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Ichikawa T, Qiu Y, Ando S, Takeuchi Y, Nagasaka A. The case of Mediterranean spotted fever of the traveler returned from Zambia. Ticks Tick Borne Dis 2024; 15:102347. [PMID: 38714072 DOI: 10.1016/j.ttbdis.2024.102347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/06/2024] [Accepted: 04/23/2024] [Indexed: 05/09/2024]
Abstract
We report the case of a traveler who returned from Zambia and was diagnosed with Mediterranean spotted fever (MSF), an infectious disease caused by Rickettsia conorii conorii. The patient presented to Sapporo City General Hospital with symptoms of fever, malaise, headache, and rash. The pathogen was identified by Polymerase Chain Reaction assays and subsequent analyses. The patient improved with 10-day treatment of oral doxycycline. Although some cases of MSF have been reported in sub-Saharan Africa, none have been reported in Zambia. Rhipicephalus sanguineus sensu lato, the vector of the Rickettsia conorii conorii, has been found in various areas of Zambia. Our case report highlights the potential threat of Mediterranean spotted fever in urban areas of Zambia.
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Affiliation(s)
- Takahiro Ichikawa
- Sapporo City General Hospital Department of Infectious Diseases, 13-1-1, Kita-11-jonishi, Chuo-ku, Sapporo 060-8604, Japan.
| | - Yongjin Qiu
- Laboratory of Parasitology, Department of Disease Control, Faculty of Veterinary Medicine, Hokkaido University, Sapporo: Kita 8, Nishi 5, Kita-ku, Sapporo 060-0808, Japan
| | - Shuji Ando
- National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Yuto Takeuchi
- Sapporo City General Hospital Department of Infectious Diseases, 13-1-1, Kita-11-jonishi, Chuo-ku, Sapporo 060-8604, Japan
| | - Atsushi Nagasaka
- Sapporo City General Hospital Department of Infectious Diseases, 13-1-1, Kita-11-jonishi, Chuo-ku, Sapporo 060-8604, Japan
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Ichikawa T, Okada H, Hamaguchi M, Nishioka N, Tateyama Y, Shimamoto T, Kurogi K, Murata H, Ito M, Iwami T, Fukui M. The transition of metabolic phenotypes and cardiovascular events: Panasonic cohort study 16. Obesity (Silver Spring) 2024; 32:999-1008. [PMID: 38444281 DOI: 10.1002/oby.23999] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/16/2023] [Accepted: 01/06/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE The study objective was to investigate whether changes in metabolic phenotype affect the risk of cardiovascular events. METHODS All 117,589 participants were included in this retrospective cohort study. The metabolic phenotypes of the participants were assessed at two points (the second evaluation was set 2 years after the first evaluation), and the incidence rate of cardiovascular events was observed for 11 years. The main outcome was 3-point major adverse cardiac events (MACE), which comprises cardiovascular death, nonfatal coronary artery disease, and nonfatal stroke incidence. RESULTS Of the participants, 2748 (2.3%) cases of 3-point MACE were identified during follow-up. The stable metabolically healthy obesity group had a higher risk of 3-point MACE than those with stable metabolically healthy nonobesity (MHNO). Additionally, the change from metabolically healthy obesity to MHNO for 2 years decreased the risk of 3-point MACE (hazard ratio [HR], 1.12: 95% CI: 0.84-1.47) to the same level as stable MHNO. However, the change from metabolically abnormal nonobesity and metabolically abnormal obesity to MHNO for 2 years maintained a higher risk of 3-point MACE (HR, 1.66 [95% CI: 1.36-2.01]; HR, 1.91 [95% CI: 1.22-2.81]) than those with stable MHNO. CONCLUSIONS Change in metabolic phenotype is associated with incident 3-point MACE.
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Affiliation(s)
- Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Yukiko Tateyama
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Tomonari Shimamoto
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Kazushiro Kurogi
- Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Japan
| | - Hiroaki Murata
- Department of Orthopaedic Surgery, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Masato Ito
- Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Japan
| | - Taku Iwami
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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Imai D, Nakanishi N, Shinagawa N, Yamamoto S, Ichikawa T, Sumi M, Matsui T, Hosomi Y, Hasegawa Y, Munekawa C, Miyoshi T, Okamura T, Kitagawa N, Hashimoto Y, Okada H, Sakui N, Sasano R, Hamaguchi M, Fukui M. Association of Elevated Serum Branched-chain Amino Acid Levels With Longitudinal Skeletal Muscle Loss. J Endocr Soc 2024; 8:bvad178. [PMID: 38213909 PMCID: PMC10783241 DOI: 10.1210/jendso/bvad178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Indexed: 01/13/2024] Open
Abstract
Context Branched-chain amino acids (BCAA) are substrates for protein synthesis. Although their intake may contribute to an increase in skeletal muscle mass, elevated serum BCAA levels have been reported to be associated with insulin resistance, potentially resulting in decreased skeletal muscle mass. Objective This study aimed to explore the association between elevated serum BCAA levels and longitudinal skeletal muscle loss. Design and Setting A cohort analysis was conducted, in which serum amino acids were analyzed in healthy individuals who underwent a medical health checkup at Kameoka Municipal Hospital (HOZUGAWA study), Japan. Patients Seventy-one participants (37 men and 34 women) underwent follow-up checkups after the baseline visit. The follow-up duration was 1.2 ± .4 years. Main Outcome Measures The relationship between fasting baseline serum BCAA levels and lifestyle factors, body composition, blood test results, dietary history, and changes in skeletal muscle mass was evaluated. Results In both men and women, serum BCAA levels were positively correlated with body weight, body mass index, skeletal muscle mass index (SMI), and serum triglycerides but inversely correlated with serum high-density lipoprotein cholesterol. In men, fasting serum BCAA levels were inversely associated with the rate of change in SMI (adjusted β = -.529, P = .006), and elevated BCAA levels were independently associated with a longitudinal decrease in skeletal muscle mass (odds ratio: 1.740; 95% confidence interval: 1.023-2.960 per 50 nmol/mL serum BCAAs increase). Conclusion Increased circulating BCAAs could be an indicator of skeletal muscle loss in men.
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Affiliation(s)
- Dan Imai
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Natsuko Shinagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Shinta Yamamoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Madoka Sumi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Takaaki Matsui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Yukako Hosomi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Yuka Hasegawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Chihiro Munekawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Tomoki Miyoshi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
- Department of Diabetology and Endocrinology, Kyoto Okamoto Memorial Hospital, Kyoto, 613-0034, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
- Department of Diabetology, Kameoka Municipal Hospital, Kyoto, 621-8585, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, 570-8540, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | | | | | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
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Haydon A, Avila S, Patino S, Callender B, Ortega P, Franco II, Ichikawa T, Golden DW. Communicating the External Beam Radiotherapy Experience (CEBRE) Discussion Guides: Real World Implementation and Evaluation. Int J Radiat Oncol Biol Phys 2023; 117:e107-e108. [PMID: 37784640 DOI: 10.1016/j.ijrobp.2023.06.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Communicating about the radiotherapy treatment process can be difficult for patients and healthcare professionals. The "Communicating the External Beam Radiotherapy Experience" (CEBRE) and Communicating the Gynecologic Brachytherapy Experience (CoGBE) discussion guides use graphic narrative to explain external beam radiotherapy and gynecologic high-dose rate brachytherapy, respectively. The CEBRE, CoGBE, and CEBRE en Español guides have been available for free download since 10/2018, 6/2020, and 8/2021, respectively. This study aims to characterize how the guides are being implemented and used in practice. MATERIALS/METHODS Global downloads of the CEBRE, CoGBE, and CEBRE en Español guides were analyzed. Email addresses submitted at the time of download were used to contact study subjects. Duplicate emails, fake addresses, and expired emails were removed resulting in 500 individuals being invited to participate in the survey. A data collection web application survey was distributed on 1/27/23. Two reminders were sent prior to the survey closing on 2/13/23. The survey addressed how physicians or other radiotherapy team members use the CEBRE guides, where they are used, and how the guides can be improved. Likert-type data (1 = strongly disagree, 5 = strongly agree) are reported as median [interquartile range]. RESULTS As of 10/16/22, the CEBRE guides (English) had been downloaded 602 times, CoGBE 86 times, and CEBRE en Español 63 times. 42/500 individuals responded to the survey for an 8% response rate. 40/42 (95%) of participants were healthcare providers with 35/40 (87.5%) radiation oncologists. 16/40 (40%) have used the CEBRE guides in some way. 6/16 (37.5%) "always use," 2/16 (12.5%) "often use," and 3/16 (18.8%) "sometimes use" the guides during consultation. 8/16 (50%) report using the guides for education of medical students, residents, and fellows. The 16 respondents that use the guides felt the guides were useful overall (5[5-5]), felt "very confident" using the guides (4.5[4-5]), and felt the guides "help patients prepare for their treatment" (5[4-5]). 40 respondents provided suggestions on additional language translations with 19/40 (48%) recommending translation into Mandarin, 6/40 (15%) into Cantonese, Portuguese, French and Arabic, and 5/40 (12.5%) into Haitian, Hindi, and Vietnamese. CONCLUSION The majority of respondents did not use the CEBRE guides which may be due to difficulty with implementation. However, respondents who use the guides are confident using them and rate them as useful for patients. These data, although limited by the low response rate, suggest that the CEBRE guides have accomplished the goal of facilitating patient-physician conversations. Moreover, there is an interest in translating the guides into additional languages other than Spanish. Due to the low response rate, definitive conclusions cannot be made from these data. Therefore, further research such as interviews and focus groups may be beneficial.
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Affiliation(s)
- A Haydon
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
| | - S Avila
- The University of Chicago Pritzker School of Medicine, Chicago, IL
| | - S Patino
- The University of Chicago, Chicago, IL
| | - B Callender
- Department of Medicine, University of Chicago Medical Center and Pritzker School of Medicine, Chicago, IL
| | - P Ortega
- Departments of Emergency Medicine and Medical Education, University of Illinois College of Medicine, Chicago, IL
| | - I I Franco
- Department of Radiation Oncology, Harvard Medical School, Boston, MA
| | - T Ichikawa
- Institute of Design, Illinois Institute of Technology, Chicago, IL
| | - D W Golden
- Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
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Kajiyama S, Nakanishi N, Yamamoto S, Ichikawa T, Okamura T, Hashimoto Y, Kitagawa N, Hamaguchi M, Fukui M. The Impact of Nutritional Markers and Dietary Habits on the Bioimpedance Phase Angle in Older Individuals. Nutrients 2023; 15:3599. [PMID: 37630789 PMCID: PMC10458185 DOI: 10.3390/nu15163599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Low phase angle (PhA), as determined via bioelectrical impedance analysis, reflects unhealthy aging and mortality. In this study, we assessed whether nutritional status, including serum nutritional markers and dietary habits, is related to PhA in older individuals. We recruited 212 participants (aged ≥ 65 years) who underwent medical health checkups. PhA was measured using a multi-frequency impedance body composition analyzer. Habitual food and nutrient intake was evaluated using a brief, self-administered diet history questionnaire. Low PhA values were defined as ≤4.95 in males and ≤4.35 in females. Males with low PhA had poor exercise habits (p = 0.0429) and a lower body mass index (p = 0.0024). PhA was significantly correlated with serum cholinesterase levels, a nutritional status marker (r = 0.3313, p = 0.0004 in males; r = 0.3221, p = 0.0070 in females). The low-PhA group had significantly lower total energy and carbohydrate intake per ideal body weight (IBW) than the high-PhA group in males (total energy intake:30.2 ± 9.8 and 34.5 ± 9.3 kcal/kg/day, p = 0.0307; carbohydrate intake:15.2 ± 4.9 and 18.0 ± 5.8 kcal/kg/day, p = 0.0157). Total energy intake per IBW (adjusted odds ratio [95% confidence interval], 0.94 [0.89-1.00] per 1 kcal/kg/day increase) was independently associated with a low PhA in males. Our study revealed that lower total energy intake independently impacted low PhA in older males.
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Affiliation(s)
- Shintaro Kajiyama
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Shinta Yamamoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Kameoka Municipal Hospital, Kyoto 621-8585, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Ichikawa T, Okada H, Hamaguchi M, Kurogi K, Murata H, Ito M, Fukui M. Estimated small dense low-density lipoprotein-cholesterol and incident type 2 diabetes in Japanese people: Population-based Panasonic cohort study 13. Diabetes Res Clin Pract 2023; 199:110665. [PMID: 37031889 DOI: 10.1016/j.diabres.2023.110665] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/25/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIMS This study aimed to investigate the association between estimated small dense low-density lipoprotein (sd-LDL) and incident type 2 diabetes. METHODS We analyzed the data from a health checkup under a program conducted by Panasonic Corporation between 2008 and 2018. A total of 120,613 participants were included, of whom 6,080 developed type 2 diabetes. Estimated large buoyant (lb)-LDL cholesterol and sd-LDL cholesterol was calculated by the formula using triglyceride and LDL cholesterol. Cox proportional hazard model and time-dependent receiver operating characteristic (ROC) analysis were used to evaluate the association between the lipid profiles and incident type 2 diabetes. RESULTS Multivariate analysis showed that LDL cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, estimated large buoyant (lb)-LDL cholesterol, and estimated sd-LDL were associated with incident type 2 diabetes. Moreover, the area under the ROC curve and optimal cut-off values for estimated sd-LDL cholesterol for incident type 2 diabetes at 10 years were 0.676 and 35.9 mg/dL, respectively. The area under the curve of estimated sd-LDL cholesterol was higher than that of HDL cholesterol, LDL cholesterol, or estimated lb-LDL cholesterol. CONCLUSION The estimated sd-LDL cholesterol was an important predictor of future incidence of diabetes within 10 years.
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Affiliation(s)
- Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan.
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kazushiro Kurogi
- Department of Health Care Center, Panasonic Health Insurance Organization, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Hiroaki Murata
- Department of Orthopaedic Surgery, Matsushita Memorial Hospital, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Masato Ito
- Department of Health Care Center, Panasonic Health Insurance Organization, 5-55 Sotojima-cho, Moriguchi 570-8540, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Yokote R, Kuwabara Y, Kasano S, Yonezawa M, Ouchi N, Ichikawa T, Suzuki S, Takeshita T. Risk factors for persistent positive anticardiolipin antibodies in women with recurrent pregnancy loss. J Reprod Immunol 2023; 156:103920. [PMID: 36863074 DOI: 10.1016/j.jri.2023.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 02/26/2023]
Abstract
Antiphospholipid syndrome (APS) is an established cause of recurrent pregnancy loss (RPL). It is necessary to detect persistently positive antiphospholipid antibodies to diagnose APS. This study aimed to explore risk factors for persistent anticardiolipin (aCL) positivity. Women with a history of RPL or with a history of one or more intrauterine fetal deaths after 10 weeks underwent examinations to determine the causes of RPL, including antiphospholipid antibodies. If aCL-IgG or aCL-IgM antibodies were positive, retests were performed at least 12 weeks apart. Risk factors for persistent aCL antibody positivity were retrospectively investigated. The number and percentage of cases above the 99th percentile were 74/2399 (3.1%) for aCL-IgG, and 81/2399 (3.5%) for aCL-IgM. Of the initially tested cases, 2.3% (56/2399) for aCL-IgG and 2.0% (46/2289) for aCL-IgM were ultimately positive above the 99th percentile in retests. Retest values after 12 weeks were significantly lower than the initial values for both IgG and IgM immunoglobulin classes. Initial aCL antibody titers were significantly higher in the persistent-positive group than in the transient-positive group for both IgG and IgM immunoglobulin classes. The cut-off values for predicting persistent positivity of aCL-IgG antibodies and aCL-IgM antibodies were 15 U/mL (99.1 percentile) and 11 U/mL (99.2 percentile), respectively. The only risk factor for persistently positive aCL antibodies is a high antibody titer during the initial test. When the aCL antibody titer in the initial test exceeds the cut-off value, therapeutic strategies can be defined in subsequent pregnancies without waiting for 12 weeks.
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Affiliation(s)
- R Yokote
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Y Kuwabara
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.
| | - S Kasano
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - M Yonezawa
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - N Ouchi
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - T Ichikawa
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - S Suzuki
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - T Takeshita
- Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
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Sakamoto S, Takei A, Nino J, Takeuchi N, Kanesaka M, Shibata Y, Sazuka T, Imamura Y, Akakura K, Ichikawa T. The difference in serum testosterone recovery between Gn-RH antagonist and LH-RH agonist among prostate cancer patients treated radiation therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01155-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Ogura K, Hamazaki N, Kamiya K, Kitamura T, Kobayashi S, Ichikawa T, Yamashita M, Uchida S, Noda T, Nagumo D, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J, Miyaji K. Perme ICU Mobility Score as a comprehensive assessment tool of acute-phase rehabilitation is correlated with clinical outcomes in patients after cardiovascular surgery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early mobility therapy in the intensive care unit (ICU) is widely employed to improve the physical function and prognosis of patients with critically ill. On the other hand, patients who undergo cardiovascular surgery frequently suffer from disabilities after ICU care due to their cardiopulmonary conditions and treatments. However, few studies have reported the procedures and assessments of acute-phase rehabilitation in these patients. Recently, the Perme ICU Mobility Score (Perme Score) was developed as a reliable tool to assess comprehensive mobility status of patients in the ICU. We hypothesised that the Perme Score is a useful tool for assessing the mobility levels in the ICU and predicting clinical outcomes in patients undergoing acute-phase rehabilitation after cardiovascular surgery.
Purpose
To investigate the associations between the Perme Score within the second days after cardiovascular surgery and the patients' clinical outcomes, including physical function and the incidence of clinical events.
Methods
We studied 224 consecutive patients (34.4% female; aged 65±13 years) who were admitted to the ICU of a tertiary academic hospital after cardiac and/or major vascular surgery. Clinical characteristics including patient profiles, comorbidities, surgical details and APACHE II and SOFA scores were evaluated on ICU admission. The Perme Score contains categories on mental status, potential mobility barriers, muscle strength and mobility level, with higher scores indicating greater activity levels in the ICU. We assessed the Perme Score within the second days after the surgery. As a physical function at hospital discharge, we measured the six-minute walk distance (6MWD). The primary endpoint was a composite outcome of the number of all-cause mortality and/or all-cause unplanned readmission. We analysed the associations of the Perme Score with the 6MWD and the incidence of clinical events using multiple regression analysis and multivariate Poisson regression analysis, respectively.
Results
After adjusting for clinical confounding factors, a higher Perme Score was an independent factor of a higher 6MWD (Table 1). During the median follow-up period of 1.3 years, 51 cases of all-cause mortality/readmission occurred in 37 (16.5%) patients, with an incidence rate of 18.6/100 person-years. In the multivariate Poisson regression analysis, even after adjusting for the severity score in the ICU, a higher Perme Score was significantly and independently associated with lower rates of all-cause clinical events (adjusted incident rate ratio: 0.96, 95% confidence interval: 0.93–0.99, P=0.008, Figure 1).
Conclusions
The Perme Score within the second days after cardiovascular surgery is correlated with physical function at hospital discharge and the incidence of clinical events after discharge. Thus, a comprehensive assessment of acute-phase rehabilitation after cardiovascular surgery may be useful in predicting clinical outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Ogura
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - T Kitamura
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - D Nagumo
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - K Miyaji
- Kitasato University School of Medicine, Department of Cardiovascular Surgery , Sagamihara , Japan
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Miki T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Ueno K, Yamaoka-Tojo M, Maekawa E, Sasaki J, Matsunaga A, Ako J. Cancer as a risk factor for physical dysfunction and poor prognosis in patients with cardiovascular disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
The emerging interdisciplinary field of cardio-oncology is of interest to clinicians because a history of cancer or cancer treatment is considered a severe risk factor for cardiovascular disease (CVD). Both cancer and CVD can reduce skeletal muscle mass; together, they can lead to a poorer prognosis. However, it is unclear whether a patient's cancer history can lower physical function and lead to a poor prognosis with the coexistence of cancer history and physical dysfunction in patients with CVD. This study aimed to identify the relationship between cancer history and physical function, as well as the prognostic value of their combination, in patients with CVD.
Methods
We reviewed 3,640 patients with CVD (mean age, 67.9±13.5 years) who underwent physical-function tests (gait speed and 6-min walking distance [6MWD]). We performed multivariate linear regression analysis to assess potential associations between cancer history and physical-function tests in patients with CVD. Additionally, we used the Kaplan–Meier curve and Cox regression analyses to assess survival and prognostic significance for patients divided into four groups according to the presence or absence of cancer history and high or low physical function.
Results
In multivariate linear regression analysis, cancer history was independently associated with lower gait speed and 6MWD (gait speed, P=0.048 and 6MWD, P=0.040). A total of 581 deaths occurred over a median follow-up period of 3.08 years (interquartile range: 1.36–5.27). For all-cause mortality, patients with a history of cancer and reduced physical function were found to have a significantly higher mortality risk even after adjusting for several covariates (gait speed, HR: 1.66, P=0.003 and 6MWD, HR: 1.71, P=0.003).
Conclusion
Cancer history was correlated with physical dysfunction in patients with CVD. Moreover, the coexistence of cancer history and physical dysfunction resulted in poorer prognosis in patients with CVD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Miki
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Ueno
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - J Sasaki
- Kitasato University School of Medicine, Research and Development Center for New Medical Frontiers , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
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11
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Nagumo D, Hamazaki N, Kamiya K, Obara S, Kobayashi S, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Ogura K, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Impact of small-airway disease on exercise intolerance and long-term outcomes in patients with heart failure and reduced or preserved ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Exercise intolerance in patients with heart failure (HF) is a strong indicator of a poor prognosis. As the respiratory impairment in HF patients, the small airway is reportedly more susceptible than central airways, which results in increased airway resistance and may cause poor outcomes. However, the impact of small-airway disease (SAD) on exercise intolerance and prognosis in patients with HF is still unclear.
Purpose
We investigated the associations between SAD and exercise intolerance in patients with HF, and the clinical significance of SAD for long-term clinical events with a reduced or preserved ejection fraction.
Methods
We reviewed 1015 patients with HF (mean age, 66.9±14.6 years; male, 64.5%) admitted for medical treatment. Patients with a prior history of chronic respiratory disease or an obstructive lung pattern – defined as the forced expiratory volume (%) in 1 s relative to <70% forced vital capacity using spirometry – were excluded. Characteristics including HF aetiology, comorbidities conditions, medications, blood parameters, and echocardiographic variables were obtained from clinical records. All patients underwent spirometry at hospital discharge, and SAD was defined as the maximum mid-expiratory flow (%) relative to a <60% predicted value. At hospital discharge, we measured 6-min walk distance (6MWD), and <300 m was considered as exercise intolerance. The primary endpoint was a composite clinical event of all-cause death and/or unplanned readmission for HF. Multivariate logistic regression analysis was used to assess the association between SAD and exercise intolerance. The multivariate Cox proportional hazard model was used to clarify whether SAD was an independent predictor for the incidence of clinical events. We also performed subgroup analyses in each multivariate analysis based on a left ventricular ejection fraction (LVEF) of 40%.
Result
SAD was observed in 479 (47.2%) patients. LVEF subgroups included 458 (45.1%) and 518 (51.0%) patients with LVEF <40% and ≥40%, respectively. After adjusting for clinical characteristics, SAD was independently associated with 6MWD <300 m (Figure 1). Moreover, this association was consistently observed in the LVEF <40% and ≥40% (Figure 1). During the median follow-up period of 1.5 years, all-cause death/readmission occurred in 431 patients (42.5%), and the incidence rate was 17.5/100 person-years. In the multivariate Cox proportional hazard model, SAD was independently associated with lower event-free survival rates in all patients and the LVEF <40% subgroup, but not LVEF ≥40% subgroup (Figure 2A, B, and C, respectively).
Conclusion
This study is the first to reveal that SAD is associated with exercise intolerance in patients with HF regardless of LVEF. Moreover, SAD may have a predictive significance for long-term outcomes in patients with HF and subgroups with reduced, but not preserved ejection fraction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Nagumo
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Kamiya
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - S Obara
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation , Sagamihara , Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - K Ogura
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences , Sagamihara , Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
| | - M Yamaoka-Tojo
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - A Matsunaga
- Kitasato University of Allied Health Sciences, Department of Rehabilitation , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine , Sagamihara , Japan
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Ueno K, Maekawa E, Terada T, Reed J, Yamaoka-Tojo M, Matsunaga A, Ako J. SARC-F PREDICTS POOR MOTOR FUNCTION AND PROGNOSIS IN OLDER PATIENTS WITH CARDIOVASCULAR DISEASE WITH COGNITIVE IMPAIRMENT. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Hara J, Rajeev-Kumar G, Arya R, Rudra S, Awan A, Malik R, McCall A, Ichikawa T, Golden D. Prospective Pilot Study to Measure Baseline Radiation Knowledge Prior to Radiotherapy After Standard Education at Consultation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Komiya A, Kawai K, Sujino T, Iijima M, Tsukamoto S, Kato M, Tajima M, Takayanagi Y, Nako Y, Hiraoka K, Uchida N, Ishikawa S, Ichikawa T. O-015 Results of urological consultation in the setting of IVF clinic. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
In the management of male infertility, we investigated whether urological consultation could improve the live birth rate, and who should visit urologists in the setting of IVF clinic.
Summary answer
Urologic consultation resulted in improvement of semen quality and live birth rate with more IVF use in those with adverse semen parameters.
What is known already
Male factor infertility exists in about a half of infertility couples. This accounts for about 8% in male reproductive age. Therefore, ideally every male partner of infertility couples attempting conception should have a urological evaluation. However, it is not very easy to access urologists who specialized in reproductive medicine in Japan because we have very few of such urologists. One the other hand, a certain number of couples are wasting their time during IVF failure without urological evaluation.
Study design, size, duration
This is a single-institution retrospective study. We enrolled male partners of infertility couples who visited Kameda IVF clinic Makuhari, Chiba, Japan, between May 2016 and December 2020 and followed at least one year. Live birth rate and the frequency of IVF use were investigated according to semen quality and urological consultation status. Chi-square tests and T tests were used to compare the results between groups.
Participants/materials, setting, methods
Among 2225 couples who visited Kameda IVF clinic Makuhari, 803 male partners (Group A, 36.0%) were evaluated by urologists who were specialized in male reproductive medicine. Remaining 1422 patients did not (Group B, 64.0%). Lifestyle evaluation, physical examination, semen analyses, scrotal ultrasonography, blood test including sexual hormones and zinc concentration were performed in Group A. Semen analyses and lifestyle evaluation were performed in Group B. Urological treatments were done according to factors of male infertility.
Main results and the role of chance
Semen quality was worse in Group A as compared to Group B (sperm motility, 28.5±16.9% vs. 46.0±17.0%; total sperm count, 105±108 million/mL vs. 176±155; total motile sperm count, 34±49 vs.87±98; mean±S.D.; p = 0.0001, 0.0001, 0.0001, A vs. B, respectively). After urologic consultation and managements, sperm motility was improved to 34±18% (p = 0.001). Live birth rate in groups A and B were similar (56.0% vs. 57.2%), however couples who obtained a child in Group A used IVF more often than those in Group B (70% vs. 49.9%, p < 0.001). Among those with adverse semen quality (total motile sperm count less than 15.6 million/mL, n = 472), 350 visited urologists (Group 1, 74.2%) and remaining 122 did not (Group 2, 25.8%). Live birth rate in Group 1 was significantly better than in Group 2 (65.3% vs. 54.1%, p = 0.0359). Use of IVF was significantly more frequent in Group 1 than Group 2 (79.3% vs. 63.6%, p = 0.0359) among who obtained a child. In those with better semen quality (motile sperm count >50 million, n = 900), 119 visited urologist (31.1%, Group 3) and 781 did not (Group 4). Live birth rate and the use of IVF were not different between Groups 3 and 4 (51.1% vs.60.9%; 50.4% vs. 62.9%).
Limitations, reasons for caution
This study is a single-institution, retrospective study in the setting of IVF clinic. There may be a selection bias since men first visit gynecologists. These could affect the study results.
Wider implications of the findings
In the setting of IVF clinic, urologic consultation resulted in improved semen quality and better live birth rate with the use of IVF, especially in those who have adverse semen parameters. The results of this study encourage patients to see urologists and physicians to introduce urologist to patients.
Trial registration number
not applicable
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Affiliation(s)
- A Komiya
- Chiba University Hospital, Urology, Chiba-shi , Japan
| | - K Kawai
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - T Sujino
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - M Iijima
- Kanazawa University Hospital, Urology, Kanazawa-shi , Japan
| | - S Tsukamoto
- Touyu Clinic Shinmatsudo, Urology, Matsudo-shi , Japan
| | - M Kato
- Chiba University Hospital, Urology, Chiba-shi , Japan
| | - M Tajima
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - Y Takayanagi
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - Y Nako
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - K Hiraoka
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - N Uchida
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - S Ishikawa
- Kameda IVF Clinic Makuhari, Reproductive Medicine, Chiba-shi , Japan
| | - T Ichikawa
- Chiba University Hospital, Urology, Chiba-shi , Japan
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Sada KE, Miyawaki Y, Shidahara K, Nawachi S, Katayama Y, Asano Y, Hayashi K, Ohashi K, Katsuyama E, Katsuyama T, Narazaki M, Matsumoto Y, Oguro N, Ishikawa Y, Sakurai N, Hidekawa C, Yoshimi R, Ichikawa T, Kishida D, Shimojima Y, Kurita N, Yajima N. POS0728 ASSOCIATION BETWEEN TREATMENT GOAL ACHIEVEMENT AND GRIT PERSONALITY CHARACTERISTICS OF ATTENDING PHYSICIAN IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTICENTER CROSS-SECTIONAL STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.449] [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
BackgroundIn clinical practice for systemic lupus erythematosus (SLE), the concept of “treat to target” has been introduced with an established goal of reducing glucocorticoid dose as much as possible while controlling disease activity. Although it has been shown that various personality characteristics of patients with SLE affect their disease activity and damage, it is not clear whether the personality characteristics of attending physicians affect the outcomes of patients with SLE. Grit is a personality trait characterized by perseverance and passion for achieving long-term goals.ObjectivesThis study aims to evaluate the relationship between attending physicians’ grit personality characteristics and treatment goal achievements in patients with SLE.MethodsA cross-sectional study was conducted on 386 patients with SLE in five referral hospitals in Japan. The main exposure was the “perseverance” and “consistency” (scores 1-5) of the attending physicians, as measured by the Short Grit Scale, and the primary outcome was the achievement of the Lupus Low Disease Activity Score (LLDAS). Considering the clustering of achievement of LLDAS by each attending physician, the association between attending physician’s personality and LLDAS was analyzed by logistic regression with cluster robust variance estimation. Odds ratios to assess the relationship between perseverance and consistency and LLDAS were estimated with adjustment for confounders (age, sex, disease duration, hydroxychloroquine use, immunosuppressant use, and Systemic Lupus International Collaborating Clinics-Damage Index). We used multiple imputation to handle the uncertainty caused by missing values of potential confounders on the assumption of missing at random.ResultsThe median age of the patients was 45 years (interquartile range[IQR],36-56), 88% were female, and the median disease duration was 152 months(IQR, 80-240). Thirty-seven doctors were in charge of the patients (1-79 patients/each doctor). The median age of the attending physicians was 40 years (IQR, 35-43), and 19% were female. The median perseverance and consistency scores of attending physicians were 3.1 (IQR, 3.0-3.5) and 3.3 (IQR, 2.8-3.8), respectively. Of the enrolled patients, 154 (40%) had achieved LLDAS. The attending physicians with a lower consistency score of <3 were more frequent in the patients who achieved LLDAS (40% vs. 29%, p=0.026). The lower consistency score of attending physicians was still related to LLDAS independently (adjusted odds ratio 1.63, 95% confidential interval 1.17-2.27). There was no association between the achievement of LLDAS and perseverance.ConclusionThe grit personality characteristics of the attending physician may affect the achievement of treatment goals in patients with SLE.Disclosure of InterestsKEN-EI SADA Speakers bureau: I received speaker’s fees from Glaxo Smith Kline K.K., Grant/research support from: I received a research grant from Pfizer Inc., Yoshia Miyawaki: None declared, Kenta Shidahara: None declared, Shoichi Nawachi: None declared, Yu Katayama: None declared, Yosuke ASANO: None declared, Keigo Hayashi: None declared, Keiji Ohashi: None declared, Eri Katsuyama: None declared, Takayuki Katsuyama: None declared, Mariko Narazaki: None declared, Yoshinori Matsumoto: None declared, Nao Oguro: None declared, Yuichi Ishikawa: None declared, Natsuki Sakurai: None declared, Chiharu Hidekawa: None declared, Ryusuke Yoshimi: None declared, Takanori Ichikawa: None declared, Dai Kishida: None declared, Yasuhiro Shimojima: None declared, Noriaki Kurita: None declared, Nobuyuki Yajima: None declared
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Ichikawa T, Shimojima Y, Kishida D, Yajima N, Yoshimi R, Sada KE, Miyawaki Y, Oguro N, Sakurai N, Hidekawa C, Hayashi K, Shidahara K, Ishikawa Y, Sekijima Y, Kurita N. POS1404 SHARED DECISION MAKING AND INTERNET USE FOR GATHERING HEALTH INFORMATION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTICENTER CROSS-SECTIONAL STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.973] [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
BackgroundIt is well known that providing appropriate health information to patients with systemic lupus erythematosus (SLE) has an advantage in the treatment decision making process. In modern information society the growing popularity of smartphones and social networking services, patients have more access to online health information. However, there are concerns that Internet use may inversely affect the shared decision making (SDM) process with their attending physicians if they receive inaccurate information.ObjectivesThis study aimed to investigate how online information gathering behavior affects SDM with their attending physicians.MethodsIn this cross-sectional study, information of 386 patients with SLE, which were enrolled from five Japanese institutions between June 2020 and August 2021, were analyzed. The main exposure was time spent on the Internet per day (excluding time used for working). It was divided into four categories (none, <1 hour, 1-2 hours, > 2 hours). Patients were asked to select the source of health care information they would like to access first and were categorized into physicians, the Internet, and other media sources (family and friends, healthcare professionals other than physicians, or TV and radio, etc.). Outcome was shared decision making measured via the 9-item Shared Decision Making Questionnaire (SDM-Q-9 [scores 0-100]). To assess the relationship between the time of Internet use and SDM, we fitted general linear models adjusted for age, gender, education level, household income, marital status, history of cancer, disease duration, and disease activity. Chained equations were used to impute missing values of covariates.ResultsThis study ultimately employed 334 patients whose mean age and female ratio were 45.3 years (standard deviation 13.8) and 87.7%, respectively. 68.9% of the patients indicated that they would like to access their physicians first, and 19.5% indicated that they would like to access the Internet first. Compared to patients who chose their physician as their first access to health information, there was no difference in SDM-Q-9 among patients who chose the Internet, but patients who chose other media had significantly lower SDM-Q-9 (-7.7 point, 95% confident interval [CI] -14.4 to -0.92, P=0.026). Besides, SDM-Q-9 scores were significantly lower in patients who did not use the Internet compared to those who used it for more than two hours except for their work activities (-9.6, 95%CI -18.9 to -0.26, P=0.044).ConclusionThe present study suggests that SDM between physicians and patients is positively rather than adversely associated with online information-gathering behavior. Rheumatologists also need to be aware that how patients prefer to access health information to establish a good physician-patient relationship for SDM. In addition, rheumatologists may need to introduce their patients to websites offering appropriate health information.Disclosure of InterestsNone declared
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Shimojima Y, Kishida D, Ichikawa T, Kida T, Yajima N, Omura S, Nakagomi D, Abe Y, Masatoshi K, Takizawa N, Nomura A, Kukida Y, Kondo N, Yasuhiko Y, Yanagida T, Endo K, Hirata S, Kawahata K, Matsui K, Takeuchi T, Ichinose K, Kato M, Yanai R, Matsuo Y, Yamasaki A, Nishioka R, Takata T, Moriyama M, Takatani A, Ito T, Miyawaki Y, Ito-Ihara T, Kawaguchi T, Kawahito Y, Sekijima Y. POS0822 HYPERTROPHIC PACHYMENINGITIS IN ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A MULTICENTER SURVEY IN JAPAN. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundHypertrophic pachymeningitis (HP), characterized by an inflammatory disorder indicating intracranial or spinal thickening of dura mater, is found to develop as a neurological involvement in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Meanwhile, the previous studies focusing on HP in AAV have been reported as a single-institution study, and the analyses were performed in a small number of patients because HP is a rare neurological disorder. Therefore, neither etiological nor clinical characteristics of HP in AAV have been adequately elucidated.ObjectivesThis study clarified the characteristics of HP in AAV by analyzing the information of multicenter study in Japan (Japan collaborative registry of ANCA-associated vasculitis: J-CANVAS).MethodsWe analyzed the clinical information from 541 Asian patients with AAV enrolled in J-CANVAS. Of them, newly diagnosed and relapsed AAV were included in 448 and 93, respectively. The epidemiological and clinical findings were compared between patients with and without HP. Clinical manifestations related to AAV were evaluated based on the Birmingham Vasculitis Activity Score version 3. To elucidate independent factors in HP development, logistic regression analyses were additionally performed.ResultsOf the total 541 patients (mean age: 71±14 years, M:F = 1:1.2), HP was demonstrated in 28 (5.17%), including 17 (3.79%) in newly diagnosed AAV and 11 (11.8%) in relapsed AAV. The classification of granulomatosis with polyangiitis (GPA) was significantly higher in patients with HP than those without HP (50% vs. 21%, p = 0.0007). In newly diagnosed AAV, patients with HP significantly had higher GPA classification and higher positivity for PR3-ANCA than those without HP (53% vs. 17%, p = 0.001; 29% vs. 9%, p = 0.015, respectively). Conversely, positivity for MPO-ANCA was significantly higher in patients with HP than those without HP in relapsed AAV (91% vs. 55%, p = 0.025), despite not significantly different in the classification of AAV. Headache and cranial neuropathies were significant neurological symptoms in patients with HP compared to those without HP (82% vs. 6.6%, p < 0.0001; 32% vs. 2.9%, p < 0.0001, respectively). Besides, ear, nose and throat (ENT) and mucous membranes/eyes were significantly higher involvements in patients with HP than in those without HP (54% vs. 26%, p = 0.003; 29% vs. 9%, p = 0.003, respectively). Moreover, higher complications of “conjunctive hearing loss” and “sudden visual loss”, which are included in the categories of ENT and mucous membranes/eyes involvement, respectively, were significantly indicated in patients with HP than those without HP (39% vs. 7.2%, p < 0.0001; 21% vs. 1.2%, p < 0.0001, respectively). Multivariable logistic regression analysis identified that ENT (odds ratio [OR] 1.28, 95% confident interval [CI] 1.09 to 1.49, p = 0.002) and mucous membranes/eyes involvement (OR 1.37, CI 1.14 to 1.65, p = 0.0006), as well as conjunctive hearing loss (OR 4.52, CI 1.56 to 13.05, p = 0.005) and sudden visual loss (OR 1.84, CI 1.12 to 3.00, p = 0.015), were independent related factors in patients with HP.ConclusionGPA could be significantly classified in patients with HP. Notably, patients with HP significantly showed higher positivity for PR3-ANCA than those without HP in newly diagnosed AAV. Furthermore, sudden visual loss and conjunctive hearing loss might be implicated in HP development.Disclosure of InterestsNone declared
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Oguro N, Yajima N, Miyawaki Y, Yoshimi R, Shimojima Y, Sada KE, Hayashi K, Shidahara K, Sakurai N, Hidekawa C, Kishida D, Ichikawa T, Ishikawa Y, Kurita N. AB0474 IMPACT OF HEALTH LITERACY ON TRUST IN PHYSICIANS AMONG PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: THE TRUMP2-SLE PROJECT. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1344] [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
BackgroundInformation technology has expanded the gap in patient health literacy (HL), and HL has various implications on the trust in patient-doctor relationship. Previously, only functional HL, the ability to interpret health information through reading and writing skills, has been studied in patients with SLE (1).ObjectivesWe examined how trust in physicians is affected by the broader concept of HL, including communicative HL, the ability to extract health information from communication to use, and critical HL, the ability to discern and use such information (2).MethodsThis cross-sectional study enrolled 362 SLE patients at 5 sites between June 2020 and August 2021. Three domains of HL (i.e., functional HL, communicative HL, and critical HL) were assessed using the 14-item FCCHL scale (range: 1-4 points for each domain). The outcomes were patients’ trust in their physicians and physicians in general and were measured using the Japanese version of the 5-item Wake Forest Physician Trust scales (range: 0-100 points for each scale). General linear models adjusted for age, gender, education, income, SLEDAI, disease duration, depression, and hours of Internet use were conducted. Subsequently, a series of general linear models were then fit to each of the three domains of HL to examine whether or not it was associated with the aforementioned covariates.ResultsThe median age of the patients was 45 (interquartile range [IQR],34-55), 88% were female. The median value of SLEDAI was 4 ([IQR], 2-8), Trust in one’s physician was 80 ([IQR], 70-95) and trust in physicians generally was 65 ([IQR], 50-80). Trust in one’s physician increased with higher functional and communicative HL (per 1-pt increase, 3.2 [95%CI 0.7 to 5.9]; 5.4 [95%CI 1.6 to 9.3]). Trust in doctors generally increased with higher communicative HL and decreased with higher critical HL (per 1-pt increase, 6.8 [95% CI 2.0 to 12]; -6.7 [95% CI -12 to -1.9]). Lower functional HL was associated with older age and depression, while higher HL was associated with higher educational level. Higher communicative HL and critical HL were each associated with longer Internet use.ConclusionIn patients with SLE, higher trust in one’s physician was associated with both functional and communicative HL, while higher trust in physicians generally was associated with higher communicative HL and lower critical HL. Our findings suggest that trusting relationships may be fostered by the encouragement of rheumatologists to cultivate patients’ ability to share their health problems with their physicians and family members and to obtain useful health information (i.e., communicative HL), rather than to improve their ability to discern health information (i.e., critical HL).References[1]Maheswaranathan M, Cantrell S, Eudy AM, Rogers JL, Clowse MEB, Hastings SN, et al. Investigating Health Literacy in Systemic Lupus Erythematosus: a Descriptive Review. Curr Allergy Asthma Rep. 2020;20(12):79.[2]Ishikawa H, Takeuchi T, Yano E. Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care. 2008;31(5):874-9.Disclosure of InterestsNao Oguro: None declared, Nobuyuki Yajima: None declared, Yoshia Miyawaki: None declared, Ryusuke Yoshimi: None declared, Yasuhiro Shimojima: None declared, KEN-EI SADA Speakers bureau: He received speaker’s fees from Glaxo SmithKline K.K., Grant/research support from: He received a research grant from Pfizer Inc.,, Keigo Hayashi: None declared, Kenta Shidahara: None declared, Natsuki Sakurai: None declared, Chiharu Hidekawa: None declared, Dai Kishida: None declared, Takanori Ichikawa: None declared, Yuichi Ishikawa: None declared, Noriaki Kurita: None declared
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Prevalence of metabolic dysfunction-associated fatty liver disease and its association with physical function in patients with acute coronary syndrome. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI
Background
It is widely known that patients with acute coronary syndrome (ACS) are at increased risk of nonalcoholic fatty liver disease (NAFLD), which is linked to sarcopenia and physical dysfunction. However, the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and physical dysfunction remains unclear.
Purpose
The purpose of this study was to investigate the prevalence of MAFLD in patients with ACS to assess the relationship between MAFLD and muscle strength, walking speed, and 6-minute walking distance (6 MWD).
Methods
We reviewed patients with ACS who were assessed for hepatic steatosis using the fatty liver index, and the results were further assessed to determine the presence of MAFLD. Multiple regression analysis was used to examine the association between MAFLD and physical function.
Results
Among 479 enrolled hospitalized patients, MAFLD was identified in 234 (48.9%) patients. We conducted a multiple regression analysis in which MAFLD was independently associated with lower leg strength, gait speed, and 6 MWD (leg strength, P = 0.023; gait speed, P = 0.002 and 6 MWD, P = 0.017). Furthermore, having more metabolic impairment was still associated with lower physical function decline (leg strength, P for trend = 0.002; gait speed, P for trend = 0.019 and 6 MWD, P for trend = 0.003).
Conclusions
MAFLD is common in hospitalized patients with ACS, and most patients with MAFLD have many overlapping metabolic abnormalities. MAFLD is associated with impaired physical function, and the greater the number of overlapping metabolic abnormalities, the worse the motor function.
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Affiliation(s)
- T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Uchida S, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Noda T, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Skeletal muscle mass metrics as factors in the prognosis of heart failure patients. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI Grant
Background
Sarcopenia is a chronic condition that is characterized by the loss of skeletal muscle mass with declining muscle strength and/or performance that occurs gradually with aging. It has been reported that sarcopenia is highly prevalent in patients with heart failure (HF) and is a poor prognostic factor. Therefore, it is important to accurately assess skeletal muscle mass in patients with HF. However, there are no reports that have simultaneously examined different skeletal muscle mass metrics as factors in the prognosis of HF patients.
Purpose
The purpose of this study is to examine if the different skeletal muscle mass metrics are associated with the prognosis of HF patients.
Methods
We examined a total of 869 patients with HF, aged ≥20 years (73 [63, 80] years; 537 males), who were admitted to our hospital and participated in an inpatient cardiac rehabilitation program. We used skeletal muscle mass index (SMI) as measured by bioelectrical impedance analysis (BIA), mid-upper arm circumference (MUAC), arm muscle circumference (AMC), and calf circumference (CC) as metrics of skeletal muscle mass. The primary outcome was all-cause deaths, and secondary outcome was HF readmission. To investigate the association between each skeletal muscle mass metric and prognosis, patients were divided into three groups according to the tertiles of SMI, MUAC, AMC, and CC. In addition, cumulative event rates of survival curves, Gray test, and Fine & Gray test were performed to evaluate the prognostic predictive capability.
Results
Over a median follow-up period of 0.9 years (interquartile 0.4–1.9) years, a total of 80 deaths and 195 HF readmissions occurred in the patients. Cumulative event rates of survival curves and Gray test showed that there was a significant decrease in all-cause mortality and HF readmission in the high MUAC group and high AMC group compared to their respective low groups (P < 0.05). Fine & Gray test after multivariate adjustment showed significantly better prognosis in the high MUAC group and high AMC group compared to their respective low groups (All-cause mortality: high MUAC group, subdistribution hazard ratio [sHR] = 0.42, 95% confidence interval [CI] = 0.20-0.88, P < 0.05; high AMC group, sHR = 0.34, 95%CI = 0.16-0.72 P < 0.05, HF readmission: high MUAC group, sHR = 0.69, 95%CI = 0.47-1.00, P < 0.05; high AMC group, sHR = 0.63, 95%CI = 0.43-0.93, P < 0.05).
Conclusion
Patients with HF who maintained high MUAC and high AMC had a good prognosis. CC and SMI were not associated with the prognosis of HF patients. This suggests the importance of evaluating MUAC and AMC in HF patients.
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Affiliation(s)
- S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Ichikawa T, Kusumi N, Tsushima T, Shiraishi H, Watari S, Sakuma T, Kubota R. A Case of late-onset hypogonadism syndrome with rapidly elevated prostate specific antigen. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ichikawa T, Ono S, Nagafuji Y, Kobayashi M, Yashiro H, Koizumi J, Uchiyama F, Fujii Y, Hasebe T, Terayama H, Hashimoto J. Congenital venous anomalies associated with retrocaval ureter: evaluation using computed tomography. Folia Morphol (Warsz) 2022; 82:300-306. [PMID: 35411547 DOI: 10.5603/fm.a2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Retrocaval ureter is a rare congenital anomaly resulting from anomalous development of inferior vena cava (IVC) and not from anomalous of the ureter. The anomaly always occurs on the right side due to regression of right supracardinal vein and persistence of right posterior cardinal vein. Retrocaval ureter tends to be associated with various vena cava anomalies because of the embryogenesis. We aimed to identify the prevalence of associated congenital venous anomalies (CVA) resulting from cardinal vein development in adults with retrocaval ureter using computed tomography (CT) images. MATERIALS AND METHODS The study included 22 adults with retrocaval ureter. We evaluated CT findings and determined the incidence of associated CVA using thin slice data sets from CT scanner with 64 or more detectors. We compared the prevalence of CVA in the retrocaval ureter group (mean age: 57±19 years) and in the control group of 6189 adults with normal ureter (mean age: 66±14 years). RESULTS In the retrocaval ureter group, 4 adults (18.2 %) had CVA including double IVC, right double IVC, preisthmic IVC with horseshoe kidney, and preaortic iliac confluence. One of 2 adults with preaortic iliac confluence had right double right IVC. In the control group, 49 adults (0.79%) had CVA including 37 double IVCe, 11 left IVCe, and 1 IVC interruption azygos continuation. Fifteen horseshow kidneys were found. The prevalence of associated CVA in the retrocaval ureter group was higher than that in the control group (p<0.001). CONCLUSIONS Retrocaval ureter is frequently associated with CVA. Various CVA with retrocaval ureter could happen because of abnormal development of not only the right posterior or supra cardinal vein but also other cardinal veins.
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Affiliation(s)
- T Ichikawa
- Department of Radiology, Tokai University School of Medicine, Isehara-si, Japan.
| | - S Ono
- Department of Radiology, Tokai University School of Medicine, Isehara-si, Japan
| | - Y Nagafuji
- Department of Radiology, Ebina General Hospital, Ebina, Japan
| | - M Kobayashi
- Department of Radiology, Hirastuka City Hospital, Kanagawa, Japan
| | - H Yashiro
- Department of Radiology, Hirastuka City Hospital, Kanagawa, Japan
| | - J Koizumi
- Department of Radiology, Chiba University, 1-8-1 Inohana, Chuo-Ku, 260-8677 Chiba, Japan
| | - F Uchiyama
- Department of Radiology, Ebina General Hospital, Ebina, Japan
| | - Y Fujii
- Department of Radiology, Fujisawa City Hospital, Kanagawa, Japan
| | - T Hasebe
- Department of Radiology, Tokai University Hachioji Hospital, Tokyo, Japan
| | - H Terayama
- Department of Anatomy, Tokai University School of Medicine, Kanagawa, Japan
| | - J Hashimoto
- Department of Radiology, Tokai University School of Medicine, Isehara-si, Japan
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Inaishi T, Shibata M, Ichikawa T, Kanda M, Hayashi M, Soeda I, Takeuchi D, Takano Y, Tsunoda N, Kodera Y, Kikumori T. Platelet isoform of phosphofructokinase accelerates malignant features in breast cancer. Oncol Rep 2021; 47:9. [PMID: 34751415 DOI: 10.3892/or.2021.8220] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/06/2021] [Indexed: 11/06/2022] Open
Abstract
The platelet isoform of phosphofructokinase (PFKP) is one of the key enzymes in the glycolytic pathway. PFKP is highly expressed in several cancers, and it has been reported to be involved in the progression of cancer cells. However, its oncological role in breast cancer (BC) remains unclear. The present study aimed to evaluate the function of PFKP in BC cells and its expression level in patients with BC. Firstly, the mRNA and protein expression of PFKP was evaluated in BC and non‑cancerous mammary cell lines. Polymerase chain reaction (PCR) array analysis was conducted to evaluate the correlation between PFKP and 84 cancer‑related genes. Then, PFKP knockdown was conducted using small interfering RNA, and cell proliferation, invasiveness and migration were analyzed. Furthermore, the association between PFKP mRNA expression and clinicopathological factors was investigated in 167 patients with BC. PFKP was highly expressed in estrogen receptor‑negative and human epidermal growth factor receptor 2‑negative BC cell lines. PCR array analysis demonstrated that the expression level of PFKP was significantly correlated with that of transforming growth factor‑β1 and MYC proto‑oncogene. PFKP knockdown significantly decreased the proliferation and invasiveness of MCF7, SK‑BR‑3, and MDA‑MB‑231 cells. Furthermore, cell migration was inhibited in SK‑BR‑3 and MDA‑MB‑231 cells. In the clinical specimens, patients with T2/T3/T4, lymph node metastasis, or stage II/III/IV exhibited higher expression of PFKP mRNA than patients with less severe disease. In conclusion, the present findings indicated that PFKP is involved in promoting tumor‑progressive oncological roles in BC cells across different subtypes and is considered a possible novel therapeutic target for BC.
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Affiliation(s)
- Takahiro Inaishi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Takahiro Ichikawa
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Masamichi Hayashi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Ikumi Soeda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Dai Takeuchi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Yuko Takano
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Nobuyuki Tsunoda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466‑8550, Japan
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Hamazaki N, Kamiya K, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Noda T, Maekawa E, Meguro K, Yamaoka-Tojo M, Matsunaga A, Ako J. Associations between kidney function and outcomes following cardiac rehabilitation in patients with heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Kidney dysfunction is considered one of the most prevalent comorbidities in patients with heart failure (HF). A combination of HF and kidney dysfunction is associated with peripheral muscle impairment, exercise intolerance, and poor prognosis. Conversely, cardiac rehabilitation (CR) for HF patients has been recognized to improve their clinical outcomes. However, the impact of kidney function on responses to CR in patients with HF is still unclear.
Purpose
This study aimed to investigate the associations between baseline kidney function and outcomes following CR including changes in physical function and prognosis in HF patients.
Methods
We reviewed a total of 3,727 patients who were admitted for HF treatment and underwent comprehensive CR during hospitalization. In addition to clinical characteristics, we assessed the kidney function using estimated glomerular filtration rate (eGFR) based on serum creatinine level at hospital discharge as baseline. The quadriceps strength (QS) and 6-minute walk distance (6MWD) were measured as muscle strength and functional capacity, respectively, at baseline. We also remeasured these parameter 5 months after hospital discharge in patients who participated in outpatient CR. The association between participation in outpatient CR and composite outcome of all-cause death and/or unplanned readmission were assessed using the multivariate Cox proportional hazard models in a subgroup of baseline eGFR. We also compared the changes in QS and 6MWD (ΔQS and Δ6MWD) between the eGFR stages.
Results
During the median follow-up period of 1.9 years, all-cause death/readmission occurred in 1604 (43.0%) patients, and their rate of incidence was 20.9/100 person-years. Out of studied patients, 1,585 (42.5%) patients participated in outpatient CR that was significantly associated with lower incidences of all-cause clinical events in patients with both eGFR ≥60 (adjusted hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.60–0.89, P=0.002) and eGFR <60 (adjusted HR: 0.88, 95% CI: 0.78–0.99, P=0.045), but those with an eGFR <60 showed significant interaction between CR participation and adverse clinical events (interaction P<0.035, Figure 1). Among the outpatient CR participants, QS and 6MWD were significantly higher after 5-month CR than those at baseline (P<0.001, respectively), but the low baseline eGFR correlated with low ΔQS and Δ6MWD (trend P<0.001, respectively) even after adjustment for clinical confounding factors (Figure 2).
Conclusions
Although the outcomes following CR is affected by baseline kidney function, outpatient CR is significantly associated with the positive change in physical function and better prognosis in HF patients with low kidney function.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Sagamihara, Japan
| | - K Kamiya
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - T Noda
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University School of Allied Health Sciences, Department of Rehabilitation, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Ichikawa T, Shibata M, Inaishi T, Soeda I, Kanda M, Hayashi M, Takano Y, Takeuchi D, Tsunoda N, Kodera Y, Kikumori T. Synaptotagmin 13 Is Highly Expressed in Estrogen Receptor-Positive Breast Cancer. Curr Oncol 2021; 28:4080-4092. [PMID: 34677264 PMCID: PMC8535095 DOI: 10.3390/curroncol28050346] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 09/24/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Accumulating evidence indicates tumor-promoting roles of synaptotagmin 13 (SYT13) in several cancers; however, no studies have investigated its expression in breast cancer (BC). This study aimed to clarify the significance of SYT13 in BC. Methods: SYT13 mRNA expression levels were evaluated in BC cell lines. Polymerase chain reaction (PCR) array analysis was conducted to determine the correlation between expression levels of SYT13 and other tumor-associated genes. Then, the association of SYT13 expression levels in the clinical BC specimens with patients’ clinicopathological factors was evaluated. These findings were subsequently validated using The Cancer Genome Atlas (TCGA) database. Results: Among 13 BC cell lines, estrogen receptor (ER)-positive cells showed higher SYT13 mRNA levels than ER-negative cells. PCR array analysis revealed positive correlations between SYT13 and several oncogenes predominantly expressed in ER-positive BC, such as estrogen receptor 1, AKT serine/threonine kinase 1, and cyclin-dependent kinases 4. In 165 patients, ER-positive specimens exhibited higher SYT13 mRNA expression levels than ER-negative specimens. The TCGA database analysis confirmed that patients with ER-positive BC expressed higher SYT13 levels than ER-negative patients. Conclusion: This study suggests that SYT13 is highly expressed in ER-positive BC cells and clinical specimens, and there is a positive association of SYT13 with the ER signaling pathways.
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Affiliation(s)
- Takahiro Ichikawa
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
- Correspondence: ; Tel.: +81-52-744-2251; Fax: +81-52-744-2252
| | - Takahiro Inaishi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Ikumi Soeda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (M.K.); (M.H.); (Y.K.)
| | - Masamichi Hayashi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (M.K.); (M.H.); (Y.K.)
| | - Yuko Takano
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Dai Takeuchi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Nobuyuki Tsunoda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (M.K.); (M.H.); (Y.K.)
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan; (T.I.); (T.I.); (I.S.); (Y.T.); (D.T.); (N.T.); (T.K.)
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Takeuchi H, Ichikawa T. Creation of Gyroid Nanostructured Polymer Films from Lyotropic Liquid Crystals Containing a Polymerizable Ionic Liquid as a Solvent. CHEM LETT 2021. [DOI: 10.1246/cl.210021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Hiroaki Takeuchi
- Department of Biotechnology, Tokyo University of Agriculture and Technology, 2-24-16 Naka-cho, Koganei, Tokyo 184-8588, Japan
| | - Takahiro Ichikawa
- Department of Biotechnology, Tokyo University of Agriculture and Technology, 2-24-16 Naka-cho, Koganei, Tokyo 184-8588, Japan
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Kobayashi T, Li Y, Hirota Y, Maekawa A, Nishiyama N, Zeng X, Ichikawa T. Gyroid‐Nanostructured All‐Solid Polymer Films Combining High H
+
Conductivity with Low H
2
Permeability. Macromol Rapid Commun 2021. [DOI: 10.1002/marc.202170045] [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: 11/09/2022]
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28
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Noda T, Kamiya K, Hamazaki N, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Associations of severity of liver damages with physical function and prognosis in patients with heart failure. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Heart failure (HF) and liver dysfunction often coexist because of complex cardiohepatic interactions, which adversely affects prognosis. However, the association between liver dysfunction and physical dysfunction, and between coexistence of both and prognosis in HF patients remains unclear.
Purpose
We evaluated the associations of severity of liver damage and physical function and prognosis in patients with HF.
Methods
The study population consisted of 895 patients with HF (mean age, 69.4 ± 14.2 years) who underwent liver function test using model for end-stage liver disease excluding international normalized ratio (MELD-XI) score and physical function test (grip strength, leg strength, gait speed, and 6-minute walking distance [6MWD]). The associations between MELD-XI score and physical function were assessed by multivariate linear regression model analysis. Moreover, we investigated the prognostic value of coexistence of liver dysfunction and physical dysfunction. The endpoint was all-cause mortality.
Results
After adjusting for covariates, MELD-XI score was independently associated with lower grip strength, leg strength, gait speed, and 6MWD (P < 0.001). In addition, hierarchical multivariate linear regression analysis revealed that adding MELD-XI scores or BNP explained additional variance in the physical function measures. The MELD-XI score added to the clinical model was significantly more predictive of physical function (grip strength, change in F: 27.105, P < 0.001; leg strength, change in F: 33.980, P < 0.001; gait speed, change in F: 22.826, P < 0.001; 6MWD, change in F: 59.193, P < 0.001) than BNP added to the clinical model. Eighty-six deaths occurred over a median follow-up period of 1.67 years (interquartile range: 0.62 – 3.04). Patients with high MELD-XI score and reduced physical function were found to have significantly higher mortality risk even after adjusting for several covariates (grip strength, hazard ratio [HR] = 3.80 [95% confidence interval (CI) = 2.04 – 7.08], P < 0.001; leg strength, HR = 4.65 [95% CI = 2.47 - 8.75], P < 0.001 and gait speed, HR = 2.49 [95% CI = 1.43 - 4.33], P = 0.001; 6MWD, HR = 5.48 [95% CI = 2.88 - 10.41], P < 0.001).
Conclusions
Liver dysfunction was correlated with reduced physical function. Moreover, the coexistence of lower physical function and liver dysfunction considerably affected prognosis in patients with HF.
Abstract Figure. Kaplan–Meier survival curves
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Affiliation(s)
- T Noda
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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29
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Yamashita M, Kamiya K, Matsunaga A, Kitamura T, Hamazaki N, Nozaki K, Ichikawa T, Maekawa E, Meguro K, Yamaoka-Tojo M, Miyaji K. Low skeletal muscle density combined with muscle dysfunction predicts adverse events after adult cardiovascular surgery. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This study was supported by the Grant for Japan Society for the Promotion of Science (JSPS) KAKENHI.
Introduction
Although muscle dysfunction is widely known as a poor prognostic factor in patients with cardiovascular disease, no study has examined whether the addition of low skeletal muscle density (SMD) assessed by computed tomography (CT) to muscle dysfunction is useful.
Purpose
The present study aimed to examine whether SMDs can strengthen the predictive ability of muscle dysfunction for adverse events in patients who underwent cardiovascular surgery.
Methods
We retrospectively reviewed 853 patients (median age: 69 years, 65.1% male) aged ≥40 years who had preoperative CT for risk management purposes and muscle dysfunctions measured during postoperative cardiac rehabilitation. Muscle dysfunctions were determined from weakness (low grip strength) and slowness (slow gait speed) based on the Asia Working Group for Sarcopenia. Low SMD based on transverse abdominal CT images was defined as a mean Hounsfield unit of the psoas muscle <45. To examine the complementary prognostic value for all-cause deaths, all-cause events, and cardiovascular-related events when low SMDs were added to four patterns of muscle dysfunction (weakness only, slowness only, weakness or slowness, and weakness and slowness), the continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) index were calculated.
Results
For all definitions of muscle dysfunction, the addition of SMDs was shown to significantly improve the cNRI (estimates: 0.377 to 0.468 for all-cause death, 0.220 to 0.248 for all-cause events, 0.308 to 0.322 for cardiovascular-related events) and IDI (estimates: 0.005 to 0.011 for all-cause death, 0.005 to 0.010 for all-cause events, 0.009 to 0.012 for cardiovascular-related events) in all analyses. Low SMDs combined with muscle dysfunctions were associated with the highest risk of all-cause death (Figure 1: A-D). Patients with neither low SMDs nor muscle dysfunction had the lowest risk of all-cause events and cardiovascular-related events (Figure1: E-L).
Conclusion
The predictive ability of muscle dysfunction for adverse events was consistently increased by addition of SMDs in patients who underwent cardiovascular surgery. Our results suggest that when CT is performed for any clinical investigation, the addition of the organic assessment of skeletal muscle can strengthen the diagnostic accuracy of muscle wasting.
Abstract Figure 1
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Affiliation(s)
- M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - T Kitamura
- Kitasato University School of Medicine, Department of Cardiovascular Surgery, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - K Meguro
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Miyaji
- Kitasato University School of Medicine, Department of Cardiovascular Surgery, Sagamihara, Japan
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30
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Kobayashi T, Li YX, Hirota Y, Maekawa A, Nishiyama N, Zeng XB, Ichikawa T. Gyroid-Nanostructured All-Solid Polymer Films Combining High H + Conductivity with Low H 2 Permeability. Macromol Rapid Commun 2021; 42:e2100115. [PMID: 33960572 DOI: 10.1002/marc.202100115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/01/2021] [Indexed: 11/08/2022]
Abstract
Gyroid-nanostructured all-solid polymer films with exceedingly high proton conductivity and low H2 gas permeability have been created via crosslinking polymerization of mixtures of a zwitterionic amphiphilic monomer and a polymerizable imide-type acid that co-organize into bicontinuous cubic liquid-crystalline phases. The gyroid nanostructures are visualized by reconstructing a 3D electron map from the synchrotron X-ray diffraction patterns. These films exhibit high proton conductivity of the order of 10-1 S cm-1 and extremely low H2 gas permeability of the order of 10-15 mol m m-2 s-1 Pa-1 . These properties can be ascribed to the presence of the ionic liquid-like layer along the gyroid minimal surface. Since these two characteristics are required for improving the performance of proton-exchange membrane fuel cells, the present membrane design represents a promising strategy for the development of advanced devices, pertinent to establishing sustainable energy sources.
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Affiliation(s)
- Tsubasa Kobayashi
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Ya-Xin Li
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - Yuichiro Hirota
- Division of Chemical Engineering, Osaka University, Osaka, 560-8531, Japan.,Department of Life Science and Applied Chemistry Graduate School of Engineering, Nagoya Institute of Technology, Aichi, 466-8555, Japan
| | - Asako Maekawa
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Naka-cho, Koganei, Tokyo, 184-8588, Japan
| | - Norikazu Nishiyama
- Division of Chemical Engineering, Osaka University, Osaka, 560-8531, Japan
| | - Xiang-Bing Zeng
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - Takahiro Ichikawa
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Naka-cho, Koganei, Tokyo, 184-8588, Japan.,Institute of Global Innovation Research, Tokyo University of Agriculture and Technology, Tokyo, 184-8588, Japan
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31
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Ichikawa T, Kitae A, Takeda S, Sueyoshi A, Hamaguchi M, Fukui M. Transition of blood glucose level in a patient with pregnancy-associated fulminant type 1 diabetes mellitus. J Diabetes Investig 2021; 12:894-896. [PMID: 33000569 PMCID: PMC8089018 DOI: 10.1111/jdi.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022] Open
Abstract
We report on the transition in blood glucose levels before and after the onset of fulminant type 1 diabetes mellitus in a perinatal woman. In week 38 of pregnancy, before which the patient had normal glucose tolerance, idiopathic acute pancreatitis was diagnosed. Five days thereafter, she became hypoglycemic, so we closely monitored her blood glucose levels. A total of 13 days later, she was hyperglycemic with a blood glucose level >16.0 mmol/L and glycated hemoglobin of 6.4%. Her fasting serum C-peptide reactivity level was 3.6 ng/mL on the 5th day, and 0.2 ng/mL on the 18th day. Multiple insulin injection therapy was administered since the 18th day; after that, ketoacidosis did not occur. The patient was diagnosed with fulminant type 1 diabetes mellitus based on hyperglycemia without high glycated hemoglobin levels and sudden onset insulin-dependent diabetes. Monitoring glucose levels in the case of idiopathic acute pancreatitis during pregnancy and prompt initiation of insulin therapy are important.
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Affiliation(s)
- Takahiro Ichikawa
- Department of Endocrinology and MetabolismGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Aya Kitae
- Department of Endocrinology and MetabolismGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Sorou Takeda
- Department of GastroenterologyUji Tokushukai Medical CenterUjiJapan
| | - Atsushi Sueyoshi
- Department of DiabetetologyUji Tokushukai Medical CenterUjiJapan
| | - Masahide Hamaguchi
- Department of Endocrinology and MetabolismGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Michiaki Fukui
- Department of Endocrinology and MetabolismGraduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
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32
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Kato K, Onishi K, Maeda K, Yagyu M, Fa S, Ichikawa T, Mizuno M, Kakuta T, Yamagishi TA, Ogoshi T. Thermally Responsive Poly(ethylene oxide)-Based Polyrotaxanes Bearing Hydrogen-Bonding Pillar[5]arene Rings*. Chemistry 2021; 27:6435-6439. [PMID: 33543802 DOI: 10.1002/chem.202005099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/26/2020] [Indexed: 11/09/2022]
Abstract
Poly(ethylene oxide)s (PEOs) are useful polymers with good water solubility, biological compatibility, and commercial availability. PEOs with various end groups were threaded into pillar[5]arene rings in a mixture of water and methanol to afford pseudopolyrotaxanes. Corresponding polyrotaxanes were also constructed by capping COOH-terminated pseudopolyrotaxanes with bulky amines, in which multiple hydrogen bonds involving the pillar[5]arene OH groups were critically important to prevent dethreading. The number of threaded ring components could be rationally controlled in these materials, providing a simple and versatile method to tune the mechanical and thermal properties. Specifically, a polyrotaxane with a high-molecular-weight axle became elastic upon heating above the melting point of PEOs and exhibited temperature-dependent shape memory property because of the topological confinement and crosslinked hydrogen bonds.
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Affiliation(s)
- Kenichi Kato
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Katsuto Onishi
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Koki Maeda
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Masafumi Yagyu
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Shixin Fa
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Takahiro Ichikawa
- Department of Biotechnology, Faculty of Engineering, Tokyo University of Agriculture and Technology, Nakacho, Koganei, Tokyo, 1848588, Japan
| | - Motohiro Mizuno
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Takahiro Kakuta
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan.,WPI Nano Life Science Institute, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Tada-Aki Yamagishi
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Tomoki Ogoshi
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan.,WPI Nano Life Science Institute, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
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33
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Kato K, Onishi K, Maeda K, Yagyu M, Fa S, Ichikawa T, Mizuno M, Kakuta T, Yamagishi T, Ogoshi T. Front Cover: Thermally Responsive Poly(ethylene oxide)‐Based Polyrotaxanes Bearing Hydrogen‐Bonding Pillar[5]arene Rings (Chem. Eur. J. 21/2021). Chemistry 2021. [DOI: 10.1002/chem.202100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kenichi Kato
- Department of Synthetic Chemistry and Biological Chemistry Graduate School of Engineering Kyoto University Nishikyo-ku Kyoto 6158510 Japan
| | - Katsuto Onishi
- Department of Synthetic Chemistry and Biological Chemistry Graduate School of Engineering Kyoto University Nishikyo-ku Kyoto 6158510 Japan
| | - Koki Maeda
- Department of Synthetic Chemistry and Biological Chemistry Graduate School of Engineering Kyoto University Nishikyo-ku Kyoto 6158510 Japan
| | - Masafumi Yagyu
- Graduate School of Natural Science and Technology Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
| | - Shixin Fa
- Department of Synthetic Chemistry and Biological Chemistry Graduate School of Engineering Kyoto University Nishikyo-ku Kyoto 6158510 Japan
| | - Takahiro Ichikawa
- Department of Biotechnology Faculty of Engineering Tokyo University of Agriculture and Technology Nakacho Koganei Tokyo 1848588 Japan
| | - Motohiro Mizuno
- Graduate School of Natural Science and Technology Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
| | - Takahiro Kakuta
- Graduate School of Natural Science and Technology Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
- WPI Nano Life Science Institute Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
| | - Tada‐aki Yamagishi
- Graduate School of Natural Science and Technology Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
| | - Tomoki Ogoshi
- Department of Synthetic Chemistry and Biological Chemistry Graduate School of Engineering Kyoto University Nishikyo-ku Kyoto 6158510 Japan
- WPI Nano Life Science Institute Kanazawa University Kakuma-machi Kanazawa 9201192 Japan
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34
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Shibata M, Inaishi T, Ichikawa T, Shimizu D, Soeda I, Takano Y, Takeuchi D, Tsunoda N, Kikumori T. Identifying the tumor-progressive gene expression profile in high-risk papillary thyroid cancer. Surg Today 2021; 51:1703-1712. [PMID: 33733290 DOI: 10.1007/s00595-021-02262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/31/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Papillary thyroid cancer (PTC) is generally associated with a favorable prognosis. However, some patients have fatal disease, with locally infiltrating tumors or progressive distant metastases; yet few studies have investigated the characteristics of the tumor-progressive gene expression profile in advanced PTC. We conducted this study to clarify the gene expression status in advanced PTC and identify candidate molecules for prognostic biomarkers. METHODS We analyzed 740 tumor-progressive gene expression levels from formalin-fixed paraffin-embedded blocks of samples from six patients with low-risk PTC and six patients with high-risk PTC, using the nCounter PanCancer Progression panel. Then, we investigated the association between the expression levels of focused genes and pathological factors in PTC patients in The Cancer Genome Atlas (TCGA) database. RESULTS The expression levels of 14 genes in the high-risk PTC specimens were more than two-fold those in the low-risk PTC specimens. In the TCGA database, expression levels of four genes (CCL11, COL6A3, INHBA, and SRPX2) were significantly higher in patients with advanced PTC. Among the patients with advanced PTC, those with high SRPX2 expression levels had poor disease-free survival. Univariate and multivariate analyses revealed that high SRPX2 expression was an independent prognostic factor. CONCLUSION Based on the findings of this study, CCL11, COL6A3, INHBA, and SRPX2 are potential biomarkers that indicate advanced PTC. SRPX2, in particular, is considered a prognostic biomarker.
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Affiliation(s)
- Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Takahiro Inaishi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Takahiro Ichikawa
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Dai Shimizu
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Ikumi Soeda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Yuko Takano
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Dai Takeuchi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Nobuyuki Tsunoda
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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35
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Kato K, Onishi K, Maeda K, Yagyu M, Fa S, Ichikawa T, Mizuno M, Kakuta T, Yamagishi TA, Ogoshi T. Thermally Responsive Poly(ethylene oxide)-Based Polyrotaxanes Bearing Hydrogen-Bonding Pillar[5]arene Rings. Chemistry 2021; 27:6358. [PMID: 33615596 DOI: 10.1002/chem.202100515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Invited for the cover of this issue are Tomoki Ogoshi and co-workers at Kyoto University, Kanazawa University and Tokyo University of Agriculture and Technology. The image depicts musical notation to represent hydrogen bond networks and poly(ethylene oxide) chains. Read the full text of the article at 10.1002/chem.202005099.
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Affiliation(s)
- Kenichi Kato
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Katsuto Onishi
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Koki Maeda
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Masafumi Yagyu
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Shixin Fa
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan
| | - Takahiro Ichikawa
- Department of Biotechnology, Faculty of Engineering, Tokyo University of Agriculture and Technology, Nakacho, Koganei, Tokyo, 1848588, Japan
| | - Motohiro Mizuno
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Takahiro Kakuta
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan.,WPI Nano Life Science Institute, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Tada-Aki Yamagishi
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
| | - Tomoki Ogoshi
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Nishikyo-ku, Kyoto, 6158510, Japan.,WPI Nano Life Science Institute, Kanazawa University, Kakuma-machi, Kanazawa, 9201192, Japan
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36
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Hamazaki N, Kamiya K, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Tabata M, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Correlation between respiratory muscle weakness and frailty status as risk markers for prognosis in patients with cardiovascular disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Respiratory muscle weakness (RMW), frequently observed in patients with cardiovascular disease (CVD), is documented as a predictor for exercise intolerance and poor prognosis. On the other hand, frailty is commonly associated with disease condition, leading to increased risk of morbidity and mortality. Although the developmental mechanism of RMW and frailty is partly similar, the relationship between these statuses remains unclear.
Purpose
We aimed to investigate the correlation between RMW and frailty and its impact on prognosis in patients with CVD.
Methods
We studied 771 consecutive patients (68.5±13.1 years, 256 females) who were hospitalized for CVD treatment and underwent cardiac rehabilitation during hospitalization. Patients who received thoracic surgery within the last 3 months or could not perform respiratory function test were excluded from this study. As patient characteristics, we obtained body mass index, comorbidity conditions, smoking history, blood examinations, echocardiographical variables, and lung function from medical database. The frailty status on admission was assessed using frailty score consisting of 5 items including gait speed, nutrition/shrinking, physical activity, forgetfulness, and emotions/exhaustion, and patients who had 3 items were defined as frailty. We also measured maximal inspiratory pressure (PImax) as respiratory muscle strength at hospital discharge, and RMW was defined with PImax <70% of predicted value. Primary end-point was all-cause clinical events including all-cause death and/or unplanned readmission after hospital discharge. We examined the prevalence of RMW and frailty and the correlation between these statuses. The relationships of RMW with the clinical events for each presence or absence of frailty were also investigated using multivariate Cox proportional hazard models.
Results
RMW and frailty were defined in 163 (33.5%) and 126 (28.7%) patients, respectively, and 95 patients (12.4%) among them showed an overlap of both statuses (Figure 1). Frailty was detected as a significant indicator of RMW after adjusting for confounding factors (adjusted odds ratio: 1.57, 95% CI: 1.12–2.19, P=0.009). Over the median follow-up periods of 1.2 years, all-cause clinical events occurred in 154 patients (20.0%). RMW was significantly and independently associated with increased incidence of all-cause clinical events in patients with both non-frailty (adjusted hazard ratio [HR]: 1.64, 95% CI: 1.09–2.46, P=0.017) and frailty (adjusted HR: 1.97, 95% CI: 1.14–3.42, P=0.015) even after adjusting for clinical confounding factors (Figure 2).
Conclusions
This study is the first to demonstrate that RMW correlated to frailty in patients with CVD, and 12.4% of patients had overlap status. Moreover, RMW was significantly associated with an increased risk of all-cause clinical events in patients with CVD and frailty.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Society for the Promotion of Science Grant-in-Aid
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - M Tabata
- Tokyo Professional University of Health Sciences, Department of Physical Therapy, School of Rehabilitation, Tokyo, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Maekawa A, Kobayashi T, Ichikawa T. Gyroid nanostructured soft membranes formed by controlling the degree of crosslinking polymerization of bicontinuous cubic liquid-crystalline monomers. Polym J 2020. [DOI: 10.1038/s41428-020-00436-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Watanabe M, Shibata M, Inaishi T, Ichikawa T, Soeda I, Miyajima N, Takano Y, Takeuchi D, Tsunoda N, Kanda M, Kikumori T, Kodera Y, Nagino M. MZB1 expression indicates poor prognosis in estrogen receptor-positive breast cancer. Oncol Lett 2020; 20:198. [PMID: 32963604 PMCID: PMC7491119 DOI: 10.3892/ol.2020.12059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/18/2020] [Indexed: 02/07/2023] Open
Abstract
Breast cancer (BC) is the most common malignant tumor in females. Development of novel biomarkers or therapeutic targets may contribute toward the improvement of a patient's prognosis. Marginal zone B and B1 cell-specific protein (MZB1) is an unfolded protein response-related chaperone and mainly exists in the endoplasmic reticulum of B lymphocytes, although little is known regarding its role in BC cells. The present study aimed to investigate the significance of MZB1 expression in BC. To begin with, MZB1 mRNA expression levels in 13 BC cell lines and two non-cancerous mammary cell lines were evaluated. Next, mRNA and protein expression of MZB1 in BC patient tumor specimens was evaluated to assess the association between expression and clinicopathological factors or prognosis. MZB1 mRNA expression levels were detectable in four estrogen receptor (ER)-positive BC cell lines. When ratios of MZB1 mRNA expression levels between BC and non-cancerous specimens were evaluated, patients with stage III disease exhibited a higher ratio than patients with stage 0/I/II disease (P=0.009). Using immunohistochemistry, patients with ER-positive BC more frequently expressed MZB1, compared with patients with ER-negative BC (P=0.003). In patients with ER-positive BC, patients with MZB1-positive BC experienced shorter disease-free survival (DFS) times than patients with negative BC (P=0.026). Multivariate analysis of DFS demonstrated that MZB1 positivity was an independent prognostic factor (P=0.022). The results of the present study suggested that MZB1 expression may be associated with a more advanced stage of BC. Furthermore, in patients with ER-positive BC, MZB1 may be a potential prognostic marker.
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Affiliation(s)
- Manabu Watanabe
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.,Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Takahiro Inaishi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Takahiro Ichikawa
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Ikumi Soeda
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.,Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Noriyuki Miyajima
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Yuko Takano
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Dai Takeuchi
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Nobuyuki Tsunoda
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan.,Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Mitsuro Kanda
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
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Kikumori T, Ichikawa T, Inaishi T, Miyajima N, Shibata M, Takeuchi D. Measurement of the AST to LD Ratio in Parathyroid Tissue Suspension Can Precisely Differentiate a Hyperfunctioning Parathyroid. J Clin Endocrinol Metab 2020; 105:5837656. [PMID: 32413136 DOI: 10.1210/clinem/dgaa264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Frozen section of excised tissue is used to confirm removal of the etiology of primary hyperparathyroidism in the current era of intraoperative parathyroid hormone measurement and provides safeguards for surgeons. We recently reported that the aspartate aminotransferase (AST)/lactate dehydrogenase (LD) ratio in tissue suspension can accurately distinguish normal parathyroid tissue from other tissues. Therefore, we hypothesized that this ratio may also be applied to distinguish hyperfunctioning parathyroid tissue (HPT) from other tissues. METHODS We prospectively analyzed 22 patients who underwent parathyroidectomy for primary hyperparathyroidism (benign, 21; malignant, 1) from July 2018 to October 2019. In total, 27 specimens were examined. Approximately 1 mm3 of minced HPT as confirmed by frozen sections was suspended in 1 mL of normal saline and AST and LD levels were measured. The AST/LD ratios of other tissues (normal parathyroid tissue, thyroid gland, adipose tissue, and others; n = 94) were obtained from our previous report. RESULTS The AST/LD ratio of benign HPT was consistently higher than that of other tissues (P < 0.001). The optimal cut-off value was 0.36 according to the receiver operating characteristic curve, with 100% sensitivity and specificity. The AST/LD ratio in malignant HPT was also markedly lower than that in benign HPT. CONCLUSION This method might be a new adjunct for intraoperative differentiation of HPT with an accuracy and turnaround time comparable with those of frozen sections, minimal cost, and no need for dedicated pathological staff. Additionally, this method might increase the treatment success rate in settings with limited medical resources.
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Affiliation(s)
- Toyone Kikumori
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
| | - Takahiro Ichikawa
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
| | - Takahiro Inaishi
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
| | - Noriyuki Miyajima
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
| | - Masahiro Shibata
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
| | - Dai Takeuchi
- Department of Breast and Endocrine Surgery, Nagoya University Hospital, Showaku, Nagoya, Japan
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Komiya A, Sakamoto S, Imamura Y, Sugiura M, Kato M, Baba H, Nakamura K, Ichikawa T. Presence of compensated and primary hypogonadism is related to ISUP Grade Groups 3-5 prostate cancer diagnosis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Shimojima Y, Kishida D, Ichikawa T, Sekijima Y. THU0052 RELATIONSHIP BETWEEN INTERFERON-Γ-PRODUCING IMMUNOCOMPETENT CELLS AND DISEASE ACTIVITY IN ADULT-ONSET STILL’S DISEASE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:In the acute phase of adult-onset Still’s disease (AOSD), elevated levels of proinflammatory cytokines including interferon-γ (IFN-γ) are shown. Moreover, IFN-γ impacts on activating macrophages which play a crucial role in the pathogenesis of AOSD. Natural killer (NK) cells and T helper cells are in charge of secreting IFN-γ in the innate and adaptive immune systems of disease, respectively. However, the features of their IFN-γ-producing variation depending on disease activity are still uncertain in AOSD.Objectives:We investigated characteristics of IFN-γ-producing CD4+T cells and NK cells in patients with AOSD.Methods:Twenty-four patients in the acute phase of AOSD (active AOSD), 8 of them after treatment (remission), and 12 healthy controls (HC) were recruited in this study. Peripheral blood mononuclear cells and serum samples were provided from them for the experimental analysis. Flow cytometry was used for analyzing CD4+T cells, CD4+regulatory T cells (Tregs), NK cells, and their intracellular IFN-γ expression levels as well as suppression assay of Tregs. The serum concentration of interleukin-18 (IL-18) was measured using commercially available ELISA kit. Relationship between the analyzed data and clinical findings related to disease activity were statistically evaluated.Results:IFN-γ expression in CD4+T cells was significantly higher in active AOSD than in HC (p < 0.05). Tregs also significantly indicated higher expression of IFN-γ in active AOSD than in HC (p < 0.0001); and moreover, Tregs were significantly impaired in their suppression ability (p < 0.05). In both CD4+T cells and Tregs, expression of IFN-γ was significantly correlated with serum ferritin levels in active AOSD (p < 0.05). IFN-γ expression in CD4+T cells was significantly higher in patients with splenomegaly than those without that (p < 0.05). The proportion of NK cells was significantly lower in active AOSD than in HC (p < 0.005), whereas IFN-γ expression in NK cells was significantly higher in active AOSD than in HC (p < 0.0005). The number of NK cells and IFN-γ-expressing NK cells had inverse relationship with serum ferritin levels in active AOSD (p < 0.05 and p < 0.005, respectively). Increased number of NK cells and their decreased expression of IFN-γ were significantly demonstrated in remission (p < 0.05). In the analyses of NK cell subsets, lower expression of IFN-γ in CD56brightNK cells and higher that in CD56dimNK cells were significantly indicated in active AOSD than HC (p < 0.05). In remission, IFN-γ expression was significantly decreased in CD56dimNK cells (p < 0.05) despite no significant recovery of that in CD56brightNK cells (p = 0.311). Meanwhile, increased expression of IFN-γ in CD56brightNK cells was demonstrated in only patients who were treated with biologics. Although serum levels of IL-18 were significantly higher in active AOSD than in remission and HC; however, they had no significant correlations with any analyzed data.Conclusion:CD4+T cells and NK cells promote IFN-γ expression in the acute phase of AOSD. Meanwhile, increased expression of IFN-γ in CD4+T cells and decreased number of NK cells were correlated with serum ferritin levels, suggesting that they are indicators of disease activity. Furthermore, high disease activity may impact on the alteration of IFN-γ-producing balance in two distinct population of NK cells, and the plasticity of Tregs leading to defect in suppression ability.Disclosure of Interests:None declared
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Uemura N, Kobayashi T, Yoshida S, Li YX, Goossens K, Zeng X, Watanabe G, Ichikawa T. Double-Gyroid Nanostructure Formation by Aggregation-Induced Atropisomerization and Co-Assembly of Ionic Liquid-Crystalline Amphiphiles. Angew Chem Int Ed Engl 2020; 59:8445-8450. [PMID: 32128958 PMCID: PMC7318300 DOI: 10.1002/anie.202000424] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 01/09/2020] [Revised: 02/17/2020] [Indexed: 11/17/2022]
Abstract
We report a new molecular‐design principle for creating double‐gyroid nanostructured molecular assemblies based on atropisomerization. Ionic amphiphiles containing two imidazolium rings close to each other were designed and synthesized. NMR data revealed that the rotation of the imidazolium rings is restricted, with an activation energy as high as 63 kJ mol−1 in DMSO‐d6 solution (DFT prediction for a model compound in the vacuum: 90–100 kJ mol−1). Due to the restricted rotation, the amphiphiles feature “double” atropisomeric axes in their ionic segments and form three stable atropisomers: meso, R, and S. These isomers co‐organize into Ia3‾d
‐type bicontinuous cubic liquid‐crystalline mesophases through nanosegregation of the ionic and non‐ionic parts. Considering the intrinsic characteristic of Ia3‾d
‐type bicontinuous cubic structures that they are composed of intertwined right‐ and left‐handed single gyroids, we propose that the simultaneous presence of both R‐ and S‐atropisomers is an important contributor to the formation of double‐gyroid structures.
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Affiliation(s)
- Nanami Uemura
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Tokyo, 184-8588, Japan
| | - Tsubasa Kobayashi
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Tokyo, 184-8588, Japan
| | - Shintaro Yoshida
- Department of Physics, School of Science, Kitasato University, Sagamihara, Kanagawa, 252-0373, Japan
| | - Ya-Xin Li
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - Karel Goossens
- Center for Multidimensional Carbon Materials (CMCM), Institute for Basic Science (IBS), Ulsan, 44919, Republic of Korea
| | - Xiangbing Zeng
- Department of Materials Science and Engineering, University of Sheffield, Sheffield, S1 3JD, UK
| | - Go Watanabe
- Department of Physics, School of Science, Kitasato University, Sagamihara, Kanagawa, 252-0373, Japan
| | - Takahiro Ichikawa
- Department of Biotechnology, Tokyo University of Agriculture and Technology, Tokyo, 184-8588, Japan
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43
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Uemura N, Kobayashi T, Yoshida S, Li Y, Goossens K, Zeng X, Watanabe G, Ichikawa T. Double‐Gyroid Nanostructure Formation by Aggregation‐Induced Atropisomerization and Co‐Assembly of Ionic Liquid‐Crystalline Amphiphiles. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202000424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nanami Uemura
- Department of Biotechnology Tokyo University of Agriculture and Technology Tokyo 184-8588 Japan
| | - Tsubasa Kobayashi
- Department of Biotechnology Tokyo University of Agriculture and Technology Tokyo 184-8588 Japan
| | - Shintaro Yoshida
- Department of Physics School of Science Kitasato University Sagamihara Kanagawa 252-0373 Japan
| | - Ya‐xin Li
- Department of Materials Science and Engineering University of Sheffield Sheffield S1 3JD UK
| | - Karel Goossens
- Center for Multidimensional Carbon Materials (CMCM) Institute for Basic Science (IBS) Ulsan 44919 Republic of Korea
| | - Xiangbing Zeng
- Department of Materials Science and Engineering University of Sheffield Sheffield S1 3JD UK
| | - Go Watanabe
- Department of Physics School of Science Kitasato University Sagamihara Kanagawa 252-0373 Japan
| | - Takahiro Ichikawa
- Department of Biotechnology Tokyo University of Agriculture and Technology Tokyo 184-8588 Japan
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Kobayashi T, Li YX, Ono A, Zeng XB, Ichikawa T. Correction: Gyroid structured aqua-sheets with sub-nanometer thickness enabling 3D fast proton relay conduction. Chem Sci 2020. [DOI: 10.1039/d0sc90190c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Correction for ‘Gyroid structured aqua-sheets with sub-nanometer thickness enabling 3D fast proton relay conduction’ by Tsubasa Kobayashi et al., Chem. Sci., 2019, 10, 6245–6253, DOI: 10.1039/C9SC00131J.
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Affiliation(s)
- Tsubasa Kobayashi
- Department of Biotechnology
- Tokyo University of Agriculture and Technology
- Tokyo
- Japan
| | - Ya-xin Li
- Department of Materials Science and Engineering
- University of Sheffield
- Sheffield S1 3JD
- UK
| | - Ayaka Ono
- Department of Biotechnology
- Tokyo University of Agriculture and Technology
- Tokyo
- Japan
| | - Xiang-bing Zeng
- Department of Materials Science and Engineering
- University of Sheffield
- Sheffield S1 3JD
- UK
| | - Takahiro Ichikawa
- Department of Biotechnology
- Tokyo University of Agriculture and Technology
- Tokyo
- Japan
- JST
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Uchida S, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Ichikawa T, Nakamura T, Yamashita M, Kootaka Y, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J. P6331Influence of dynapenia and obesity on prognoses of elderly heart failure patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In elderly people, a decline in activities of daily living is more closely associated with low muscle strength (dynapenia) than with low muscle mass. Moreover, the combination of low muscle strength and obesity (dynapenic obesity) is associated with a higher risk of mortality than dynapenia or obesity alone, but its influence on prognosis is still unknown in elderly heart failure (HF) patients. To clarify these relationships may contribute to the development of rehabilitation programs for elderly HF patients and the improvement their prognoses in the future.
Purpose
We aimed to investigate the influence of dynapenia and obesity on prognoses of elderly HF patients.
Methods
We evaluated 1006 elderly HF patients aged ≥65 years (76.5±6.9 years, 579 males) who were admitted to our hospital and participated in an inpatient cardiac rehabilitation program. We assessed patients' characteristics, including body mass index (BMI) and handgrip strength during hospitalization. Patients with low handgrip strength (<26 kg and <18 kg in males and females, respectively) and high BMI (≥25 kg/m2) were considered to have dynapenia and obesity, respectively. Moreover, patients fulfilling the above two criteria (dynapenia, obesity) were considered to have dynapenic obesity. Patients were divided into four groups: normal, dynapenia only, obesity only, and dynapenic obesity. We compared survival rates among the four groups using the Kaplan-Meier method and log-rank test. To identify predictors for all-cause mortality, we performed Cox regression analysis.
Results
During the 8-year follow-up period, 228 patients (21.2%) died. Eight-year cumulative incidences of mortality were 35.4%, 26.0%, 62.6%, and 33.1% in the normal, obesity only, dynapenia only, and dynapenic obesity groups, respectively. Significantly lower survival rates were observed in the dynapenia only group than in the other 3 groups (log-rank: 28.893, P<0.001). Cox regression analysis, after adjusting for age and sex, showed significantly poor prognosis in the dyanapenia only group than in the other 3 groups (normal group, hazard ratio [HR] = 0.684, 95% confidence interval [CI] = 0.488–0.959, P=0.028; obesity only group, HR = 0.330, 95% CI = 0.182–0.598, P<0.001; dynapenic obesity group, HR = 0.390, 95% CI = 0.206–0.739, P=0.004).
Conclusion
Elderly HF patients with dynapenia alone had poor prognoses. Obesity may have protective effects on the survival of dynapenia patients with HF.
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Affiliation(s)
- S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Nakamura
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Y Kootaka
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Harada M, Motoike Y, Nomura Y, Nishimura A, Nagasaka R, Koshikawa M, Ichikawa T, Watanabe E, Ozaki Y. P1901Use of direct thrombin inhibitor on the day of atrial fibrillation ablation decreases incidence of silent cerebral ischemia detected by magnetic resonance imaging. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is increasing evidence to use direct oral anticoagulants (DOACs) in atrial fibrillation (AF) ablation. Uninterrupted use of DOACs is recommended for peri-procedural anticoagulation; the ways of choosing and/or using DOACs depend on physicians' decisions and preferences. Uninterrupted dabigatran (DAB), a direct thrombin inhibitor, reportedly decreased the risk of major bleeding (MB) in AF ablation, compared to uninterrupted warfarin (NEJM 2017; 376:1627). Among DOACs, only regular-dose of DAB (150 mg b.i.d.), showed superiority to warfarin for preventing ischemic thromboembolism (TE) in patients with non-valvular AF, implicating the powerful anti-thrombotic agent. DAB may decrease the potential risk of procedure-related TE.
Purpose
To evaluate whether use of DAB on the day of AF ablation decreases the prevalence of silent cerebral ischemia (SCI) detected by magnetic resonance imaging (MRI).
Methods
414 AF patients on DOACs were enrolled and admitted on the day before AF ablation. Among 354 patients on factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), the original DOACs were switched to DAB (150 mg b.i.d.) on the day of the procedure in 172 patients (Group D); the treatment remained unchanged in 182 patients (Group non-D). In both groups, DOACs were continuously used throughout the procedure. After propensity-score matching, procedure-related parameters/events and the incidence of MRI-detected SCI were compared between Group D (n=134) and Group non-D (n=134). These parameters in patients originally taking DAB, used without interruption during the procedure (uninterrupted DAB, n=55), were also compared to Group D (n=55) after propensity-score matching.
Results
Baseline activated clotting time (ACT) before initial heparin injection was increased in Group D vs. Group-non-D (179±25* vs. 146±23 sec, *p<0.05 vs. Group non-D). The time to achieve optimal ACT (>300 sec) was shorter in Group D (34±29* vs. 43±32 min). The amounts of heparin needed to achieve optimal ACT and the total amount of heparin used during the procedure were unchanged between Group D and Group non-D. The incidence of SCI decreased in Group D (13.1%* vs. 21.9%), suggesting the potential anti-thrombotic efficacy of DAB. No MB or symptomatic TE events were observed in either group. Baseline ACT, the time to achieve ACT >300 sec, and the incidence of SCI in Group D were comparable to those in uninterrupted DAB (183±38 vs. 181±32 sec, 39±31 vs. 42±28 min, and 14.5% vs. 16.4%, respectively). No MB or symptomatic TE events were observed either in Group D or uninterrupted DAB.
Conclusions
Temporarily switching to DAB from the other DOACs and using it on the day of procedure enable us to achieve optimal ACT quickly and decrease the incidence of SCI, showing similar potential anti-thrombotic efficacy to uninterrupted DAB. Use of DAB on the day of AF ablation also benefits from the availability of its antidote in the case of MB during the procedure.
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - R Nagasaka
- Fujita Health University, Toyoake, Japan
| | | | - T Ichikawa
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Nozaki K, Kamiya K, Hamazaki N, Matsuzawa R, Ichikawa T, Nakamura T, Yamashita M, Maekawa E, Matsunaga A, Tojo M, Ako J. P2514Pupillary area predicts all-cause mortality in patients with cardiovascular disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Autonomic dysfunction is among the most important pathophysiological factors involved in the high mortality rate associated with cardiovascular disease (CVD). Autonomic function is generally evaluated by heart rate variability, which is obtained by Holter electrocardiography. However, the measurement of heart rate variability requires continuous electrocardiographic monitoring for 24 h, which is time consuming and not always feasible. The pupillary area is controlled by the autonomic nervous system; however, limited data are available regarding the utility of the pupillary area for predicting prognosis in patients with CVD.
Purpose
We aimed to investigate whether pupillary area can be used as a novel prognostic marker in patients with CVD.
Methods
We retrospectively reviewed 1342 consecutive Japanese patients hospitalized for CVD. The study was performed in accordance with the tenets of the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of our University Hospital. The pupillary area measurement was performed on both eyes at least 7 days after hospitalization for CVD using a portable videopupillography system (Iriscorder Dual C10641; Hamamatsu Photonics, Hamamatsu, Japan) consisting of a goggle-shaped measurement portion with a charge-coupled device camera and a control portion with a video monitor and microcomputer with software for data analysis. After securing the goggles on the patient's face and fully covering the patient's eyes, a 5-minute period was allowed for dark adaptation. All patients were tested once between 09:00 and 12:00 h. The primary outcome of this study was all-cause mortality, and the endpoint time was calculated as the number of days from the date of pupillary area measurement up to three years. We performed the Kaplan–Meier and log-rank tests and multivariable Cox regression analysis to evaluate the prognostic predictive capability of the pupillary area.
Results
The study population had a mean age of 65±13 years, and 69.4% of the patients were male. The median of the pupillary area was 18.5 mm2 (interquartile range: 13.3–23.4 mm2). Over a median follow-up period of 1.9 years (interquartile range: 1.0–3.0 years), a total of 114 deaths occurred in the patient population. The Kaplan–Meier and log-rank tests revealed that all-cause mortality was significantly higher in the small pupillary area group than in the large pupillary area group (P<0.0001, Figure). Furthermore, Cox regression analysis indicated that the pupillary area was an independent predictor of mortality (Hazard ratio: 0.96; 95% confidence interval: 0.93–0.98; P=0.006) even after adjusting for several preexisting prognostic factors.
Kaplan-Meire Curve
Conclusion
The pupillary area can be an independent predictor of prognosis in patients with CVD, and our observations suggest that the assessment of the pupillary area can be useful as a new noninvasive prognostic predictor in patients with CVD.
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Affiliation(s)
- K Nozaki
- Kitasato University Hospital, Rehabilitation, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Nakamura
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular of Medicine, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - M Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular of Medicine, Sagamihara, Japan
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48
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Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tabata M, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Ako J. 298Change in respiratory muscle strength predicts clinical events in patients with chronic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Respiratory muscle weakness, frequently observed in patients with chronic heart failure (CHF), has been documented as a predictor for poor prognosis. Several studies have reported that respiratory muscle training increases respiratory muscle strength and consequently improves exercise tolerance and quality of life in these patients. However, the relationship between the change in respiratory muscle strength and prognosis is still unclear.
Purpose
We aimed to investigate whether the change in respiratory muscle strength following cardiac rehabilitation predicts the incidence of clinical events in CHF patients.
Methods
We studied 348 patients with CHF who were hospitalized because of decompensated heart failure and received 5-month cardiac rehabilitation during hospitalization and after hospital discharge. Clinical characteristics including aetiology of heart failure, comorbidity conditions, medications, blood examination and echocardiographic variables were obtained from clinical records. We also measured maximal inspiratory pressure (PImax) as respiratory muscle strength at hospital discharge and 5 months later. The change of PImax (ΔPImax) between the 5-month observation period was examined. We followed up the patients after the observation period and investigated the incidence of all-cause mortality or all-cause unplanned readmission. In statistical analysis, patients were divided into two groups based on the median value of ΔPImax. We compared the event-free survival rate between the two groups using the Kaplan-Meier method with a log-rank test. We also performed the Cox proportional hazard model to clarify whether the ΔPImax was an independent predictor for the incidence of clinical events.
Results
Over a median follow-up of 1.6 years, 121 patients (34.8%) died or readmitted, and their rate of incidence was 21.7/100 person-years. The higher ΔPImax was associated significantly with a higher rate of event-free survival (Log-rank: 8.085, P=0.004, Figure 1). In univariate Cox proportional hazard model, ΔPImax was a significant predictor for the all-cause mortality/readmission (unadjusted hazard ratio for PImax increase of 10 cmH2O: 0.842, 95% CI: 0.763 - 0.931, P=0.001). Even after adjustment for clinical confounding factors including baseline PImax, ΔPImax remained significant and independent predictor for the all-cause mortality/readmission (adjusted hazard ratio for PImax increase of 10 cmH2O: 0.862, 95% CI: 0.763 - 0.974, P=0.017, Figure 2).
Conclusion
This study is the first to demonstrate that the change in respiratory muscle strength following cardiac rehabilitation independently predicts the incidence of clinical events in patients with CHF. The increase in PImax of 10 cmH2O was associated significantly with a 14% decrease in the rate of all-cause mortality or readmission.
Acknowledgement/Funding
JSPS KAKENHI JP16K16442
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Tabata
- Toyohashi Sozo University, Department of Physical Therapy, School of Health Sciences, Toyohashi, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - C Noda
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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49
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Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tabata M, Maekawa E, Fukaya H, Yamaoka-Tojo M, Matsunaga A, Ako J. P3106Atrial fibrillation is not associated with the responses to exercise training in heart failure patients with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is known as a common arrhythmia in heart failure patients with preserved left ventricular ejection fraction (HFpEF). Several studies have reported that HFpEF patients with AF show lower exercise tolerance and poorer prognosis as compared with those with sinus rhythm (SR). On the other hand, exercise training is documented to improve peripheral muscle function and exercise tolerance in HFpEF patients. However, the relationship between AF status and outcomes due to exercise training is still unclear in these patients.
Purpose
We aimed to investigate the influence of AF on the responses to outcomes with exercise training in HFpEF patients.
Methods
We studied 426 patients with HFpEF who received 5-month cardiac rehabilitation including exercise training during hospitalization and after hospital discharge. As clinical characteristics, we obtained body mass index, disease aetiology, comorbidity conditions, blood examination and echocardiographic variables from medical records. We also measured isometric quadriceps strength (QS) and 6-minute walk distance (6MWD) as peripheral muscle strength and exercise tolerance, respectively. The QS and 6MWD were assessed at hospital discharge as the baseline and 5 months later. AF status was determined by the presence on electrocardiogram at baseline 6MWD or medical history of AF during hospitalization. In statistical analysis, we compared baseline clinical characteristics, QS and 6MWD between the rhythm status (SR group or AF group). We also examined the changes in QS and 6MWD from baseline to the 5-month observation period (ΔQS and Δ6MWD) and compared them between the 2 groups using analysis of covariance with adjustment for baseline clinical confounding factors.
Results
At baseline, 289 patients (68%) were in SR, and 111 patients (26%) had AF. The AF was associated significantly with older age (P<0.001) and lower levels of estimated glomerular filtration rate (P=0.013), QS (P<0.001) and 6MWD (P<0.001) at baseline. The QS increased significantly from 25.2±11.0 kg at baseline to 30.8±13.0 kg after 5-month cardiac rehabilitation in the SR group, and from 21.1±8.3 kg to 26.0±9.4 kg in the AF group (P<0.001, respectively). The 6MWD also increased significantly from 394.8±129.2 to 463.5±133.5 meters in the SR, and from 343.7±107.9 to 403.0±114.5 meters in the AF (P<0.001, respectively). There were no significant differences in ΔQS and Δ6MWD between the SR and AF groups even after adjustment for clinical confounding factors including baseline QS or 6MWD (Figure).
Conclusions
The AF status in HFpEF patients was associated with older age, lower peripheral muscle function and also lower exercise tolerance at baseline, but not associated with the responses to exercise training.
Acknowledgement/Funding
JSPS KAKENHI JP16K16442
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Tabata
- Toyohashi Sozo University, Department of Physical Therapy, School of Health Sciences, Toyohashi, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - H Fukaya
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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50
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.
Methods
We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.
Results
We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).
Figure 1
Conclusion
IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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