1
|
Tsuchiya N, Xu YY, Ito J, Yamashiro T, Ikemiyagi H, Mummy D, Schiebler ML, Yonemoto K, Murayama S, Nishie A. Chronic thromboembolic pulmonary hypertension is associated with a loss of total lung volume on computed tomography. World J Radiol 2023; 15:146-156. [PMID: 37275304 PMCID: PMC10236971 DOI: 10.4329/wjr.v15.i5.146] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 04/04/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Although lung volumes are usually normal in individuals with chronic thromboembolic pulmonary hypertension (CTEPH), approximately 20%-29% of patients exhibit a restrictive pattern on pulmonary function testing.
AIM To quantify longitudinal changes in lung volume and cardiac cross-sectional area (CSA) in patients with CTEPH.
METHODS In a retrospective cohort study of patients seen in our hospital between January 2012 and December 2019, we evaluated 15 patients with CTEPH who had chest computed tomography (CT) performed at baseline and after at least 6 mo of therapy. We matched the CTEPH cohort with 45 control patients by age, sex, and observation period. CT-based lung volumes and maximum cardiac CSAs were measured and compared using the Wilcoxon signed-rank test and the Mann-Whitney u test.
RESULTS Total, right lung, and right lower lobe volumes were significantly reduced in the CTEPH cohort at follow-up vs baseline (total, P = 0.004; right lung, P = 0.003; right lower lobe; P = 0.01). In the CTEPH group, the reduction in lung volume and cardiac CSA was significantly greater than the corresponding changes in the control group (total, P = 0.01; right lung, P = 0.007; right lower lobe, P = 0.01; CSA, P = 0.0002). There was a negative correlation between lung volume change and cardiac CSA change in the control group but not in the CTEPH cohort.
CONCLUSION After at least 6 mo of treatment, CT showed an unexpected loss of total lung volume in patients with CTEPH that may reflect continued parenchymal remodeling.
Collapse
Affiliation(s)
- Nanae Tsuchiya
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0125, Okinawa, Japan
| | - Yan-Yan Xu
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Junji Ito
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0125, Okinawa, Japan
| | - Tsuneo Yamashiro
- Department of Radiology, Yokohama City University, Yokohama 2360027, Japan
| | - Hidekazu Ikemiyagi
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Nishihara 9030125, Okinawa, Japan
| | - David Mummy
- Center for In Vivo Microscopy and Department of Radiology, Duke University, Durham, NC 27710, United States
| | - Mark L Schiebler
- Department of Radiology, University of Wisconsin-Madison, Madison, WI 53792, United States
| | - Koji Yonemoto
- Department of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara 903-0215, Okinawa, Japan
| | - Sadayuki Murayama
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0125, Okinawa, Japan
| | - Akihiro Nishie
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0125, Okinawa, Japan
| |
Collapse
|
2
|
Tominaga R, Kurita N, Sekiguchi M, Yonemoto K, Kakuma T, Konno SI. Diagnostic accuracy of the lumbar spinal stenosis-diagnosis support tool and the lumbar spinal stenosis-self-administered, self-reported history questionnaire. PLoS One 2022; 17:e0267892. [PMID: 35511759 PMCID: PMC9070893 DOI: 10.1371/journal.pone.0267892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
Despite the applicability of the lumbar spinal stenosis (LSS)-diagnosis support tool (DST) and the LSS-self-administered, self-reported history questionnaire (SSHQ), their diagnostic accuracy has never been compared with that of the well-known North American Spine Society (NASS) clinical description of LSS. This study aimed to compare the diagnostic accuracy of the two diagnostic tools with that of the NASS guidelines’ clinical description of LSS in a Japanese secondary care hospital setting. This multicenter cross-sectional study used data from the lumbar spinal stenosis diagnostic support tool (DISTO) project, which was conducted from December 1, 2011 to December 31, 2012. Japanese adults with low back pain (LBP) aged ≥20 years were consecutively included. The reference standard was LSS diagnosed by orthopedic physicians. The diagnostic accuracy of the two support tools was compared. Of 3,331 patients, 1,416 (42.5%) patients were diagnosed with LSS. The NASS clinical description of LSS had a sensitivity of 63.9% and specificity of 89.5%. The LSS-DST and LSS-SSHQ had sensitivities of 91.3% and 83.8% and specificities of 76.0% and 57.6%, respectively, with substantial improvements in sensitivity (P < 0.0001). Similar results were obtained when we limited included patients to those aged >60 years. These findings indicated that the LSS-DST and LSS-SSHQ were more sensitive in screening patients with LBP for a diagnosis of LSS than the NASS clinical description of LSS. This study strongly supports prioritizing the use of either of these two diagnostic support tools for screening.
Collapse
Affiliation(s)
- Ryoji Tominaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
- Department of Orthopaedic and Spinal Surgery, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Noriaki Kurita
- Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Innovative Research and Education for Clinicians and Trainees, Fukushima Medical University Hospital, Fukushima, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- * E-mail:
| | - Miho Sekiguchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Koji Yonemoto
- Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa Japan
| | | | - Shin-ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
3
|
Nikaido T, Sekiguchi M, Yonemoto K, Kakuma T, Watanabe K, Kato K, Kobayashi H, Tominaga R, Otani K, Yabuki S, Kikuchi SI, Konno SI. Generalization of a clinical diagnosis support tool for lumbar spinal stenosis: Can the ankle brachial pressure index be replaced by palpation of the posterior tibial artery in the lumbar spinal stenosis diagnostic support tool? (DISTO project). J Orthop Sci 2022; 28:543-546. [PMID: 35305863 DOI: 10.1016/j.jos.2022.02.005] [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] [Received: 10/06/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND The Japanese Society for Spine Surgery and Related Research previously developed a diagnostic support tool for lumbar spinal stenosis (LSS-DST). Using the LSS-DST, general physicians can identify potential cases of LSS. However, in the LSS-DST, measurement of the ankle brachial pressure index (ABI) is required to exclude peripheral artery lesions in the lower limbs. We can expect further application of the LSS-DST if we can identify a simpler and easier method than ABI measurement. Therefore, in this large-scale, multicenter, cross-sectional study, we verified whether palpation of the posterior tibial (PT) artery could be used instead of ABI in the LSS-DST. METHODS This survey was conducted at 2177 hospitals and included 28,883 participants. The sensitivity and specificity of the original LSS-DST method using the ABI and that of the LSS-DST ver2.0 with PT artery palpation were assessed to screen their ability for diagnosing LSS, using the physicians' final diagnosis based on the patients' history, physical examination and radiographic findings as the gold standard. RESULTS The sensitivity and specificity [95%CI] of the LSS-DST were 88.2% [87.5, 88.8] and 83.9% [83.4, 84.5], respectively, whereas the sensitivity and specificity of the LSS-DST ver2.0 were 87.7% [87.0, 88.3] and 78.3% [77.7, 78.9], respectively, indicating that LSS-DST ver2.0 is a useful screening tool for LSS with good sensitivity. CONCLUSION When the item of ABI in the LSS-DST is replaced by palpation of the PT artery (LSS-DST ver2.0), its sensitivity is maintained as a screening tool for LSS. LEVEL OF EVIDENCE Level 3.
Collapse
Affiliation(s)
- Takuya Nikaido
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan.
| | - Miho Sekiguchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Japan; Advanced Medicine Research Center, School of Medicine, University of the Ryukyus, Japan; Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Japan
| | | | - Kazuyuki Watanabe
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Hiroshi Kobayashi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Ryoji Tominaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Shoji Yabuki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Shin-Ichi Kikuchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | | |
Collapse
|
4
|
Kitagawa K, Arima H, Yamamoto Y, Ueda S, Rakugi H, Kohro T, Yonemoto K, Matsumoto M, Saruta T, Shimada K. Intensive or standard blood pressure control in patients with a history of ischemic stroke: RESPECT post hoc analysis. Hypertens Res 2022; 45:591-601. [PMID: 35241817 DOI: 10.1038/s41440-022-00862-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/10/2022] [Accepted: 01/13/2022] [Indexed: 11/09/2022]
Abstract
The Recurrent Stroke Prevention Clinical Outcome (RESPECT) Study and its pooled analysis showed that intensive blood pressure (BP) lowering reduced recurrent stroke risk by 22% in patients with a history of stroke. Here, we report the effect of intensive BP lowering on the risk of recurrent stroke subtypes in patients with a history of ischemic stroke. RESPECT was a randomized clinical trial among 1280 people with a history of cerebral infarction or intracerebral hemorrhage. Participants were assigned to the intensive blood pressure control group (blood pressure < 120/80 mmHg) or standard blood pressure control group (blood pressure < 140/90 mmHg). In this post hoc analysis, we analyzed 1074 patients with a history of cerebral infarction. The mean BP at baseline was 140.7/81.4 mmHg. Throughout the follow-up period, the mean BP was 133.4/77.5 (95% CI, 132.7-134.1/76.9-78.2) mmHg in the standard group and 126.7/74.1 (95% CI, 126.0-127.4/73.5-74.8) mmHg in the intensive group. During a mean follow-up of 3.9 years, 78 first recurrent strokes occurred. Intensive treatment tended to reduce overall annual stroke recurrence (1.74% in intensive vs. 2.17% in standard; P = 0.351 by log-rank test) and did not change the risk of ischemic stroke (1.74% vs. 1.75%, P = 0.999) but markedly reduced the risk of hemorrhagic stroke (0.00% vs. 0.39%, P = 0.005). Beneficial effects of intensive BP control were observed for the risk of hemorrhagic stroke in patients with a history of ischemic stroke. The findings of this study indicate the benefit of intensive BP control for patients with a history of ischemic stroke at high risk of hemorrhagic stroke.
Collapse
Affiliation(s)
- Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
| | - Hisatomi Arima
- Department of Prevented Medicine and Public Health, Faculty of Medicine, Fukuoka University, Jonan, Fukuoka, Japan
| | - Yasumasa Yamamoto
- Department of Stroke Center, Kyoto Katsura Hospital, Nishikyo, Kyoto, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology & Therapeutics, Faculty of Medicine, University of the Ryukyus, Nakagamigunn, Okinawa, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takahide Kohro
- Department of Cardiovascular Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Koji Yonemoto
- Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nakagamigunn, Okinawa, Japan
| | | | - Takao Saruta
- Department of Internal Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kazuyuki Shimada
- Cardiovascular Medicine, Shin-Oyama City Hospital, Oyama, Tochigi, Japan
| | | |
Collapse
|
5
|
Ninomiya T, Nakaji S, Maeda T, Yamada M, Mimura M, Nakashima K, Mori T, Takebayashi M, Ohara T, Hata J, Kokubo Y, Uchida K, Taki Y, Kumagai S, Yonemoto K, Yoshida H, Muto K, Momozawa Y, Akiyama M, Kubo M, Ikeda M, Kanba S, Kiyohara Y. Study design and baseline characteristics of a population-based prospective cohort study of dementia in Japan: the Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD). Environ Health Prev Med 2020; 25:64. [PMID: 33129280 PMCID: PMC7603740 DOI: 10.1186/s12199-020-00903-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 08/13/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The burden of dementia is growing rapidly and has become a medical and social problem in Japan. Prospective cohort studies have been considered an effective methodology to clarify the risk factors and the etiology of dementia. We aimed to perform a large-scale dementia cohort study to elucidate environmental and genetic risk factors for dementia, as well as their interaction. METHODS The Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD) is a multisite, population-based prospective cohort study of dementia, which was designed to enroll approximately 10,000 community-dwelling residents aged 65 years or older from 8 sites in Japan and to follow them up prospectively for at least 5 years. Baseline exposure data, including lifestyles, medical information, diets, physical activities, blood pressure, cognitive function, blood test, brain magnetic resonance imaging (MRI), and DNA samples, were collected with a pre-specified protocol and standardized measurement methods. The primary outcome was the development of dementia and its subtypes. The diagnosis of dementia was adjudicated by an endpoint adjudication committee using standard criteria and clinical information according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd Revised Edition. For brain MRI, three-dimensional acquisition of T1-weighted images was performed. Individual participant data were pooled for data analyses. RESULTS The baseline survey was conducted from 2016 to 2018. The follow-up surveys are ongoing. A total of 11,410 individuals aged 65 years or older participated in the study. The mean age was 74.4 years, and 41.9% were male. The prevalence of dementia at baseline was 8.5% in overall participants. However, it was 16.4% among three sites where additional home visit and/or nursing home visit surveys were performed. Approximately two-thirds of dementia cases at baseline were Alzheimer's disease. CONCLUSIONS The prospective cohort data from the JPSC-AD will provide valuable insights regarding the risk factors and etiology of dementia as well as for the development of predictive models and diagnostic markers for the future onset of dementia. The findings of this study will improve our understanding of dementia and provide helpful information to establish effective preventive strategies for dementia in Japan.
Collapse
Affiliation(s)
- Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Shigeyuki Nakaji
- Department of Social Medicine, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Tetsuya Maeda
- Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Masahito Yamada
- Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Nakashima
- National Hospital Organization, Matsue Medical Center, Matsue, Japan
| | - Takaaki Mori
- Department of Neuropsychiatry, Neuroscience Ehime University Graduate School of Medicine, Ehime, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomoyuki Ohara
- Department of Neuropsychiatry, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazuhiro Uchida
- Department of Health Promotion, School of Health and Nutrition Sciences, Nakamura-Gakuen University, Fukuoka, Japan
| | - Yasuyuki Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | | | - Koji Yonemoto
- Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kaori Muto
- Department of Public Policy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Saitama, Japan
| | - Masato Akiyama
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michiaki Kubo
- Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Medical School, Suita, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Yutaka Kiyohara
- Hisayama Research Institute for Lifestyle Diseases, Fukuoka, Japan
| | | |
Collapse
|
6
|
Kuwano M, Nakao T, Yonemoto K, Yamada S, Murayama K, Okada K, Honda S, Ikari K, Tomiyama H, Hasuzawa S, Kanba S. Clinical characteristics of hoarding disorder in Japanese patients. Heliyon 2020; 6:e03527. [PMID: 32181397 PMCID: PMC7063155 DOI: 10.1016/j.heliyon.2020.e03527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/19/2019] [Accepted: 02/28/2020] [Indexed: 11/30/2022] Open
Abstract
Previous studies have reported clinical characteristics of hoarding disorder (HD), such as early onset, a chronic course, familiality, high unmarried rate, and high rates of comorbidities. However, clinical research targeting Japanese HD patients has been very limited. As a result, there is a low recognition of HD in Japan, leading to insufficient evaluation and treatment of Japanese HD patients. The aim of the current study was to delineate the clinical characteristics of Japanese HD patients. Thirty HD patients, 20 obsessive-compulsive disorder (OCD) patients, and 21 normal controls (NC) were targeted in this study. The HD group had a tendency toward higher familiality, earlier onset, and longer disease duration compared to the OCD group. In addition, the HD group showed a significantly higher unmarried rate than the NC group. The top two comorbidities in the HD group were major depressive disorder (56.7%) and attention-deficit/hyperactivity disorder (26.7%). The HD group had significantly higher scores on hoarding rating scales and lower scores on the Global Assessment of Functioning Scale than the other two groups. The current study showed a clinical trend in Japanese HD patients similar to previous studies in various countries, suggesting that HD may be a universal disease with consistent clinical symptoms.
Collapse
Affiliation(s)
- Masumi Kuwano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Nagasaki Support Center for Children, Women and People with Disabilities, Nagasaki, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Satoshi Yamada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Fukuoka Prefectural Psychiatric Center Dazaifu Hospital, Fukuoka, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kayo Okada
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Okehazama Hospital Fujita Mental Care Center, Aichi, Japan
| | - Shinichi Honda
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Neuropsychiatry, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Keisuke Ikari
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
7
|
Yamauchi M, Kinjo T, Parrott G, Miyagi K, Haranaga S, Nakayama Y, Chibana K, Fujita K, Nakamoto A, Higa F, Owan I, Yonemoto K, Fujita J. Diagnostic performance of serum interferon gamma, matrix metalloproteinases, and periostin measurements for pulmonary tuberculosis in Japanese patients with pneumonia. PLoS One 2020; 15:e0227636. [PMID: 31917802 PMCID: PMC6952104 DOI: 10.1371/journal.pone.0227636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/23/2019] [Indexed: 12/18/2022] Open
Abstract
Serum markers that differentiate between tuberculous and non-tuberculous pneumonia would be clinically useful. However, few serum markers have been investigated for their association with either disease. In this study, serum levels of interferon gamma (IFN-γ), matrix metalloproteinases 1 and 9 (MMP-1 and MMP-9, respectively), and periostin were compared between 40 pulmonary tuberculosis (PTB) and 28 non-tuberculous pneumonia (non-PTB) patients. Diagnostic performance was assessed by analysis of receiver-operating characteristic (ROC) curves and classification trees. Serum IFN-γ and MMP-1 levels were significantly higher and serum MMP-9 levels significantly lower in PTB than in non-PTB patients (p < 0.001, p = 0.002, p < 0.001, respectively). No significant difference was observed in serum periostin levels between groups. ROC curve analysis could not determine the appropriate cut-off value with high sensitivity and specificity; therefore, a classification tree method was applied. This method identified patients with limited infiltration into three groups with statistical significance (p = 0.01), and those with MMP-1 levels < 0.01 ng/mL and periostin levels ≥ 118.8 ng/mL included only non-PTB patients (95% confidence interval 0.0–41.0). Patients with extensive infiltration were also divided into three groups with statistical significance (p < 0.001), and those with MMP-9 levels < 3.009 ng/mL included only PTB patients (95% confidence interval 76.8–100.0). In conclusion, the novel classification tree developed using MMP-1, MMP-9, and periostin data distinguished PTB from non-PTB patients. Further studies are needed to validate our cut-off values and the overall clinical usefulness of these markers.
Collapse
Affiliation(s)
- Momoko Yamauchi
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takeshi Kinjo
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- * E-mail:
| | - Gretchen Parrott
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kazuya Miyagi
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shusaku Haranaga
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Center for General Clinical Training and Education, University of the Ryukyus Hospital, Okinawa, Japan
| | - Yuko Nakayama
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Kenji Chibana
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Kaori Fujita
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Atsushi Nakamoto
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Futoshi Higa
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Isoko Owan
- Department of Respiratory Medicine, National Hospital Organization Okinawa Hospital, Okinawa, Japan
| | - Koji Yonemoto
- Division of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
- Division of Biostatistics, Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
8
|
Kitagawa K, Yamamoto Y, Arima H, Maeda T, Sunami N, Kanzawa T, Eguchi K, Kamiyama K, Minematsu K, Ueda S, Rakugi H, Ohya Y, Kohro T, Yonemoto K, Okada Y, Higaki J, Tanahashi N, Kimura G, Umemura S, Matsumoto M, Shimamoto K, Ito S, Saruta T, Shimada K. Effect of Standard vs Intensive Blood Pressure Control on the Risk of Recurrent Stroke: A Randomized Clinical Trial and Meta-analysis. JAMA Neurol 2019; 76:1309-1318. [PMID: 31355878 DOI: 10.1001/jamaneurol.2019.2167] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Importance The Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated that a systolic blood pressure (BP) target less than 120 mm Hg was superior to less than 140 mm Hg for preventing vascular events. This trial excluded patients with prior stroke; therefore, the ideal BP target for secondary stroke prevention remains unknown. Objective To assess whether intensive BP control would achieve fewer recurrent strokes vs standard BP control. Design, Setting, and Participants Randomized clinical trial (RCT) of standard vs intensive BP control in an intent-to-treat population of patients who had a history of stroke. Patients were enrolled between October 20, 2010, and December 7, 2016. For an updated meta-analysis, PubMed and the Cochrane Central Library database were searched through September 30, 2018, using the Medical Subject Headings and relevant search terms for cerebrovascular disease and for intensive BP lowering. This was a multicenter trial that included 140 hospitals in Japan; 1514 patients who had a history of stroke within the previous 3 years were approached, but 234 refused to give informed consent. Interventions In total, 1280 patients were randomized 1:1 to BP control to less than 140/90 mm Hg (standard treatment) (n = 640) or to less than 120/80 mm Hg (intensive treatment) (n = 640). However, 17 patients never received intervention; therefore, 1263 patients assigned to standard treatment (n = 630) or intensive treatment (n = 633) were analyzed. Main Outcomes and Measures The primary outcome was stroke recurrence. Results The trial was stopped early. Among 1263 analyzed patients (mean [SD] age, 67.2 [8.8] years; 69.4% male), 1257 of 1263 (99.5%) completed a mean (SD) of 3.9 (1.5) years of follow-up. The mean BP at baseline was 145.4/83.6 mm Hg. Throughout the overall follow-up period, the mean BP was 133.2/77.7 (95% CI, 132.5-133.8/77.1-78.4) mm Hg in the standard group and 126.7/77.4 (95% CI, 125.9-127.2/73.8-75.0) mm Hg in the intensive group. Ninety-one first recurrent strokes occurred. Nonsignificant rate reductions were seen for recurrent stroke in the intensive group compared with the standard group (hazard ratio [HR], 0.73; 95% CI, 0.49-1.11; P = .15). When this finding was pooled in 3 previous relevant RCTs in a meta-analysis, the risk ratio favored intensive BP control (relative risk, 0.78; 95% CI, 0.64-0.96; P = .02; absolute risk difference, -1.5%; 95% CI, -2.6% to -0.4%; number needed to treat, 67; 95% CI, 39-250). Conclusions and Relevance Intensive BP lowering tended to reduce stroke recurrence. The updated meta-analysis supports a target BP less than 130/80 mm Hg in secondary stroke prevention. Trial Registration ClinicalTrials.gov identifier: NCT01198496.
Collapse
Affiliation(s)
- Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Yasumasa Yamamoto
- Department of Neurology, Kyoto Katsura Hospital, Nishikyo, Kyoto, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Fukuoka University Faculty of Medicine, Jyonan, Fukuoka, Japan
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Fukuoka University Faculty of Medicine, Jyonan, Fukuoka, Japan
| | - Norio Sunami
- Department of Neurosurgery, Fukuzumi Hospital, Matsuyama, Ehime, Japan
| | - Takao Kanzawa
- Department of Stroke Medicine, Institute of Brain and Blood Vessel, Mihara Memorial Hospital, Isesaki, Gunnma, Japan
| | - Kazuo Eguchi
- Department of Internal Medicine, Hanyu General Hospital, Hanyu, Saitama, Japan
| | - Kenji Kamiyama
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan
| | - Kazuo Minematsu
- General of the Hospital, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shinichiro Ueda
- Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus School of Medicine, Nakagamigunn, Okinawa, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nakagamigunn, Okinawa, Japan
| | - Takahide Kohro
- Department of Cerebrovascular Medicine, Jichi Medical School, Shimotsuke, Tochigi, Japan
| | - Koji Yonemoto
- Department of Environmental Health, University of the Ryukyus School of Medicine, Nakagamigunn, Okinawa, Japan
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center Clinical Research Institute, Chuo, Fukuoka, Japan
| | | | - Norio Tanahashi
- Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Genjiro Kimura
- Cardio-renal and Health Research Institute, Nagoya, Aichi, Japan
| | | | | | | | - Sadayoshi Ito
- Department of Nephrology Endocrinology and Vascular Medicine, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Takao Saruta
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | | | | |
Collapse
|
9
|
Miyazato M, Yonemoto K, Ashikari A, Saito S, Yamashiro K, Uehara M, Masuzaki H, Ishida H, Matsushita M. Inside Front Cover Picture: Validation of a novel digital health monitoring system to measure the volume of voided urine (Neurourology and Urodynamics 38/2019). Neurourol Urodyn 2019. [DOI: 10.1002/nau.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Minoru Miyazato
- Department of Urology, Graduate School of MedicineUniversity of the RyukyusOkinawa Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of MedicineUniversity of the RyukyusOkinawa Japan
- Division of BiostatisticsSchool of Health SciencesOkinawa Japan
| | - Asuka Ashikari
- Department of Urology, Graduate School of MedicineUniversity of the RyukyusOkinawa Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of MedicineUniversity of the RyukyusOkinawa Japan
| | - Kiyoto Yamashiro
- Kumejima Public HospitalOkinawa Japan
- Division of EndocrinologyDiabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine)Okinawa Japan
| | - Moriyuki Uehara
- Kumejima Public HospitalOkinawa Japan
- Division of EndocrinologyDiabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine)Okinawa Japan
| | - Hiroaki Masuzaki
- Division of EndocrinologyDiabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine)Okinawa Japan
| | - Hajime Ishida
- Department of Human Biology and AnatomyUniversity of the RyukyusOkinawa Japan
| | - Masayuki Matsushita
- Department of Molecular and Cellular PhysiologyUniversity of the RyukyusOkinawa Japan
| |
Collapse
|
10
|
Miyazato M, Yonemoto K, Ashikari A, Saito S, Yamashiro K, Uehara M, Masuzaki H, Ishida H, Matsushita M. Validation of a novel digital health monitoring system to measure the volume of voided urine. Neurourol Urodyn 2019; 38:1106-1110. [PMID: 30848839 DOI: 10.1002/nau.23965] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/19/2019] [Accepted: 02/14/2019] [Indexed: 11/08/2022]
Abstract
AIM To validate a novel digital health monitoring system to measure the volume of voided urine. METHODS Micturition volume was calculated using our novel digital self-health monitoring system of urine excretion (s-HMSU) in 18 participants (16 women and 2 men; average age, 40.8 years), without a history of voiding symptoms. Participants completed a self-reported questionnaire regarding their medical history and water intake during the period of observation, as well as the Core Lower Urinary Tract Symptom Score (CLSS) questionnaire. To assess the reliability of the voided volumes measured using the s-HMSU, the intraclass correlation coefficient (ICC) was calculated between the volume and the change in body weight before and after micturition. RESULTS The CLSS questionnaire confirmed the absence of urinary system diseases in all participants. The medical history was also negative with the exception of hypertension in one participant. The ICC (1,1) between the measured volume of urine excretion using the s-HMSU and the change in body weight was 0.972 (95% confidence interval, 0.957-0.982). CONCLUSIONS The s-HMSU system provides a reliable measure of voiding volume and is appropriate for home use. It has the potential to facilitate large-scale clinical research to examine the relationship between medical diseases and voiding dysfunction.
Collapse
Affiliation(s)
- Minoru Miyazato
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.,Division of Biostatistics, School of Health Sciences, Okinawa, Japan
| | - Asuka Ashikari
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kiyoto Yamashiro
- Kumejima Public Hospital, Okinawa, Japan.,Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Moriyuki Uehara
- Kumejima Public Hospital, Okinawa, Japan.,Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology (Second Department of Medicine), Okinawa, Japan
| | - Hajime Ishida
- Department of Human Biology and Anatomy, University of the Ryukyus, Okinawa, Japan
| | - Masayuki Matsushita
- Department of Molecular and Cellular Physiology, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
11
|
Nishio S, Matsuo K, Yonemoto K, Shimokawa M, Hosaka M, Kodama M, Miyake TM, Ushijima K, Kamura T, Westin SN, Soliman PT, Coleman RL. Race and nodal disease status are prognostic factors in patients with stage IVB cervical cancer. Oncotarget 2018; 9:32321-32330. [PMID: 30190789 PMCID: PMC6122357 DOI: 10.18632/oncotarget.25962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022] Open
Abstract
Background Patients presenting with stage IVB cervical cancer pose a significant clinical challenge. While previous studies described several poor prognostic factors, they were limited by small sample sizes. The aim of this study was to identify clinicopathological prognostic factors in a large sample of patients with stage IVB cervical cancer at a single institution. Methods Patients with primary stage IVB cervical cancer diagnosed between 1992 and 2011 were extracted from a search of the MD Anderson Cancer Center registry. Clinicopathological data retrieved from their medical records included demographics (age and race), tumor characteristics (primary lesion size, grade, and histology), TNM classification, and metastatic site (nodal/organ). Treatment approach (radiation, chemotherapy, or both) and intent (palliation or curative) were recorded. Survival rates were evaluated using the Kaplan-Meier method. Cox proportional hazards regression was used to model the association between key variables and overall survival (OS). Results Two hundred sixty-six patients with stage IVB cervical cancer were identified. Their median OS was 12.7 months. The hazard ratio for African-Americans vs. patients with other ethnicities was 1.76 (95% confidence interval [CI], 1.18-2.54, P = 0.0063), and that for patients with para-aortic nodes alone vs. more extensive metastases was 0.37 (95% CI, 0.26-0.51, P < 0.0001). Other clinicopathological factors were not significantly associated with survival. Conclusions African-American race was an independent adverse prognostic factor in this cohort. On the other hand, nodal disease in the para-aortic chain alone predicted a favorable prognosis.
Collapse
Affiliation(s)
- Shin Nishio
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.,Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan
| | | | - Masayuki Hosaka
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Michiko Kodama
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Takahito M Miyake
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Toshiharu Kamura
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shannon N Westin
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Pamela T Soliman
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Robert L Coleman
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
12
|
Sekiguchi H, Tamaki Y, Kondo Y, Nakamura H, Hanashiro K, Yonemoto K, Moritani T, Kukita I. Surface electromyographic evaluation of the neuromuscular activation of the inspiratory muscles during progressively increased inspiratory flow under inspiratory-resistive loading. Physiol Int 2018; 105:86-99. [PMID: 29602291 DOI: 10.1556/2060.105.2018.1.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study aimed to evaluate neuromuscular activation in the scalene and sternocleidomastoid muscles using surface electromyography (EMG) during progressively increased inspiratory flow, produced by increasing the respiratory rate under inspiratory-resistive loading using a mask ventilator. Moreover, we attempted to identify the EMG inflection point (EMGIP) on the graph, at which the root mean square (RMS) of the EMG signal values of the inspiratory muscles against the inspiratory flow velocity acceleration abruptly increases, similarly to the EMG anaerobic threshold (EMGAT) reported during incremental-resistive loading in other skeletal muscles. We measured neuromuscular activation of healthy male subjects and found that the inspiratory flow velocity increased by approximately 1.6-fold. We successfully observed an increase in RMS that corresponded to inspiratory flow acceleration with ρ ≥ 0.7 (Spearman's rank correlation) in 17 of 27 subjects who completed the experimental protocol. To identify EMGIP, we analyzed the fitting to either a straight or non-straight line related to the increasing inspiratory flow and RMS using piecewise linear spline functions. As a result, EMGIP was identified in the scalene and sternocleidomastoid muscles of 17 subjects. We believe that the identification of EMGIP in this study infers the existence of EMGAT in inspiratory muscles. Application of surface EMG, followed by identification of EMGIP, for evaluating the neuromuscular activation of respiratory muscles may be allowed to estimate the signs of the respiratory failure, including labored respiration, objectively and non-invasively accompanied using accessory muscles in clinical respiratory care.
Collapse
Affiliation(s)
- H Sekiguchi
- 1 Department of Intensive Care, Tomishiro Central Hospital , Okinawa, Japan.,2 Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus , Okinawa, Japan
| | - Y Tamaki
- 2 Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus , Okinawa, Japan
| | - Y Kondo
- 2 Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus , Okinawa, Japan
| | - H Nakamura
- 3 Faculty of Biomedical Engineering, Department of Health-Promotion and Sports Science, Osaka Electro-Communication University , Osaka, Japan
| | - K Hanashiro
- 4 Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus , Okinawa, Japan
| | - K Yonemoto
- 5 Faculty of Medicine, Advanced Medical Research Center, University of the Ryukyus , Okinawa, Japan
| | - T Moritani
- 6 Department of Applied Physiology, Institute for the Promotion of Common Education, Kyoto Sangyo University , Kyoto, Japan
| | - I Kukita
- 2 Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus , Okinawa, Japan
| |
Collapse
|
13
|
Tominaga R, Sekiguchi M, Yonemoto K, Kakuma T, Konno SI. Establishment of reference scores and interquartile ranges for the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) in patients with low back pain. J Orthop Sci 2018; 23:643-648. [PMID: 29728303 DOI: 10.1016/j.jos.2018.03.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 03/20/2018] [Accepted: 03/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was developed in 2007, including the five domains of Pain-related disorder, Lumbar spine dysfunction, Gait disturbance, Social life disturbance, and Psychological disorder. It is used by physicians to evaluate treatment efficacy by comparing scores before and after treatment. However, the JOABPEQ does not allow evaluation of the severity of a patient's condition compared to the general population at a single time point. Given the unavailability of a standard measurement of back pain, we sought to establish reference scores and interquartile ranges using data obtained from a multicenter, cross-sectional survey taken in Japanese primary care settings. METHODS The Lumbar Spinal Stenosis Diagnosis Support Tool project was conducted from 2011 to 2012 in 1657 hospitals in Japan to investigate the establishment of reference scores using JOABPEQ. Patients aged ≥ 20 years undergoing medical examinations by either non-orthopaedic primary care physicians or general orthopedists were considered for enrollment. RESULTS A total of 10,651 consecutive low back pain patients (5331 men, 5320 women, 18 subjects with missing sex data) who had undergone a medical examination were included. Reference scores and interquartile ranges for each of the five domains of the JOABPEQ according to age and sex were recorded. The median score and interquartile range are the same in the domain of Pain-related disorder in all ages and sexes. The reference scores for Gait disturbance, Social life disturbance and Psychological disorder declined with increasing age in both age- and sex-stratified groups, while there was some different trend in Lumbar spine dysfunction between men and women. CONCLUSION Reference scores and interquartile ranges for JOABPEQ were generated based on the data from the examination data. These provide a measurement standard to assess patient perceptions of low back pain at any time point during evaluation or therapy.
Collapse
Affiliation(s)
- Ryoji Tominaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| | - Miho Sekiguchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University, 67 Asahimachi, Kurume, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan
| |
Collapse
|
14
|
Kohagura K, Kochi M, Miyagi T, Zamami R, Nagahama K, Yonemoto K, Ohya Y. Augmented Association Between Blood Pressure and Proteinuria in Hyperuricemic Patients With Nonnephrotic Chronic Kidney Disease. Am J Hypertens 2018; 31:480-485. [PMID: 28927237 DOI: 10.1093/ajh/hpx166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/12/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hyperuricemia (HU) may enhance susceptibility to hypertensive renal damage via disrupted autoregulation of glomerular hemodynamics. The effect of HU on the association between blood pressure (BP) and proteinuria remains unknown in patients with chronic kidney disease (CKD). METHODS In total, 109 patients with nonnephrotic CKD (55 men and 54 females) who underwent renal biopsy were recruited. Arteriolar hyalinosis was semiquantitatively assessed via arteriole grading. Correlation between BP and urine protein (UP) level was examined based on the presence of HU, which was defined as the use of urate-lowering drugs or serum uric acid levels of ≥7 and ≥5 mg/dl in males and females, respectively, which were associated with increased risks of hyalinosis in our previous study. RESULTS Median age, BP, estimated glomerular filtration rate, and UP level were 38 years, 124/74 mm Hg, 82 ml/min/1.73 m2, and 0.8 g/gCr, respectively. In patients with HU (n = 59), log-transformed systolic BP (SBP) was significantly correlated with log-transformed UP level (r = 0.49, P < 0.0001); this was not observed in patients without HU (n = 50). Multiple regression analysis (R2 = 0.21, P = 0.0001) revealed that the interaction between HU and log-transformed SBP with respect to proteinuria was significantly correlated with log-transformed UP level (β = 7.0, P = 0.03), independent of age, sex, and potential confounding factors; however, this statistical significance was completely eliminated after adjustment for the arteriolar hyalinosis index. CONCLUSIONS HU potentiates susceptibility to hypertensive glomerular damage via disrupted autoregulation in patients with nonnephrotic CKD.
Collapse
Affiliation(s)
- Kentaro Kohagura
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Masako Kochi
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tsuyoshi Miyagi
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Ryo Zamami
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kazufumi Nagahama
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yusuke Ohya
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
- Department of Cardiovascular Medicine, Nephrology and Neurology Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
15
|
Arinaga-Hino T, Ide T, Miyajima I, Ogata K, Kuwahara R, Amano K, Kawaguchi T, Nakamura T, Kawaguchi T, Koga H, Yonemoto K, Torimura T. Risk of malignancies in autoimmune hepatitis type 1 patients with a long-term follow-up in Japan. Hepatol Res 2018; 48:E222-E231. [PMID: 28841782 DOI: 10.1111/hepr.12973] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/18/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
AIM The risk of malignancies in autoimmune diseases is high and is regarded to be due to immunological abnormalities, the use of immunosuppressive agents, and/or chronic inflammation. The aim of this study was to investigate the incidence and risk of malignancies in patients with autoimmune hepatitis (AIH) type 1 in Japan. METHODS Two hundred and fifty-six patients diagnosed with AIH were enrolled. A person-year calculation was carried out for AIH patients, and the numbers of expected events were clarified using data from "The Monitoring of Cancer Incidence in Japan Project" in order to examine the standard incident rate (SIR) of each type of malignancy. Biochemical data regarding carcinogenesis and its background factors were also examined. RESULTS Twenty-seven patients (10.5%) developed malignancies; 11 (4.3%) with hepatobiliary cancer and 16 (6.3%) with extrahepatic malignancies. The overall SIR for malignancies in AIH was significantly high at 2.04 (95% confidence interval [CI], 1.34-2.96), and was high among female patients at 2.49 (95% CI, 1.60-3.71). The SIR for hepatobiliary cancer was 14.14 (95% CI, 7.05-25.30), and was markedly high for female patients at 21.83 (95% CI, 10.45-40.16). The SIR for oral/pharyngeal cancer was significantly high for female patients at 14.61 (95% CI, 1.64-52.77). The risk factors for hepatobiliary cancer at the diagnosis of AIH were low levels of alanine aminotransferase (P = 0.0226), low platelet counts (P < 0.0001), and cirrhosis (P = 0.0004). The risk factor for extrahepatic malignancy was relapse of AIH (P = 0.0485). CONCLUSION The risk of malignancies was generally high among AIH patients. Those with the risk factors of malignancies should be carefully followed up.
Collapse
Affiliation(s)
- Teruko Arinaga-Hino
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tatsuya Ide
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ichiro Miyajima
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kei Ogata
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Reiichiro Kuwahara
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Amano
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Toshihiro Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Toru Nakamura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hironori Koga
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Koji Yonemoto
- The Biostatistics Center, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuji Torimura
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | | |
Collapse
|
16
|
Watanabe K, Sekiguchi M, Yonemoto K, Nikaido T, Kato K, Otani K, Yabuki S, Kakuma T, Kikuchi SI, Konno SI, Kikuchi SI, Konno SI, Sekiguchi M, Takahashi K, Ohtori S, Kakuma T, Yonemoto K, Yonenobu K, Takahashi K, Iizuka H, Taguchi T, Kanchiku T, Takeshita K, Hara N, Tani T, Takemasa R, Chiba K, Hozogane N, Nagata K, Sato K, Nohara Y, Teneichi H, Hoshino Y, Seichi A, Yamashita T, Takebayashi T, Yoshida M, Yamada H, Nikaido T, Watanabe K, Kato K. Bowel/bladder dysfunction and numbness in the sole of the both feet in lumbar spinal stenosis - A multicenter cross-sectional study. J Orthop Sci 2017; 22:647-651. [PMID: 28551282 DOI: 10.1016/j.jos.2017.04.006] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 04/03/2017] [Accepted: 04/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Numbness in the soles of both feet at rest or bowel/bladder dysfunction can occur in patients with lumbar spinal stenosis (LSS), especially in patients with cauda equina lesions. The purpose of this study was to clarify the relationship between cauda equina symptoms at rest and quality of life (QOL) in LSS patients using standardized questionnaires developed for the Japanese population. METHODS A survey was conducted in 564 hospitals and general practice clinics nationwide from December 1, 2011 to December 31, 2012. All patients who visited hospital or clinic because of low back pain were included. Patients were diagnosed with LSS using the LSS-Diagnostic Support Tool (LSS-DST), and the severity of the disease was measured using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) for quality of life. Presence of both sole numbness and/or bowel/bladder dysfunction were determined by medical interview. 3647 patients were diagnosed with LSS according to the results of the LSS-DST. 1294 of these patients (35.5%) had symptoms at rest. Of these patients, 359 patients with sole numbness, 135 patients with bowel/bladder dysfunction, and 52 patients with both numbness and bowel/bladder dysfunction were compared to the patients without rest symptoms (n = 2182). Comparisons between groups with or without sole numbness and bowel/bladder dysfunction were performed using statistical analysis of JOABPEQ responses in the categories of pain-related disorder, lumbar spine disorder, gait disturbance, social life disturbance, and psychological disorder. RESULTS All groups with sole numbness and/or bowel/bladder dysfunction had statistically lower (worse) scores in all categories of the JOABPEQ compared to the group without these symptoms at rest. CONCLUSION LSS patients having numbness in the soles of both feet at rest or bowel/bladder dysfunction had lower measurements of QOL and activities of daily living than those patients without symptoms at rest. These symptoms appear to be related to QOL of LSS patients.
Collapse
Affiliation(s)
- Kazuyuki Watanabe
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan.
| | - Miho Sekiguchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Kurume, Japan
| | - Takuya Nikaido
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Shoji Yabuki
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | | | - Shin-Ichi Kikuchi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Sakata S, Hata J, Fukuhara M, Yonemoto K, Mukai N, Yoshida D, Kishimoto H, Ohtsubo T, Kitazono T, Kiyohara Y, Ninomiya T. Morning and Evening Blood Pressures Are Associated With Intima-Media Thickness in a General Population - The Hisayama Study. Circ J 2017. [PMID: 28626161 DOI: 10.1253/circj.cj-16-1306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The association of morning and evening home blood pressures (HBPs) with carotid atherosclerosis has been uncertain in general populations, so we aimed to investigate it in a general Japanese population.Methods and Results:We performed a cross-sectional survey of 2,856 community-dwelling individuals aged ≥40 years to examine the association of morning and evening HBPs with carotid mean intima-media thickness (IMT). The age- and sex-adjusted geometric averages of carotid mean IMT increased significantly with increasing morning HBP (optimal: 0.67 mm; normal: 0.69 mm; high normal: 0.72 mm; grade 1 hypertension: 0.74 mm; and grade 2+3 hypertension: 0.76 mm) and with increasing evening HBP (0.68 mm, 0.71 mm, 0.73 mm, 0.76 mm, and 0.78 mm, respectively) (both P for trend <0.001). These associations remained significant even after adjusting for potential confounding factors. Likewise, both isolated morning hypertension (morning HBP ≥135/85 mmHg and evening HBP <135/85 mmHg) and isolated evening hypertension (evening HBP ≥135/85 mmHg and morning HBP <135/85 mmHg) as well as sustained hypertension (both morning and evening HBP ≥135/85 mmHg) were significantly associated with thicker mean IMT. CONCLUSIONS Our findings suggested that both morning and evening HBPs were significantly associated with carotid atherosclerosis in this general Japanese population.
Collapse
Affiliation(s)
- Satoko Sakata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Masayo Fukuhara
- Division of General Internal Medicine, Kyushu Dental University
| | - Koji Yonemoto
- Advanced Medical Research Center, Faculty of Medicine, University of the Ryukyus
| | - Naoko Mukai
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Daigo Yoshida
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Hiro Kishimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Toshio Ohtsubo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | | | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.,Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| |
Collapse
|
18
|
Shimazaki Y, Fu B, Yonemoto K, Akifusa S, Shibata Y, Takeshita T, Ninomiya T, Kiyohara Y, Yamashita Y. Stimulated salivary flow rate and oral health status. J Oral Sci 2016; 59:55-62. [PMID: 28049967 DOI: 10.2334/josnusd.16-0372] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the relationship between stimulated salivary flow rate and oral health status in an adult population. Multinomial multivariate logistic regression analysis was used to examine the associations of salivary flow rate with dental caries status and periodontal status at the individual level among 2,110 Japanese adults with ≥10 teeth. Then, a spline model was used to examine the nonlinear relationship between salivary flow rate and teeth with dental caries or periodontal disease in multilevel analysis. Odds ratios were calculated for a 1.0-mL/min reduction in salivary flow rate at a point. After adjusting for confounding variables, participants with a flow rate ≤3.5 mL/min had significantly higher odds ratios for high caries status, and participants with a flow rate ≤1.4 mL/min had a higher odds ratio for broad periodontal disease, than did those with a flow rate >3.5 mL/min. In spline models, the odds ratio for teeth with dental caries or periodontal disease increased with reduced saliva secretion. The present findings suggest that decreased saliva secretion affects both dental caries and general periodontal health status.
Collapse
Affiliation(s)
- Yoshihiro Shimazaki
- Section of Preventive and Public Health Dentistry, Division of Oral Health, Growth and Development, Faculty of Dental Science, Kyushu University
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Ikeda F, Shikata K, Hata J, Fukuhara M, Hirakawa Y, Ohara T, Mukai N, Nagata M, Yoshida D, Yonemoto K, Esaki M, Kitazono T, Kiyohara Y, Ninomiya T. Combination of Helicobacter pylori Antibody and Serum Pepsinogen as a Good Predictive Tool of Gastric Cancer Incidence: 20-Year Prospective Data From the Hisayama Study. J Epidemiol 2016; 26:629-636. [PMID: 27265836 PMCID: PMC5121431 DOI: 10.2188/jea.je20150258] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/13/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is little information regarding whether the combination of Helicobacter pylori (H. pylori) antibody and serum pepsinogen (sPG), which is a marker of the degree of atrophic gastritis, has a discriminatory ability for detecting incident gastric cancer. We examined this issue in a long-term prospective cohort study of a Japanese population. METHODS A total of 2446 Japanese community-dwelling individuals aged ≥40 years were stratified into four groups according to baseline H. pylori serological status and sPG: Group A (H. pylori[-], sPG[-]), Group B (H. pylori[+], sPG[-]), Group C (H. pylori[+], sPG[+]), and Group D (H. pylori[-], sPG[+]), and participants were followed up prospectively for 20 years. RESULTS During the follow-up, 123 subjects developed gastric cancer. Compared with that in Group A, the cumulative incidence of gastric cancer was significantly increased in Groups B, C, and D, whereas no significant difference was found between Groups C and D. The multivariable-adjusted risk of gastric cancer was significantly increased in Group B (hazard ratio [HR], 4.08; 95% confidence interval [CI], 1.62-10.28) and in Groups C and D combined (HR 11.1; 95% CI, 4.45-27.46). When the multivariable model with H. pylori antibody was changed into that with the combination of H. pylori antibody and sPG, the C statistics for developing gastric cancer increased significantly (0.773 vs 0.732, P = 0.005), and the continuous net reclassification improvement value was 0.591 (P < 0.001). CONCLUSIONS Our findings suggest that the combination of H. pylori antibody and sPG is a useful tool for predicting the development of gastric cancer.
Collapse
|
20
|
Shimazaki Y, Saito T, Yonemoto K, Kiyohara Y, Iida M, Yamashita Y. Relationship of Metabolic Syndrome to Periodontal Disease in Japanese Women: The Hisayama Study. J Dent Res 2016; 86:271-5. [PMID: 17314261 DOI: 10.1177/154405910708600314] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Recent studies have suggested that several systemic conditions—such as obesity, hypertension, hyperlipidemia, and diabetes—are related to periodontitis. The objective of this study was to examine the relationship between periodontitis and 5 components of metabolic syndrome—abdominal obesity, triglyceride level, high-density lipoprotein cholesterol level, blood pressure, and fasting blood sugar level—in 584 Japanese women. In multivariate analyses, persons exhibiting more components of metabolic syndrome had significantly higher odds ratios for a greater pocket depth and clinical attachment loss than did those with no components; the odds ratios for a greater pocket depth and clinical attachment loss of the persons exhibiting 4 or 5 components were 6.6 (95% confidence interval = 2.6–16.4) and 4.2 (95% confidence interval = 1.2–14.8), respectively. These results indicate that metabolic syndrome increases risk of periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination.
Collapse
Affiliation(s)
- Y Shimazaki
- Department of Preventive Dentistry, Kyushu University Faculty of Dental Science, 3-1-1 Maidashi, Fukuoka, Japan.
| | | | | | | | | | | |
Collapse
|
21
|
Kanazawa E, Nakashima A, Yonemoto K, Otsuka M, Yoshioka N, Kuramoto T, Mitao H, Imaishi H, Komai K, Ushijima K. Injury to the endometrium prior to the frozen-thawed embryo transfer cycle improves pregnancy rates in patients with repeated implantation failure. J Obstet Gynaecol Res 2016; 43:128-134. [DOI: 10.1111/jog.13182] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 07/19/2016] [Accepted: 08/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Emiko Kanazawa
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| | - Akira Nakashima
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| | - Koji Yonemoto
- Biostatistics Center; Kurume University; Fukuoka Japan
| | | | | | | | - Hiroshi Mitao
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| | - Hiroto Imaishi
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| | - Kan Komai
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology; Kurume University School of Medicine; Fukuoka Japan
| |
Collapse
|
22
|
Honda T, Chen S, Yonemoto K, Kishimoto H, Chen T, Narazaki K, Haeuchi Y, Kumagai S. Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study. BMC Public Health 2016; 16:888. [PMID: 27562190 PMCID: PMC5000401 DOI: 10.1186/s12889-016-3570-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/20/2016] [Indexed: 02/09/2023] Open
Abstract
Background This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome. Methods We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having ≥ 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated ≥ 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome. Results During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 – 5.73), 2.42 (1.11 – 5.50), and 2.85 (1.31 – 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts. Conclusions Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3570-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Takanori Honda
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.,Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.,Research Fellow of the Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Sanmei Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka Prefecture, 830-0011, Japan
| | - Hiro Kishimoto
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan
| | - Tao Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Kenji Narazaki
- Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 811-0295, Japan
| | - Yuka Haeuchi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan
| | - Shuzo Kumagai
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan. .,Faculty of Arts and Science, Kyushu University, 6-1 Kasuga kouen, Kasuga City, Fukuoka Prefecture, 816-8580, Japan.
| |
Collapse
|
23
|
Kawano K, Tsuda N, Nishio S, Yonemoto K, Tasaki K, Tasaki R, Ushijima K. Identification of appropriate cone length to avoid positive cone margin in high grade cervical intraepithelial neoplasia. J Gynecol Oncol 2016; 27:e54. [PMID: 27401478 PMCID: PMC4944020 DOI: 10.3802/jgo.2016.27.e54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 05/31/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022] Open
Abstract
Objective To identify key factors for predicting positive cone margin and appropriate cone length. Methods We retrospectively reviewed the margin status of patients who received conization with high grade cervical intraepithelial neoplasia, along with other factors such as patient age, parity, preoperative cytology, size of disease, type of transformation zone, and cone length from patient records. Cut-off value of cone length was analyzed in women younger than 40 years old because we design conization with minimum length especially for women who wish for future pregnancy. Cut-off value of cone length was defined as length corresponds to estimated probability of positive cone margin equal to 0.1 by logistic regression analysis with variables selected by stepwise methods. Results Among 300 patients, 75 patients had positive cone margin. Multivariable analysis revealed that squamous cell carcinoma at preoperative cytology (p=0.001), 2 or more quadrant disease (p=0.011), and shorter cone length (p<0.001) were risk factors for positive cone margin. Stepwise methods identified cone length and size of lesion as important variables. With this condition, cut-off value of cone length was estimated as 15 mm in single quadrant disease and 20 mm in 2 or more quadrant disease, respectively. Conclusion We identified the independent risk factors of positive cone margin and identified the cut-off value of cone length to avoid positive cone margin in women younger than 40 years old. Conization should be performed not only according to colposcopic findings including type of transformation zone but size of disease and cone length.
Collapse
Affiliation(s)
- Kouichiro Kawano
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
| | - Naotake Tsuda
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Kurume, Japan
| | - Kazuto Tasaki
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Rurika Tasaki
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
| |
Collapse
|
24
|
Inoue S, Shinagawa T, Horinouchi T, Kozuma Y, Yonemoto K, Hori D, Ushijima K. Predictors of Abnormal Glucose Tolerance in the Early Postpartum Period in Patients with Gestational Diabetes. Kurume Med J 2016; 62:47-51. [PMID: 27237938 DOI: 10.2739/kurumemedj.ms65006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study was designed to investigate the clinical predictors of abnormal glucose tolerance 5-7 weeks after delivery. Subjects were 155 women diagnosed with gestational diabetes mellitus (GDM) between October 2005 and September 2013 whose pregnancy and delivery were managed at our center. Subjects were divided into a normal glucose tolerance group (NGT; n = 113), or abnormal glucose tolerance group (AGT; n = 42) with borderline or overt diabetes mellitus, based on 75-g oral glucose tolerance test (75 gOGTT) results 5-7 weeks after delivery. We extracted profiles by which abnormal glucose tolerance levels 5-7 weeks after delivery were predicted using a classification and regression tree (CART) from parameters measured at the time of GDM diagnosis. Logistic regression analysis was used to determine prediction accuracy. Subjects with fasting plasma glucose (FPG) ≥92 mg/dL and immuno-reactive insulin level <100 μU/mL 60 min after load (IRI60min) at time of diagnosis showed a significantly higher risk of developing abnormal glucose tolerance 5-7 weeks after delivery than subjects with FPG <92 mg/dL (p < 0.0001). Subjects with FPG ≥92 mg/dL and IRI60min ≥ 100 μU/mL had the same risk as those with FPG of <92 mg/dL. Patients with gestational diabetes who met the criteria specified above at diagnosis were at a higher risk of developing diabetes mellitus in the future. By explaining this issue to patients, we expect to improve the rate of postpartum follow-up. This should facilitate early detection of diabetes, and help prevent associated complications.
Collapse
Affiliation(s)
- Shigeru Inoue
- Department of Obstetrics and Gynecology, Kurume University School of Medicine
| | | | | | | | | | | | | |
Collapse
|
25
|
Akazawa S, Tojikubo M, Nakano Y, Nakamura S, Tamai H, Yonemoto K, Sadasima E, Kawasaki T, Koga N. Usefulness of carotid plaque (sum and maximum of plaque thickness) in combination with intima-media thickness for the detection of coronary artery disease in asymptomatic patients with diabetes. J Diabetes Investig 2015; 7:396-403. [PMID: 27330727 PMCID: PMC4847895 DOI: 10.1111/jdi.12403] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 07/04/2015] [Accepted: 07/27/2015] [Indexed: 02/06/2023] Open
Abstract
AIMS/INTRODUCTION The usefulness of markers of carotid plaque, such as sum (PS) and maximum (P-max) of the plaque thickness, in combination with intima-media thickness in the common carotid artery (CIMT) for the detection of obstructive coronary artery disease (CAD) was investigated in patients with type 2 diabetes without known CAD. MATERIALS AND METHODS B-mode ultrasonographic scanning of the carotid artery and multislice computed tomography coronary angiography were carried out in 332 asymptomatic patients with type 2 diabetes. RESULTS For the presence of obstructive CAD when incorporating PS or P-max to standard risk factors in a multiple logistic regression model, the classification ability in PS and P-max increased greatly (area under the curve [AUC] 0.827 vs 0.720 [net reclassification index {NRI} = 0.652, P < 0.01] and AUC 0.820 vs 0.720 [NRI = 0.775, P < 0.01], respectively), and it in CIMT increased slightly (AUC 0.740 vs 0.720, NRI = 0.230, P = 0.041). Furthermore, the classification abilities for a model with interaction terms between PS* or P-max* and CIMT were statistically larger than those for a model without interaction terms (AUC 0.833 vs 0.827 [NRI = 0.411, P < 0.01] and 0.823 vs 0.820 [NRI = 0.269, P < 0.05], respectively). Partitioning showed the patients in the values of the PS <2.6 mm and CIMT <0.725 mm (100%), or in P-max <2.1 mm and CIMT <0.725 mm (95.4%), did not have obstructive CAD, whereas those in the values of PS ≧2.6 mm, presence of hyperlipidemia and CIMT ≧0.675 mm (84%) or those in the value of P-max ≧2.1 mm and body mass index ≧24 (91.7%) had obstructive CAD. CONCLUSIONS Although the P-max and PS in the carotid artery were useful as detectors of CAD, combining them with CIMT provided a much superior first-line screening method in detecting CAD in asymptomatic patients with diabetes.
Collapse
Affiliation(s)
- Shoichi Akazawa
- Center of Diabetes and Endocrinology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Masayuki Tojikubo
- Center of Diabetes and Endocrinology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Yuko Nakano
- Center of Diabetes and Endocrinology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Satoe Nakamura
- Center of Diabetes and Endocrinology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Hidekazu Tamai
- Center of Diabetes and Endocrinology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Koji Yonemoto
- Biostatistics Center Kurume University Kurume City Fukuoka Japan
| | - Eiji Sadasima
- Laboratory Center Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Tomohiro Kawasaki
- Department of Cardiology Shin-Koga Hospital Kurume City Fukuoka Japan
| | - Nobuhiko Koga
- Department of Cardiology Shin-Koga Hospital Kurume City Fukuoka Japan
| |
Collapse
|
26
|
Sekiguchi M, Yonemoto K, Kakuma T, Nikaido T, Watanabe K, Kato K, Otani K, Yabuki S, Kikuchi SI, Konno SI. Relationship between lumbar spinal stenosis and psychosocial factors: a multicenter cross-sectional study (DISTO project). Eur Spine J 2015; 24:2288-94. [DOI: 10.1007/s00586-015-4002-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 05/04/2015] [Accepted: 05/05/2015] [Indexed: 11/28/2022]
|
27
|
Abstract
Lichen planus annularis is a relatively rare skin manifestation of lichen planus. The mechanisms in the formation of annular lesions are not fully understood. We reported here a 57-year-old female with this disease. The eruption initially occurred as lichen-papules, then enlarged (bean-sized, umbilicated small plaques), and finally developed annular manifestations. We performed immunohistochemical examinations of specimens taken from different types of eruptions. In all specimens, HLA-DR was expressed in the focal keratinocytes adjacent to the dermal HLA-DR positive cell infiltration. Both in the initial papule and in the final annular lesion, expression of ICAM-1 was present only in the keratinocytes above the dermal cell infiltration, similar to HLA-DR. It is of interest that, in the umbilicated small plaques, the peripheral epidermis other than the central site extensively reacted to ICAM-1. LFA-1 expression was most prominent in the mononuclear cells impinging on the dermo-epidermal junction in all specimens. In addition, in the periphery of the umbilicated small plaques, which showed no bandlike dense cell infiltration nor degeneration of basement membrane, TNF-alpha, but not LFA-1, was positive in the infiltrated cells of the upper dermis. These results suggest that expressions of ICAM-1 and TNF-alpha in the peripheral keratinocytes and dermal infiltrated cells are important molecular events in the mechanisms of formation of the annular lesions.
Collapse
Affiliation(s)
- Y Ohta
- Department of Dermatology, National Yokohama Hospital, Japan
| | | | | | | |
Collapse
|
28
|
Hata A, Yonemoto K, Shikama Y, Aki N, Kosugi C, Tamura A, Ichihara T, Minagawa T, Kuwamura Y, Miyoshi M, Nakao T, Funaki M. Cut-off value of total adiponectin for managing risk of developing metabolic syndrome in male Japanese workers. PLoS One 2015; 10:e0118373. [PMID: 25705909 PMCID: PMC4337907 DOI: 10.1371/journal.pone.0118373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/11/2015] [Indexed: 11/26/2022] Open
Abstract
Aim To determine the optimal cut-off value of serum total adiponectin for managing the risk of developing metabolic syndrome (MetS) in male Japanese workers. Methods A total of 365 subjects without MetS aged 20–60 years were followed up prospectively for a mean of 3.1 years. The accelerated failure-time model was used to estimate time ratio (TR) and cut-off value for developing MetS. Results During follow-up, 45 subjects developed MetS. Age-adjusted TR significantly declined with decreasing total adiponectin level (≤ 4.9, 5.0–6.6, 6.7–8.8 and ≥ 8.9 μg/ml, P for trend = 0.003). In multivariate analyses, TR of MetS was 0.12 (95% CI 0.02–0.78; P = 0.03) in subjects with total adiponectin level of 5.0–6.6 μg/ml, and 0.15 (95% CI 0.02–0.97; P = 0.047) in subjects with total adiponectin level ≤ 4.9 μg/ml compared with those with total adiponectin level ≥ 8.9 μg/ml. The accelerated failure-time model showed that the optimal cut-off value of total adiponectin for managing the risk of developing MetS was 6.2 μg/ml. In the multivariate-adjusted model, the mean time to the development of MetS was 78% shorter for total adiponectin level ≤ 6.2 μg/ml compared with > 6.2 μg/ml (TR 0.22, 95% CI: 0.08–0.64, P = 0.005). Conclusion Our findings suggest that the cut-off value for managing the risk of developing MetS is 6.2 μg/ml in male Japanese workers. Subjects with total adiponectin level ≤ 6.2 μg/ml developed MetS more rapidly than did those with total adiponectin level > 6.2 μg/ml.
Collapse
Affiliation(s)
- Akiko Hata
- Clinical Research Center for Diabetes, Tokushima University Hospital, Tokushima, Japan
- * E-mail:
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Fukuoka, Japan
| | - Yosuke Shikama
- Clinical Research Center for Diabetes, Tokushima University Hospital, Tokushima, Japan
| | - Nanako Aki
- Clinical Research Center for Diabetes, Tokushima University Hospital, Tokushima, Japan
- Department of Medicine and Bioregulatory Sciences, The University of Tokushima Graduate School of Medical Sciences, Tokushima, Japan
| | - Chisato Kosugi
- Clinical Research Center for Diabetes, Tokushima University Hospital, Tokushima, Japan
| | - Ayako Tamura
- Department of Nursing Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Takako Ichihara
- Department of Nursing Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Takako Minagawa
- Department of Nursing Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Yumi Kuwamura
- Department of Nursing Science, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Masashi Miyoshi
- Clinical laboratory, Tokushima University Hospital, Tokushima, Japan
| | - Takayuki Nakao
- Clinical laboratory, Tokushima University Hospital, Tokushima, Japan
| | - Makoto Funaki
- Clinical Research Center for Diabetes, Tokushima University Hospital, Tokushima, Japan
| |
Collapse
|
29
|
Kondo H, Ninomiya T, Hata J, Hirakawa Y, Yonemoto K, Arima H, Nagata M, Tsuruya K, Kitazono T, Kiyohara Y. Angiotensin I-Converting Enzyme Gene Polymorphism Enhances the Effect of Hypercholesterolemia on the Risk of Coronary Heart Disease in a General Japanese Population: The Hisayama Study. J Atheroscler Thromb 2015; 22:390-403. [DOI: 10.5551/jat.24166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Hideki Kondo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Toshiharu Ninomiya
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Jun Hata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
| | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
- The George Institute for Global Health, University of Sydney
| | | | - Hisatomi Arima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Masaharu Nagata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kazuhiko Tsuruya
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
| | - Yutaka Kiyohara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
| |
Collapse
|
30
|
Narazaki K, Matsuo E, Honda T, Nofuji Y, Yonemoto K, Kumagai S. Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems. J Sports Sci Med 2014; 13:590-596. [PMID: 25177186 PMCID: PMC4126296] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/09/2014] [Indexed: 06/03/2023]
Abstract
Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score ≥24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of dementia. Key pointsThere is a great need for identifying lifestyle-related markers which help detect subtle cognitive impairment in the preclinical or earlier phase of dementia.In the present study, each of the five physical fitness measures employed was linearly and positively associated with the Montreal Cognitive Assessment score in the present older adults without apparent cognitive problems, after adjusting for age, sex, education, body mass index, and other confounding factors.The results suggest the potential of each physical fitness measure as a single lifestyle-related marker of low cognitive function in the population, which can be useful in community-based preventive care of dementia.
Collapse
Affiliation(s)
- Kenji Narazaki
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Eri Matsuo
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Takanori Honda
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan
| | - Yu Nofuji
- Tokyo Metropolitan Institute of Gerontology , Tokyo, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University , Fukuoka, Japan
| | - Shuzo Kumagai
- Graduate School of Human-Environment Studies, Kyushu University , Fukuoka, Japan ; Faculty of Arts and Science, Kyushu University , Fukuoka, Japan
| |
Collapse
|
31
|
Ohtori S, Sekiguchi M, Yonemoto K, Kakuma T, Takahashi K, Konno S. Awareness and use of diagnostic support tools for lumbar spinal stenosis in Japan. J Orthop Sci 2014; 19:412-7. [PMID: 24570300 DOI: 10.1007/s00776-014-0551-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 01/27/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Lumbar spinal stenosis (LSS) is a major clinical problem associated with back pain, intermittent claudication, leg pain, and leg numbness. Diagnostic support tools for LSS such as the self-administered, self-reported history questionnaire (SSHQ) and developmental clinical diagnosis support tool (ST) have been validated in Japan. However, the degree of awareness and use of these two diagnostic support tools for LSS in Japan has not been clarified. The aims of the current study were to determine the degree of awareness and use of these two diagnostic support tools by Japanese physicians. Furthermore, we compared these results among nonorthopedic general practitioner (GP), orthopedic GP, and hospital-based orthopedic physicians. METHODS The LSS Diagnosis Support Tool (DISTO) Project was conducted to evaluate the degree of awareness and use of these two diagnostic support tools in Japan from 2011 to 2012. A total of 1,811 answers were obtained from physicians including nonorthopedic general practitioners (GP), orthopedic GPs, and hospital-based orthopedic physicians. Questions were (1) Do you know about these two diagnostic tools? and (2) If you know about these two diagnostic tools, have you used them? RESULTS The degree of awareness of ST and SSHQ was about 30 and 26 % by nonorthopedic GPs, 70 and 46 % by orthopedic GPs, and 68 and 41 % by hospital-based orthopedic physicians. The degree of awareness of ST and SSHQ by nonorthopedic GPs was significantly lower than by orthopedic GPs or hospital-based orthopedic physicians (p < 0.001). For physicians who were aware of ST and SSHQ, the degree of use of ST or SSHQ was <50 % by nonorthopedic GPs, orthopedic GPs, and hospital-based orthopedic physicians. CONCLUSIONS We expect that use of the ST or SSHQ tools in primary care will improve the accuracy of diagnosis and lead to improved quality of patient care. The low proportion of awareness by nonorthopedic GPs (<30 %) and use by all physicians (<50 %) indicate a need to encourage physicians to use ST and SSHQ more frequently.
Collapse
Affiliation(s)
- Seiji Ohtori
- Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan,
| | | | | | | | | | | |
Collapse
|
32
|
Shibata M, Ninomiya T, Jensen MP, Anno K, Yonemoto K, Makino S, Iwaki R, Yamashiro K, Yoshida T, Imada Y, Kubo C, Kiyohara Y, Sudo N, Hosoi M. Alexithymia is associated with greater risk of chronic pain and negative affect and with lower life satisfaction in a general population: the Hisayama Study. PLoS One 2014; 9:e90984. [PMID: 24621785 PMCID: PMC3951296 DOI: 10.1371/journal.pone.0090984] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 02/06/2014] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Chronic pain is a significant health problem worldwide, with a prevalence in the general population of approximately 40%. Alexithymia -- the personality trait of having difficulties with emotional awareness and self-regulation -- has been reported to contribute to an increased risk of several chronic diseases and health conditions, and limited research indicates a potential role for alexithymia in the development and maintenance of chronic pain. However, no study has yet examined the associations between alexithymia and chronic pain in the general population. METHODS We administered measures assessing alexithymia, pain, disability, anxiety, depression, and life satisfaction to 927 adults in Hisayama, Japan. We classified the participants into four groups (low-normal alexithymia, middle-normal alexithymia, high-normal alexithymia, and alexithymic) based on their responses to the alexithymia measure. We calculated the risk estimates for the criterion measures by a logistic regression analysis. RESULTS Controlling for demographic variables, the odds ratio (OR) for having chronic pain was significantly higher in the high-normal (OR: 1.49, 95% CI: 1.07-2.09) and alexithymic groups (OR: 2.56, 95% CI: 1.47-4.45) compared to the low-normal group. Approximately 40% of the participants belonged to these two high-risk groups. In the subanalyses of the 439 participants with chronic pain, the levels of pain intensity, disability, depression, and anxiety were significantly increased and the degree of life satisfaction was decreased with elevating alexithymia categories. CONCLUSIONS The findings demonstrate that, in the general population, higher levels of alexithymia are associated with a higher risk of having chronic pain. The early identification and treatment of alexithymia and negative affect may be beneficial in preventing chronic pain and reducing the clinical and economic burdens of chronic pain. Further research is needed to determine if this association is due to a causal effect of alexithymia on the prevalence and severity of chronic pain.
Collapse
Affiliation(s)
- Mao Shibata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America
| | - Kozo Anno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yonemoto
- Biostatistics Center, Kurume University, Fukuoka, Japan
| | - Seiko Makino
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rie Iwaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yamashiro
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiyuki Yoshida
- Department of Speech and Hearing Sciences, International University of Health and Welfare, School of Health Sciences at Fukuoka, Fukuoka, Japan
| | - Yuko Imada
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Chiharu Kubo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yutaka Kiyohara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- * E-mail:
| |
Collapse
|
33
|
Izumaru K, Ninomiya T, Nagata M, Usui T, Yoshida D, Yonemoto K, Fukuhara M, Tsuruya K, Kitazono T, Kiyohara Y. Serum 1,25-dihydroxyvitamin d and the development of kidney dysfunction in a Japanese community. Circ J 2013; 78:732-7. [PMID: 24351652 DOI: 10.1253/circj.cj-13-0422] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 11/09/2022]
Abstract
BACKGROUND Recent evidence indicates that vitamin D deficiency is associated with an increased risk of renal impairment, but studies addressing the influence of vitamin D deficiency on the development of chronic kidney disease (CKD) in the general Asian population have been few. METHODS AND RESULTS A total of 2,417 community-dwelling individuals without CKD stage 3-5 aged ≥40 years were followed for 5 years (mean age, 60 years; women, 59.1%). The cumulative incidence of CKD stage 3-5, defined as estimated glomerular filtration rate (eGFR) <60ml·min(-1)·1.73m(-2), and the rate of decline in eGFR according to quartile of serum 1,25-dihydroxyvitamin D (1,25(OH)2D), were estimated. During follow-up, 378 subjects experienced CKD stage 3-5. The age- and sex-adjusted incidence of CKD stage 3-5 increased significantly with decreasing serum 1,25(OH)2D (P for trend <0.001). Compared with the highest quartile, the multivariate-adjusted odds ratio for the development of CKD stage 3-5 was 1.90 in the lowest quartile and 1.74 in the second lowest quartile, after adjusting for confounding factors. Additionally, lower serum 1,25(OH)2D was significantly associated with a greater change in eGFR (-0.10ml·min(-1)·1.73m(-2)·year(-1) per 10-pg/ml decrement in serum 1,25(OH)2D). CONCLUSIONS Lower serum 1,25(OH)2D is a significant risk factor for the development of CKD stage 3-5 in the general Asian population.
Collapse
Affiliation(s)
- Kensuke Izumaru
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Sekita A, Arima H, Ninomiya T, Ohara T, Doi Y, Hirakawa Y, Fukuhara M, Hata J, Yonemoto K, Ga Y, Kitazono T, Kanba S, Kiyohara Y. Elevated depressive symptoms in metabolic syndrome in a general population of Japanese men: a cross-sectional study. BMC Public Health 2013; 13:862. [PMID: 24044502 PMCID: PMC3848461 DOI: 10.1186/1471-2458-13-862] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 09/05/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uncertainty still surrounds the association between metabolic syndrome (MetS) and depression. We aimed to evaluate the association between MetS and elevated depressive symptoms in a general Japanese population. METHODS This is a cross-sectional survey of 3,113 community-dwelling individuals aged 40 years or over. MetS was defined according to the joint interim statement. MetS was diagnosed when a subject had three or more of the following components: 1) central obesity (waist circumference ≥ 90 cm for men, ≥ 80 cm in for women); 2) elevated blood pressure (≥ 130/85 mmHg or current use of antihypertensive medication); 3) hypertriglyceridemia (≥ 1.7 mmol/L); 4) low HDL cholesterol (< 1.0 mmol/L for men, < 1.3 mmol/L for women); and 5) elevated fasting plasma glucose (≥ 5.55 mmol/L or current use of antidiabetic medication). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). The age- and multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated using a logistic regression model. RESULTS Elevated depressive symptoms were observed in 4.3% of male and 6.3% of female participants. In men, the age-adjusted prevalence of elevated depressive symptoms was significantly higher in subjects with MetS than in those without (7.1% versus 3.6%, p = 0.04). The prevalence of elevated depressive symptoms rose progressively as the number of MetS components increased (3.5%, 3.6%, 5.8%, and 9.2% in male subjects with 0-1, 2, 3, and ≥ 4 components, respectively; p = 0.02 for trend). This association remained significant even after adjustment for age, marital status, history of cardiovascular disease, smoking habit, alcohol intake, and regular exercise. In women, on the other hand, there was no clear association between MetS and depressive symptoms. CONCLUSIONS MetS was associated with elevated depressive symptoms in a general population of Japanese men.
Collapse
Affiliation(s)
- Atsuko Sekita
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Sanada S, Futami K, Terada A, Yonemoto K, Ogasawara S, Akiba J, Yasumoto M, Sumi A, Ushijima K, Kamura T, Furuichi Y, Yano H. RECQL1 DNA repair helicase: a potential therapeutic target and a proliferative marker against ovarian cancer. PLoS One 2013; 8:e72820. [PMID: 23951333 PMCID: PMC3739757 DOI: 10.1371/journal.pone.0072820] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 07/09/2013] [Indexed: 11/24/2022] Open
Abstract
Objective This study analyzed the clinicopathological correlation between ovarian cancer (OC) and RECQL1 DNA helicase to assess its therapeutic potential. Methods Surgically resected OC from 118 retrospective cases, for which paraffin blocks and all clinical data were complete, were used in this study. RECQL1 and Ki-67 immunostaining were performed on sections to correlate RECQL1 staining with subtype and patient survival. Ten OC and two normal cell lines were then examined for RECQL1 expression and were treated with siRNA against RECQL1 to assess its effect on cell proliferation. Results Of the 118 cases of adenocarcinoma (50, serous; 26, endometrioid; 21, clear cell; 15, mucinous; 6, other histology), 104 (90%) showed varying levels of RECQL1 expression in the nuclei of OC cells. The Cox hazards model confirmed that diffuse and strong staining of RECQL1 was correlated with histological type. However, RECQL1 expression did not correlate with overall patient survival or FIGO stage. In vitro, RECQL1 expression was exceptionally high in rapidly growing OC cell lines, as compared with normal cells. Using a time-course analysis of RECQL1-siRNA transfection, we observed a significant inhibition in cell proliferation. Conclusions RECQL1 DNA helicase is a marker of highly proliferative cells. RECQL1-siRNA may offer a new therapeutic strategy against various subtypes of OC, including platinum-resistant cancers, or in recurrent cancers that gain platinum resistance.
Collapse
MESH Headings
- Adenocarcinoma, Clear Cell/enzymology
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adenocarcinoma, Mucinous/enzymology
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/pathology
- Biomarkers, Tumor/antagonists & inhibitors
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cell Line, Tumor
- Cell Proliferation
- Cystadenocarcinoma, Serous/enzymology
- Cystadenocarcinoma, Serous/genetics
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- DNA Repair
- Female
- Gene Expression
- Humans
- Ki-67 Antigen/genetics
- Ki-67 Antigen/metabolism
- Middle Aged
- Neoplasm Recurrence, Local/enzymology
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Ovarian Neoplasms/enzymology
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Proportional Hazards Models
- RNA, Small Interfering/genetics
- RNA, Small Interfering/metabolism
- RecQ Helicases/antagonists & inhibitors
- RecQ Helicases/genetics
- RecQ Helicases/metabolism
- Retrospective Studies
- Survival Analysis
Collapse
Affiliation(s)
- Sakiko Sanada
- Department of Pathology, Kurume University School of Medicine, Fukuoka, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Hata J, Ninomiya T, Hirakawa Y, Nagata M, Mukai N, Gotoh S, Fukuhara M, Ikeda F, Shikata K, Yoshida D, Yonemoto K, Kamouchi M, Kitazono T, Kiyohara Y. Secular trends in cardiovascular disease and its risk factors in Japanese: half-century data from the Hisayama Study (1961-2009). Circulation 2013; 128:1198-205. [PMID: 23902756 DOI: 10.1161/circulationaha.113.002424] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Changes in lifestyle and advances in medical technology during the past half century are likely to have affected the incidence and mortality of cardiovascular disease and the prevalence of its risk factors in Japan. METHODS AND RESULTS We established 5 cohorts consisting of residents aged ≥40 years in a Japanese community, in 1961 (n=1618), 1974 (n=2038), 1983 (n=2459), 1993 (n=1983), and 2002 (n=3108), and followed up each cohort for 7 years. The age-adjusted incidence of stroke decreased greatly, by 51% in men and by 43% in women, from the 1960s to the 1970s, but this decreasing trend slowed from the 1970s to the 2000s. Among the stroke subtypes, ischemic stroke in both sexes and intracerebral hemorrhage in men showed a similar pattern. Stroke mortality decreased as a result of the decline in incidence and a significant improvement in survival rate. Although the incidence of acute myocardial infarction did not change in either sex, disease mortality declined slightly in women. From the 1960s to the 2000s, blood pressure control among hypertensive individuals improved significantly and the smoking rate decreased, but the prevalence of glucose intolerance, hypercholesterolemia, and obesity increased steeply. CONCLUSIONS Our findings suggest that in Japanese, the decreasing trends in the incidence of ischemic stroke have recently slowed down, and there has been no clear change in the incidence of acute myocardial infarction, probably because the benefits of hypertension control and smoking cessation have been negated by increasing metabolic risk factors.
Collapse
Affiliation(s)
- Jun Hata
- Department of Environmental Medicine (J.H., T.N., Y.H., M.N., N.M., S.G., M.F., F.I., K.S., D.Y., Y.K.) and Department of Medicine and Clinical Science (J.H., T.N., Y.H., M.N., N.M., S.G., M.F., F.I., K.S., M.K., T.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; and Biostatistics Center, Kurume University, Kurume, Japan (K.Y.)
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Yutani S, Komatsu N, Yoshitomi M, Matsueda S, Yonemoto K, Mine T, Noguchi M, Ishihara Y, Yamada A, Itoh K, Sasada T. A phase II study of a personalized peptide vaccination for chemotherapy-resistant advanced pancreatic cancer patients. Oncol Rep 2013; 30:1094-100. [PMID: 23784011 DOI: 10.3892/or.2013.2556] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 05/09/2013] [Indexed: 12/17/2022] Open
Abstract
Pancreatic cancer is one of the most aggressive cancers with a median survival time (MST) of <6 months in chemotherapy-resistant patients. Therefore, the development of novel treatment modalities is needed. In the present study, a phase II study of personalized peptide vaccination (PPV) was conducted, in which vaccine antigens were selected and administered based on the pre-existing IgG responses to 31 different pooled peptides, for 41 chemotherapy-resistant advanced pancreatic cancer patients. No vaccine-related severe adverse events were observed. IgG responses specific to at least one of the vaccine peptides were augmented in 14 of 36 patients (39%) and in 18 of 19 patients (95%) tested after the 5th and 11th vaccination, respectively. MST from the first vaccination was 7.9 months with a 1-year survival rate of 26.8%. Higher serum amyloid A (SAA) and C-reactive protein (CRP) levels in pre-vaccination plasma were unfavorable factors for overall survival (OS). Due to the safety profile and the potential clinical efficacy, the conduction of additional clinical trials of PPV for chemotherapy-resistant advanced pancreatic cancer patients is warranted.
Collapse
Affiliation(s)
- Shigeru Yutani
- Department of Immunology and Immunotherapy, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Fukuhara M, Arima H, Ninomiya T, Hata J, Hirakawa Y, Doi Y, Yonemoto K, Mukai N, Nagata M, Ikeda F, Matsumura K, Kitazono T, Kiyohara Y. White-coat and masked hypertension are associated with carotid atherosclerosis in a general population: the Hisayama study. Stroke 2013. [PMID: 23640825 DOI: 10.1161/strokeaha/111000704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE On the basis of combined measurements of clinic blood pressure (CBP) and home blood pressure (HBP), blood pressure status can be divided into normotension, white-coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Despite the clear impact of MHT and SHT on clinical and subclinical arterial disease, uncertainty about the influence of WCHT remains. The objective of this study was to investigate the associations of WCHT, MHT, and SHT with carotid atherosclerosis in a general population. METHODS This is a cross-sectional survey of 2915 community-dwelling Japanese aged ≥ 40 years. Normotension was defined as CBP<140/90 and HBP<135/85 mm Hg; WCHT, CBP ≥ 140/90 and HBP<135/85 mm Hg; MHT, CBP<140/90 and HBP ≥ 135/85 mm Hg; and SHT, CBP ≥ 140/90 and HBP ≥ 135/85 mm Hg. Mean intima-media thickness of carotid arteries was measured using a computer-automated system, and carotid stenosis was defined as diameter stenosis ≥ 30%. RESULTS There were 1374 subjects (47.1%) with normotension, 200 (6.9%) with WCHT, 639 (21.9%) with MHT, and 702 (24.1%) with SHT. The geometric average of mean intima-media thickness was significantly higher among subjects with WCHT (0.73 mm), MHT (0.77 mm), and SHT (0.77 mm) than those with normotension (0.67 mm; all P<0.001 versus normotension). Compared with normotension, all types of hypertension were also associated with increased likelihood of carotid stenosis (age- and sex-adjusted odds ratio, 2.36 [95% confidence interval, 1.27-4.37] for WCHT, 1.95 [1.25-3.03] for MHT, and 3.02 [2.01-4.54] for SHT). These associations remained significant even after adjustment for other cardiovascular risk factors. CONCLUSIONS WCHT, as well as MHT, and SHT were associated with carotid atherosclerosis in a general Japanese population.
Collapse
Affiliation(s)
- Masayo Fukuhara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Fukuhara M, Arima H, Ninomiya T, Hata J, Hirakawa Y, Doi Y, Yonemoto K, Mukai N, Nagata M, Ikeda F, Matsumura K, Kitazono T, Kiyohara Y. White-coat and masked hypertension are associated with carotid atherosclerosis in a general population: the Hisayama study. Stroke 2013; 44:1512-7. [PMID: 23640825 DOI: 10.1161/strokeaha.111.000704] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE On the basis of combined measurements of clinic blood pressure (CBP) and home blood pressure (HBP), blood pressure status can be divided into normotension, white-coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Despite the clear impact of MHT and SHT on clinical and subclinical arterial disease, uncertainty about the influence of WCHT remains. The objective of this study was to investigate the associations of WCHT, MHT, and SHT with carotid atherosclerosis in a general population. METHODS This is a cross-sectional survey of 2915 community-dwelling Japanese aged ≥ 40 years. Normotension was defined as CBP<140/90 and HBP<135/85 mm Hg; WCHT, CBP ≥ 140/90 and HBP<135/85 mm Hg; MHT, CBP<140/90 and HBP ≥ 135/85 mm Hg; and SHT, CBP ≥ 140/90 and HBP ≥ 135/85 mm Hg. Mean intima-media thickness of carotid arteries was measured using a computer-automated system, and carotid stenosis was defined as diameter stenosis ≥ 30%. RESULTS There were 1374 subjects (47.1%) with normotension, 200 (6.9%) with WCHT, 639 (21.9%) with MHT, and 702 (24.1%) with SHT. The geometric average of mean intima-media thickness was significantly higher among subjects with WCHT (0.73 mm), MHT (0.77 mm), and SHT (0.77 mm) than those with normotension (0.67 mm; all P<0.001 versus normotension). Compared with normotension, all types of hypertension were also associated with increased likelihood of carotid stenosis (age- and sex-adjusted odds ratio, 2.36 [95% confidence interval, 1.27-4.37] for WCHT, 1.95 [1.25-3.03] for MHT, and 3.02 [2.01-4.54] for SHT). These associations remained significant even after adjustment for other cardiovascular risk factors. CONCLUSIONS WCHT, as well as MHT, and SHT were associated with carotid atherosclerosis in a general Japanese population.
Collapse
Affiliation(s)
- Masayo Fukuhara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Ozawa M, Ninomiya T, Ohara T, Doi Y, Uchida K, Shirota T, Yonemoto K, Kitazono T, Kiyohara Y. Dietary patterns and risk of dementia in an elderly Japanese population: the Hisayama Study. Am J Clin Nutr 2013; 97:1076-82. [PMID: 23553168 DOI: 10.3945/ajcn.112.045575] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To our knowledge, there are no previous reports that assessed the association between dietary patterns and risk of dementia in Asian populations. OBJECTIVE We investigated dietary patterns and their potential association with risk of incident dementia in a general Japanese population. DESIGN A total of 1006 community-dwelling Japanese subjects without dementia, aged 60-79 y, were followed up for a median of 15 y. The reduced rank regression procedure was used to efficiently determine their dietary patterns. Estimated risk conferred by a particular dietary pattern on the development of dementia was computed by using a Cox proportional hazards model. RESULTS Seven dietary patterns were extracted; of these, dietary pattern 1 was correlated with high intakes of soybeans and soybean products, vegetables, algae, and milk and dairy products and a low intake of rice. During the follow-up, 271 subjects developed all-cause dementia. Of these individuals, 144 subjects had Alzheimer disease (AD), and 88 subjects had vascular dementia (VaD). After adjustment for potential confounders, risks of development of all-cause dementia, AD, and VaD were reduced by 0.66 (95% CI: 0.46, 0.95), 0.65 (95% CI: 0.40, 1.06), and 0.45 (95% CI: 0.22, 0.91), respectively, in subjects in the highest quartile of score for dietary pattern 1 compared with subjects in the lowest quartile. CONCLUSION Our findings suggest that a higher adherence to a dietary pattern characterized by a high intake of soybeans and soybean products, vegetables, algae, and milk and dairy products and a low intake of rice is associated with reduced risk of dementia in the general Japanese population.
Collapse
Affiliation(s)
- Mio Ozawa
- Departments of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Tajiri Y, Yonemoto K, Yamada K. Subcutaneous fat of extremities independent of abdominal fat does not promote insulin resistance and cardiovascular risk in Japanese type 2 diabetic patients. Diabetol Int 2013. [DOI: 10.1007/s13340-012-0095-6] [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: 10/27/2022]
|
42
|
Okamura K, Nagata N, Wakamatsu K, Yonemoto K, Ikegame S, Kajiki A, Takayama K, Nakanishi Y. Hypoalbuminemia and lymphocytopenia are predictive risk factors for in-hospital mortality in patients with tuberculosis. Intern Med 2013; 52:439-44. [PMID: 23411698 DOI: 10.2169/internalmedicine.52.8158] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to clarify the association between nutritional state on admission and in-hospital death in tuberculosis (TB) patients, including a high proportion of elderly patients. METHODS A retrospective cohort study of 246 TB patients was conducted. The serum albumin concentrations and peripheral blood lymphocyte counts were measured on admission, and the primary outcome of interest was in-hospital death. Patient mortality was categorized into two groups: TB death and non-TB death. A multivariate analysis was performed to evaluate the relationship between nutritional state on admission and in-hospital mortality in TB patients. RESULTS The median [interquartile range] patient age was 79 [69-83] years, and the in-hospital death rate was 20.73% (TB death: 26 patients; non-TB death: 25 patients). The multivariate analysis revealed that the serum albumin concentrations (OR: 0.21, 95% CI: 0.10-0.41; p<0.0001) and peripheral blood total lymphocyte counts (Category 2 [627.2-1,106.7/mm(3)] vs. 1 [<627.2/mm(3)]. OR: 0.28, 95% CI: 0.11-0.73; p=0.009, Category 3 [>1,106.7/mm(3)] vs. 1. OR: 0.24, 95% CI: 0.08-0.76, p=0.015) on admission were significantly associated with all in-hospital deaths in the TB patients. The serum albumin concentrations and peripheral blood total lymphocyte counts were also found to be associated with in-hospital deaths directly caused by TB. CONCLUSION Hypoalbuminemia and lymphocytopenia on admission are predictive risk factors for in-hospital mortality in TB patients. Nutritional defects should thus receive special attention in order to reduce TB patient mortality, particularly among elderly patients.
Collapse
Affiliation(s)
- Kyoko Okamura
- Department of Respiratory Medicine, National Hospital Organization Omuta National Hospital, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Narazaki K, Nofuji Y, Honda T, Matsuo E, Yonemoto K, Kumagai S. Normative data for the montreal cognitive assessment in a Japanese community-dwelling older population. Neuroepidemiology 2012; 40:23-9. [PMID: 23075757 DOI: 10.1159/000339753] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 05/28/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the Montreal Cognitive Assessment (MoCA) is acknowledged as a promising neuropsychological tool, its normative data for older populations have not been established yet. The purpose of this study was to provide normative data for the MoCA in Japanese community-dwelling older people. METHODS In a Japanese town, 1,977 participants aged 65 years or older (mean age 73.6 years; male 41.3%) completed MoCA tests. After descriptive and regression analyses, normative data were developed for MoCA scores in the population. RESULTS The mean MoCA score observed (21.8 points) was lower than that for normal controls (27.4 points) in the original validation study of the MoCA. Additionally, 82.6% of MoCA scores fell below the standard cutoff of 26 points for detecting mild cognitive impairment (MCI). The regression analysis showed that higher age and fewer years of formal education were associated with lower MoCA scores (p < 0.001). Normative data for MoCA scores were presented with respect to age and education. CONCLUSION This study provided normative data for the MoCA in a Japanese community-dwelling older population. This research also suggests that conventional use of the MoCA as a screening tool for MCI might be problematic in cultures different from that in which the cutoff was developed.
Collapse
Affiliation(s)
- Kenji Narazaki
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | |
Collapse
|
44
|
Shikata K, Ninomiya T, Yonemoto K, Ikeda F, Hata J, Doi Y, Fukuhara M, Matsumoto T, Iida M, Kitazono T, Kiyohara Y. Optimal cutoff value of the serum pepsinogen level for prediction of gastric cancer incidence: the Hisayama Study. Scand J Gastroenterol 2012; 47:669-75. [PMID: 22428879 DOI: 10.3109/00365521.2012.658855] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 02/04/2023]
Abstract
BACKGROUND Serum pepsinogen (sPG) levels have been established as a good marker of chronic atrophic gastritis and the sequential occurrence of gastric cancer. However, there have been few prospective investigations which investigated the predictive performance of sPG for future gastric cancer incidence. SUBJECTS AND METHODS We prospectively followed-up a total of 2446 community-dwelling Japanese aged ≥ 40 years for 10 years and used the Youden's index to determine the cutoff values of the pepsinogen I level and pepsinogen I/II ratio to accurately discriminate gastric cancer events. Predictive performance of sPG was assessed by ROC curve. RESULTS During the follow-up, 69 subjects developed gastric cancer. The most predictive sPG test criteria were determined to be a pepsinogen I level ≤ 59 ng/ml and pepsinogen I/II ratio ≤ 3.9. The sensitivity and specificity of these criteria to discriminate the actual occurrence of gastric cancer were 71.0% and 69.2%, respectively. The area under the ROC curve for gastric cancer occurrence increased significantly by adding the sPG test to the model that included the status of Helicobater pylori infection and other potential risk factors (from 0.742 to 0.809; p for difference in the area < 0.001). CONCLUSIONS This study determined the optimal sPG test criteria for predicting gastric cancer occurrence over 10 years in a general Japanese population. These criteria would be effective to screen for individuals at high risk of this disease.
Collapse
Affiliation(s)
- Kentaro Shikata
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Iida M, Ikeda F, Ninomiya T, Yonemoto K, Doi Y, Hata J, Matsumoto T, Iida M, Kiyohara Y. White blood cell count and risk of gastric cancer incidence in a general Japanese population: the Hisayama study. Am J Epidemiol 2012; 175:504-10. [PMID: 22366378 DOI: 10.1093/aje/kwr345] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The authors examined the association between white blood cell (WBC) count and the development of gastric cancer in a 19-year follow-up study of 2,558 Japanese subjects aged ≥40 years (1988-2007). The subjects were stratified into 4 groups according to baseline WBC quartile (≤4.4, 4.5-5.2, 5.3-6.3, or ≥6.4 × 10(3) cells/μL). During follow-up, 128 subjects developed gastric cancer. The age- and sex-adjusted incidence of gastric cancer increased linearly with higher WBC level: 1.7, 2.6, 3.9, and 5.4 per 1,000 person-years, respectively, for the 4 quartile groups (P for trend < 0.01). The risk of gastric cancer was 2.22-fold (95% confidence interval: 1.19, 4.14) higher in the highest WBC quartile group than in the lowest group after adjustment for confounding factors. With respect to Helicobacter pylori infection status, H. pylori-seropositive subjects in the highest WBC quartile group showed a significantly greater risk of gastric cancer than those in the lower 3 quartile groups, whereas such an association was not observed in H. pylori-seronegative subjects. There was no evidence of heterogeneity in the association (P for heterogeneity = 0.65). The study findings suggest that higher WBC levels are a risk factor for gastric cancer, especially in subjects with H. pylori infection.
Collapse
Affiliation(s)
- Masahiro Iida
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Fukuoka City, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Kaji R, Takedatsu H, Okabe Y, Ishida Y, Sugiyama G, Yonemoto K, Mitsuyama K, Tsuruta O, Sata M. Serum immunoglobulin G4 associated with number and distribution of extrapancreatic lesions in type 1 autoimmune pancreatitis patients. J Gastroenterol Hepatol 2012; 27:268-72. [PMID: 21929654 DOI: 10.1111/j.1440-1746.2011.06933.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [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: 12/15/2022]
Abstract
BACKGROUND AND AIM Type 1 autoimmune pancreatitis (AIP) is characterized by the increase of serum immunoglobulin (Ig)G4 and abundant IgG4 plasma cell infiltration in the pancreas and various extrapancreatic lesions (EPL), which are proposed as IgG4-related disease. We assessed the correlation between serum IgG4 and the number of EPL, and the association between serum IgG4 and the distribution of EPL in type 1 AIP patients. METHODS Serum IgG4 was measured in 35 type 1 AIP patients and 71 non-AIP patients. The clinical characteristics and distribution of eight EPL were determined in 35 type 1 AIP patients. RESULTS Serum IgG4 in type 1 AIP was significantly higher than in non-AIP (P < 0.001). A total of 33 patients had EPL among 35 patients with type 1 AIP (94.3%). There was a significant correlation between serum IgG4 and the number of EPL (ρ = 0.75, P < 0.001). Further, to assess the association between serum IgG4 and the distribution of EPL, type 1 AIP patients were divided into two groups: as abdominal localized EPL and systemic EPL. Both serum IgG4 and total numbers of EPL in systemic EPL were remarkably higher than those in abdominal localized EPL. Serum IgG4 cut-off value was 346 mg/dL to distinguish between abdominal localized EPL and systemic EPL according to the receiver-operator characteristic curve data. CONCLUSIONS Our findings indicated that serum IgG4 was useful in both the diagnosis of type 1 AIP and the detection of systemic EPL. Our finding may help the concept and diagnostic criteria of IgG4-related disease with type 1 AIP.
Collapse
Affiliation(s)
- Ryohei Kaji
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Koike K, Fukami K, Yonemoto K, Iwatani R, Obata R, Ueda K, Toyonaga M, Ueda S, Ohara A, Takeda K, Yamagishi SI, Okuda S. A new vasculitis activity score for predicting death in myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis patients. Am J Nephrol 2012; 35:1-6. [PMID: 22134171 DOI: 10.1159/000334357] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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: 08/01/2011] [Accepted: 10/06/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND/AIMS Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-positive microscopic polyangiitis patients with renal involvement have been shown to have a progressive clinical course. In this study, we compared the clinical utility of the Japanese Vasculitis Activity Score (JVAS) with the Birmingham Vasculitis Activity Score (BVAS) for predicting death in patients with MPO-ANCA-associated renal involvement. METHODS Sixty-nine patients with MPO-ANCA-associated vasculitis with renal involvement (22 males and 47 females, age 69.8 ± 8.7 years) were enrolled in this study. We retrospectively investigated which score was better for predicting the poor prognosis of patients. RESULTS The mortality rate of the patients within 2 years after disease onset was 33% (23/69). JVAS was not correlated with BVAS. Univariate logistic regression analysis for death showed that the odds ratio (OR) of JVAS was statistically significant (OR 1.76, 95% confidence interval, CI, 1.29-2.41, p < 0.001), while that of BVAS was not (OR 1.07, 95% CI 0.98-1.16, p = 0.14). Moreover, a multivariate model showed that JVAS was an independent determinant of death (OR 1.59, 95% CI 1.12-2.25, p = 0.009). The area under the receiver operating characteristic curve for JVAS was 0.778, which was significantly larger (p = 0.02) than that for BVAS (0.586). The estimated optimal cut-off point of JVAS for the prediction of death was 5. At this point, the sensitivity was 82.6% and the specificity was 60.9%. CONCLUSION We demonstrated that compared with BVAS, JVAS was a simpler and more reliable measure for predicting death in patients with MPO-ANCA-associated vasculitis with renal involvement.
Collapse
Affiliation(s)
- Kiyomi Koike
- Division of Nephrology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Doi N, Sakamoto T, Sonoda Y, Yasuda M, Yonemoto K, Arimura N, Uchino E, Ishibashi T. Comparative study of vitrectomy versus intravitreous triamcinolone for diabetic macular edema on randomized paired-eyes. Graefes Arch Clin Exp Ophthalmol 2011; 250:71-8. [PMID: 21853229 DOI: 10.1007/s00417-011-1777-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 07/11/2011] [Accepted: 07/28/2011] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The present study was performed to compare the effects of pars plana vitrectomy (PPV) and single intravitreaous triamcinolone acetonide (IVTA) on diabetic macular edema (DME) in paired eyes. METHODS Prospective comparative study on randomized paired-eyes was carried out at two hospitals. Forty eyes of 20 patients with bilateral DME were included. One randomly-selected eye was treated with PPV (PPV group), and the other eye was treated with IVTA (4 mg, IVTA group). The central macular thickness (CMT) measured by optical coherence tomography (OCT) and best-corrected visual acuity (BCVA) were monitored for 12 months after treatment. Changes from baseline and differences between groups were analyzed using a mixed model. RESULTS At 1 and 3 months, CMT decreased significantly in the IVTA group compared to baseline (p < 0.0001 both), but CMT then increased gradually and no significant difference was found at 12 months (p = 0.90). In the PPV group, CMT decreased continuously and reached a significant level at 12 months (p < 0.0001). CMT of the IVTA group was significantly less than that of the PPV group at 1 month (p = 0.009); however, there was no significant difference at 3 months. Conversely, CMT was significantly less in the PPV group than in the IVTA group at 12 months (p = 0.0003). The changes of BCVA paralleled those of CMT, but no significant difference was detected between baseline BCVA and any time point. CONCLUSIONS Despite the short-term improvement, DME recurred 6 months after IVTA, while it remained resolved after PPV. Although this study did not reveal a significant change of BCVA with either treatment, PPV resolved DME more effectively than IVTA at 1 year.
Collapse
Affiliation(s)
- Norihito Doi
- Department of Ophthalmology Faculty of Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Yasuda M, Kiyohara Y, Wang JJ, Arakawa S, Yonemoto K, Doi Y, Ninomiya T, Ishibashi T. High serum bilirubin levels and diabetic retinopathy: the Hisayama Study. Ophthalmology 2011; 118:1423-8. [PMID: 21600659 DOI: 10.1016/j.ophtha.2010.12.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [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: 06/17/2010] [Revised: 10/30/2010] [Accepted: 12/09/2010] [Indexed: 01/23/2023] Open
Abstract
PURPOSE To assess the association between serum total bilirubin levels and diabetic retinopathy prevalence in participants of the Hisayama Study who had diabetes and impaired glucose metabolism. DESIGN Population-based, cross-sectional study. PARTICIPANTS Of 3119 participants of the Hisayama Study Eye Examinations in 2007, Japan, 1672 aged ≥40 years with either diabetes or impaired glucose metabolism (defined by a 75-g oral glucose tolerance test) were enrolled in the present study. METHODS Diabetic retinopathy was assessed via ophthalmic examination after pupil dilatation. The presence and the severity of diabetic retinopathy were determined by grading of color fundus photographs using the modified Airlie House classification system. Association of diabetic retinopathy with serum bilirubin quartiles was assessed using logistic regression model adjusting for age and known risk factors for diabetic retinopathy. MAIN OUTCOME MEASURES Prevalent diabetic retinopathy. RESULTS Diabetic retinopathy was present in 70 of 1672 (4.2%) participants. The prevalence of diabetic retinopathy in persons with the highest bilirubin quartile (≥0.9 mg/dL) was 2.7%, compared with the prevalence of 3.4%, 5.1%, and 5.1% in those with the first (<0.6 mg/dL), second (0.6-0.69 mg/dL), and third quartiles (0.7-0.89 mg/dL). After adjusting for factors known to be associated with diabetic retinopathy, the prevalence was significantly lower among persons with the highest bilirubin quartile compared with those with the lowest quartile (odds ratio [OR], 0.25; 95% confidence interval [CI], 0.09-0.72) or compared with those in the 3 lower quartiles (OR, 0.25; 95% CI, 0.11-0.58). CONCLUSIONS Elevated serum bilirubin levels may be protective against diabetic retinopathy among persons with either diabetes or impaired glucose metabolism, independent of known risk factors for diabetic retinopathy.
Collapse
Affiliation(s)
- Miho Yasuda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Yoh J, Nishi Y, Hosoda H, Tajiri Y, Yamada K, Yanase T, Doi R, Yonemoto K, Kangawa K, Kojima M, Tanaka E, Kusukawa J. Plasma levels of n-decanoyl ghrelin, another acyl- and active-form of ghrelin, in human subjects and the effect of glucose- or meal-ingestion on its dynamics. ACTA ACUST UNITED AC 2011; 167:140-8. [DOI: 10.1016/j.regpep.2010.12.010] [Citation(s) in RCA: 13] [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] [Received: 10/15/2010] [Revised: 12/08/2010] [Accepted: 12/29/2010] [Indexed: 10/18/2022]
|