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Hattori K, Matsuda T, Takagi Y, Nagaya M, Inoue T, Mizuno Y, Nakajima H, Nishida Y, Hasegawa Y, Kawaguchi K, Fukui T, Ozeki N, Yokoi K, Ito S. P3.16-010 Preoperative Six-Minute Walk Distance Is Associated with Complications of Pneumonia after Lung Resection. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Okamoto W, Bando H, Fukui T, Yamanaka T, Akagi K, Yoshino T. Clinical utility of quasi-monomorphic variation range (QMVR) on the determination of microsatellite instability (MSI) status in patients (pts) with colorectal cancer (CRC): GI-SCREEN-CRC-MSI sub-study 01. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Takahashi S, Fukui T, Nomizu T, Kakugawa Y, Ishida T, Yamaguchi S, Kato S, Ohuchi N, Gondo N, Ishioka C. Development of TP53 signature diagnostic system using multiplex RT-PCR and observational study to confirm the prognostic value of TP53 signature in breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nötzel R, Temmyo J, Tamamura T, Fukui T, Hasegawa H. Self-Organized Quantum Dots. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/epn/19962704148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Ichida K, Suzuki K, Muto Y, Fukui T, Takayama Y, Futsuhara K, Tsujinaka S, Miyakura Y, Noda H, Rikiyama T. 208P Significance of the difference in size of liver tumors in management of patients with colorectal liver metastases. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Matsumoto S, Yoh K, Kodani M, Ohashi K, Saeki S, Furuya N, Nishioka Y, Ohe Y, Seto T, Hayashi R, Kataoka Y, Fukui T, Sakamoto T, Ikemura S, Kohno T, Tsuta K, Tsuchihara K, Goto K. Detectability of druggable gene fusions by amplicon-based next generation sequencing in nationwide lung cancer genomic screening project (LC-SCRUM-Japan). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozeki N, Okasaka T, Kawaguchi K, Fukui T, Fukumoto K, Nakamura S, Hakiri S, Yokoi K. O-024SURVIVAL ANALYSIS USING PHYSIQUE-ADJUSTED SIZE OF NON-SMALL CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozeki N, Okasaka T, Kawaguchi K, Fukui T, Fukumoto K, Nakamura S, Hakiri S, Yokoi K. P-189DIFFUSING CAPACITY OF THE LUNG FOR CARBON MONOXIDE IS ASSOCIATED WITH TUMOUR DIFFERENTIATION, SCAR GRADE, NUCLEAR ATYPIA, AND MITOTIC INDEX OF LUNG ADENOCARCINOMA. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kono N, Ohashi K, Okuyama Y, Mori S, Hiruma K, Akiyama H, Fukui T, Osumi K, Sakamaki H. Treatment of Relapsing Ph+ Acute Lymphoblastic Leukemia with Donor Leukocyte Infusion Followed by Quantitative Monitoring of Residual Disease. ACTA ACUST UNITED AC 2016; 6:261-5. [PMID: 27414845 DOI: 10.1080/10245332.2001.11746579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The case of a 34-year-old man with relapsing Ph+ acute lymphoblastic leukemia (ALL), which occurred five months after allogeneic bone marrow transplantation, is described. He was originally treated with aggressive chemotherapy, which put him in hematological remission, and he subsequently received donor leukocyte infusion (DLI) form the original donor. To assess the efficacy of this adoptive immunotherapy, we monitored minor-BCR/ABL (m-BCR/ABL) mRNA levels using the recently established real-time quantitative RT-PCR (RQ-PCR) assay. The results were compared with those obtained using conventional qualitative RT-PCR assays run in parallel. RQ-PCR, but not RT-PCR-based, minimum residual disease (MRD) detection showed a good correlation with the rapid changes documented during the post-DLI clinical course. Currently, six months after DLI, the patient continues to be in remission, which is consistent with the undetectable levels of m-BCR/ABL mRNA in the leukemic clone using RQ-PCR found in this study. Thus, monitoring of m-bcr/abl transcripts using RQ-PCR provides more useful information on a clinical assessment of MRD.
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Maeda K, Shimbo T, Fukui T. Cost-effectiveness of a community-based screening programme for chronic atrial fibrillation in Japan. J Med Screen 2016; 11:97-102. [PMID: 15153326 DOI: 10.1258/096914104774061092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives: To examine the cost-effectiveness of a community-based screening programme for chronic atrial fibrillation (AF) in Japan. Methods: Using a computer model of a Markov process, the cost-effectiveness of an annual ECG screening programme and an annual pulse palpation screening programme for arrhythmia were compared with no screening. A hypothetical Japanese population of 65 year old individuals was followed until 85 years of age. We assumed that individuals with irregular beats on palpation were worked up by ECG and that ECG was perfect in detecting AF, whereas palpation was not. It was also assumed that patients diagnosed with AF received anticoagulant therapy, that some AF patients developed ischaemic stroke, and that some on anticoagulant therapy developed intracranial or gastrointestinal haemorrhage. Costs, efficacy of anticoagulation, utility of health status, and clinical variables were estimated from the literature. Outcomes were expressed as US dollars per quality-adjusted life-year (QALY). Results: Both annual ECG screening programme and annual palpation screening programme were more costly and at the same time more effective compared with no screening, with their incremental cost-effectiveness ratios approximately US$8000 per QALY in males and US$10,000 per QALY in females. Sensitivity analyses showed high sensitivity of cost-effectiveness ratios to the incidence of ischaemic stroke and anticoagulants prescription rate. Two annual screening programmes were similar in effectiveness and costs. Conclusion: To prevent ischaemic stroke associated with AF, both annual ECG screening and annual palpation screening were favourable in the context of conventional criteria for cost-effectiveness.
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Yuasa M, Aoyama Y, Shimada R, Sawamura H, Ebara S, Negoro M, Fukui T, Watanabe T. Effects of Biotin Deficiency on Biotinylated Proteins and Biotin-Related Genes in the Rat Brain. J Nutr Sci Vitaminol (Tokyo) 2016; 62:81-7. [PMID: 27264091 DOI: 10.3177/jnsv.62.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Biotin is a water-soluble vitamin that functions as a cofactor for biotin-dependent carboxylases. The biochemical and physiological roles of biotin in brain regions have not yet been investigated sufficiently in vivo. Thus, in order to clarify the function of biotin in the brain, we herein examined biotin contents, biotinylated protein expression (e.g. holocarboxylases), and biotin-related gene expression in the brain of biotin-deficient rats. Three-week-old male Wistar rats were divided into a control group, biotin-deficient group, and pair-fed group. Rats were fed experimental diets from 3 wk old for 8 wk, and the cortex, hippocampus, striatum, hypothalamus, and cerebellum were then collected. In the biotin-deficient group, the maintenance of total biotin and holocarboxylases, increases in the bound form of biotin and biotinidase activity, and the expression of an unknown biotinylated protein were observed in the cortex. In other regions, total and free biotin contents decreased, holocarboxylase expression was maintained, and bound biotin and biotinidase activity remained unchanged. Biotin-related gene (pyruvate carboxylase, sodium-dependent multivitamin transporter, holocarboxylase synthetase, and biotinidase) expression in the cortex and hippocampus also remained unchanged among the dietary groups. These results suggest that biotin may be related to cortex functions by binding protein, and the effects of a biotin deficiency and the importance of biotin differ among the different brain regions.
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Sakaue K, Fukui T, Sasakura C, Hori K, Ono T, Saito I. Tongue pressure production during swallowing in patients with mandibular prognathism. J Oral Rehabil 2016; 43:348-55. [PMID: 26751817 DOI: 10.1111/joor.12379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2015] [Indexed: 12/01/2022]
Abstract
UNLABELLED Abnormalities of swallowing in patients with mandibular prognathism have not been evaluated quantitatively. The aim of this study was to compare tongue pressure production for bolus transfer between volunteers with normal occlusion and patients with mandibular prognathism. The control group had 10 female volunteers with normal occlusion, and the patient group had 10 women with mandibular prognathism. Tongue pressure was measured by a palatal sensor sheet at five sites on swallowing 4 mL of a tasteless and odourless jelly. RESULTS The tongue pressure waveform differed between the control and patient groups. The incidence of a double-peak tongue pressure waveform was more frequent in the patient group. In both groups, the exertion of tongue pressure began at the anterior point of the sensor sheet, followed by the peripheral parts. Although the order of expression of tongue pressure was the same for the two groups, maximum tongue pressure at all parts of the sensor sheet was lower in the patient group than in the control group. Furthermore, swallowing time was longer in the patient group than in the control group at the peripheral parts of the palate. These results clearly show the difference in tongue pressure production during swallowing between patients with mandibular prognathism and volunteers with normal occlusion. The current findings suggest that maxillofacial morphology may affect tongue movement during swallowing.
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Fukumoto K, Taniguchi T, Kawaguchi K, Fukui T, Ishiguro F, Nakamura S, Mori S, Yokoi K. P-205USE OF 18F-FDG POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IN PATIENTS WITH INVASIVE THYMIC EPITHELIAL TUMOURS WHO UNDERWENT INDUCTION THERAPIES. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fukui T, Otake Y, Kondo T. In which direction does skin move during joint movement? Skin Res Technol 2015; 22:181-8. [DOI: 10.1111/srt.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2015] [Indexed: 11/26/2022]
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Muto Y, Suzuki K, Ichida K, Takayama Y, Fukui T, Kakizawa N, Watanabe F, Kato T, Saito M, Konishi F, Rikiyama T. P-210 Detection of epithelial-mesenchymal transition in colorectal cancer in consideration of intratumor heterogeneity. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fukui T, Nishida H, Takanashi S. Biocompatibility of cardiopulmonary bypass circuit with new polymer Senko E-Ternal CoatingTM. Perfusion 2015; 30:572-9. [DOI: 10.1177/0267659115580666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The aim of this study was to compare the biocompatibility of a new Senko E-Ternal coating (SEC) for cardiopulmonary bypass (CPB) circuits with the well-established poly-2-methoxyethyl acrylate (PMEA) coating. Methods: Forty patients undergoing aortic valve replacement were randomly assigned to either an SEC-coated group (n = 20) or a PMEA-coated group (n = 20). Clinical data and the following markers were analyzed: platelet count, platelet factor (PF) 4, fibrinogen, fibrinogen degradation products (FDPs), antithrombin III (AT III), thrombin-antithrombin complex (TAT), plasminogen, complement hemolytic activity (CH50), complement 3 (C3) and interleukin-6 (IL-6). Blood samples were obtained at five time points in both groups. Results: CPB time, aortic cross-clamp time and blood loss and transfusion were similar in both groups. There were no significant differences between the groups in terms of platelet count, PF4 and all coagulation and fibrinolytic parameters (FDP, AT III, TAT, and plasminogen) at any time points. Inflammatory markers (CH50, C3 and IL-6) were also similar in both groups at all time points. Conclusions: The SEC-coated circuit demonstrated equivalent biocompatibility to the PMEA-coated circuit. SEC-coated circuits are, therefore, favorably comparable to PMEA-coated circuits for clinical use in CPB.
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Kato T, Taniguchi T, Kawaguchi K, Fukui T, Ishiguro F, Hirakawa A, Iwano S, Yokoi K. 087 * THE CONTACT LENGTH BETWEEN THE TUMOUR CONTOUR AND LUNG ON COMPUTED TOMOGRAPHY IS A RISK FACTOR FOR PLEURAL RECURRENCE AFTER COMPLETE RESECTION OF THYMOMA. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Takahashi Y, Fukui T, Kishimoto M, Suzuki R, Mitsuyama T, Sumimoto K, Okazaki T, Sakao M, Sakaguchi Y, Yoshida K, Uchida K, Nishio A, Matsuzaki K, Okazaki K. Phosphorylation of Smad2/3 at the specific linker threonine residue indicates slow-cycling esophageal stem-like cells before re-entry to the cell cycle. Dis Esophagus 2014; 29:107-15. [PMID: 25168378 DOI: 10.1111/dote.12277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
UNLABELLED The stem cell compartment in the esophageal epithelium is possibly located in the basal layer. We have identified significant expression of Smad2/3, phosphorylated at specific linker threonine residues (pSmad2/3L-Thr), in the epithelial cells of murine stomach and intestine, and have suggested that these cells are epithelial stem cells. In this study, we explore whether pSmad2/3L-Thr could serve as a biomarker for esophageal stem cells. We examined esophageal tissues from normal C57BL/6 mice and those with esophagitis. Double immunofluorescent staining of pSmad2/3L-Thr with Ki67, CDK4, p63, or CK14 was performed. After immunofluorescent staining, we stained the same sections with hematoxylin-eosin and observed these cells under a light microscope. We used the 5-bromo-2-deoxyuridine (BrdU) labeling assay to examine label retention of pSmad2/3L-Thr immunostaining-positive cells. We collected specimens 5, 10, 15 and 20 days after repeated BrdU administrations and observed double immunofluorescent staining of pSmad2/3L-Thr with BrdU. In the esophagus, pSmad2/3L-Thr immunostaining-positive cells were detected in the basal layer. These cells were detected between Ki67 immunostaining-positive cells, but they were not co-localized with Ki67. pSmad2/3L-Thr immunostaining-positive cells showed co-localization with CDK4, p63, and CK14. Under a light microscope, pSmad2/3L-Thr immunostaining-positive cells indicated undifferentiated morphological features. Until 20 days follow-up period, pSmad2/3L-Thr immunostaining-positive cells were co-localized with BrdU. pSmad2/3L-Thr immunostaining-positive cells significantly increased in the regeneration phase of esophagitis mucosae, as compared with control mice (esophagitis vs. CONTROL 6.889 ± 0.676/cm vs. 4.293 ± 0.659/cm; P < 0.001). We have identified significant expression of pSmad2/3L-Thr in the specific epithelial cells of murine esophagi. We suggest that these cells are slow-cycling epithelial stem-like cells before re-entry to the cell cycle.
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Tan G, Rintala DH, Jensen MP, Fukui T, Smith D, Williams W. A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. Eur J Pain 2014; 19:271-80. [PMID: 24934738 DOI: 10.1002/ejp.545] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Chronic low back pain (CLBP) is common and results in significant costs to individuals, families and society. Although some research supports the efficacy of hypnosis for CLBP, we know little about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of treatment benefits beyond 3 months. METHODS One hundred veterans with CLBP participated in a randomized, four-group design study. The groups were (1) an eight-session self-hypnosis training intervention without audio recordings for home practice; (2) an eight-session self-hypnosis training intervention with recordings; (3) a two-session self-hypnosis training intervention with recordings and brief weekly reminder telephone calls; and (4) an eight-session active (biofeedback) control intervention. RESULTS Participants in all four groups reported significant pre- to post-treatment improvements in pain intensity, pain interference and sleep quality. The hypnosis groups combined reported significantly more pain intensity reduction than the control group. There was no significant difference among the three hypnosis conditions. Over half of the participants who received hypnosis reported clinically meaningful (≥ 30%) reductions in pain intensity, and they maintained these benefits for at least 6 months after treatment. Neither hypnotizability nor amount of home practice was associated significantly with treatment outcome. CONCLUSIONS The findings indicate that two sessions of self-hypnosis training with audio recordings for home practice may be as effective as eight sessions of hypnosis treatment. If replicated in other patient samples, the findings have important implications for the application of hypnosis treatment for chronic pain management.
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Ozeki N, Kawaguchi K, Taniguchi T, Usami N, Fukui T, Ishiguro F, Nakamura S, Yokoi K. P-139 * WHICH VARIABLES BEST PREDICT OUTCOMES IN PATIENTS WITH STAGE II/III NON-SMALL-CELL LUNG CANCER AFTER NEOADJUVANT THERAPY? Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yoshizawa K, Fukui T, Sasaki Y, Sato T, Nomura E, Abe Y, Ito Y, Yoshioka T, Ueno Y. A Case of Gastric Neuroendocrine Carcinoma with Cavernous Sinus Metastasis. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hiyoshi Y, Fukui T, Nagashima Y, Takakura A, Katono K, Yokoba M, Sasaki J, Masuda N. Salvage Nogitecan Chemotherapy for Relapsed Small-Cell Lung Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ozeki N, Fukui T, Taniguchi T, Usami N, Kawaguchi K, Ito S, Sakao Y, Mitsudomi T, Hirakawa A, Yokoi K. Significance of the serum carcinoembryonic antigen level during the follow-up of patients with completely resected non-small-cell lung cancer. Eur J Cardiothorac Surg 2013; 45:687-92. [DOI: 10.1093/ejcts/ezt424] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ozeki N, Fukui T, Kawaguchi K, Ito S, Usami N, Sakao Y, Mitsudomi T, Yokoi K. F-082SIGNIFICANCE OF SERUM CARCINOEMBRYONIC ANTIGEN AT THE FOLLOW-UP OF COMPLETELY RESECTED NON-SMALL CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kawabata K, Kobayashi M, Kusaka-Kikushima A, Akasaka E, Mabuchi T, Fukui T, Sugiyama Y, Takekoshi S, Miyasaka M, Ozawa A, Sakai S. A new objective histological scale for studying human photoaged skin. Skin Res Technol 2013; 20:155-63. [PMID: 23800248 DOI: 10.1111/srt.12099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND A quantitative understanding of the histological alteration of the skin is important for assessing the severity of photoaging. METHODS We performed Elastica-van Gieson staining and immunohistochemistry for decorin on 34 facial skin sections. We evaluated the alteration of collagen fibers and decorin (a modulator for collagen fibrillogenesis), according to the 5 grades of morphological change in elastic fibers that was established by Kligman (1969). The objectivity of a stage (Stages I-VI), which was established in this study, was evaluated using weighted kappa statistical analysis based on the degree of agreement in stage determination by 11 observers using a blind procedure. Correlation between the crow's-feet-area wrinkles grades of another 26 women and stages was also analyzed. RESULTS The initial alteration of elastic fibers was observed in the deep dermis. Decorin was not detected in very severely altered skin. Based on the combination of changes in the elastic fibers, collagenic fibers, and decorin, skin tissues were categorized into 6 stages according to severity. The statistical analysis showed almost perfect agreement between observers. Significant positive correlation between stages and wrinkle scores was found. CONCLUSIONS We propose a new objective histological scale that is useful for assessing the severity of photoaging.
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