studies in the intestinal milieu of fish for the uptake and control of heavy metal bioaccumulation.
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Affiliation(s)
- J N Bhakta
- Research Institute of Molecular Genetics, Faculty of Agriculture, Kochi University, Monobe, Nankoku, Kochi, Japan
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Harada I, Yanagisawa S, Iwasaki K, Cho CS, Akaike T. Local mechanical stimulation of Mardin-Darby canine kidney cell sheets on temperature-responsive hydrogel. Int J Mol Sci 2012; 13:1095-1108. [PMID: 22312306 PMCID: PMC3269740 DOI: 10.3390/ijms13011095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 12/25/2011] [Accepted: 01/13/2012] [Indexed: 11/16/2022] Open
Abstract
Collective motion of cell sheets plays a role not only in development and repair, but also in devastating diseases such as cancer. However, unlike single-cell motility, collective motion of cell sheets involves complex cell-cell communication during migration; therefore, its mechanism is largely unknown. To elucidate propagation of signaling transduced by cell-cell interaction, we designed a hydrogel substrate that can cause local mechanical stretching of cell sheets. Poly (N-isopropyl acrylamide) (PNIPAAm) hydrogel is a temperature-responsive polymer gel whose volume changes isotropically in response to temperature changes below 37 °C. We designed a combined hydrogel substrate consisting of collagen-immobilized PNIPAAm as the local stimulation side and polyacrylamide (PAAm) as the non-stimulation side to assess propagation of mechanical transduction. Mardin-Darby canine kidney (MDCK) cells adhered to the collagen-immobilized PNIPAAm gel increased it area and were flattened as the gel swelled with temperature decrease. E-cadherin in these cells became undetectable in some domains, and actin stress fibers were more clearly observed at the cell base. In contrast, E-cadherin in cells adhered to the collagen-immobilized PAAm side was equally stained as that in cells adhered to the collagen-immobilized PAAm side even after temperature decrease. ERK1/2 MAPK activation of cells on the non-stimulated substrate occurred after partial stretching of the cell sheet suggesting the propagation of signaling. These results indicate that a change in the balance of mechanical tension induced by partial stretching of cell sheets leads to activation and propagation of the cell signaling.
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Affiliation(s)
- Ichiro Harada
- Department of Biomolecular Engineering, Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, B-57, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8501, Japan; E-Mails: (S.Y.); (K.I.); (T.A.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-45-924-5792; Fax: +81-45-924-5815
| | - Shunpei Yanagisawa
- Department of Biomolecular Engineering, Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, B-57, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8501, Japan; E-Mails: (S.Y.); (K.I.); (T.A.)
| | - Katsuhiko Iwasaki
- Department of Biomolecular Engineering, Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, B-57, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8501, Japan; E-Mails: (S.Y.); (K.I.); (T.A.)
| | - Chong-Su Cho
- Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul 151-921, Korea; E-Mail:
| | - Toshihiro Akaike
- Department of Biomolecular Engineering, Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, B-57, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8501, Japan; E-Mails: (S.Y.); (K.I.); (T.A.)
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Iwasaki K, Kikuchi A, Takeda A, Satoh T, Sawada JI, Konno H, Takahashi T, Takayama S, Tobita M, Yaegashi N. 1.257 A CROSSOVER STUDY OF A TRADITIONAL ASIAN HERBAL MEDICINE FOR HUNTINGTON'S DISEASE. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sawabe M, Aoki A, Komaki M, Iwasaki K, Ogita M, Izumi Y. Gingival healing following Er:YAG laser ablation Vs electrosurgery in rats. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Miyazaki N, Akita F, Nakagawa A, Omura T, Iwasaki K. Structural analysis of rice dwarf virus in vitroand in vivo. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311094293] [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: 11/10/2022] Open
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Tanaka H, Kato K, Fujita C, Suemoto E, Sumizawa T, Yoshimura M, Yong Z, Yao M, Iwasaki K, Tsukihara T. The mechanisms of self-assembly of the vault, the largest cytoplasmic ribonucleo-protein complex. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311093408] [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: 11/10/2022] Open
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Takino Y, Okura F, Kitazawa M, Iwasaki K, Tagami H. Zinc l-pyrrolidone carboxylate inhibits the UVA-induced production of matrix metalloproteinase-1 by in vitro cultured skin fibroblasts, whereas it enhances their collagen synthesis. Int J Cosmet Sci 2011; 34:23-8. [DOI: 10.1111/j.1468-2494.2011.00676.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Yamada M, Oita M, Kai K, Ogawa K, Matsuda K, Iwasaki K, Kuroda S, Takahashi S. 1369 poster DOSIMETRIC INVESTIGATION OF PATIENT SPECIFIC QA USING FOUR DIFFERENT COMMERCIAL 2D DETECTORS. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71491-8] [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: 11/28/2022]
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Yamada M, Kunio O, Kai K, Matsuda K, Iwasaki K, Kuroda S, Takahashi S, Uchida N, Tateoka K. 1467 poster AN ANALYSIS OF THE LONG TERM PRECISION OF MLC IN DYNAMIC IMRT THROUGH DAILY ROUTINE MLC QA. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71589-4] [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: 11/16/2022]
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Fujiwara H, Takayama S, Iwasaki K, Tabuchi M, Yamaguchi T, Sekiguchi K, Ikarashi Y, Kudo Y, Kase Y, Arai H, Yaegashi N. Yokukansan, a traditional Japanese medicine, ameliorates memory disturbance and abnormal social interaction with anti-aggregation effect of cerebral amyloid β proteins in amyloid precursor protein transgenic mice. Neuroscience 2011; 180:305-13. [PMID: 21303686 DOI: 10.1016/j.neuroscience.2011.01.064] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 01/28/2011] [Accepted: 01/31/2011] [Indexed: 10/18/2022]
Abstract
The deposition of amyloid β protein (Aβ) is a consistent pathological hallmark of Alzheimer's disease (AD) brains. Therefore, inhibition of Aβ aggregation in the brain is an attractive therapeutic and preventive strategy in the development of disease-modifying drugs for AD. An in vitro study demonstrated that yokukansan (YKS), a traditional Japanese medicine, inhibited Aβ aggregation in a concentration-dependent manner. An in vivo study demonstrated that YKS and Uncaria hook (UH), a constituent of YKS, prevented the accumulation of cerebral Aβ. YKS also improved the memory disturbance and abnormal social interaction such as increased aggressive behavior and decreased social behavior in amyloid precursor protein transgenic mice. These results suggest that YKS is likely to be a potent and novel therapeutic agent to prevent and/or treat AD, and that this may be attributed to UH.
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Affiliation(s)
- H Fujiwara
- Department of Traditional Asian Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
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Iida R, Iwasaki K, Kato J, Ogawa S. Bispectral index is related to the spread of spinal sensory block in patients with combined spinal and general anaesthesia. Br J Anaesth 2011; 106:202-7. [DOI: 10.1093/bja/aeq359] [Citation(s) in RCA: 14] [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: 11/12/2022] Open
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Iwasaki K, Yamamoto T, Motomura G, Ikemura S, Mawatari T, Nakashima Y, Iwamoto Y. Prognostic factors associated with a subchondral insufficiency fracture of the femoral head. Br J Radiol 2010; 85:214-8. [PMID: 21159802 DOI: 10.1259/bjr/44936440] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to identify the risk factors associated with the prognosis of a subchondral insufficiency fracture of the femoral head (SIF). METHODS Between June 2002 and July 2009, 25 patients diagnosed with SIF were included in this study. Sequential radiographs were evaluated for the progression of collapse. Clinical profiles, including age, body mass index, follow-up period and Singh's index, were documented. The morphological characteristics of the low-intensity band on T(1) weighted MRI were also examined with regards to four factors: band length, band thickness, the length of the weight-bearing portion and the band length ratio (defined as the proportion of the band length to the weight-bearing portion of the femoral head in the slice through the femoral head centre). RESULTS Radiographically, a progression of collapse was observed in 15 of 25 (60.0%) patients. The band length in patients with progression of collapse [22.5 mm; 95% confidence interval (CI) 17.7, 27.3] was significantly larger than in patients without a progression of collapse (13.4 mm; 95% CI 7.6, 19.3; p<0.05). The band length ratio in patients with progression of collapse (59.8%; 95% CI 50.8, 68.9) was also significantly higher than in patients without a progression of collapse (40.9%; 95% CI 29.8, 52.0; p<0.05). No significant differences were present in the other values. CONCLUSION These results indicate that the band length and the band length ratio might be predictive for the progression of collapse in SIF.
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Affiliation(s)
- K Iwasaki
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ebe N, Hara-Yokoyama M, Iwasaki K, Iseki S, Okuhara S, Podyma-Inoue KA, Terasawa K, Watanabe A, Akizuki T, Watanabe H, Yanagishita M, Izumi Y. Pocket epithelium in the pathological setting for HMGB1 release. J Dent Res 2010; 90:235-40. [PMID: 21149855 DOI: 10.1177/0022034510385688] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
High-mobility group box-1 (HMGB1) protein acts as a transcription factor in the nucleus and also as a pro-inflammatory cytokine when released into extracellular fluids. The presence of higher levels of HMGB1 is reported in the gingival crevicular fluid from periodontal patients. Since the proliferation of bacteria within the periodontal pocket is closely involved in the exacerbation of periodontal disease, it is hypothesized that the periodontal pocket causes the release of HMGB1. Immunohistochemical staining of inflamed gingiva revealed that HMGB1 is exclusively dislocated from the nucleus to the cytoplasm in the pocket epithelium, whereas it is mainly present in the nucleus in the gingival epithelium. Butyric acid, an extracellular metabolite from periodontopathic bacteria populating the periodontal pocket, induced the passive release of HMGB1 as a result of eliciting necrosis in the human gingival epithelial cell line. Thus, the periodontal epithelium may provide a unique pathological setting for HMGB1 release by bacterial insult.
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Affiliation(s)
- N Ebe
- Section of Periodontology, Department of Hard Tissue Engineering, Biochemistry, Division of Bio-Matrix, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
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Furukawa H, Iwasaki K, Samukawa M, Nagamachi K, Aono H, Matsumoto T, Ohkado A. [Impact of preoperative 64-row multislice computed tomography for congenital aortic stenosis; report of a case]. Kyobu Geka 2010; 63:1078-1081. [PMID: 21066852] [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: 05/30/2023]
Abstract
A 63-year-old woman was diagnosed as having severe aortic stenosis (AS) with 98 mmHg peak pressure gradient detected by echocardiography. Since, preoperative enhanced 64-row multislice computed tomography (MSCT) showed bicuspid aortic valve with only 2 sinuses of Valsalva, congenital aortic stenosis was suspected. The left and right coronary arteries originated from respective sinus of Valsalva, and severely thickened cusps of aortic valve were detected clearly by preoperative 64-row MSCT. Aortic valve replacement with a 21 mm ATS mechanical bileaflet prosthesis was performed without aortic annulus enlargement. The postoperative course was uneventful and postoperative 64-row MSCT indicated good performance of the ATS valve. Preoperative 64-row MSCT could be useful to detect complex aortic valve disease in detail. Moreover. 64-row MSCT might be a reliable tool to evaluate valvular heart disease.
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Affiliation(s)
- H Furukawa
- Department of Cardiovascular Surgery, Cardiovascular Center, Okayama Central Hospital, Okayama, Japan
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Emoto C, Nishida H, Hirai H, Iwasaki K. CYP3A4 and CYP3A5 catalyse the conversion of theN-methyl-D-aspartate (NMDA) antagonist CJ-036878 to two novel dimers. Xenobiotica 2010. [DOI: 10.3109/00498250701658304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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