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Hashimoto N, Uchiyama S, Nakazawa T, Iwasaki T, Hashimoto T. POS0707 SALIVARY GLAND ULTRASONOGRAPHY AND THE CLINICAL FEATURES USING ESSDAI IN PATIENTS OF EARLY-ONSET VERSUS LATE-ONSET WITH PRIMARY SJÖGREN’S SYNDROME. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.419] [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
Background:Primary Sjögren’s syndrome (pSS) is a chronic inflammatory autoimmune disease characterized by lymphocyte infiltration in salivary and lacrimal glands. pSS affects primarily middle-aged and elderly patients, although younger age groups may also be involved. However, differences of etiology and pathogenesis between early-onset pSS (EOpSS) and late-onset pSS (LOpSS) are unknown. Recently, standardized outcome tools for measuring disease-specific activity and patients’ reported symptoms have been formulated by the European League Against Rheumatism (EULAR) SS study group: the EULAR SS Disease Activity Index (ESSDAI) for systemic features of pSS [1]. Also, as the new imaging techniques, salivary gland ultrasonography (SGUS) proved valuable for assessing salivary gland involvement in SS and seemed to exhibit good diagnostic properties. In addition, previous studies have demonstrated usefulness of SGUS for the prognostic stratification of patients with pSS [2], [3], [4].Objectives:The aim of this study was to examine the differences of etiology and pathogenesis between EOpSS and LOpSS using ESSDAI and SGUS.Methods:Fifty-six pSS patients who fulfilled the American College of Rheumatology (ACR) / European League Against Rheumatism (EULAR) classification criteria for SS were studied. Based on the disease onset age, all pSS patients were divided into two groups as those with the onset age of 40 years old or younger (EOpSS: n=26) and those with the onset age of older than 65 years old (LOpSS: n=30). The clinical findings were evaluated ESSDAI and OMERACT SGUS score at the first visit to our hospital. The ESSDAI (0–123) proposes the evaluation of 12 domains or organ systems (constitutional, lymphadenopathy, glandular, articular, cutaneous, pulmonary, renal, peripheral nervous system, central nervous system, muscular, hematological and biology). All patients were examined SGUS by a single investigator who was blinded to device (TUS-A300; Canon Medical Systems, Tokyo, Japan) with a linear transducer (7.5-10MHz). The OMERACT SGUS score was used for graded changes in the parenchymal homogeneity of salivary glands: grade 0, normal-appearing salivary gland parenchyma; grade 1, minimal change: mild inhomogeneity without hypo/anechoic areas; grade 2, moderate change: moderate inhomogeneity with focal hypo/anechoic areas; grade 3, severe change: diffuse inhomogeneity with hypo/anechoic areas occupying the entire gland surface [5].Results:The proportions of positive sera of RF, anti-SS-A and anti-SS-B antibodies were not different in the two groups, but the disease activities were higher in the EOpSS than in the LOpSS patients by measuring ESSDAI (7.30 vs 4.23, p=0.008), especially in constitutional domain (1.50 vs 0.60, p=0.03), articular domain (1.54 vs 0.40, p=0.0002) and biological domain (1.35 vs 0.90, p=0.04). No difference in salivary secretion was found between two groups (EOpSS: 8.02 vs LOpSS: 6.31 mL/10min.), but the OMERACT SGUS score was higher in LOpSS than in EOpSS patients (2.00 vs 2.70, p=0.0002).Conclusion:Although serological findings were not different, EOpSS patients had higher disease activity but less severe salivary gland degeneration than that in LOpSS patients, suggesting the pathogenesis of these two groups was different.References:[1]Seror R, et al. Ann Rheum Dis. 2010 Jun;69(6):1103-9.[2]Arthritis Care Res (Hoboken). 2014 Jul;66(7):1102-7.[3]Hammenfors DS, et al. Clin Exp Rheumatol. 2015 Jan-Feb;33(1):56-62.[4]Milic V, et al. PLoS One. 2019 Dec 31;14(12): e0226498.[5]Jousse-Joulin S, et al. Ann Rheum Dis. 2019 Jul;78(7):967-973.Disclosure of Interests:None declared
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Tanaka K, Uehara T, Ohara T, Sato S, Hayakawa M, Kimura K, Okada Y, Hasegawa Y, Tanahashi N, Suzuki A, Nakagawara J, Arii K, Nagahiro S, Ogasawara K, Uchiyama S, Matsumoto M, Iihara K, Toyoda K, Minematsu K. Transient ischemic attack without self-awareness of symptoms witnessed by bystanders: analysis of the PROMISE-TIA registry. Eur J Neurol 2020; 28:509-515. [PMID: 32961590 PMCID: PMC7820962 DOI: 10.1111/ene.14550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/14/2020] [Indexed: 11/30/2022]
Abstract
Background and purpose A transient ischemic attack (TIA) can occur without self‐awareness of symptoms. We aimed to investigate characteristics of patients with a tissue‐based diagnosis of TIA but having no self‐awareness of their symptoms and whose symptoms were witnessed by bystanders. Methods We used data from the multicenter registry of 1414 patients with a clinical diagnosis of TIA. For patients without evidence of ischemic lesions on imaging, clinical characteristics were compared between patients with and without self‐awareness of their TIA symptoms. Results Among 896 patients (559 men, median age of 70 years), 59 (6.6%) were unaware of their TIA symptoms, but had those symptoms witnessed by bystanders. Patients without self‐awareness of symptoms were older and more frequently female, and more likely to have previous history of stroke, premorbid disability, and atrial fibrillation, but less likely to have dyslipidemia than those with self‐awareness. Patients without self‐awareness of symptoms arrive at hospitals earlier than those with self‐awareness (P < 0.001). ABCD2 score was higher in patients without self‐awareness of symptoms than those with self‐awareness (median 5 vs. 4, P = 0.002). Having no self‐awareness of symptoms was a significant predictor of ischemic stroke within 1 year after adjustment for sex, ABCD2 score, and onset to arrival time (hazard ratio = 2.44, 95% confidential interval: 1.10–4.83), but was not significant after further adjustment for arterial stenosis or occlusion. Conclusions Patients with a TIA but having no self‐awareness of their symptoms might have higher risk of subsequent ischemic stroke rather than those with self‐awareness, suggesting urgent management is needed even if patients have no self‐awareness of symptoms.
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Affiliation(s)
- K Tanaka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.,Department of Neurology, Graduate School of Medical Sciences, Neurological Institute, Kyushu University, Fukuoka, Japan
| | - T Uehara
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - T Ohara
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - S Sato
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - M Hayakawa
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - K Kimura
- Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Y Okada
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Y Hasegawa
- Department of Neurology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - N Tanahashi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University Saitama International Medical Center, Hidaka, Japan
| | - A Suzuki
- Department of Stroke Science, Research Institute for Brain and Blood Vessels-Akita, Akita, Japan
| | - J Nakagawara
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - K Arii
- Department of Neurology, Ebara Hospital, Tokyo, Japan
| | - S Nagahiro
- Department of Neurosurgery, Tokushima University, Tokushima, Japan
| | - K Ogasawara
- Department of Neurosurgery, Iwate Medical University, Morioka, Japan
| | - S Uchiyama
- Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.,Clinical Research Center for Medicine, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, International University of Health and Welfare, Tokyo, Japan
| | - M Matsumoto
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Hiroshima, Japan.,Department of Neurology, Sakai City Medical Center, Sakai, Japan
| | - K Iihara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - K Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - K Minematsu
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
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Hashimoto N, Uchiyama S, Kitano M, Nakazawa T, Iwasaki T, Hashimoto T. SAT0546 COMPARISON OF SHEAR WAVE ELASTOGRAPHY AND CONVENTIONAL ULTRASONOGRAPHY OF SALIVARY GLANDS IN PATIENTS WITH PRIMARY SJOGREN’S SYNDROME: CAN SHEAR WAVE ELASTOGRAPHY CAPTURE LESIONS THAT ARE DIFFICULT TO DIAGNOSE WITH CONVENTIONAL ULTRASONOGRAPHY? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.977] [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
Background:Sjögren’s syndrome (SS) is a chronic inflammatory autoimmune disease characterized by lymphocyte infiltration in salivary and lacrimal glands. Recently, salivary gland ultrasonography (US) proved valuable for assessing salivary gland involvement in SS and seemed to exhibit good diagnostic properties. In the literature, studies conducted by the scoring of the structural changes according to B-Mode US of salivary glands showed a wide variability regarding sensitivity and specificity. Our previously study demonstrated that although conventional B-mode US findings were useful for the diagnosis of SS with low salivary flow they were not for subclinical SS with normal salivary flow (EULAR 2016). Recently, we reported that the tissue elasticity was decreased due to structural changes in the submandibular glands (SG) at the advanced stage of the disease and the shear wave elastography (SWE) is useful to distinguish pathological changes of the SG in patients with SS (EULAR2018).Objectives:The aim of this study was to compare the usefulness of SG conventional B-mode US and SWE findings in non-SS and SS patients classified by salivary flow.Methods:Twenty-two non-SS patients and 99 SS patients who fulfilled the American College of Rheumatology (ACR) / European League Against Rheumatism (EULAR) classification criteria for SS were studied. SS patients were divided into three groups according to salivary flow using gum test (VL/SS <5mL/10min. (n=38), L/SS 5-10mL/10min. (n=41) and N/SS >10mL/10min. (n=20)). All patients were examined SGUS by a single investigator who was blinded to device (TUS-A300; Canon Medical Systems, Tokyo, Japan) with a linear transducer (7.5-10MHz). The examination consisted of conventional B-mode US (US staging score), pulsed wave Doppler US (PD grading score) and SWE with quantitative assessment. US staging scores were assessed by glandular size, inhomogeneity and contrast of diagastric muscle (stage 0 to 3). PD grading scores were graded by pulsed wave pattern in pulsed wave Doppler US at the internal SG facial arteries (grade 0 to 2). With the region-of-interest (ROI) placed over the stiffest areas of the lesion on SWE, the quantitative means of the elasticity values were measured by shear wave velocity (Vs; m/s) and elasticity (E; kPa) for each lesion.Results:The US staging score, the PD grading score, the values of Vs and E were significantly higher in patients with SS than in non-SS group (SS vs non-SS; US staging score 2.10±1.07 vs 0.86±0.99, p<0.0001, PD grading score 1.17±0.83 vs 0.23±0.61, p<0.0001, Vs 1.75±0.34 vs 1.57±0.29m/s, p=0.02, E 9.64±4.02 vs 7.81±2.27kPa, p=0.04). However, there was no significant difference between non-SS and N/SS in early-stage SS by US staging score (N/SS vs non-SS; 0.95±0.89 vs 0.86±0.99) and PD grading score (N/SS vs non-SS; 0.40±0.15 vs 0.23±.061). In contrast, the values of Vs and E were highest in N/SS as compared with all groups, and were significantly higher in N/SS than in non-SS (N/SS vs non-SS; Vs 2.02±0.24 vs 1.57±0.29m/s, p<0.01, E 12.58±3.16 vs 7.81±2.27kPa, p<0.01).Conclusion:The present study demonstrated that although the tissue elasticity was decreased due to structural changes at the advanced stage, it increased due to inflammation and high viscosity in the SG at the subclinical SS with normal salivary flow comparing that in non-SS patients. The SWE may be a useful tool for the differential diagnosis between patients with non-SS and subclinical SS with normal salivary flow, which is difficult to distinguish by conventional B-mode US.Disclosure of Interests:None declared
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Furuyama T, Uchiyama S, Chikamatsu T, Horikawa T, Maeda H, Segi M, Takahashi H, Taima T. Temperature-dependent changes in the molecular orientation and visible color of phthalocyanine films. RSC Adv 2020; 10:31348-31354. [PMID: 35520682 PMCID: PMC9056400 DOI: 10.1039/d0ra06273a] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/10/2020] [Indexed: 11/21/2022] Open
Abstract
A simple phthalocyanine zinc complex exhibits a visible color change in response to weak external stimuli, i.e., changes in solvent and temperature. Its chromism was attributed to its controlled aggregation via weak interactions between the central metal and peripheral oxygen atoms. In solution, intense absorption and fluorescence bands appeared in both the longer-wavelength and NIR region in non-coordinating solvents, while a simple sharp Q band was observed in coordinating solvents. Variable-temperature absorption spectra and fluorescence lifetime measurements were used to characterize the aggregation-induced absorption and emission in non-coordinating solvents. A selective aggregation–disaggregation process was also observed in thin films of this phthalocyanine zinc complex, and the optical properties of the film depend on the annealing temperature. The changes in the NIR region lead to a sizable visible color change that is recognizable by the naked human eye. The temperature-dependent control of the aggregation process in the thin film was confirmed using operando spectroscopy techniques. A simple phthalocyanine zinc complex exhibits a visible color change in response to weak external stimuli, i.e., changes in solvent and temperature.![]()
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Affiliation(s)
- Taniyuki Furuyama
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
- Japan Science and Technology Agency (JST)-PRESTO
| | - Shiori Uchiyama
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
| | - Tatsuki Chikamatsu
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
| | - Takafumi Horikawa
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
| | - Hajime Maeda
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
| | - Masahito Segi
- Graduate School of Natural Science and Technology
- Kanazawa University
- Kanazawa 920-1192
- Japan
| | | | - Tetsuya Taima
- Nanomaterials Research Institute
- Kanazawa University
- Kanazawa 920-1192
- Japan
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Shiokawa M, Omatsu T, Katayama Y, Nishine K, Fujimoto Y, Uchiyama S, Kameyama KI, Nagai M, Mizutani T, Sakoda Y, Fukusho A, Aoki H. END-phenomenon negative bovine viral diarrhea virus that induces the host's innate immune response supports propagation of BVDVs with different immunological properties. Virology 2019; 538:97-110. [PMID: 31590058 DOI: 10.1016/j.virol.2019.09.016] [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: 09/05/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
Our previous study reported that persistently infected (PI) cattle of bovine viral diarrhea virus (BVDV) have co-infected with BVDV/END- and /END+ that promote and inhibit host's type-I interferon (IFN) production, respectively. However, the relationship between co-infection of immunologically distinct BVDVs and persistent infection as well as the biological significance of END- viruses remains unknown. Experiments using cultured cells revealed that END+ virus, which is unable to propagate in situations where the host's immune response is induced by IFN-α addition, is able to propagate under those conditions when co-infecting with END- virus. These results indicate that BVDV/END- can coexist with BVDV/END+ and that co-infection with END- viruses supports the propagation of END+ viruses. Our in vitro experiments strongly suggest that co-infection with END- virus is involved in the maintenance of persistent infection of BVDV.
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Affiliation(s)
- Mai Shiokawa
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Tsutomu Omatsu
- Research and Education Center for Prevention of Global Infectious Disease of Animal, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Yukie Katayama
- Research and Education Center for Prevention of Global Infectious Disease of Animal, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Kaoru Nishine
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan; Kyoto Biken Laboratories, Inc. Formulation Department, Formulation Section 1, Kyoto, Japan
| | - Yuri Fujimoto
- Laboratory of Microbiology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Shiori Uchiyama
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ken-Ichiro Kameyama
- Division of Transboundary Animal Disease, National Institute of Animal Health, NARO, Ibaraki, Japan
| | - Makoto Nagai
- Research and Education Center for Prevention of Global Infectious Disease of Animal, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Tetsuya Mizutani
- Research and Education Center for Prevention of Global Infectious Disease of Animal, Faculty of Agriculture, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Yoshihiro Sakoda
- Laboratory of Microbiology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, Hokkaido, Japan
| | - Akio Fukusho
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hiroshi Aoki
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan.
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Komiya Y, Shimomura Y, Higurashi T, Sugi Y, Arimoto J, Umezawa S, Uchiyama S, Matsumoto M, Nakajima A. Patients with colorectal cancer have identical strains of Fusobacterium nucleatum in their colorectal cancer and oral cavity. Gut 2019; 68:1335-1337. [PMID: 29934439 PMCID: PMC6582823 DOI: 10.1136/gutjnl-2018-316661] [Citation(s) in RCA: 146] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/25/2018] [Accepted: 06/05/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Yasuhiko Komiya
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan,Gastroenterology, Yokosuka General Hospital Uwamachi, Yokosuka, Japan
| | - Yumi Shimomura
- Dairy Science and Technology Institute, Kyodo Milk Industry Co. Ltd, Tokyo, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yutaka Sugi
- Dairy Science and Technology Institute, Kyodo Milk Industry Co. Ltd, Tokyo, Japan
| | - Jun Arimoto
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shotaro Umezawa
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Mitsuharu Matsumoto
- Dairy Science and Technology Institute, Kyodo Milk Industry Co. Ltd, Tokyo, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
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Kamimura M, Taguchi A, Komatsu M, Koiwai H, Ashizawa R, Ichinose A, Takahara K, Uchiyama S, Kato H. Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese. Osteoporos Int 2019; 30:621-628. [PMID: 30460382 DOI: 10.1007/s00198-018-4775-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/27/2018] [Accepted: 11/11/2018] [Indexed: 12/13/2022]
Abstract
UNLABELLED In osteoporosis patients receiving antiresorptive medications, stopping the drug and delaying tooth extraction has been suggested to reduce the risk of osteonecrosis of the jaw (ONJ). However, postponing tooth extraction for ≥ 2 months was associated with an increased risk of delayed wound healing beyond 8 weeks after extraction, a risk factor for developing ONJ. INTRODUCTION A long waiting time before tooth extraction could result from concern about a potential increased risk of osteonecrosis of the jaw (ONJ) in osteoporosis patients. We clarified whether a long waiting time before tooth extraction during the past year may be associated with an increased risk of delayed wound healing beyond 8 weeks after tooth extraction, which may be a risk factor of ONJ. METHODS Of 5639 patients aged ≥ 60 years who visited our 20 clinics or hospitals and answered a structured questionnaire, 426 patients (151 men, 275 women) aged 60-96 years comprised the final participants in this study. Self-reported kyphosis was used as a surrogate marker of vertebral fractures. Stepwise logistic regression analysis, adjusted for covariates, was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) for the presence of delayed wound healing longer than 8 weeks after tooth extraction during the past year based on the duration before extraction. RESULTS Subjects who had waited > 2 months for tooth extraction had a significantly higher risk of delayed wound healing compared with those whose tooth was extracted within 1 month (OR = 7.23; 95% CI = 2.19-23.85, p = 0.001) regardless if antiresorptive medications for osteoporosis were used. The presence of self-reported kyphosis was significantly associated with an increased risk of delayed wound healing (OR = 5.08; 95% CI = 1.11-23.32, p = 0.036). CONCLUSIONS A long waiting time before tooth extraction may be a risk factor for delayed wound healing beyond 8 weeks after extraction in patients aged ≥ 60 years.
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Affiliation(s)
- M Kamimura
- Center for Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, 595-17 Kotobuki, Matsumoto, 399-0021, Japan
| | - A Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, 399-0781, Japan.
| | - M Komatsu
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
| | - H Koiwai
- Koiwai Orthopedic Clinic, 1585-4 Mikageshinden, Komoro, 384-0091, Japan
| | - R Ashizawa
- Ashizawa Orthopedic Clinic, 12205-2 Nakaminowa, Minowacho, Kamiina-gun, Nagano, 399-4601, Japan
| | - A Ichinose
- Ichinose Clinic, 4824, Shimosuwa-machi, Suwa-gun, Nagano, 393-0087, Japan
| | - K Takahara
- Takahara Clinic, 5586-2, Minami-Minowa, Kamiina-gun, Nagano, 399-4511, Japan
| | - S Uchiyama
- Department of Orthopedic Surgery, Okaya City Hospital, 4-11-33, Honmachi, Okaya, Nagano, 394-8512, Japan
| | - H Kato
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan
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Adachi T, Abe T, Mizuno T, Iida Y, Yamada T, Uchiyama S, Nishi M, Nagao T, Sakamoto K, Ito T, Fujimoto N, Kobayashi K, Okumura T, Yamada S. P3196Anorexia coexisted in frailty predicts 1-year prognosis in patients with heart failure: a multicenter prospective cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Adachi
- Nagoya University Graduate School of Medicine, Department of Rehabilitation, Nagoya, Japan
| | - T Abe
- Aichi Medical University Hospital, Department of Rehabilitation, Nagakute, Japan
| | - T Mizuno
- Aichi Medical University Hospital, Department of Cardiology, Nagakute, Japan
| | - Y Iida
- Kainan Hospital, Department of Rehabilitation, Yatomi, Japan
| | - T Yamada
- Kainan Hospital, Department of Cardiology, Yatomi, Japan
| | - S Uchiyama
- New Tokyo hospital, Department of Rehabilitation, Matsudo, Japan
| | - M Nishi
- New Tokyo hospital, Department of Rehabilitation, Matsudo, Japan
| | - T Nagao
- Hoshi General Hospital, Department of Rehabilitation, Koriyama, Japan
| | - K Sakamoto
- Hoshi General Hospital, Department of Cardiology, Koriyama, Japan
| | - T Ito
- Mie University Hospital, Department of Rehabilitation, Tsu, Japan
| | - N Fujimoto
- Mie University Graduate School of Medicine, Department of Cardiology, Tsu, Japan
| | - K Kobayashi
- Nagoya University Hospital, Department of Rehabilitation, Nagoya, Japan
| | - T Okumura
- Nagoya University Hospital, Department of Cardiology, Nagoya, Japan
| | - S Yamada
- Nagoya University, Department of Health Sciences, Nagoya, Japan
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Umezawa S, Nagata N, Arimoto J, Uchiyama S, Higurashi T, Nakano K, Ishii N, Sakurai T, Moriyasu S, Takeda Y, Nagase H, Komatsu H, Nakajima A, Mizuki A. Contrast-enhanced CT for Colonic Diverticular Bleeding before Colonoscopy: A Prospective Multicenter Study. Radiology 2018; 288:755-761. [PMID: 29893642 DOI: 10.1148/radiol.2018172910] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose To demonstrate the usefulness of precolonoscopy intravenous contrast material-enhanced CT for colonic diverticular bleeding (CDB). Materials and Methods A prospective, multicenter, observational study was performed. Patients with acute-onset hematochezia who were admitted to hospital were included, and those without CDB were excluded. CT was performed before colonoscopy. A Mann-Whitney U test, χ2 test, and multivariable logistic regression analysis were performed to determine the accuracy of CT before colonoscopy. Results A total of 442 patients (mean age, 71.2 years; 302 male patients; 68.3% men) were included between January 2014 and December 2015, and 202 patients were diagnosed as having CDB. The positive extravasation rate during CT was 50 of 202 (24.7%) among all patients and five of nine (55.6%) among patients who underwent CT within 1 hour of the last hematochezia. At multivariable analysis, the interval from the last hematochezia until CT was a predictor of extravasation (beta coefficient, -.0038 ± 0.0014 [standard deviation]). Extravasation at CT had a sensitivity of 38 of 66 (57.6%; 95% confidence interval: 44.8%, 69.7%) and a specificity of 124 of 136 (91.2%; 95% confidence interval: 85.1%, 95.4%) for the prediction of stigmata of recent hemorrhage of diverticula during colonoscopy. The sensitivity was higher in patients who underwent CT examination within 4 hours of hematochezia, compared with those examined after 4 hours (64.7% [33 of 51] vs 33.3% [five of 15]; P < .01). Conclusion Extravasation findings for CT with intravenous contrast material had high specificity for the prediction of stigmata of recent hemorrhage of diverticula during colonoscopy, regardless of the timing of the CT examination. Although the sensitivity was relatively low, it was higher when the CT examination was performed within 4 hours after the last hematochezia. Therefore, urgent precolonoscopy CT may contribute to decision making regarding whether an urgent colonoscopy should be performed.
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Affiliation(s)
- Shotaro Umezawa
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Naoyoshi Nagata
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Jun Arimoto
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Shiori Uchiyama
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Takuma Higurashi
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Kaoru Nakano
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Naoki Ishii
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Toshiyuki Sakurai
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Shiori Moriyasu
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Yuichi Takeda
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Hajime Nagase
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Hirokazu Komatsu
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Atsushi Nakajima
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
| | - Akira Mizuki
- From the Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanagawa-ku, Yokohama 236-0004 Japan (S. Umezawa, S. Uchiyama, T.H., A.N.); Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan (N.N., T.S., S.M.); Department of Gastroenterology, Hiratsuka Citizen Hospital, Kanagawa, Japan (J.A.); Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan (K.N., N.I.); Department of Endoscopy, Koritsu Showa Hospital, Tokyo, Japan (Y.T.); Department of Gastroenterology, Yokohama Rosai Hospital, Kanagawa, Japan (H.N.); Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan (H.K.); and Department of Gastroenterology, Keiyu Hospital, Kanagawa, Japan (A.M.)
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10
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Inoh Y, Kanoshima K, Ohkuma K, Fuyuki A, Uchiyama S, Ohkubo H, Higurashi T, Iida H, Nonaka T, Fujita K, Kusakabe A, Inamori M, Hiroishi K, Nagase H, Nakajima A, Takahara T. Assessment of colonic contents in patients with chronic constipation using MRI. J Clin Biochem Nutr 2018; 62:277-280. [PMID: 29892169 PMCID: PMC5990404 DOI: 10.3164/jcbn.17-104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/10/2017] [Indexed: 12/12/2022] Open
Abstract
Although chronic constipation is common, colonic functional evaluating tests are uncommon. This study examines whether chronic constipation and gastrointestinal symptoms are correlated with the lateral diameter of the colon measured from MRI images. We included chronic constipation patients in a prospective, cross-sectional study using MRI at three centers. We divided 3D MRI colorectal images into 6 segments using with specified sequences and selected the maximum luminal diameter from each segment. We used the GSRS questionnaire to evaluate gastrointestinal symptoms. We evaluated the correlation between luminal diameters and GSRS scores. We found the following positive correlations: descending colon and unsatisfactory defecation symptoms; sigmoid colon and diarrhea; and rectum and constipation. The sum and ratio of the ascending and sigmoid colon diameters correlated with nausea and diarrhea. The sum of the transvers to the sigmoid colon diameter also correlated with nausea and diarrhea. The sum of all segment diameters correlated with nausea and constipation. In conclusion, we showed cross-sectional study of colonic MRI correlate with gastrointestinal symptoms. MRI might be useful for colonic motility evaluations to determine appropriate constipation treatments (Clinical trial registry number UMIN 000021274).
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Affiliation(s)
- Yumi Inoh
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Kenji Kanoshima
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Kanji Ohkuma
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Akiko Fuyuki
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Hidenori Ohkubo
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takuma Higurashi
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hiroshi Iida
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Nonaka
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Koji Fujita
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Akihiko Kusakabe
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Masahiko Inamori
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Kazumasa Hiroishi
- Department of Gastroenterology, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa 215-0026, Japan
| | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Atushi Nakajima
- Department of Hepatology and Gastroenterology, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Taro Takahara
- Department of Biological Engineering, Tokai University, School of Biological Engineering, Isehara, Kanagawa 259-1193, Japan
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11
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Takayanagi T, Sekino Y, Ishii K, Sato S, Umemura R, Uchiyama S, Kanazawa N, Kawana K, Nagase H. [Successful endoscopic ultrasound-guided cyst drainage (EUS-CD) of pancreatic pseudocyst in the abdominal cavity to the cervical region accompanied by spontaneous rupture into the portal vein:a case study]. Nihon Shokakibyo Gakkai Zasshi 2018; 115:219-227. [PMID: 29459566 DOI: 10.11405/nisshoshi.115.219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 53-year-old man was admitted to our hospital with the complaint of neck pain and dyspnea. His blood examination revealed increased C-reactive protein and amylase levels. Enhanced computed tomography (CT) images demonstrated a retropharyngeal and a mediastinal low-density area extending to the portal area. He was diagnosed with pancreatic pseudocyst from the abdominal cavity to the cervical region accompanied by spontaneous rupture into the portal vein. Endoscopic ultrasound-guided cyst drainage (EUS-CD) of the most inferior cavity around the superior mesenteric artery was performed through the gastric wall. No adverse events were recorded during the procedure, and a near-complete resolution of his symptoms and the pseudocyst was achieved.
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Affiliation(s)
| | - Yusuke Sekino
- Department of Gastroenterology, Yokohama Rosai Hospital
| | - Ken Ishii
- Department of Gastroenterology, NTT Medical Center Tokyo
| | - Shinji Sato
- Department of Gastroenterology, Yokohama Rosai Hospital
| | | | | | | | | | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital
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12
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Abstract
Herein, we show that the Zn complex of 1,4,8,11,15,18,22,28-octakis(butoxy)phthalocyanine exhibits solvatochromism and characterize the corresponding visible color changes. In particular, we reveal that although the variation of the solvent-dependent position of the Q band is relatively small (~100 nm), the solution colors change from red to yellow and green depending on the composition of the solvent mixture. Moreover, the above Q band was located at the border between the visible and near-IR regions, [Formula: see text]. its red shift could not be directly recognized by the human naked eye. Substituents on oxygen atoms were shown to influence phthalocyanine aggregation and thus affect near-IR absorption, with the observed near-IR solvatochromism providing a new strategy of color change in response to weak external stimuli.
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Affiliation(s)
| | - Shiori Uchiyama
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan
| | - Takayuki Iwamoto
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan
| | - Hajime Maeda
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan
| | - Masahito Segi
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-Machi, Kanazawa, 920-1192, Japan
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13
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Yasaka M, Uchiyama S, Atarashi H, Okumura K, Koretsune Y, Yamashita T, Fukaya T, Inoue H. The final results for secondary stroke prevention of j-dabigatran surveillance program: Safety and effectiveness of dabigatran long-term treatment in Japanese patients with atrial fibrillation. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3630] [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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14
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Uchiyama S, Hirotsugu A, Inoue H, Kitazono T, Shimizu W, Yamashita T, Ikeda T, Kamouchi M, Kaikita K, Fukuda K, Origasa H, Shimokawa H. Primary and secondary prevention of stroke and systemic embolism with rivaroxaban in patients with non-valvular atrial fibrillation (sub-analysis of the expand study). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3148] [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: 10/18/2022]
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15
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Uchiyama S. Atrial fibrillation - practical issues. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.143] [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: 10/18/2022]
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16
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Ohi H, Uchiyama S, Kanda T, Mukoda M, Hayashi M, Kato H. Outcomes of grafting intrasynovial tendons of the toes to the hands in 10 patients: a preliminary report. J Hand Surg Eur Vol 2017; 42:469-472. [PMID: 28193099 DOI: 10.1177/1753193417691653] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Ten patients had intrasynovial tendon grafting harvested from the toes for secondary flexor tendon reconstruction in nine fingers and one thumb in our institutes from 2009 to 2014. These patients were followed for a mean of 15 (range: 8-36) months. The ranges of total active motion of the proximal and distal interphalangeal joints of these nine fingers were 143° (range: 108-175°) and of the metacarpophalangeal and interphalangeal joints of one thumb were 110°. In conclusion, this technique is feasible and gives a good result when successful but with a high complication rate. Level of Evidence IV.
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Affiliation(s)
- H Ohi
- 1 Hand and Microsurgery Center, Seirei Hamamatsu Hospital, Hamamatsu, Japan
| | - S Uchiyama
- 2 Department of Orthopaedic Surgery, Shinshu University School of Medicine. Matsumoto, Japan
| | - T Kanda
- 1 Hand and Microsurgery Center, Seirei Hamamatsu Hospital, Hamamatsu, Japan
| | - M Mukoda
- 1 Hand and Microsurgery Center, Seirei Hamamatsu Hospital, Hamamatsu, Japan
| | - M Hayashi
- 2 Department of Orthopaedic Surgery, Shinshu University School of Medicine. Matsumoto, Japan
| | - H Kato
- 2 Department of Orthopaedic Surgery, Shinshu University School of Medicine. Matsumoto, Japan
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17
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Kamimura M, Nakamura Y, Ikegami S, Uchiyama S, Kato H, Taguchi A. Significant improvement of bone mineral density and bone turnover markers by denosumab therapy in bisphosphonate-unresponsive patients: response to comments. Osteoporos Int 2017; 28:1757-1758. [PMID: 28127625 DOI: 10.1007/s00198-017-3923-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M Kamimura
- Center of Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, Kotobuki-Toyooka 595-17, Matsumoto, 399-0021, Japan
| | - Y Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
- Department of Orthopedic Surgery, Showa-Inan General Hospital, Akaho 3230, Komagane, 399-4117, Japan.
| | - S Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - S Uchiyama
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - H Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - A Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, 399-0781, Japan
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18
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Kato T, Honda Y, Kurita Y, Iwasaki A, Sato T, Kessoku T, Uchiyama S, Ogawa Y, Ohkubo H, Higurashi T, Yamanaka T, Usuda H, Wada K, Nakajima A. Lubiprostone improves intestinal permeability in humans, a novel therapy for the leaky gut: A prospective randomized pilot study in healthy volunteers. PLoS One 2017; 12:e0175626. [PMID: 28410406 PMCID: PMC5391961 DOI: 10.1371/journal.pone.0175626] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/24/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS The barrier function of the small intestinal mucosa prevents the introduction of undesired pathogens into the body. Breakdown of this barrier function increases intestinal permeability. This has been proposed to induce not only gastrointestinal diseases, including inflammatory bowel disease and irritable bowel syndrome, but also various other diseases, including allergies, diabetes mellitus, liver diseases, and collagen diseases, which are associated with this so called "leaky gut syndrome." As such, a method to prevent leaky gut syndrome would have substantial clinical value. However, no drugs have been demonstrated to improve disturbed intestinal permeability in humans to date. Therefore, we investigated whether a drug used to treat chronic constipation, lubiprostone, was effective for this purpose. METHODS Healthy male volunteers were treated with lubiprostone (24 μg/day) for 28 days. Intestinal permeability was evaluated by measuring the lactulose-mannitol ratio (LMR) after administration of diclofenac and compared with an untreated group. The examination was conducted three times in total, i.e., at baseline before diclofenac administration and after 14 and 28 days of lubiprostone treatment. Blood endotoxin activity was also evaluated at the same time points. RESULTS The final analysis was conducted on 28 subjects (14 in the lubiprostone group and 14 in the untreated group). The LMR after 28 days of treatment was significantly lower in the lubiprostone group than that in the untreated group (0.017 vs. 0.028, respectively; 95% confidence interval, -0.022--0.0001; p = 0.049). Blood endotoxin activity exhibited almost no change over time in the lubiprostone and untreated groups and displayed no significant differences at any time point of examination. CONCLUSIONS This study is the first to report an improvement in leaky gut using an available drug in humans. The result suggests that lubiprostone may prevent and ameliorate "leaky gut syndrome". However, a pivotal trial is needed to confirm our finding.
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Affiliation(s)
- Takayuki Kato
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Yasushi Honda
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Yusuke Kurita
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Akito Iwasaki
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Takamitsu Sato
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Yuji Ogawa
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Hidenori Ohkubo
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Takeharu Yamanaka
- Department of Biostatistics, Yokohama City University Graduate School of Medicine, Yokoahama, Kanagawa, Japan
| | - Haruki Usuda
- Department of Pharmacology, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Koichiro Wada
- Department of Pharmacology, Shimane University School of Medicine, Izumo, Shimane, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
- * E-mail:
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19
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Kamimura M, Nakamura Y, Ikegami S, Uchiyama S, Kato H, Taguchi A. Significant improvement of bone mineral density and bone turnover markers by denosumab therapy in bisphosphonate-unresponsive patients. Osteoporos Int 2017; 28:559-566. [PMID: 27650642 PMCID: PMC5269470 DOI: 10.1007/s00198-016-3764-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/31/2016] [Indexed: 11/12/2022]
Abstract
UNLABELLED Bone mineral density (BMD) sometimes cannot be improved by long-term bisphosphonate (BP) therapy in osteoporosis (OP). This study showed that lumbar as well as hip BMD significantly increased after denosumab treatment in patients not responsive to BPs. Thus, denosumab may be a strong OP treatment option for BP-unresponsive patients. INTRODUCTION BMD sometimes cannot be improved by long-term BP therapy. METHODS We administered denosumab to osteoporotic patients with a poor response to BPs who had been taking them for 2 years or longer. Ninety-eight women with BP-poor responsive OP were enrolled in this study. Mean (standard deviation [SD]) age was 71.2 (6.9) years and mean (SD) duration of BP treatment was 59.9 (34.3) months. We distinguished BP responders from non-responders based on changes in BMD values at denosumab commencement (baseline) from 2 years beforehand. RESULTS There were no significant differences in age, duration of BP use, bone turnover markers, or BMD at baseline between the groups. Prior to denosumab, BMD had increased significantly in responders and decreased significantly in non-responders. Bone turnover markers had decreased significantly at 4 months of denosumab treatment (P < 0.001) and lumbar and hip BMD were significantly increased at 1 year of therapy in both groups (P < 0.001). Simple correlation coefficients were -0.337 for lumbar and -0.339 for hip BMD changes (both P = 0.001) before and after denosumab treatment. Both at the lumbar spine and hips, decreased BMD before denosumab therapy was significantly associated with an increase in BMD at 1 year of treatment (spine, t value = -3.502, P = 0.001, R = 0.113; hip, t value = -3.526, P = 0.001, R = 0.115). CONCLUSIONS These results suggest that denosumab may be a strong OP treatment option for BP-unresponsive patients.
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Affiliation(s)
- M Kamimura
- Center of Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, Kotobuki 595-17, Matsumoto, 399-0021, Japan
| | - Y Nakamura
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan.
- Department of Orthopedic Surgery, Showa-Inan General Hospital, Akaho 3230, Komagane, 399-4117, Japan.
| | - S Ikegami
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - S Uchiyama
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - H Kato
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan
| | - A Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, 1780 Gobara Hirooka, Shiojiri, 399-0781, Japan
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20
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Nonaka T, Inamori M, Honda Y, Kanoshima K, Inoh Y, Matsuura M, Uchiyama S, Sakai E, Higurashi T, Ohkubo H, Iida H, Endo H, Fujita K, Kusakabe A, Atsukawa K, Takahashi H, Tateishi Y, Maeda S, Ohashi K, Nakajima A. Can magnifying endoscopy with narrow-band imaging discriminate between carcinomas and low grade adenomas in gastric superficial elevated lesions? Endosc Int Open 2016; 4:E1203-E1210. [PMID: 27853747 PMCID: PMC5110354 DOI: 10.1055/s-0042-117632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/09/2016] [Indexed: 02/08/2023] Open
Abstract
UNLABELLED Background and study aims: The aim of this study was to investigate the capability of magnifying endoscopy with narrow-band imaging (ME-NBI) to discriminate between early carcinomas (EC) and low grade adenomas (LGA) in gastric superficial elevated epithelial neoplasias. Patients and methods: We investigated 100 consecutive cases of gastric superficial elevated epithelial neoplasias that were removed using endoscopic submucosal dissection. The pathological diagnostic criteria were based on the revised Vienna classification; category 4 (mucosal high grade neoplasia) and category 5 (submucosal invasion by carcinoma) lesions were diagnosed as EC, whereas category 3 (mucosal low grade neoplasia) lesions were diagnosed as LGA. The associations between the postoperative pathological diagnoses and the ME-NBI findings were analyzed, and included the shape, specification, and area of irregularity in the microvascular architecture (MV) and the microsurface structure (MS). Results: Seventy-nine EC and 21 LGA cases diagnosed postoperatively were evaluated retrospectively. The lesion size (median; range (mm)) was significantly larger in the EC group (14; 2 - 95) compared to the LGA group (5; 2 - 16) (P < 0.001). Wavy forms in the MV shapes (P = 0.031), extension in the MV specifications (P = 0.035), and area with MV irregularity (P = 0.001) were found to be statistically significant predictive findings for EC. Villous forms in the MS shapes (P = 0.026), enlargement in the MS specifications (P = 0.044), and area with MS irregularity (P = 0.021) were also found to be statistically significant predictive findings for EC. The rates of preoperative sensitivity, specificity, and diagnostic accuracy of ME-NBI for discriminating EC were 86.1 %, 38.9 %, and 75 %, respectively. Conclusions: The present study suggests that ME-NBI is useful for the differential diagnosis of EC and LGA in gastric superficial elevated epithelial neoplasias. STUDY REGISTRATION UMIN000012925.
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Affiliation(s)
- Takashi Nonaka
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Masahiko Inamori
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan,Corresponding author Masahiko Inamori, MD PhD Department of Medical EducationYokohama City University School of Medicine3-9 FukuuraKanazawa-kuYokohama236-0004Japan+81-45-7843546
| | - Yasushi Honda
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kenji Kanoshima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yumi Inoh
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Mizue Matsuura
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Eiji Sakai
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hidenori Ohkubo
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hiroshi Iida
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hiroki Endo
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Koji Fujita
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Akihiko Kusakabe
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kazuhiro Atsukawa
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
| | - Hisao Takahashi
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Kanagawa, Japan
| | - Yoko Tateishi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shin Maeda
- Department of Medical Education, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
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21
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Yamazaki M, Ohnishi T, Hosokawa K, Yamaguchi K, Yoneyama T, Kawashima A, Okada Y, Kitagawa K, Uchiyama S. Measurement of residual platelet thrombogenicity under arterial shear conditions in cerebrovascular disease patients receiving antiplatelet therapy. J Thromb Haemost 2016; 14:1788-97. [PMID: 27328457 DOI: 10.1111/jth.13391] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 05/22/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED Essentials A consensus methodology for assessing the effects of antiplatelet agents has not been established. Measuring platelet thrombus formation (PTF) for evaluating antiplatelet effects was assessed. PTF differentially reflected antiplatelet effects compared to other tests. PTF may be associated with the severity of carotid or intracranial arterial stenosis. Click to hear a presentation on platelet function testing in the clinic by Gresele and colleagues SUMMARY Background A consensus methodology for assessing the effects of antiplatelet agents has not been established. Objective We investigated the usefulness of directly measuring platelet thrombus formation (PTF) using a microchip-based flow chamber system for evaluating antiplatelet therapy. Patients/Methods Platelet thrombus formation in the whole blood of 94 patients with ischemic cerebrovascular disease treated with clopidogrel and/or aspirin was measured in a flow chamber system at a shear rate of 1500 s(-1) and was compared with the results of assays for agonist-induced platelet aggregability, phosphorylation of vasodilator-stimulated phosphoprotein, platelet p-selectin expression (PS), and platelet-monocyte complexes. Results In all patients tested, area under the flow pressure curve (AUC10), which represents platelet thrombogenicity, showed weak correlation with platelet aggregation induced by either adenosine diphosphate or collagen. In addition, AUC10 was lower in patients treated with dual antiplatelet therapy (median 79.4) compared with patients treated with aspirin or clopidogrel alone (217.7 and 301.0, respectively), whereas the parameters evaluated by the other assays did not reflect the combined treatment efficacy. In clopidogrel monotherapy patients, AUC10 was associated with the severity of arterial stenosis (R(2) = 0.127, β = 1.25), and AUC10 and PS were higher in patients with severe carotid or intracranial arterial stenosis than in those with mild stenosis. Conclusions Platelet thrombus formation measurement using a flow-chamber system was useful for evaluating the efficacy of treatment with aspirin and clopidogrel, both alone and in combination. The present findings indicate that high residual platelet thrombogenicity in patients treated with clopidogrel may be associated with the severity of carotid or intracranial arterial stenosis.
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Affiliation(s)
- M Yamazaki
- Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
| | - T Ohnishi
- Research Institute, Fujimori Kogyo Co., Ltd, Yokohama, Kanagawa, Japan
| | - K Hosokawa
- Research Institute, Fujimori Kogyo Co., Ltd, Yokohama, Kanagawa, Japan
| | - K Yamaguchi
- Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - T Yoneyama
- Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - A Kawashima
- Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Y Okada
- Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - K Kitagawa
- Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - S Uchiyama
- Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
- Clinical Research Center for Medicine, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Minato-ku, Japan
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22
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Perera KS, Vanassche T, Bosch J, Swaminathan B, Mundl H, Giruparajah M, Barboza MA, O’Donnell MJ, Gomez-Schneider M, Hankey GJ, Yoon BW, Roxas A, Lavallee P, Sargento-Freitas J, Shamalov N, Brouns R, Gagliardi RJ, Kasner SE, Pieroni A, Vermehren P, Kitagawa K, Wang Y, Muir K, Coutinho JM, Connolly SJ, Hart RG, Czeto K, Kahn M, Mattina K, Ameriso S, Pujol-Lereis V, Hawkes M, Pertierra L, Perera N, De Smedt A, Van Dyck R, Van Hooff R, Yperzeele L, Gagliardi V, Cerqueir L, Yang X, Chen W, Amarenco P, Guidoux C, Ringleb P, Bereczki D, Vastagh I, Canavan M, Toni D, Anzini A, Colosimo C, De Michele M, Di Mascio M, Durastanti L, Falcou A, Fausti S, Mancini A, Mizumo S, Uchiyama S, Kim C, Jung S, Kim Y, Kim J, Jo J, Arauz A, Quiroz-Compean A, Colin J, Nederkoorn P, Marianito V, Cunha L, Santo G, Silva F, Coelho J, Kustova M, Meshkova K, Williams G, Siegler J, Zhang C, Gallatti N, Kruszewski M. Global Survey of the Frequency of Atrial Fibrillation–Associated Stroke. Stroke 2016; 47:2197-202. [DOI: 10.1161/strokeaha.116.013378] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/27/2016] [Indexed: 12/22/2022]
Abstract
Background and Purpose—
Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features.
Methods—
Consecutive patients hospitalized for ischemic stroke in 2013 to 2014 were surveyed from 19 stroke research centers in 19 different countries. Data were analyzed by global regions and World Bank income levels.
Results—
Of 2144 patients with ischemic stroke, 590 (28%; 95% confidence interval, 25.6–29.5) had AF-associated stroke, with highest frequencies in North America (35%) and Europe (33%) and lowest in Latin America (17%). Most had a history of AF before stroke (15%) or newly detected AF on electrocardiography (10%); only 2% of patients with ischemic stroke had unsuspected AF detected by poststroke cardiac rhythm monitoring. The mean age and 30-day mortality rate of patients with AF-associated stroke (75 years; SD, 11.5 years; 10%; 95% confidence interval, 7.6–12.6, respectively) were substantially higher than those of patients without AF (64 years; SD, 15.58 years; 4%; 95% confidence interval, 3.3–5.4;
P
<0.001 for both comparisons). There was a strong positive correlation between the mean age and the frequency of AF (
r
=0.76;
P
=0.0002).
Conclusions—
This cross-sectional global sample of patients with recent ischemic stroke shows a substantial frequency of AF-associated stroke throughout the world in proportion to the mean age of the stroke population. Most AF is identified by history or electrocardiography; the yield of conventional short-duration cardiac rhythm monitoring is relatively low. Patients with AF-associated stroke were typically elderly (>75 years old) and more often women.
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Affiliation(s)
- Kanjana S. Perera
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Thomas Vanassche
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Jackie Bosch
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Balakumar Swaminathan
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Hardi Mundl
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Mohana Giruparajah
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Miguel A. Barboza
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Martin J. O’Donnell
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Maia Gomez-Schneider
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Graeme J. Hankey
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Byung-Woo Yoon
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Artemio Roxas
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Philippa Lavallee
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Joao Sargento-Freitas
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Nikolay Shamalov
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Raf Brouns
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Rubens J. Gagliardi
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Scott E. Kasner
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Alessio Pieroni
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Philipp Vermehren
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Kazuo Kitagawa
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Yongjun Wang
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Keith Muir
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Jonathan M. Coutinho
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Stuart J. Connolly
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - Robert G. Hart
- From the Population Health Research Institute, McMaster University, Hamilton Health Sciences, Ontario, Canada (K.S.P., J.B., B.S., M.G., S.J.C., R.G.H.); Department of Cardiovascular Sciences, University of Leuven, Belgium (T.V.); Bayer-Pharma AG, Wuppertal, Germany (H.M.); Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico (M.A.B.); University of Galway, Ireland (M.J.O.); Institute for Neurological Research, Fundacion para la Lucha contra las Enfermedades Neurologicas de la
| | - K. Czeto
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - M. Kahn
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - K.R. Mattina
- Population Health Research Institute (Coordinating Center), Hamilton, Ontario, Canada
| | - S.F. Ameriso
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - V. Pujol-Lereis
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - M. Hawkes
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - L. Pertierra
- Institute for Neurological Research, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - N. Perera
- School of Medicine & Pharmacology, University of Western Australia and Sir Charles Gairdner Hospital, Perth, Australia
| | - A. De Smedt
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - R. Van Dyck
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - L. Yperzeele
- Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - L.G. Cerqueir
- Santa Casa de São Paulo, Medical School, Sao Paulo, Brazil
| | - X. Yang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - W. Chen
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | | | - P.A. Ringleb
- University Hospital Heidelberg, Heidelberg, Germany
| | | | - I. Vastagh
- Semmelweis University, Budapest, Hungary
| | - M. Canavan
- Galway University Hospitals, Galway, Ireland
| | - D. Toni
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Anzini
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - C. Colosimo
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - M. De Michele
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - M.T. Di Mascio
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - L. Durastanti
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Falcou
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - S. Fausti
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - A. Mancini
- Department of Neurology and Psychiatry, ‘Sapienza’ University, Rome, Italy
| | - S. Mizumo
- Tokyo Women’s Medical University, Tokyo, Japan
| | - S. Uchiyama
- Tokyo Women’s Medical University, Tokyo, Japan
| | - C.K. Kim
- Seoul National University Hospital, Seoul, Korea
| | - S. Jung
- Seoul National University Hospital, Seoul, Korea
| | - Y. Kim
- Seoul National University Hospital, Seoul, Korea
| | - J.A. Kim
- Seoul National University Hospital, Seoul, Korea
| | - J.Y. Jo
- Seoul National University Hospital, Seoul, Korea
| | - A. Arauz
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | - A. Quiroz-Compean
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | - J. Colin
- Instituto Nacional de Neurologia y Neurocirugia, Mexico D.F., Mexico
| | | | | | - L. Cunha
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - G. Santo
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F. Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J. Coelho
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M. Kustova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - K. Meshkova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - G. Williams
- Institute of Neuroscience and Physiology, University of Glasgow, Queen Elizabeth Hospital, Glasgow, United Kingdom
| | - J. Siegler
- Hospital of the University of Pennslyvania, Philadelphia
| | - C. Zhang
- Hospital of the University of Pennslyvania, Philadelphia
| | - N. Gallatti
- Hospital of the University of Pennslyvania, Philadelphia
| | - M. Kruszewski
- Hospital of the University of Pennslyvania, Philadelphia
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Nagai F, Uchiyama S, Nakagawa H. Posterior Interosseous Nerve Palsy caused by Osteoarthritic Synovitis of the Proximal Radioulnar Joint. ACTA ACUST UNITED AC 2016; 31:697-8. [PMID: 16962217 DOI: 10.1016/j.jhsb.2006.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 07/02/2006] [Accepted: 07/17/2006] [Indexed: 11/23/2022]
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Hashimoto N, Uchiyama S, Kitano M, Nakazawa T, Iwasaki T, Hashimoto T. THU0348 Assessment of Submandibular Gland Ultrasonography in Early-Stage Sjögren's Syndrome. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1469] [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: 11/03/2022]
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Higurashi T, Hosono K, Takahashi H, Komiya Y, Umezawa S, Sakai E, Uchiyama T, Taniguchi L, Hata Y, Uchiyama S, Hattori A, Nagase H, Kessoku T, Arimoto J, Matsuhashi N, Inayama Y, Yamanaka S, Taguri M, Nakajima A. Metformin for chemoprevention of metachronous colorectal adenoma or polyps in post-polypectomy patients without diabetes: a multicentre double-blind, placebo-controlled, randomised phase 3 trial. Lancet Oncol 2016; 17:475-483. [PMID: 26947328 DOI: 10.1016/s1470-2045(15)00565-3] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/24/2015] [Accepted: 12/02/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prevalence of, and mortality from, colorectal cancer is increasing worldwide, and new strategies for prevention are needed to reduce the burden of this disease. The oral diabetes medicine metformin might have chemopreventive effects against cancer, including colorectal cancer. However, no clinical trial data exist for the use of metformin for colorectal cancer chemoprevention. Therefore, we devised a 1-year clinical trial to assess the safety and chemopreventive effects of metformin on sporadic colorectal cancer (assessed by adenoma and polyp recurrence) in patients with a high risk of adenoma recurrence. METHODS This trial was a multicentre, double-blind, placebo-controlled, randomised phase 3 trial. Non-diabetic adult patients who had previously had single or multiple colorectal adenomas or polyps resected by endoscopy were enrolled into the study from five hospitals in Japan. Eligible patients were randomly assigned (1:1) to receive oral metformin (250 mg daily) or identical placebo tablets by a stratified computer-based randomisation method, with stratification by institute, age, sex, and body-mass index. All patients, endoscopists, doctors, and investigators were masked to drug allocation until the end of the trial. After 1 year of administration of metformin or placebo, colonoscopies were done to assess the co-primary endpoints: the number and prevalence of adenomas or polyps. Our analysis included all participants who underwent random allocation, according to the intention-to-treat principle. This trial is registered with University Hospital Medical Information Network (UMIN), number UMIN000006254. FINDINGS Between Sept 1, 2011, and Dec 30, 2014, 498 patients who had had single or multiple colorectal adenomas resected by endoscopy were enrolled into the study. After exclusions for ineligibility, 151 patients underwent randomisation: 79 were assigned to the metformin group and 72 to the placebo group. 71 patients in the metformin group and 62 in the placebo group underwent 1-year follow-up colonoscopy. The prevalence of total polyps (hyperplastic polyps plus adenomas) and of adenomas in the metformin group was significantly lower than that in the placebo group (total polyps: metformin group 27 [38·0%; 95% CI 26·7-49·3] of 71 patients, placebo group 35 [56·5%; 95% CI 44·1-68·8] of 62; p=0·034, risk ratio [RR] 0·67 [95% CI 0·47-0·97]; adenomas: metformin group 22 [30·6%; 95% CI 19·9-41·2] of 71 patients, placebo group 32 [51·6%; 95% CI 39·2-64·1] of 62; p=0·016, RR 0·60 [95% CI 0·39-0·92]). The median number of polyps was zero (IQR 0-1) in the metformin group and one (0-1) in the placebo group (p=0·041). The median number of adenomas was zero (0-1) in the metformin group and zero (0-1) in the placebo group (p=0·037). 15 (11%) of patients had adverse events, all of which were grade 1. We recorded no serious adverse events during the 1-year trial. INTERPRETATION The administration of low-dose metformin for 1 year to patients without diabetes was safe. Low-dose metformin reduced the prevalence and number of metachronous adenomas or polyps after polypectomy. Metformin has a potential role in the chemoprevention of colorectal cancer. However, further large, long-term trials are needed to provide definitive conclusions. FUNDING Ministry of Health, Labour and Welfare, Japan.
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Affiliation(s)
- Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kunihiro Hosono
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hirokazu Takahashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yasuhiko Komiya
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shotaro Umezawa
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Eiji Sakai
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takashi Uchiyama
- Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan
| | - Leo Taniguchi
- Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan
| | - Yasuo Hata
- Department of Gastroenterology, Chigasaki Municipal Hospital, Chigasaki, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Akiko Hattori
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Takaomi Kessoku
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Jun Arimoto
- Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
| | - Nobuyuki Matsuhashi
- Department of Gastroenterology, Kanto Medical Center, NTT East, Shinagawa, Japan
| | - Yoshiaki Inayama
- Department of Pathology, Yokohama City University, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University, Yokohama, Japan
| | - Masataka Taguri
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
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Arimoto J, Endo H, Kato T, Umezawa S, Fuyuki A, Uchiyama S, Higurashi T, Ohkubo H, Nonaka T, Takeno M, Ishigatsubo Y, Sakai E, Matsuhashi N, Nakajima A. Clinical value of capsule endoscopy for detecting small bowel lesions in patients with intestinal Behçet's disease. Dig Endosc 2016; 28:179-85. [PMID: 26459917 DOI: 10.1111/den.12552] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/14/2015] [Accepted: 09/25/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIM To evaluate the clinical value of capsule endoscopy (CE) in patients with intestinal Behçet's disease (BD). METHODS The present study was a case-control pilot study conducted in intestinal BD patients and healthy volunteers. A total of 19 patients with intestinal BD (intestinal BD group) and 19 healthy volunteers (control group) matched for age and sex were enrolled. Frequency, number of small bowel lesions per subject, and Lewis score were comparatively evaluated between the two groups. RESULTS Of the 19 patients with intestinal BD, 18 (94.7%) had reddened lesions, 15 (78.9%) had erosions, and nine (47.4%) had ulcers. There were significant differences in the frequency of reddened lesions (P < 0.0001), erosions (P < 0.0001) and ulcers (P = 0.0011) between the two groups. The difference in the number of small bowel lesions between the two groups was also statistically significant. The median Lewis score in the intestinal BD group was significantly higher than that in the control group (intestinal BD group 237 (0-768) vs. control group 8 (0-135); P < 0.0001). Analysis according to the location in the small bowel revealed that the frequency of ulcers tended to increase towards the distal intestine. CONCLUSION This is the first CE study conducted to examine small bowel involvement in intestinal BD patients. Our results suggest that CE evaluation is necessary, in addition to colonoscopy, in all intestinal BD patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Mitsuhiro Takeno
- Division of Internal Medicine and Clinical Immunology, Yokohama City University School of Medicine, Yokohama
| | - Yoshiaki Ishigatsubo
- Division of Internal Medicine and Clinical Immunology, Yokohama City University School of Medicine, Yokohama
| | - Eiji Sakai
- Department of Gastroenterology, Kanto Medical Center NTT EC, Tokyo, Japan
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Nonaka T, Inamori M, Kanoshima K, Ohkuma K, Inoh Y, Matsuura M, Fuyuki A, Uchiyama S, Higurashi T, Ohkubo H, Iida H, Endo H, Tateishi Y, Kusakabe A, Ohashi K, Maeda S, Nakajima A. Evaluation of endoscopic findings for discriminating between early carcinomas and low-grade adenomas in superficial elevated gastric lesions. Turk J Gastroenterol 2016; 27:108-14. [PMID: 26853793 DOI: 10.5152/tjg.2015.150359] [Citation(s) in RCA: 2] [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] [Indexed: 11/22/2022]
Abstract
BACKGROUND/AIMS This study aimed to determine the useful endoscopic findings in a differential diagnosis between early carcinomas (EC) and low-grade adenomas (LGA) in superficial elevated gastric epithelial neoplasia during conventional endoscopy with white-light imaging (C-WLI). MATERIALS AND METHODS We investigated 270 consecutive cases of superficial elevated gastric epithelial neoplasias, which were removed by endoscopic submucosal dissection. The pathological diagnostic criteria were based on the revised Vienna classification: category 4 (mucosal high-grade neoplasia) or 5 (submucosal invasion by carcinoma) lesions were diagnosed as EC, while category 3 (mucosal low-grade neoplasia) lesions were diagnosed as LGA. The association between the postoperative pathological diagnoses (EC or LGA) and the following endoscopic findings: localized site, lesion size, color (reddish or whitish), shape (smooth, petal, or irregular), and presences of depression, erosion, ulceration, or nodularity on the surface, were evaluated. RESULTS Of 270 epithelial neoplasias, 222 (58 LGA and 164 EC) were retrospectively evaluated. Multiple logistic regression analysis revealed that the lesion size [odds ratio (OR), 1.216; p<0.001) and reddish color (OR, 5.274; p<0.001) were independent findings for EC. CONCLUSION The lesion size and reddish color were useful optical findings for discriminating between EC and LGA.
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Affiliation(s)
- Takashi Nonaka
- Division of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan.
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Ezuka A, Sakai E, Kawana K, Nagase H, Kakuta Y, Uchiyama S, Ohkubo H, Higurashi T, Nonaka T, Endo H, Takahashi H, Nakajima A. Association between factors associated with colorectal cancer and rectal aberrant crypt foci in humans. Oncol Lett 2015; 10:3689-3695. [PMID: 26788192 DOI: 10.3892/ol.2015.3763] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 07/28/2015] [Indexed: 12/26/2022] Open
Abstract
Aberrant crypt foci (ACF) are regarded as potential biomarkers for colorectal cancer (CRC), and have been used as such in recent early-phase chemoprevention trials. However, the associations between the presence of ACF and other factors associated with the development of CRC, such as lifestyle factors, medication use and comorbid medical conditions, remain unknown. Thus, the present retrospective, large, cross-sectional study was conducted to evaluate the potential usefulness of ACF as a surrogate biomarker of CRC. Total colonoscopy was performed and the number of rectal ACF was counted in a total of 902 subjects. A retrospective review of the medical records of the study subjects was performed, and the factors associated with the increased prevalence of ACF was investigated using univariate and multivariate logistic regression analyses. The analysis results identified older age [odds ratio (OR), 9.24; 95% confidence interval (CI), 4.80-17.8; P<0.01], smoking habit (OR, 1.78; 95% CI, 1.20-2.63; P<0.01) and use of insulin (OR, 9.97; 95% CI, 1.28-77.5; P=0.03) as significant independent risk factors associated with the increased prevalence of ACF, regardless of the presence/absence of colon tumors. In addition, it was revealed that the prevalence and number of ACF, and the Ki-67 labeling indices of the colonic epithelial cells were significantly higher in diabetic patients receiving insulin therapy than in those not receiving insulin therapy (P<0.01, P=0.03 and P=0.01, respectively). In conclusion, the potential usefulness of ACF as a surrogate biomarker of CRC was confirmed, although useful data could not be obtained on candidate chemopreventive agents. These results indicated that insulin can enhance colonic epithelial proliferative activity and induce the formation of ACF, thereby possibly triggering CRC development.
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Affiliation(s)
- Akiko Ezuka
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Eiji Sakai
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Kenichi Kawana
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Yukio Kakuta
- Department of Pathology, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hidenori Ohkubo
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Nonaka
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hiroki Endo
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hirokazu Takahashi
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan; Department of Gastroenterology, National Cancer Center, Tokyo 104-0045, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
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Yamazaki H, Uchiyama S, Komatsu M, Hashimoto S, Kobayashi Y, Sakurai T, Kato H. Arthroscopic assistance does not improve the functional or radiographic outcome of unstable intra-articular distal radial fractures treated with a volar locking plate. Bone Joint J 2015; 97-B:957-62. [DOI: 10.1302/0301-620x.97b7.35354] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There is no consensus on the benefit of arthroscopically assisted reduction of the articular surface combined with fixation using a volar locking plate for the treatment of intra-articular distal radial fractures. In this study we compared the functional and radiographic outcomes of fluoroscopically and arthroscopically guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral unstable intra-articular distal radial fractures were randomised equally into the two groups for treatment. The mean age of these 74 patients was 64 years (24 to 92). We compared functional outcomes including active range of movement of the wrist, grip strength and Disabilities of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic outcomes that included gap, step, radial inclination, volar angulation and ulnar variance. There were no significant differences between the techniques with regard to functional outcomes or radiographic parameters. The mean gap and step in the fluoroscopic and arthroscopic groups were comparable at 0.9 mm (standard deviation (sd) 0.7) and 0.7 mm (sd 0.7) and 0.6 mm (sd 0.6) and 0.4 mm (sd 0.5), respectively; p = 0.18 and p = 0.35). Arthroscopic reduction conferred no advantage over conventional fluoroscopic guidance in achieving anatomical reduction of intra-articular distal radial fractures when using a volar locking plate. Cite this article: Bone Joint J 2015; 97-B:957–62.
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Affiliation(s)
- H. Yamazaki
- Aizawa Hospital, 1-5-2
Honjo, Matsumoto, 390-8510, Japan
| | - S. Uchiyama
- Shinshu University School of Medicine, Matsumoto, Japan
| | - M. Komatsu
- Aizawa Hospital, 1-5-2
Honjo, Matsumoto, 390-8510, Japan
| | - S. Hashimoto
- Aizawa Hospital, 1-5-2
Honjo, Matsumoto, 390-8510, Japan
| | - Y. Kobayashi
- Aizawa Hospital, 1-5-2
Honjo, Matsumoto, 390-8510, Japan
| | - T. Sakurai
- Aizawa Hospital, 1-5-2
Honjo, Matsumoto, 390-8510, Japan
| | - H. Kato
- Shinshu University School of Medicine, Matsumoto, Japan
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Hashimoto N, Uchiyama S, Kitano M, Sano H, Iwasaki T, Hashimoto T. FRI0414 Assessment of Salivary Gland Functions and Submandibular Gland Ultrasonography Findings During 10-Years Follow-Up in Patients with Sjögren's Syndrome. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1700] [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: 11/04/2022]
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Matsuura M, Inamori M, Nakajima A, Komiya Y, Inoh Y, Kawasima K, Naitoh M, Fujita Y, Eduka A, Kanazawa N, Uchiyama S, Tani R, Kawana K, Ohtani S, Nagase H. Effectiveness of therapeutic barium enema for diverticular hemorrhage. World J Gastroenterol 2015; 21:5555-5559. [PMID: 25987779 PMCID: PMC4427678 DOI: 10.3748/wjg.v21.i18.5555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/03/2014] [Accepted: 01/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding.
METHODS: We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August 2010 and March 2012 at Yokohama Rosai Hospital. Twenty patients were included in the review, consisting of 14 men and 6 women. The median age of the patients was 73.5 years. The duration of the follow-up period ranged from 1 to 19 mo (median: 9.8 mo). Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization, 6 patients who required it for re-bleeding that developed after the patient left the hospital, and 3 patients who required the procedure for the prevention of re-bleeding. Barium (concentration: 150 w%/v%) was administered per the rectum, and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy. After confirmation that the ascending colon and cecum were filled with barium, the enema tube was withdrawn, and the patient’s position was changed every 20 min for 3 h.
RESULTS: Twelve patients remained free of re-bleeding during the follow-up period (range: 1-19 mo) after the therapeutic barium enema, including 9 men and 3 women with a median age of 72.0 years. Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years: 4 developed early re-bleeding, defined as re-bleeding that occurs within one week after the procedure, and the remaining 4 developed late re-bleeding. The DFI (disease-free interval) decreased 0.4 for 12 mo. Only one patient developed a complication from therapeutic barium enema (colonic perforation).
CONCLUSION: Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy.
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Umezawa S, Higurashi T, Uchiyama S, Sakai E, Ohkubo H, Endo H, Nonaka T, Nakajima A. Visual distraction alone for the improvement of colonoscopy-related pain and satisfaction. World J Gastroenterol 2015; 21:4707-4714. [PMID: 25914482 PMCID: PMC4402320 DOI: 10.3748/wjg.v21.i15.4707] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/02/2014] [Accepted: 12/22/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effect of a relaxing visual distraction alone on patient pain, anxiety, and satisfaction during colonoscopy.
METHODS: This study was designed as an endoscopist-blinded randomized controlled trial with 60 consecutively enrolled patients who underwent elective colonoscopy at Yokohama City University Hospital, Japan. Patients were randomly assigned to two groups: group 1 watched a silent movie using a head-mounted display, while group 2 only wore the display. All of the colonoscopies were performed without sedation. We examined pain, anxiety, and the satisfaction of patients before and after the procedure using questionnaires that included the Visual Analog Scale. Patients were also asked whether they would be willing to use the same method for a repeat procedure.
RESULTS: A total of 60 patients were allocated to two groups. Two patients assigned to group 1 and one patient assigned to group 2 were excluded after the randomization. Twenty-eight patients in group 1 and 29 patients in group 2 were entered into the final analysis. The groups were similar in terms of gender, age, history of prior colonoscopy, and pre-procedural anxiety score. The two groups were comparable in terms of the cecal insertion rate, the time to reach the cecum, the time needed for the total procedure, and vital signs. The median anxiety score during the colonoscopy did not differ significantly between the two groups (median scores, 20 vs 24). The median pain score during the procedure was lower in group 1, but the difference was not significant (median scores, 24.5 vs 42). The patients in group 1 reported significantly higher median post-procedural satisfaction levels, compared with the patients in group 2 (median scores, 89 vs 72, P = 0.04). Nearly three-quarters of the patients in group 1 wished to use the same method for repeat procedures, and the difference in rates between the two groups was statistically significant (75.0% vs 48.3%, P = 0.04). Patients with greater levels of anxiety before the procedure tended to feel a painful sensation. Among patients with a pre-procedural anxiety score of 50 or higher, the anxiety score during the procedure was significantly lower in the group that received the visual distraction (median scores, 20 vs 68, P = 0.05); the pain score during the colonoscopy was also lower (median scores, 23 vs 57, P = 0.04). No adverse effects arising from the visual distraction were recognized.
CONCLUSION: Visual distraction alone improves satisfaction in patients undergoing colonoscopy and decreases anxiety and pain during the procedure among patients with a high pre-procedural anxiety score.
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Taniguchi L, Higurashi T, Uchiyama T, Kondo Y, Uchida E, Uchiyama S, Jono F, Hamanaka J, Kuriyama H, Hata Y, Endo H, Takahashi H, Nagase H, Matsuhashi N, Nakajima A. Metabolic factors accelerate colorectal adenoma recurrence. BMC Gastroenterol 2014; 14:187. [PMID: 25341954 PMCID: PMC4287308 DOI: 10.1186/1471-230x-14-187] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 10/15/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Metabolic factors have been reported to increase the prevalence of colorectal adenomas, however, whether metabolic factors might also accelerate the recurrence after removal of adenomas has not yet been discussed. In this retrospective multicenter study, we clarified the risk factors for adenoma recurrence focusing on metabolic factors. METHODS We analyzed the medical records of 43,195 patients who had undergone colonoscopy between January 2005 and December 2011 at 5 hospitals in Japan. Of these, the data of 1111 patients who had undergone removal of adenomas at the first screening colonoscopy, and then been followed up by colonoscopy 1 year and 2 years later were analyzed. RESULTS The following 8 factors were demonstrated with a multivariate analysis as being associated with colorectal adenomas recurrence: for adenoma-related factors, 5 factors (villous features, grade of dysplasia, location and size of the largest removed adenoma, and number of the removed adenomas) were identified; for metabolic factors and other factors, 3 factors (age, body mass index (BMI), and fasting blood glucose (FBG)) were identified. A risk score (0-10 points) was developed based on these 8 factors. The risk of adenoma recurrence increased as the risk score increased. When the risk score was ≥3 (3-10) points, the odds ratio relative to <3 (0-2) points was 7.07 (95% CIs 5.30-9.43). CONCLUSIONS In addition to adenoma-related factors (villous features, grade of dysplasia, location, size and number), 3 factors (age, BMI and FBG) were demonstrated to influence the recurrence rate of colorectal adenoma. When the risk score was ≥3, the risk of recurrence was significantly elevated.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Atsushi Nakajima
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004 Yokohama, Kanagawa, Japan.
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Nonaka T, Inamori M, Endo H, Matsuura M, Uchiyama S, Yamada E, Sekino Y, Sakai E, Higurashi T, Ohkubo H, Akimoto K, Iida H, Takahashi H, Koide T, Shibata W, Ida T, Kusakabe A, Gotoh E, Nakajima A, Maeda S. Correlation between gastric transit time measured by video capsule endoscopy and gastric emptying determined by the continuous real-time 13C breath test (BreathID system). Hepatogastroenterology 2014; 61:2159-2162. [PMID: 25713924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS The aim of this study was to determine the possible existence of a correlation between the gastric transit time (GTT) measured by video capsule endoscopy (VCE) and the parameters of gastric emptying determined using 13C breath test (BreathID system). METHODS Eight healthy male volunteers participated in this randomized, two-way crossover study. The subjects were randomly assigned to undergo VCE using the PillCam SB capsule endoscopy system or the 13C breath test for 4 hours after a test meal (400 kcal per 400 mL) containing 100 mg of 13C acetic acid administered after overnight fasting. The VCE images were analyzed and the GTT was determined using the proprietary RAPID software. The parameters, namely T lag, T 1/2 and GEC were calculated using the Oridion Research Software (β version). The GTT measured by VCE and the parameters of gastric emptying were compared statistically. RESULTS No significant correlation was observed between the GTT and T lag (p = 0.5263), T 1/2 (p = 0.4100) or GEC (p = 0.2410), as determined by calculation of the Spearman’s rank correlation coefficient. CONCLUSIONS GTT measured by VCE cannot serve as asubstitute for the gastric emptying time measured bythe 13C breath test.
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Higurashi T, Endo H, Uchiyama T, Uchiyama S, Yamada E, Ohkubo H, Sakai E, Takahashi H, Maeda S, Wada K, Natsumeda Y, Hippo Y, Nakajima A, Nakagama H. Conditional knockout of the leptin receptor in the colonic epithelium revealed the local effects of leptin receptor signaling in the progression of colonic tumors in mice. Carcinogenesis 2014; 35:2134-41. [PMID: 24958593 DOI: 10.1093/carcin/bgu135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Leptin, secreted by the adipose tissue and known to be related to obesity, is considered to be involved in the onset and progression of colorectal cancer. However, the exact role of leptin in colorectal carcinogenesis is still unclear, as several controversial reports have been published on the various systemic effects of leptin. The aim of this study was to clarify the local and precise roles of leptin receptor (LEPR)-mediated signaling in colonic carcinogenesis using intestinal epithelium-specific LEPRb conditional knockout (cKO) mice. We produced and used colonic epithelium-specific LEPRb cKO mice to investigate the carcinogen-induced formation of aberrant crypt foci (ACF) and tumors in the colon, using their littermates as control. There were no differences in the body weight or systemic condition between the control and cKO mice. The tumor sizes and number of large-sized tumors were significantly lower in the cKO mice as compared with those in the control mice. On the other hand, there was no significant difference in the proliferative activity of the normal colonic epithelial cells or ACF formation between the control and cKO mice. In the control mice, marked increase of the LEPRb expression level was observed in the colonic tumors as compared with that in the normal epithelium; furthermore, signal transducer and activator of transcription (STAT3) was activated in the tumor cells. These findings suggest that STAT3 is one of the important molecules downstream of LEPRb, and LEPRb/STAT3 signaling controls tumor cell proliferation. We demonstrated the importance of local/regional LEPR-mediated signaling in colorectal carcinogenesis.
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Affiliation(s)
- Takuma Higurashi
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Hiroki Endo
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Takashi Uchiyama
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Shiori Uchiyama
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Eiji Yamada
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Hidenori Ohkubo
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Eiji Sakai
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Hirokazu Takahashi
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Shin Maeda
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Koichiro Wada
- Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan
| | - Yutaka Natsumeda
- Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and
| | - Yoshitaka Hippo
- Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Atsushi Nakajima
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan, Department of Pharmacology, Graduate School of Dentistry, Osaka University, Osaka 565-0871, Japan, Department of Molecular Pharmacology and Neurobiology, Yokohama City University School of Medicine, Yokohama 236-0004, Japan and Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Hitoshi Nakagama
- Biochemistry Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan
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Uchiyama S. [Sleep disorder]. Seishin Shinkeigaku Zasshi 2014; 116:1028-1034. [PMID: 26027064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Hlaing Z, Wajima T, Uchiyama S, Nakagome H. Reduction of Bromine Compounds in the Pyrolysis Oil of Computer Casing Plastics Using Shell, Ca(OH)2 and NaOH. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.apcbee.2014.10.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Uchiyama S, Itsubo T, Nakamura K, Fujinaga Y, Sato N, Imaeda T, Kadoya M, Kato H. Effect of early administration of alendronate after surgery for distal radial fragility fracture on radiological fracture healing time. Bone Joint J 2013; 95-B:1544-50. [PMID: 24151277 DOI: 10.1302/0301-620x.95b11.31652] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This multicentre prospective clinical trial aimed to determine whether early administration of alendronate (ALN) delays fracture healing after surgical treatment of fractures of the distal radius. The study population comprised 80 patients (four men and 76 women) with a mean age of 70 years (52 to 86) with acute fragility fractures of the distal radius requiring open reduction and internal fixation with a volar locking plate and screws. Two groups of 40 patients each were randomly allocated either to receive once weekly oral ALN administration (35 mg) within a few days after surgery and continued for six months, or oral ALN administration delayed until four months after surgery. Postero-anterior and lateral radiographs of the affected wrist were taken monthly for six months after surgery. No differences between groups was observed with regard to gender (p = 1.0), age (p = 0.916), fracture classification (p = 0.274) or bone mineral density measured at the spine (p = 0.714). The radiographs were assessed by three independent assessors. There were no significant differences in the mean time to complete cortical bridging observed between the ALN group (3.5 months (SE 0.16)) and the no-ALN group (3.1 months (SE 0.15)) (p = 0.068). All the fractures healed in the both groups by the last follow-up. Improvement of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, grip strength, wrist range of movement, and tenderness over the fracture site did not differ between the groups over the six-month period. Based on our results, early administration of ALN after surgery for distal radius fracture did not appear to delay fracture healing times either radiologically or clinically.
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Affiliation(s)
- S Uchiyama
- Shinshu University School of Medicine, Department of Orthopaedic Surgery, Shinshu Society for Surgery of the Upper Extremities, Asahi 3-1-1, Matsumoto 390-8621, Japan
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Ono Y, Abe K, Suzuki K, Iimura H, Sakai S, Uchiyama S, Okada Y. Usefulness of 4D-CTA in the detection of cerebral dural sinus occlusion or stenosis with collateral pathways. Neuroradiol J 2013; 26:428-38. [PMID: 24007731 DOI: 10.1177/197140091302600408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 07/05/2013] [Indexed: 11/15/2022] Open
Abstract
In time-resolved CT angiography (4D-CTA), it is of substantial merit to detect the veins and sinuses of the whole brain with the simultaneous demonstration of the natural drainage flow in order to find occlusion or stenosis of the dural sinuses with collateral pathways. As preoperative information for patients with brain tumors, it is important to detect feeding arteries, incidentally found aneurysms or other vascular lesions, and to detect patency of the dural sinuses and the important cortical veins, whether they are compressed by tumors or not. On the other hand, cerebral venous thrombosis (CVT) may occur in patients due to various causes, which has not been unusual in recent years. For patients with acute symptomatic or chronic non-symptomatic CVT, identification of dural sinus occlusion (DSO) or dural sinus stenosis (DSS) and compensatory collateral pathways is necessary for suitable thrombolytic therapy or careful investigation to avoid further CVT. This study reviews our experiences in 116 cases of 4D-CTA for 90 patients with brain tumors and 26 other patients including 11 with arteriovenous malformation, and four with acute CVT and other conditions. 4D-CTA presented DSO/DSS with compensatory venous collateral pathways, which was helpful to detect the severity of the venous abnormality, and see whether it was compressed by brain tumors, or due to other causes in patients with symptomatic or non-symptomatic CVT. 4D-CTA is a useful non-invasive diagnostic tool to detect cerebral venous abnormalities as an alternative to DSA.
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Affiliation(s)
- Y Ono
- Department of the Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University; Tokyo, Shinjuku-ku, Japan - ,
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Hashimoto N, Uchiyama S, Kitano M, Iwasaki T, Sano H, Hashimoto T. THU0190 Ultrasonagraphic assessment of submandibular glands in anti-centromere antibody positive and negative primary sjogren’s syndrome patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2155] [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: 11/04/2022]
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Hara Y, Nishida O, Nakamura T, Uchiyama S, Shibata J, Yamashita C, Yumoto M, Shimomura Y, Kuriyama N, Yasuoka N, Ito M, Kawata K, Hayakawa S, Yamada S, Miyasho T, Moriyama K. Extracorporeal membrane oxygenation: the MOTOR of cytokine production? Crit Care 2013. [PMCID: PMC3642403 DOI: 10.1186/cc12065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Equilibrina I, Matsunaga S, Morimoto A, Hashimoto T, Uchiyama S, Fukui K. ASURA (PHB2) interacts with Scc1 through chromatin. Cytogenet Genome Res 2013; 139:225-33. [PMID: 23548868 DOI: 10.1159/000350004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2012] [Indexed: 11/19/2022] Open
Abstract
Sister chromatid cohesion mediated by the cohesin complex is essential for faithful chromosome segregation. Previously we reported that PHB2 (prohibitin2/ASURA), a multifunctional protein, has a role in sister chromatid cohesion. Nevertheless, how ASURA is involved in sister chromatid cohesion still remains unclear. The present co-immunoprecipitation analysis reveals that ASURA interacts with cohesin subunit Scc1 in vivo. We show that ASURA associates with chromatin in a similar manner as Scc1 throughout the cell cycle. Furthermore, our observation using the Fucci (fluorescent ubiquitination-based cell cycle indicator) system indicates that ASURA is important for cohesin maintenance at early mitosis. We have also identified that the conserved PHB domain is responsible for chromatin targeting of ASURA. Our results suggest that the regulation of sister chromatid cohesion is mediated by ASURA binding to chromatin, where ASURA might be involved in cohesin protection through ASURA-Scc1 interactions.
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Affiliation(s)
- I Equilibrina
- Department of Biotechnology, Graduate School of Engineering, Osaka University, Suita, Japan
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Suzuki K, Uchiyama S, Imajyo K, Tomeno W, Sakai E, Yamada E, Tanida E, Akiyama T, Watanabe S, Endo H, Fujita K, Yoneda M, Takahashi H, Koide T, Tokoro C, Abe Y, Kawaguchi M, Gotoh E, Maeda S, Nakajima A, Inamori M. Risk factors for colonic diverticular hemorrhage: Japanese multicenter study. Digestion 2012; 85:261-5. [PMID: 22472917 DOI: 10.1159/000336351] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 01/06/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Diverticular hemorrhage is the common cause of lower gastrointestinal bleeding, and its incidence has been increasing in Japan. However, the exact cause of diverticular hemorrhage is not well understood. We investigated the risk factors for diverticular hemorrhage. METHODS We selected 103 patients with diverticular hemorrhage as cases and patients with colonic diverticulosis without a history of bleeding were selected as control subjects, exactly matched for age and gender. We collected the data from the medical records of each of the patients, such as those related to the comorbidities, medications and findings of colonoscopy, and conducted a matched case-control study to analyze the risk factors for diverticular hemorrhage. RESULTS Both groups were composed of 75 men and 28 women. The median age of the patients in both groups was 72.0 years (47.0-87.0). The body weight (p = 0.0065), body mass index (p = 0.006), prevalence of hypertension (p = 0.0242), prevalence of ischemic heart disease (p = 0.0015), and frequency of use of low-dose aspirin (p = 0.042) were significantly different between the two groups. The percentage of patients with bilateral diverticula, that is, diverticula on both the right and left hemicolon, was significantly higher in the diverticular hemorrhage group (p = 0.0011). Multiple regression analysis identified only the diverticular location as being significantly associated with the risk of diverticular hemorrhage (p = 0.0021). CONCLUSIONS Only the diverticular location (bilateral) was found to be an independent risk factor for diverticular hemorrhage.
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Affiliation(s)
- Kaori Suzuki
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
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Higurashi T, Hosono K, Endo H, Takahashi H, Iida H, Uchiyama T, Ezuka A, Uchiyama S, Yamada E, Ohkubo H, Sakai E, Maeda S, Morita S, Natsumeda Y, Nagase H, Nakajima A. Eicosapentaenoic acid (EPA) efficacy for colorectal aberrant crypt foci (ACF): a double-blind randomized controlled trial. BMC Cancer 2012; 12:413. [PMID: 22992267 PMCID: PMC3515435 DOI: 10.1186/1471-2407-12-413] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 07/13/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most commonly occurring neoplasms and a leading cause of cancer death worldwide, and new preventive strategies are needed to lower the burden of this disease. Eicosapentaenoic acid (EPA), the omega-3 polyunsaturated fatty acid that is widely used in the treatment of hyperlipidemia and prevention of cardiovascular disease, has recently been suggested to have a suppressive effect on tumorigenesis and cancer cell growth. In CRC chemoprevention trials, in general, the incidence of polyps or of the cancer itself is set as the study endpoint. Although the incidence rate of CRC would be the most reliable endpoint, use of this endpoint would be unsuitable for chemoprevention trials, because of the relatively low occurrence rate of CRC in the general population and the long-term observation period that it would necessitate. Moreover, there is an ethical problem in conducting long-term trials to determine whether a test drug might be effective or harmful. Aberrant crypt foci (ACF), defined as lesions containing crypts that are larger in diameter and stain more darkly with methylene blue than normal crypts, are considered as a reliable surrogate biomarker of CRC. Thus, we devised a prospective randomized controlled trial as a preliminary study prior to a CRC chemoprevention trial to evaluate the chemopreventive effect of EPA against colorectal ACF formation and the safety of this drug, in patients scheduled for polypectomy. METHODS This study is a multicenter, double-blind, placebo-controlled, randomized controlled trial to be conducted in patients with both colorectal ACF and colorectal polyps scheduled for polypectomy. Eligible patients shall be recruited for the study and the number of ACF in the rectum counted at the baseline colonoscopy. Then, the participants shall be allocated randomly to either one of two groups, the EPA group and the placebo group. Patients in the EPA group shall receive oral 900-mg EPA capsules thrice daily (total daily dose, 2.7 g per day), and those in the placebo group shall receive oral placebo capsules thrice daily. After one month's treatment with EPA/placebo, colonoscopic examination and polypectomy will be performed to evaluate the formation of ACF, and the cell-proliferative activity and cell-apoptotic activity in normal colorectal mucosa and colorectal polyps. DISCUSSION This is the first study proposed to explore the effect of EPA against colorectal ACF formation in humans.This trial has been registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000008172.
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Affiliation(s)
- Takuma Higurashi
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Kunihiro Hosono
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hiroki Endo
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hirokazu Takahashi
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hiroshi Iida
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Takashi Uchiyama
- Department of Gastroenterology, Chigasaki Municipal Hospital, Kanagawa, Japan
| | - Akiko Ezuka
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Shiori Uchiyama
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Eiji Yamada
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Hidenori Ohkubo
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Eiji Sakai
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Shin Maeda
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Satoshi Morita
- Department of Biostatistics and Epidemiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Yutaka Natsumeda
- Department of molecular pharmacology and neurobiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Hajime Nagase
- Department of Gastroenterology, Yokohama Rosai Hospital, Yokohama, Japan
| | - Atsushi Nakajima
- Division of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan
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Shimizu Y, Ohashi T, Maruyama K, Nakashima I, Yokoyama K, Fujihara K, Uchiyama S. Neuromyelitis Optica Relapse Associated with Pregnancy: Similarities to Multiple Sclerosis (P06.184). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.184] [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: 11/15/2022] Open
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Higurashi T, Endo H, Yoneda M, Hosono K, Sakai E, Takahashi H, Inamori M, Uchiyama S, Kojima T, Kawana K, Natsumeda Y, Nagase H, Nakajima A. Capsule-endoscopic findings of ulcerative colitis patients. Digestion 2012; 84:306-14. [PMID: 22041924 DOI: 10.1159/000333086] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 09/13/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by diffuse mucosal inflammation, traditionally regarded as being limited to the colorectum. Although several gastroduodenal lesions have also been reported recently in cases of UC, in general, small-bowel lesions in UC are believed to be extremely rare. The aim of this study was to examine the small bowel by capsule endoscopy in patients with UC. METHODS The study was conducted in 23 well-documented UC patients and 23 control volunteers. The frequency of small-bowel lesions, the number of small-bowel lesions per patient and the capsule endoscopy score were comparatively evaluated between the two groups. RESULTS Of the 23 UC patients, 13 (57%) showed small-bowel lesions, and 8 (35%) had erosions. There were significant differences in the frequency of the small-bowel lesions (p < 0.001) and erosions (p = 0.009) between the two groups. The capsule endoscopy score was correlated with the UC disease activity index (r = 0.718, p < 0.001). CONCLUSIONS This is the first capsule-endoscopic study conducted to examine the small-bowel involvement in UC patients as compared with the healthy volunteers. It was concluded that UC, a chronic inflammatory bowel disease, can also involve the small bowel.
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Affiliation(s)
- Takuma Higurashi
- Division of Gastroenterology, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan
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Kabasawa C, Shimizu Y, Suzuki S, Masuda M, Nagane Y, Utsugisawa K, Suzuki Y, Utsumi H, Fujihara K, Suzuki N, Uchiyama S. Taste disorders in myasthenia gravis: a multicenter cooperative study. Eur J Neurol 2012; 20:205-7. [DOI: 10.1111/j.1468-1331.2012.03713.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Higurashi T, Takahashi H, Endo H, Hosono K, Yamada E, Ohkubo H, Sakai E, Uchiyama T, Hata Y, Fujisawa N, Uchiyama S, Ezuka A, Nagase H, Kessoku T, Matsuhashi N, Yamanaka S, Inayama Y, Morita S, Nakajima A. Metformin efficacy and safety for colorectal polyps: a double-blind randomized controlled trial. BMC Cancer 2012; 12:118. [PMID: 22443173 PMCID: PMC3353167 DOI: 10.1186/1471-2407-12-118] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 03/26/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Colorectal cancer is one of the major neoplasms and a leading cause of cancer death worldwide, and new preventive strategies are needed to lower the burden of this disease. Metformin, a biguanide, which is widely used for treating diabetes mellitus, has recently been suggestive to have a suppressive effect on tumorigenesis and cancer cell growth. In a previous study conducted in non-diabetic subjects, we showed that oral short-term low-dose metformin suppressed the development of colorectal aberrant crypt foci (ACF). ACF have been considered as a useful surrogate biomarker of CRC, although the biological significance of these lesions remains controversial. We devised a prospective randomized controlled trial to evaluate the chemopreventive effect of metformin against metachronous colorectal polyps and the safety of this drug in non-diabetic post-polypectomy patients. METHODS/DESIGN This study is a multi-center, double-blind, placebo-controlled, randomized controlled trial to be conducted in non-diabetic patients with a recent history of undergoing colorectal polypectomy. All adult patients visiting the Yokohama City University hospital or affiliated hospitals for polypectomy shall be recruited for the study. Eligible patients will then be allocated randomly into either one of two groups: the metformin group and the placebo group. Patients in the metformin group shall receive oral metformin at 250 mg per day, and those in the placebo group shall receive an oral placebo tablet. At the end of 1 year of administration of metformin/placebo, colonoscopy will be performed to evaluate the polyp formation. DISCUSSION This is the first study proposed to explore the effect of metformin against colorectal polyp formation. Metformin activates AMPK, which inhibits the mammalian target of rapamycin (mTOR) pathway. The mTOR pathway plays an important role in the cellular protein translational machinery and cell proliferation. Patients with type 2 diabetes taking under treatment with metformin have been reported to be at a lower risk of cancer development than those not taking under treatment with metformin. We showed in a previous study that metformin suppressed the formation of human colorectal ACF. We therefore decided to conduct a study to determine whether metformin might suppress the formation of human colorectal polyps. TRIAL REGISTRATION This trial has been registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000006254.
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Affiliation(s)
- Takuma Higurashi
- Division of Gastroenterology, Yokohama City University School of Medicine, Yokohama, Japan
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Murase T, Higurashi T, Akatsuka S, Nagase H, Kawana K, Otani S, Tani R, Kojima T, Uchiyama S, Eduka A, Iinuma M, Fujita Y, Watai K. [A case of endocrine cell carcinoma of the esophagus successfully treated by chemoradiotherapy]. Gan To Kagaku Ryoho 2012; 39:111-113. [PMID: 22241363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The patient was a 74-year-old man who suffered from epigastric abdominal pain. He visited our hospital in April 2008. An esophageal endocrine cell carcinoma was pointed out by gastrointestinal endoscopy, and he was diagnosed as esophageal endoscopic cell carcinoma with mediastinum lymph node by CT scan(Stage IVa: cT3N4M0). Concurrent chemoradiotherapy using CDDP+EP was started. After two courses, the primary tumor was markedly reduced, and endoscopy showed only a scar. We diagnosed the patient as being in complete remission. However, CT showed a liver metastasis relapse in June 2009, and we started AMR as second-line chemotherapy. His general condition went into a decline, however, He died on October 2, 2009.
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Iijima M, Osawa M, Uchiyama S. 2.111 DIFFERENCES IN OLFACTORY FUNCTION BETWEEN PARKINSON'S DISEASE AND VASCULAR PARKINSONISM. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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