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Kakiuchi T, Matsuo M, Endo H, Sakata Y, Esaki M, Noda T, Imamura I, Hashiguchi K, Ogata S, Fujioka Y, Hanada K, Fukuda K, Yoshimura M, Kajiwara T, Yamamoto K, Yamaguchi D, Kawakubo H, Matsunaga T, Sumino M, Matsunaga K, Muro E, Watanabe A, Fujimoto K. Efficacy and safety of vonoprazan-based regimen for Helicobacter pylori eradication therapy in Japanese adolescents: a prospective multicenter study. J Gastroenterol 2023; 58:196-204. [PMID: 36528706 DOI: 10.1007/s00535-022-01942-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 08/21/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Vonoprazan (VPZ)-based regimen for Helicobacter pylori (H. pylori) is safe and more efficacious than the proton pump inhibitor-based regimen mainly in adults. This study aimed to evaluate the efficacy and safety of a VPZ-based regimen for H. pylori eradication therapy in adolescents. METHODS An H. pylori screening and treatment longitudinal project for third-year junior high school students in Saga Prefecture began in 2016. Students who tested positive for both urine and stool tests received a VPZ-based regimen. On the checklist, students were asked for diarrhea, fever, abdominal pain, nausea, vomiting, urticaria, dysgeusia, or bloody stool occurrence during the therapy. RESULTS The longitudinal project for H. pylori screening and treatment among third-grade students in Saga Prefecture targeted 41,115 students from 2017 to 2021 and 836 as positive. Of the 645 students, 542 (84.0% in per protocol [PP] analysis and 73.6% in intention-to-treat [ITT] analysis) were successful in primary eradication therapy. The secondary eradication therapy was successful in 79 (96.3% in PP analysis and 76.7% in ITT analysis) of 82 students. In the primary eradication therapy, abdominal pain occurred in 164 (27.9%), diarrhea in 217 (36.9%), nausea or vomiting in 7 (1.2%), and urticaria in 13 (2.2%) students. In the secondary eradication therapy, abdominal pain occurred in 12 (19.4%) and diarrhea in 17 (27.4%) students. The eradication therapy of 5 students was interrupted due to adverse events only by primary eradication therapy. CONCLUSIONS VPZ-based regimen for H. pylori was efficacious and safe for adolescents, as in adults, for both primary and secondary eradication therapies.
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Affiliation(s)
- Toshihiko Kakiuchi
- Departments of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.
| | - Muneaki Matsuo
- Departments of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Karatsu, Japan
| | - Yasuhisa Sakata
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takahiro Noda
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
| | - Ichiro Imamura
- Department of Gastroenterology, Imamura Hospital, Tosu, Japan
| | | | - Shinichi Ogata
- Department of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | | | | | - Kayoko Fukuda
- Department of Gastroenterology, Hiramatsu Hospital, Ogi, Japan
| | - Masaya Yoshimura
- Department of Gastroenterology, National Hospital Organization East Saga Hospital, Miyaki, Japan
| | - Tetsuro Kajiwara
- Department of Gastroenterology, Shiroishikyoritsu Hospital, Shiroishi, Japan
| | | | - Daisuke Yamaguchi
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Hiroharu Kawakubo
- Department of Gastroenterology, Imari Arita Kyouritsu Hospital, Arita, Japan
| | - Takuya Matsunaga
- Department of Internal Medicine, National Hospital Organization Saga Hospital, Saga, Japan
| | - Michihiro Sumino
- Department of Internal Medicine, Inutsuka Hospital, Kashima, Japan
| | - Keiji Matsunaga
- Department of Gastroenterology, Oda Hospital, Kashima, Japan
| | - Eriko Muro
- Departments of Pediatrics, Takashima Hospital, Shiroishi, Japan
| | - Akira Watanabe
- Department of Internal Medicine, Taku City Hospital, Taku, Japan
| | - Kazuma Fujimoto
- Department of Gastroenterology, International University of Health and Welfare, Okawa, Japan
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Nakamura A, Kagaya Y, Saito H, Kanazawa M, Sato K, Miura M, Kondo M, Endo H. Efficacy and safety of pemafibrate versus bezafibrate in coronary artery disease patients receiving statin treatment: a randomized, open-label, cross-over study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2665] [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
Fibrates activate peroxisome proliferator-activated receptor (PPAR)-α which is associated with lipid metabolism. Bezafibrate is a non-selective PPAR-α agonist, whereas pemafibrate has been developed as a higher selective PPAR-α agonist.
Objective
The efficacy and safety of pemafibrate for 24-week in patients with dyslipidemia was examined in comparison with bezafibrate.
Methods
Sixty patients with hypertriglyceridemia (fasting triglyceride (TG) level of ≥150 mg/dL) were treated with pemafibrate of 0.2 mg/day or bezafibrate of 400 mg/day for 24-week in a randomized cross-over study. Percent change from baseline in TG levels was the primary endpoint, and that in HDL-C and apolipoprotein A-I (Apo A-I) levels was the secondary endpoints.
Results
A significantly greater reduction in TG percent change was observed in pemafibrate than in bezafibrate (−46.1% vs. −34.7%, p<0.001). There was no significant difference in HDL-C percent change between pemafibrate and bezafibrate (18.4% vs. 14.0%, p=0.067), whereas Apo A-I percent change was significantly greater in pemafibrate than in bezafibrate (9.2% vs. 5.7%, p=0.018). Pemafibrate and bezafibrate significantly decreased alanine aminotransferase (ALT) and gamma-glutamyltransferase (γ-GT) levels, and pemafibrate showed a greater reduction than bezafibrate (ALT: −21.9% vs. −10.6%, p=0.048; γ-GT: −43.5% vs. −33.1%, p=0.025). Creatinine levels significantly increased in both treatments (both p<0.001), however, creatinine percent change was significantly smaller in pemafibrate than in bezafibrate (5.72% vs. 15.5%, p<0.001). There was no difference in frequency of adverse event (AE) or serious AE between two treatments, but frequency of creatinine elevation (≥0.5 mg/d and/or 25%) was significantly higher in bezafibrate than in pemafibrate (16/60 vs. 3/60, p=0.004).
Conclusion
As compared with bezafibrate, pemafibrate is more effective to reduce TG levels and to elevate Apo A-I levels, and it is safer in terms of liver and renal function.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Nakamura
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - H Saito
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Kanazawa
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - K Sato
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Miura
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Kondo
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - H Endo
- Iwate Prefectural Central Hospital , Morioka , Japan
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Ishikawa Y, Tanaka N, Asano Y, Kodera M, Shirai Y, Akahoshi M, Hasegawa M, Matsushita T, Kazuyoshi S, Motegi S, Yoshifuji H, Yoshizaki A, Kohmoto T, Takagi K, Oka A, Kanda M, Tanaka Y, Ito Y, Nakano K, Kasamatsu H, Utsunomiya A, Sekiguchi A, Niro H, Jinnin M, Makino K, Makino T, Ihn H, Yamamoto M, Suzuki C, Takahashi H, Nishida E, Morita A, Yamamoto T, Fujimoto M, Kondo Y, Goto D, Sumida T, Ayuzawa N, Yanagida H, Horita T, Atsumi T, Endo H, Shima Y, Kumanogoh A, Hirata J, Otomo N, Suetsugu H, Koike Y, Tomizuka K, Yoshino S, Liu X, Ito S, Hikino K, Suzuki A, Momozawa Y, Ikegawa S, Tanaka Y, Ishikawa O, Takehara K, Torii T, Sato S, Okada Y, Mimori T, Matsuda F, Matsuda K, Imoto I, Matsuo K, Kuwana M, Kawaguchi Y, Ohmura K, Terao C. OP0112 THE EVER-LARGEST ASIAN GWAS FOR SYSTEMIC SCLEROSIS AND TRANS-POPULATION META-ANALYSIS IDENTIFIED SEVEN NOVEL LOCI AND A CANDIDATE CAUSAL SNP IN A CIS-REGULATORY ELEMENT OF THE FCGR REGION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.665] [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
BackgroundGenome-wide association studies (GWASs) have identified 29 disease-associated single nucleotide polymorphisms (SNPs) for systemic sclerosis (SSc) in non-human leukocyte antigen (HLA) regions (1-7). While these GWASs have clarified genetic architectures of SSc, study subjects were mainly Caucasians limiting application of the findings to Asians.ObjectivesThe study was conducted to identify novel causal variants for SSc specific to Japanese subjects as well as those shared with European population. We also aimed to clarify mechanistic effects of the variants on pathogenesis of SSc.MethodsA total of 114,108 subjects comprising 1,499 cases and 112,609 controls were enrolled in the two-staged study leading to the ever-largest Asian GWAS for SSc. After applying a strict quality control both for genotype and samples, imputation was conducted using the reference panel of the phase 3v5 1,000 genome project data combined with a high-depth whole-genome sequence data of 3,256 Japanese subjects. We conducted logistic regression analyses and also combined the Japanese GWAS results with those of Europeans (6) by an inverse-variance fixed-effect model. Polygenicity and enrichment of functional annotations were evaluated by linkage disequilibrium score regression (LDSC), Haploreg and IMPACT programs. We also constructed polygenic risk score (PRS) to predict SSc development.ResultsWe identified three (FCRLA-FCGR, TNFAIP3, PLD4) and four (EOMES, ESR1, SLC12A5, TPI1P2) novel loci in Japanese GWAS and a trans-population meta-analysis, respectively. One of Japanese novel risk SNPs, rs6697139, located within FCGR gene clusters had a strong effect size (OR 2.05, P=4.9×10-11). We also found the complete LD variant, rs10917688, was positioned in cis-regulatory element and binding motif for an immunomodulatory transcription factor IRF8 in B cells, another genome-wide significant locus in our trans-ethnic meta-analysis and the previous European GWAS. Notably, the association of risk allele of rs10917688 was significant only in the presence of the risk allele of the IRF8. Intriguingly, rs10917688 was annotated as one enhancer-related histone marks, H3K4me1, in B cells, implying that FCGR gene(s) in B cells may play an important role in the pathogenesis of SSc. Furhtermore, significant heritability enrichment of active histone marks and a transcription factor C-Myc were found in B cells both in European and Japanese populations by LDSC and IMPACT, highlighting a possibility of a shared disease mechanism where abnormal B-cell activation may be one of the key drivers for the disease development. Finally, PRS using effects sizes of European GWAS moderately fit in the development of Japanese SSc (AUC 0.593), paving a path to personalized medicine for SSc.ConclusionOur study identified seven novel susceptibility loci in SSc. Downstream analyses highlighted a novel disease mechanism of SSc where an interactive role of FCGR gene(s) and IRF8 may accelerate the disease development and B cells may play a key role on the pathogenesis of SSc.References[1]F. C. Arnett et al. Ann Rheum Dis, 2010.[2]T. R. Radstake et al. Nat Genet, 2010.[3]Y. Allanore et al. PLoS Genet, 2011.[4]O. Gorlova et al. PLoS Genet, 2011.[5]C. Terao et al. Ann Rheum Dis, 2017.[6]E. López-Isac et al. Nat Commun, 2019.[7]W. Pu et al. J Invest Dermatol, 2021.Disclosure of InterestsNone declared
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Funaki T, Kanazawa M, Takahashi S, Seki T, Iguchi A, Kagaya Y, Sato K, Saito H, Kondo M, Miura M, Kawatsu S, Endo H, Oda K, Nakamura A. The orthostatic hypotension in patients with Stanford type A aortic dissection after surgery. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Orthostatic hypotension (OH) is sometimes observed during cardiac rehabilitation in patients with surgery for aortic dissection. However, little is known about the primary determinant of OH and influence of surgical range on incidence of OH.
Purpose
The aim of this study was to elucidate the incidence of OH in patients with surgery for aortic dissection, and compare it between the patients with ascending aortic replacement surgery (ascending group) and those with ascending aorta and hemiarch or total arch replacement surgery (arch group).
Methods
We analyzed 59 patients who underwent emergent surgery due to Stanford type A aortic dissection from January 2014 to March 2018, and compared the incidence of OH between ascending group (n = 28, age 69.8 ± 11.3 years) and arch group (n = 31, age 64.1 ± 13.0 years).
Results
The incidence of OH in total patients was 30.5%. There were no significant differences in patient characteristics including body tall, body weight, antihypertensive use and progress of rehabilitation between 2 groups. The arch group showed a significant higher incidence of OH as compared with ascending group (arch group: 46.4% vs. ascending group: 16.1%, p = 0.03). Moreover, the patients who occurred OH were significantly taller than those who did not occur OH.
Conclusions
OH was observed in about one third of patients with surgery for aortic dissection and it showed a close relationship with patient’s height and the range repaired by surgical operation. More careful cardiac rehabilitation is needed for tall patients with large area replacement of aorta.
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Affiliation(s)
- T Funaki
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kanazawa
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Takahashi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - T Seki
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - A Iguchi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Sato
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - H Saito
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kondo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Miura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Kawatsu
- Iwate Prefectural Central Hospital, Department of Cardiovascular surgery, Morioka, Japan
| | - H Endo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Oda
- Iwate Prefectural Central Hospital, Department of Cardiovascular surgery, Morioka, Japan
| | - A Nakamura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
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Kose E, Endo H, Hori H, Hosono S, Kawamura C, Kodama Y, Yamazaki T, Yasuno N. Association of Pharmacist-led Deprescribing Intervention with the Functional Recovery in Convalescent Setting. Pharmazie 2022; 77:165-170. [PMID: 35655381 DOI: 10.1691/ph.2022.2323] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
So far, no studies investigated the association between pharmacist intervention and rehabilitation outcomes. The aim of study was to establish whether the pharmacist-led deprescribing intervention affects rehabilitation outcomes. This retrospective, observational, single-center, cohort study included consecutive geriatric patients (n = 448) with pharmacist-led intervention between 2017 and 2019. Participants were divided based on pharmacist-led deprescribing and non deprescribing interventions during hospitalization. Demographic data, laboratory data, the Functional Independence Measure were (FIM) analyzed between the groups. Multiple linear regression analysis was performed to analyze the relationship between pharmacist-led deprescribing and FIM total gain. The primary outcome was FIM total gain. The rate of pharmacist intervention during the study period was 92.4%. A multiple linear regression analysis of FMI-T gain, adjusting for confounding factors, revealed that the pharmacist-led deprescribing intervention was independently correlated with FMI-T gain. Particularly, the use of dyslipidemia drugs, antipsychotic drugs, hypnotics, and nonsteroidal anti-inflammatory drugs significantly decreased during hospitalization. The pharmacist-led deprescribing intervention was independently and significantly associated with FIM-T gain. The pharmacist-led deprescribing intervention improved functional recovery in a rehabilitation setting.
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Affiliation(s)
- E Kose
- Department of Pharmacy, Teikyo University School of Medicine University Hospital; Department of Pharmacy, Teikyo University School of Medicine University Hospital, 2-11-1 Kaga, Itabashi-ku, Tokyo 274-8555, Japan;,
| | - H Endo
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - H Hori
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - S Hosono
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - C Kawamura
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - Y Kodama
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - T Yamazaki
- Department of Pharmacy, Ogaki Tokushukai Hospital
| | - N Yasuno
- Department of Pharmacy, Teikyo University School of Medicine University Hospital; Laboratory of Hospital Pharmacy, School of Pharmacy, Teikyo University, Tokyo, Japan
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Toki Y, Yamauchi R, Kayashima E, Adachi K, Kishi K, Suetsugu H, Wada T, Endo H, Yamada H, Osaga S, Kamiya T, Nakada K, Iwakiri K, Haruma K, Joh T. Predictive Factors for Future Onset of Reflux Esophagitis: A Longitudinal Case-control Study Using Health Checkup Records. J Neurogastroenterol Motil 2022; 28:86-94. [PMID: 34980691 PMCID: PMC8748855 DOI: 10.5056/jnm20237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background/Aims Although risk factors of reflux esophagitis (RE) have been investigated in numerous cross-sectional studies, little is known about predictive factors associated with future onset of RE. We investigated time courses of clinical parameters before RE onset by a longitudinal case-control study using health checkup records. Methods We used health checkup records between April 2004 and March 2014 at 9 institutions in Japan. A multivariate logistic regression analysis was performed to evaluate associations of baseline clinical parameters with RE. The time courses of the clinical parameters of RE subjects were compared with those of non-RE subjects by the mixed-effects models for repeated measures analysis or longitudinal multivariate logistic analysis. Results Initial data were obtained from 230 056 individuals, and 2066 RE subjects and 4132 non-RE subjects were finally included in the analysis. Body mass index, alanine aminotransferase, smoking, acid reflux symptoms, hiatal hernia, and absence of atrophic gastritis at baseline were independently associated with RE. The time courses of body mass index, fasting blood sugar, triglyceride, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, percentages of acid reflux symptoms, feeling of fullness, and hiatal hernia in the RE group were significantly worse than in the non-RE group. Conclusions The RE group displayed a greater worsening of the clinical parameters associated with lifestyle diseases, including obesity, diabetes, hyperlipidemia, and fatty liver for 5 years before RE onset compared with the non-RE group. These results suggest that RE is a lifestyle disease and thus lifestyle guidance to at-risk person may help to prevent RE onset.
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Affiliation(s)
- Yuzuru Toki
- Department of Internal Medicine, Hidaka Hospital, Takasaki, Gunma, Japan
| | - Ryo Yamauchi
- Department of Internal Medicine, Mitsubishi Mihara Hospital, Mihara, Hiroshima, Japan
| | - Eizo Kayashima
- Junpukai Health Maintenance Center, Okayama, Okayama, Japan
| | - Kyoichi Adachi
- Health Center, Shimane Environment and Health Public Corporation, Matsue, Shimane, Japan
| | - Kiyohiko Kishi
- Department of Internal Medicine, Meiwa Hospital, Nishinomiya, Hyogo, Japan
| | - Hiroshi Suetsugu
- Department of Preventive Medicine, Matsue Red Cross Hospital, Matsue, Shimane, Japan
| | - Tsuneya Wada
- Public Health Center, Okazaki City Medical Association, Okazaki, Aichi, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Karatsu, Saga, Japan
| | - Hajime Yamada
- Department of Gastroenterology and Hepatology, Shinko Hospital, Kobe, Hyogo, Japan
| | - Satoshi Osaga
- Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Takeshi Kamiya
- Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Koji Nakada
- Department of Laboratory Medicine, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Katsuhiko Iwakiri
- Department of Gastroenterology, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ken Haruma
- Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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Shimada F, Endo H, Takamori A, Matsunaga T, Fujimoto S, Shirai S, Kakiuchi T, Akutagawa T, Sakata Y, Node K, Yamanouchi K, Nakamura S, Fujimoto K, Esaki M. Lifestyle- and comorbidity-related factors for the prescription of proton pump inhibitors after Helicobacter pylori eradication in Japan. JGH Open 2021; 5:1284-1288. [PMID: 34816014 PMCID: PMC8593788 DOI: 10.1002/jgh3.12666] [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: 07/02/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 11/24/2022]
Abstract
Background and Aim The aim of the present study was to examine the lifestyle‐ and comorbidity‐related determinant factors of the prescription of proton pump inhibitors (PPIs) for patients in whom Helicobacter pylori has been eradicated, and to evaluate the relationship between PPI prescription and the severity of endoscopic esophagitis. Methods This retrospective study included patients who underwent H. pylori eradication from May 2012 to September 2016 at Saiseikai Karatsu Hospital. All patients received upper gastrointestinal endoscopy before H. pylori eradication. Patients with open peptic ulcers and/or malignant diseases were excluded, and a final total of 389 patients were evaluated. Medical records were reviewed to determine the prescription of PPIs after H. pylori eradication, lifestyle‐related factors, and comorbidities. Lifestyle‐related factors were confirmed by a questionnaire. Results PPIs were administered to 124 of 389 patients (31.9%). The only lifestyle‐related risk factor for the prescription of PPIs after H. pylori eradication was older age (P < 0.01). Hypertension increased the prescription of PPIs (P = 0.034). The prescription of PPIs was not influenced by the presence of grade A esophagitis, whereas the PPI prescription rate was significantly increased in patients with grades B/C/D endoscopic esophagitis (P < 0.01). The grade of chronic gastritis before H. pylori eradication had no effect on the prescription of PPIs. Conclusion The lifestyle‐ and comorbidity‐related risk factors for the prescription of PPIs after H. pylori eradication were older age and hypertension, while mild endoscopic esophagitis had no influence on PPI prescription.
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Affiliation(s)
- Furitsu Shimada
- Division of Gastroenterology Saiseikai Karatsu Hospital Saga Japan.,Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan.,International University of Health and Welfare Fukuoka Japan
| | - Hiroyoshi Endo
- Division of Gastroenterology Saiseikai Karatsu Hospital Saga Japan
| | - Ayako Takamori
- Division of Clinical Research Center Saga University Hospital Saga Japan
| | - Takuya Matsunaga
- Division of Gastroenterology Saiseikai Karatsu Hospital Saga Japan
| | - Shun Fujimoto
- Division of Gastroenterology Saiseikai Karatsu Hospital Saga Japan.,Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan
| | - Shimpei Shirai
- Division of Gastroenterology Saiseikai Karatsu Hospital Saga Japan
| | - Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine Saga University Saga Japan
| | - Takashi Akutagawa
- Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan
| | - Yasuhisa Sakata
- Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan
| | - Koichi Node
- Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan
| | | | | | - Kazuma Fujimoto
- International University of Health and Welfare Fukuoka Japan
| | - Motohiro Esaki
- Department of Internal Medicine, Faculty of Medicine Saga University Saga Japan
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Takeuchi M, Dohi T, Takahashi N, Endo H, Wada H, Doi S, Kato Y, Ogita M, Okai I, Iwata H, Okazaki S, Isoda K, Suwa S, Miyauchi K, Minamino T. Comparison of clinical effect of living alone between urban area and rural area in patient with acute coronary syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objective
Living alone is reported as an independent risk factor for worse clinical outcomes after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Manifestations of psychological stress such as depression and anxiety in patients living alone is thought to be associated with subsequent cardiovascular events. The impact of living alone on the psychological factors of patients may be differ depending on their living environment. However, comparison of the effects of living alone in different living environment on the prognosis of patients with ACS has not been reported.
Purpose
The aim of the present study was to compare the clinical effect of living alone on clinical outcomes in patients with ACS between urban area and rural area.
Methods
Data from a multi-center, observational study of consecutive patients who underwent emergency PCI for ACS between January 2012 and December 2016 were analyzed. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE). MACCE was defined as composite of cardiovascular death, ACS, and stroke.
Results
In this study, 1349 patients were enrolled and divided into two population according to their living environment: urban area population (n=417), and rural area population (n=932). In urban area population, 87 patients (20.9%) were living alone, and 330 (79.1%) were living together. In rural area population, 169 (18.1%) were living alone, and 763 (81.9%) were living together. There are no significant differences in baseline characteristics between the living alone group and the living together group in both urban area population and rural area population. During a median follow-up period of 2.1 years, Kaplan-Meier curves showed the living alone group had higher risk of MACCE than the living together group in urban area population (log-rank, p=0.01). On the other hands, there are no significant differences in the incidences of MACCE between two groups in rural area population (p=0.86). After adjustment for other covariates, the living alone was significantly associated with MACCE (hazard ratio [HR], 2.83; 95% confidential interval [CI], 1.16–6.91; p=0.02) compared with the living together group in urban area population. However, in rural area population, the living alone group was not significantly associated with MACCE (HR, 1.02; 95% CI, 0.66–1.57; p=0.92) compared with the living together group.
Conclusion
Living alone was significantly associated with worse clinical outcomes after emergency PCI of ACS in urban area but not in rural area.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- M Takeuchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - N Takahashi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Wada
- Juntendo University Shizuoka Hospital, Department of Cardiovascular Medicine, Izunokuni, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - M Ogita
- Juntendo University Shizuoka Hospital, Department of Cardiovascular Medicine, Izunokuni, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Department of Cardiovascular Medicine, Izunokuni, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
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9
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Takeuchi M, Dohi T, Fukase T, Nishio R, Takahashi N, Endo H, Doi S, Kato Y, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Minamino T. Comparison of clinical outcomes between percutaneous coronary intervention for the de novo lesion versus in-stent restenosis lesion. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1118] [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 and objective
Percutaneous coronary intervention (PCI) with metallic coronary stent (bare-metal stents [BMS] and drug-eluting stents [DES]) implantation is most frequently performed therapeutic procedures for coronary artery disease. In-stent restenosis (ISR) is a critical drawback of metallic coronary stents. Incidence of ISR has been reported in up to 30% after BMS implantation. The use of DES has greatly reduced the proportion of restenosis compared with the BMS. However, ISR still remains the primary concern after PCI even in the contemporary DES era, and thought to be associated with worse clinical outcomes. However, comparative data on ISR and de novo lesions are rare.
Purpose
The aim of the present study was to compare the clinical outcomes after PCI for the de novo lesion and the ISR lesion.
Methods
We performed a retrospective analysis of patients who underwent PCI between 2013 and 2020. The incidences of major adverse cardiac and cerebrovascular events (MACCE) and all-cause death were evaluated. MACCE was defined as composite of cardiovascular death, non-fatal myocardial infarction, and stroke.
Results
In this study, 1538 patients were enrolled and divided into two groups: PCI for de novo lesion group (n=1258, 81.8%), and PCI for ISR lesion group (n=280, 18.2%). Patients in the ISR lesion group were significantly older and had higher prevalence of hypertension, diabetes mellitus, dyslipidemia and chronic kidney disease than patients in the de novo lesion group. During a median follow-up period of 1.9 years, Kaplan-Meier curves showed no significant differences in the incidences of MACCE (log-rank, p=0.86) and all-cause death (p=0.84) between two groups. After adjustment for other covariates, PCI for ISR lesion were not significantly associated with MACCE (hazard ratio [HR], 1.10; 95% confidential interval [CI], 0.61–1.97; p=0.76) and all-cause death (HR, 0.93; 95% CI, 0.56–1.56; p=0.79)
Conclusion
PCI for the ISR lesion was not associated with worse clinical outcomes compared with PCI for the de novo lesion.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Takeuchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Fukase
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - R Nishio
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - N Takahashi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Biology and Medicine, Tokyo, Japan
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10
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Takahashi N, Dohi T, Endo H, Nishio R, Fukase T, Takeuchi M, Doi S, Kato Y, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Daida H, Minamino T. The relationship among extent of lipid-rich plaque, factors associated with a reduction of lipid-rich plaque and late lumen loss: a near-infrared spectroscopy and intravascular ultrasound study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) are useful imaging modalities to identify lipid-rich plaque (LRP) which is associated with an increased risk of future cardiovascular events in individuals undergoing PCI. Pathological studies have raised concerns that treating LRP with stents may impair vascular healing. However, the impact of stent implantation to LRP lesions was less known. Moreover, little information is available about changes in the extent of LRP at before and after PCI.
Purpose
The aim of this study was to investigate changes in LRP by NIRS between pre- and post-stent implantation, and to evaluate an association among impact of LRP by NIRS at pre- and post-stenting and late lumen loss (LLL) by angiography.
Methods
We studied 175 lesions in 149 patients who underwent PCI under NIRS-IVUS guidance and follow-up angiography at 8-month later from 2017 to 2020. Plaque characteristics on IVUS, the extent of LRP [defined as a long segment with a 4-mm maximum lipid core burden index (maxLCBI4mm)] on NIRS, and quantitative coronary angiography measurements were analyzed. We evaluated a change of the extent of LRP between pre- and post-stenting at index PCI procedure, and association between the extent of LRP and a 8-month LLL at follow-up coronary angiography. A large LRP was defined as maxLCBI4mm>400 at pre-stenting.
Results
Mean age was 64.5 years old, and 123 (82%) patients were male. The prevalence of large LRP was 51% and median plaque burden at minimum lumen area was 81%. The extent of LRP at culprit lesion significantly decreased from pre- to post-stenting (median maxLCBI4mm [interquartile range (IQR)]: 407 [199, 580] to 133 [13, 319], p<0.001) (Figure 1). In multivariable liner regression analysis, independent predictors for the reduction of LRP were a pre-stenting LRP (β coefficient = −57.0, 95% confidence interval (CI) [−65.1 to −48.8], p<0.001) and plaque burden (β coefficient = −30.0, 95% CI [−56.6 to −3.4], p<0.001), respectively. On the other hands, patient comorbidities, lipid profile and inflammatory markers were not associated with the reduction of LRP (all p>0.05). Median LLL at follow-up angiogram was 0.17 [0.07–0.35] mm. Both the extent of pre- and post-stenting LRP were not associated with LLL (r=0.018, p=0.80 and r=0.022, p=0.76, respectively) (Figure 2). In addition, there was no significant difference in LLL between the post-stenting large and non-large LRP (median [IQR] 0.18 [0.08–0.35] vs. 0.17 [0.07–0.35]; P=0.95).
Conclusions
This study showed coronary stent implantation significantly reduced the NIRS-derived LRP in patients undergoing PCI. Although the extent of pre-stenting LRP and IVUS plaque burden predicted the reduction of LRP, the extent of pre- and post-stenting LRP were not associated with LLL. These findings suggest that stent implantation for LRP, even in a large LRP, is safe and does not affect LLL.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Scatter plotsFigure 2. CENTRAL Figure
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Affiliation(s)
- N Takahashi
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - R Nishio
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - T Fukase
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - M Takeuchi
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Cardiovascular Biology and Medicine, Tokyo, Japan
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11
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Takahashi N, Dohi T, Endo H, Nishio R, Fukase T, Takeuchi M, Doi S, Kato Y, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Daida H, Minamino T. Coronary lipid-rich plaque characteristics with acute coronary syndrome and chronic coronary syndrome: a near infrared spectroscopy and intravascular ultrasound study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Asians have a much lower incidence of adverse coronary events than Caucasians, and the characteristics of vulnerable plaque might be different among the ethnics.
Purpose
The aim of this study was to investigate the clinical characteristics of lipid-rich plaque (LRP) in the Asian population and we also aimed to distinguish the characteristics of an acute coronary syndrome (ACS) culprit lesion and a chronic coronary syndrome (CCS) culprit lesion. Furthermore, we evaluated the association between lipid core burden index (LCBI) and cardiovascular risk factors, lipid profiles, and inflammatory biomarkers, as determined in vivo by near infrared spectroscopy intravascular ultrasound (NIRS-IVUS) imaging in patients undergoing percutaneous coronary intervention (PCI).
Methods
We evaluated 207 patients (ACS, n=75; CCS, n=132) who underwent PCI under NIRS-IVUS. Plaque characteristics and the extent of LRP [defined as a long segment with a 4-mm maximum LCBI (maxLCBI4mm)] on NIRS in de-novo culprit and non-culprit segments were analyzed.
Results
The mean age was 65 years old and 82% of patients were male. The ACS culprit lesions had a significantly higher maxLCBI4mm (median [interquartile range (IQR)]: 533 [385–745] vs. 361 [174–527], p<0.001) than the CCS culprit lesions. Whereas, no significant difference was seen in maxLCBI4mm between ACS and CCS non-culprit lesion segments (246 [53, 342] vs. 185 [37, 350], p=0.47) (Figure 1). Receiver-operating characteristic analysis showed that the NIRS maxLCBI4mm could distinguish the ACS culprit segment from the CCS culprit segment, with a sensitivity of 73% and a specificity of 69% (c-statistic = 0.69; p<0.001, cut-off value of max LCBI4mm = 408) (Figure 2). On multivariate logistic analysis, a large LRP (defined as maxLCBI4mm ≥400) was the strongest independent predictor of the ACS culprit segment (odds ratio, 3.87; 95% confidence interval, 1.95–8.02). In non-culprit segments, 19.8% of patients had at least one large LRP without a small lumen. No significant correlation was found between the extent of LRP and circulating lipid profiles and inflammatory makers biomarkers (hs-CRP, IL-6, TNF-α) in both the culprit and non-culprit lesion segments, whereas the extent of LRP was positively correlated with IVUS plaque burden (r=0.24, p<0.001).
Conclusions
We confirmed that NIRS-IVUS plaque assessment could be useful to differentiate ACS from CCS culprit lesions, and that a threshold maxLCBI4mm ≥400 was clinically suitable in Japanese patients. No systemic surrogate markers were found to be associated with the extent of LRP by NIRS in culprit and non-culprit segments. Consequently, we believe that direct intravascular evaluation of coronary plaque characteristics remains important for identification of high-risk LRP.
Funding Acknowledgement
Type of funding sources: None. Figure 1. The difference of maxLCBI4mmFigure 2. ROC curve
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Affiliation(s)
- N Takahashi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - R Nishio
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - T Fukase
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - M Takeuchi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Minamino
- Juntendo University Graduate School of Medicine, Tokyo, Japan
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12
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Matsuyama T, Endo H, Yamamoto H, Takemasa I, Uehara K, Hanai T, Miyata H, Kimura T, Hasegawa H, Kakeji Y, Inomata M, Kitagawa Y, Kinugasa Y. Outcomes of robot-assisted versus conventional laparoscopic low anterior resection in patients with rectal cancer: propensity-matched analysis of the National Clinical Database in Japan. BJS Open 2021; 5:6374226. [PMID: 34553225 PMCID: PMC8458638 DOI: 10.1093/bjsopen/zrab083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/14/2021] [Accepted: 08/02/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Robot-assisted laparoscopic surgery has several advantages over conventional laparoscopy. However, population-based comparative studies for low anterior resection are limited. This article aimed to compare peri-operative results of robot-assisted low anterior resection (RALAR) and laparoscopy. METHODS This retrospective cohort study used data from patients treated with RALAR or conventional laparoscopic low anterior resection (CLLAR) between October 2018 and December 2019, as recorded in the Japanese National Clinical Database, a data set registering clinical information, perioperative outcomes, and mortality. Of note, the registry does not include information on the tumour location (centimetres from the anal verge) and diverting stoma creation. Perioperative outcomes, including rate of conversion to open surgery, were compared between RALAR and CLLAR groups. Confounding factors were adjusted for using propensity score matching. RESULTS Of 21 415 patients treated during the study interval, 20 220 were reviewed. Two homogeneous groups of 2843 patients were created by propensity score matching. The conversion rate to open surgery was significantly lower in the RALAR group than in the CLLAR group (0.7 versus 2.0 per cent; P < 0.001). The RALAR group had a longer operating time (median: 352 versus 283 min; P < 0.001), less intraoperative blood loss (15 versus 20 ml; P < 0.001), a lower in-hospital mortality rate (0.1 versus 0.5 per cent; P = 0.007), and a shorter postoperative hospital stay (median: 13 versus 14 days; P < 0.001) compared with the CLLAR group. The CLLAR group had a lower rate of readmission within 30 days (2.4 versus 3.3 per cent; P = 0.045). CONCLUSION These data highlight the reduced conversion rate, in-hospital mortality rate, intraoperative blood loss, and length of postoperative hospital stay for rectal cancer surgery in patients treated using robot-assisted laparoscopic surgery compared with laparoscopic low anterior resection.
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Affiliation(s)
- T Matsuyama
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - H Endo
- Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - H Yamamoto
- Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - I Takemasa
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - K Uehara
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Hanai
- Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan
| | - H Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Kimura
- Project Management Subcommittee, Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - H Hasegawa
- Project Management Subcommittee, Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Y Kakeji
- Database Committee, Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - M Inomata
- Department of Gastroenterological and Paediatric Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Y Kitagawa
- Japanese Society of Gastroenterological Surgery, Tokyo, Japan
| | - Y Kinugasa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
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13
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Matsunaga T, Endo H, Takamori A, Shimada F, Takedomi H, Shirai S, Tsuruoka N, Sakata Y, Shimoda R, Anzai K, Node K, Yamanouchi K, Fujimoto K. Lifestyle- and Comorbidity-Related Risk Factors Associated with Prescription of Gastric Acid Secretion Inhibitors to Japanese Patients Who Were Helicobacter pylori Negative and Had No Upper Gastrointestinal Lesions. Digestion 2021; 102:437-445. [PMID: 32097905 DOI: 10.1159/000506153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/27/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to determine the characteristics of patients without Helicobacter pylori infection who were prescribed antacid medications (potassium-competitive acid blockers, proton pump inhibitors, and/or H2 receptor antagonist) and had no upper gastrointestinal lesions detected by endoscopy. METHODS This cross-sectional study included the patients who underwent upper gastrointestinal endoscopy in our institution between August 2017 and July 2018. They were aged from 55 to 89 years, had no upper gastrointestinal lesions detected by endoscopy, and no H. pylori infection. Exclusion criteria comprised low-dose aspirin and/or nonsteroidal anti-inflammatory drugs. The subjects were allocated to middle-aged (55-69 years) and older age groups (70-89 years). The relationships between antacid medications and patient lifestyle and comorbidities were evaluated by multivariate analyses. RESULTS Of the 420 patients, 272 were in the middle-aged group and 148 patients in the older age group. Age was found to be a risk factor for antacid medications in both groups (p = 0.002, p = 0.007). No other lifestyle related factors were risk factors. As to comorbidities, hiatal hernia was positively associated with antacid medications in the middle-aged group (p = 0.002). Hypertension and Ca-blockers were positively associated with prescription of antacids in the older age group (p = 0.013); this association was not significant in the middle-aged group. CONCLUSIONS Three lifestyle-related and/or comorbidity-associated factors known to exacerbate gastroesophageal reflux, namely, age, hiatus hernia, and Ca-blockers, were associated with prescription of antacid medications, even in patients without endoscopic reflux esophagitis.
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Affiliation(s)
- Takuya Matsunaga
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan.,Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroyoshi Endo
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan,
| | - Ayako Takamori
- Division of Clinical Research Center, Saga University Hospital, Saga, Japan
| | - Furitsu Shimada
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan.,Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hironobu Takedomi
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Shimpei Shirai
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Nanae Tsuruoka
- Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yasuhisa Sakata
- Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Ryo Shimoda
- Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Keizo Anzai
- Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Koichi Node
- Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Kohei Yamanouchi
- Division of Gastroenterology, International University of Health and Welfare, Fukuoka, Japan
| | - Kazuma Fujimoto
- Division of Gastroenterology, International University of Health and Welfare, Fukuoka, Japan
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14
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Kakiuchi T, Matsuo M, Endo H, Sakata Y, Esaki M, Noda T, Imamura I, Hashiguchi K, Ogata S, Fujioka Y, Hanada K, Fukuda K, Yoshimura M, Kajiwara T, Yamamoto K, Yamaguchi D, Kawakubo H, Akashi T, Sumino M, Matsunaga K, Muro E, Kuwahara A, Taniguchi K, Fukuyama K, Watanabe A, Takamori A, Okuda M, Yamanouchi K, Fujimoto K. Gastrointestinal adverse reactions reduce the success rate of Helicobacter pylori eradication therapy: A multicenter prospective cohort study. Helicobacter 2021; 26:e12776. [PMID: 33368891 DOI: 10.1111/hel.12776] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The screening and treatment of Helicobacter pylori infection for all junior high students in Saga Prefecture, Japan, were started in 2016. The present study aims to evaluate the influence of adverse reactions on the success of the eradication therapy. METHODS From 2017 to 2019, 25,006 third-grade junior high school students were tested for urinary anti-H. pylori antibodies. Positive cases were confirmed by H. pylori stool antigen tests. Of the 531 students who were found to be H. pylori-positive, 390 (358 in first-line and 32 in second-line therapy) underwent eradication therapy, and 274 (242 in first-line and 32 in second-line) students actually completed a self-reported form to rate stool consistency (based on the Bristol Stool Scale), the maximum number of bowel movements, and abdominal symptoms during the 7 days of treatment. RESULTS Among the 274 students, the total of primary and secondary eradication success rates was 87% (95% confidential interval: 82.9-90.1) in intention-to-treat analysis. On days 4, 5, and 6, stool consistency was looser in the primary eradication failure group than in the success group (p < .05). Looser stool consistencies were observed in male students with abdominal pain compared to those who did not experience pain (p < .05). Abdominal pain and diarrhea were detected in 28.5% and 42.7% of the subjects, respectively. The overall incidence of other adverse events was low (n = 8/274, 2.9%), and only two students discontinued treatment because of adverse events. CONCLUSIONS Softening of the stool was related to the eradication failure in the junior high school students, especially in males with abdominal pain. Adverse effects did not induce discontinuation of the eradication treatment.
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Affiliation(s)
- Toshihiko Kakiuchi
- Departments of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Muneaki Matsuo
- Departments of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Karatsu, Japan
| | - Yasuhisa Sakata
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Takahiro Noda
- Department of Internal Medicine, Karatsu Red Cross Hospital, Karatsu, Japan
| | - Ichiro Imamura
- Department of Gastroenterology, Imamura Hospital, Tosu, Japan
| | | | - Shinichi Ogata
- Department of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | | | | | - Kayoko Fukuda
- Department of Gastroenterology, Hiramatsu Hospital, Ogi, Japan
| | - Masaya Yoshimura
- Department of Gastroenterology, National Hospital Organization East Saga Hospital, Miyaki, Japan
| | - Tetsuro Kajiwara
- Department of Gastroenterology, Shiroishikyoritsu Hospital, Shiroishi, Japan
| | | | - Daisuke Yamaguchi
- Department of Gastroenterology, National Hospital Organization Ureshino Medical Center, Ureshino, Japan
| | - Hiroharu Kawakubo
- Department of Gastroenterology, Imari Arita Kyouritsu Hospital, Nishimatsuura, Japan
| | - Taro Akashi
- Department of Internal Medicine, National Hospital Organization Saga Hospital, Saga, Japan
| | - Michihiro Sumino
- Department of Internal Medicine, Inutsuka Hospital, Kashima, Japan
| | - Keiji Matsunaga
- Department of Gastroenterology, Oda Hospital, Kashima, Japan
| | - Eriko Muro
- Departments of Pediatrics, Takashima Hospital, Kishima, Japan
| | - Atsuo Kuwahara
- Department of Internal Medicine, Ogi Public Hospital, Ogi, Japan
| | | | - Koji Fukuyama
- Department of Internal Medicine, Saga City Fuji-Yamato Spa Hospital, Saga, Japan
| | - Akira Watanabe
- Department of Internal Medicine, Taku City Hospital, Taku, Japan
| | - Ayako Takamori
- Divisions of Clinical Research Center, Saga University Hospital, Saga, Japan
| | - Masumi Okuda
- Department of Pediatrics, Hyogo College of Medicine, Sasayama, Japan
| | - Kohei Yamanouchi
- Department of Gastroenterology, International University of Health and Welfare, Okawa, Japan
| | - Kazuma Fujimoto
- Department of Gastroenterology, International University of Health and Welfare, Okawa, Japan
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15
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Kase K, Saito M, Yamada L, Nakajima S, Ashizawa M, Kanke Y, Hanayama H, Onozawa H, Okayama H, Endo H, Fujita S, Sakamoto W, Saze Z, Momma T, Mimura K, Ohki S, Kono K. 152P ARID1A deficiency in EBV-positive gastric cancer is partially regulated by EBV-encoded miRNAs, but not by DNA promotor hypermethylation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.173] [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: 10/22/2022] Open
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16
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Nakamura A, Kanazawa M, Kagaya Y, Kondo M, Sato K, Endo H, Nozaki E. Effects of evolocumab on plasma levels of proprotein convertase subtilisin/kexin type 9 and lipoprotein(a) in acute myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
There are two types of circulating proprotein convertase subtilisin/kexin type 9 (PCSK9), mature and furin-cleaved. Most types of lipoprotein(a) [Lp(a)], an independent risk factor of cardiovascular events, bound to mature PCSK9.
Purpose
This study examined the effects of monoclonal anti-PCSK9 antibody on plasma PCSK9 and Lp(a) levels in acute myocardial infarction (MI).
Methods
Acute MI patients (n=36) were randomly divided into evolocumab (140 mg; n=17) and non-evolocumab (n=19) groups. Changes in plasma PCSK9 and Lp(a) levels were monitored before and 1, 3, 5, 10, and 20 days after evolocumab administration.
Results
In the non-evolocumab group, plasma levels of mature PCSK9, furin-cleaved PCSK9, and Lp(a) (236.4±57.3 ng/mL, 22.4±5.8 ng/mL, and 19.2. ± 16.5 mg/dL, respectively) significantly increased by day 3 (408.8±77.1 ng/mL, P<0.001; 47.2±15.7 ng/mL, P<0.001; and 39.7±21.3 mg/dL, P<0.005, respectively) and returned to the baseline by day 10 or 20. In the evolocumab group, mature PCSK9 significantly increased by >1000 ng/mL with a simultaneous decline of furin-cleaved PCSK9 below the measurement sensitivity level after day 3. The incremental area under the curve for plasma Lp(a) levels was significantly smaller in the evolocumab group compared with the non-evolocumab group (P=0.038).
Conclusion
Mature and furin-cleaved PCSK9 are transiently upregulated after MI onset. Evolocumab significantly increases mature PCSK9 and decreases furin-cleaved PCSK9 and might inhibit transient increase of plasma Lp(a) in acute MI.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Nakamura
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - M Kanazawa
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - M Kondo
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - K Sato
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - H Endo
- Iwate Prefectural Central Hospital, Morioka, Japan
| | - E Nozaki
- Iwate Prefectural Central Hospital, Morioka, Japan
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17
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Takahashi N, Dohi T, Funamizu T, Endo H, Wada H, Doi S, Kato Y, Ogita M, Okai I, Iwata H, Okazaki S, Isoda K, Miyauchi K, Shimada K. Combined impact of residual inflammatory risk and chronic kidney disease on long-term clinical outcomes in patients undergoing percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Inflammatory status pre-percutaneous coronary intervention (PCI) and post-PCI has been reported not only associated with poor prognosis, but also to impair renal function. Statins reduce cardiovascular events by lowering lipids and have anti-inflammatory impacts, but residual inflammatory risk (RIR) exists. It remains unclear that the synergistic effect of RIR and chronic kidney disease (CKD) on long-term clinical outcome in stable coronary artery disease (CAD) patients undergoing PCI in statin era.
Aim
The aim of this study was to investigate the long-term combined impact of RIR evaluating hs-CRP at follow-up and CKD among stable CAD patients undergoing PCI in statin era.
Methods
This is a single-center, observational, retrospective cohort study assessing consecutive 2,984 stable CAD patients who underwent first PCI from 2000 to 2016. We analyzed 2,087 patients for whom hs-CRP at follow-up (6–9 months later) was available. High residual inflammatory risk was defined as hs-CRP >0.6 mg/L according to the median value at follow up. Patients were assigned to four groups as Group1 (high RIR and CKD), Group2 (low RIR and CKD), Group3 (high RIR and non-CKD) or Group4 (low RIR and non-CKD). We evaluated all-cause death and major adverse cardiac events (MACE), defined as a composite of cardiovascular (CV) death, non-fatal myocardial infarction (MI) and non-fatal stroke.
Results
Of patients (83% men; mean age 67 years), there were 299 (14.3%) patients in group 1, 201 (9.6%) patients in group 2, 754 (36.1%) patients in group 3, and 833 (39.9%) patients in group 4. The median follow-up period was 5.2 years (IQR, 1.9–9.9 years). In total, 189 (frequency, 16.1%) cases of all-cause death and 128 (11.2%) MACE were identified during follow-up, including 53 (4.6%) CV deaths, 27 (2.4%) MIs and 52 (4.8%) strokes. The rate of all-cause death and MACE in group 1 was significantly higher than other groups (p<0.001, respectively). There was a stepwise increase in the incidence rates of all-cause death and MACE. After adjustment for important covariates, the presence of high RIR and/or CKD were independently associated with higher incidence of MACE and higher all-cause mortality. (shown on figure).
Conclusion
The presence of both high RIR and CKD conferred a synergistic adverse effect on the risk for long-term adverse cardiac events in patients undergoing PCI.
Kaplan-Meier curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Takahashi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - T Funamizu
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Endo
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Wada
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - S Doi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - Y Kato
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - M Ogita
- Juntendo University Shizuoka Hospital, Cardiology, Izunokuni, Japan
| | - I Okai
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Cardiovascular Medicine, Tokyo, Japan
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18
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Kanazawa M, Toyoda M, Seki T, Iguchi A, Takahashi S, Kagaya Y, Sato K, Saito H, Ito K, Miura M, Kondo M, Kawatsu S, Endo H, Oda K, Nakamura A. Chronotropic incompetence and exercise capacity after mitral valve surgery: the importance of blood hemoglobin level. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronotropic incompetence (CI) is sometimes observed during exercise training of cardiac rehabilitation in patients with cardiac surgery, however, little is known concerning the differences between patients with mitral valve (MV) and aortic valve (AV) surgery.
Purpose
Because the possibility exists that cardiac sympathetic nerves might be impaired by left atrium incision, we hypothesized that the incidence of CI was higher in patients with MV surgery (Mitral Valve Replacement and Mitral Valvuloplasty) as compared with patients with AV surgery (Aortic Valve Replacement). And if so, which factor determines the exercise capacity of patients after MV surgery. We thus aimed this study to elucidate the hypothesis with cardiopulmonary exercise testing (CPX).
Methods
We performed CPX by ramp loading with ergometer exercise in total 61 patients who had undergone elective cardiac valve operation (25 patients with MV surgery, age 59.2±9.9 years; 36 patients with AV surgery, age 64.6±12.3 years). We analyzed chronotropic response index (CRI), peak oxygen uptake (peak VO2/W), anaerobic threshold (AT), and peak oxygen pulse (peak VO2/HR) with CPX, and blood hemoglobin concentration (Hb).
Results
The value of CRI was significantly decreased in the patients with MV surgery compared with those with AV surgery (MV; 0.19±0.10 vs. AV; 0.41±0.17, p<0.001). Peak VO2, peak VO2/HR and Hb were not significantly different between patients with MV and those with AV surgery. Patients with MV surgery showed correlations between peak VO2 and Hb (r=0.45, p<0.05), AT and Hb (r=0.52, p<0.01), and a strong correlation between peak VO2 and peak VO2/HR (r=0.63, p<0.001), but not in those with AV surgery.
Conclusions
The present study demonstrated that higher incidence of CI was shown in patients with MV surgery as compared with those with AV surgery. The exercise capacity of patients with MV surgery was determined by peak VO2/HR and Hb. These results suggest that 1) left atrium incision impairs cardiac sympathetic nerves and causes CI, 2) peak VO2/HR which is consisted of arterio-venous oxygen difference and Hb is critical indicator for exercise capacity in patients with MV surgery with CI.
Main results
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Kanazawa
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Toyoda
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - T Seki
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - A Iguchi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - S Takahashi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Sato
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - H Saito
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Ito
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - M Miura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kondo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Kawatsu
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - H Endo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Oda
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - A Nakamura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
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19
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Imahori Y, Endo H, Ohtani Y. Changes in subcellular localization of enzymes involved in ascorbate-glutathione cycle during the maturation of sweet pepper (Capsicum annuum L.) fruit. ACTA ACUST UNITED AC 2020. [DOI: 10.17660/actahortic.2020.1292.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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20
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Kunimasa K, Nakamura H, Sakai K, Kimura M, Inoue T, Tamiya M, Nishino K, Kumagai T, Nakatsuka S, Endo H, Inoue M, Nishio K, Imamura F. Heterogeneity of EGFR-mutant clones and PD-L1 highly expressing clones affects treatment efficacy of EGFR-TKI and PD-1 inhibitor. Ann Oncol 2019; 29:2145-2147. [PMID: 30099497 DOI: 10.1093/annonc/mdy312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Kunimasa
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan.
| | - H Nakamura
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka City, Japan
| | - K Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - M Kimura
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
| | - T Inoue
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
| | - M Tamiya
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
| | - K Nishino
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
| | - T Kumagai
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
| | - S Nakatsuka
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka City, Japan
| | - H Endo
- Department of Biochemistry, Osaka International Cancer Institute, Osaka City, Japan
| | - M Inoue
- Department of Biochemistry, Osaka International Cancer Institute, Osaka City, Japan; Department of Clinical Bio-resource Research and Development, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - K Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - F Imamura
- Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka City, Japan
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21
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Sugishita Y, Sugawara T, Ohkusa Y, Ishikawa T, Yoshida M, Endo H. Syndromic surveillance using ambulance transfer data in Tokyo, Japan. J Infect Chemother 2019; 26:8-12. [PMID: 31611069 DOI: 10.1016/j.jiac.2019.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/08/2019] [Accepted: 09/15/2019] [Indexed: 11/28/2022]
Abstract
Bioterrorism attacks become more probable when important high-profile international or political events are held, such as G7 summit meetings or mass gathering events including Olympic and Paralympic games and FIFA World Cup tournaments. Outbreaks of infectious disease and widespread incidents of food poisoning are also public health concerns at such times. In Japan, the Tokyo Metropolitan Government operates Ambulance Transfer Syndromic Surveillance (ATSS), which can help monitor such incidents. The present study presents and assesses the ATSS framework. During the study period of October 2017 through November 2018, we monitored 33 areas for symptoms of 9 categories: vomiting/nausea, dizziness, palpitation, unconsciousness, breathing disorder, fever, spasm/paralysis, collapse/weakness, and bloody emesis/nasal hemorrhage. Among all symptoms, we found 9929 low-level aberrations, 2537 medium-level aberrations, and 577 high-level aberrations, with respective frequencies of 9.2%, 2.3%, and 0.5%. Of those, Tokyo Metropolitan Institute of Public Health reported the information to Tokyo Metropolitan Government 28 times during the period. Of the 28 identified clusters, Tokyo Metropolitan Government judged the necessity for investigating 7. All of those were investigated at hospitals by the jurisdictional public health center. Because ATSS covers almost the entire Tokyo metropolitan area, with about 13.8 million residents, it is definitely the largest syndromic surveillance in the world.
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Affiliation(s)
- Yoshiyuki Sugishita
- National Institute of Infectious Diseases, Japan; Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Japan.
| | | | | | | | - Michihiko Yoshida
- Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, Japan
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22
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Takara Y, Endo H, Nakano R, Kawachi K, Hidaka H, Matsunaga T, Tsuruoka N, Sakata Y, Shimoda R, Hara M, Fujimoto K. Smoking and Drinking Did Not Increase the Failure of Therapeutic Helicobacter pylori Eradication by Vonoprazan, Clarithromycin, and Amoxicillin. Digestion 2019; 99:172-178. [PMID: 30179876 DOI: 10.1159/000490889] [Citation(s) in RCA: 15] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/12/2018] [Indexed: 02/04/2023]
Abstract
AIMS The influence of lifestyle-related factors, including smoking and drinking, was evaluated for Helicobacter pylori eradication therapy with vonoprazan or proton pump inhibitors (PPIs). METHODS Between 2012 and 2016, the medical records of 620 patients receiving H. pylori eradication therapy at Saiseikai Karatsu Hospital were evaluated. Patients had received vonoprazan (20 mg) or PPIs with 200 mg clarithromycin and 750 mg amoxicillin twice daily for 7 days. The influence of lifestyle-related factors on eradication failure was determined in the 2 groups. RESULTS The eradication rates for vonoprazan and lansoprazole, rabeprazole, and esomeprazole were, respectively, 91.0, 73.8, 72.0, and 84.6%. The vonoprazan eradication rate was significantly higher than those for the PPIs (p < 0.01). Habitual smoking and drinking did not increase eradication failure, and smoking and drinking during the eradication period did not reduce the eradication rate. Metabolic syndrome-related factors including obesity, hypertension, and diabetes mellitus had no negative influence on the eradication rate. Eradication with vonoprazan was more effective compared with that achieved through the use of PPIs. CONCLUSION Lifestyle-related factors including smoking and drinking did not exacerbate the H. pylori eradication failure, and vonoprazan was more effective than the PPIs.
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Affiliation(s)
- Yoshimichi Takara
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Hiroyoshi Endo
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga,
| | - Ryo Nakano
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Kojiro Kawachi
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Hidenori Hidaka
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Takuya Matsunaga
- Division of Gastroenterology, Saiseikai Karatsu Hospital, Saga, Japan
| | - Nanae Tsuruoka
- Departments of Internal Medicine, Saga Medical School, Saga, Japan
| | - Yasuhisa Sakata
- Departments of Internal Medicine, Saga Medical School, Saga, Japan
| | - Ryo Shimoda
- Departments of Internal Medicine, Saga Medical School, Saga, Japan
| | - Megumi Hara
- Departments of Preventive Medicine, Saga Medical School, Saga, Japan
| | - Kazuma Fujimoto
- Departments of Internal Medicine, Saga Medical School, Saga, Japan
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23
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Kakiuchi T, Matsuo M, Endo H, Nakayama A, Sato K, Takamori A, Sasaki K, Takasaki M, Hara M, Sakata Y, Okuda M, Kikuchi S, Eguchi Y, Takahashi H, Anzai K, Fujimoto K. A Helicobacter pylori screening and treatment program to eliminate gastric cancer among junior high school students in Saga Prefecture: a preliminary report. J Gastroenterol 2019; 54:699-707. [PMID: 30770975 DOI: 10.1007/s00535-019-01559-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 02/07/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND To present the strategies and preliminary findings of the first 3 years after implementing a Helicobacter pylori screening and eradication program to prevent gastric cancer in Saga Prefecture. METHODS A screening and treatment program to eradicate H. pylori from third-grade junior high students was started in Saga Prefecture in 2016, using local governmental grants. Screening was with urinary anti-H. pylori antibody tests, followed by H. pylori stool antigen tests for students who were antibody positive. Those positive on both tests underwent H. pylori eradication by triple therapy based on a potassium-competitive acid blocker. RESULTS From 2016 to 2018, the participation rate was 83.1% and the H. pylori infection rate was 3.1% (660/21,042). The participation rates were higher in 2017 (85.4%) and 2018 (85.9%) compared with 2016 (78.5%) (P < 0.0001), and the infection rate also decreased in a time-dependent manner (2016: 3.6%, 2017: 3.3%, 2018: 2.5%, P = 0.0001). In total, 501 students positive for H. pylori received eradication therapy (85.1% success) and adverse events occurred in 20 of these (4.0%). However, no serious complications occurred. CONCLUSIONS The H. pylori screening and eradication project for school students in Saga Prefecture has started successfully and we have seen both a steady increase in the participation rate and a steady decrease in the infection rate, without major safety concerns.
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Affiliation(s)
- Toshihiko Kakiuchi
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan.
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, 817 Motohata-machi, Karatsu-shi, 847-0852, Japan
| | - Aiko Nakayama
- Department of Pediatrics, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Keiko Sato
- Clinical Research Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Kazumi Sasaki
- Saga Cancer Center, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Mitsuhiro Takasaki
- Medical Informatics, Saga University Hospital, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Megumi Hara
- Department of Prevention Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Yasuhisa Sakata
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Masumi Okuda
- Department of Pediatrics, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute-shi, 480-1195, Aichi, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute-shi, 480-1195, Aichi, Japan
| | - Yuichiro Eguchi
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Hirokazu Takahashi
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Keizo Anzai
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
| | - Kazuma Fujimoto
- Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, 849-8501, Saga, Japan
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24
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Takedomi H, Tsuruoka N, Takamori A, Miyahara K, Yamanouchi K, Shimamura T, Fujimoto Y, Noda T, Matsunaga T, Takara Y, Shimada F, Hidaka H, Endo H, Anzai K, Fujimoto K. Correlation of Barrett's esophagus with colorectal polyps in Japanese patients: A retrospective chart review. J Gastroenterol Hepatol 2019; 34:1160-1165. [PMID: 30667560 DOI: 10.1111/jgh.14610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Barrett's esophagus and colorectal polyps have several overlapping risk factors. Whereas several reports in Western countries have indicated a close relationship between Barrett's esophagus and colorectal polyps, the relationship between these two diseases remains unclear in Japan. This study was performed to determine whether the prevalence of Barrett's esophagus is related to that of colorectal polyps in Japanese patients. METHODS The present retrospective chart review included 1582 Japanese patients who underwent both total colonoscopy and esophagogastroduodenoscopy from January 2010 to December 2016. The data on colorectal polyps and Barrett's esophagus were obtained from the endoscopic findings. The medical record of each patient was checked for age, sex, body mass index, smoking, alcohol drinking, use of acid suppression agents, and comorbidities including a history of diabetes, ischemic heart disease, gastroesophageal reflux disease, hiatal hernia, and Helicobacter pylori infection. RESULTS Colorectal polyps were detected in 789 of the 1582 patients (49.9%). Barrett's esophagus was detected in 233 patients (14.7%), and most cases of Barrett's esophagus (n = 229) were classified as short-segment Barrett's esophagus. Colorectal polyps were more frequent in patients with than without Barrett's esophagus (odds ratio, 1.79; 95% confidence interval, 1.31-2.46; P < 0.001). In addition to Barrett's esophagus, the data indicated that old age, male sex, obesity, smoking, alcohol drinking, diabetes mellitus, and ischemic heart disease were independent risk factors for colorectal polyps. CONCLUSIONS The present study revealed the correlation between the prevalence of Barrett's esophagus and colorectal polyps in Japanese patients.
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Affiliation(s)
- Hironobu Takedomi
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.,Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Nanae Tsuruoka
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.,Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Ayako Takamori
- Clinical Research Center, Saga Medical School, Saga, Japan
| | - Koichi Miyahara
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan
| | - Kohei Yamanouchi
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Takuya Shimamura
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Yo Fujimoto
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan
| | - Takahiro Noda
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan
| | - Takuya Matsunaga
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Yoshimichi Takara
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Furitsu Shimada
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan.,Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Hidenori Hidaka
- Department of Internal Medicine, Karatsu Red Cross Hospital, Saga, Japan.,Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan
| | - Hiroyoshi Endo
- Department of Internal Medicine, Saiseikai Karatsu Hospital, Saga, Japan
| | - Keizo Anzai
- Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
| | - Kazuma Fujimoto
- Departments of Internal Medicine and Clinical Research Center, Saga Medical School, Saga, Japan
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25
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Endo H, Dohi T, Miyauchi K, Funamizu T, Shitara J, Wada H, Doi S, Iwata H, Kasai T, Okazaki S, Isoda K, Daida H. 6134Long-term predictive value of high sensitivity c-reactive protein for cancer mortality in patients undergoing percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- H Endo
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - T Dohi
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - T Funamizu
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - J Shitara
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - H Wada
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - S Doi
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - T Kasai
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - S Okazaki
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University, Department of Cardiovasculer Medicine, Tokyo, Japan
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26
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Shitara J, Kasai T, Miyauchi K, Endo H, Wada H, Doi S, Naito R, Konishi H, Tsuboi S, Ogita M, Dohi T, Okazaki S, Isoda K, Daida H. P6535Differing efficacy of beta blockers on long-term clinical outcomes between ischemic heart failure patients with reduced and mid-range ejection fraction following percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Shitara
- Juntendo University, Circulation, Tokyo, Japan
| | - T Kasai
- Juntendo University, Circulation, Tokyo, Japan
| | - K Miyauchi
- Juntendo University, Circulation, Tokyo, Japan
| | - H Endo
- Juntendo University, Circulation, Tokyo, Japan
| | - H Wada
- Juntendo University, Circulation, Tokyo, Japan
| | - S Doi
- Juntendo University, Circulation, Tokyo, Japan
| | - R Naito
- Juntendo University, Circulation, Tokyo, Japan
| | - H Konishi
- Juntendo University Shizuoka Hospital, Circulation Department, Izunokuni, Japan
| | - S Tsuboi
- Juntendo University Shizuoka Hospital, Circulation Department, Izunokuni, Japan
| | - M Ogita
- Juntendo University Shizuoka Hospital, Circulation Department, Izunokuni, Japan
| | - T Dohi
- Juntendo University, Circulation, Tokyo, Japan
| | - S Okazaki
- Juntendo University, Circulation, Tokyo, Japan
| | - K Isoda
- Juntendo University, Circulation, Tokyo, Japan
| | - H Daida
- Juntendo University, Circulation, Tokyo, Japan
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27
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Mita T, Hombhanje F, Takahashi N, Sekihara M, Yamauchi M, Tsukahara T, Kaneko A, Endo H, Ohashi J. Rapid selection of sulphadoxine-resistant Plasmodium falciparum and its effect on within-population genetic diversity in Papua New Guinea. Sci Rep 2018; 8:5565. [PMID: 29615786 PMCID: PMC5882878 DOI: 10.1038/s41598-018-23811-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 03/21/2018] [Indexed: 11/18/2022] Open
Abstract
The ability of the human malarial parasite Plasmodium falciparum to adapt to environmental changes depends considerably on its ability to maintain within-population genetic variation. Strong selection, consequent to widespread antimalarial drug usage, occasionally elicits a rapid expansion of drug-resistant isolates, which can act as founders. To investigate whether this phenomenon induces a loss of within-population genetic variation, we performed a population genetic analysis on 302 P. falciparum cases detected during two cross-sectional surveys in 2002/2003, just after the official introduction of sulphadoxine/pyrimethamine as a first-line treatment, and again in 2010/2011, in highly endemic areas in Papua New Guinea. We found that a single-origin sulphadoxine-resistant parasite isolate rapidly increased from 0% in 2002/2003 to 54% in 2010 and 84% in 2011. However, a considerable number of pairs exhibited random associations among 10 neutral microsatellite markers located in various chromosomes, suggesting that outcrossing effectively reduced non-random associations, albeit at a low average multiplicity of infection (1.35–1.52). Within-population genetic diversity was maintained throughout the study period. This indicates that the parasites maintained within-population variation, even after a clonal expansion of drug-resistant parasites. Outcrossing played a role in the preservation of within-population genetic diversity despite low levels of multiplicity of infection.
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Affiliation(s)
- Toshihiro Mita
- Department of Tropical Medicine and Parasitology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan.
| | - Francis Hombhanje
- Centre for Health Research & Diagnostics, Divine Word University, Nabasa Road, P.O. Box 483, Madang, Papua New Guinea
| | - Nobuyuki Takahashi
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Makoto Sekihara
- Department of Tropical Medicine and Parasitology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan
| | - Masato Yamauchi
- Department of Tropical Medicine and Parasitology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan
| | - Takahiro Tsukahara
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Akira Kaneko
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Department of Parasitology, Osaka City University Graduate School of Medicine, Asahi-cho 1-4-3, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroyoshi Endo
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Jun Ohashi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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28
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Wada H, Dohi T, Miyauchi K, Shitara J, Endo H, Doi S, Konishi H, Naito R, Tsuboi S, Ogita M, Kasai T, Hassan A, Okazaki S, Isoda K, Suwa S, Daida H. Long-term clinical impact of serum albumin in coronary artery disease patients with preserved renal function. Nutr Metab Cardiovasc Dis 2018; 28:285-290. [PMID: 29289574 DOI: 10.1016/j.numecd.2017.11.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND AIMS Low serum albumin level is reportedly associated with worse clinical outcomes in patients with chronic kidney disease (CKD). However, associations between decreased serum albumin level and outcomes in non-CKD patients with coronary artery disease (CAD) remain unclear. Therefore, we aimed to evaluate the prognostic value of serum albumin concentrations in stable CAD patients with preserved renal function. METHODS AND RESULTS We studied 1316 patients with CAD and preserved renal function (estimated glomerular filtration rate ≥60 mL/min/1.73 m2) who underwent their first PCI between 2000 and 2011 and had data available for pre-procedural serum albumin. Patients were assigned to quartiles based on pre-procedural albumin concentrations. The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. Mean albumin concentration was 4.1 ± 0.4 g/dL. During the median follow-up of 7.5 years, 181 events occurred (13.8%). Kaplan-Meier curves revealed that patients with decreased serum albumin concentrations showed a higher event rate for MACE (log-rank, p < 0.0001). Using the highest tertiles (>4.3 g/dL) as reference, adjusted hazard ratios were 1.97 (95% CI, 1.12-3.55), 1.77 (95% CI, 0.99-3.25), and 1.19 (95% CI, 0.68-2.15) for serum albumin concentrations of <3.9, 3.9-4.0, and 4.1-4.3 g/dL, respectively. Decreased serum albumin concentration was associated with MACE even after adjusting for other independent variables (HR, 2.21 per 1-g/dL decrease; 95% CI, 1.37-3.56, p = 0.001). CONCLUSION Decreased serum albumin concentration independently predicted worse long-term prognosis in non-CKD patients after PCI. Pre-procedural serum albumin concentration could offer a useful predictor for patients with CAD and preserved renal function.
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Affiliation(s)
- H Wada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Dohi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - K Miyauchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - J Shitara
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Endo
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Doi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - H Konishi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - R Naito
- Department of Cardiovascular Medicine, Juntendo University Urayasu Hospital, Urayasu, Chiba, Japan
| | - S Tsuboi
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - M Ogita
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - T Kasai
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Hassan
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Cardiology, Suez Canal University, Ismailia, Egypt
| | - S Okazaki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Isoda
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Suwa
- Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan
| | - H Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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29
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Kamiyanagi A, Sumita Y, Ino S, Chikai M, Nakane A, Tohara H, Minakuchi S, Seki Y, Endo H, Taniguchi H. Evaluation of swallowing ability using swallowing sounds in maxillectomy patients. J Oral Rehabil 2017; 45:126-131. [PMID: 29197111 DOI: 10.1111/joor.12593] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 11/28/2022]
Abstract
Maxillectomy for oral tumours often results in debilitating oral hypofunction, which markedly decreases quality of life. Dysphagia, in particular, is one of the most serious problems following maxillectomy. This study used swallowing sounds as a simple evaluation method to evaluate swallowing ability in maxillectomy patients with and without their obturator prosthesis placed. Twenty-seven maxillectomy patients (15 men, 12 women; mean age 66.0 ± 12.1 years) and 30 healthy controls (14 men, 16 women; mean age 44.9 ± 21.3 years) were recruited for this study. Participants were asked to swallow 4 mL of water, and swallowing sounds were recorded using a throat microphone. Duration of the acoustic signal and duration of peak intensity (DPI) were measured. Duration of peak intensity was significantly longer in maxillectomy patients without their obturator than with it (P < .05) and was significantly longer in maxillectomy patients without their obturator than in healthy controls (P < .025 after Bonferroni correction). With the obturator placed, DPI was significantly longer in maxillectomy patients who had undergone soft palate resection than in those who had not (P < .05). These results suggest swallowing ability in maxillectomy patients could be improved by wearing an obturator prosthesis, particularly during the oral stage. However, it is difficult to improve the oral stage of swallowing in patients who have undergone soft palate resection even with obturator placement.
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Affiliation(s)
- A Kamiyanagi
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Y Sumita
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - S Ino
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - M Chikai
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - A Nakane
- Department of Gerodontology and Oral Rehabilitation, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - H Tohara
- Department of Gerodontology and Oral Rehabilitation, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - S Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Y Seki
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - H Endo
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - H Taniguchi
- Department of Maxillofacial Prosthetics, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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30
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Shibasaki S, Takamizawa T, Nojiri K, Imai A, Tsujimoto A, Endo H, Suzuki S, Suda S, Barkmeier WW, Latta MA, Miyazaki M. Polymerization Behavior and Mechanical Properties of High-Viscosity Bulk Fill and Low Shrinkage Resin Composites. Oper Dent 2017; 42:E177-E187. [DOI: 10.2341/16-385-l] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The present study determined the mechanical properties and volumetric polymerization shrinkage of different categories of resin composite. Three high viscosity bulk fill resin composites were tested: Tetric EvoCeram Bulk Fill (TB, Ivoclar Vivadent), Filtek Bulk Fill posterior restorative (FB, 3M ESPE), and Sonic Fill (SF, Kerr Corp). Two low-shrinkage resin composites, Kalore (KL, GC Corp) and Filtek LS Posterior (LS, 3M ESPE), were used. Three conventional resin composites, Herculite Ultra (HU, Kerr Corp), Estelite ∑ Quick (EQ, Tokuyama Dental), and Filtek Supreme Ultra (SU, 3M ESPE), were used as comparison materials. Following ISO Specification 4049, six specimens for each resin composite were used to determine flexural strength, elastic modulus, and resilience. Volumetric polymerization shrinkage was determined using a water-filled dilatometer. Data were evaluated using analysis of variance followed by Tukey's honestly significant difference test (α=0.05). The flexural strength of the resin composites ranged from 115.4 to 148.1 MPa, the elastic modulus ranged from 5.6 to 13.4 GPa, and the resilience ranged from 0.70 to 1.0 MJ/m3. There were significant differences in flexural properties between the materials but no clear outliers. Volumetric changes as a function of time over a duration of 180 seconds depended on the type of resin composite. However, for all the resin composites, apart from LS, volumetric shrinkage began soon after the start of light irradiation, and a rapid decrease in volume during light irradiation followed by a slower decrease was observed. The low shrinkage resin composites KL and LS showed significantly lower volumetric shrinkage than the other tested materials at the measuring point of 180 seconds. In contrast, the three bulk fill resin composites showed higher volumetric change than the other resin composites. The findings from this study provide clinicians with valuable information regarding the mechanical properties and polymerization kinetics of these categories of current resin composite.
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Affiliation(s)
- S Shibasaki
- Sho Shibasaki, DDS, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - T Takamizawa
- Toshiki Takamizawa, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - K Nojiri
- Kie Nojiri, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - A Imai
- Arisa Imai, DDS, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - A Tsujimoto
- Akimasa Tsujimoto, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - H Endo
- Hajime Endo, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - S Suzuki
- Soshi Suzuki, DDS, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - S Suda
- Syunichi Suda, DDS, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - WW Barkmeier
- Wayne W Barkmeier, EBM, DDS, MS, General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
| | - MA Latta
- Mark A Latta, DMD, MS, General Dentistry, Creighton University School of Dentistry, Omaha, NE, USA
| | - M Miyazaki
- Masashi Miyazaki, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
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31
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Hirano S, Ma Y, Peng S, Shimada H, Shinotoh H, Endo H, Nakano Y, Li H, Higuchi M, Kuwabara S, Eidelberg D, Suhara T. Abnormal metabolic brain networks in progressive supranuclear palsy and corticobasal syndrome: diagnostic performance using perfusion spect scans in patients with movement disorders. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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32
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Komaki R, Oda T, Takata M, Endo H, Hosomi M, Hamaguchi H. Frailty and malnutrition predict poor outcomes in acute ischemic stroke patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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33
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Ohta K, Ito J, Shimizu H, Takahashi H, Kakita A, Tobinaga M, Endo H, Ikeda T, Aida I, Yonemoti Y, Ozawa T, Nakajima T. A case of sporadic amyotrophic lateral sclerosis presenting with chorea as the initial symptom. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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34
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Yonemochi Y, Tobinaga M, Ikeda T, Endo H, Oota K, Aida I, Nakajima T, Takahara M, Ozawa T, Tanaka H, Toyoshima Y, Takahashi H, Kakita A. Clinico-pathological consolidation of fibro-dysplasia ossification progressiva. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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35
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Aida I, Miyoshi M, Endo H, Tobinaga M, Ikeda T, Oota K, Yonemochi Y, Takahara M, Kanaya H, Ozawa T, Nakajima T. Percutaneous endoscopic gastrostomy procedure in patients with advanced duchenne muscular dystrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Tobinaga M, Hayashi T, Endo H, Ikeda T, Ohta K, Yonemochi Y, Aida I, Fujinaka H, Suzuki Y, Nakajima T. Construction of a database of the normal GABAA receptor brain SPECT to visualize neuronal loss in neurodegenerative diseases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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37
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Endo H, Iwata H, Naito R, Wada H, Doi S, Konishi H, Tsuboi S, Ogita M, Dohi T, Kasai T, Okazaki S, Isoda K, Miyauchi K, Daida H. P5336Persistent higher high sensitivity C-reactive protein after percutaneous coronary intervention (PCI) predicts higher mortality in patients undergoing PCI with stable coronary artery disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Kawabata Y, Bradbury R, Kugizaki S, Weigandt K, Melnichenko YB, Sadakane K, Yamada NL, Endo H, Nagao M, Seto H. Effect of interlamellar interactions on shear induced multilamellar vesicle formation. J Chem Phys 2017; 147:034905. [PMID: 28734290 DOI: 10.1063/1.4994563] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Shear-induced multilamellar vesicle (MLV) formation has been studied by coupling the small-angle neutron scattering (SANS) technique with neutron spin echo (NSE) spectroscopy. A 10% mass fraction of the nonionic surfactant pentaethylene glycol dodecyl ether (C12E5) in water was selected as a model system for studying weak inter-lamellar interactions. These interactions are controlled either by adding an anionic surfactant, sodium dodecyl sulfate, or an antagonistic salt, rubidium tetraphenylborate. Increasing the charge density in the bilayer induces an enhanced ordering of the lamellar structure. The charge density dependence of the membrane bending modulus was determined by NSE and showed an increasing trend with charge. This behavior is well explained by a classical theoretical model. By considering the Caillé parameters calculated from the SANS data, the layer compressibility modulus B¯ is estimated and the nature of the dominant inter-lamellar interaction is determined. Shear flow induces MLV formation around a shear rate of 10 s-1, when a small amount of charge is included in the membrane. The flow-induced layer undulations are in-phase between neighboring layers when the inter-lamellar interaction is sufficiently strong. Under these conditions, MLV formation can occur without significantly changing the inter-lamellar spacing. On the other hand, in the case of weak inter-lamellar interactions, the flow-induced undulations are not in-phase, and greater steric repulsion leads to an increase in the inter-lamellar spacing with shear rate. In this case, MLV formation occurs as the amplitude of the undulations gets larger and the steric interaction leads to in-phase undulations between neighboring membranes.
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Affiliation(s)
- Y Kawabata
- Department of Chemistry, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - R Bradbury
- Center for Exploration of Energy and Matter, Department of Physics, Indiana University, Bloomington, Indiana 47408, USA
| | - S Kugizaki
- Department of Chemistry, Tokyo Metropolitan University, Hachioji, Tokyo 192-0397, Japan
| | - K Weigandt
- NIST Center for Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland 20899-6102, USA
| | - Y B Melnichenko
- Biology and Soft Matter Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831-6393, USA
| | - K Sadakane
- Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto 610-0321, Japan
| | - N L Yamada
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - H Endo
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - M Nagao
- Center for Exploration of Energy and Matter, Department of Physics, Indiana University, Bloomington, Indiana 47408, USA
| | - H Seto
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, Tokai 319-1106, Japan
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Endo H, Tsunekawa N, Sonoe M, Sasaki T, Ogawa H, Amano T, Nguyen TS, Phimphachanhvongsod V, Kudo K, Yonezawa T, Akishinonomiya F. Geographical variation in the skeletal morphology of red jungle fowl. Br Poult Sci 2017; 58:348-357. [PMID: 28418277 DOI: 10.1080/00071668.2017.1311008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
1. The skulls and postcranial skeletons of the red jungle fowl (Gallus gallus) were compared osteometrically between the populations from North and South Vietnam, North and Central Laos and Southeast Bangladesh. The populations include the three subspecies of G. g. spadiceus, G. g. gallus and G. g. murghi and were sampled to reveal the geographical morphological variations among populations in G. gallus. 2. The morphometric characteristics of subspecies murghi could be clearly distinguished from those of the other subspecies using a canonical discriminant analysis. However, the size and shape of the skull of the gallus population from South Vietnam were not statistically different from that of the subspecies spadiceus from North Laos. The canonical discriminant scores also clearly indicated that there were morphological similarities in the skulls of the populations from North Laos and South Vietnam. 3. From the results, therefore, it is concluded that red jungle fowls do not exhibit high levels of osteometric variation between geographical localities at least within the Indochinese Peninsula. 4. This contrasts with previous studies which have described these subspecies as having various external morphological differences and have argued that zoogeographical barriers exist between the north and south areas of the Indochinese Peninsula.
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Affiliation(s)
- H Endo
- a The University Museum, The University of Tokyo , Tokyo , Japan
| | - N Tsunekawa
- b Department of Bioscience in Daily Life , College of Bioresource Sciences, Nihon University , Kanagawa , Japan
| | - M Sonoe
- c Department of International Development Studies , College of Bioresource Sciences, Nihon University , Kanagawa , Japan
| | - Tї Sasaki
- d Laboratory of Wild Animals, Department of Human and Animal-Plant Relationships, Faculty of Agriculture , Tokyo University of Agriculture , Kanagawa , Japan
| | - H Ogawa
- d Laboratory of Wild Animals, Department of Human and Animal-Plant Relationships, Faculty of Agriculture , Tokyo University of Agriculture , Kanagawa , Japan
| | - T Amano
- e Faculty of Animal Health Technology , Yamazaki Gakuen University , Tokyo , Japan
| | - T S Nguyen
- f Department of Vertebrate Zoology , Institute of Ecology and Biological Resources and Graduate University of Science and Technology, Vietnam Academy of Science and Technology , Hanoi , Vietnam
| | - V Phimphachanhvongsod
- g Research Management Division , National Agriculture and Forestry Research Institute (NAFRI), Ministry of Agriculture and Forestry , Vientiane , Laos
| | - K Kudo
- h Department of Global Agricultural Sciences, Graduate School of Agriculture and Agricultural Life Sciences , The University of Tokyo , Tokyo , Japan
| | - T Yonezawa
- i School of Life Sciences , Fudan University , Shanghai , China
| | - F Akishinonomiya
- a The University Museum, The University of Tokyo , Tokyo , Japan
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Miyano S, Syakantu G, Komada K, Endo H, Sugishita T. Cost-effectiveness analysis of the national decentralization policy of antiretroviral treatment programme in Zambia. Cost Eff Resour Alloc 2017; 15:4. [PMID: 28413361 PMCID: PMC5388995 DOI: 10.1186/s12962-017-0065-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 03/24/2017] [Indexed: 11/23/2022] Open
Abstract
Background In resource-limited settings with a high prevalence of human immunodeficiency virus (HIV) infection such as Zambia, decentralization of HIV/acquired immunodeficiency syndrome (HIV/AIDS) treatment and care with effective use of resources is a cornerstone of universal treatment and care. Objectives This research aims to analyse the cost effectiveness of the National Mobile Antiretroviral Therapy (ART) Services Programme in Zambia as a means of decentralizing ART services. Methods Cost-effectiveness analyses were performed using a decision analytic model and Markov model to compare the original ART programme, ‘Hospital-based ART’, with the intervention programme, Hospital-based plus ‘Mobile ART’, from the perspective of the district government health office in Zambia. The total cost of ART services, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were examined. Results The mean annual per-patient costs were 1259.16 USD for the original programme and 2601.02 USD for the intervention programme, while the mean number of QALYs was 6.81 for the original and 7.27 for the intervention programme. The ICER of the intervention programme relative to the original programme was 2965.17 USD/QALY, which was much below the willingness-to-pay (WTP), or three times the GDP per capita (4224 USD), but still over the GDP per capita (1408 USD). In the sensitivity analysis, the ICER of the intervention programme did not substantially change. Conclusion The National Mobile ART Services Programme in Zambia could be a cost-effective approach to decentralizing ART services into rural areas in Zambia. This programme could be expanded to more districts where it has not yet been introduced to improve access to ART services and the health of people living with HIV (PLHIV) in rural areas. Electronic supplementary material The online version of this article (doi:10.1186/s12962-017-0065-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shinsuke Miyano
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan
| | - Gardner Syakantu
- Department of Clinical Care and Diagnostic Services, Ministry of Health Zambia, Lusaka, Zambia
| | - Kenichi Komada
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan
| | - Hiroyoshi Endo
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Tomohiko Sugishita
- Department of International Affairs and Tropical Medicine, Tokyo Women's University, Tokyo, Japan
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Abstract
BACKGROUND The International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) has been used in various Asia-Pacific countries for more than 20 years. Although ICD-10 is a powerful tool, clinical coding processes are complex; therefore, many developing countries have not been able to implement ICD-10-based health statistics (WHO-FIC APN, 2007). OBJECTIVE This study aimed to simplify ICD-10 clinical coding processes, to modify index terms to facilitate computer searching and to provide a simplified version of ICD-10 for use in developing countries. METHOD The World Health Organization Family of International Classifications Asia-Pacific Network (APN) developed a simplified version of the ICD-10 and conducted field testing in Cambodia during February and March 2016. Ten hospitals were selected to participate. Each hospital sent a team to join a training workshop before using the ICD-10 simplified version to code 100 cases. All hospitals subsequently sent their coded records to the researchers. RESULTS Overall, there were 1038 coded records with a total of 1099 ICD clinical codes assigned. The average accuracy rate was calculated as 80.71% (66.67-93.41%). Three types of clinical coding errors were found. These related to errors relating to the coder (14.56%), those resulting from the physician documentation (1.27%) and those considered system errors (3.46%). DISCUSSION The field trial results demonstrated that the APN ICD-10 simplified version is feasible for implementation as an effective tool to implement ICD-10 clinical coding for hospitals. CONCLUSION Developing countries may consider adopting the APN ICD-10 simplified version for ICD-10 code assignment in hospitals and health care centres. The simplified version can be viewed as an introductory tool which leads to the implementation of the full ICD-10 and may support subsequent ICD-11 adoption.
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Affiliation(s)
| | | | | | | | - Sukil Kim
- 5 Catholic University of Korea, Republic of Korea
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Takeshita E, Sakata Y, Hara M, Akutagawa K, Sakata N, Endo H, Ohyama T, Matsunaga K, Yoshioka T, Kawakubo H, Tanaka Y, Shirai S, Ito Y, Tsuruoka N, Iwakiri R, Kusano M, Fujimoto K. Higher Frequency of Reflux Symptoms and Acid-Related Dyspepsia in Women than Men Regardless of Endoscopic Esophagitis: Analysis of 3,505 Japanese Subjects Undergoing Medical Health Checkups. Digestion 2017; 93:266-71. [PMID: 27160990 DOI: 10.1159/000445713] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/18/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS This study aimed at (i) clarifying the factors associated with high scores on the modified frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) among 3,505 relatively healthy subjects undergoing routine medical health checkups with gastrointestinal endoscopy and (ii) comparing risk factors for high FSSG scores between subjects with and without reflux esophagitis. METHODS In total, 3,505 subjects (male/female: 1,922/1,583) who underwent upper gastrointestinal endoscopy during health medical checkups at 5 hospitals in Saga, Japan from January 2013 to December 2013 were enrolled. All subjects completed a modified FSSG questionnaire, which comprised 7 questions regarding reflux symptoms and 7 questions regarding acid-related dyspepsia. Each question was assigned a score based on the frequency of symptoms. RESULTS Younger age, female gender, hiatal herniation, and endoscopic reflux esophagitis were risk factors for a FSSG score with a high total. Subjects with high scores but without esophagitis were women, and hiatal herniation and Barrett's esophagus were frequently seen in patients with reflux esophagitis. CONCLUSION Younger age, female gender, hiatal hernia, and endoscopic esophagitis were risk factors for a high FSSG score, and women tended to complain of upper gastrointestinal symptoms more frequently than did men among subjects without endoscopic esophagitis.
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Affiliation(s)
- Eri Takeshita
- Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
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Shirai T, Inoue O, Tamura S, Tsukiji N, Sasaki T, Endo H, Satoh K, Osada M, Sato-Uchida H, Fujii H, Ozaki Y, Suzuki-Inoue K. C-type lectin-like receptor 2 promotes hematogenous tumor metastasis and prothrombotic state in tumor-bearing mice. J Thromb Haemost 2017; 15:513-525. [PMID: 28028907 DOI: 10.1111/jth.13604] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [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: 03/22/2016] [Indexed: 01/01/2023]
Abstract
Essentials The role of C-type lectin-like receptor-2 (CLEC-2) in cancer progression is unclear. CLEC-2-depleted mouse model is generated by using a rat anti-mouse CLEC-2 monoclonal antibody. CLEC-2 depletion inhibits hematogenous tumor metastasis of podoplanin-expressing B16F10 cells. CLEC-2 depletion prolongs cancer survival by suppressing thrombosis and inflammation. SUMMARY Background C-type lectin-like receptor 2 (CLEC-2) is a platelet activation receptor of sialoglycoprotein podoplanin, which is expressed on the surface of certain types of tumor cells. CLEC-2-podoplanin interactions facilitate hematogenous tumor metastasis. However, direct evidence of the role of CLEC-2 in hematogenous metastasis and cancer progression is lacking. Objective and methods We generated immunological CLEC-2-depleted mice by using anti-mouse CLEC-2 monoclonal antibody 2A2B10 and investigated whether CLEC-2 promoted hematogenous tumor metastasis and tumor growth and exacerbated the prognosis of mice bearing podoplanin-expressing B16F10 melanoma cells. Results Our results showed that hematogenous metastasis was significantly inhibited in CLEC-2-depleted mice. B16F10 cells co-cultured with wild-type platelets, but not with CLEC-2-deficient platelets, showed increased proliferation. However, B16F10 cell proliferation was not inhibited in CLEC-2-depleted mice. Histological analysis showed that thrombus formation in tumor vessels was significantly inhibited and functional vessel density was significantly increased in CLEC-2-depleted mice. These data suggest that CLEC-2 deficiency may inhibit thrombus formation in tumor vessels and increase the density of functional vessels, thus improving oxygen and nutrient supply to tumors, indirectly promoting tumor proliferation. Furthermore, the overall survival of CLEC-2-depleted mice was significantly prolonged, which may be due to the suppression of thrombus formation in the lungs and subsequent inhibition of systemic inflammation and cachexia. Conclusions These data provide a rationale for the targeted inhibition of CLEC-2 as a new strategy for preventing hematogenous tumor metastasis and for inhibiting cancer-related thromboembolism.
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Affiliation(s)
- T Shirai
- Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - O Inoue
- Infection Control Office, Yamanashi University Hospital, Yamanashi, Japan
| | - S Tamura
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - N Tsukiji
- Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - T Sasaki
- Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - H Endo
- Department of Food Science and Nutrition, School of Human Cultures, University of Shiga Prefecture, Shiga, Japan
| | - K Satoh
- Division of Laboratory Medicine, Yamanashi University Hospital, Yamanashi, Japan
| | - M Osada
- Division of Laboratory Medicine, Yamanashi University Hospital, Yamanashi, Japan
- School of Medical Technology, Faculty of Health Science, Gumma Paz College, Takasaki, Japan
| | - H Sato-Uchida
- Department of Clinical Nursing, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - H Fujii
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Y Ozaki
- Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - K Suzuki-Inoue
- Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
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Endo H, Okami J, Okuyama H, Nishizawa Y, Imamura F, Inoue M. The induction of MIG6 under hypoxic conditions is critical for dormancy in primary cultured lung cancer cells with activating EGFR mutations. Oncogene 2016; 36:2824-2834. [DOI: 10.1038/onc.2016.431] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/05/2016] [Accepted: 10/11/2016] [Indexed: 02/08/2023]
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Omodaka S, Endo H, Niizuma K, Fujimura M, Inoue T, Sato K, Sugiyama SI, Tominaga T. Quantitative Assessment of Circumferential Enhancement along the Wall of Cerebral Aneurysms Using MR Imaging. AJNR Am J Neuroradiol 2016; 37:1262-6. [PMID: 26939634 DOI: 10.3174/ajnr.a4722] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/03/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The incidence of wall enhancement of cerebral aneurysms on vessel wall MR imaging has been described as higher in ruptured intracranial aneurysms than in unruptured intracranial aneurysms, but the difference in the degree of enhancement between ruptured and unruptured aneurysms is unknown. We compared the degree of enhancement between ruptured and unruptured intracranial aneurysms by using quantitative MR imaging measures. MATERIALS AND METHODS We performed quantitative analyses of circumferential enhancement along the wall of cerebral aneurysms in 28 ruptured and 76 unruptured consecutive cases by using vessel wall MR imaging. A 3D-T1-weighted fast spin-echo sequence was obtained before and after contrast media injection, and the wall enhancement index was calculated. We then compared characteristics between ruptured and unruptured aneurysms. RESULTS The wall enhancement index was significantly higher in ruptured than in unruptured aneurysms (1.70 ± 1.06 versus 0.89 ± 0.88, respectively; P = .0001). The receiver operating characteristic curve analysis found that the most reliable cutoff value of the wall enhancement index to differentiate ruptured from unruptured aneurysms was 0.53 (sensitivity, 0.96; specificity, 0.47). The wall enhancement index remained significant in the multivariate logistic regression analysis (P < .0001). CONCLUSIONS Greater circumferential enhancement along the wall of cerebral aneurysms correlates with the ruptured state. A quantitative evaluation of circumferential enhancement by using vessel wall MR imaging could be useful in differentiating ruptured from unruptured intracranial aneurysms.
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Affiliation(s)
- S Omodaka
- From the Departments of Neurosurgery (S.O., H.E.)
| | - H Endo
- From the Departments of Neurosurgery (S.O., H.E.)
| | - K Niizuma
- Department of Neurosurgery (K.N., M.F., T.T.), Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Fujimura
- Department of Neurosurgery (K.N., M.F., T.T.), Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Inoue
- Department of Neurosurgery (T.I.), Sendai Medical Center, Sendai, Japan
| | - K Sato
- Neuroendovascular Therapy (K.S.)
| | - S-I Sugiyama
- Neuroanesthesia (S.-i.S.), Kohnan Hospital, Sendai, Japan
| | - T Tominaga
- Department of Neurosurgery (K.N., M.F., T.T.), Tohoku University Graduate School of Medicine, Sendai, Japan
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Suzuki T, Takamizawa T, Barkmeier WW, Tsujimoto A, Endo H, Erickson RL, Latta MA, Miyazaki M. Influence of Etching Mode on Enamel Bond Durability of Universal Adhesive Systems. Oper Dent 2016; 41:520-530. [PMID: 27351078 DOI: 10.2341/15-347-l] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to determine the enamel bond durability of three universal adhesives in different etching modes through fatigue testing. The three universal adhesives used were Scotchbond Universal, Prime&Bond Elect universal dental adhesive, and All-Bond Universal light-cured dental adhesive. A single-step self-etch adhesive, Clearfil S3 Bond Plus was used as a control. The shear bond strength (SBS) and shear fatigue strength (SFS) to human enamel were evaluated in total-etch mode and self-etch mode. A stainless steel metal ring with an internal diameter of 2.4 mm was used to bond the resin composite to the flat-ground (4000-grit) tooth surfaces for determination of both SBS and SFS. For each enamel surface treatment, 15 specimens were prepared for SBS and 30 specimens for SFS. The staircase method for fatigue testing was then used to determine the SFS of the resin composite bonded to the enamel using 10-Hz frequencies for 50,000 cycles or until failure occurred. Scanning electron microscopy was used to observe representative debonded specimen surfaces and the resin-enamel interfaces. A two-way analysis of variance and the Tukey post hoc test were used for analysis of the SBS data, whereas a modified t-test with Bonferroni correction was used for the SFS data. All adhesives in total-etch mode showed significantly higher SBS and SFS values than those in self-etch mode. Although All-Bond Universal in self-etch mode showed a significantly lower SBS value than the other adhesives, there was no significant difference in SFS values among the adhesives in this mode. All adhesives showed higher SFS:SBS ratios in total-etch mode than in self-etch mode. With regard to the adhesive systems used in this study, universal adhesives showed higher enamel bond strengths in total-etch mode. Although the influence of different etching modes on the enamel-bonding performance of universal adhesives was found to be dependent on the adhesive material, total-etch mode effectively increased the enamel bond strength and durability, as measured by fatigue testing.
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Arai K, Kadoya N, Kato T, Endo H, Komori S, Abe Y, Hirose K, Nakamura T, Wada H, Kikuchi Y, Jingu K. TH-CD-209-03: Feasibility of CBCT-Based Proton Dose Calculation Using a Histogram-Matching Algorithm in Proton Beam Therapy. Med Phys 2016. [DOI: 10.1118/1.4958197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Tsukahara T, Ogura S, Sugahara T, Sekihara M, Furusawa T, Kondo N, Mita T, Endo H, Hombhanje F. The Choice of Healthcare Providers for Febrile Children after Introducing Non-professional Health Workers in a Malaria Endemic Area in Papua New Guinea. Front Public Health 2015; 3:275. [PMID: 26734599 PMCID: PMC4689805 DOI: 10.3389/fpubh.2015.00275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/04/2015] [Indexed: 11/30/2022] Open
Abstract
Background Disease burden of malaria in Papua New Guinea (PNG) is the highest in Asia and the Pacific, and prompt access to effective drugs is the key strategy for controlling malaria. Despite the rapid economic growth, primary healthcare services have deteriorated in rural areas; the introduction of non-professional health workers [village health volunteers (VHVs)] is expected to improve antimalarial drug deliveries. Previous studies on PNG suggested that distance from households negatively affected the utilization of health services; however, price effect on healthcare demand decisions has not been explored. Empirical studies on household’s affordability as well as accessibility of healthcare services contribute to policy implications, such as efficient introduction of out-of-pocket costs and effective allocation of health facilities. Therefore, we investigate price responsiveness and other determinants of healthcare provider choice for febrile children in a malaria endemic rural area wherein VHVs were introduced. Methods Cross-sectional surveys were conducted using a structured questionnaire distributed in a health center’s catchment area of East Sepik Province in the 2011/2012 rainy seasons. Caretakers were interviewed and data on fever episodes of their children in the preceding 2 weeks were collected. Mixed logit model was employed to estimate the determinants of healthcare provider choice. Results Among 257 fever episodes reported, the main choices of healthcare providers were limited to self-care, VHV, and a health center. Direct cost and walking distance negatively affected the choice of a VHV and the health center. An increase of VHV’s direct cost or walking distance did not much affect predicted probability of the health center, but rather that of self-care, while drug availability and illness severity increased the choice probability of a VHV and the health center. Conclusion The results suggest that the net healthcare demand increases with the introduction of a VHV. Allocations from the government’s budget are required to sustain VHV activities because the introduction of a small user fee could impede the utilization of a VHV. A large travel cost related to the choice of the health center suggests that resource allocation is required for the expansion of formal healthcare providers to adequately operate a referral system.
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Affiliation(s)
- Takahiro Tsukahara
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University, Tokyo, Japan; School of Economics, Hosei University Graduate School, Tokyo, Japan
| | - Seiritsu Ogura
- Hosei Institute of Aging, Hosei University , Tokyo , Japan
| | - Takuma Sugahara
- School of Economics, Hosei University Graduate School , Tokyo , Japan
| | - Makoto Sekihara
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University , Tokyo , Japan
| | - Takuro Furusawa
- Division of Southeast Asian Area Studies, Graduate School of Asian and African Area Studies, Kyoto University , Kyoto , Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo , Tokyo , Japan
| | - Toshihiro Mita
- Department of Molecular and Cellular Parasitology, Juntendo University School of Medicine , Tokyo , Japan
| | - Hiroyoshi Endo
- Department of International Affairs and Tropical Medicine, Tokyo Women's Medical University , Tokyo , Japan
| | - Francis Hombhanje
- Centre for Health Research and Diagnostics, Divine Word University , Madang , Papua New Guinea
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Anzai H, Yoshida Y, Sugiyama S, Endo H, Matsumoto Y, Ohta M. Porosity dependency of an optimized stent design for an intracranial aneurysm. Technol Health Care 2015; 23:547-56. [PMID: 26410116 DOI: 10.3233/thc-151007] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Optimal design of stents for a cerebral aneurysm is desired for efficient flow reduction in the aneurysm. OBJECTIVE In this study, we aimed to optimize stent design at several porosities, estimate the influence of stent design on aneurysm flow, and evaluate the ability of stents to reduce flow. METHODS Stent models were constructed as sets of squares or rectangles in the necks of a two-dimensional (2D) and realistic aneurysm. Then, automated optimization was performed using a combination of simulated annealing and lattice Boltzmann flow simulation. RESULTS By simulated annealing, stents were gradually modified to reduce the average velocity in an aneurysm. As a result of optimization, stents of all porosities demonstrated an inhomogeneous distribution with dense struts in the inflow area. Flow reduction was increased compared with the initial stent. Under the condition of high porosity, flow reduction by the stent drastically increased as porosity decreased. Under low porosity, the increase of velocity reduction was moderate even as porosity decreased. CONCLUSIONS Optimization can enhance flow reduction by stents. However, the increase in reduction associated with decreasing porosity is moderate under lower-porosity conditions. This threshold may help in the choice of stent porosity for each specific aneurysm.
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Affiliation(s)
- H Anzai
- Frontier Research Institute of Interdisciplinary Sciences, Tohoku University, Sendai, Japan.,Institute of Fluid Science, Tohoku University, Sendai, Japan
| | - Y Yoshida
- Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - S Sugiyama
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan.,Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - H Endo
- Department of Neurosurgery, Kohnan Hospital, Sendai, Japan
| | - Y Matsumoto
- Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan
| | - M Ohta
- Institute of Fluid Science, Tohoku University, Sendai, Japan
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Okawa T, Tatewaki I, Ishizu T, Endo H, Tsuboi Y, Saitou H. Fuel behavior analysis code FEMAXI-FBR development and validation for core disruptive accident. Progress in Nuclear Energy 2015. [DOI: 10.1016/j.pnucene.2014.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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