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Kubo T, Sunami K, Koyama T, Kitami M, Fujiwara Y, Kondo S, Yonemori K, Noguchi E, Morizane C, Goto Y, Maejima A, Iwasa S, Hamaguchi T, Kawai A, Namikawa K, Arakawa A, Sugiyama M, Ohno M, Yoshida T, Hiraoka N, Yoshida A, Yoshida M, Nishino T, Furukawa E, Narushima D, Nagai M, Kato M, Ichikawa H, Fujiwara Y, Kohno T, Yamamoto N. The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology. ESMO Open 2024; 9:102981. [PMID: 38613908 PMCID: PMC11033064 DOI: 10.1016/j.esmoop.2024.102981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP. MATERIALS AND METHODS A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response. RESULTS Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively). CONCLUSION Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.
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Affiliation(s)
- T Kubo
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo
| | - K Sunami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Division of Genome Biology, National Cancer Center Research Institute, Tokyo
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo
| | - M Kitami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - Y Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi
| | - S Kondo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - K Yonemori
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - E Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - Y Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - A Maejima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo; Department of Urology, National Cancer Center Hospital, Tokyo
| | - S Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Hamaguchi
- Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama
| | - A Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo
| | - A Arakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Sugiyama
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo
| | - T Yoshida
- Department of Genetic Services and Medicine, National Cancer Center Hospital, Tokyo
| | - N Hiraoka
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - A Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - M Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - T Nishino
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - E Furukawa
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - D Narushima
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Nagai
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Kato
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - H Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - Y Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - N Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo.
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Kouzu K, Tsujimoto H, Ishinuki T, Shinji S, Shinkawa H, Tamura K, Uchino M, Ohge H, Shimizu J, Haji S, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Hanai Y, Nobuhara H, Imaoka H, Yoshida M, Mizuguchi T, Mayumi T, Kitagawa Y. The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. J Hosp Infect 2024; 146:174-182. [PMID: 37734678 DOI: 10.1016/j.jhin.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
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Affiliation(s)
- K Kouzu
- Department of Surgery, National Defense Medical College, Japan
| | - H Tsujimoto
- Department of Surgery, National Defense Medical College, Japan.
| | - T Ishinuki
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - S Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Japan
| | - H Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - K Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - M Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Japan
| | - H Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - J Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Japan
| | - S Haji
- Department of Surgery, Soseikai General Hospital, Japan
| | - Y Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Japan
| | - C Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Japan
| | - Y Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Japan
| | - K Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Japan
| | - M Kobayashi
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Japan
| | - Y Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Japan
| | - H Nobuhara
- Department of Dentistry, Hiroshima Prefectural Hospital, Japan
| | - H Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Japan
| | - M Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Japan
| | - T Mizuguchi
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - T Mayumi
- Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Japan
| | - Y Kitagawa
- Keio University, School of Medicine, Japan
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Kin F, Itoh K, Bando T, Shinohara K, Oyama N, Terakado A, Yoshida M, Sumida S. Impact of avalanche type of transport on internal transport barrier formation in tokamak plasmas. Sci Rep 2023; 13:19748. [PMID: 37957265 PMCID: PMC10643559 DOI: 10.1038/s41598-023-46978-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
In magnetic fusion plasmas, a transport barrier is essential to improve the plasma confinement. The key physics behind the formation of a transport barrier is the suppression of the micro-scale turbulent transport. On the other hand, long-range transport events, such as avalanches, has been recognized to play significant roles for global profile formations. In this study, we observed the impact of the avalanche-type of transport on the formation of a transport barrier for the first time. The avalanches are found to inhibit the formation of the internal transport barrier (ITB) observed in JT-60U tokamak. We found that (1) ITBs do not form in the presence of avalanches but form under the disappearance of avalanches, (2) the surface integral of avalanche-driven heat fluxe is comparable to the time rate change of stored energy retained at the ITB onset, (3) the mean E × B flow shear is accelerated via the ion temperature gradient that is not sustained under the existence of avalanches, and (4) after the ITB formation, avalanches are damped inside the ITB, while they remain outside the ITB.
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Affiliation(s)
- F Kin
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan.
- Institute of Advanced Energy, Kyoto University, Uji, 611-0011, Japan.
| | - K Itoh
- Frontier Research Institute, Chubu University, Kasugai, 487-8501, Japan
- Research Center for Plasma Turbulence, Kyushu University, Kasuga, 816-8580, Japan
| | - T Bando
- Toyohashi University of Technology, Toyohashi, 441-8580, Japan
| | - K Shinohara
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
- The University of Tokyo, Kashiwa, 277-8561, Japan
| | - N Oyama
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - A Terakado
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - M Yoshida
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
| | - S Sumida
- National Institutes for Quantum Science and Technology, Naka, 311-0193, Japan
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Hida K, Hirano S, Poudel S, Kurashima Y, Stefanidis D, Hashimoto D, Akiyama H, Eguchi S, Fukui T, Hagiwara M, Izaki T, Kawamoto S, Otomo Y, Nagai E, Takami H, Takeda Y, Toi M, Yamaue H, Yoshida M, Yoshida S, Kodera Y, Saito M. The degree of satisfaction and level of learning in male and female surgical residents: a nationwide questionnaire survey of graduating residents in Japan. Surg Today 2023; 53:1275-1285. [PMID: 37162584 DOI: 10.1007/s00595-023-02683-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 03/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Since 2002, the Japan Surgical Society has established a board certification system for surgeons to be certified for a specialty. Surgery remains a male-dominated field in Japan. This study aimed to clarify if the Japanese surgical residency training system is equally suitable for female and male residents. METHODS The Japan Surgical Society conducted the first questionnaire survey regarding the system of surgical training for the residents in 2016. The questionnaire included the degree of satisfaction with 7 aspects of the training system, including the number and variety of cases experienced and duration and quality of instruction, and the learning level for 31 procedures. The degree of satisfaction and level of learning were compared between female and male residents. RESULTS The degree of satisfaction was similar for all items between female and male residents. Female residents chose breast surgery as their subspecialty more frequently than male residents and were more confident in breast surgery procedures than male residents. Conversely, fewer female residents chose gastrointestinal surgery and were less confident in gastrointestinal surgery procedures than male residents. CONCLUSION Female residents were as satisfied with the current surgical training system as male residents. However, there may be room for improvement in the surgical system, considering that fewer applications for gastrointestinal surgery come from female residents than from males.
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Affiliation(s)
- Koya Hida
- Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Dimitrios Stefanidis
- Department of Surgery, School of Medicine, Indiana University, Indianapolis, USA
| | | | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University, Kumamoto, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Tomoko Izaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Takeda
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motofumi Yoshida
- Department of Medical Education, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Shigetoshi Yoshida
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
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Yoshii Y, Jimbo K, Hashiguchi H, Shikata S, Ogawa A, Watase C, Shiino S, Murata T, Yoshida M, Takayama S, Suto A. P173 Should positive surgical margin involvement of in situ carcinoma of invasive breast cancer after breast conserving surgery be treated with additional resection? Breast 2023. [DOI: 10.1016/s0960-9776(23)00290-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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Tokuzawa T, Nasu T, Inagaki S, Moon C, Ido T, Idei H, Ejiri A, Imazawa R, Yoshida M, Oyama N, Tanaka K, Ida K. 3D metal powder additive manufacturing phased array antenna for multichannel Doppler reflectometer. Rev Sci Instrum 2022; 93:113535. [PMID: 36461436 DOI: 10.1063/5.0101723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/07/2022] [Indexed: 06/17/2023]
Abstract
Measuring the time variation of the wavenumber spectrum of turbulence is important for understanding the characteristics of high-temperature plasmas, and the application of a Doppler reflectometer with simultaneous multi-frequency sources is expected. To implement this diagnostic in future fusion devices, the use of a phased array antenna (PAA) that can scan microwave beams without moving antennas is recommended. Since the frequency-scanning waveguide leaky-wave antenna-type PAA has a complex structure, we have investigated its characteristics by modeling it with 3D metal powder additive manufacturing (AM). First, a single waveguide is fabricated to understand the characteristics of 3D AM techniques, and it is clear that there are differences in performance depending on the direction of manufacture and surface treatment. Then, a PAA is made, and it is confirmed that the beam can be emitted in any direction by frequency scanning. The plasma flow velocity can be measured by applying the 3D manufacturing PAA to plasma measurement.
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Affiliation(s)
- T Tokuzawa
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
| | - T Nasu
- The Graduate University for Advanced Studies, SOKENDAI, Toki 509-5292, Japan
| | - S Inagaki
- Institute of Advanced Energy, Kyoto University, Gokasho, Uji 611-0011, Japan
| | - C Moon
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - T Ido
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - H Idei
- Research Institute for Applied Mechanics, Kyushu University, Kasuga 816-8580, Japan
| | - A Ejiri
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa 277-8561, Japan
| | - R Imazawa
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - M Yoshida
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - N Oyama
- National Institutes for Quantum Science and Technology, 801-1 Mukoyama, Naka, Ibaraki 311-0193, Japan
| | - K Tanaka
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
| | - K Ida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki 509-5292, Japan
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Osaka M, Yoshida M. Citrullination of histoneH3 in neutrophil via CXCL1 enhances neutrophil adhesion to femoral artery of LDLR−/− mice fed HFD. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Vascular inflammation plays an important role in the development of atherosclerosis. Previously we have shown that a high-fat diet (HFD) increased neutrophil adhesion to the vascular intima in wild-type (wt) mice (Osaka M. Sci Rep. 2016). However, the involvement of neutrophils in atherosclerosis-related vascular inflammation is not well known.
Purpose
This study examined that neutrophil extracellular trap (NETs) or the hypercitrullination of histone H3 in neutrophils enhances neutrophil adhesion to atheroprone-arteries in LDL receptor null (LDLR−/−) mice.
Methods
We observed leukocyte adhesion in the femoral artery of LDLR−/− mice fed normal chow (NC) or HFD, and determined leukocyte subtype that adhered on vascular endothelium under neutrophil or monocyte depletion using intravital microscopy. Importantly, neutrophil adhesion was examined under the administration of TDFA which inhibits NETs and citrullination of histone H3, in LDLR−/− mice fed HFD. Furthermore, immunohistochemistry for citrullinated histone H3 in peripheral neutrophils of mice was examined. Comprehensive cytokine/chemokine analysis for a plasma of mice was performed to determine the factors citrullinating histone H3 in LDLR−/− mice. Moreover, these mice were treated with a novel specific PPARα agonist, to reduce the elevation of plasma triglyceride levels.
Results
Leukocyte adhesion in LDLR−/− mice fed HFD significantly increased compared to NC. More interestingly, it significantly enhanced compared to wt mice fed HFD. Furthermore, neutrophil depletion rather than monocyte depletion diminished leukocyte adhesion, suggesting that the leukocyte subtype that adhered in LDLR−/− mice fed HFD was neutrophil. Neutrophil adhesion in these mice significantly was reduced by the administration of TDFA, suggesting a pivotal role for histone H3 citrullination in neutrophil adhesion. Moreover, citrullination of histone H3 in neutrophils from LDLR−/− mice fed HFD but not from those without HFD was significantly enhanced. In addition, comprehensive cytokine/chemokine analysis revealed an increase of CXCL1 in plasma of LDLR−/− mice fed HFD. CXCL1 enhanced neutrophil adhesion to HUVECs, and the adhesion significantly decreased by the treatment of TDFA to neutrophil in vitro non-static adhesion assay. These results showed that CXCL1 enhanced neutrophil adhesion in LDLR−/− mice fed HFD through citrullination. Furthermore, when these mice were treated with PPARα agonist, observed histone citrullination, as well as neutrophil adhesion, was significantly reduced.
Conclusion
These results suggest that HFD induced histone citrullination in neutrophils in LDLR−/− mice and PPARα agonist plays a role during hypertriglyceridemia-mediated vascular inflammation in atherosclerosis.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research(C)
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Affiliation(s)
- M Osaka
- Tokyo Medical and Dental University , Tokyo , Japan
| | - M Yoshida
- Tokyo Medical and Dental University , Tokyo , Japan
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Kim M, Baumlin N, Mohiuddin M, Yoshida M, Dennis J, Bengtson C, Salathe M. 426 Metformin improves high mobility group box protein 1–induced mucociliary dysfunction in cystic fibrosis airway epithelial cells. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)01116-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Yoshida M, Zoshima T, Kawano M. AB0270 EFFECT OF METHOTREXATE USE ON JOINT AND LUNG DISEASE OUTCOMES IN PATIENTS HAVING RHEUMATOID ARTHRITIS WITH INTERSTITIAL LUNG DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundInterstitial lung disease (ILD) is a frequent complication of rheumatoid arthritis (RA). Although methotrexate (MTX) is an anchor drug for RA management, its use may worsen lung disease severity in patients with RA related ILD (RA-ILD). The safety and efficacy of MTX use in RA-ILD treatment have not been elucidated.ObjectivesWe aimed to clarify the clinical characteristics of patients with RA-ILD and the effect of MTX use on joint and lung disease outcomes.MethodsIn this retrospective study, we included patients with RA-ILD who visited our department from 2011 to 2019 and underwent chest computed tomography (CT). RA was diagnosed using the 1987 ACR criteria or the 2010 ACR/EULAR classification criteria. During the abovementioned period, we defined the baseline as the time of the first chest CT scan; moreover, the final observation was defined as the time of the final chest CT scan in patients who underwent CT more than once, or as the final visit in those without a second chest CT scan. We excluded patients whose RA-ILD status could not be fully evaluated using chest CT scans due to other causes, including respiratory infections. Severe infections were defined as infectious events requiring hospitalization.To identify the clinical characteristics of patients with RA-ILD, we compared the features of RA with versus without ILD at baseline. To clarify the effect of MTX use on RA-ILD outcomes, we compared the outcomes of patients with RA-ILD with versus without MTX use. Furthermore, we investigated factors associated with RA disease activity or ILD deterioration using multivariate analyses.ResultsIn this study, we included 452 patients (mean age, 60.2 years; females, 78.5%; mean observational period, 77.5 months), 325 (71.9%) of whom underwent chest CT more than two times.Patients with ILD (ILD; n=90, 19.9%) were older and had a higher RF positivity rate than those without ILD. Moreover, patients with ILD were treated with lower MTX use (20.2% vs. 52.9%, p<0.001; 1.46 vs. 3.53 mg/week, p<0.001) and TNF inhibitors exposure (21.1% vs. 13.1%, p<0.044) than those without ILD, albeit with similar uses of prednisolone and other bDMARDs, including tocilizumab and abatacept. DAS28-CRP was higher in patients with than in those without ILD at baseline (4.60 vs. 3.42, p=0.063) and at the final observation (2.42 vs. 2.09, p=0.025). Linear regression analysis showed that baseline age and ILD were significantly associated with DAS28-CRP at the final observation (β=0.206 and 0.173, respectively). Kaplan Meier analysis revealed that patients with ILD experienced severe infections and respiratory infections more frequently than those without ILD (log-rank test, p<0.001 and p<0.001).Seventeen patients (20.2%) with ILD were treated with MTX. At baseline, these patients had similar ages and RF/ACPA positivity rates, as well as prednisolone and tDMARDs exposures, with higher bDMARD exposure (41.2 vs. 13.4%, p=0.016) compared to that in ILD patients without MTX use. DAS28-CRP was comparable in patients with and without MTX use at baseline, but was lower at the final observation in MTX-treated patients with ILD (1.41 vs. 2.73, p<0.001). Kaplan Meier analyses revealed no differences in the frequencies of severe infections, respiratory infections, or ILD deterioration between patients with and without MTX use. Cox regression analysis demonstrated that the risk factors for ILD deterioration included baseline age (hazard ratio [HR] 1.088; 95% confidence interval [CI] 1.037-1.147), but not MTX use (HR 1.666; 95% CI 0.472-5.876).ConclusionRA-ILD were treated with lower MTX use, which resulted in higher RA disease activity. In contrast, patients with RA-ILD treated with MTX had lower RA disease activity without ILD deterioration. As RA-ILD is undertreated, appropriate MTX use may be required for effective RA-ILD treatmentReferences[1]Arthritis Rheumatol 2021;73:1108-23.Disclosure of InterestsNone declared
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Tsuge S, Fujii H, Tamai M, Mizushima I, Yoshida M, Suzuki N, Takahashi Y, Takeji A, Horita S, Fujisawa Y, Matsunaga T, Zoshima T, Nishioka R, Nuka H, Hara S, Tani Y, Suzuki Y, Ito K, Yamada K, Nakazaki S, Kawakami A, Kawano M. POS1339 FACTORS RELATED TO SERUM IgG4 ELEVATION AND DEVELOPMENT OF IgG4-RELATED DISEASE: DATA FROM RESIDENT EXAMINATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundElevated serum IgG4 levels are one of the characteristic findings in immunoglobulin G4 (IgG4)-related disease (IgG4-RD). Serum IgG4 levels have an impact to a certain extent on the diagnosis of IgG4-RD although there are some issues in their sensitivity and specificity. In the reports from Japan, China, USA, and Europe, elevated serum IgG4 levels were reported to be observed in 83-97% of patients with IgG4-RD [1-5]. In the past investigations of hospital patients, some studies reported that 10-15% of hospital patients with elevated serum IgG4 levels had IgG4-RD [6,7]. However, in general adults with no symptom, investigations of prevalence of elevated serum IgG4 levels and/or IgG4-RD have rarely been conducted.ObjectivesThis study aimed to investigate the frequency of serum IgG4 elevation in the general Japanese population and its associated factors using data from resident examinations.MethodsWe measured the serum IgG4 levels in 1,204 residents who underwent a general medical examination in Ishikawa prefecture, Japan. Logistic regression analysis was used to search for factors related to elevated serum IgG4 levels. Secondary examinations were conducted for participants in whom elevation was identified.ResultsThe mean serum IgG4 level was 44 mg/dL, and elevated serum IgG4 levels were observed in 42 patients (3.5%). Univariate logistic regression analyses showed that male sex, older age, lower estimated glomerular filtration rates based on cystatin C (eGFR-CysC), serum high-density lipoprotein cholesterol levels, and higher hemoglobin A1c (HbA1c) levels were associated with elevated serum IgG4 levels. Subgroup analyses in men showed that older age, lower eGFR-CysC levels, and higher serum HbA1c levels were associated with elevated serum IgG4 levels. In contrast, the analyses in women found no significant factors. One of the 10 residents who underwent secondary examinations was diagnosed with possible IgG4-related retroperitoneal fibrosis.ConclusionIn the general population, elevated serum IgG4 levels are more common in elderly men, which is similar to the epidemiological features of IgG4-RD.References[1]Inoue D, et al. IgG4-related disease: dataset of 235 consecutive patients. Medicine (Baltimore). 2015;94(15):e680.[2]Yamada K, et al. New clues to the nature of immunoglobulin G4-related disease: a retrospective Japanese multicenter study of baseline clinical features of 334 cases. Arthritis Res Ther. 2017;19(1):262[3]Culver EL, et al. Elevated serum IgG4 levels in diagnosis, treatment response, organ involvement, and relapse in a prospective IgG4-related disease UK cohort. Am J Gastroenterol 2016;111:733–43.[4]Lin W, et al. Clinical characteristics of immunoglobulin G4-related disease: a prospective study of 118 Chinese patients. Rheumatology (Oxford). 2015;54(11):1982–90.[5]Carruthers MN, et al. The diagnostic utility of serum IgG4 concentrations in IgG4-related disease. Ann Rheum Dis 2015;74:14-18.[6]James Yun, et al. Poor positive predictive value of serum immunoglobulin G4 concentrations in the diagnosis of immunoglobulin G4-related sclerosing disease. Asia Pac Allergy. 2014 Jul;4(3):172-176.[7]Taiwo N Ngwa, et al. Sreum immunoglobulin G4 level is a poor predictor of immunoglobulin G4–related disease. Pancreas. 2014 Jul;43(5):704-7.Disclosure of InterestsNone declared
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Kato H, Nemoto K, Shimizu M, Abe A, Asai S, Ishihama N, Matsuoka S, Daimon T, Ojika M, Kawakita K, Onai K, Shirasu K, Yoshida M, Ishiura M, Takemoto D, Takano Y, Terauchi R. Recognition of pathogen-derived sphingolipids in Arabidopsis. Science 2022; 376:857-860. [PMID: 35587979 DOI: 10.1126/science.abn0650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In plants, many invading microbial pathogens are recognized by cell-surface pattern recognition receptors, which induce defense responses. Here, we show that the ceramide Phytophthora infestans-ceramide D (Pi-Cer D) from the plant pathogenic oomycete P. infestans triggers defense responses in Arabidopsis. Pi-Cer D is cleaved by an Arabidopsis apoplastic ceramidase, NEUTRAL CERAMIDASE 2 (NCER2), and the resulting 9-methyl-branched sphingoid base is recognized by a plasma membrane lectin receptor-like kinase, RESISTANT TO DFPM-INHIBITION OF ABSCISIC ACID SIGNALING 2 (RDA2). 9-Methyl-branched sphingoid base is specific to microbes and induces plant immune responses by physically interacting with RDA2. Loss of RDA2 or NCER2 function compromised Arabidopsis resistance against an oomycete pathogen. Thus, we elucidated the recognition mechanisms of pathogen-derived lipid molecules in plants.
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Affiliation(s)
- H Kato
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - K Nemoto
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - M Shimizu
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - A Abe
- Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
| | - S Asai
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan
| | - N Ishihama
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan
| | - S Matsuoka
- RIKEN Center for Sustainable Resource Science, Wako 351-0198, Japan
| | - T Daimon
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - M Ojika
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - K Kawakita
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - K Onai
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - K Shirasu
- RIKEN Center for Sustainable Resource Science, Yokohama 230-0045, Japan.,Graduate School of Science, The University of Tokyo, Tokyo 113-8654, Japan
| | - M Yoshida
- RIKEN Center for Sustainable Resource Science, Wako 351-0198, Japan.,Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-8657, Japan
| | - M Ishiura
- Graduate School of Science, Nagoya University, Nagoya 464-8601, Japan
| | - D Takemoto
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - Y Takano
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan
| | - R Terauchi
- Graduate School of Agriculture, Kyoto University, Kyoto 606-8502, Japan.,Iwate Biotechnology Research Center, Kitakami 024-0003, Japan
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Horii C, Iidaka T, Muraki S, Oka H, Asai Y, Tsutsui S, Hashizume H, Yamada H, Yoshida M, Kawaguchi H, Nakamura K, Akune T, Oshima Y, Tanaka S, Yoshimura N. The cumulative incidence of and risk factors for morphometric severe vertebral fractures in Japanese men and women: the ROAD study third and fourth surveys. Osteoporos Int 2022; 33:889-899. [PMID: 34797391 DOI: 10.1007/s00198-021-06143-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/30/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED This population-based cohort study with a 3-year follow-up revealed that the annual incidence rates of vertebral fracture (VF) and severe VF (sVF) were 5.9%/year and 1.7%/year, respectively. The presence of mild VF at the baseline was a significant risk factor for incident sVF in participants without prevalent sVF. INTRODUCTION This study aimed to estimate the incidence of morphometric vertebral fracture (VF) and severe VF (sVF) in men and women and clarify whether the presence of a mild VF (mVF) increases the risk of incident sVF. METHODS Data from the population-based cohort study, entitled the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) study, were analyzed. In total, 1190 participants aged ≥ 40 years (mean age, 65.0 ± 11.2) years completed whole-spine lateral radiography both at the third (2012-2013, baseline) and fourth surveys performed 3 years later (2015-2016, follow-up). VF was defined using Genant's semi-quantitative (SQ) method: VF as SQ ≥ 1, mVF as SQ = 1, and sVF as SQ ≥ 2. Cumulative incidence of VF and sVF was estimated. Multivariate logistic regression analyses were performed to evaluate risk factors for incident sVF. RESULTS The baseline prevalence of mVF and sVF were 16.8% and 6.0%, respectively. The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The annual incidence rates of sVF in participants without prevalent VF, with prevalent mVF, and with prevalent sVF were 0.6%/year, 3.8%/year, and 11.7%/year (p < 0.001), respectively. Multivariate logistic regression analyses in participants without prevalent sVF showed that the adjusted odds ratios for incident sVF were 4.12 [95% confident interval 1.85-9.16] and 4.53 [1.49-13.77] if the number of prevalent mVF at the baseline was 1 and ≥ 2, respectively. CONCLUSIONS The annual incidence rates of VF and sVF were 5.9%/year and 1.7%/year, respectively. The presence of prevalent mVF was an independent risk factor for incident sVF.
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Affiliation(s)
- C Horii
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - T Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Y Asai
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - S Tsutsui
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - M Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8510, Japan
| | - H Kawaguchi
- Department of Orthopaedic Surgery, Tokyo Neurological Center, 4-1-17, Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - K Nakamura
- Department of Orthopaedics, Towa Hospital, Towa 4-7-10, Adachi-ku, Tokyo, 120-0003, Japan
| | - T Akune
- Department of Orthopaedics, National Rehabilitation Center for Persons With Disabilities, 4-1 Namiki, Tokorozawa City, Saitama, 359-0042, Japan
| | - Y Oshima
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
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Odagawa S, Watari T, Yoshida M. Chinkui dermatitis: the sea bather's eruption. QJM 2022; 115:100-101. [PMID: 34791435 DOI: 10.1093/qjmed/hcab277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Odagawa
- From the General Medicine Center, Shimane University Hospital, Shimane, Japan
- Department of General Medicine, Oki Hospital, ShimaneJohoku-cho 335, Okinoshima-cho, Oki, Shimane, 685-0016, JAPANTEL 08512-2-1356
| | - T Watari
- From the General Medicine Center, Shimane University Hospital, Shimane, Japan
| | - M Yoshida
- Marine Biological Science Section, Education and Research Center for Biological Resources, Faculty of Life and Environmental Science, Shimane UniversityKamo 194, Okinoshima-cho, Oki, Shimane, 685-0024, JAPANTEL 08512-3-1007
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14
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Terakado A, Koide Y, Yoshida M, Nakano T, Homma H, Oyama N. Design of Heat-Resistant in-Vessel Components for Deuterium Beam-Aided Charge Exchange Recombination Spectroscopy in JT-60SA. Fusion Science and Technology 2022. [DOI: 10.1080/15361055.2021.1951529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A. Terakado
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - Y. Koide
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - M. Yoshida
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - T. Nakano
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - H. Homma
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
| | - N. Oyama
- National Institutes for Quantum and Radiological Science and Technology, Naka, Ibaraki 311-0193, Japan
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Bengtson C, Yoshida M, Baumlin N, Dennis J, Kim M, Salathe M. 363: Losartan increases the efficacy of CFTR modulators to reverse inflammation-related mucociliary dysfunction. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Miyoshi T, Nakamura K, Amioka N, Yonezawa T, Kondo M, Saito Y, Yoshida M, Akagi S, Ito H. Sacubitril/valsartan ameliorates doxorubicin-induced cardiomyocyte toxicity through inhibiting oxidative stress in rats. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Doxorubicin (DOX)-based chemotherapy induces cardiotoxicity, which is considered the main limitation of its clinical application.
Purpose
The present study investigated the potential protective effect of sacubitril/valsartan, an angiotensin receptor–neprilysin inhibitor, against DOX-induced cardiotoxicity in rats and H9c2 cells, and whether the underlying mechanism for any such protection involves its antioxidant activity.
Methods
Male Sprague-Dawley rats were randomly divided into four groups: DOX (1.5 mg/kg/day intraperitoneally for 10 days), DOX+valsartan (31 mg/kg/day by gavage from day 1 to day 18), DOX+sacubitril/valsartan (68 mg/kg/day by gavage from day 1 to day 18), and control (saline intraperitoneally for 10 days). There were 15 rats in each group. At the end of the treatment period, samples were collected and analysed. Cardiac function, tissue morphology, and reactive oxygen species (ROS) were evaluated in rats. Serum levels of Malondialdehyde (MDA) and cardiac troponin T were also measured. Mitochondrial ROS production and cell viability were evaluated in H9c2 cells.
Results
DOX-induced cardiac dysfunction was not prevented by valsartan and sacubitril/valsartan in this model. However, the serum level of cardiac troponin T on day 18 was increased in the DOX group (0.046±0.006 ng/mL, p<0.01 vs. control) and significantly reduced in the DOX+sacubitril/valsartan group (0.039±0.007 ng/mL, p=0.03 vs. DOX), but not in the DOX+valsartan group (0.046±0.005 ng/mL, p=1.00 vs. DOX). Regarding the effect of sacubitril/valsartan on fibrosis in rat myocardium, Masson's trichrome staining showed increased intestinal fibrosis in the DOX group compared to that in the control group (1.35±0.07% and 0.49±0.04%, p<0.01) and significantly decreased intestinal fibrosis in the DOX+sacubitril/valsartan group (1.08±0.08%), but not in the DOX+ valsartan group (1.15±0.05%) compared to that in the DOX group (p=0.01 and p=0.15, respectively). The fluorescence intensity of dihydroethidium as a measure of ROD production in left ventricle, which was increased in the DOX group (1.56±0.07), was significantly reduced in the DOX+sacubitril/valsartan group (1.44±0.05, p=0.03), but not in the DOX+valsartan group (1.29±0.06, p=1.00). On day 11, the serum MDA level, which was increased in the DOX group, was significantly reduced in the DOX+ sacubitril/valsartan group (p=0.02), but not in the DOX+ valsartan group (p=0.75). In H9c2 cells, sacubitril/valsartan reduced DOX-induced mitochondrial ROS generation by 25%, which was more marked than valsartan-induced ROS generation (p<0.01 and p=0.01, respectively). Sacubitril/valsartan improved cell viability more markedly than valsartan. Thus, DOX-induced cytotoxicity in H9c2 cells was improved by sacubitril/valsartan, but not valsartan.
Conclusions
Sacubitril/valsartan protected rat hearts from DOX-induced cardiotoxicity in vivo and in vitro by decreasing oxidative stress.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This work was supported by Novartis Pharma K.K.
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Affiliation(s)
| | | | - N Amioka
- Okayama University, Okayama, Japan
| | | | - M Kondo
- Okayama University, Okayama, Japan
| | - Y Saito
- Okayama University, Okayama, Japan
| | | | - S Akagi
- Okayama University, Okayama, Japan
| | - H Ito
- Okayama University, Okayama, Japan
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Yoshida M, Saito M. Neutrophil-Reduced Platelet Rich Plasma with Optimal Platelets Concentrations for Epicondylitis of the Elbow. Muscles Ligaments Tendons J 2021. [DOI: 10.32098/mltj.03.2021.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Yazaki S, Shimoi T, Yoshida M, Okuma H, Kita S, Yamamoto K, Kojima Y, Nishikawa T, Tanioka M, Sudo K, Noguchi E, Murata T, Takayama S, Suto A, Yonemori K. 171P Combining tumor-infiltrating lymphocytes and PD-L1 expression can stratify prognosis in early-stage triple-negative breast cancer patients who did not receive adjuvant chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Binh PDU, An PL, Nguyen NA, Nguyen DV, Huynh G, Gomi H, Yoshida M. Health Science Students' Perspective on Quality-of-Care-Relating Medical Professionalism. J Multidiscip Healthc 2021; 14:2229-2238. [PMID: 34434049 PMCID: PMC8380627 DOI: 10.2147/jmdh.s321094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Health science students need to be professional to improve quality of care (QOC) in the current Vietnamese healthcare system. Therefore, we aim to evaluate medicine and traditional medicine (TM) students’ perception of the professional attributes relating to QOC for improving inter-disciplined professionalism training that promotes QOC in Vietnam. Methods The cross-sectional study was carried on 2039 students of 6 years at the University of Medicine and Pharmacy at Ho Chi Minh City (HUMP) from the medical and TM faculty in March, 2021. The Vietnamese American Board of Internal Medicine (ABIM) questionnaire (2011) was used as the survey instrument. The confirmatory factor analysis (CFA) was performed to confirm the validity of the scale in TM students. Mean, Min–Max, standard deviation and sample paired t-test were performed for Likert scale. The one-way ANOVA was used for inferential statistics. Results The CFA demonstrated the validity of the Vietnamese questionnaire in measuring 4 QOC-relating professional attributes, previously found in medical students for TM students. In both faculties and across academic years, students perceived self-awareness and ensuring QOC as the leading important attribute, while social duty and professional habit as the least important attribute. Contrasting with preclinical phase, students’ perception did not differ significantly between the two faculties in their clinical years (p > 0.05). Conclusion TM students share universal QOC-relating professional traits with medical students. Moreover, exposure to clinical environment might increase inter-disciplined agreement on importance of these attributes. However, health sciences students’ underestimation of social duty and professional habit persists throughout 6 academic years. Hidden curriculum in clinical training such as specialist-centeredness might hinder the students’ improvement in perception of these traits. Therefore, these traits should strongly be emphasized in professionalism training to decrease the effects of hidden curriculum on them.
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Affiliation(s)
- Pham Duong Uyen Binh
- Department of Educational Quality Assurance, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Pham Le An
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nghia An Nguyen
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Dan Van Nguyen
- Faculty of Traditional Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Giao Huynh
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Harumi Gomi
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Motofumi Yoshida
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan
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Nakajima N, Kawano H, Kai Y, Takai A, Abe M, Iimura Y, Cheng M, Yoshida M, Yamashita N. P–248 Statistical estimation for incidence of blastocyst trophectoderm vesicles (TVs) and efficacy of assisted hatching (AH). Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
The aim of this study is to analyse the association between blastocyst diameter and TVs development, and to examine the efficacy of AH.
Summary answer
Blastocysts with a diameter of more than 170 μm leads to high incidence of TVs and AH applied from the incidence should be effective.
What is known already
TVs are protrusion of trophectoderm cells often observed in expanding blastocyst stages. TVs can be observed in expanding blastocysts regardless of Intracytoplasmic sperm injection (ICSI) and Conventional-IVF (C-IVF), when the internal pressure of blastocysts increase. The rate of TVs incidence in blastocysts inseminated by ICSI is higher than that by C-IVF, due to penetration of the needle into the zona pellucida. Moreover, it has been reported that TVs may inhibit blastocyst hatching. However, the developmental timing of TVs is still unclear, and there is no study that has analysed the association between blastocyst diameter and the incidence of TVs.
Study design, size, duration
1) Diameters and TVs incidence of blastocysts by ICSI and C-IVF were measured, and the cut-off value and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve were calculated to estimate the timing of TV incidence. 2) We analysed the clinical pregnancy rates of blastocysts with TVs treated by AH compared to those of blastocysts by C-IVF not subjected to AH.
Participants/materials, setting, methods
This study included 821 transferred frozen blastocysts ranging from March 2018 to November 2019. The embryos were cultured in a dry incubator after insemination by ICSI or C-IVF. Blastocyst freezing conditions were set at day5 to day7 with a diameter of more than 150 μm in inner diameter of zona pellucida, and this was measured before freezing. The ROC curve was performed using EZR statistical analysis software.
Main results and the role of chance
1) The incidence of TVs in blastocysts by ICSI and C-IVF was 27.5% (117/424) and 14.6% (58/397) respectively. The rate of the incidence of TVs in blastocysts inseminated by ICSI and C-IVF; 8.6% (12/140) and 0.95% (1/105) in 150–159 μm, 12.7% (14/110) and 8.2% (6/73) in 160–169 μm, 40.6% (28/69) and 10.5% (6/57) in 170–179 μm, 55.6% (30/54) and 25.5% (13/51) in 180–189 μm, 66.7% (20/30) and 35.7% (10/28) in 190–199 μm, and 68.4% (13/19) and 26.8% (22/82) in the diameter of more than 200 μm. The cut-off value of the ROC curve was respectively 170 μm (sensitivity 78.6% and specificity 73.0%) and 176 μm (sensitivity 84.5% and specificity 59.6%) in the diameter; the AUC was 0.8 [95%CI:0.752–0.848] and 0.74 [95%CI:0.687–0.793] respectively. 2) The clinical pregnancy rate of TVs blastocyst vs C-IVF blastocyst was 52.7% (88/167) vs 57.8% (37/64) respectively. There is no significant difference between the two clinical pregnancy rates (P = 0.556).
Limitations, reasons for caution
The findings of this study have to be seen in light of some limitations. Since this study aimed to analyse the incidence of TVs based on blastocyst size, we did not take into account the grade according to the Gardner classification and the number of trophectoderm cells.
Wider implications of the findings: Blastocysts inseminated by ICSI and C-IVF were highly likely to have TVs above 170 μm and 176 μm respectively. The clinical pregnancy rates of the blastocyst with TV treated by AH was similar to those of the C-IVF blastocyst.
Trial registration number
Not applicable
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Affiliation(s)
- N Nakajima
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - H Kawano
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - Y Kai
- Reproductive research center in Yamashita Shonan Yume Clinic, Researcher, Fujisawa city, Japan
| | - A Takai
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Abe
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - Y Iimura
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Cheng
- Yamashita Shonan Yume Clinic, Embryologist, Fujisawa city- Kanagawa, Japan
| | - M Yoshida
- Yamashita Shonan Yume Clinic, Physician, Fujisawa city- Kanagawa, Japan
| | - N Yamashita
- Yamashita Shonan Yume Clinic, Physician, Fujisawa city- Kanagawa, Japan
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21
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Kikukawa M, Taketomi K, Yoshida M. Does the hospitalization immersion experience improve medical students' understanding of patients' perspectives? A qualitative study. Korean J Med Educ 2021; 33:97-106. [PMID: 34062641 PMCID: PMC8169374 DOI: 10.3946/kjme.2021.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Although many studies have assessed the impact of interventions to increase medical students' empathy by improving their understanding of patients' perspectives and feelings, the impact of hospitalization experiences remains unclear. METHODS Fifth-year medical students at Kyushu University from 2009-2013 participated in a 2-day/1-night course to provide a hospitalization experience. After the course, participants answered an online, anonymous, open-ended questionnaire created by the authors. RESULTS Of 488 participants, 462 provided responses (95% response rate), which were evaluated by thematic analysis. Students understood inpatients not only through their own hospitalization experience, but also through observations of and conversations with the inpatients they encountered, from a shared perspective of both. Students experienced the realities of hospital life, stress and psychological states of being an inpatient, and psychological pressure from physicians. In addition, students observed the distress of other inpatients and dedication of medical staff. Furthermore, through communication with these inpatients, students understood other inpatients' anxiety about illness and empathy as one of the requirements of health care providers from the patients' perspective. CONCLUSION This qualitative study investigated the effectiveness of a course on the hospitalization experience. Results showed that medical students understood the perspectives, distress, and anxiety of being an inpatient, not only from their own experiences but also from observation and communication with other inpatients they encountered during their hospitalization. This experience appeared to be an effective teaching strategy for enhancing medical students' empathy by improving their understanding of patients' perspectives and feelings.
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Affiliation(s)
- Makoto Kikukawa
- Department of Medical Education, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Motofumi Yoshida
- Medical Education, Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
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22
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Sanders M, Ida K, Yoshinuma M, Suzuki C, Yoshimura Y, Seki R, Emoto M, Yoshida M, Kobayashi T. Analysis of the Motional Stark Effect (MSE) diagnostic to measure the rotational transform and current profile in the Large Helical Device. Rev Sci Instrum 2021; 92:053503. [PMID: 34243309 DOI: 10.1063/5.0018859] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 04/07/2021] [Indexed: 06/13/2023]
Abstract
The analysis method of the Motional Stark Effect (MSE) diagnostic to measure the rotational transform and current profiles in the Large Helical Device has been improved. This was done by using the Variational Moments Equilibrium Code to calculate an equilibrium database for various pressure profiles and current profiles. This method looks for the radial profile of the rotational transform in the equilibrium database that gives the best fit to the polarization angle profiles measured with the MSE diagnostic. This analysis improves the measurements of rotational transform, especially near the magnetic axis, where the sensitivity of the polarization angle measurements becomes low and the uncertainty due to error in the estimation of the Pfirsch-Schlüter current becomes large. The radial profiles of the rotational transform and current profiles for Electron Cyclotron Current Drive and Neutral Beam Current Drive are obtained in the new analysis method with a sufficiently high accuracy to discuss the discrepancy of the current density profiles between the measurements and the calculations.
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Affiliation(s)
- M Sanders
- Department of Applied Physics, Eindhoven University of Technology, Eindhoven 5600 MB, The Netherlands
| | - K Ida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Yoshinuma
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - C Suzuki
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - Y Yoshimura
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - R Seki
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Emoto
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - M Yoshida
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
| | - T Kobayashi
- National Institute for Fusion Science, National Institutes of Natural Sciences, Toki, Gifu 509-5292, Japan
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Taylor DP, Yoshida M, Fuller K, Giannobile WV, Sfeir CS, Wagner WR, Kohn DH. Translating Dental, Oral, and Craniofacial Regenerative Medicine Innovations to the Clinic through Interdisciplinary Commercial Translation Architecture. J Dent Res 2021; 100:1039-1046. [PMID: 33906502 DOI: 10.1177/00220345211009502] [Citation(s) in RCA: 2] [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: 11/15/2022] Open
Abstract
Few university-based regenerative medicine innovations in the dental, oral, and craniofacial (DOC) space have been commercialized and affected clinical practice in the United States. An analysis of the commercial translation literature and National Institute for Dental and Craniofacial Research's (NIDCR's) portfolio identified barriers to commercial translation of university-based DOC innovations. To overcome these barriers, the NIDCR established the Dental Oral Craniofacial Tissue Regeneration Consortium. We provide generalized strategies to inform readers how to bridge the "valley of death" and more effectively translate DOC technologies from the research laboratory or early stage company environment to clinical trials and bring needed innovations to the clinic. Three valleys of death are covered: 1) from basic science to translational development, 2) from translational technology validation to new company formation (or licensing to an existing company), and 3) from new company formation to scaling toward commercialization. An adapted phase-gate model is presented to inform DOC regenerative medicine teams how to involve regulatory, manufacturability, intellectual property, competitive assessments, business models, and commercially oriented funding mechanisms earlier in the translational development process. An Industrial Partners Program describes how to conduct market assessments, industry maps, business development processes, and industry relationship management methods to sustain commercial translation through the later-stage valley of death. Paramount to successfully implementing these methods is the coordination and collaboration of interdisciplinary teams around specific commercial translation goals and objectives. We also provide several case studies for translational projects with an emphasis on how they addressed DOC biomaterials for tissue regeneration within a rigorous commercial translation development environment. These generalized strategies and methods support innovations within a university-based and early stage company-based translational development process, traversing the many funding gaps in dental, oral, and craniofacial regenerative medicine innovations. Although the focus is on shepherding technologies through the US Food and Drug Administration, the approaches are applicable worldwide.
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Affiliation(s)
- D P Taylor
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,sciVelo, University of Pittsburgh Health Sciences, Pittsburgh, PA, USA
| | - M Yoshida
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - K Fuller
- Medical Device Regulatory Solutions LLC, Ann Arbor, MI, USA
| | | | - C S Sfeir
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - W R Wagner
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - D H Kohn
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Maseki H, Jimbo K, Nakadaira U, Watase C, Murata T, Shiino S, Takayama S, Yamamoto N, Yoshida M, Suto A. Evaluation of incidental implantation of tumor cells after diagnostic needle biopsy in breast cancer patients. Breast 2021. [DOI: 10.1016/s0960-9776(21)00198-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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25
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Yoshida M, Funasaki H. Optimal Platelet Concentration for The Therapeutic Effect of Autologous Neutrophil-Reduced Platelet Rich Plasma in A Rat Model of Achilles Tendinopathy. Muscles Ligaments Tendons J 2020. [DOI: 10.32098/mltj.04.2020.08] [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)
- M. Yoshida
- Department of Orthopaedic Surgery,The Jikei University School of Medicine
| | - H. Funasaki
- Department of Orthopaedic Surgery,The Jikei University School of Medicine
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26
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Miki T, Miyoshi T, Suruga K, Ichikawa K, Otsuka H, Toda H, Yoshida M, Nakamura K, Morita H, Ito H. Triglyceride to HDL-cholesterol ratio is a predictor of future coronary events: a possible role of high-risk coronary plaques detected by coronary CT angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2930] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
For the prevention of future cardiovascular events, control of residual risks such as triglyceride rich lipoproteins and HDL-cholesterol is an emerging problem beyond LDL-cholesterol. Triglyceride to HDL-cholesterol ratio (TG/HDL ratio) has been reported to be useful for risk classification of cardiovascular diseases. Meanwhile, several studies showed that high-risk plaque characteristics evaluated with coronary CT angiography (cCTA) was associated with the incidence of acute coronary syndrome. However, the relationship of TG/HDL ratio with coronary plaque characteristics and its impact of this association on future coronary events have not been fully elucidated.
Purpose
The aim of this study was to evaluate the association between TG/HDL ratio and high-risk plaque detected by cCTA and its impact on future coronary events.
Methods
A total of 944 patients suspected stable coronary artery disease who underwent cCTA at our institution were analyzed (mean 64-year-old, 55% male). Patients were divided into two groups by the median value of TG/HDL ratio (higher TG/HDL: TG/HDL ratio ≥2.0, lower TG/HDL: TG/HDL ratio <2.0). Coronary high-risk plaques were defined as a plaque with all three components; low attenuation plaque (<50H.U.), positive remodeling (remodeling index >1.1) and spotty calcification. Cardiovascular event was defined as cardiovascular death, acute coronary syndrome, and late coronary revascularization after 30 days of CT acquisition.
Results
The higher TG/HDL ratio was significantly associated with male gender (63% vs. 48%, P<0.001), body mass index (24.8±3.8 vs. 22.9±4.0, p<0.001), the prevalence of hypertension (65% vs. 54%, P<0.001), dyslipidemia (60% vs. 42%, P<0.001), diabetes mellitus (38% vs. 27%, P=0.001) and current smoking (26% vs. 10%, p<0.001). Regarding cCTA findings, the prevalence of significant stenosis, calcified plaque, non-calcified plaque, coronary plaques with low attenuation plaque, positive remodeling and spotty calcification in the higher TG/HDL group were greater than those in the lower group (Figure 1A). Of note, the difference in high-risk plaque between two groups was significant. (18% vs. 11%, p=0.004). Multivariate logistic analysis revealed that the TG/HDL ratio was an independent risk factor for high-risk plaque even after adjustment (OR, 1.35; 95% CI, 1.01–1.81; p=0.049). Regarding coronary events (median follow-up duration; 48 months), Kaplan-Meier curve showed poor event-free rate in the higher TG/HDL group (Figure 1B). At Cox proportional hazard analysis, higher TG/HDL ratio (HR, 1.94; 95% CI, 1.01–3.70; p=0.046) and CT-verified high-risk plaque (HR, 2.36; 95% CI, 1.27–4.38; p=0.006) were independent predictive factors for coronary events even after adjustment.
Conclusion
TG/HDL ratio is involved in the vulnerability of CT-verified coronary plaque characteristics. This association may play an important role in the prognostic impact of TG/HDL ratio on future cardiovascular events.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Miki
- Okayama University Hospital, Okayama, Japan
| | - T Miyoshi
- Okayama University Hospital, Okayama, Japan
| | - K Suruga
- Okayama University Hospital, Okayama, Japan
| | - K Ichikawa
- Okayama University Hospital, Okayama, Japan
| | - H Otsuka
- Okayama University Hospital, Okayama, Japan
| | - H Toda
- Okayama University Hospital, Okayama, Japan
| | - M Yoshida
- Okayama University Hospital, Okayama, Japan
| | - K Nakamura
- Okayama University Hospital, Okayama, Japan
| | - H Morita
- Okayama University Hospital, Okayama, Japan
| | - H Ito
- Okayama University Hospital, Okayama, Japan
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Nakano Y, Okumura N, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Impact of higher detection rate of residual pulmonary thromboemboli one-year after acute pulmonary embolism: modified CT scan imaging method with modified CT obstruction index. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently, post pulmonary embolism (PE) syndrome or chronic thromboembolic disease after acute PE, has been recognized as important long-term complications. Furthermore, patients may develop with chronic thromboembolic pulmonary hypertension.
Purpose
We aimed to evaluate the frequency of residual pulmonary thromboemboli after acute PE by using our “higher”-resolution CT scan imaging method to detect residual thromboemboli down to sub-segmental pulmonary arteries.
Methods
This study was a prospective multi-center observational study. We enrolled consecutive 34 patients with acute symptomatic PE whose informed consent was obtained, and followed up for one year. One year after the onset of acute PE, patients were referred to our hospital and multiple examination including CT scan, 6-minute walk test (6MWT), questionnaire of SF-36, echocardiography and laboratory testing were performed. Additionally, we have modified the CT obstruction index (CTOI) to quantitatively evaluate the thromboemboli down to sub-segmental pulmonary arteries.
Results
Mean age was 60.5±15.8 years, and 56% were male. No patient was categorized as low recurrent VTE risk which was caused by transient factors, one patient was associated with active cancer, and 12% had known thrombophilia. In 85% of the patients, this onset was the first obvious episode of PE. At diagnosis, elevated B-type natriuretic peptide (BNP) (≥100 pg/ml) or N-terminal (NT)-proBNP (≥500 pg/ml) was observed in 45% of the patients. Median tricuspid regurgitation peak gradient (TRPG) by echocardiography was 30.9 (19.3–50.1) mmHg. Among all, 35% of the patients received single-drug approach with DOACs. At discharge, all of the patients except two were treated with DOACs.
One year after the onset, 21% of the patient were in NYHA II and others were in NYHA I. It was notable that pulmonary thromboemboli was detected by our CT scan in 76% of the patients. Modified CTOI was median 11.9 (1.8–24.4) % as shown in the figure.
In multiple regression analysis, TRPG at diagnosis and BNP at one month were significantly associated with mCTOI (β=0.536, p=0.002 and β=−0.482, p=0.003, respectively). Additionally, lowest SpO2 during 6MWT after one year from the onset, tended to inversely associate with mCTOI (β=−0.341, p=0.052).
Conclusions
Using our modified CT scan imaging method and modified CTOI, residual pulmonary thromboemboli was able to be detected more frequently than the previous studies. Residual pulmonary thromboemboli could be one of the cause of the post PE syndrome and lead to exercise-induced desaturation.
Figures
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - N Okumura
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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Nakano Y, Imai R, Yoshida M, Shimokata S, Adachi S, Murohara T, Kondo T. Clinical course of pulmonary embolism patients treated with DOACs: comparing prognosis, recurrent thromboembolism, and major bleeding between patients with and without cancer. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Venous thromboembolism (VTE) is the third frequent acute cardiovascular syndrome in the Europe and Japan. Since direct oral anticoagulants (DOACs) are widely used now, the morbidity and mortality of pulmonary embolism (PE) patients especially associated with cancer needs to be re-evaluated.
Purpose
We evaluated the clinical course of patients with PE mainly treated with DOACs.
Methods
This retrospective observational study was conducted in a single center. The data were collected from the medical record of consecutive patients who received inpatient treatment of PE. In this study, we have compared PE patients with cancer (cancer PE) to those without cancer (non-cancer PE) and evaluated the mortality, recurrent of VTE and major bleedings.
Results
In total, 140 patients were enrolled: 94 patients were cancer-related, and 46 patients were without cancer (Table). The type of the tumor in cancer PE patients were as follows: gastric 8 (9%), esophageal 5 (5%), pancreatic 12 (13%), lung 14 (15%), lymphoma 2 (2%), gynecologic 17 (18%), renal 2 (2%), bile duct 8 (9%), colon 12 (13%), and others 17 (18%).
Kaplan-Meier curve showed that the cumulative all-cause mortality was significantly higher in the cancer PE group (35/94 (37%) vs. 2/46 (4%), P<0.001 (log rank), HR 10.3 [95% CI:2.5–43.3]). The cumulative incidence of recurrent VTE was significantly higher in the cancer PE group (7/94 (7%) vs. 0/46, P=0.03 (log rank)). There was no significant difference in the cumulative incidence of major bleeding between the cancer PE group and the non-cancer PE group (8/94 (9%) vs. 5/46 (11%)).
Conclusions
The risk of recurrent VTE was still higher in cancer PE patients compared to non-cancer PE patients, although DOACs were used. Meanwhile the incidence of major bleeding was comparable in both groups, the risk of bleeding might be acceptable with using DOACs especially in cancer PE patients.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Nakano
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
| | - R Imai
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - M Yoshida
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Shimokata
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - S Adachi
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University, Graduate School of Medicine, Department of Cardiology, Nagoya, Japan
| | - T Kondo
- Nagoya University, Graduate School of Medicine, Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya, Japan
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Amioka N, Miyoshi T, Akagi S, Yoshida M, Nakamura K, Morita H, Ito H. Pemafibrate protects the rupture of experimental aortic aneurysm in mice through anti-oxidative stress with induced catalase. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Abdominal aortic aneurysm (AAA) is a life-threatening disease, while effective and preventive medical treatments remain unestablished.
Purpose
The aim of this study was to evaluate the effect of selective peroxi- some proliferator-activated receptor alpha (PPARα) modulator pemafibrate on AAA formation in mice.
Methods
AAA was induced by subcutaneous infusion of angiotensin II (AngII) in apolipoprotein E-deficient mice for 4 weeks. Treatment by pemafibrate or vehicle was started one week before AngII infusion. Oxidative stress was evaluated by dihydroethidium (DHE) staining.
Results
Prognosis after AngII infusion in pemafibrate-treated mice was significantly better than that in vehicle-treated mice (log-rang test, p=0.035) by reducing the occurrence of fatal AAA rupture. Meanwhile pemafibrate did not significantly reduce maximal diameter of the aorta. Histological findings demonstrated that the expression of collagen in adventitia in pemafibrate-treated mice was significantly greater than that in vehicle-treated mice (p<0.05). Oxidative stress in aorta of pemafibrate-treated mice was significantly reduced comparing to vehicle-treated mice, accompanying by the reduction of mRNA expression of matrix metalloproteinase 2, tumor necrosis factor-α, and interleukin-6 (all p<0.05). Catalase expression in abdominal aortic tissue was increased 1.5-fold in mice treated with pemafibrate than in mice treated with vehicle (p=0.032). In human vascular smooth muscle cells (hVSMC), pemafibrate attenuated AngII-induced oxidative stress (p<0.001), which was canceled by administrating small interfering RNA (siRNA) of PPARα (p<0.001). Furthermore, in hVSMC, pemafibrate increased catalase expression significantly (p<0.001), while this increase was significantly suppressed by knockdown of PPAR-α with siRNA. (p<0.001).
Conclusion
Pemafibrate reduced the rupture of AAA in this murine model, which is associated with anti-oxidative stress via catalase induction.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Amioka
- Okayama University Hospital, Okayama, Japan
| | - T Miyoshi
- Okayama University Hospital, Okayama, Japan
| | - S Akagi
- Okayama University Hospital, Okayama, Japan
| | - M Yoshida
- Okayama University Hospital, Okayama, Japan
| | - K Nakamura
- Okayama University Hospital, Okayama, Japan
| | - H Morita
- Okayama University Hospital, Okayama, Japan
| | - H Ito
- Okayama University Hospital, Okayama, Japan
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Fujimoto N, Kozuki T, Aoe K, Miyamoto Y, Wada S, Harada D, Yoshida M, Sakurai J, Hotta K. 1898P A phase II trial of first-line combination chemotherapy with cisplatin, pemetrexed, and nivolumab for unresectable malignant pleural mesothelioma: JME-001. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Shirakawa T, Ueda Y, Shimokawa M, Koga F, Nakazawa J, Komori A, Arima S, Fukahori M, Makiyama A, Taguchi H, Honda T, Uneda S, Yoshida M, Shibuki T, Nio K, Ide Y, Ureshino N, Mitsugi K, Otsuka T. P-88 A multicenter analysis of the correlation between overall survival and progression-free survival and the number of chemotherapeutic key drugs used in patients with advanced/unresectable pancreatic cancer: Results from the NAPOLEON study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Yoshida M, Yokoyama T, Nishii H, Nomiya M. Studies of relationships between overactive bladder and frailty in the elderly. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Hashimoto D, Poudel S, Hirano S, Kurashima Y, Akiyama H, Eguchi S, Fukui T, Hagiwara M, Hida K, Izaki T, Iwase H, Kawamoto S, Otomo Y, Nagai E, Saito M, Takami H, Takeda Y, Toi M, Yamaue H, Yoshida M, Yoshida S, Ohki T, Kodera Y. Is there disparity between regions and facilities in surgical resident training in Japan? Insights from a national survey. Surg Today 2020; 50:1585-1593. [PMID: 32488479 DOI: 10.1007/s00595-020-02037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/19/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study sought to assess the disparity between regions and facilities in surgical resident training in Japan via a national level needs-assessment. METHODS A survey was sent to all 909 graduating residents of 2016. Residents trained in the six prefectures with a population of 7 million or more were included in the large prefecture (LP) group. Residents trained in the other 41 prefectures were included in the small prefecture (SP) group. Each group was further divided into a university hospital (UH) group and a non-university hospital (NUH) group. RESULTS The response rate was 56.3% (n = 512). Excluding nine residents who did not report their prefectures and facilities, surveys from 503 residents were analyzed. The UH group received significantly more years of training. In the SP and UH groups, there were significantly fewer residents who had performed 150 procedures or more under general anesthesia in comparison to the LP and NUH groups, respectively. Self-assessed competencies for several procedures were significantly lower in the SP and UH groups. CONCLUSION Disparity in surgical resident training was found between regions and facilities in Japan. The surgical residency curriculum in Japan could be improved to address this problem.
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Affiliation(s)
- Daisuke Hashimoto
- Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata-city, Osaka, 573-1010, Japan. .,Department of Gastroenterological Surgery, Omuta Tenryo Hospital, Fukuoka, Japan. .,Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan.
| | - Saseem Poudel
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Koya Hida
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoko Izaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Kumamoto University, Kumamoto, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Takeda
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motofumi Yoshida
- Department of Medical Education, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Shigetoshi Yoshida
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Takao Ohki
- Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Iyama S, Takada K, Yoshida M, Takahashi D, Kobune M. Acquired amegakaryocytic thrombocytopenic purpura possibly induced by anti-PD-1 antibody. Ann Hematol 2020; 99:1669-1670. [PMID: 32367179 DOI: 10.1007/s00277-020-04053-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Satoshi Iyama
- Department of Hematology, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - K Takada
- Department of Hematology, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.,Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - M Yoshida
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - D Takahashi
- Research and Development Department, Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - M Kobune
- Department of Hematology, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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Takahashi M, Uchihara T, Yoshida M, Wakabayashi K, Kakita A, Takahashi H, Toru S, Orimo S. Clinical and pathological features affecting cardiac sympathetic denervation in autopsy-confirmed dementia with Lewy bodies. Eur J Neurol 2020; 27:1155-1163. [PMID: 32239599 DOI: 10.1111/ene.14240] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to clarify the features affecting cardiac sympathetic denervation in autopsy-confirmed dementia with Lewy bodies (DLB) patients. METHODS Fifty-four autopsy-confirmed DLB patients were enrolled. Tissue samples of the left ventricular anterior wall were immunostained with anti-tyrosine hydroxylase antibody to identify catecholaminergic nerve axons. Immunostained areas were quantified as residual cardiac sympathetic nerve (CSN) axons and the relationship between the degree of residual CSN axons and clinical and neuropathological features was examined. RESULTS Virtually all patients showed small amounts of residual CSN axons (0.87%, range 0.02%-9.98%), with 50 patients (92.6%) showing <2.0% of residual axons. The patients who showed psychological symptoms within the first year of the disease had significantly more residual CSN axons than the remaining patients did (1.50% vs. 0.40%, P < 0.01). Patients with a short disease duration and neocortical-type Lewy body pathology tended to have more preserved CSN axons, although this difference was not statistically significant. Fifty-three patients (98.1%) who had neurofibrillary tangles in the brain and strong concomitant Alzheimer's disease pathology also had statistically significantly more preserved CSN axons. The patient with the most preserved CSN axons showed different characteristics from the results, except for the first symptom. CONCLUSION Psychological symptoms within the first year of the disease, a short disease duration, neocortical-type Lewy body pathology and strong concomitant Alzheimer's disease pathology may be related to mild CSN degeneration in DLB patients. Thus, DLB patients with broad Lewy body pathology in the brain in the early stages may show mild CSN degeneration.
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Affiliation(s)
- M Takahashi
- Department of Neurology, Kanto Central Hospital of the Mutual Aid Association of Public-School Teachers, Tokyo, Japan
| | - T Uchihara
- Laboratory of Structural Neuropathology, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Neurology, Nitobe-Memorial Nakano General Hospital, Tokyo, Japan
| | - M Yoshida
- Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan
| | - K Wakabayashi
- Department of Neuropathology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - A Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - H Takahashi
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - S Toru
- Department of Neurology, Nitobe-Memorial Nakano General Hospital, Tokyo, Japan
| | - S Orimo
- Department of Neurology, Kanto Central Hospital of the Mutual Aid Association of Public-School Teachers, Tokyo, Japan
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Poudel S, Hirano S, Kurashima Y, Stefanidis D, Akiyama H, Eguchi S, Fukui T, Hagiwara M, Hashimoto D, Hida K, Izaki T, Iwase H, Kawamoto S, Otomo Y, Nagai E, Saito M, Takami H, Takeda Y, Toi M, Yamaue H, Yoshida M, Yoshida S, Kodera Y. Are graduating residents sufficiently competent? Results of a national gap analysis survey of program directors and graduating residents in Japan. Surg Today 2020; 50:995-1001. [PMID: 32125504 DOI: 10.1007/s00595-020-01981-0] [Citation(s) in RCA: 3] [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: 11/06/2019] [Accepted: 01/16/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE To evaluate the self-assessed competency of graduating residents (GRs) in Japan upon completion of their residency and to identify the gap between their competency and the competency expected by their program directors (PDs). METHOD A list of 31 essential surgical procedures was compiled according to the consensus of surgical educators from around the country. A survey with this list was sent to all 909 GRs and their 611 PDs in 2016. The GRs rated their competency to perform these procedures and the PDs were asked to evaluate the expected competency of their GRs using the Zwisch Scale. RESULT The response rate was 56.3% for the GRs and 76.8% for the PDs. Fewer than half of the GRs who responded felt confident performing ten (32%) of the surgical procedures evaluated. For most procedures, the GRs' self-reported competency was lower than the expectation reported by their PDs. This gap was more than 10% for 13 of the procedures. CONCLUSION More than half of the GRs in Japan lacked the confidence in their skill to perform one-third of the surgical procedures selected for evaluation in this study. These findings should be used to update the surgical education curriculum in Japan.
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Affiliation(s)
- Saseem Poudel
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan.
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan
| | - Dimitrios Stefanidis
- Department of Surgery, School of Medicine, Indiana University, Indianapolis, USA
| | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Daisuke Hashimoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koya Hida
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoko Izaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Kumamoto University, Kumamoto, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Takeda
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motofumi Yoshida
- Department of Medical Education, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Shigetoshi Yoshida
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Yoshida M, Oohara W, Ichikawa M, Hiratsuka J, Saquilayan GQ, Umeda N, Kojima A, Kashiwagi M. Analysis of the cesium distribution in the JT-60SA negative ion sources for steady long-pulse operation. Rev Sci Instrum 2020; 91:033313. [PMID: 32259933 DOI: 10.1063/1.5131103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
To realize stable negative ion beams for 100 s required in the neutral beam injector of JT-60SA, a physical model to control cesium (Cs) distribution inside the negative ion source has been developed in order to maintain the stable negative ion production at the plasma grid (PG) surface with Cs. In this work, to quantitatively evaluate Cs coverage on the PG, a three-dimensional Cs transportation code was introduced to consider the spatial Cs distribution in the source. The spatial temperature distribution of the chamber wall was also introduced in this model. As a result, the reasonable variation of the Cs coverage for 100 s was obtained, compared to that in the initial model. Based on the modified model, the operational temperature of the chamber wall was proposed to be less than 60 °C to suppress the desorption of Cs in the chamber wall and to sustain the stable negative ion production. In addition, it was also suggested that a slightly higher wall temperature before the operation leads to a decrease in the amount of Cs stored at the chamber wall, resulting in suppression of Cs consumption in the ion source.
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Affiliation(s)
- M Yoshida
- Division of Electrical, Electronic, and Information Engineering, Yamaguchi University, Ube 755-8611, Japan
| | - W Oohara
- Division of Electrical, Electronic, and Information Engineering, Yamaguchi University, Ube 755-8611, Japan
| | - M Ichikawa
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
| | - J Hiratsuka
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
| | - G Q Saquilayan
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
| | - N Umeda
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
| | - A Kojima
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
| | - M Kashiwagi
- National Institutes for Quantum and Radiological Science and Technology, 801-1, Mukouyama, Naka 311-0193, Japan
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Inoue T, Yoshida M, Zoysa MD, Ishizaki K, Noda S. Design of photonic-crystal surface-emitting lasers with enhanced in-plane optical feedback for high-speed operation. Opt Express 2020; 28:5050-5057. [PMID: 32121733 DOI: 10.1364/oe.385277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 01/27/2020] [Indexed: 05/27/2023]
Abstract
Photonic-crystal surface-emitting lasers (PCSELs) use the two-dimensional (2D) resonance at the band-edge of a photonic crystal for lasing, and they feature various outstanding functionalities such as high-brightness lasing, arbitrary shaping of beam patterns and on-chip 2D beam steering. In this paper, to investigate the applicability of PCSELs for high-speed operation, we design PCSELs with enhanced in-plane optical feedback, which enable single-mode lasing inside a circular region the diameter of which is less than 10 µm. To realize a strong in-plane confinement of the lasing mode, we increase the one-dimensional coupling coefficients between counter-propagating waves through the careful design of the lattice points. We also introduce an in-plane heterostructure composed of two photonic crystals with different photonic bandgaps and utilize reflection at the boundary of the two photonic crystals in addition to the optical feedback at the band-edge of each photonic crystal. By using three-dimensional finite-difference time-domain method (3D-FDTD), we confirm that the proposed hetero-PCSELs can achieve single-mode lasing operation inside a 9-µm-diameter and possibly realize a 3-dB modulation bandwidth larger than 40 GHz.
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Hiratsuka J, Kashiwagi M, Ichikawa M, Umeda N, Saquilayan GQ, Tobari H, Watanabe K, Kojima A, Yoshida M. Achievement of high power and long pulse negative ion beam acceleration for JT-60SA NBI. Rev Sci Instrum 2020; 91:023506. [PMID: 32113410 DOI: 10.1063/1.5131302] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
Long pulse acceleration of hydrogen negative ion beams with the power density over 70 MW/m2 and the pulse length over 100 s has been demonstrated for the first time by using a multi-aperture 3-stage accelerator. Such long pulse acceleration was achieved by integrating the design of beam optics and voltage holding capability to meet the requirements of JT-60SA. By using the newly designed accelerator for JT-60SA, voltage holding at 500 kV with beam acceleration was stably sustained even after 5 g of cesium was seeded, and heat load on each acceleration grid was reduced below the allowable level for long pulse, less than 5% of total acceleration power. As a result, 500 keV, 154 A/m2 for 118 s beam acceleration was achieved, which satisfies the requirement of the negative ion source for JT-60SA. This pulse length of such high-power density beams is longest in the world. In addition, the result contributes to the long pulse acceleration of multi-stage electrostatic accelerators, such as 1 MeV negative ion accelerator for ITER.
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Affiliation(s)
- J Hiratsuka
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - M Kashiwagi
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - M Ichikawa
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - N Umeda
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - G Q Saquilayan
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - H Tobari
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - K Watanabe
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - A Kojima
- National Institutes for Quantum and Radiological Science and Technology (QST), 801-1 Mukoyama, Naka 311-0193, Japan
| | - M Yoshida
- Department of Electrical, Electronic, and Information Engineering, Yamaguchi University, Ube 755-8611, Japan
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Morita K, Tsuka H, Kimura H, Mori T, Yoshikawa M, Yoshida M, Kimura M, Tsuga K. Oral function and vertical jump height among healthy older people in Japan. Community Dent Health 2019; 36:275-279. [PMID: 31670918 DOI: 10.1922/cdh_4515morita05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Vertical jump height and oral function affect the general muscle condition. This study aimed to evaluate the association between vertical jump height and oral function among healthy older individuals. BASIC RESEARCH DESIGN Cross-sectional analytic study. PARTICIPANTS 231 independent older people (mean age, 74.4 ± 5.6 years) who participated in the Kyoto Elders Physical Fitness Measurement Research Project. Individuals with partial or complete edentulousness who did not use a prosthetic device or complained of oral/maxillofacial pain were excluded from the study. INTERVENTIONS Grip strength was measured using a Smedley Hand Dynamometer. To measure masticatory performance, the participants were instructed to chew a gummy jelly on their habitual chewing side (left or right) for 20 s. Occlusal force, contact area, and pressure were also assessed. MAIN OUTCOME MEASURES The outcome variable was vertical jump height. The predictor variables were physical status (age, body mass index, and grip strength), oral status (number of present teeth and denture use), and oral function (masticatory performance, occlusal force, occlusal contact area, occlusal pressure, and tongue pressure). These relationships were evaluated with univariate analysis, and then multiple regression analysis was performed with age as the covariate for each male and female participant. RESULTS Vertical jump height was significantly associated with grip strength in both men and women. Moreover, in women, it was associated with masticatory performance, occlusal force, and occlusal contact area. CONCLUSIONS Vertical jump height was closely associated with oral function among healthy older women.
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Affiliation(s)
- K Morita
- Assistant Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - H Tsuka
- Assistant Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - H Kimura
- Clinical Staff, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - T Mori
- Assistant Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - M Yoshikawa
- Associated Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - M Yoshida
- Associated Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - M Kimura
- Professor, Department of Health and Medical Sciences, Kyoto Gakuen University, Kyoto, Japan
| | - K Tsuga
- Professor, Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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Soejima S, Kondo K, Tsuboi M, Kishibuchi R, Muguruma K, Tegshee B, Kajiura K, Kawakami Y, Kawakita N, Yoshida M, Takizawa H, Tangoku A, Wusiman N. MA20.02 GAD1 Expression and Its Methylation Become Indicators of Malignant Behavior in Thymic Epithelial Tumor. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kondo K, Tsuboi M, Soejima S, Kawakita N, Toba H, Kawakami Y, Yoshida M, Takizawa H, Tangoku A. P2.03-22 Chromate Exposure Induces DNA Hypermethylation of the Mismatch Repair Gene MLH1 in Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Deguchi T, Hashizume H, Nakajima M, Teraguchi M, Akune T, Yamada H, Tanaka S, Yoshimura N, Nojima M, Yoshida M, Ikegawa S. A population-based study identifies an association of THBS2 with intervertebral disc degeneration. Osteoarthritis Cartilage 2019; 27:1501-1507. [PMID: 31233787 DOI: 10.1016/j.joca.2019.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/26/2019] [Accepted: 06/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To clarify the genetic mechanisms underlying intervertebral disc degeneration (IDD), we examined the associations between single-nucleotide polymorphisms (SNPs) and indicated as coefficient of interaction term (IDD) in a general population in Japan. METHODS This was a cross-sectional study. In 1,605 participants, C2-3 to L5/S1 in the total spine magnetic resonance imaging (MRI) were evaluated using the Pfirrmann's scoring system. Disc scores of 4 and 5 were defined as IDD. Eight SNPs in eight genes associated with IDD were examined at each disc level, considering the non-genetic risk factors of age, sex, and body mass index (BMI). RESULTS The highest odds ratio was found for rs9406328 in the THBS2 gene at disc level T12-L1 (OR 1.27, 95%CI 1.05 to 1.53), and this association was strengthened after adjustment for age using logistic regression (OR 1.37, 95%CI 1.12 to 1.67). Among participants aged <50 years and 50-59, the average IDD score in those with 2 risk alleles of rs9406328 was markedly higher than in those with 0 or 1 risk allele, and the difference is much wider than the elderly participants. It indicates the genetic effect of rs9406328 is stronger in the younger age groups. Finally, multiple linear regression analyses of the association between rs9406328 and IDD, adjusted for age, sex, and BMI at each disc level, showed a statistical interaction between age and the number of risk alleles at C7-T1, T3-4 and T4-T5 as well as T12-L1. CONCLUSION CONCLUSION: The association between rs9406328 in THBS2 and IDD was replicated. The contributions of genetic and environmental factors to IDD differed by disc level.
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Affiliation(s)
- T Deguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - H Hashizume
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan.
| | - M Nakajima
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - M Teraguchi
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - T Akune
- Rehabilitation Services Bureau, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - H Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - S Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Nojima
- Biostatistics & Data Management, Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan
| | - M Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - S Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan.
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Sone J, Mitsuhashi S, Fujita A, Takashima H, Sugiyama H, Kohno Y, Takiyama Y, Maeda K, Tanaka F, Iwasaki Y, Yoshida M, Matsumoto N, Sobue G. GGC repeat expansion in NOTCH2NLC is the cause of both sporadic and familial neuronal intranuclear inclusion disease. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Muguruma K, Kondo K, Kishibuchi R, Tsuboi M, Soejima S, Tegshee B, Kajiura K, Kawakami Y, Kawakita N, Yoshida M, Takizawa H, Tangoku A. MA20.03 DNA Methylation of MT1A and NPTX2 Genes Predict Malignant Behavior of Thymic Epithelial Tumors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yoshida M, Miyagawa Y, Fujita H, Adachi S. Crystallization kinetics of safflower and olive oils during low-temperature storage. Grasas y Aceites 2019. [DOI: 10.3989/gya.0825182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The crystallization behaviors of safflower and olive oils were investigated according to changes in volume and transmitted light intensity during isothermal storage at low temperature. The changes between the oils were significantly different even though their fatty acid compositions were similar, with oleic acid accounting for more than 75% (w/w) of the total oil. It was expected that minor components with high melting points would affect the crystallization behaviors of these oils. The crystallization processes of the oils were then analyzed using a kinetic model in which the oil crystallizes through two different processes. It is suggested that although the crystallization behaviors were apparently different, the crystallization mechanisms of these oils are essentially the same.
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Shigematsu A, Ota S, Kobayashi R, Kondo T, Endo T, Tsutsumi Y, Kobayashi H, Kakinoki Y, Yamamoto S, Konuma Y, Miyagishima T, Igarashi T, Oda T, Sakai H, Ishihara T, Yoshida M, Nagashima T, Sato K, Kanisawa Y, Haseyama T, Hirayama Y, Kurosawa M. PF184 EFFICACY OF CONSOLIDATION CHEMOTHERAPY FOR PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA WHO ACHIEVED COMPLETE REMISSION BY FIRST COURSE OF REMISSION INDUCTION THERAPY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000558952.18518.ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Epp DA, Kubota T, Yoshida M, Kishimoto J, Kobayashi D, Shimazoe T. Promoting Patient Care Through Communication Training in a Pre-clerkship Pharmacy Education Course in Japan. Am J Pharm Educ 2019; 83:6745. [PMID: 31333251 PMCID: PMC6630866 DOI: 10.5688/ajpe6745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/29/2018] [Indexed: 06/01/2023]
Abstract
Objective. The purpose of this study was to teach communication skills for patient care to pre-clerkship students and observe changes in student perspectives towards communication from pre- to post-training. Methods. Two cohorts of fourth-year pharmacy students completed an eight-week pre-clerkship training course designed to improve their communication skills. The course involved class discussions and in-class research of medications, practicing communication skills, learning to give science-based responses, and developing an awareness of patient education for lifestyle, self-medication, quality of life, and medication adherence. A comparison of students' pre- and post-training responses to a questionnaire were used to assess changes in students' ability and confidence in communicating with patients. An exploratory factor analysis was used to analyze and compare the data results. Results. Students' mean post-training scores for perceived ability to make small talk and confidence to communicate with patients increased compared to pre-training scores. Based on the results of the exploratory factor analysis, the greatest increase in students' scores was in the area of patient education skills. Conclusion. The pre-clerkship communication training improved student understanding of the pharmacy communication skills needed to conduct effective patient education and pharmacist-patient interaction beyond dispensing, affirming the theory that specialized communication training before students' begin a clerkship may be essential.
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Affiliation(s)
- Denise A. Epp
- Center for Advancing Pharmaceutical Education, Daiichi University of Pharmacy, Fukuoka, Japan
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshio Kubota
- Center of Pharmaceutical Care for Community Health, Daiichi University of Pharmacy, Fukuoka, Japan
| | - Motofumi Yoshida
- Faculty of Medicine, International University for Health and Welfare, Narita, Japan
| | - Junji Kishimoto
- Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Kobayashi
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
| | - Takao Shimazoe
- Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan
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Poudel S, Hirano S, Kurashima Y, Stefanidis D, Akiyama H, Eguchi S, Fukui T, Hagiwara M, Hashimoto D, Hida K, Izaki T, Iwase H, Kawamoto S, Otomo Y, Nagai E, Saito M, Takami H, Takeda Y, Toi M, Yamaue H, Yoshida M, Yoshida S, Kodera Y. A snapshot of surgical resident training in Japan: results of a national-level needs assessment survey. Surg Today 2019; 49:870-876. [PMID: 31102022 DOI: 10.1007/s00595-019-01819-4] [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: 11/09/2018] [Accepted: 04/13/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the status of surgical training in Japan through a national-level needs assessment. METHODS A survey was sent to all 909 graduating residents (GRs) and their 611 program directors (PDs) for the year 2016. A working group of surgical educators from around the country was formed under the education committee of the Japan Surgical Society. The survey items were developed by consensus of this working group. The survey investigated the knowledge and problems of the current curriculum, and the status of the current residency training. RESULTS The response rates were 56.3% of the GRs and 76.8% of the PDs. Among the participants, 47.6% of the GRs and 29.4% of the PDs believed that the residency curriculum did not match the clinical experience. Over 80% of the GRs and PDs agreed on the importance of training outside of the OR, whereas only 13% of the GRs had received such training regularly. Trainees also reported a lower satisfaction rate about the opportunity to train outside of the OR. CONCLUSION This national-level needs assessment of surgical training in Japan identified several gaps in the curriculum. These results provide valuable data to assist the ongoing efforts for surgical residency curriculum improvement.
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Affiliation(s)
- Saseem Poudel
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan.
| | - Yo Kurashima
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan
| | - Dimitrios Stefanidis
- Department of Surgery, School of Medicine, Indiana University, Indianapolis, USA
| | - Hirotoshi Akiyama
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshihiro Fukui
- Department of Cardiovascular Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Masaru Hagiwara
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Daisuke Hashimoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koya Hida
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoko Izaki
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hirotaka Iwase
- Department of Breast and Endocrine Surgery, Kumamoto University, Kumamoto, Japan
| | - Shunsuke Kawamoto
- Division of Cardiovascular Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yasuhiro Otomo
- Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Eishi Nagai
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideki Takami
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuko Takeda
- Division of Medical Education, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motofumi Yoshida
- Department of Medical Education, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Shigetoshi Yoshida
- Department of Thoracic Surgery, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Watase C, Shiino S, Tokura M, Ogisawa K, Murata T, Jimbo K, Iwamoto E, Takayama S, Yoshida M, Kinoshita T. Relationship between p53 staining and clinicopathological factors in breast cancer. Breast 2019. [DOI: 10.1016/s0960-9776(19)30142-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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