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Ono S, Sasabuchi Y, Yamana H, Yokota I, Okada A, Matsui H, Itai S, Yonenaga K, Tonosaki K, Watanabe R, Ono Y, Yasunaga H, Hoshi K. Weight loss and functional decline in older Japanese people: A cohort study using large-scale claims data. Arch Gerontol Geriatr 2024; 120:105354. [PMID: 38309105 DOI: 10.1016/j.archger.2024.105354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/19/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The association between weight loss and subsequent functional decline is uncertain. The study aims to elucidate the association between weight loss over a year and subsequent functional decline requiring assistance in performing their activities of daily living in older individuals. METHODS The study used data from the publicly funded Long-Term Care Insurance service in Japan, which provides coverage for long-term care services for individuals unable to perform activities of daily living due to physical or cognitive impairment. The study enrolled people born in or before 1949, who underwent health checkups in both 2014 and 2015. The participants were followed from 2015 to the worsening of functional decline requiring long-term care services, death, or February 28, 2019, whichever occurred first. The risk of subsequent functional decline in each weight loss category was estimated using a Cox regression model adjusted for age, sex, baseline body mass index, smoking, and Charlson comorbidity index. RESULTS We identified 67,452 eligible individuals from the database. The median follow-up period was 1,284 days. The hazard ratios (95 % confidence interval) of functional decline for -1 %, -2 %, -3 %, -4 %, and ≤-5% weight change compared to 0 % weight change were 1.17 (1.03-1.32), 1.26 (1.11-1.43), 1.29 (1.12-1.49), 1.61 (1.39-1.87), and 1.79 (1.58-1.99), respectively. CONCLUSIONS AND IMPLICATIONS Older people with weight loss of 1 % or more were at risk of functional decline. Close weight monitoring may serve as an easy and inexpensive means of identifying older individuals at risk of functional decline.
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Affiliation(s)
- Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan.
| | - Yusuke Sasabuchi
- Department of Real World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Data Science Center, Jichi Medical University, Tochigi, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Data Science Center, Jichi Medical University, Tochigi, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Itai
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Kazumichi Yonenaga
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Kanata Tonosaki
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Rinji Watanabe
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Hideo Yasunaga
- Data Science Center, Jichi Medical University, Tochigi, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kazuto Hoshi
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan
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Sato M, Ono S, Yamana H, Okada A, Ishimaru M, Ono Y, Iwasaki M, Aida J, Yasunaga H. Effect of periodontal therapy on glycaemic control in type 2 diabetes. J Clin Periodontol 2024; 51:380-389. [PMID: 38171535 DOI: 10.1111/jcpe.13939] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024]
Abstract
AIM This study aimed to elucidate the impact of periodontal therapy on glycaemic control in individuals with type 2 diabetes and various baseline blood glucose levels using a large-scale claims database from Japan. MATERIALS AND METHODS Using the JMDC Claims Database, we identified individuals with type 2 diabetes who underwent health check-ups in the fiscal years 2018 or 2019 and were followed up until the next year's health check-up. We conducted a weighted cohort analysis using stabilized inverse probability weights for treatment and censoring to estimate the effect of periodontal therapy on changes in haemoglobin A1c levels within a year. Analysis was done for different baseline haemoglobin A1c categories: 6.5%-6.9%, 7.0%-7.9% and ≥8.0%. RESULTS Of the 4279 insured persons included in the study, 957 received periodontal therapy. Overall, there was a tendency towards improved glycaemic control among those who received periodontal therapy. Participants with baseline haemoglobin A1c levels of 7.0%-7.9% who received periodontal therapy exhibited significantly better glycaemic control compared with those without dental visits (difference; -0.094 [95% confidence interval: -0.181 to -0.007]). CONCLUSIONS Periodontal therapy may improve glycaemic control in individuals with diabetes, especially in those with haemoglobin A1c levels ≥7.0%.
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Grants
- 19K10419 Ministry of Education, Culture, Sports, Science and Technology
- 20H03907 Ministry of Education, Culture, Sports, Science and Technology
- 21H03159 Ministry of Education, Culture, Sports, Science and Technology
- 21AA2007 Ministry of Health, Labour and Welfare
- 21FA1033 Ministry of Health, Labour and Welfare
- 23FA1022 Ministry of Health, Labour and Welfare
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Affiliation(s)
- Misuzu Sato
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo City, Tokyo, Japan
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Hayato Yamana
- Data Science Center, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Miho Ishimaru
- The Institute of Education, Tokyo Medical and Dental University, Bunkyo City, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo City, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo City, Tokyo, Japan
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Fujita N, Ono Y, Hashimoto K, Kawamura Y, Kimata M, Sekizawa A, Obuchi Y, Tanaka Y. Efficacy of denosumab in the treatment of hypercalcemic renal dysfunction in sarcoidosis: a case report. Osteoporos Int 2024; 35:733-736. [PMID: 38102330 DOI: 10.1007/s00198-023-06998-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
A 70-year-old female patient was admitted for close examination and treatment of hypercalcemia (corrected serum calcium levels: 3.04 mmol/L) and renal dysfunction (serum creatinine levels: 254.59 µmol/L). The patient had a history of sarcoidosis, diagnosed based on epithelioid cell granulomas in subcutaneous nodule biopsies, uveitis, and bilateral hilar lymphadenopathy, which had spontaneously remitted 10 years before admission. Because the patient was diagnosed with hypercalcemia associated with recurrent sarcoidosis, prednisone (20 mg/day) was initiated, and its dose was tapered following the decrease in serum calcium and creatinine levels. However, the levels of these parameters increased again when the prednisone dose was reduced to ≤ 4 mg/day. We were concerned about glucocorticoid-induced osteoporosis in the patient but hesitated to use first-line bisphosphonates because of renal dysfunction. Therefore, denosumab was initiated to reduce the risk of hypercalcemia, renal dysfunction, and glucocorticoid-induced osteoporosis. Serum creatinine and corrected serum calcium levels subsequently decreased. The prednisone dose could be reduced following repeated denosumab administration.Thus, denosumab can be a multifaceted, beneficial option for sarcoidosis-induced hypercalcemia, as it alleviates renal dysfunction indirectly by normalizing serum calcium levels, facilitates reduction of the glucocorticoid dose, and ameliorates glucocorticoid-induced osteoporosis.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
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Nishikawa K, Ono Y, Mori S, Takayama K, Ihara M, Matsuda K, Morimoto Y. Divergent Nine-Step Syntheses of Perhydrohistrionicotoxin Analogs and Their Inhibition Activity Toward Chicken α4β2-Neuronal Nicotinic Acetylcholine Receptors. J Org Chem 2024; 89:4128-4133. [PMID: 38407917 DOI: 10.1021/acs.joc.3c02988] [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] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Histrionicotoxin (HTX) alkaloids, which are isolated from Colombian poison dart frogs, are analgesic neurotoxins that modulate nicotinic acetylcholine receptors (nAChRs) as antagonists. Perhydrohistrionicotoxin (pHTX) is the potent synthetic analogue of HTX and possesses a 1-azaspiro[5.5]undecane skeleton common to the HTX family. Here, we show for the first time the divergent nine-step synthesis of pHTX and its three stereoisomers from the known aldehyde through a one-step construction of the 1-azaspiro[5.5]undecane framework from a linear amino ynone substrate. Surprisingly, some pHTX diastereomers exhibited antagonistic activities on the chicken α4β2-neuronal nAChRs that were more potent than pHTX.
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Affiliation(s)
- Keisuke Nishikawa
- Department of Chemistry, Graduate School of Science, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Yosuke Ono
- Department of Chemistry, Graduate School of Science, Osaka Metropolitan University, Osaka 558-8585, Japan
| | - Sumito Mori
- Department of Applied Biological Chemistry, Faculty of Agriculture, Kindai University, Nara 631-8505, Japan
| | - Koichi Takayama
- Department of Applied Biological Chemistry, Faculty of Agriculture, Kindai University, Nara 631-8505, Japan
| | - Makoto Ihara
- Department of Applied Biological Chemistry, Faculty of Agriculture, Kindai University, Nara 631-8505, Japan
| | - Kazuhiko Matsuda
- Department of Applied Biological Chemistry, Faculty of Agriculture, Kindai University, Nara 631-8505, Japan
| | - Yoshiki Morimoto
- Department of Chemistry, Graduate School of Science, Osaka Metropolitan University, Osaka 558-8585, Japan
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Asaga T, Hashimoto K, Kawamura Y, Fujita N, Kimata M, Sekizawa A, Ono Y, Obuchi Y, Kobayashi N, Hirasawa H, Kanbayashi T, Tanaka Y. Idiopathic hypersomnia with a video recording of a spontaneous sleep attack: A case report. Medicine (Baltimore) 2024; 103:e36782. [PMID: 38363934 PMCID: PMC10869082 DOI: 10.1097/md.0000000000036782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/13/2023] [Indexed: 02/18/2024] Open
Abstract
RATIONALE Although patients with central disorders of hypersomnolence (CDH) exhibit characteristic symptoms of hypersomnia frequently, it takes 5 to 15 years from the onset for its diagnosis due to the lack of symptom recognition. Here, we present a case of idiopathic hypersomnia (IH), a CDH, wherein early diagnosis was aided by a video footage of a spontaneous sleep attack. PATIENT CONCERNS A 21-year-old man lost consciousness while driving and experienced an accident. He had complained of excessive daytime sleepiness (EDS) over half a year. During his hospitalization for close monitoring of the loss of consciousness, an in-room surveillance camera captured a 14-minutes long spontaneous sleep attack, during which he experienced general muscle weakness and loss of consciousness without warnings or convulsions leading to a fall from the bed. There were no abnormalities in vital signs. DIAGNOSES There was no significant cataplexy and less than 2 sleep-onset rapid eye movements (SOREM) in 2 sleep latency tests, with a mean sleep latency of 2.1 and 4.6 minutes. Other sleep deprivation syndromes were excluded from differential diagnosis and finally, a diagnosis of IH was confirmed according to the criteria of the Third Edition of the International Classification of Sleep Disorders. During the course of the disease, attention-deficit/hyperactive disorder (ADHD) and a gaming disorder also diagnosed. INTERVENTIONS Pharmacological treatment with modafinil was administered for IH and methylphenidate for ADHD. Cognitive behavioral therapy was performed for the gaming disorder. OUTCOMES The EDS improved, and sleep attacks were no longer observed. The disruption of daily life caused by the gaming disorder was also reduced. LESSONS Video recordings of sleep attacks are beneficial for identifying the cause of loss of consciousness. Home video recordings may be helpful in the early diagnosis of IH.
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Affiliation(s)
- Takamasa Asaga
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Yusuke Kawamura
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Motohiro Kimata
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Akinori Sekizawa
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine National Defense Medical College, Saitama, Japan
| | - Nanase Kobayashi
- Department of Psychiatry and Behavioral Sciences, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | | | - Takashi Kanbayashi
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
- Ibaraki Prefectural Medical Center of Psychiatry, Kasama, Japan
| | - Yuji Tanaka
- Department of General Medicine National Defense Medical College, Saitama, Japan
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Kobayashi T, Ono Y. Medical history-taking by highlighting the time course: PODCAST approach. Diagnosis (Berl) 2024; 11:109-111. [PMID: 37677070 DOI: 10.1515/dx-2023-0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Affiliation(s)
- Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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Sekizawa A, Nagano A, Hashimoto K, Ono Y. Conjunctival petechiae in infective endocarditis. Cleve Clin J Med 2024; 91:20-21. [PMID: 38167396 DOI: 10.3949/ccjm.91a.23041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Ayaka Nagano
- Department of Cardiology, National Defense Medical College, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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Kobayashi T, Ono Y. Splenic Infarctions in Epstein-Barr Virus Infectious Mononucleosis. Intern Med 2024:2942-23. [PMID: 38171871 DOI: 10.2169/internalmedicine.2942-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Affiliation(s)
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
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Zhang C, Brunt L, Ono Y, Rogers S, Scholpp S. Cytoneme-mediated transport of active Wnt5b-Ror2 complexes in zebrafish. Nature 2024; 625:126-133. [PMID: 38123680 PMCID: PMC10764289 DOI: 10.1038/s41586-023-06850-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
Chemical signalling is the primary means by which cells communicate in the embryo. The underlying principle refers to a group of ligand-producing cells and a group of cells that respond to this signal because they express the appropriate receptors1,2. In the zebrafish embryo, Wnt5b binds to the receptor Ror2 to trigger the Wnt-planar cell polarity (PCP) signalling pathway to regulate tissue polarity and cell migration3,4. However, it remains unclear how this lipophilic ligand is transported from the source cells through the aqueous extracellular space to the target tissue. In this study, we provide evidence that Wnt5b, together with Ror2, is loaded on long protrusions called cytonemes. Our data further suggest that the active Wnt5b-Ror2 complexes form in the producing cell and are handed over from these cytonemes to the receiving cell. Then, the receiving cell has the capacity to initiate Wnt-PCP signalling, irrespective of its functional Ror2 receptor status. On the tissue level, we further show that cytoneme-dependent spreading of active Wnt5b-Ror2 affects convergence and extension in the zebrafish gastrula. We suggest that cytoneme-mediated transfer of ligand-receptor complexes is a vital mechanism for paracrine signalling. This may prompt a reevaluation of the conventional concept of characterizing responsive and non-responsive tissues solely on the basis of the expression of receptors.
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Affiliation(s)
- Chengting Zhang
- Living Systems Institute, School of Biosciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Lucy Brunt
- Living Systems Institute, School of Biosciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Yosuke Ono
- Living Systems Institute, School of Biosciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Sally Rogers
- Living Systems Institute, School of Biosciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steffen Scholpp
- Living Systems Institute, School of Biosciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
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Fujita N, Ono Y, Yamashita K, Kimata M, Sekizawa A, Hashimoto K, Obuchi Y, Tanaka Y. Proximal Renal Tubular Acidosis Complicated by Severe Hypocalcemia Caused by Malnutrition and Inappropriate Long-term Use of Zoledronate: A Case Report and Review of the Literature. Intern Med 2023:1753-23. [PMID: 38044157 DOI: 10.2169/internalmedicine.1753-23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
An 80-year-old man presented with electrolyte abnormalities, particularly hypocalcemia (3.6 mg/dL). He was diagnosed with bone and lymph node metastases from prostate cancer seven years earlier and continuously received goserelin, bicalutamide, and zoledronate. He later developed gradually worsening hypocalcemia, hypokalemia, hypophosphatemia, hypouricemia, renal dysfunction, and weight loss. Urinary potassium and phosphate loss, renal glucosuria, metabolic acidosis, and a low urine pH (5.0) were observed. Given the acquired onset and clinical course, we diagnosed the patient with zoledronate-induced proximal renal tubular acidosis. In the present case, severe hypocalcemia may have been caused by malnutrition and inappropriate long-term use of zoledronate.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Keiko Yamashita
- Department of General Medicine, National Defense Medical College, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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Hashimoto K, Harada N, Kimata M, Kawamura Y, Fujita N, Sekizawa A, Ono Y, Obuchi Y, Takayama T, Kasamaki Y, Tanaka Y. Increasing averaging beats improves the test accuracy on Holter-based late potentials in patients with myocardial infarction. Ann Noninvasive Electrocardiol 2023; 28:e13089. [PMID: 37724719 PMCID: PMC10646378 DOI: 10.1111/anec.13089] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The prevalence of Holter-based late potentials (H-LPs) in cases of fatal cardiac events has increased. Although the noise level of H-LP is higher than that of conventional real-time late potential (LP) recording, a procedure to reduce the noise severity in H-LP by increasing the averaging beats has not been investigated. METHODS We enrolled 104 patients with post-myocardial infarction (MI) and 86 control participants. Among the patients, 30 reported sustained ventricular tachycardia (VT), and the remaining 74 had unrecorded VT. H-LPs were measured twice in all groups to evaluate the efficacy of increasing the averaging beats for H-LPs. Thereafter, the average of LP was calculated at 250 (default setting), 300, 400, 500, 600, 700, and 800 beats. RESULTS Across all three groups (MI-VT group, MI non-VT group, and control group), the noise levels significantly decreased in consonance with the increase in averaging beats. In the MI-VT group, the H-LP positive rate considerably increased with the increase in the averaging beats from 250 to 800 both at night and daytime. In the MI-VT group, the LP parameters significantly deteriorated, which led to a positive judgment corresponding to the increment of the averaged night and day beats. The H-LP positive rates were unchanged in the MI non-VT and control groups, while the LP parameters remained consistent, despite the increased averaging beats in the MI non-VT and control groups. CONCLUSION Increasing the calculated averaging beats in H-LPs can improve the sensitivity of predicting fatal cardiac events in patients with MI.
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Affiliation(s)
- Kenichi Hashimoto
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Naomi Harada
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Motohiro Kimata
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Yusuke Kawamura
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
- Department of Integrative Physiology and Bio‐Nano MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Naoya Fujita
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Akinori Sekizawa
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Yosuke Ono
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Yasuhiro Obuchi
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
| | - Tadateru Takayama
- Department of General MedicineNihon University School of MedicineTokyoJapan
| | - Yuji Kasamaki
- Department of General MedicineKanazawa Medical College Himi Municipal HospitalHimiJapan
| | - Yuji Tanaka
- Department of General MedicineNational Defense Medical CollegeTokorozawaJapan
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Fujita N, Ono Y. Wandering Pneumonia. JMA J 2023; 6:543-545. [PMID: 37941682 PMCID: PMC10628320 DOI: 10.31662/jmaj.2023-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/06/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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13
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Kobayashi T, Fujita N, Sekizawa A, Ono Y. Unilateral Leg Edema and Hydronephrosis in IgG4-Related Retroperitoneal Fibrosis. JMA J 2023; 6:541-542. [PMID: 37941719 PMCID: PMC10628025 DOI: 10.31662/jmaj.2023-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/01/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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Ando Y, Ono Y, Ono S, Tanaka Y. Restrictive Ventilatory Impairment Due to Severe Scoliosis with a Large Cobb Angle. JMA J 2023; 6:539-540. [PMID: 37941683 PMCID: PMC10628184 DOI: 10.31662/jmaj.2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 06/01/2023] [Indexed: 11/10/2023] Open
Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Saitama, Japan
- Department of Internal Medicine, Self-Defense Forces Central Hospital, Tokyo, Japan
- Department of Family Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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15
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Hakim U, De Felice S, Pinti P, Zhang X, Noah JA, Ono Y, Burgess PW, Hamilton A, Hirsch J, Tachtsidis I. Quantification of inter-brain coupling: A review of current methods used in haemodynamic and electrophysiological hyperscanning studies. Neuroimage 2023; 280:120354. [PMID: 37666393 DOI: 10.1016/j.neuroimage.2023.120354] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
Hyperscanning is a form of neuroimaging experiment where the brains of two or more participants are imaged simultaneously whilst they interact. Within the domain of social neuroscience, hyperscanning is increasingly used to measure inter-brain coupling (IBC) and explore how brain responses change in tandem during social interaction. In addition to cognitive research, some have suggested that quantification of the interplay between interacting participants can be used as a biomarker for a variety of cognitive mechanisms aswell as to investigate mental health and developmental conditions including schizophrenia, social anxiety and autism. However, many different methods have been used to quantify brain coupling and this can lead to questions about comparability across studies and reduce research reproducibility. Here, we review methods for quantifying IBC, and suggest some ways moving forward. Following the PRISMA guidelines, we reviewed 215 hyperscanning studies, across four different brain imaging modalities: functional near-infrared spectroscopy (fNIRS), functional magnetic resonance (fMRI), electroencephalography (EEG) and magnetoencephalography (MEG). Overall, the review identified a total of 27 different methods used to compute IBC. The most common hyperscanning modality is fNIRS, used by 119 studies, 89 of which adopted wavelet coherence. Based on the results of this literature survey, we first report summary statistics of the hyperscanning field, followed by a brief overview of each signal that is obtained from each neuroimaging modality used in hyperscanning. We then discuss the rationale, assumptions and suitability of each method to different modalities which can be used to investigate IBC. Finally, we discuss issues surrounding the interpretation of each method.
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Affiliation(s)
- U Hakim
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom.
| | - S De Felice
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Department of Psychology, University of Cambridge, United Kingdom
| | - P Pinti
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom; Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
| | - X Zhang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - J A Noah
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Y Ono
- Department of Electronics and Bioinformatics, School of Science and Technology, Meiji University, Kawasaki, Kanagawa, Japan
| | - P W Burgess
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - A Hamilton
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - J Hirsch
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom; Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Departments of Neuroscience and Comparative Medicine, Yale School of Medicine, New Haven, CT, United States; Yale University, Wu Tsai Institute, New Haven, CT, United States
| | - I Tachtsidis
- Department of Medical Physics and Biomedical Engineering, University College London, Malet Place Engineering Building, Gower Street, London WC1E 6BT, United Kingdom
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16
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Ono Y, Ota H, Fukushi Y, Tagaya H, Okuda Y, Yoshino O, Yamada H, Hirata S, Wada S. Effectiveness of Laparoscopic Adenomyomectomy on Perinatal Outcomes. Gynecol Minim Invasive Ther 2023; 12:211-217. [PMID: 38034106 PMCID: PMC10683966 DOI: 10.4103/gmit.gmit_45_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 01/18/2023] Open
Abstract
Objectives The objective of this study was to observe the influence of laparoscopic adenomyomectomy on perinatal outcomes. Materials and Methods The retrospective cohort study included 43 pregnant cases with adenomyosis who did not undergo laparoscopic surgery before pregnancy (nonsurgery group; 26 cases) and did (surgery group; 17 cases). To evaluate the impact of surgery on perinatal outcomes, nine obstetric complications including preterm delivery, hypertensive disorder of pregnancy, placental malposition, oligohydramnios, gestational diabetes mellitus, uterine rupture, abruptio placentae, and postpartum hemorrhage were selected. One obstetric complication was counted as one point (Maximum 9 points for one person). The obstetrical morbidity was compared by adding up the number of relevant events (0-9) between the two groups. Apgar score, umbilical artery pH (UApH), neonatal intensive care unit (NICU) admission, and neonatal death were also examined. Results The surgery group had a significantly lower prevalence of fetal growth restriction compared to the nonsurgery group (nonsurgery vs. surgery; 26.9%, 7/26 vs. 0%, 0/17: P = 0.031). No differences were found in the morbidity of the nine obstetric complications (19.2%, 45/234 vs. 13.7%, 21/153), gestational weeks (mean ± standard deviation, 37.2 ± 2.4 vs. 36.4 ± 3.2), birth weight (2573.6 ± 557.9 vs. 2555.4 ± 680.8 g), Apgar score (1, 5 min; 8.0 ± 0.7 vs. 7.7 ± 1.2, 8.9 ± 0.6 vs. 8.5 ± 1.8), UApH (7.28 ± 0.08 vs. 7.28 ± 0.06), NICU admission (26.9%, 7/26 vs. 41.2%, 7/17), and neonatal death (0%, 0%) between both groups. Conclusion Laparoscopic adenomyomectomy may not increase obstetric complications, although attention must be paid to uterine rupture during pregnancy.
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Affiliation(s)
- Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hikaru Tagaya
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Yasuhiko Okuda
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shuji Hirata
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Japan
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17
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Kobayashi T, Ono Y. Annular Erythema on the Cheeks and Ear Lobes in Sjögren's Syndrome. Am J Med 2023; 136:e193-e194. [PMID: 37148993 DOI: 10.1016/j.amjmed.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan.
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18
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Iwai T, Yoshimura M, Ogawa A, Ono Y, Masui T, Nagai K, Anazawa T, Mizowaki T. The Outcomes of Neoadjuvant Chemoradiotherapy Using Moderately Hypofractionated Intensity Modulated Radiotherapy for Borderline Resectable Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e306. [PMID: 37785112 DOI: 10.1016/j.ijrobp.2023.06.2328] [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) Complete resection of borderline resectable pancreatic cancer (BRPC) is difficult because of its invasion to the vital vessels. Although neoadjuvant therapy is recommended for BRPC, its optimal regimens remain unclear. Neoadjuvant chemoradiotherapy using moderately hypofractionated intensity-modulated radiotherapy (NAC-MH-IMRT) has potentials to improve the treatment outcomes with shorter treatment periods. Therefore, we evaluated the outcomes for BRPC patients treated with NAC-MH-IMRT. MATERIALS/METHODS Between February 2013 and June 2021, patients with BRPC treated with NAC-MH-IMRT at our institution were evaluated. All patients were classified as BRPC-A and BRPC-V according to NCCN guidelines. Information regarding patient status, tumor and treatment characteristics, margin-negative resection (R0) rates, histological effects assessed by Evans classification, and outcomes were obtained from the clinical records. Overall survival (OS) and progression-free survival (PFS) were calculated by the Kaplan-Meier method from the start date of any first treatment for BRPC. Toxicity was evaluated by CTCAE version 5.0. RESULTS Sixty-eight patients were included in this study (Table). All patients underwent induction chemotherapy, and 67 were treated with IMRT at 42 Gy in 15 fractions with concurrent gemcitabine (for 65) or S-1 (for 2). All patients achieved completion of radiotherapy. Fifty-seven of the 68 patients (83.8%) underwent surgical exploration, and 48 patients (70.6%) had a resection. The R0 resection was achieved in 44 patients, and the R0 resection rate was 91.7% in resected patients. Therapeutic effects by Evans classification showed as below: Grade 1/2a/2b/3/4 = 6 (12.5%)/17 (35.4%)/17 (35.4%)/7 (14.6%)/1 (2.1%). Adjuvant chemotherapy was performed for 41 patients, and S-1 and gemcitabine were used for 40 and 1 patient(s), respectively. The median follow-up time and median survival time (MST) were 23.6 months and 42.7 months, and 2-year OS and PFS were 67.3% and 30.2%, respectively. Recurrence was observed in 54 patients (79.4%), and the first recurrence pattern was as follows: 7 (13.0%)/42 (77.8%)/5 (9.3%) patients had local recurrence, distant metastases, and both of them, respectively. Regarding ≥ Grade 3 gastrointestinal toxicity related NAC-MH-IMRT, grade 3 ileus was observed in 1 patient. CONCLUSION NAC-MH-IMRT for BRPC showed preferable outcomes and acceptable toxicities with high completion rate.
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Affiliation(s)
- T Iwai
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Yoshimura
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A Ogawa
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Ono
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Masui
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Nagai
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Anazawa
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Mizowaki
- Department of Radiation Oncology and Image-applied therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Hashimoto K, Harada N, Kimata M, Kawamura Y, Fujita N, Sekizawa A, Ono Y, Obuchi Y, Takayama T, Kasamaki Y, Tanaka Y. Diurnal Variation in and Optimal Time to Measure Holter-Based Late Potentials to Predict Lethal Arrhythmia after Myocardial Infarction. Medicina (Kaunas) 2023; 59:1460. [PMID: 37629750 PMCID: PMC10456944 DOI: 10.3390/medicina59081460] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: Holter-based late potentials (LPs) are useful for predicting lethal arrhythmias in organic cardiac diseases. Although Holter-based LPs exhibit diurnal variation, no studies have evaluated the optimal timing of LP measurement over 24 h for predicting lethal arrhythmia that leads to sudden cardiac death. Thus, this study aimed to validate the most effective timing for Holter-based LP testing and to explore factors influencing the diurnal variability in LP parameters. Materials and Methods: We retrospectively analyzed 126 patients with post-myocardial infarction (MI) status and 60 control participants who underwent high-resolution Holter electrocardiography. Among the 126 post-MI patients, 23 developed sustained ventricular tachycardia (VT) (the MI-VT group), while 103 did not (the MI-non-VT group) during the observation period. Holter-based LPs were measured at 0:00, 4:00, 8:00, 12:00, 16:00, and 20:00, and heart rate variability analysis was simultaneously performed to investigate factors influencing the diurnal variability in LP parameters. Results: Holter-based LP parameters showed diurnal variation with significant deterioration at night and improvement during the day. Assessment at the time with the longest duration of low-amplitude signals < 40 μV in the filtered QRS complex terminus (LAS40) gave the highest receiver operating characteristics curve (area under the curve, 0.659) and the highest odds ratio (3.75; 95% confidence interval, 1.45-9.71; p = 0.006) for predicting VT. In the multiple regression analysis, heart rate and noise were significant factors affecting the LP parameters in the MI-VT and control groups. In the non-VT group, the LP parameters were significantly influenced by noise and parasympathetic heart rate variability parameters, such as logpNN50. Conclusions: For Holter-based LP measurements, the test accuracy was higher when the LP was measured at the time of the highest or worst value of LAS40. Changes in autonomic nervous system activity, including heart rate, were factors influencing diurnal variability. Increased parasympathetic activity or bradycardia may exacerbate Holter-based LP parameters.
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Affiliation(s)
- Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Naomi Harada
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
| | - Tadateru Takayama
- Department of General Medicine, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Yuji Kasamaki
- Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Toyama 953-8531, Japan;
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan; (N.H.); (M.K.); (Y.K.); (N.F.); (A.S.); (Y.O.); (Y.O.); (Y.T.)
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20
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Ono Y, Wada S, Ota H, Fukushi Y, Tanimura K, Yoshino O, Arase H, Yamada H. Anti-β2-glycoprotein I/HLA-DR antibody in infertility. J Reprod Immunol 2023; 158:103955. [PMID: 37253286 DOI: 10.1016/j.jri.2023.103955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
To evaluate whether anti-β2-Glycoprotein I/HLA-DR (anti-β2GPI/HLA-DR) antibody is associated with pathophysiology of infertility, 224 women with infertility were enrolled from July 2020 to December 2021 in this prospective study. The serum levels of anti-β2GPI/HLA-DR antibody (normal < 73.3 U) were determined in 224 women with infertility. Backgrounds, causes and clinical factors were compared between women with and without anti-β2GPI/HLA-DR antibody. Forty (17.9 %) of the 224 women tested positive for anti-β2GPI/HLA-DR antibody. The prevalence of endometriosis was higher in women with anti-β2GPI/HLA-DR antibody than in women without the antibody (32.5 %, 13/40 vs. 17.4 %, 32/184; P = 0.048). Logistic regression analyses revealed that, among clinical factors and diseases, endometriosis was associated with anti-β2GPI/HLA-DR antibody positivity in infertile women (adjusted-odds ratio [OR] 3.01, 95 % confidence interval [CI] 1.30-6.99; P = 0.010). Twenty-three (15.5 %) of 148 women who underwent assisted reproductive technology (ART) tested positive for anti-β2GPI/HLA-DR antibody. The prevalence of recurrent implantation failure (RIF) defined as three or more implantation failures following in vitro fertilization and embryo transfers was higher in women with ART who tested positive for the antibody (43.5 %, 10/23) than in women with ART who tested negative (20.8 %, 26/125; P = 0.032). Logistic regression analyses revealed that RIF was associated with anti-β2GPI/HLA-DR antibody positivity in women with ART (adjusted-OR 2.92, 95 % CI 1.05-8.11; P = 0.040). Anti-β2GPI/HLA-DR antibody may be associated with the pathophysiology of infertility, endometriosis and RIF; and can be a potential therapeutic target in infertility.
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Affiliation(s)
- Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, 1110 Shimokawahigashi, Chuo City, Yamanashi Prefecture 409-3898, Japan; Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan
| | - Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi, 1110 Shimokawahigashi, Chuo City, Yamanashi Prefecture 409-3898, Japan
| | - Hisashi Arase
- World Premier International Immunology Frontier Research Center, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, 1-40, 12-chome, Maeda, Teine-ku, Sapporo-shi 006-8555, Japan.
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Tanimura K, Saito S, Tsuda S, Ono Y, Ota H, Wada S, Deguchi M, Nakatsuka M, Nagamatsu T, Fujii T, Kobashi G, Arase H, Yamada H. Anti-β2-glycoprotein I/HLA-DR Antibody and Adverse Obstetric Outcomes. Int J Mol Sci 2023; 24:10958. [PMID: 37446134 DOI: 10.3390/ijms241310958] [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] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
Anti-β2-glycoprotein I/HLA-DR (anti-β2GPI/HLA-DR) antibody has been reported to be associated with antiphospholipid syndrome and recurrent pregnancy loss (RPL). We conducted a prospective multicenter cross-sectional study aimed at evaluating whether the anti-β2GPI/HLA-DR antibody is associated with adverse obstetric outcomes and RPL. From 2019 to 2021, serum anti-β2GPI/HLA-DR antibody levels (normal, <73.3 U) were measured in 462 women with RPL, 124 with fetal growth restriction (FGR), 138 with hypertensive disorders of pregnancy (HDP), 71 with preterm delivery before 34 gestational weeks (preterm delivery (PD) ≤ 34 GWs), and 488 control women who experienced normal delivery, by flow cytometry analysis. The adjusted odds ratios (aORs) of anti-β2GPI/HLA-DR antibody positivity for adverse obstetric outcomes and RPL were evaluated on the basis of comparisons between the control and each patient group, using multivariable logistic regression analysis. The following were the positivity rates for the anti-β2GPI/HLA-DR antibody in the patient and control groups: RPL, 16.9%; FGR, 15.3%; HDP, 17.4%; PD ≤ 34 GWs, 11.3%; and the control, 5.5%. It was demonstrated that anti-β2GPI/HLA-DR antibody positivity was a significant risk factor for RPL (aOR, 3.3 [95% confidence interval {CI} 1.9-5.6], p < 0.001), FGR (2.7 [1.3-5.3], p < 0.01), and HDP (2.7 [1.4-5.3], p < 0.01) although not for PD ≤ 34 GWs. For the first time, our study demonstrated that the anti-β2GPI/HLA-DR antibody is involved in the pathophysiology underlying FGR and HDP, as well as RPL.
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Affiliation(s)
- Kenji Tanimura
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan
| | - Sayaka Tsuda
- Department of Obstetrics and Gynecology, University of Toyama, Toyama 930-0194, Japan
| | - Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, Yamanashi 409-3898, Japan
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
| | - Masashi Deguchi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Mikiya Nakatsuka
- Faculty of Health Sciences, Okayama University, Okayama 700-8558, Japan
| | - Takeshi Nagamatsu
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 113-8655, Japan
- Department of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Narita 286-8520, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, The University of Tokyo, Tokyo 113-8655, Japan
- Department of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Narita 286-8520, Japan
- Sanno Hospital, Tokyo 107-0052, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hisashi Arase
- Department of Immunochemistry, Research Institute for Microbial Disease, Osaka University, Suita 565-0871, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
- Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
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22
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Fujita N, Ono Y. Scintigraphic Findings in FGF23-related Hypophosphatemic Osteomalacia. JMA J 2023; 6:214-215. [PMID: 37179728 PMCID: PMC10169269 DOI: 10.31662/jmaj.2022-0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 05/15/2023] Open
Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
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Ono S, Sasabuchi Y, Ishimaru M, Ono Y, Matsui H, Yasunaga H. Short-term effects of reduced cost sharing on childhood dental care utilization and dental caries prevention in Japan. Community Dent Oral Epidemiol 2023; 51:228-235. [PMID: 35072286 DOI: 10.1111/cdoe.12730] [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] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Generous dental insurance coverage can improve oral health among children. However, most previous studies were from the United States, and the results may not be applicable to countries with universal healthcare systems. The purpose of the present study was to examine the effect of dental subsidy on dental service utilization and oral health among school-aged children. METHODS An administrative claims database in Kumamoto Prefecture, Japan, between 2014 and 2015 was used for the study. Municipalities in which the upper age limit of qualification for the dental subsidy was either 9 years of age or older were selected. The difference-in-differences approach was used to investigate the impact of subsidy discontinuation on dental care utilization and dental caries prevention. Dental care utilization was measured by number of first visits, number of total visits, and dental care cost per visit. Failure in dental caries prevention was determined by identifying treatment for acute severe dental conditions. RESULTS During the study period, 1108 eligible children made a total of 6276 visits to the 455 selected dental clinics. Among the dental clinics, 230 (50.5%) were located in municipalities in which the dental subsidy was discontinued when children reached age 10. After adjusting for area income and minimal user charges, there were no significant differences in subsequent dental care utilization (mean ratio 1.01, 95% confidence interval [CI] 0.97-1.04 for first visits; mean ratio 1.01, 95% CI 0.98-1.05 for total visits), acute severe dental conditions (mean ratio 1.06, 95% CI 0.90-1.24) or cost (coefficient 0.7 US dollars; 95%CI -0.2-1.6) during the 12-month period following the policy change. CONCLUSION The current dental subsidy policy may have limited value for promoting dental care utilization and improving oral health among school-aged children in Japan.
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Affiliation(s)
- Sachiko Ono
- Department of Eat-loss Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Miho Ishimaru
- Department of Health Services Research, Faculty of Medicine, Tsukuba University, Ibaraki, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Kobayashi T, Ishiyama S, Ono Y. Osler-Weber-Rendu Disease: Unexpected Cause of Anemia. Intern Med 2023; 62:955-956. [PMID: 35989270 PMCID: PMC10076148 DOI: 10.2169/internalmedicine.0135-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Sano Ishiyama
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
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Ono Y, Sakurai Y, Ota H, Tanaka K, Okada H, Tagaya H, Fukushi Y, Yoshino O, Wada S. Hysteroscopic resection with temporary balloon catheter occlusion of bilateral internal iliac arteries for managing retained products of conception after spontaneous abortion: Two cases report. J Obstet Gynaecol Res 2023; 49:753-758. [PMID: 36305385 DOI: 10.1111/jog.15480] [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: 05/08/2022] [Revised: 10/01/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022]
Abstract
Retained products of conception (RPOC) is a condition in which trophoblastic tissue remains in the uterus after pregnancy, causing massive hemorrhage in some cases. Though RPOC is commonly treated by intrauterine curettage or hysteroscopic resection uterine artery embolization or hysterectomy may be performed in case of massive bleeding. We experienced two cases of RPOC after surgery for missed abortion that failed to respond to conservative treatment and required surgical treatment. They were treated by hysteroscopic resection with temporary balloon catheter occlusion of bilateral internal iliac arteries for fertility preservation. After the balloon catheters were inflated, the reduction of blood flow to RPOC was observed under transvaginal ultrasound. In both cases, good visualization was maintained throughout the surgery with minimal bleeding. They were discharged the next day and resumed menstruation 1 month after surgery. This paper demonstrates the usefulness of this procedure as a minimally invasive and fertility-preserving surgery.
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Affiliation(s)
- Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan.,Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapparo, Japan
| | - Yasuo Sakurai
- Department of Radiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapparo, Japan
| | - Kota Tanaka
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Hiroki Okada
- Department of Radiology, University of Yamanashi, Chuo, Japan
| | - Hikaru Tagaya
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapparo, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi, Chuo, Japan
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapparo, Japan
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Ono S, Ishimaru M, Yokota I, Konishi T, Okada A, Ono Y, Matsui H, Itai S, Yonenaga K, Tonosaki K, Watanabe R, Hoshi K, Yasunaga H. Risk of post-extraction bleeding with direct oral anticoagulant compared with warfarin: Retrospective cohort study using large scale claims data in Japan. Thromb Res 2023; 222:24-30. [PMID: 36563522 DOI: 10.1016/j.thromres.2022.12.007] [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: 08/10/2022] [Revised: 11/22/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Comparative safety of direct oral anticoagulants vs. warfarin in patients undergoing tooth extraction remains unclear. We compared the incidence of post-extraction bleeding between patients taking warfarin and those taking direct oral anticoagulants (DOACs) using administrative claims data. MATERIALS AND METHODS We identified outpatients on anticoagulant therapy who underwent permanent tooth extraction between 2015 and 2020 and categorized them into the warfarin and DOAC groups based on medication prescribed within six months prior to tooth extraction. We used the overlap propensity score weighting method to balance the baseline characteristics between the groups and compared the incidence of post-extraction bleeding within seven days after tooth extraction. RESULTS Among 5253 eligible patients, those in the DOAC group (n = 3696) were older and less frequently prescribed antiplatelets than those in the warfarin group (n = 1557). The distribution of tooth extraction type and number of teeth extracted in a single procedure did not differ between the groups. The unadjusted incidences of post-extraction bleeding in the warfarin and DOAC groups were 35 (2.2 %) and 71 (1.9 %), respectively. Moreover, the overlap weighting analysis showed that the adjusted odds ratio of post-extraction bleeding in the DOAC group in comparison with that in the warfarin group was 0.84 (95 % confidence interval, 0.54-1.31). CONCLUSION The incidence of post-extraction bleeding in patients taking DOACs was comparable to that in patients taking warfarin. The findings suggest that dentists and physicians should exercise the same degree of caution when extracting teeth in patients on DOACs and those on warfarin in terms of post-extraction bleeding.
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Affiliation(s)
- Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Miho Ishimaru
- Department of Oral Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
| | - Takaaki Konishi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shunsuke Itai
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kazumichi Yonenaga
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kanata Tonosaki
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Rinji Watanabe
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kazuto Hoshi
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Hashimoto K, Harada N, Kimata M, Kawamura Y, Fujita N, Sekizawa A, Ono Y, Obuchi Y, Takayama T, Kasamaki Y, Tanaka Y. Age-related reference intervals for ambulatory electrocardiographic parameters in healthy individuals. Front Cardiovasc Med 2023; 10:1099157. [PMID: 36950291 PMCID: PMC10026132 DOI: 10.3389/fcvm.2023.1099157] [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: 11/15/2022] [Accepted: 02/16/2023] [Indexed: 03/08/2023] Open
Abstract
Background The advent of novel monitoring technologies has dramatically increased the use of ambulatory electrocardiography (AECG) devices. However, few studies have conducted detailed large-scale investigations on the incidence of arrhythmias over 24 h, especially ectopy, in healthy individuals over a wide age range. Objectives This study aimed to investigate the incidence of arrhythmias detected using AECG and associated factors, in healthy individuals, over a wide age range. Methods In this cross-sectional study, we performed AECG on 365 healthy volunteers (median [interquartile range]: 48 [36, 67], 20-89 years, 165 men) under free-running conditions for 24 h. Ultrasonic echocardiography and heart rate variability analysis were performed to explore the factors associated with the incidence of arrhythmias. Results The 97.5th percentile of single ventricular ectopy (VE) was 149/day, 254/day, and 1,682/day in the 20-39-, 40-59- and 60-89-year age groups, respectively; that of single supraventricular ectopy (SVE) was 131/day, 232/day, and 1,063/day, respectively. Multivariate analysis revealed that aging was the only independent significant factor influencing the frequency of VE (β = 0.207, P = 0.001). Age (β = 0.642, P < 0.001), body mass index (BMI) (β = -0.112, P = 0.009), and the root mean square of successive differences in RR intervals (β = 0.097, P = 0.035) were factors significantly associated with SVE frequency. Conclusions Age-specific reference intervals of VE and SVE in a large population of healthy participants over a wide age range were generated. VE and SVE increased with age; SVE was influenced by BMI and the aging-induced decrease in parasympathetic tone activity.
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Affiliation(s)
- Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
- Correspondence: Kenichi Hashimoto
| | - Naomi Harada
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Tadateru Takayama
- Department of General Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuji Kasamaki
- Department of General Medicine, Kanazawa Medical College Himi Municipal Hospital, Himi, Toyama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
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Kobayashi T, Ono Y, Fujita N, Tanaka Y. Herpes Zoster with Contact Dermatitis Developing under a Patch. Intern Med 2023; 62:151. [PMID: 35598999 PMCID: PMC9876713 DOI: 10.2169/internalmedicine.9766-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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29
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Fujita N, Ono Y, Kobayashi T, Kozono S, Horiuchi Y, Sano A, Kawamura Y, Miyoshi Y, Kimata M, Sekizawa A, Hashimoto K, Obuchi Y, Tanaka Y. Iodine-containing ointment-induced hypothyroidism in a patient with anorexia nervosa and sacral decubitus ulcer: a case report with literature review. Endocr J 2022; 69:1423-1429. [PMID: 36058848 DOI: 10.1507/endocrj.ej22-0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We present a case of a 58-year-old woman with anorexia nervosa and a sacral decubitus ulcer who developed hypothyroidism because of an iodine-containing ointment. Considering the absence of autoimmune thyroid diseases, the development of hypothyroidism after the use of an iodine-containing ointment, and the recovery of thyroid function after the discontinuation of the ointment, we presumed that her hypothyroidism was induced by the iodine-containing ointment. Although the hypothyroidism improved after discontinuing the iodine-containing ointment, she developed aspiration pneumonia and required long-term hospitalization. Many patients with autoimmune thyroid diseases develop hypothyroidism after excessive iodine intake. However, anorexia nervosa may have exacerbated the iodine-induced hypothyroidism in our patient. To the best of our knowledge, no previous study has reported a case of hypothyroidism caused by iodine-containing ointment in a patient with anorexia nervosa. Hence, physicians must pay careful attention to a patient's background factors to ensure the early diagnosis of hypothyroidism due to iodine-containing ointments.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Sawako Kozono
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yugo Horiuchi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yuka Miyoshi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
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30
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Ando Y, Ono Y, Sano A, Fujita N, Ono S, Tanaka Y. Clinical characteristics and outcomes of pheochromocytoma crisis: a literature review of 200 cases. J Endocrinol Invest 2022; 45:2313-2328. [PMID: 35857218 DOI: 10.1007/s40618-022-01868-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/09/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Pheochromocytoma crisis is a life-threatening endocrine emergency that requires prompt diagnosis and treatment. Because of its rarity, sudden onset, and lack of internationally uniform and validated diagnostic criteria, pheochromocytoma crisis remains to be fully clarified. Therefore, we aimed to describe the clinical characteristics and outcomes of pheochromocytoma crisis through a literature review. METHODS We performed a systematic literature search of PubMed/MEDLINE database, Igaku-Chuo-Zasshi (Japanese database), and Google Scholar to identify case reports of pheochromocytoma crisis published until February 5, 2021. Information was extracted and analyzed from the literature that reported adequate individual patient data of pheochromocytoma crisis in English or Japanese. Cases were also termed as pheochromocytoma multisystem crisis (PMC) if patients had signs of hyperthermia, multiple organ failure, encephalopathy, and labile blood pressure. RESULTS In the 200 cases of pheochromocytoma crisis identified from 187 articles, the mean patient age was 43.8 ± 15.5 years. The most common symptom was headache (39.5%). The heart was the most commonly damaged organ resulting from a complication of a pheochromocytoma crisis (99.0%), followed by the lungs (44.0%) and the kidney (21.5%). PMC accounted for 19.0% of all pheochromocytoma crisis cases. After excluding 12 cases with unknown survival statuses, the mortality rate was 13.8% (26/188 cases). Multivariable logistic regression analysis revealed that nausea and vomiting were significantly associated with a higher mortality rate. CONCLUSION Pheochromocytoma can present with different symptomatology, affecting different organ systems. Clinicians should be aware that patients with nausea or vomiting are at a higher risk of death because of pheochromocytoma crisis.
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Affiliation(s)
- Y Ando
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
- Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Y Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - A Sano
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - N Fujita
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - S Ono
- Department of Eat-Loss Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Y Tanaka
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
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Ito M, Yoshino O, Hiraoka T, Ono Y, Tanaka K, Iwahata S, Honda M, Furue A, Nishijima J, Shimoda T, Iwase H, Miki A, Tagaya H, Hirata S, Unno N. Oral Gonadotropin-Releasing Hormone Antagonist Relugolix Has the Same Effect as Gonadotropin-Releasing Hormone Agonist Injections in Terms of Preparation for Transcervical Resection Myomectomy. Gynecol Minim Invasive Ther 2022; 11:238-241. [PMID: 36660323 PMCID: PMC9844050 DOI: 10.4103/gmit.gmit_9_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
For preparing the optimal condition in transcervical resection (TCR) surgery, gonadotropin-releasing hormone (GnRH) agonist has been utilized. Recently, an oral GnRH antagonist (relugolix) is available and acts directly on GnRH receptor, avoiding flare up and reducing blood E2 levels rapidly. We retrospectively compared the oral GnRH antagonist (n = 14) effect to that of subcutaneous GnRH agonist (n = 19) for the pretreatment of endometrium in TCR myomectomy. Endometrial thickening was determined by intraoperative videos. The color tone of the endometrium in the normal part was assessed by digital image processing. The median duration of the first GnRH agonist injection and the surgery was 67 days (21-136 days), which is significantly longer than that of the oral GnRH antagonist group, 18.5 days (7-157 days P < 0.01). Both the GnRH agonist and antagonist groups did not exhibit prominence in the endometrium. The GnRH antagonist group showed the same degree of whiteness in the normal endometrium as the GnRH agonist group. The oral GnRH antagonist administration could rapidly atrophy the endometrium and create an optimal surgical field for TCR in a short period.
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Affiliation(s)
- Mika Ito
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan,Department of Obstetrics and Gynecology, Kitasato University Medical Center, School of Medicine, Kitamoto, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan,Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan,Address for correspondence: Dr. Osamu Yoshino, Department of Obstetrics and Gynecology, University of Yamanashi, 1110 Shimokato, Chuo-Shi, Zip: 409-3898, Yamanashi, Japan. E-mail:
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Ono
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Kouta Tanaka
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Shunsuke Iwahata
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masako Honda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akiko Furue
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junichi Nishijima
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takahito Shimoda
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Haruko Iwase
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Akinori Miki
- Department of Obstetrics and Gynecology, Kitasato University Medical Center, School of Medicine, Kitamoto, Japan
| | - Hikaru Tagaya
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Shuji Hirata
- Department of Obstetrics and Gynecology, University of Yamanashi, Kofu, Japan
| | - Nobuya Unno
- Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan
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Matsui H, Shoji M, Higano S, Yoda H, Ono Y, Yang J, Misumi T, Fujita A. Infrared Plasmonic Metamaterials Based on Transparent Nanoparticle Films of In 2O 3:Sn for Solar-Thermal Shielding Applications. ACS Appl Mater Interfaces 2022; 14:49313-49325. [PMID: 36261131 DOI: 10.1021/acsami.2c14257] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Three-dimensional nanoparticle (NP) assemblies show interesting optical responses that differ from naturally occurring materials, such as metals, oxides, and semiconductors. In this study, we investigate the optical response of thin films comprising Sn:In2O3 NPs (ITO NP films) based on the correlation between complex permittivity and infrared (IR) reflectance for solar-thermal shielding applications. IR ellipsometry measurements are conducted to clarify the presence of Lorentz resonances in plasmonic metamaterials. The Lorentz resonances are correlated to the electric field strength at interparticle gaps by varying the Sn dopant concentration, as confirmed using finite-difference time-domain (FDTD) simulations. High solar-thermal shielding performance was obtained owing to selective near-IR reflection based on strong Lorentz resonances as the ITO NP films were electrically polarizable but magnetically inactive. Thermal shielding efficiency was demonstrated via a comparison of the air temperature change in a simulated box used as a model house. Additionally, we demonstrate the significance of NP packing density on the enhancement of the near-IR reflectance. The role of interparticle spacing for high near-IR reflectance was revealed by comparing effective medium approximation analyses and FDTD simulations. This relationship was also demonstrated by the reduction of solar-thermal shielding performance when using aggregated ITO NPs. Our work confirmed that the control of complex permittivity in plasmonic metamaterials must be considered in the structural design of transparent and reflective materials for solar-thermal shielding applications.
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Affiliation(s)
- Hiroaki Matsui
- Department of Bioengineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
- Department of Electrical Engineering and Information Systems, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Miho Shoji
- Central Laboratory, Mitsubishi Materials Co., 14-1002, Mu Koyama, Naka, Ibaraki 311-0102, Japan
| | - Satoko Higano
- Central Laboratory, Mitsubishi Materials Co., 14-1002, Mu Koyama, Naka, Ibaraki 311-0102, Japan
| | - Hidehiko Yoda
- Department of Fundamental Engineering, Utsunomiya University, 7-1-2, Yoto, Utsunomiya, Tochigi 321-8585, Japan
| | - Yosuke Ono
- Attract to Japan Co., 9-14-9, Takaya Takamigaoka, Higashi-Hiroshima, Hiroshima 739-2115, Japan
| | - Jiaqi Yang
- Department of Bioengineering, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - Teppei Misumi
- Science & Technology Institute, Co., 3-5-4 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Aki Fujita
- Science & Technology Institute, Co., 3-5-4 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
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Wada S, Fukushi Y, Ono Y, Ota H, Tsuzuki Y, Yamada H. Influence of Uterine Cavity Breach in Laparoscopic Myomectomy on the Risk of Obstetric Complications. Gynecol Minim Invasive Ther 2022; 11:221-223. [PMID: 36660322 PMCID: PMC9844043 DOI: 10.4103/gmit.gmit_146_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/14/2022] [Accepted: 05/04/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Prepregnancy myomectomy is effective for the treatment of infertility or prevention of obstetric complications and is usually performed with laparoscopy. However, pregnancies following myomectomy have risks of obstetric complications, especially in cases with uterine cavity breaches, but the evidence remains unclear. We investigated how uterine cavity breach in laparoscopic myomectomy influenced the occurrence of obstetric complications. Patients and Methods One hundred and eighty women who underwent a cesarean section from 2014 to 2020 in pregnancies following laparoscopic myomectomy were included. They were divided into two groups: 25 women in the uterine cavity breach group and 155 in the nonbreach group. Obstetric complications, including placenta accreta spectrum (PAS), uterine rupture, placental malposition, abruption placenta, preterm delivery, threatened premature labor, premature rupture of membranes, and massive intrapartum hemorrhage, were assessed. Results Multivariate analysis revealed that the frequency of PAS in the breach group (24.0%) was statistically significantly higher than in the nonbreach group (5.2%, P < 0.05). Conclusion This study demonstrated that women who experienced uterine cavity breach in laparoscopic myomectomy had an increased risk of PAS in subsequent pregnancies.
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Affiliation(s)
- Shinichiro Wada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan,Address for correspondence: Dr. Shinichiro Wada, Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Teine-Ku Maeda 1-12-1-40, Sapporo 006-0855, Hokkaido, Japan. E-mail:
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yosuke Ono
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Yoko Tsuzuki
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan
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Iguchi M, Wada H, Shinozaki T, Suzuki M, Ajiro Y, Matsuda M, Koike A, Koizumi T, Shimizu M, Ono Y, Takenaka T, Kotani K, Abe M, Akao M, Hasegawa K. Vascular endothelial factor C and D in patients with heart failure with preserved, mildly reduced, and reduced ejection fraction: the PREHOSP-CHF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.916] [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
The lymphatic system has been suggested to play an important role in cardiovascular diseases including heart failure (HF). Vascular endothelial growth factor C (VEGF-C) and D (VEGF-D) are key regulators of lymphangiogenesis, and we recently reported the association of low VEGF-C with the risk of all-cause death and high VEGF-D with the risk of HF hospitalization in patients with HF.
Purpose
To investigate the association of VEGF-C and VEGF-D with prognosis in patients with HF with preserved ejection fraction (EF) (HFpEF: EF≥50%), mildly reduced EF (HFmrEF: EF, 40–49%), and reduced EF (HFrEF: EF<40%).
Methods
The PREHOSP-CHF study is a multicenter prospective cohort study to determine the predictive value of angiogenesis-related biomarkers in HF. A total of 1,024 patients (mean age 75.5±12.6 years; 58.7% male) admitted to acute decompensated HF were included in the analyses. Serum levels of VEGF-C and VEGF-D, as well as N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin-I (hs-cTnI), high sensitivity C reactive protein, were measured at the time of discharge. Patients were followed-up over two years.
Results
The numbers of HFpEF, HFmrEF, and HFrEF were 429 (41.9%), 186 (18.2%), and 409 (39.9%), respectively. HFpEF patients were older, more likely to be female, and had more hypertension, atrial fibrillation, and anemia, but less coronary artery disease. NT-proBNP and hs-cTnI levels increased with decreasing EF. VEGF-C levels decreased with increasing EF (median [interquartile range]: HFpEF, 4508 [3318–5919] pg/ml; HFmrEF, 4719 [3663–6203] pg/ml; HFrEF, 5023 [3804–6382] pg/ml), whereas VEGF-D levels were comparable among the three EF groups (HFpEF, 404.6 [293.1–560.3] pg/ml; HFmrEF, 386.0 [298.5–556.3] pg/ml; HFrEF, 414.2 [296.1–557.3] pg/ml). In multivariate stepwise logistic regression analyses, anemia and high NT-proBNP were independently associated with low VEGF-C levels, and high NT-proBNP was independently associated with high VEGF-D levels, across all the EF groups. During the follow-up, incidences of all-cause death and HF hospitalizations were similar among the three EF groups (log-rank P=0.6 for all-cause death, and log-rank P=0.3 for HF hospitalization). On multivariate Cox proportional hazard analyses including established risk factors and cardiovascular biomarkers, VEGF-C levels tended to be inversely associated with the incidence of all-cause death in patients with HFpEF and HFrEF (Figure). On the contrary, VEGF-D levels were significantly and positively associated with the incidence of HF hospitalization in patients with HFpEF, and tended to be positively associated with it in patients with HFmrEF and HFrEF (Figure).
Conclusions
Low VEGF-C was associated with the risk of all-cause death in patients with HFpEF and HFrEF, while high VEGF-D was associated with the risk of HF hospitalization especially in HFpEF.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Grant-in-Aid for Clinical Research from the National Hospital Organization
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Affiliation(s)
- M Iguchi
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - H Wada
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - T Shinozaki
- National Hospital Organization Sendai Medical Center , Sendai , Japan
| | - M Suzuki
- National Hospital Organization Saitama Hospital , Saitama , Japan
| | - Y Ajiro
- National Hospital Organization Yokohama Medical Center , Yokohama , Japan
| | - M Matsuda
- National Hospital Organization Kure Medical Center and Chugoku Cancer Center , Kure , Japan
| | - A Koike
- National Hospital Organization Fukuokahigashi Medical Center , Fukuoka , Japan
| | - T Koizumi
- National Hospital Organization Mito Medical Center , Ibaraki , Japan
| | - M Shimizu
- National Hospital Organization Kobe Medical Center , Kobe , Japan
| | - Y Ono
- National Hospital Organization Higashihiroshima Medical Center , Hiroshima , Japan
| | - T Takenaka
- National Hospital Organization Hokkaido Medical Center , Sapporo , Japan
| | - K Kotani
- Jichi Medical University , Tochigi , Japan
| | - M Abe
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
| | - K Hasegawa
- Kyoto Medical Center, National Hospital Organization , Kyoto , Japan
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Ando Y, Sano A, Ono Y. Primary central nervous system lymphoma mimicking brain hemorrhage. Am J Med Sci 2022; 364:e19-e20. [PMID: 35595080 DOI: 10.1016/j.amjms.2022.05.015] [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] [Received: 02/18/2021] [Revised: 10/02/2021] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Saitama, Japan; Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan.
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Ono S, Michihata N, Yamana H, Uemura K, Ono Y, Jo T, Yasunaga H. Comparative Effectiveness of BNT162b2 and mRNA-1273 Booster Dose After BNT162b2 Primary Vaccination Against the Omicron Variants: A Retrospective Cohort Study Using Large-Scale Population-Based Registries in Japan. Clin Infect Dis 2022; 76:18-24. [PMID: 36124762 PMCID: PMC9494390 DOI: 10.1093/cid/ciac763] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Direct comparative effectiveness of booster doses of BNT162b2 and mRNA-1273 after BNT162b2 primary vaccination is unknown. METHODS We investigated comparative effectiveness of BNT162b2 and mRNA-1273 booster dose using data from registry systems for vaccination and coronavirus disease 2019 (COVID-19) infection in a local city in Japan. We followed participants aged ≥16 years who completed the BNT162b2 primary vaccination between 22 November 2021, and 15 April 2022. We collected information on age, sex, vaccination status, vaccine type, and infection status. Age was categorized as 16-44, 45-64, 65-84, and ≥85 years. Vaccine effectiveness for mRNA-1273 and no booster vaccination against BNT162b2 was estimated using age-stratified Cox regression adjusted for age, sex, and days since the second vaccination. The estimated hazard ratios for mRNA-1273 and no booster vaccinations were integrated separately using random effects meta-analyses. RESULTS During the study period, we identified 62 586 (40.4%), 51 490 (33.2%), and 40 849 (26.4%) participants who received BNT162b2, mRNA-1273, and no booster dose, respectively. The median age was 69, 71, and 47 years for BNT162b2, mRNA-1273, and no booster dose, respectively. The integrated hazard ratio with reference to BNT162b2 was 1.72 for no booster vaccination and 0.62 for mRNA-1273. The comparative effectiveness of mRNA-1273 was similar across age categories. CONCLUSIONS Both homologous and heterologous vaccinations are effective against Omicron variants. In the head-to-head comparison, the effect was stronger in people who received heterologous vaccination than in those who received homologous vaccination. These findings may help improve logistics and decision making in future vaccination programs.
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Affiliation(s)
- Sachiko Ono
- Correspondence to: Sachiko Ono, MPH, PhD Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 Japan
| | - Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hayato Yamana
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kohei Uemura
- Department of Biostatistics & Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Taisuke Jo
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,Department of Respiratory Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology & Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Ando Y, Ono Y, Sano A, Fujita N, Ono S. Subacute Thyroiditis after COVID-19: A Literature Review. Am J Trop Med Hyg 2022; 107:1074-1082. [PMID: 36067987 DOI: 10.4269/ajtmh.21-1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/17/2022] [Indexed: 11/07/2022] Open
Abstract
Subacute thyroiditis (SAT), potentially caused by severe acute respiratory syndrome coronavirus 2 infection, has been reported as a complication of COVID-19 since 2020. The clinical characteristics and outcomes of SAT after COVID-19 remain incompletely defined. Therefore, we aimed to collect and survey case reports of SAT after COVID-19. We performed a systematic search of PubMed/MEDLINE, Web of Science, and Google Scholar. The keywords and MeSH terms used for the searches were "subacute thyroiditis" and "COVID-19." A total of 38 patients from 26 case reports, case series, and letters on SAT associated with COVID-19 were included and analyzed. The most frequent SAT symptom was neck pain (27 cases), followed by fever (22 cases). Of the 25 cases with information on the duration between onset of COVID-19 symptoms and onset of SAT symptoms, the shortest was simultaneous occurrence, and the longest was 4 months. In most cases, patients developed SAT at several days or weeks after the onset of COVID-19. All patients with SAT recovered with no severe complications or sequelae. Clinicians should be aware of the possibility of SAT development in patients with neck pain and fever following COVID-19. Further research is necessary to determine the relationship between SAT and COVID-19.
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Affiliation(s)
- Yuya Ando
- Department of Internal Medicine, Division of Gastroenterology, Self-Defense Forces Central Hospital, Tokyo, Japan.,Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Sekizawa A, Hashimoto K, Kobayashi S, Kozono S, Kobayashi T, Kawamura Y, Kimata M, Fujita N, Ono Y, Obuchi Y, Tanaka Y. Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report. Front Med (Lausanne) 2022; 9:963393. [PMID: 35979213 PMCID: PMC9377515 DOI: 10.3389/fmed.2022.963393] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
B-cell lymphomas are neoplastic diseases occasionally associated with chronic inflammation. mRNA vaccines for coronavirus disease 2019 (COVID-19) induce inflammatory responses, which often lead to fever and lymphadenopathies indistinguishable from lymphomas. Although both lymphadenopathies and lymphomas can be influential, the correlation between them is unclear. Herein, we present the first case of marginal zone B-cell lymphoma following mRNA COVID-19 vaccination. An 80-year-old Japanese woman presented with a right temporal mass that appeared the morning after she was administered her first mRNA COVID-19 vaccination (BNT162b2). The mass gradually decreased in size but persisted over 6 weeks after her first vaccination (3 weeks after her second vaccination). At her first visit to our hospital, ultrasound revealed the size of the mass to be 28.5 × 5.7 mm, and computed tomography revealed multiple lymphadenopathies in the right parotid, submandibular, jugular, and supraclavicular regions. Initially, we suspected head-and-neck benign lymphadenopathy as a side effect of vaccination. Nine weeks later, the number of swollen submandibular and parotid glands increased, and the lymph nodes further enlarged. Finally, the right temporal mass was diagnosed as marginal zone B-cell lymphoma based on immunohistochemical and flow cytometry findings of biopsy specimens. Our findings suggest that although 4–6 weeks of observation for lymph node inflammation after the second vaccination is recommended, malignancy should also be considered in the differential diagnosis of lymphadenopathy following vaccination.
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Affiliation(s)
- Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
- *Correspondence: Kenichi Hashimoto
| | - Shinichi Kobayashi
- Department of Hematology, National Defense Medical College, Tokorozawa, Japan
| | - Sawako Kozono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Japan
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Affiliation(s)
- Yuya Ando
- Department of Internal Medicine, Self-Defense Forces Central Hospital, Tokyo, Japan; Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoko Senda
- Department of Dermatology, Self-Defense Forces Central Hospital, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan.
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Horiuchi Y, Hashimoto K, Horikoshi H, Sano A, Kawamura Y, Fujita N, Kimata M, Ono Y, Obuchi Y, Makino A, Kaneko M, Kimura F, Itoh K, Tanaka Y. Fulminant elderly adult-onset Still disease effectively treated with tocilizumab and methotrexate: A case report. Medicine (Baltimore) 2022; 101:e29354. [PMID: 35839054 DOI: 10.1097/md.0000000000029354] [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] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Adult-onset Still disease (AOSD) is a rare inflammatory disease of unknown etiology. AOSD is common in young or middle-aged adults; however, in recent years, there have been increasing reports of elderly AOSD. Differentiating AOSD from diseases such as infections and malignancies is difficult. Moreover, rare fulminant AOSD cases with resistance to corticosteroids and immunosuppressive drugs have been reported. PATIENT CONCERNS An 80-year-old woman presented with flaccid fever, generalized arthralgia, and erythema of the anterior chest for 2 weeks. On day 5 of hospitalization, the patient developed pleural effusion with hypoxemia and her vital signs indicated rapid progression to shock. During the clinical course, the levels of inflammatory markers, including maximum level of ferritin and white blood cells (WBCs) were elevated (252,796 ng/mL and 86,500/μV, respectively) with disseminated intravascular coagulation syndrome (DIC) and macrophage activation syndrome (MAS). DIAGNOSIS The patient was diagnosed with elderly AOSD as per the Yamaguchi criteria for AOSD. The state of disease was extremely severe with rapid progression and was, thus, categorized as a fulminant form of elderly AOSD. INTERVENTIONS The patient was treated with prednisolone (PSL) pulse therapy (1000 mg/d) twice and plasma exchange in the intensive care unit for the primary disease and shock. Although she recovered from shock, she developed DIC and MAS. Methotrexate (MTX; 10 mg/d) improved the DIC and MAS. However, severe pleuritis recurred and the patient developed pericarditis; her primary disease was poorly controlled. Finally, tocilizumab (TCZ) was introduced using interleukin-18 (IL-18) as a surrogate marker. The IL-18 level was measured repeatedly following admission, with the peak level (170,000 pg/mL) recorded on the 75th day of hospitalization, immediately prior to introducing TCZ. OUTCOMES The combined use of MTX, TCZ, and PSL was effective in suppressing elderly AOSD, which was unsuccessfully controlled with MTX and PSL. Frequent monitoring of IL-18 levels proved useful for differentiating elderly AOSD from other diseases. LESSONS A fulminant form of elderly AOSD was treated with a combination of MTX, TCZ, and PSL. Repeated monitoring of IL-18 levels can be useful for decision-making in treating elderly AOSD.
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Affiliation(s)
- Yugo Horiuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Hideyuki Horikoshi
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Arisa Makino
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Mayuko Kaneko
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Fumihiko Kimura
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Kenji Itoh
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
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Fujita N, Ono Y, Obuchi Y, Tanaka Y. Bilateral inguinal bladder hernias. Clin Case Rep 2022; 10:e6075. [PMID: 35865768 PMCID: PMC9290772 DOI: 10.1002/ccr3.6075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/25/2022] [Indexed: 11/28/2022] Open
Abstract
Inguinal hernia may contain the bladder as one of its contents, while bilateral inguinal bladder herniation is rare. Urinary obstruction and obesity are associated with increased abdominal pressure and are risk factors of bladder herniation. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine National Defense Medical College Saitama Japan
| | - Yosuke Ono
- Department of General Medicine National Defense Medical College Saitama Japan
| | - Yasuhiro Obuchi
- Department of General Medicine National Defense Medical College Saitama Japan
| | - Yuji Tanaka
- Department of General Medicine National Defense Medical College Saitama Japan
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Abstract
BackgroundTocilizumab (TCZ) is a humanized anti-IL-6 receptor monoclonal antibody that improves the signs and symptoms of rheumatoid arthritis (RA). In previous clinical trials, long-term outcomes have been increasingly evaluated in daily clinical practice. We report the five-year outcomes of TCZ treatment at our institute.ObjectivesThis retrospective study determined the long-term trends in TCZ use in clinical practice.MethodsData from the Toyohashi RA database (TRAD) were used. The TRAD is single-center retrospective data. Last observation carried forward was used as a complementary method for missing data. Participants were 59 RA patients in whom TCZ therapy was started at our institute from September 2009 to May 2016. Subsequent items, baseline patient characteristics, disease activity, treatment continuation rates of TCZ using the Kaplan-Meier method, reasons for stopping TCZ, concomitant use of methotrexate (MTX) and prednisolone (PSL) were investigated.ResultsBaseline characteristics at the start of TCZ treatment were 17 men and 42 women with a mean age of 58.6 years (30–81). The mean RA duration was 8.7 years (0–31). The mean SDAI score was 27.9 ± 11.6; the mean DAS28-CRP was 5.0 ± 1.0. CRP was 4.1 ± 3.0 mg/dl and MMP-3 388.3 ± 311.5 ng/ml. Methotrexate (MTX) was administered in 37 patients (62.7%, mean 6.0 mg, mean MTX dose administered in cases, 9.6 mg/week). Prednisolone (PSL) was administered in 37 patients (62.7%, mean 3.6 mg; the mean PSL dose administered in cases 5.7 mg/day).Regarding disease activity, the mean SDAI was 27.9 at baseline; 12.3 at three months; 8.1 at one year; 7.3 at two years; 6.5 at three years; 46.7 at four years; 5.6 at five years, and 5.2 at final observation. The SDAI significantly improved after two years compared to baseline. Remission and low disease activity also significantly improved at one year and gradually improved after one year (Figure 1). The remission rate at the final observation was 55.2%, with an SDAI ≦3.3.TCZ continuation rates were 86.9% at one year, 78.7% at three years, and 68.9% at five years (Figure 2). TCZ was discontinued due to adverse events in 11 cases (18%), and inadequate efficacy occurred in 9 (14.8%). The adverse events were respiratory infection (5), purulent arthritis (1), infectious endocarditis (1), subarachnoid hemorrhage (1), breast cancer (1), pruritis (1), and skin ulcer (1). Other reasons for discontinuation were dialysis (2), suspension of hospital visits (2), kidney transplant (1), and financial difficulties (1). Concomitant use from baseline to final observation declined from 62.7% to 15.3% for MTX and from 62.7% to 23.7% for PSL.ConclusionLong-term treatment with TCZ was acceptable. We found that with TCZ therapy, the remission and low disease activity rates significantly improved at one year and continued to improve after one year. Treatment persistence was high, but careful monitoring for infection is necessary.Disclosure of InterestsNone declared
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Kashiwagi E, Ono Y, Higashihara H, Tanaka K, Nagai K, Kosai S, Yano H, Tomiyama N. Abstract No. 35 Percutaneous sclerotherapy with OK-432 for lymphocele after pelvic or para-aortic lymphadenectomy: preliminary results. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hirano Y, Ono Y. AB0368 EFFECTS OF SWITCHING FROM ETANERCEPT ORIGINATOR TO ETANERCEPT BIOSIMILAR ON DISEASE ACTIVITY, PHYSICAL FUNCTION, AND PATIENT-REPORTED OUTCOME REGARDING A SELF-INJECTION DEVICE IN PATIENTS WITH WELL-CONTROLLED RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4365] [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
BackgroundAlthough biological drugs have dramatically changed and improved the outcome of patients with rheumatoid arthritis (RA), a lot of unresolved problems still exist. Although comorbidity by which enough treatment drugs cannot be prescribed or RA patients refractory to biological agents are representatives, financial difficulty is another representative. There are RA patients who hesitate biological treatment or treatment with Janus-kinase inhibitor due to financial difficulty. Although biosimilar disease-modifying anti-rheumatic drugs (DMARDs) are promising treatment options for such patients, real-world clinical experiences are still lacking in respect to exchanging from biological originator DMARDs to biosimilar DMARDs.ObjectivesThis retrospective study investigated the effects of switching from etanercept originator (ETN-OR) to ETN biosimilar (ETN-BS: LBEC0101 developed by LG Chem) on disease activity, physical function, and patient reported outcome (PRO) regarding a self-injection device in patients with well-controlled RA.MethodsData from the Toyohashi RA Database (TRAD) was used, which is a collection of single-center retrospective data. We retrospectively investigated disease activity, modified health assessment questionnaire (mHAQ), and patient characteristics in 42 RA patients that switched from ETN-OR to ETN-BS at least 6 months prior. Patients were also requested to answer the Toyohashi Self-Injection Assessment Questionnaire (T-SAQ), originally designed to assess PRO. T-SAQ consisted of 18 questions about self-injection device such as burden, learning, pain, convenience, handling and so on. Best was 0 and worst was 4 in each question and mean score of 18 questions was called total T-SAQ score. ResultsAll the patients were female. The mean age, RA duration, and ETN-OR treatment duration were 63.1 years, 18.3 years, and 3107 days, respectively. Mean disease activity and mean mHAQ after switching were as follows (baseline-3 months-6): DAS28-CRP (1.86-2.00-2.03), SDAI (4.3-5.0-5.3), and mHAQ (0.43-0.44-0.46). SDAI after 6 months was significantly elevated compare to baseline. Among each parameter, tender joints count at 3 months and patients’ global assessment at 6 months after switching are significantly increased compared to baseline (Table 1). Other parameters such as swollen joint counts, physician global assessment and CRP were not significantly changed. Total T-SAQ scores before and after switching were 1.3 and 1.1 (p < 0.01), respectively. Ease of use, mental tension, and pain were especially improved after switching to ETN-BS.ConclusionSwitching from ETN-OR to ETN-BS worsened disease activity in well-controlled RA patients in our real-world clinical practice due to not objective findings, but subjective complaints by RA patient. We thought that nocebo effect was one of the reasons to explain the results. On the other hand, the PRO regarding the injection device was improved. This improvement may be due to Finer needle of ETN-BS (ETN-OR: 27G, ETN-OR: 29G).Disclosure of InterestsNone declared
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Hirano Y, Ono Y. AB1016 ROMOSOZUMAB AS A TREATMENT FOR OSTEOPOROSIS: PREDICTORS OF EFFICACY AT 12 MONTHS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2194] [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
BackgroundRomosozumab (ROMO) is an antisclerostin antibody that is used in the treatment of severe osteoporosis (OP). In March 2019, ROMO was approved for use in Japan for treating severe OP in clinical practice, causing an increase in its prescription in our institute. Although efficacy data for ROMO have been presented in clinical trials, there is a lack of real-world data. In our experience, ROMO treatment results in significant bone mineral density (BMD) gain in some patients, but not all. Therefore, understanding the predictors that enhance the efficacy of ROMO treatments to achieve BMD gain is essential.ObjectivesThis study investigated the efficacy of a 12-month ROMO treatment in patients with OP and explored the efficacy predictors of increased BMD.MethodsOur study included 52 patients with OP, who were started on ROMO treatment between June 2019 and August 2020. The following information was collected: 1) baseline characteristics, 2) time-course of BMD (lumbar spine [LS] and total hip [TH]) and bone turnover markers (BTM; bone-specific alkaline phosphatase [BAP], type I procollagen-N-propeptide [P1NP], type I procollagen-N-propeptide[NTX], and tartrate-resistant acid phosphatase-5b [TRACP-5b]), 3) multiple regression analysis results following Spearman’s correlation analysis of increased BMD values (%) at 12 months and BL characteristics, including BTM change (%) at one month, to investigate the efficacy predictors of ROMO.Results1) The mean age of the participants was 72.9 years (48 female and four male). Of the 52 understudied patients, 78.8% had past insufficiency fractures, whereas 21.2% had been treated with concomitant prednisolone. Furthermore, 21 patients had primary OP, 20 had rheumatoid arthritis, nine had glucocorticoid-induced OP, and two had other conditions. Pretreatments for OP were bisphosphonate (33 patients), vitamin D (6), none (5), selective estrogen receptor modulator (4), and denosumab (3).2) Both mean LS- and TH-BMD significantly increased in the patients for whom ROMO administration was continued for 12 months. The average percentage changes of LS- and TH-BMD were 7.1% and 1.6% at six months and 11.7% and 3.0% at 12 months, respectively (Figure 1). However, BAP and P1NP increased steeply at one month, followed by a gradual decrease. As observed, the average percentage changes of BAP and P1NP were +70.1% and +166.8% at one month, +50.3% and +91.7% at six months, and +24.4% and +41.5% at 12 months, respectively. The results also showed that TRACP-5b decreased from one to 12 months, with the average percentage changes being −22.9% at one month, −13.8% at six months, and −17.7% at 12 months. Moreover, NTX, a bone-resorptive marker, was slightly increased during ROMO treatment.3) Multiple regression analysis results revealed that the baseline BAP and percentage calcium changes at 12 months were significant factors positively correlated with the percentage change of LS-BMD at 12 months. As observed, the baseline T-score of LS-BMD was a significant factor negatively correlated with the percentage change of LS-BMD at 12 months. The standardized partial regression coefficient values were +0.68, +0.26, and −0.40, respectively. Moreover, the multiple regression analysis results revealed no significant factor that was correlated with the percentage changes of TH-BMD at 12 months.Figure 1.ConclusionROMO treatments rapidly increased BMD, especially LS-BMD, and changed BTM after one month. Baseline BAP were correlated with increased LS-BMD but not with TH-BMD. The factors correlated with increased BMD may differ between LS-BMD and TH-BMD.Disclosure of InterestsNone declared
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Sano A, Ono Y, Fujita N, Tanaka Y. Spotty skin pigmentation in Carney complex. Cleve Clin J Med 2022; 89:307-308. [PMID: 35649565 DOI: 10.3949/ccjm.89a.21069] [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: 11/14/2022]
Affiliation(s)
- Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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Hirano Y, Ono Y. POS1143 FIVE-YEAR TREATMENT OUTCOME OF DENOSUMAB ON OSTEOPOROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS, IN CLINICAL PRACTICE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1499] [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
BackgroundOsteoporosis (OP) is a frequent complication identified in patients with rheumatoid arthritis (RA). Effective treatment must be provided to treat OP in RA (RAOP). Denosumab (DMB) is a promising drug, currently being used for the treatment of RAOP. Although DMB was determined to be effective in a long-term FREEDOM extension trial [1] for treating postmenopausal OP, its efficacy in the treatment of RAOP in real-world is not be fully evaluated.ObjectivesThis retrospective study assessed the five-year treatment outcome of DMB in Japanese patients with RAOP.MethodsData from the Toyohashi RA Database (TRAD) was used, which is a collection of single-center retrospective data. Our study included 65 female patients with RAOP for whom DMB treatment was initiated between October 2013 and May 2016. The following information was collected: 1) baseline characteristics, 2) DMB continuation rates using the Kaplan–Meier method and reasons for stopping DMB, 3) fracture occurrence during DMB treatment, and 4) time-course of bone mineral density (BMD) [lumbar spine (LS) and total hip (TH)] and bone turnover markers (BTM) [bone-specific alkaline phosphatase (BAP), type I procollagen-N-propeptide (P1NP), type I procollagen-N-propeptide (NTX), and tartrate-resistant acid phosphatase-5b (TRACP-5b)] in 38 patients who underwent DMB treatment over a period of five years.Results1) The mean age and RA duration were 69.4 years (46–86) and 17.2 years (1–49), respectively. Prednisolone and biologics were administered in 21 (32.3%) and 20 (30.8%) patients, respectively. Twenty-seven patients (41.5%) had a history of fragility fractures, and 24 patients (36.9%) had a history of vertebral fractures. Pretreatment drugs for OP were as follows: bisphosphonate in 22 patients; teriparatide, 17; none, 16; activated vitamin D, 7; and selective estrogen receptor modulator, 3.2) Continuation rates of DMB were 96.9% at one year, 95.4% at two years, 85.8% at three years, 79.4% at four years, and 71.1% at five years. DMB treatment was terminated in 24 patients due to lack of efficacy in nine patients, death in seven patients (unknown reason in four, pneumonia in two, and senile decay in one), adverse events except death in five patients (worsening of dementia in two, brain hemorrhage in one, necrosis of jaw in one, and pneumonia in one), and other reasons in three patients.3) Nine patients (13.8%) experienced fractures during DMB treatment; vertebral and non-vertebral fractures occurred in three and four patients, respectively. Two cases of fractures remained undefined.4) Both mean LS-BMD and TH-BMD significantly increased in 38 patients for whom DMB administration was continued for five years. Average percent changes of LS-BMD and TH-BMD were 3.9% and 3.0% at six months, 5.5% and 3.8% at one year, 7.6% and 4.1% at two years, 9.8% and 5.7% at three years, 10.8% and 6.5% at four years, and 12.9% and 6.8% at five years (Figure 1). Four BTMs, BAP, P1NP, NTX, and TRACP-5b, significantly decreased from six months to five years when compared to baseline values, with average changes at 5 years equaling −38.4%, −37.8%, −23.8%, and −24.6%, respectively.ConclusionDMB treatment of RAOP proved effective and reasonably safe, and it increased BMD by a percentage similar to that observed in the FREEDOM extension trial. However, DMB administration was ceased in 13.8% of cases due to fractures and lack of efficacy. Although DMB is recommended for the treatment of RAOP, future evaluations should be conducted to predict its efficacy and determine alternative treatment strategies.References[1]Bone HG et al. Lancet Diabetes Endocrinol. 2017.Disclosure of InterestsNone declared
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Winter MJ, Ono Y, Ball JS, Walentinsson A, Michaelsson E, Tochwin A, Scholpp S, Tyler CR, Rees S, Hetheridge MJ, Bohlooly-Y M. A Combined Human in Silico and CRISPR/Cas9-Mediated in Vivo Zebrafish Based Approach to Provide Phenotypic Data for Supporting Early Target Validation. Front Pharmacol 2022; 13:827686. [PMID: 35548346 PMCID: PMC9082939 DOI: 10.3389/fphar.2022.827686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/16/2022] [Indexed: 12/29/2022] Open
Abstract
The clinical heterogeneity of heart failure has challenged our understanding of the underlying genetic mechanisms of this disease. In this respect, large-scale patient DNA sequencing studies have become an invaluable strategy for identifying potential genetic contributing factors. The complex aetiology of heart failure, however, also means that in vivo models are vital to understand the links between genetic perturbations and functional impacts as part of the process for validating potential new drug targets. Traditional approaches (e.g., genetically-modified mice) are optimal for assessing small numbers of genes, but less practical when multiple genes are identified. The zebrafish, in contrast, offers great potential for higher throughput in vivo gene functional assessment to aid target prioritisation, by providing more confidence in target relevance and facilitating gene selection for definitive loss of function studies undertaken in mice. Here we used whole-exome sequencing and bioinformatics on human patient data to identify 3 genes (API5, HSPB7, and LMO2) suggestively associated with heart failure that were also predicted to play a broader role in disease aetiology. The role of these genes in cardiovascular system development and function was then further investigated using in vivo CRISPR/Cas9-mediated gene mutation analysis in zebrafish. We observed multiple impacts in F0 knockout zebrafish embryos (crispants) following effective somatic mutation, including changes in ventricle size, pericardial oedema, and chamber malformation. In the case of lmo2, there was also a significant impact on cardiovascular function as well as an expected reduction in erythropoiesis. The data generated from both the human in silico and zebrafish in vivo assessments undertaken supports further investigation of the potential roles of API5, HSPB7, and LMO2 in human cardiovascular disease. The data presented also supports the use of human in silico genetic variant analysis, in combination with zebrafish crispant phenotyping, as a powerful approach for assessing gene function as part of an integrated multi-level drug target validation strategy.
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Affiliation(s)
- Matthew J Winter
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Yosuke Ono
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Jonathan S Ball
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Anna Walentinsson
- Translational Science and Experimental Medicine, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Erik Michaelsson
- Early Clinical Development, Research and Early Development, Cardiovascular, Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Anna Tochwin
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Steffen Scholpp
- Living Systems Institute, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Charles R Tyler
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Steve Rees
- Discovery Biology, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Cambridge, United Kingdom
| | - Malcolm J Hetheridge
- Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Mohammad Bohlooly-Y
- Translational Genomics, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Ono Y, Furumura K, Yoshino O, Ota H, Sasaki Y, Hidaka T, Fukushi Y, Hirata S, Yamada H, Wada S. Influence of laparoscopic surgery for endometriosis and its recurrence on perinatal outcomes. Reprod Med Biol 2022; 21:e12456. [PMID: 35414762 PMCID: PMC8986974 DOI: 10.1002/rmb2.12456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/27/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose It is unknown whether surgery for endometriosis or recurrence of endometriosis affects obstetric outcomes. Methods A total of 208 pregnant women with a history of endometriosis were analyzed. Patients who had endometriomas >3 cm and no history of laparoscopic surgery for endometriosis were defined as non‐surgery group (n = 60), while those who had a history of surgery for endometriosis (n = 148) were defined as surgery group. We investigated the obstetric outcomes in 208 patients according to with or without postoperative recurrence of endometriosis and the time from surgery to pregnancy. Results Among 177 cases of on‐going pregnancy, in surgery group, there were lower prevalence of placenta previa compared with non‐surgery group (8.5% vs. 23.4%; p = 0.020). Subgroup analysis revealed a decreased prevalence of placenta previa in postoperative non‐recurrence group (6.0%: p = 0.007) compared with non‐surgery (23.4%) and postoperative recurrence group (28.6%). Placenta previa was more prevalent in the patients who got pregnant more than 2 years after surgery (20.0%) than the patients who got pregnant within 2 years (2.4%: p = 0.002). Multivariate analysis revealed that the surgery was associated with a reduction in placenta previa (OR: 0.32, 95% CI [0.11–0.90]; p = 0.032). Conclusions Pregnancy within two years after laparoscopic surgery for endometriosis may reduce placenta previa.
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Affiliation(s)
- Yosuke Ono
- Department of Obstetrics and Gynecology Teine Keijinkai Hospital Sapparo Japan
| | - Kyoko Furumura
- Department of Obstetrics and Gynecology Tonami General Hospital Toyama Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology University of Yamanashi Yamanashi Japan
| | - Hajime Ota
- Department of Obstetrics and Gynecology Teine Keijinkai Hospital Sapparo Japan
| | - Yasushi Sasaki
- Department of Obstetrics and Gynecology Tonami General Hospital Toyama Japan
| | - Takao Hidaka
- Department of Obstetrics and Gynecology Kurobe City Hospital Kurobe Japan
| | - Yoshiyuki Fukushi
- Department of Obstetrics and Gynecology Teine Keijinkai Hospital Sapparo Japan
| | - Shuji Hirata
- Department of Obstetrics and Gynecology University of Yamanashi Yamanashi Japan
| | - Hideto Yamada
- Center for Recurrent Pregnancy Loss Teine Keijinkai Hospital Sapporo Japan
| | - Shinichiro Wada
- Department of Obstetrics and Gynecology Teine Keijinkai Hospital Sapparo Japan
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Ando Y, Ono Y, Ono S. Pheochromocytoma-related posterior reversible encephalopathy syndrome. Am J Med Sci 2022; 364:e29-e30. [DOI: 10.1016/j.amjms.2022.04.008] [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] [Received: 02/24/2021] [Accepted: 04/06/2022] [Indexed: 11/27/2022]
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