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Affiliation(s)
| | - Kyosuke Ono
- Graduate School of Engineering, Gifu University
| | - Baiqiang Zhang
- School of Energy and Power Engineering, Zhengzhou University of Light Industry
| | | | | | - Akira Suami
- Graduate School of Engineering, Gifu University
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102
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Kamisaka K, Kamiya K, Iwatsu K, Iritani N, Iida Y, Adachi T, Yamada S. Weight loss early after discharge predicts the risk of rehospitalization in non-obese patients with heart failure preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0863] [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
Weight loss (WL) has been considered as a prognostic factor in heart failure with reduced ejection fraction (HFrEF). However, the prognosis and associated factors of WL in heart failure with preserved ejection fraction (HFpEF) have remained unclear.
Purpose
This study aimed to examine the prevalence, prognosis, and clinical characteristics of worse prognosis based on the identified WL after discharge in HFpEF.
Methods
The study was conducted as a part of a multicenter cohort study (Flagship). The cohort study enrolled ambulatory HF who hospitalized due to acute HF or exacerbation of chronic HF. Patients with severe cognitive, psychological disorders or readmitted within 6-month after discharge were excluded in the study. WL was defined as ≥5% weight loss in 6-month after discharge and HFpEF was defined as left ventricular ejection fraction (LVEF) ≥50% at discharge. Age, gender, etiology, prior HF hospitalization, New York Heart Association (NYHA) class, brain natriuretic peptide (BNP) or N-terminal-proBNP (NT-proBNP), anemia (hemoglobin; male <13g/dL, female <12g/dL), serum albumin, Geriatric Depression Scale, hand grip strength and comorbidities were collected at discharge. Patients were stratified according to their body mass index (BMI) at discharge as non-obese (BMI <25) or obese (BMI ≥25). We analyzed the association between WL and HF rehospitalization from 6 month to 2 years after discharge using Kaplan-Meier curve analysis and Cox regression analysis adjusted for age and gender, and clinical characteristics associated to worse prognosis in WL using logistic regression analysis adjusted for potential confounders in HFpEF.
Results
A total of 619 patients with HFpEF were included in the analysis. The prevalence of WL was 12.9% in 482 non-obese and 15.3% in 137 obese patients. During 2 years, 72 patients were readmitted for HF (non-obese: 48, obese: 24). WL in non-obese independently associated with poor prognosis (hazard ratio: 2.2: 95% confidence interval: 1.13–4.25) after adjustment for age and sex, while WL in obese patients did not. Logistic regression analysis chose age (odds ratio 1.02 per 1 year; 1.00–1.05), anemia (2.14; 1.32–3.48), and BNP ≥200pg/mL or NT-proBNP ≥900pg/mL (1.83; 1.18–2.86) as independent associated factors for worse prognosis of WL in non-obese patients.
Conclusion
In HFpEF, WL in early after discharge in non-obese elderly patients may be a prognostic indicator for HF rehospitalization. HF management including WL prevention along with controlling anemia is likely to improve prognosis in this population.
Kaplan Meier survival curves
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): A Grant-in-Aid for Scientific Research (A) from the Japan Society for the Promotion of Science
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Affiliation(s)
| | - K Kamiya
- Osaka Medical College, Department of Hygiene and Public Health, Takatsuki, Japan
| | - K Iwatsu
- Hirakata Kohsai Hospital, Department of Rehabilitation, Hirakata, Japan
| | - N Iritani
- Toyohashi Heart Center, Department of Rehabilitation, Toyohashi, Japan
| | - Y Iida
- Kainan Hospital, Department of Rehabilitation, Yatomi, Japan
| | - T Adachi
- Nagoya University, Department of Health Sciences, Nagoya, Japan
| | - S Yamada
- Nagoya University, Department of Health Sciences, Nagoya, Japan
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103
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Nagai T, Yokota I, Omote K, Sakuma I, Nakagawa Y, Kamiya K, Kimura T, Nagai R, Anzai T. High-density lipoprotein cholesterol does not predict future cardiovascular events in patients treated with statins for secondary prevention: an observation from the REAL-CAD study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The relation between high-density lipoprotein cholesterol (HDL-C) level after statin therapy and cardiovascular events in patients with stable coronary artery disease remains unclear.
Purpose
We sought to determine the association of the HDL-C level after statin therapy with cardiovascular events in stable coronary artery disease patients.
Methods
This study was a post-hoc analysis of the Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study, which is randomised, open-label, blinded endpoint, physician-initiated, superiority clinical trial. Enrollment was from January 2010 to March 2013, and follow-up was through January 2016. From the main study, we excluded the patients without either HDL-C data at baseline or 6 months, with occurrence of the primary outcome at 6 months and reported poor adherence for pitavastatin. The primary outcome of interest was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission after 6 months from randomisation, consistent with the primary analysis of the trial. We constructed landmark Cox proportional hazards regression models with the 18 selected clinically relevant risk-adjusting variables during the entire follow-up period starting at 6 months after randomisation. Absolute and relative changes of HDL-C level were defined as (6 months value – baseline value) and (absolute change / baseline value) × 100, respectively.
Results
Among 14,774 participants in the REAL-CAD study, 9,221 patients were included in this analysis (7652 [83.0%] male; median [IQR] age, 70 [63–75] years; median [IQR] HDL-C, 49 [42–57] mg/dL; median [IQR] low-density lipoprotein cholesterol [LDL-C], 88 [75–101] mg/dL). During a median follow-up period of 4.0 (IQR 3.2–4.7) years, the primary outcome occurred in 417 (4.5%) patients. There was no significant difference in crude and adjusted cumulative incidence of the primary outcome among the quartiles of HDL-C level at 6 months (Figure 1). The adjusted risks of all the HDL-C related variables (baseline value, 6 months value, absolute and relative changes) for the primary outcome were not significant (Figure 2). Furthermore, the adjusted hazard ratio (HR) as HDL-C level at 6 months increased by 10 mg/dL remained non-significant for the primary outcome for each on-treatment LDL-C level at 6 months (<70 mg/dL [HR 0.97, 95% CI 0.82–1.15], 70–100 mg/dL [HR 1.10, 95% CI 0.98–1.24], and ≥100 mg/dL [HR 0.94, 95% CI 0.78–1.13]). There was also no significant association between HDL-C level at 6 months and the primary outcome both in the low (1 mg/day [HR 1.02, 95% CI 0.91–1.14], increased by 10 mg/dL) dose and high (4 mg/day [HR 1.04, 95% CI 0.91–1.19]) dose pitavastatin groups
Conclusion
After statin therapy with modestly controlled LDL-C, HDL-C level has little prognostic value in patients with stable coronary artery disease.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Comprehensive Support Project for Clinical Research of Lifestyle-Related Disease of the Public Health Research Foundation
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Affiliation(s)
- T Nagai
- Hokkaido University, Sapporo, Japan
| | - I Yokota
- Hokkaido University, Sapporo, Japan
| | - K Omote
- Hokkaido University, Sapporo, Japan
| | - I Sakuma
- Hokko Memorial Clinic, Sapporo, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Otsu, Japan
| | - K Kamiya
- Hokkaido University, Sapporo, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - R Nagai
- Jichi Medical University, Tochigi, Japan
| | - T Anzai
- Hokkaido University, Sapporo, Japan
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104
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Hamazaki N, Kamiya K, Nozaki K, Ichikawa T, Yamashita M, Uchida S, Tabata M, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Ako J. Correlation between respiratory muscle weakness and frailty status as risk markers for prognosis in patients with cardiovascular disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Respiratory muscle weakness (RMW), frequently observed in patients with cardiovascular disease (CVD), is documented as a predictor for exercise intolerance and poor prognosis. On the other hand, frailty is commonly associated with disease condition, leading to increased risk of morbidity and mortality. Although the developmental mechanism of RMW and frailty is partly similar, the relationship between these statuses remains unclear.
Purpose
We aimed to investigate the correlation between RMW and frailty and its impact on prognosis in patients with CVD.
Methods
We studied 771 consecutive patients (68.5±13.1 years, 256 females) who were hospitalized for CVD treatment and underwent cardiac rehabilitation during hospitalization. Patients who received thoracic surgery within the last 3 months or could not perform respiratory function test were excluded from this study. As patient characteristics, we obtained body mass index, comorbidity conditions, smoking history, blood examinations, echocardiographical variables, and lung function from medical database. The frailty status on admission was assessed using frailty score consisting of 5 items including gait speed, nutrition/shrinking, physical activity, forgetfulness, and emotions/exhaustion, and patients who had 3 items were defined as frailty. We also measured maximal inspiratory pressure (PImax) as respiratory muscle strength at hospital discharge, and RMW was defined with PImax <70% of predicted value. Primary end-point was all-cause clinical events including all-cause death and/or unplanned readmission after hospital discharge. We examined the prevalence of RMW and frailty and the correlation between these statuses. The relationships of RMW with the clinical events for each presence or absence of frailty were also investigated using multivariate Cox proportional hazard models.
Results
RMW and frailty were defined in 163 (33.5%) and 126 (28.7%) patients, respectively, and 95 patients (12.4%) among them showed an overlap of both statuses (Figure 1). Frailty was detected as a significant indicator of RMW after adjusting for confounding factors (adjusted odds ratio: 1.57, 95% CI: 1.12–2.19, P=0.009). Over the median follow-up periods of 1.2 years, all-cause clinical events occurred in 154 patients (20.0%). RMW was significantly and independently associated with increased incidence of all-cause clinical events in patients with both non-frailty (adjusted hazard ratio [HR]: 1.64, 95% CI: 1.09–2.46, P=0.017) and frailty (adjusted HR: 1.97, 95% CI: 1.14–3.42, P=0.015) even after adjusting for clinical confounding factors (Figure 2).
Conclusions
This study is the first to demonstrate that RMW correlated to frailty in patients with CVD, and 12.4% of patients had overlap status. Moreover, RMW was significantly associated with an increased risk of all-cause clinical events in patients with CVD and frailty.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Society for the Promotion of Science Grant-in-Aid
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - S Uchida
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - M Tabata
- Tokyo Professional University of Health Sciences, Department of Physical Therapy, School of Rehabilitation, Tokyo, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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105
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Saito K, Matsue Y, Kamiya K, Saito H, Ogasahara Y, Kitai T, Konishi M, Maekawa E, Iwata K, Jujo K, Wada H, Kasai T, Nagamatsu H, Momomura S, Kagiyama N. Prognostic significance of 2019 Asian Working Group for Sarcopenia update on definition of sarcopenia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1078] [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/Introduction
Sarcopenia plays a major role in the pathophysiology of frailty and is associated with worse outcome in the elderly population including patients with heart failure. A recent update of the most common definition of sarcopenia in Asia, Asian Working Group for Sarcopenia (AWGS2019), included significant changes in the diagnostic algorithm with newly dividing sarcopenia into severe and “non-severe” sarcopenia.
Purpose
The objective of this study was to evaluate the differences between AWGS2014 and AWGS2019 in patients with heart failure.
Methods
In the multicenter prospective FRAGILE-HF registry, which included elderly (≥65 years old) patients who were hospitalized with heart failure, we studied 865 patients (80±8 years old, 42% female). All-cause death in 1-year follow-up was tracked.
Results
Based on the original version of AWGS (AWGS2014), 183 patients (21%) were diagnosed with sarcopenia, which was associated with higher age, lower physical performance, less muscle mass, and greater heart failure risk (all p<0.001) as well as higher rate of all-cause death (HR 1.90, p=0.004 after adjustment by multivariable regression). Those patients with sarcopenia by AWGS2014 were reclassified mainly to severe sarcopenia (155, 84.7%) by AWGS2019, and 25 (13.7%) and 2 (1.1%) were classified into sarcopenia and non-sarcopenia. Meanwhile, 24 (3.5%) and 4 (0.6%) of patients without sarcopenia by AWGS2014 were reclassified into sarcopenia and severe sarcopenia, respectively. Although severe sarcopenia by AWGS2019 was associated with higher age, lower physical performance, less muscle mass, and greater heart failure risk (all p<0.001), patients with “non-severe” sarcopenia was rather younger (p<0.001) and had better physical performance (p=0.021) despite less muscle mass (p<0.001) than those without sarcopenia. Multivariate Cox analysis demonstrated severe sarcopenia by AWGS2019 was an independent prognostic factor (HR 1.77, p=0.014), but “non-severe” sarcopenia was not (HR 1.52, p=0.37). The prognosis of patients who were reclassified from non-sarcopenia to sarcopenia or severe sarcopenia were comparable to those remained non-sarcopenia. When added to other risk factors, the prognostic predictability of AWGS2019 was significantly lower than AWGS2014 (net reclassification improvement −0.26, p=0.025).
Conclusions
About a half of “non-severe” sarcopenia in AWGS2019 were patients without sarcopenia in AWGS2014. The prognosis of such patients who were newly diagnosed as sarcopenia was good, resulting in low overall prognostic predictability of AWGS2019. A further consideration for diagnostic algorithms of sarcopenia may be warranted in patients with heart failure.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Japan Heart Foundation
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Affiliation(s)
- K Saito
- The Sakakibara Heart Institute of Okayama, Cardiac rehabilitation, Okayama, Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - H Saito
- Kameda Medical Center, Chiba, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Konishi
- Yokohama City University Medical Center, Yokohama, Japan
| | - E Maekawa
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Iwata
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Jujo
- Nishiarai Heart Center, Tokyo, Japan
| | - H Wada
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - T Kasai
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - S Momomura
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - N Kagiyama
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
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106
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Konishi M, Kagiyama N, Saito H, Saito K, Ogasahara Y, Maekawa E, Kitai T, Momomura S, Tamura K, Kimura K, Kamiya K, Matsue Y. Negative impact of skeletal muscle impairment in older patients with heart failure with reduced versus preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1143] [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/Introduction
Reduced functional capacity is an important phenotype of heart failure (HF), even though it may be considered multifactorial, especially in HF with preserved ejection fraction (HFpEF). Impairment in skeletal muscle may be one of extra-cardiac factors for reduced functional capacity and subsequent poor outcome.
Purpose
We sought to investigate the impact of the impairment in skeletal muscle, defined by the cut-offs proposed by the international consensus, on functional capacity and clinical outcome, in HF patients with preserved and reduced EF (HFrEF).
Methods
This is a multicenter prospective study including 1317 consecutive older (≥65 years) hospitalized patients with HF [HFpEF (ejection fraction ≥45%, n=675, 82±7 years, 46.4% male) and HFrEF (ejection fraction <45%, n=642, 78±8 years, 68.4% male)].
Results
HFrEF patients were more likely to have low skeletal muscle mass measured by bioelectrical impedance analysis (30.9% vs 22.1%, p=0.003) whereas less likely to have low muscle strength (handgrip strength; 62.9% vs 73.8%, p<0.001) than HFpEF, resulting in similar prevalence of sarcopenia between the two groups (21.6% vs 18.1%, p=0.19). In HFrEF, presence of sarcopenia was an independent predictor of reduced functional capacity assessed by a 6-minute walk distance (standardized beta=−0.093, p=0.039 in multivariate linear regression analysis) and 1-year mortality (adjusted hazard ratio (aHR) and 95% CI; 2.14 (1.22–3.70), p=0.009 in multivariate Cox-regression analysis). In patients with HFpEF, sarcopenia could predict mortality (aHR and 95% CI; 2.23 (1.23–3.91), p=0.009), though its association with reduced functional capacity was not significant after multivariate adjustment (standardized beta=−0.059, p=0.20). Kaplan-Meier survival curves in HFpEF and HFrEF are shown (Figure).
Conclusion(s)
In older patients with HF, sarcopenia was similarly contributed to mortality in HFpEF and HFrEF whereas its influence on functional capacity was pronounced in HFrEF.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Japan Heart Foundation Research Grant
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Affiliation(s)
- M Konishi
- Yokohama City University Hospital, Yokohama, Japan
| | - N Kagiyama
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - H Saito
- Kameda Medical Center, Kamogawa, Japan
| | - K Saito
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Momomura
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - K Tamura
- Yokohama City University Hospital, Yokohama, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - K Kamiya
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Matsue
- Juntendo University School of Medicine, Tokyo, Japan
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107
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Murayama M, Iwano H, Tsujinaga S, Nishino H, Yokoyama S, Nakabachi M, Sarashina M, Ishizaka S, Chiba Y, Okada K, Kaga S, Nishida M, Kamiya K, Nagai T, Anzai T. Simple echocardiographic scoring system to estimate left ventricular filling pressure based on visual assessment of time sequence of mitral and tricuspid valve opening. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In the presence of elevated left ventricular (LV) filling pressure, mitral valve (MV) becomes to open early and precedes tricuspid valve (TV) opening in early diastole. Accordingly, time-delay of right ventricular inflow relative to LV inflow assessed by dual Doppler system was recently reported as a parameter of LV filling pressure. We assumed that visually-assessed time-delay of TV relative to MV opening could be a simple and alternative marker of elevated LV filling pressure.
Purpose
This study aimed to elucidate the clinical usefulness of the 2-dimensional echocardiographic scoring system, Visual assessment of time-difference between Mitral and Tricuspid valve opening (VMT) score, in patients with heart failure (HF).
Methods
We analyzed 119 consecutive HF patients who underwent echocardiography and cardiac catheterization within a day. Elevated LV filling pressure was defined as mean pulmonary arterial wedge pressure (PAWP) ≥15 mmHg. LV diastolic function was graded according to the ASE/EACVI recommendations. Time sequence of opening of MV and TV was visually assessed in the apical 4-chamber view and scored to 3 grades (0: TV opening first, 1: simultaneous, 2: MV opening first). When the inferior vena cava diameter was >21 mm and collapsed <20% during normal respiration, 1 point was added and VMT score was calculated as 4 grades from 0 to 3. We also investigated 113 patients without worsening HF at VMT scoring for cardiac events defined as worsening HF, LV assist device implantation, or cardiac death for 1 year after the echocardiography.
Results
VMT was scored as 0 in 20 patients, 1 in 50 patients, 2 in 37 patients, and 3 in 12 patients. PAWP was elevated in patients with VMT score of 2 and 3 (0: 10±5, 1: 12±4, 2: 22±8, 3: 28±4 mmHg, ANOVA P<0.001) (Figure). In overall patients, VMT≥2 predicted elevated PAWP with accuracy of 86%. When the accuracy was tested in patients with reduced (<40%, HFrEF) and preserved LV ejection fraction (≥40%) respectively, the accuracy was excellent in HFrEF (96% and 77%, respectively). Importantly, VMT≥2 also had good accuracy of 82% for elevated PAWP in 33 patients in whom recommendations usually cannot grade diastolic function due to monophasic LV inflow. In the sequential Cox models, the addition of VMT score to the model including the plasma brain natriuretic peptide (BNP) level and LV diastolic grading improved the predictive power for elevated PAWP (P<0.001). During the follow-up, 20 cardiac events were observed (6 worsening HF, 9 LV assist device implantation and 5 cardiac death). Kaplan-Meier analysis showed that the patients with VMT≥2 were at higher risk of cardiac events than those with VMT≤1 (log-rank test P<0.001) (Figure).
Conclusions
The VMT score was a simple and accurate marker of elevated LV filling pressure and has an incremental benefit over BNP and LV diastolic function grading. Moreover, it could be a novel prognostic marker in patients with HF.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Murayama
- Hokkaido University Hospital, Sapporo, Japan
| | - H Iwano
- Hokkaido University Hospital, Sapporo, Japan
| | - S Tsujinaga
- Hokkaido University Hospital, Sapporo, Japan
| | - H Nishino
- Hokkaido University Hospital, Sapporo, Japan
| | - S Yokoyama
- Hokkaido University Hospital, Sapporo, Japan
| | - M Nakabachi
- Hokkaido University Hospital, Sapporo, Japan
| | - M Sarashina
- Hokkaido University Hospital, Sapporo, Japan
| | - S Ishizaka
- Hokkaido University Hospital, Sapporo, Japan
| | - Y Chiba
- Hokkaido University Hospital, Sapporo, Japan
| | - K Okada
- Hokkaido University, Sapporo, Japan
| | - S Kaga
- Hokkaido University, Sapporo, Japan
| | - M Nishida
- Hokkaido University Hospital, Sapporo, Japan
| | - K Kamiya
- Hokkaido University Hospital, Sapporo, Japan
| | - T Nagai
- Hokkaido University Hospital, Sapporo, Japan
| | - T Anzai
- Hokkaido University Hospital, Sapporo, Japan
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108
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Jujo K, Kagiyama N, Kamiya K, Saito H, Saito K, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Kasai T, Nagamatsu H, Ozawa T, Matsue Y. Social frailty provides additive prognostic impact on one-year outcome in aged patients with congestive heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1152] [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
Frailty is associated with multisystem declines in physiologic reserve and increased vulnerability to stressors, resulting in increased risks of adverse clinical outcomes in patients with heart failure (HF). Although frailty is conceptualized as an accumulation of deficits in multiple areas, most of the studies have focused mainly on physical frailty, and the social domains is one of the least investigated area.
Objectives
We prospectively evaluated the incidence and prognostic implication of social frailty (SF) in older patients with HF.
Methods
The FRAGILE-HF is a multicenter, prospective cohort study including patients hospitalized for HF and aged ≥65 years old. We defined SF by Makizako's 5 items, which are 5 questions proposed and validated to be associated with future disability. The primary endpoint of this study was a composite of death from any cause and rehospitalization due to HF. The impact of SF on all-cause mortality alone was also evaluated.
Results
Among 1,240 hospitalized HF patients, 5 simple questions revealed that 825 (66.5%) were in SF. During 1-year observation period after the discharge, the combined endpoint was observed in 399 (32.2%) patients, and 145 (11.7%) patients died. Kaplan-Meier analysis showed that SF patients had significantly higher rates of both the combined endpoint and all-cause mortality than those without SF (Log-rank test: p<0.05 for both, Figures). Moreover, SF remained independently associated with higher event rate of the combined endpoint (hazard ratio: 1.30; 95% confidence interval: 1.02 to 1.66; p=0.038) and all-cause mortality (hazard ratio: 1.53; 95% confidence interval: 1.01 to 2.30; p=0.044), even after adjusting for other covariates. Significant incremental prognostic value was shown when information on social frailty was added to known risk factors for combined endpoint (NRI: 0.189, 95% confidence interval: 0.063–0.316, p=0.003) and all-cause mortality (NRI: 0.234, 95% confidence interval: 0.073–0.395, p=0.004).
Conclusions
Among older hospitalized patients with heart failure, two-thirds of the population was with SF. Evaluating SF provides additive prognostic information in elderly patients with heart failure.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Novartis Pharma Research Grants, Japan Heart Foundation Research Grant
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Affiliation(s)
- K Jujo
- Tokyo Women's Medical University, Tokyo, Japan
| | - N Kagiyama
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - K Kamiya
- Kitasato University, Rehabilitation, Tokyo, Japan
| | - H Saito
- Kameda Medical Center, Chiba, Japan
| | - K Saito
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - E Maekawa
- Kitasato University, Nursing, Tokyo, Japan
| | - M Konishi
- Yokohama City University Medical Center, Yokohama, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Iwata
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - H Wada
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - T Kasai
- Juntendo University School of Medicine, Tokyo, Japan
| | - H Nagamatsu
- Tokai University School of Medicine, Kanagawa, Japan
| | - T Ozawa
- Odawara Municipal Hospital, Rehabilitation, Kanagawa, Japan
| | - Y Matsue
- Juntendo University School of Medicine, Tokyo, Japan
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109
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Kobayashi Y, Nagai T, Kamiya K, Konishi T, Sato T, Omote K, Kato Y, Komoriyama H, Tsujinaga S, Iwano H, Kusano K, Yasuda S, Ogawa H, Ueda H, Anzai T. Long-term prognostic significance of dispersion of ventricular repolarization in patients with cardiac sarcoidosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2145] [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
Although the presence of cardiac involvement is recognised as a determinant of worse clinical outcomes in sarcoidosis patients, the determinants of adverse outcomes in patients with cardiac sarcoidosis (CS) have not been well understood. T-peak to T-end interval (TpTe) on the surface electrocardiogram (ECG) was proposed as a marker of dispersion of ventricular repolarisation. Prolonged TpTe to QT interval ratio (TpTe/QT) represents a period of potential vulnerability to reentrant ventricular arrhythmias. Notably, prolonged TpTe/QT has been associated with increased risk of mortality in hypertrophic cardiomyopathy, congenital long-QT syndrome, and Brugada syndrome. However, its prognostic implication in patients with CS is unclear.
Purpose
We sought to investigate whether TpTe/QT was associated with long-term clinical outcomes in patients with CS.
Methods
A total of 108 consecutive CS patients between August 1986 and March 2019 in two academic hospitals who had ECG data before initiation of immunosuppressive therapy were examined. We excluded patients who received pacemaker (n=15) or cardiac resynchronization therapy (n=3) at the time of ECG. Ultimately, 90 CS patients were included in this study. All standard 12-lead ECGs were recorded at 25 mm/s with an amplification of 10 mm/mV. TpTe was measured from the peak of T wave to the end of T wave which defined as the intersection of the tangent to the down slope of the T wave and the isoelectric line. Lead V5 was selected for the analyses. If V5 is not suitable for analyses, V4 was selected. The primary outcome was the composite of advanced atrioventricular block (AVB), ventricular tachycardia or ventricular fibrillation (VT/VF), heart failure hospitalisation and all-cause death.
Results
During a median follow-up period of 4.70 (interquartile range [IQR] 2.06–7.23) years, adverse events occurred in 21 patients (23.3%), including 2 advanced AVB, 12 VT/VF, 4 heart failure hospitalisation and 3 all-cause death. Events group had higher TpTe/QT compared to no events group (0.231 [IQR 0.193–0.261] vs. 0.282 [IQR 0.263–0.304] P<0.001). Kaplan-Meier analyses revealed that the primary outcome, especially VT/VF or sudden cardiac death more frequently occurred in patients with higher TpTe/QT (≥0.242, the median) compared to those with lower TpTe/QT (Figure 1). Multivariable Cox regression analysis showed that higher TpTe/QT was independently associated with increased subsequent risk of adverse events (hazard ratio 1.09, 95% confidence interval [CI] 1.02–1.17, P=0.014) even after adjustment for age, sex and left ventricular ejection fraction. Furthermore, the optimal cut-off value of TpTe/QT for the discriminatory of primary outcome was 0.257, and c-index was 0.77 (95% CI 0.64–0.89).
Conclusions
Higher TpTe/QT was associated with worse long-term clinical outcomes in patients with CS. Our findings indicate the importance of assessing TpTe/QT for risk stratification in patients with CS.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Kobayashi
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Konishi
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Sato
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - S Tsujinaga
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Ogawa
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Ueda
- National Cerebral and Cardiovascular Center Hospital, Department of Clinical Pathology, Osaka, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
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110
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Abstract
Background Cancer incidence in Fukushima Prefecture, especially thyroid cancer, has been a public concern, since the Tokyo Electric Power Company Fukushima Daiichi Nuclear Power Plants accident following the Great East Japan Earthquake on March 11, 2011; however, cancer incidence for Fukushima residents before and after the accident based on a population-based cancer registry (PBCR) has not been known worldwide. Methods We obtained the corrected-incidence data for invasive cancers newly diagnosed from 2008 through 2015 from the Fukushima Cancer Registry. We checked data quality indicators for PBCRs to confirm comparability. We calculated age-standardized annual incidence and mortality of cancer for all-site, thyroid, and leukemia by calendar year and sex, as we did for Tochigi Prefecture and all of Japan as references for comparison. We applied joinpoint trend analysis to test an apparent trend in incidence and mortality. Results The corrected incidence data from the Fukushima Cancer Registry had sufficient quality comparable to other PBCRs. For the age-standardized annual incidence by sex and cancer type in Fukushima and Tochigi, we did not detect any joinpoint in trend with statistical significance. Cancer incidence gently increased from 2008 through 2015 nationwide. Incidence and mortality of cancer for Fukushima before the accident was very close to that for Tochigi. Conclusions We interpreted the incidence statistics of cancer for Fukushima residents from 2008 through 2015. Our results will provide fundamental statistics for subsequent researchers to assess the relationship between the disaster and cancer incidence among Fukushima residents in the long term.
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Affiliation(s)
- Akiko Shibata
- Center for Cancer Control and Information Services, National Cancer Center
| | - Shigehira Saji
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Medical Oncology, Fukushima Medical University School of Medicine
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Public Health, Fukushima Medical University School of Medicine
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111
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Hashimoto S, Nagai M, Ohira T, Fukuma S, Hosoya M, Yasumura S, Satoh H, Suzuki H, Sakai A, Ohtsuru A, Kawasaki Y, Takahashi A, Okazaki K, Kobashi G, Kamiya K, Yamashita S, Fukuhara SI, Ohto H. Influence of post-disaster evacuation on incidence of hyperuricemia in residents of Fukushima Prefecture: the Fukushima Health Management Survey. Clin Exp Nephrol 2020; 24:1025-1032. [PMID: 32715354 PMCID: PMC7524849 DOI: 10.1007/s10157-020-01924-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 06/25/2020] [Indexed: 11/13/2022]
Abstract
Aim After the Great East Japan Earthquake, over 160,000 residents in Fukushima Prefecture were forced to evacuate the area around the Fukushima Daiichi power plant following nuclear accident there. Health problems in these evacuees have since become a major issue. We have examined the association between evacuation and incidence of hyperuricemia among residents in Fukushima. Methods We conducted a cohort study of residents aged 40–90 years without hyperuricemia at the time of the Fukushima disaster. Among 8173 residents who met the inclusion criteria before the disaster, 4789 residents (men: 1971, women: 2818; follow-up duration: 1.38 years; and follow-up rate: 58.6%) remained available for follow-up examinations at the end of March 2013. The main endpoint was incidence of hyperuricemia, defined by the Japanese committee guidelines, using local health data from before and after the disaster. We divided participants by evacuation status and compared outcomes between groups. Using a logistic regression model, we estimated the odds ratio for incidence of hyperuricemia, adjusting for potential confounders, age, gender, waist circumference, physical activity, and alcohol consumption. Results Incidence of hyperuricemia was higher in evacuees (men 10.1%; women 1.1%) than in non-evacuees (men 7.4%, women 1.0%). Evacuees had higher body mass index, waist circumference, triglycerides, LDL-cholesterol, fasting plasma glucose, HbA1c, and lower HDL-cholesterol after the disaster than non-evacuees. We found that evacuation was associated with incidence of hyperuricemia (adjusted odds ratio: 1.38; 95% confidence interval: 1.03–1.86). Conclusion This is the first study to demonstrate an association between evacuation after a disaster and increased incidence of hyperuricemia.
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Affiliation(s)
- Shigeatsu Hashimoto
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan. .,Departmnt of Endocrinology, Metabolism, Diabetology and Nephrology, Fukushima Medical University Aizu Medical Center, 21-2, Maeda, Tanisawa Kawahigashi, Aizuwakamatsu, Fukushima, 969-3492, Japan.
| | - Masato Nagai
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shingo Fukuma
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan.,Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Cardiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Okazaki
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Shun-Ichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center, Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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112
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Takahashi K, Takahashi H, Nakaya T, Yasumura S, Ohira T, Ohto H, Ohtsuru A, Midorikawa S, Suzuki S, Shimura H, Yamashita S, Tanigawa K, Kamiya K. Factors Influencing the Proportion of Non-examinees in the Fukushima Health Management Survey for Childhood and Adolescent Thyroid Cancer: Results From the Baseline Survey. J Epidemiol 2020; 30:301-308. [PMID: 31204362 PMCID: PMC7280055 DOI: 10.2188/jea.je20180247] [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] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND After the Fukushima Daiichi Nuclear Power Plant accident, a preliminary ultrasound-based screening for thyroid cancer was conducted to establish a baseline for subsequent evaluations. In this survey, we assessed the relationship between the proportion of non-examinees and characteristics of the target populations. METHODS After summarizing a regional difference of non-examinees among the population of 359,200 (primary evaluation) and 2,246 (confirmatory testing) individuals who were living in Fukushima Prefecture on March 11, 2011, we estimated odds ratios (ORs) for each characteristic, including age, sex, area of residence, and moving after the accident, based on the proportion of non-examinees for the primary examination and the confirmatory testing, using a multivariate logistic regression model. RESULTS The dataset included 64,117 non-examinees (primary evaluation) and 194 (confirmatory testing). The logistic regression result indicated that girls were not likely to be non-examinees compared to boys, with adjusted OR of 0.80 (95% confidence interval [CI], 0.78-0.81) for the primary evaluation. Odds were lowest for children 6-10 years old (OR 0.26; 95% CI, 0.25-0.27), and higher for those 11-15 years old (OR 1.28; 95% CI, 1.25-1.32) and over 16 years old (OR 5.30; 95% CI, 5.16-5.43) when compared to children 0-5 years old. Individuals residing in the western part of the prefecture showed higher ORs. There was a higher proportion of non-examinees among those who moved after the accident compared to those who did not in the primary evaluation (OR 1.72; 95% CI, 1.64-1.79). CONCLUSIONS In addition to demographic characteristics, a change of residence could be a potential factor that influenced the proportion of non-examinees. Our results will help proper interpretation of reports and prospective management of the survey.
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Affiliation(s)
- Kunihiko Takahashi
- Department of Biostatistics, Nagoya University Graduate School of Medicine
| | - Hideto Takahashi
- National Institute of Public Health.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Public Health, Fukushima Medical University School of Medicine
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Sanae Midorikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Shinichi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Thyroid and Endocrinology, Fukushima Medical University
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Laboratory Medicine, Fukushima Medical University School of Medicine
| | - Shunichi Yamashita
- Fukushima Medical University.,Nagasaki University.,Center for Advanced Radiation Emergency Medicine, National Research Institutes for Quantum and Radiological Science and Technology
| | - Koichi Tanigawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Research Institute for Radiation Biology and Medicine, Hiroshima University
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113
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Takahashi H, Yasumura S, Takahashi K, Ohira T, Ohtsuru A, Midorikawa S, Suzuki S, Shimura H, Ishikawa T, Sakai A, Suzuki S, Yokoya S, Tanigawa K, Ohto H, Kamiya K. Nested matched case control study for the Japan Fukushima Health Management Survey's first full-scale (second-round) thyroid examination. Medicine (Baltimore) 2020; 99:e20440. [PMID: 32629628 PMCID: PMC7337421 DOI: 10.1097/md.0000000000020440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Since Fukushima nuclear accident in 2011, thyroid ultrasound examinations have been conducted. The first full-scale examination detected 71 thyroid-cancer cases. This study examined whether radiation exposure was associated with thyroid-cancer incidence.Subjects were participants in the baseline screening and newborns during the 2011 fiscal year. Under nested matched case-control study design, 10 controls per each case were selected by matching the age, sex, baseline screening results, and interval between examinations. With 3 dose levels of external radiation: 1.3 + mSv (upper), 0.8 to 1.3 (middle), and 0.0 to 0.8 (reference), we applied 2 logistic models adjusting for 3 participation-proportions (primary, secondary, and fine-needle aspiratory cytology), overweight, and the B-result of baseline screening (Model 1), and past medical history, family history of thyroid cancer, and frequencies of eating seafood and seaweed in addition to the parameters in Model 1 (Model 2). We examined each model in 3 ways: (a) excluding subjects with a missing radiation exposure dose; and substituting (b1) median or (b2) mean dose of the municipality with missing dose.Odds ratios (ORs) of middle-dose exposure were (a) 1.35 (0.46-3.94), (b1) 1.55 (0.61-3.96), and (b2) 1.23 (0.50-3.03) for Model 1, and (a) 1.18 (0.39-3.57), (b1) 1.31 (0.49-3.49), and (b2) 1.02 (0.40-2.59) for Model 2. For upper-dose exposure, similar results were obtained. Past medical history was significantly associated (odds ratio = 2.04-2.08) with both (b1) and (b2) in Model 2.No significant associations were obtained between the external radiation exposure and thyroid-cancer incidence.
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Affiliation(s)
- Hideto Takahashi
- National Institute of Public Health, Saitama
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima
| | - Kunihiko Takahashi
- Department of Biostatistics M&D Data Science Center Tokyo Medical and Dental University
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Epidemiology
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Health Management
| | - Sanae Midorikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Health Management
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Laboratory Medicine
| | - Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Physics and Chemistry
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Department of Radiation Life Sciences
| | - Shinichi Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University, Fukushima
| | - Koichi Tanigawa
- Fukushima Global Medical Science Center, Fukushima Medical University
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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114
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Shimura H, Yokoya S, Kamiya K. An Accurate Picture of Fukushima's Thyroid Ultrasound Examination Program. Arch Pathol Lab Med 2020; 144:797. [DOI: 10.5858/arpa.2019-0465-le] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Hiroki Shimura
- Radiation Medical Science Center and Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
| | - Susumu Yokoya
- Radiation Medical Science Center and Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center and Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
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115
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Ishikawa T, Yasumura S, Akahane K, Yonai S, Ohtsuru A, Sakai A, Ohira T, Kamiya K. AGE DEPENDENCE OF INDIVIDUAL EXTERNAL DOSES IN AN EARLY STAGE AFTER THE FUKUSHIMA NUCLEAR ACCIDENT. Radiat Prot Dosimetry 2020; 188:238-245. [PMID: 31875902 DOI: 10.1093/rpd/ncz281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/18/2019] [Accepted: 11/23/2019] [Indexed: 06/10/2023]
Abstract
Individual external doses for the first 4 months after the Fukushima accident have been estimated by the 'Basic Survey' of the Fukushima Health Management Survey. On the other hand, the UNSCEAR 2013 report presented the first-year effective dose due to external radiation for each municipality in nonevacuated areas of Fukushima Prefecture. In this study, the doses estimated by the Basic Survey were averaged for each of three age groups (infants, 0-5 y; children, 6-15 y; and adults, >16 y), in accordance with the categories adopted by the UNSCEAR report. The average dose ratios (infants/adults and children/adults) obtained from the Basic Survey were 1.08 and 1.06 for nonevacuated areas, respectively. These were smaller than the estimation by the UNSCEAR report (1.7 and 1.4, respectively). Three factors (body size factor, location factor and occupancy factor) were discussed and the location and occupancy factors were likely to be reasons for the difference.
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Affiliation(s)
- Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
| | - Keiichi Akahane
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba City, 263-8555 Japan
| | - Shunsuke Yonai
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba City, 263-8555 Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima City, 960-1295 Japan
- Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, 734-8551 Japan
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116
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Kawasaki Y, Nakano H, Hosoya M, Yasumura S, Ohira T, Satoh H, Suzuki H, Sakai A, Ohtsuru A, Takahashi A, Kobashi G, Kamiya K. Influence of post-disaster evacuation on childhood obesity and hyperlipidemia. Pediatr Int 2020; 62:669-676. [PMID: 31961051 DOI: 10.1111/ped.14162] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/22/2019] [Accepted: 01/15/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND The objectives of this study were to determine the longer-term trends in childhood obesity and hyperlipidemia among residents of Fukushima Prefecture 5 years after the Great East Japan Earthquake. METHODS We evaluated the changes in height, weight, body mass index (BMI) standard deviation score (BMI-SDS), low-density lipoprotein-cholesterol (LDL-CHO), high-density lipoprotein-cholesterol (HDL-CHO), and triglyceride (TG) in residents aged 7-15 years who had lived in the evacuation zone between 2011 and 2015. RESULTS (i) the mean BMI SDS in all residents in 2011 was 0.113, and the mean BMI-SDS in all residents gradually decreased from 2011 to 2015; (ii) serum LDL-CHO levels and TG levels in all residents with a BMI value ≧ 2SD in 2011 were higher than those in residents with a BMI value <2SD; (iii) the frequency of residents with an LDL-CHO level ≥ 140 mg/dl in 2012, 2013, and 2014 did not decrease in comparison with that in 2011, whereas the frequency of residents with an LDL-CHO level of ≥ 140 mg/dl in 2015 was lower than that in 2011. The frequency of residents with a TG level ≥ 120 mg/dl increased over the 5 years. CONCLUSIONS These results suggest that a number of pediatric residents suffered from obesity and hyperlipidemia. Furthermore, the long-term observation indicated an improvement in obesity, although the improvement in lipid abnormalities was delayed compared with that in obesity. Thus, it is necessary to continue with health checks for these residents with obesity and/or hyperlipidemia.
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Affiliation(s)
- Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Departments of, Department of, Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hironori Nakano
- Department of, Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Public Health, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Metabolism and Endocrinology, Juntendo University, Tokyo, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of, Gastroenterology and Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Tochigi, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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117
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Jinnouchi H, Ohira T, Kakihana H, Matsudaira K, Maeda M, Yabe H, Suzuki Y, Harigane M, Iso H, Kawada T, Yasumura S, Kamiya K. Lifestyle factors associated with prevalent and exacerbated musculoskeletal pain after the Great East Japan Earthquake: a cross-sectional study from the Fukushima Health Management Survey. BMC Public Health 2020; 20:677. [PMID: 32404138 PMCID: PMC7222503 DOI: 10.1186/s12889-020-08764-9] [Citation(s) in RCA: 3] [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: 12/23/2019] [Accepted: 04/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background While the prevalence of post-disaster musculoskeletal pain has been documented, its associated disaster-related factors have not been investigated. This study was to investigate the association of lifestyle factors associated with musculoskeletal pain after the Great East Japan Earthquake. Methods We conducted a cross-sectional study of 34,919 participants, aged 40–89 years, without any major disabilities at about 1 year after the disaster. The participants were asked about their musculoskeletal pain (low back and limb pain) and lifestyle factors: use of evacuation shelters or temporary housing at any point of time, job loss after the disaster, decreased income after the disaster, current smoking status, current drinking status, lack of sleep, regular exercise, and participation in recreational or community activities. Furthermore, psychological factors, such as traumatic reactions, psychological distress, and uncomfortable symptoms, affecting musculoskeletal pain were assessed. We used multinomial logistic regression analysis to calculate odds ratios of each lifestyle factor for prevalent and prevalent plus exacerbated musculoskeletal pain. Results Musculoskeletal pain prevalence was 32.8%: 27.6% for prevalent and 5.2% for prevalent plus exacerbated musculoskeletal pain. Multivariable adjusted odds ratios and 95% confidence intervals of lifestyle factors associated with prevalent and prevalent plus exacerbated musculoskeletal pain were as follows: shelter use (prevalent: 1.02, 0.96–1.08; exacerbated: 1.44, 1.29–1.60), job loss (prevalent: 1.03, 0.96–1.10; exacerbated: 1.30, 1.16–1.47), decreased income (prevalent: 1.13, 1.05–1.21; exacerbated: 1.29, 1.14–1.45), current heavy drinking (prevalent: 1.33, 1.21–1.47; exacerbated: 1.38, 1.14–1.68), insomnia (prevalent: 1.22, 1.15–1.29; exacerbated: 1.50, 1.36–1.65), exercising almost daily (prevalent: 0.83, 0.77–0.91; exacerbated: 0.80, 0.68–0.95), and participating in community activities often (prevalent: 0.83, 0.75–0.92; exacerbated: 0.76, 0.61–0.95). Conclusions Prevalent and exacerbated musculoskeletal pain were inversely associated with exercising almost daily and participating in recreational or community activities sometimes or often, and positively associated with decreased income, current heavy drinking, and insomnia. Besides, the use of evacuation shelters or temporary housing/job loss was positively associated only with exacerbated musculoskeletal pain. These results suggest that post-disaster lifestyle factors are potentially associated with musculoskeletal pain. To achieve better post-disaster pain management, further studies are needed to confirm the consistency of these results in other disasters and to highlight the underlying causative mechanisms.
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Affiliation(s)
- Hiroshige Jinnouchi
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan. .,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. .,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, 305-8575, Japan.
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Hironobu Kakihana
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, the University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Center of Neurology and Psychiatry, National Institute of Mental Health, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, 305-8575, Japan
| | - Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima, 960-1295, Japan.,Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8553, Japan
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118
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Ohira T, Shimura H, Hayashi F, Nagao M, Yasumura S, Takahashi H, Suzuki S, Matsuzuka T, Suzuki S, Iwadate M, Ishikawa T, Sakai A, Suzuki S, Nollet KE, Yokoya S, Ohto H, Kamiya K. Absorbed radiation doses in the thyroid as estimated by UNSCEAR and subsequent risk of childhood thyroid cancer following the Great East Japan Earthquake. J Radiat Res 2020; 61:243-248. [PMID: 32030428 PMCID: PMC7246065 DOI: 10.1093/jrr/rrz104] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/14/2019] [Indexed: 05/06/2023]
Abstract
The identification of thyroid cancers among children after the Chernobyl nuclear power plant accident propelled concerns regarding long-term radiation effects on thyroid cancer in children affected by the Fukushima Daiichi nuclear power plant accident in Fukushima, Japan. Herein we consider the potential association between absorbed dose in the thyroid and the risk of developing thyroid cancer as detected by ultrasonography on 300 473 children and adolescents aged 0-18 years in Fukushima. The absorbed dose mentioned in the present study indicates the sum of that from external exposure and that from internally deposited radionuclides. We grouped participants according to estimated absorbed doses in each of 59 municipalities in Fukushima Prefecture, based on The United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) 2013 report. The 59 municipalities were assigned to quartiles by dose. We limited our analyses to participants aged ≥6 years because only one case of thyroid cancer was observed in participants aged ≤5 years; 164 299 participants were included in the final analysis. Compared with the lowest dose quartile, the age- and sex-adjusted rate ratios (95% confidence intervals) for the low-middle, high-middle and highest quartiles were 2.00 (0.84-4.80), 1.34 (0.50-3.59) and 1.42 (0.55-3.67) for the 6-14-year-old groups and 1.99 (0.70-5.70), 0.54 (0.13-2.31) and 0.51 (0.12-2.15) for the >15-year-old group, respectively. No dose-dependent pattern emerged from the geographical distribution of absorbed doses by municipality, as estimated by UNSCEAR, and the detection of thyroid cancer among participants within 4-6 years after the accident. Ongoing surveillance might further clarify the effects of low-dose radiation exposure on thyroid cancer in Fukushima.
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Affiliation(s)
- Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Corresponding author. Department of Epidemiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, Fukushima 960-1295, Japan. Tel: +81-24-547-1344; Fax: +81-24-547-1336;
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Laboratory Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masanori Nagao
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- National Institute of Public Health, Saitama, Japan
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Otorhinolaryngology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Satoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Manabu Iwadate
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shinichi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenneth E Nollet
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Susumu Yokoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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119
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Abstract
Translesion synthesis (TLS) is an error-prone pathway required to overcome replication blockage by DNA damage. Aberrant activation of TLS has been suggested to play a role in tumorigenesis by promoting genetic mutations. However, the precise molecular mechanisms underlying TLS-mediated tumorigenesis in vivo remain unclear. Rev1 is a member of the Y family polymerases and plays a key role in the TLS pathway. Here we introduce the existing to date Rev1-mutated mouse models, including the Rev1 transgenic (Tg) mouse model generated in our laboratory. We give an overview of the current knowledge on how different disruptions in Rev1 functions impact mutagenesis and the suggested molecular mechanisms underlying these effects. We summarize the available data from ours and others’ in vivo studies on the role of Rev1 in the initiation and promotion of cancer, emphasizing how Rev1-mutated mouse models can be used as complementary tools for future research.
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Affiliation(s)
- Megumi Sasatani
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553 Japan
| | - Elena Karamfilova Zaharieva
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553 Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, 734-8553 Japan
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120
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Takahashi A, Ohira T, Okazaki K, Yasumura S, Sakai A, Maeda M, Yabe H, Hosoya M, Ohtsuru A, Kawasaki Y, Shimabukuro M, Kazama J, Hashimoto S, Watanabe K, Nakano H, Hayashi F, Ohto H, Kamiya K, Ohira H. Effects of Psychological and Lifestyle Factors on Metabolic Syndrome Following the Fukushima Daiichi Nuclear Power Plant Accident: The Fukushima Health Management Survey. J Atheroscler Thromb 2020; 27:1010-1018. [PMID: 32009075 PMCID: PMC7508722 DOI: 10.5551/jat.52225] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Aim: The Fukushima Daiichi Nuclear Power Plant accident dramatically changed the lifestyle of residents who lived near the plant. We evaluated the association of metabolic syndrome (MetS) with specific lifestyle- and disaster-related factors in residents following the accident. Methods: This cross-sectional study included 20,920 residents who underwent both the Comprehensive Health Check and the Mental Health and Lifestyle Survey from June 2011 to March 2012. Associations between MetS and lifestyle- and disaster-related factors, including psychological distress (post-traumatic stress disorder [PTSD]), were estimated using logistic regression analysis, adjusted for demographic and lifestyle factors, in 2019. Results: MetS was present in 30.4% of men and 11.5% of women. There were significant differences in smoking, drinking status, and PTSD prevalence between subjects with and without MetS. Multivariable logistic regression analysis showed that age, quitting smoking, and low physical activity were significantly associated with MetS. Moreover, PTSD and light to moderate drinking were also significantly associated with MetS in women. Conclusions: Lifestyle- and disaster-related factors, including PTSD, were associated with MetS among subjects who lived near the Fukushima Daiichi Nuclear Power Plant accident.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Public Health, Fukushima Medical University School of Medicine
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Radiation Life Sciences, Fukushima Medical University School of Medicine
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Disaster Psychiatry, Fukushima Medical University School of Medicine
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Neuropsychiatry, Fukushima Medical University School of Medicine
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Pediatrics, Fukushima Medical University School of Medicine
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Radiation Health Management, Fukushima Medical University School of Medicine
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Diabetology and Endocrinology, Fukushima Medical University School of Medicine
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine
| | | | - Kazuyuki Watanabe
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Fumikazu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine
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121
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Ma E, Ohira T, Sakai A, Yasumura S, Takahashi A, Kazama J, Shimabukuro M, Nakano H, Okazaki K, Maeda M, Yabe H, Suzuki Y, Kamiya K. Associations between Dietary Patterns and Cardiometabolic Risks in Japan: A Cross-Sectional Study from the Fukushima Health Management Survey, 2011-2015. Nutrients 2020; 12:nu12010129. [PMID: 31906499 PMCID: PMC7019971 DOI: 10.3390/nu12010129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/17/2022] Open
Abstract
Cardiometabolic risks were increasing in Fukushima residents after the Great East Japan Earthquake. We examined the association between dietary patterns and cardiometabolic risks in those aged ≥16 years. Dietary patterns were derived by principal component analysis for participants who underwent at least one diet assessment using a short-form food frequency questionnaire during 2011–2013 and a health checkup in 2014 and 2015 (n = 15,409 and 14,999, respectively). In 2014, the adjusted prevalence ratio (PR) and 95% confidence interval (CI) in the highest versus lowest quartile of accumulative mean scores were 0.97 (0.96–0.99) for overweight/obesity, 0.96 (0.95–0.97) for total cholesterol (TC) ≥ 220 mg/dL, 0.96 (0.95–0.98) for low-density lipoprotein cholesterol (LDL-C) ≥ 140 mg/dL, and 0.97 (0.96–0.99) for triglycerides ≥ 150 mg/dL for a vegetable diet and 1.03 (1.01–1.04) for TC ≥ 220 mg/dL and 1.02 (1.01–1.04) for LDL-C ≥ 140 mg/dL for a juice/milk diet. In 2015, we found consistently significant associations for the vegetable and juice/milk diets, and the PR and 95% CI were 0.99 (0.98–1.00) for HDL-C < 40 mg/dL for a meat diet. The continuous promotion of the vegetable pattern diet is necessary to reduce cardiometabolic risks, particularly dyslipidemia, in Japan.
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Affiliation(s)
- Enbo Ma
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Correspondence: ; Tel.: +81-24-547-1788
| | - Tetsuya Ohira
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Akira Sakai
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Junichiro Kazama
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Diabetes, Endocrinology and Metabolism School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Kanako Okazaki
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Masaharu Maeda
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan;
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan;
| | - Kenji Kamiya
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
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122
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Sakai A, Nakano H, Ohira T, Maeda M, Okazaki K, Takahashi A, Kawasaki Y, Satoh H, Ohtsuru A, Shimabukuro M, Kazama J, Hashimoto S, Hosoya M, Yasumura S, Yabe H, Ohto H, Kamiya K. Relationship between the prevalence of polycythemia and factors observed in the mental health and lifestyle survey after the Great East Japan Earthquake. Medicine (Baltimore) 2020; 99:e18486. [PMID: 31895781 PMCID: PMC6946557 DOI: 10.1097/md.0000000000018486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We have been examining the Comprehensive Health Check of the Fukushima Health Management Survey of residents of 13 municipalities who were forced by the government to evacuate due to the 2011 Great East Japan Earthquake (GEJE). Our findings showed that evacuation is a risk factor for polycythemia and suggested that experiencing an unprecedented disaster and exposure to chronic stress due to evacuation might be a cause of polycythemia.We analyzed the relationship between the prevalence of polycythemia and the following factors observed in the Mental Health and Lifestyle Survey in an observational study with a cross-sectional design: traumatic symptoms, depression status, socioeconomic factors such as residential environment, and working situation after the GEJE. Target population of the survey included men and women who were at least 15 years of age and who lived in the evacuation zones specified by the government. Participants analyzed consisted of 29,474 persons (12,379 men and 16,888 women) who had participated in both the 2011 Comprehensive Health Check and Mental Health and Lifestyle Survey from June 2011 through March 2012.The prevalence of polycythemia was not associated with mental states associated with traumatic symptoms (Post-Traumatic Stress Disorder Checklist Scale ≥ 44) and depression status (Kessler 6-item Scale ≥ 13). Furthermore, multivariate analysis showed that there was a tendency for males to develop polycythemia, with characteristics such as being aged 65 years and older, highly educated, obese (body mass index ≥ 25), hypertensive, diabetic, having liver dysfunction, and a smoker being significantly related to the prevalence of polycythemia.Our findings conclusively demonstrated that polycythemia was not significantly related to psychological factors, but was significantly related to the onset of lifestyle-related disease after the GEJE.
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Affiliation(s)
- Akira Sakai
- Department of Radiation Life Sciences
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Disaster Psychiatry
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Gastroenterology
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Metabolism and Endocrinology, Juntendo University, Tokyo
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Health Management
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Diabetes, Endocrinology, and Metabolism
| | - Junichiro Kazama
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Nephrology and Hypertension
| | | | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
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123
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Hayashi F, Sanpei M, Ohira T, Nakano H, Okazaki K, Yasumura S, Nakajima S, Yabe H, Suzuki Y, Kamiya K. Changes in the mental health status of adolescents following the Fukushima Daiichi nuclear accident and related factors: Fukushima Health Management Survey. J Affect Disord 2020; 260:432-439. [PMID: 31539677 DOI: 10.1016/j.jad.2019.09.045] [Citation(s) in RCA: 12] [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: 03/18/2019] [Revised: 07/31/2019] [Accepted: 09/08/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The present study examined the data from the Fukushima Health Management Survey conducted after the Great East Japan Earthquake to identify disaster-related factors affecting the mental health status of adolescents following the disaster and obtained basic data necessary in providing mental healthcare. METHODS The study included 2808 adolescents aged 15-19 years (male: 1327; female: 1481) who completed the 2011 edition of the registered questionnaire. The Kessler Psychological Distress Scale scores, age, sex, health status, sleep satisfaction level, Great East Japan Earthquake experience, experience of losing a loved one, change in employment status, change in residence, and awareness of the impact of radiation on health were examined. RESULTS Psychological distress was significantly correlated with sex, health status, sleep satisfaction of, experience of losing a loved one, change in employment status, extreme anxiety regarding the acute health impact of radiation, and extreme anxiety regarding the impact of radiation on health in adolescents and the next generation. LIMITATIONS The present study is limited because of its cross-sectional design, due to which, the causal relationship between each factor and psychological distress could not be clarified. CONCLUSIONS The results of the present study suggest that appropriate mental healthcare should be administered immediately following an earthquake to adolescents who have lost a loved one and experienced anxiety regarding the health impact of radiation following a nuclear accident.
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Affiliation(s)
- Fumikazu Hayashi
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Megumi Sanpei
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Hironori Nakano
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Kanako Okazaki
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan; Department of Public Health, School of Medicine, Fukushima Medical University, Japan
| | | | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan; Department of Neuropsychiatry, School of Medicine, Fukushima Medical UniversityMusashino University
| | - Yuriko Suzuki
- Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Japan
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124
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Ishikawa T, Yasumura S, Akahane K, Yonai S, Ohtsuru A, Sakai A, Sakata R, Ohira T, Kamiya K. The latest update on individual external doses in an early stage after the Fukushima nuclear accident. Radiat Prot Dosimetry 2019; 187:402-406. [PMID: 31867629 DOI: 10.1093/rpd/ncz274] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/10/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
Following the Fukushima Daiichi Nuclear Power Plant accident, a survey for estimating individual external doses for the first 4 months after the accident was started, and it remains ongoing. Since the authors' previous paper, 44 605 new dose estimates have been made. The new dose estimates increase the number of dose estimates to 465 999 and are reported in this note. Since the previous paper, most of the recently collected responses have been gotten through public relations activities to encourage responses across the prefecture. Thus, recent respondents might be biased ('selection bias'). Also, the dose estimates were based on self-administered responses about personal behaviour, which relied on memories of residents. In this respect, incorrect behaviour records possibly resulted as memories have faded over time ('recall bias'). However, the effects of these biases on dose distribution on a whole-prefecture basis seemed to be small.
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Affiliation(s)
- Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Keiichi Akahane
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Shunsuke Yonai
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan
- Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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125
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Yokoya S, Iwadate M, Shimura H, Suzuki S, Matsuzuka T, Suzuki S, Murono S, Yasumura S, Kamiya K, Hashimoto Y, Suzuki SI. Investigation of thyroid cancer cases that were not detected in the Thyroid Ultrasound Examination program of the Fukushima Health Management Survey but diagnosed at Fukushima Medical University Hospital. Fukushima J Med Sci 2019; 65:122-127. [PMID: 31839647 DOI: 10.5387/fms.2019-26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/22/2022] Open
Abstract
The Great East Japan Earthquake, which occurred on March 11, 2011, and its subsequent Fukushima Daiichi Nuclear Power Plant accident, prompted implementation of the Thyroid Ultrasound Examination (TUE) program as a part of the Fukushima Health Management Survey. The purpose of this program is to support residents of Fukushima Prefecture, and to analyze the health effects of the released radionuclides. Regardless of relatively high participation rates and a well-planned diagnostic flow, it is conceivable that not all thyroid cancer cases can be detected by the TUE program. The aims of the present study were to identify and characterize these "outside" cases, targeting patients at Fukushima Medical University (FMU) Hospital. As of June 30, 2017, we have successfully identified 11 outside cases. These corresponded to 5.7% of the 194 subjects who were identified as having thyroid cancer or suspected thyroid cancer in the TUE program. Although the outside subjects of other institutes were not investigated, the present study may have identified the majority of outside subjects in Japan, considering that FMU Hospital treats a large number of thyroid cancer subjects. Furthermore, the characteristics of the 11 subjects were not different from those of the subjects identified in the TUE program. These findings confirm that the TUE program was able to identify subjects of thyroid cancer adequately and sufficiently.
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Affiliation(s)
- Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine
| | - Manabu Iwadate
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine.,Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine
| | - Hiroki Shimura
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine.,Department of Laboratory Medicine, Fukushima Medical University School of Medicine
| | - Satoru Suzuki
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine.,Department of Otorhinolaryngology, Fukushima Medical University School of Medicine
| | - Satoshi Suzuki
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine.,Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine
| | - Shigeyuki Murono
- Department of Otorhinolaryngology, Fukushima Medical University School of Medicine
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine.,Department of Public Health, Fukushima Medical University School of Medicine
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University School of Medicine.,Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine
| | - Shin-Ichi Suzuki
- Thyroid and Endocrine Center, Fukushima Medical University School of Medicine.,Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine
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126
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Ohtsuru A, Midorikawa S, Ohira T, Suzuki S, Takahashi H, Murakami M, Shimura H, Matsuzuka T, Yasumura S, Suzuki SI, Yokoya S, Hashimoto Y, Sakai A, Ohto H, Yamashita S, Tanigawa K, Kamiya K. Incidence of Thyroid Cancer Among Children and Young Adults in Fukushima, Japan, Screened With 2 Rounds of Ultrasonography Within 5 Years of the 2011 Fukushima Daiichi Nuclear Power Station Accident. JAMA Otolaryngol Head Neck Surg 2019; 145:4-11. [PMID: 30489622 DOI: 10.1001/jamaoto.2018.3121] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Importance Ultrasonographic (US) screening for thyroid cancer was performed in the Fukushima Health Management Survey after the 2011 Fukushima Daiichi nuclear power station accident. Clinical characteristics of thyroid cancers screened by US among children and young adults during the first 5 years after the accident were analyzed. Objectives To evaluate the number of detected thyroid cancers by age group within 5 years of the Fukushima Daiichi nuclear power station accident and to compare the basic clinical characteristics and demographic patterns in first- and second-round examinations. Design, Setting, and Participants In this observational study, 324 301 individuals 18 years or younger at the time of accident were included. Patients received a cytologic diagnosis of malignant or suspected malignant thyroid cancer during the first (fiscal years 2011-2013) or second round (fiscal years 2014-2015) of screening. Number of detected cases of cancer was evaluated, correcting for the number of examinees by age group at the time of the accident and for the incidence of detected cancers according to age group at the time of the screening (age groups were divided into 3-year intervals). Results were compared using the age-specific incidence of unscreened cancers from a national cancer registry. Main Outcomes and Measures Clinical baseline characteristics of the patients and the age-specific number and incidence of thyroid cancers detected during the second round. Results Among 299 905 individuals screened in the first round (50.5% male; mean [SD] age at screening, 14.9 [2.6] years), malignant or suspected thyroid cancer was diagnosed in 116. Among 271 083 individuals screened in the second round (50.4% male; age at screening, 12.6 [3.2] years), malignant or suspected thyroid cancer was diagnosed in 71. The most common pathologic diagnosis in surgical cases was papillary thyroid cancer (149 of 152 [98.0%]). The distribution pattern by age group at the time of the accident, where the number of detected thyroid cancer cases was corrected by the number of examinees, increased with older age in both screening rounds. This demographic pattern was similar between the first and second examinations. The distribution pattern of the incidence rate by age group at the time of screening in the second round also increased with older age. The incidence rate detected by screening was 29 cases per 100 000 person-years for those aged 15 to 17 years, 48 cases per 100 000 person-years for those aged 18 to 20 years, and 64 cases per 100 000 person-years for those aged 21 to 22 years. Conclusions and Relevance Large-scale mass US screening of young people resulted in the diagnosis of a number of thyroid cancers, with no major changes in overall characteristics within 5 years of the 2011 Fukushima nuclear power station accident. These results suggest that US screening can identify many detectable cancers from a large pool of nonclinical and subclinical thyroid cancers among individuals of a relatively young age, in an age-dependent manner.
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Affiliation(s)
- Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Sanae Midorikawa
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Satoru Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Michio Murakami
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Health Risk Communication, Fukushima Medical University, Fukushima, Japan
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Laboratory Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Matsuzuka
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | - Shin-Ichi Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University, Fukushima, Japan
| | - Susumu Yokoya
- Thyroid and Endocrine Center, Fukushima Medical University, Fukushima, Japan
| | - Yuko Hashimoto
- Department of Pathology, Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Koichi Tanigawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Research Institute of Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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127
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Abe Y, Noji H, Miura T, Sugai M, Kurosu Y, Ujiie R, Tsuyama N, Yanagi A, Yanai Y, Ohba T, Ishikawa T, Kamiya K, Yoshida MA, Sakai A. Investigation of the cumulative number of chromosome aberrations induced by three consecutive CT examinations in eight patients. J Radiat Res 2019; 60:729-739. [PMID: 31665444 PMCID: PMC7357232 DOI: 10.1093/jrr/rrz068] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 08/16/2019] [Indexed: 06/10/2023]
Abstract
In our previous study, we found that chromosomes were damaged by the radiation exposure from a single computed tomography (CT) examination, based on an increased number of dicentric chromosomes (Dics) formed in peripheral blood lymphocytes after a CT examination. We then investigated whether a cumulative increase in the frequency of Dics and chromosome translocations (Trs) formation could be observed during three consecutive CT examinations performed over the course of 3-4 years, using lymphocytes in peripheral bloods of eight patients (five males and three females; age range 27-77 years; mean age, 64 years). The effective radiation dose per CT examination estimated from the computational dosimetry system was 22.0-73.5 mSv, and the average dose per case was 40.5 mSv. The frequency of Dics formation significantly increased after a CT examination and tended to decrease before the next examination. Unlike Dics analysis, we found no significant increase in the frequency of Trs formation before and after the CT examination, and we observed no tendency for the frequency to decrease before the next CT examination. The frequency of Trs formation was higher than that of Dics formation regardless of CT examination. Furthermore, neither analysis of Dics nor Trs showed a cumulative increase in the frequency of formation following three consecutive CT examinations.
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Affiliation(s)
- Yu Abe
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideyoshi Noji
- Department of Medical Oncology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomisato Miura
- Department of Bioscience and Laboratory Medicine, Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | - Misaki Sugai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yumiko Kurosu
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Risa Ujiie
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Naohiro Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Aki Yanagi
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukari Yanai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Ohba
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuo Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Mitsuaki A Yoshida
- Department of Radiation Biology, Institute of Radiation Emergency Medicine, Hirosaki University, Hirosaki, Japan
| | - Akia Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
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128
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Takiguchi M, Ohira T, Nakano H, Yumiya Y, Yamaki T, Yoshihisa A, Nakazato K, Suzuki H, Ishikawa T, Yasumura S, Kamiya K, Takeishi Y. Trends in the Incidence of Sudden Deaths and Heart Diseases in Fukushima After the Great East Japan Earthquake. Int Heart J 2019; 60:1253-1258. [PMID: 31666454 DOI: 10.1536/ihj.19-110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
On March 11, 2011, a great earthquake, known as the Great East Japan Earthquake, hit northeastern Japan, resulting in a tsunami that caused a nuclear disaster, the Fukushima Daiichi Nuclear Power Plant accident, forcing about 160,000 people to evacuate. We, therefore, sought to examine the effects of this evacuation on the onset of cardiovascular diseases and sudden death (SD) in Fukushima Prefecture, three years after the earthquake. We divided the evacuation zone into two areas, whole evacuation zone (Area 1) and partial evacuation zone (Area 2), and we defined the north district of the prefecture as the control area (Area 3). We cross-referenced the death certificate data with data from the Fukushima Prefecture acute myocardial infarction registration survey. For each area, we tallied the number of people who fell into the SD, myocardial infarction (MI), and MI suspected groups. We calculated the age-adjusted incidence rates and analyzed the differences in the adjusted incidence rates across three years using a Poisson regression model. The age-adjusted death rate of the SD group was significantly higher in 2011 in all areas than in 2012 or 2013 (P < 0.05). The total death rate was higher in Area 1 in March 2011, just after the disaster, than in the other two areas. The rate of SD was also higher in Area 1 than in the other areas in March 2011. The incidence of sudden cardiac death might have increased just after the Great East Japan Earthquake in the evacuation area, but not in other areas in Fukushima Prefecture.
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Affiliation(s)
- Mai Takiguchi
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Yui Yumiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Epidemiology, Fukushima Medical University School of Medicine
| | - Takayoshi Yamaki
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
| | - Kazuhiko Nakazato
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
| | - Hitoshi Suzuki
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
| | - Tetsuo Ishikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Radiation Physics and Chemistry, Fukushima Medical University School of Medicine
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Department of Public Health, Fukushima Medical University School of Medicine
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University.,Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University School of Medicine
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129
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Omote K, Nagai T, Kamiya K, Aikawa T, Tsujinaga S, Kato Y, Komoriyama H, Kobayashi Y, Iwano H, Yamamoto K, Yoshikawa T, Saito Y, Anzai T. P2634Prognostic value of admission left ventricular outflow tract velocity time integral in hospitalized heart failure patients with preserved ejection fraction: a report from the JASPER registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0955] [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
There are little effective treatment strategies for heart failure with preserved ejection fraction (HFpEF) to achieve a reduction of morbidity and mortality. Thus, accurate prognostication of patients with HFpEF could help improve their outcomes by identifying high-risk patients who might potentially benefit from intensive inpatient and outpatient monitoring and early referral for advanced HFpEF therapy. The left ventricular outflow tract velocity time integral (LVOT-VTI) is a representative non-invasive parameter for evaluating stroke volume, which can be a determinant of adverse outcomes in hospitalized patients with heart failure. However, the prognostic implication of admission LVOT-VTI for hospitalized HFpEF patients is undetermined.
Purpose
The aim of the present study was to investigate whether admission LVOT-VTI could predict poor clinical outcomes in hospitalized patients with HFpEF.
Methods
We examined consecutive 535 hospitalized HFpEF patients (left ventricular ejection fraction ≥50%) due to acute decompensated heart failure from the JASPER (JApanese heart failure Syndrome with Preserved Ejection fRaction) multicenter registry, obtained between November 2012 and March 2015. Patients without accessible LVOT-VTI data on admission were excluded. Finally, 214 patients were examined. The primary outcome of interest was composite of all-cause death and rehospitalization due to heart failure.
Results
Mean age was 78±11 years, 100 were male, and median plasma brain-type natriuretic peptide level was 400 (interquartile range [IQR] 223–711) pg/ml. During a median follow-up period of 688 (IQR 162–810) days, adverse events occurred in 83 patients (39%), including 47 (22%) all-cause death, 51 (24%) rehospitalization due to heart failure. The c-index of LVOT-VTI for predicting the composite of adverse events was 0.59 (95% CI 0.51 to 0.67), and the optimal cut-off value of LVOT-VTI was 15.8 cm. Low LVOT-VTI (≤15.8 cm) was significantly associated with higher adverse events compared to high LVOT-VTI (>15.8 cm) (Figure). Multivariable Cox regression analysis revealed that lower LVOT-VTI was an independent determinant of adverse events (HR 0.94, 95% CI 0.91 to 0.98, P=0.005) even after adjustment for pre-specified confounders including age, sex, systolic blood pressure, serum sodium, albumin, plasma brain-type natriuretic peptide and renal function.
Figure 1
Conclusions
Lower admission LVOT-VTI was an independent determinant of worse clinical outcomes in hospitalized HFpEF patients, indicating that LVOT-VTI on admission could be a useful marker for risk stratification in these patients.
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Affiliation(s)
- K Omote
- Hokkaido University, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Sapporo, Japan
| | | | - Y Kato
- Hokkaido University, Sapporo, Japan
| | | | | | - H Iwano
- Hokkaido University, Sapporo, Japan
| | - K Yamamoto
- Tottori University, Department of Molecular Medicine and Therapeutics, Tottori, Japan
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
| | - Y Saito
- Nara Medical University, First Department of Internal Medicine, Nara, Japan
| | - T Anzai
- Hokkaido University, Sapporo, Japan
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130
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Uchida S, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Ichikawa T, Nakamura T, Yamashita M, Kootaka Y, Maekawa E, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J. P6331Influence of dynapenia and obesity on prognoses of elderly heart failure patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In elderly people, a decline in activities of daily living is more closely associated with low muscle strength (dynapenia) than with low muscle mass. Moreover, the combination of low muscle strength and obesity (dynapenic obesity) is associated with a higher risk of mortality than dynapenia or obesity alone, but its influence on prognosis is still unknown in elderly heart failure (HF) patients. To clarify these relationships may contribute to the development of rehabilitation programs for elderly HF patients and the improvement their prognoses in the future.
Purpose
We aimed to investigate the influence of dynapenia and obesity on prognoses of elderly HF patients.
Methods
We evaluated 1006 elderly HF patients aged ≥65 years (76.5±6.9 years, 579 males) who were admitted to our hospital and participated in an inpatient cardiac rehabilitation program. We assessed patients' characteristics, including body mass index (BMI) and handgrip strength during hospitalization. Patients with low handgrip strength (<26 kg and <18 kg in males and females, respectively) and high BMI (≥25 kg/m2) were considered to have dynapenia and obesity, respectively. Moreover, patients fulfilling the above two criteria (dynapenia, obesity) were considered to have dynapenic obesity. Patients were divided into four groups: normal, dynapenia only, obesity only, and dynapenic obesity. We compared survival rates among the four groups using the Kaplan-Meier method and log-rank test. To identify predictors for all-cause mortality, we performed Cox regression analysis.
Results
During the 8-year follow-up period, 228 patients (21.2%) died. Eight-year cumulative incidences of mortality were 35.4%, 26.0%, 62.6%, and 33.1% in the normal, obesity only, dynapenia only, and dynapenic obesity groups, respectively. Significantly lower survival rates were observed in the dynapenia only group than in the other 3 groups (log-rank: 28.893, P<0.001). Cox regression analysis, after adjusting for age and sex, showed significantly poor prognosis in the dyanapenia only group than in the other 3 groups (normal group, hazard ratio [HR] = 0.684, 95% confidence interval [CI] = 0.488–0.959, P=0.028; obesity only group, HR = 0.330, 95% CI = 0.182–0.598, P<0.001; dynapenic obesity group, HR = 0.390, 95% CI = 0.206–0.739, P=0.004).
Conclusion
Elderly HF patients with dynapenia alone had poor prognoses. Obesity may have protective effects on the survival of dynapenia patients with HF.
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Affiliation(s)
- S Uchida
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Nakamura
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Y Kootaka
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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131
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Nozaki K, Kamiya K, Hamazaki N, Matsuzawa R, Ichikawa T, Nakamura T, Yamashita M, Maekawa E, Matsunaga A, Tojo M, Ako J. P2514Pupillary area predicts all-cause mortality in patients with cardiovascular disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Autonomic dysfunction is among the most important pathophysiological factors involved in the high mortality rate associated with cardiovascular disease (CVD). Autonomic function is generally evaluated by heart rate variability, which is obtained by Holter electrocardiography. However, the measurement of heart rate variability requires continuous electrocardiographic monitoring for 24 h, which is time consuming and not always feasible. The pupillary area is controlled by the autonomic nervous system; however, limited data are available regarding the utility of the pupillary area for predicting prognosis in patients with CVD.
Purpose
We aimed to investigate whether pupillary area can be used as a novel prognostic marker in patients with CVD.
Methods
We retrospectively reviewed 1342 consecutive Japanese patients hospitalized for CVD. The study was performed in accordance with the tenets of the Declaration of Helsinki, and the protocol was approved by the Ethics Committee of our University Hospital. The pupillary area measurement was performed on both eyes at least 7 days after hospitalization for CVD using a portable videopupillography system (Iriscorder Dual C10641; Hamamatsu Photonics, Hamamatsu, Japan) consisting of a goggle-shaped measurement portion with a charge-coupled device camera and a control portion with a video monitor and microcomputer with software for data analysis. After securing the goggles on the patient's face and fully covering the patient's eyes, a 5-minute period was allowed for dark adaptation. All patients were tested once between 09:00 and 12:00 h. The primary outcome of this study was all-cause mortality, and the endpoint time was calculated as the number of days from the date of pupillary area measurement up to three years. We performed the Kaplan–Meier and log-rank tests and multivariable Cox regression analysis to evaluate the prognostic predictive capability of the pupillary area.
Results
The study population had a mean age of 65±13 years, and 69.4% of the patients were male. The median of the pupillary area was 18.5 mm2 (interquartile range: 13.3–23.4 mm2). Over a median follow-up period of 1.9 years (interquartile range: 1.0–3.0 years), a total of 114 deaths occurred in the patient population. The Kaplan–Meier and log-rank tests revealed that all-cause mortality was significantly higher in the small pupillary area group than in the large pupillary area group (P<0.0001, Figure). Furthermore, Cox regression analysis indicated that the pupillary area was an independent predictor of mortality (Hazard ratio: 0.96; 95% confidence interval: 0.93–0.98; P=0.006) even after adjusting for several preexisting prognostic factors.
Kaplan-Meire Curve
Conclusion
The pupillary area can be an independent predictor of prognosis in patients with CVD, and our observations suggest that the assessment of the pupillary area can be useful as a new noninvasive prognostic predictor in patients with CVD.
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Affiliation(s)
- K Nozaki
- Kitasato University Hospital, Rehabilitation, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Nakamura
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular of Medicine, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - M Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular of Medicine, Sagamihara, Japan
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Kobayashi Y, Omote K, Nagai T, Koyanagawa K, Aikawa T, Manabe O, Kamiya K, Kato Y, Komoriyama H, Ohira H, Tsujino I, Tamaki N, Anzai T. 4089Prognostic value of cardiac metabolic activity assessed by 18F-FDG PET in patients with cardiac sarcoidosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0101] [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
Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Among these,the presenceof cardiac involvementis recognized as a determinant of worse clinical outcomes. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a valuable modality for detecting active inflammatory lesions associated with cardiac sarcoidosis (CS). Generally,the maximum standardized uptake value (SUV) is suitable for evaluating disease activity in CS, but this quantitative method had limitations because it does not integrate both volume and intensity of FDG uptake simultaneously. Cardiac metabolic activity (CMA), which is quantitative measures of FDG volume-intensity, could be a diagnostic tool in the evaluation of CS. However, its prognostic implication in patients with CS is unclear.
Purpose
We sought to investigate whether CMA assessed by FDG-PET was associated with long-term worse clinical outcomes in patients with CS.
Methods
A total of 76 consecutive patients suspected CS who underwent FDG-PET between January 2010 and April 2018 in our university hospital were registered. We excluded patients whodid not meet the Japanese Ministry of Health and Welfare 2007 criteria (n=9) and those who received oral corticosteroids at the time of FDG-PET (n=5). Ultimately, 62 CS patients with definitively diagnosed were included in this study.We used a dedicated software to analyze SUV. Cardiac metabolic volume (CMV) was defined as the volume within the boundary determined by the threshold (SUV mean of blood pool × 1.5). CMA was calculated by multiplying CMV by SUV mean. The primary outcome of interest was the composite of advanced atrioventricular block, ventricular tachycardia, ventricular fibrillation, heart failure hospitalization, and all-cause death.
Results
During a median follow-up period of 1287 (IQR 806–1809) days after the first FDG-PET, the adverse events occurred in 12 patients (19%). Events group had significantly higher CMA compared to no events group (83 [IQR 11–330] vs. 354 [IQR 70–577]) (Figure A). Based on ROC analysis, the optimal cut-off value of CMA for the discrimination of the adverse events was 244 ml, and c-index was 0.71 (95% CI, 0.55–0.87). Patients with high CMA (≥244 ml, n=23) had lower LVEF, and higher prevalence of New York Heart Association functional class III or IV, and higher plasma BNP level compared to those with low CMA (<244 ml, n=39). Kaplan-Meier analysis revealed that composite adverse events more frequently occurred in patients with high CMA compared to those with low CMA (Figure B).Univariable Cox regression analysis showed that higher CMA was associated with increased subsequent risk of adverse events (HR 1.47, 95% CI 1.06–2.24).
Conclusions
Higher CMA assessed by FDG-PET was associated with worse clinical long-term outcomes in patients with CS, suggesting that measurement of the volume-intensity of abnormal FDG uptake may be useful for risk stratification in patients with CS.
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Affiliation(s)
| | - K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Koyanagawa
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - O Manabe
- Hokkaido University, Department of Nuclear Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Ohira
- Hokkaido University, First Department of Medicine, Sapporo, Japan
| | - I Tsujino
- Hokkaido University, First Department of Medicine, Sapporo, Japan
| | - N Tamaki
- Kyoto Prefectural University of Medicine, Department of Radiology, Kyoto, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
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Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tabata M, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Ako J. 298Change in respiratory muscle strength predicts clinical events in patients with chronic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Respiratory muscle weakness, frequently observed in patients with chronic heart failure (CHF), has been documented as a predictor for poor prognosis. Several studies have reported that respiratory muscle training increases respiratory muscle strength and consequently improves exercise tolerance and quality of life in these patients. However, the relationship between the change in respiratory muscle strength and prognosis is still unclear.
Purpose
We aimed to investigate whether the change in respiratory muscle strength following cardiac rehabilitation predicts the incidence of clinical events in CHF patients.
Methods
We studied 348 patients with CHF who were hospitalized because of decompensated heart failure and received 5-month cardiac rehabilitation during hospitalization and after hospital discharge. Clinical characteristics including aetiology of heart failure, comorbidity conditions, medications, blood examination and echocardiographic variables were obtained from clinical records. We also measured maximal inspiratory pressure (PImax) as respiratory muscle strength at hospital discharge and 5 months later. The change of PImax (ΔPImax) between the 5-month observation period was examined. We followed up the patients after the observation period and investigated the incidence of all-cause mortality or all-cause unplanned readmission. In statistical analysis, patients were divided into two groups based on the median value of ΔPImax. We compared the event-free survival rate between the two groups using the Kaplan-Meier method with a log-rank test. We also performed the Cox proportional hazard model to clarify whether the ΔPImax was an independent predictor for the incidence of clinical events.
Results
Over a median follow-up of 1.6 years, 121 patients (34.8%) died or readmitted, and their rate of incidence was 21.7/100 person-years. The higher ΔPImax was associated significantly with a higher rate of event-free survival (Log-rank: 8.085, P=0.004, Figure 1). In univariate Cox proportional hazard model, ΔPImax was a significant predictor for the all-cause mortality/readmission (unadjusted hazard ratio for PImax increase of 10 cmH2O: 0.842, 95% CI: 0.763 - 0.931, P=0.001). Even after adjustment for clinical confounding factors including baseline PImax, ΔPImax remained significant and independent predictor for the all-cause mortality/readmission (adjusted hazard ratio for PImax increase of 10 cmH2O: 0.862, 95% CI: 0.763 - 0.974, P=0.017, Figure 2).
Conclusion
This study is the first to demonstrate that the change in respiratory muscle strength following cardiac rehabilitation independently predicts the incidence of clinical events in patients with CHF. The increase in PImax of 10 cmH2O was associated significantly with a 14% decrease in the rate of all-cause mortality or readmission.
Acknowledgement/Funding
JSPS KAKENHI JP16K16442
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Tabata
- Toyohashi Sozo University, Department of Physical Therapy, School of Health Sciences, Toyohashi, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - C Noda
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tabata M, Maekawa E, Fukaya H, Yamaoka-Tojo M, Matsunaga A, Ako J. P3106Atrial fibrillation is not associated with the responses to exercise training in heart failure patients with preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is known as a common arrhythmia in heart failure patients with preserved left ventricular ejection fraction (HFpEF). Several studies have reported that HFpEF patients with AF show lower exercise tolerance and poorer prognosis as compared with those with sinus rhythm (SR). On the other hand, exercise training is documented to improve peripheral muscle function and exercise tolerance in HFpEF patients. However, the relationship between AF status and outcomes due to exercise training is still unclear in these patients.
Purpose
We aimed to investigate the influence of AF on the responses to outcomes with exercise training in HFpEF patients.
Methods
We studied 426 patients with HFpEF who received 5-month cardiac rehabilitation including exercise training during hospitalization and after hospital discharge. As clinical characteristics, we obtained body mass index, disease aetiology, comorbidity conditions, blood examination and echocardiographic variables from medical records. We also measured isometric quadriceps strength (QS) and 6-minute walk distance (6MWD) as peripheral muscle strength and exercise tolerance, respectively. The QS and 6MWD were assessed at hospital discharge as the baseline and 5 months later. AF status was determined by the presence on electrocardiogram at baseline 6MWD or medical history of AF during hospitalization. In statistical analysis, we compared baseline clinical characteristics, QS and 6MWD between the rhythm status (SR group or AF group). We also examined the changes in QS and 6MWD from baseline to the 5-month observation period (ΔQS and Δ6MWD) and compared them between the 2 groups using analysis of covariance with adjustment for baseline clinical confounding factors.
Results
At baseline, 289 patients (68%) were in SR, and 111 patients (26%) had AF. The AF was associated significantly with older age (P<0.001) and lower levels of estimated glomerular filtration rate (P=0.013), QS (P<0.001) and 6MWD (P<0.001) at baseline. The QS increased significantly from 25.2±11.0 kg at baseline to 30.8±13.0 kg after 5-month cardiac rehabilitation in the SR group, and from 21.1±8.3 kg to 26.0±9.4 kg in the AF group (P<0.001, respectively). The 6MWD also increased significantly from 394.8±129.2 to 463.5±133.5 meters in the SR, and from 343.7±107.9 to 403.0±114.5 meters in the AF (P<0.001, respectively). There were no significant differences in ΔQS and Δ6MWD between the SR and AF groups even after adjustment for clinical confounding factors including baseline QS or 6MWD (Figure).
Conclusions
The AF status in HFpEF patients was associated with older age, lower peripheral muscle function and also lower exercise tolerance at baseline, but not associated with the responses to exercise training.
Acknowledgement/Funding
JSPS KAKENHI JP16K16442
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Affiliation(s)
- N Hamazaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Masuda
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - R Matsuzawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - K Nozaki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - T Ichikawa
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - M Tabata
- Toyohashi Sozo University, Department of Physical Therapy, School of Health Sciences, Toyohashi, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - H Fukaya
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - M Yamaoka-Tojo
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - A Matsunaga
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - J Ako
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
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135
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Saito H, Yamashita M, Endo Y, Mizukami A, Yoshioka K, Hashimoto T, Koseki S, Shimode Y, Kitai T, Maekawa E, Kamiya K, Matsue Y. P4516Incremental prognostic values of cognitive impairment diagnosed by mini-mental state examination and mini-cog in older hospitalized patients with heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cognitive impairment (CI) is associated with worse prognosis in patients with heart failure, especially in the elderly; however, its incremental prognostic ability in pre-existing prognostic models has not been well elucidated. Moreover, although some tools have been proposed for evaluating cognitive function, their difference in prognostic prediction has not been explicitly compared.
Methods
A total of 352 heart failure patients aged ≥75 years admitted to three hospitals were evaluated for their cognitive function using the Mini-Mental State Examination (MMSE) and Mini-cog during index hospitalization. We diagnosed CI if MMSE and Mini-cog were ≤23 and ≤2, respectively. The primary endpoint was all-cause death.
Results
The median age of the entire cohort was 85 (IQR: 80–88) years, and 47.7% of the subjects were male. Based on the MMSE and Mini-cog, the CI was diagnosed in 167 (47.4%) and 159 (45.2%) patients, respectively. The two diagnostic tools showed poor to moderate agreement (Cohen's kappa coefficient: 0.37, 95% CI: 0.27–0.47). During the follow-up period of median 346 (IQR: 195–489) days, 53 patients (15.1%) died. Although the Kaplan-Meier analysis showed that CI diagnosed using Mini-cog (CI-MC) was associated with significantly higher mortality (P=0.001), this association was not significant for CI diagnosed using MMSE (CI-MMSE) (P=0.059). On multivariate Cox regression analysis, CI-MMSE and CI-MC were individually associated with worse prognosis in older heart failure patients even after adjustment for Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk model and log B-type natriuretic peptide levels (CI-MMSE, HR: 2.05 [95% CI: 1.16–3.61]; and CI-MC, HR: 2.57 [95% CI: 1.46–4.53]). The receiver operating characteristic curve analysis for Mini-cog showed significantly higher area under the curve (AUC) than that for MMSE (0.61 vs. 0.52, p=0.045). To test the incremental prognostic capability, models were constructed by individually adding each score to the MAGGIC risk model, and the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were evaluated. CI-MMSE did not show incremental prognostic predictability (NRI: 0.28, p=0.069; IDI: 0.01, p=0.090), whereas CI-MC (NRI: 0.45, p=0.001; IDI: 0.03, p=0.001) did. Adding CI-MC instead of CI-MMSE to the MAGGIC risk model showed significant reclassification improvement (NRI: 0.45, p=0.002, IDI: 0.02, p=0.041).
Conclusion
In older patients with heart failure, CI defined by Mini-Cog is superior in providing additive prognostic value than that defined by CI based on MMSE.
Acknowledgement/Funding
This study is partially funded by Japan Heart Foundation Research Grant and Novartis Research Grants.
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Affiliation(s)
- H Saito
- Kameda Medical Center, Department of Rehabilitaion, Kamogawa, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - Y Endo
- Kameda Medical Center, Department of Rehabilitaion, Kamogawa, Japan
| | - A Mizukami
- Kameda Medical Center, Department of Cardiology, Kamogawa, Japan
| | - K Yoshioka
- Kameda Medical Center, Department of Cardiology, Kamogawa, Japan
| | - T Hashimoto
- Kameda Medical Center, Department of Pharmacy, Kamogawa, Japan
| | - S Koseki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - Y Shimode
- Kobe City Medical Center General Hospital, Department of Rehabilitation, Kobe, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Cardiovascular Respiratory Sleep Medicine, Tokyo, Japan
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136
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Ohtsuru A, Takahashi H, Kamiya K. Incidence of Thyroid Cancer Among Children and Young Adults in Fukushima, Japan-Reply. JAMA Otolaryngol Head Neck Surg 2019; 145:770. [PMID: 31194244 DOI: 10.1001/jamaoto.2019.1102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Akira Ohtsuru
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan.,Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.,National Institute of Public Health, Saitama, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.,Hiroshima University, Hiroshima, Japan
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137
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Oe M, Maeda M, Ohira T, Itagaki S, Harigane M, Suzuki Y, Yabe H, Yasumura S, Kamiya K, Ohto H. Parental Recognition of Bullying and Associated Factors Among Children After the Fukushima Nuclear Disaster: A 3-Year Follow-Up Study From the Fukushima Health Management Survey. Front Psychiatry 2019; 10:283. [PMID: 31130880 PMCID: PMC6509247 DOI: 10.3389/fpsyt.2019.00283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/11/2019] [Indexed: 11/30/2022] Open
Abstract
This study examined parental recognition of bullying victimization and associated factors among evacuated children after the 2011 Fukushima Daiichi Nuclear Power Plant accident, using a 3-year follow-up data (wave 1: January 2012; wave 2: January 2013; wave 3: February 2014). The sample included the caregivers of 2,616 children in the first-sixth grades of elementary school, who lived in one of the 13 municipalities that were the target areas of the Mental Health and Lifestyle Survey, conducted as part of the Fukushima Mental Health Management Survey. Across 3 years, around 80% of caregivers responded "not true," 15% responded "somewhat true," and 5% responded "certainly true" in response to a question about bullying victimization of their children. Being male was significantly associated with the parental recognition of bullying victimization at wave 1 and wave 3. At wave 1, experiencing the nuclear plant explosion was significantly associated with parental recognition of bullying victimization. Moreover, age at wave 3 was negatively associated with parental recognition of bullying victimization. Our findings will be helpful for establishing community- and school-based mental health care for children, parents, and teachers.
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Affiliation(s)
- Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Shuntaro Itagaki
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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138
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Tsuyama N, Abe Y, Yanagi A, Yanai Y, Sugai M, Katafuchi A, Kawamura F, Kamiya K, Sakai A. Induction of t(11;14) IgH enhancer/promoter- cyclin D1 gene translocation using CRISPR/Cas9. Oncol Lett 2019; 18:275-282. [PMID: 31289497 PMCID: PMC6539856 DOI: 10.3892/ol.2019.10303] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 04/18/2019] [Indexed: 12/13/2022] Open
Abstract
Chromosomal translocation is a key process in the oncogenic transformation of somatic cells. Previously, artificial induction of chromosomal translocation was performed using homologous recombination-mediated loxP labeling of target regions followed by Cre-mediated recombination. Recent progress in genome editing techniques has facilitated the easier induction of artificial translocation by cutting two targeted genome sequences from different chromosomes. The present study established a system to induce t(11;14)(q13;q32), which is observed primarily in multiple myeloma (MM) and involves the repositioning of the cyclin D1 (CCND1) gene downstream of the immunoglobulin heavy chain (IgH) constant region enhancers by translocation. The placing of tandem gRNAs designed to cut both the IgH Eµ and CCND1 15-kb upstream regions in lentiCRISPRv2 enabled the induction of chromosomal translocation in 293T cells, with confirmation by translocation-specific PCR and fluorescence in situ hybridization probing with IgH and CCND1. At the translocation junctions, small deletions and the addition of DNA sequences (indels) were observed in several clones. Cloned cells with t(11;14) exhibited slower growth and lower CCND1 mRNA expression compared to the parent cells, presenting the opposite phenomena induced by t(11;14) in MM cells, indicating that the silent IgH gene juxtaposed to CCND1 may negatively affect CCND1 gene expression and cell proliferation in the non-B lymphocyte lineage. Therefore, the present study achieved the induction of silent promoter/enhancer translocation in t(11;14)(q13;q32) as a preparatory experiment to study the role of IgH constant region enhancer-driven CCND1 overexpression in oncogenic transformation processes in B lymphocytes.
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Affiliation(s)
- Naohiro Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yu Abe
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Aki Yanagi
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yukari Yanai
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Misaki Sugai
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Atsushi Katafuchi
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Fumihiko Kawamura
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
| | - Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University, Fukushima 960-1295, Japan
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139
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Tamaki J, Fujimori K, Ikehara S, Kamiya K, Nakatoh S, Okimoto N, Ogawa S, Ishii S, Iki M. Estimates of hip fracture incidence in Japan using the National Health Insurance Claim Database in 2012-2015. Osteoporos Int 2019; 30:975-983. [PMID: 30648192 DOI: 10.1007/s00198-019-04844-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [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: 08/13/2018] [Accepted: 01/04/2019] [Indexed: 10/27/2022]
Abstract
UNLABELLED Using the nationwide health insurance claims database, we found that the age-standardized hip fracture incidence rates in Japan indicated significant increase in males but no significant change in females during 2012-2015. The fracture risk in subjects aged 75-84 years indicated decrease in females but no change in males. INTRODUCTION Nationwide registry data on hip fractures have not yet been established in Japan. Using the newly developed National Database of Health Insurance Claims (NDB), which covers the entire Japanese population, we investigated the incidence rates of hip fractures and the associated regional differences. We also assessed the frequency of osteoporosis prescriptions, bone turnover marker (BTM) level, and bone mineral density (BMD) measurements. METHODS The annual numbers of hip fractures, osteoporosis prescriptions, and BTM level and BMD measurements by prefecture from 2012 to 2015 were obtained from NDB data. We calculated the standardized claims-data ratio (SCR) in each prefecture. RESULTS The age-standardized incidence rates from 2012 to 2015 indicated no significant change in females and significant increase in males (p value for trend; 0.920, 0.002, respectively). The fracture risk decreased in females aged 75-84 years and indicated no increase in females aged 85-89 years during 2012-2015, while the fracture risk indicated no change in males aged 75-84 years and increased in males aged 85-89 years. The frequency of osteoporosis prescriptions, BTM level measurements, and BMD measurements in the general population in the corresponding period increased with statistical or marginal significance in females and males. West-east regional differences were observed in the incidence rates; the highest SCR values in the western prefectures were approximately double the lowest values in the eastern prefectures. CONCLUSIONS The age-standardized hip fracture incidence rates indicated no significant change in females and significant increase in males in Japan from 2012 to 2015.
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Affiliation(s)
- J Tamaki
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan.
| | - K Fujimori
- Department of Health Administration and Policy, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - S Ikehara
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - K Kamiya
- Department of Hygiene and Public Health, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka, 569-8686, Japan
| | - S Nakatoh
- Asahi General Hospital, 477, Tomari, Asahi-machi, Shimo-Shinkawa-gun, Toyama, 939-0798, Japan
| | - N Okimoto
- Okimoto Clinic, 185-4, Kubi, Yutaka-machi, Kure-city, Hiroshima, 734-0304, Japan
| | - S Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, the University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Ishii
- Japan Osteoporosis Foundation, 2-14, Oodemma-cho, Nihombashi, Chuo-ku, Tokyo, 103-0011, Japan
| | - M Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2, Oono-Higashi, Osaka Sayama city, Osaka, 589-8511, Japan
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140
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Iizuka D, Izumi S, Suzuki F, Kamiya K. Analysis of a lectin microarray identifies altered sialylation of mouse serum glycoproteins induced by whole-body radiation exposure. J Radiat Res 2019; 60:189-196. [PMID: 30521038 PMCID: PMC6430252 DOI: 10.1093/jrr/rry100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/19/2018] [Indexed: 05/08/2023]
Abstract
Microarrays containing 45 different lectins were analyzed to identify global changes in the glycosylation of serum glycoproteins from mice exposed to whole-body γ-radiation. The results showed that radiation exposure increased and decreased the relative amounts of α-2,3- and α-2,6-sialic acids, respectively. The expression of α-2,3- and α-2,6-sialyltransferase genes in the liver was analyzed to determine whether changes in their expression were responsible for the sialic acid changes. The increase in α-2,3-sialic acid correlated with St3gal5 upregulation after radiation exposure; however, a decrease in St6gal1 expression was not observed. Analysis of a PCR array of genes expressed in irradiated mouse livers revealed that irradiation did not alter the expression of most of the included genes. These results suggest that glycomic screening of serum glycoproteins using lectin microarrays can be a powerful tool for identifying radiation-induced changes in the post-translational addition of sugar moieties to proteins. In addition, the results indicate that altered sialylation of glycoproteins may be an initial response to acute radiation exposure.
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Affiliation(s)
- Daisuke Iizuka
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, Japan
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, Japan
- Corresponding author. Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan. Tel: +81-43-206-3160; Fax: +81-43-206-4138;
| | - Shunsuke Izumi
- Department of Mathematical and Life Sciences, Graduate School of Science, Hiroshima University, 1-3-2, Kagamiyama, Higashi-Hiroshima, Japan
| | - Fumio Suzuki
- Department of Molecular Radiobiology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, Japan
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141
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Kamiya K, Koga K, Matsumoto H, Muraki Y, Shibata S. Angular and Abundance Distribution of High-energy Gamma Rays and Neutrons Simulated by GEANT4 Code for Solar Flares. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920814005] [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: 11/14/2022] Open
Abstract
In the solar flare observed on June 3, 2012, high energy gamma-rays and neutrons were observed. The event includes a remarkable feature of a high neutron/gamma-ratio in the secondary particles. We have examined whether this high n/γ-ratio can be explained by simulation. As a result of simulations using the GEANT4 program, the high n/γ-ratio may be reproduced for the case that helium and other heavy ions were dominantly accelerated in the flare.
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142
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Tedoriya T, Kamiya K, Miyauchi T, Gatate Y, Fukuzumi M, Okano R. Intraoperative Three-Dimensional Model Application as Surgical Navigation for Aortic Valve Leaflet Reconstruction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.040] [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: 11/26/2022]
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143
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Tedoriya T, Kamiya K, Miyauchi T, Fukuzumi M, Gatate Y, Okano R. Virtual Reality Image Analysis in Aortic Valve Leaflet Reconstruction. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.059] [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: 10/26/2022]
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144
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Nakaya T, Takahashi K, Takahashi H, Yasumura S, Ohira T, Ohto H, Ohtsuru A, Midorikawa S, Suzuki S, Shimura H, Yamashita S, Tanigawa K, Kamiya K. Spatial analysis of the geographical distribution of thyroid cancer cases from the first-round thyroid ultrasound examination in Fukushima Prefecture. Sci Rep 2018; 8:17661. [PMID: 30518765 PMCID: PMC6281575 DOI: 10.1038/s41598-018-35971-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/13/2018] [Indexed: 01/22/2023] Open
Abstract
Following the Fukushima Daiichi Nuclear Power Plant (FNPP) accident on 11 March 2011, there have been concerns regarding the health impacts of the ensuing radioactive environmental contamination, which was spatially heterogeneous. This study aimed to assess the geographical variability of thyroid cancer prevalence among children and adolescents in Fukushima Prefecture. We computed the sex- and age-standardised prevalence ratio using 115 diagnosed or suspected thyroid cancer cases among approximately 300,000 examinees at the first-round ultrasound examination during 2011–2015 from 59 municipalities in the prefecture, under the Fukushima Health Management Survey. We applied flexibly shaped spatial scan statistics and the maximised excess events test on the dataset to detect locally anomalous high-prevalence regions. We also conducted Poisson regression with selected regional indicators. Furthermore, approximately 200 examinees showed positive ultrasound examination results but did not undergo confirmatory testing; thus, we employed simulation-based sensitivity tests to evaluate the possible effect of such undiagnosed cases in the statistical analysis. In conclusion, this study found no significant spatial anomalies/clusters or geographic trends of thyroid cancer prevalence among the ultrasound examinees, indicating that the thyroid cancer cases detected are unlikely to be attributable to regional factors, including radiation exposure resulting from the FNPP accident.
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Affiliation(s)
- Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Aoba-ku, Sendai-city, Miyagi, 980-0845, Japan.
| | - Kunihiko Takahashi
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya-city, Aichi, 466-8550, Japan
| | - Hideto Takahashi
- National Institute of Public Health, Wako-city, Saitama, 351-0197, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Health Management, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Sanae Midorikawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Health Management, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Shinichi Suzuki
- Department of Thyroid and Endocrinology, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Hiroki Shimura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki-city, Nagasaki, 852-8523, Japan
| | - Koichi Tanigawa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima-city, Fukushima, 960-1295, Japan.,Research Institute for Radiation Biology and Medicine, Hiroshima University, Minami-ku, Hiroshima-city, Hiroshima, 734-5844, Japan
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145
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Takahashi A, Ohira T, Okazaki K, Yasumura S, Sakai A, Maeda M, Yabe H, Hosoya M, Ohtsuru A, Kawasaki Y, Suzuki H, Shimabukuro M, Sugiura Y, Shishido H, Hayashi Y, Nakano H, Kobashi G, Kamiya K, Ohira H. Effects of lifestyle on hepatobiliary enzyme abnormalities following the Fukushima Daiichi nuclear power plant accident: The Fukushima health management survey. Medicine (Baltimore) 2018; 97:e12890. [PMID: 30335013 PMCID: PMC6211895 DOI: 10.1097/md.0000000000012890] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/25/2018] [Indexed: 01/12/2023] Open
Abstract
Dramatic lifestyle changes due to the Fukushima Daiichi Nuclear Power Plant accident increased the prevalence of hepatobiliary enzyme abnormalities (HEA). We aimed to evaluate associations of HEA with specific lifestyle- and disaster-related factors in residents who lived near the Fukushima Daiichi Nuclear Power Plant.This cross-sectional study included 22,246 residents who underwent a Comprehensive Health Check and the Mental Health and Lifestyle Survey from June 2011 to March 2012. Residents were divided into 2 groups based on residential area and housing status after the accident. Associations between HEA and lifestyle- and disaster-related factors, including psychological distress, were estimated using logistic regression analysis adjusted for demographic and lifestyle factors.HEA was present in 27.3% of subjects. The prevalence of HEA was significantly higher in evacuees than controls (29.5% vs 25.7%, P < .001). There were significant differences in various lifestyle characteristics and the prevalence of post-traumatic stress disorder between evacuees and controls. Multivariable logistic regression analysis showed that age, sex, moderate to heavy drinking, and low/no physical activity were significantly associated with HEA regardless of evacuation status. Changes in jobs and unemployment were significantly associated with HEA in controls and evacuees, respectively.Lifestyle and disaster-related factors, but not psychological distress, were associated with HEA among subjects who lived near the Fukushima Daiichi Nuclear Power Plant accident.
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Affiliation(s)
- Atsushi Takahashi
- Department of Gastroenterology, Fukushima Medical University School of Medicine
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Kanako Okazaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Life Sciences
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Disaster Psychiatry
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neuropsychiatry
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Radiation Health Management
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Pediatrics
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Cardiology
| | - Michio Shimabukuro
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Diabetes, Endocrinology and Metabolism
| | - Yoshihiro Sugiura
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Neurology
| | - Hiroaki Shishido
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Orthopaedic Surgery
| | - Yoshimitsu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Epidemiology
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey
- Department of Public Health, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine
- Radiation Medical Science Center for the Fukushima Health Management Survey
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146
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Omote K, Nagai T, Asakawa N, Komoriyama H, Kato Y, Aikawa T, Tokuda Y, Kamiya K, Nishida M, Kudo Y, Fukushima A, Iwano H, Yokota T, Anzai T. P2812Long-term prognostic significance of liver stiffness non-invasively measured by the virtual touch quantification in patients with acute decompensated heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2812] [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: 11/14/2022] Open
Affiliation(s)
- K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Asakawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Tokuda
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Nishida
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Hokkaido Unive, Sapporo, Japan
| | - Y Kudo
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Hokkaido Unive, Sapporo, Japan
| | - A Fukushima
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yokota
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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147
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Omote K, Nagai T, Asakawa N, Aikawa T, Tokuda Y, Kato Y, Kamiya K, Komoriyama H, Nishida M, Kudo Y, Fukushima A, Iwano H, Yokota T, Anzai T. P3734Clinical value of a non-invasive measurement of increased liver stiffness by using virtual touch quantification for predicting elevated right atrial pressure in heart failure patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3734] [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)
- K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Asakawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Aikawa
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Tokuda
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - M Nishida
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Sapporo, Japan
| | - Y Kudo
- Hokkaido University, Diagnostic Center for Sonography and Division of Laboratory and Transfusion Medicine, Sapporo, Japan
| | - A Fukushima
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Yokota
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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148
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Shimura T, Sasatani M, Kawai H, Kamiya K, Kobayashi J, Komatsu K, Kunugita N. Radiation-Induced Myofibroblasts Promote Tumor Growth via Mitochondrial ROS-Activated TGFβ Signaling. Mol Cancer Res 2018; 16:1676-1686. [PMID: 30042177 DOI: 10.1158/1541-7786.mcr-18-0321] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/06/2018] [Accepted: 07/06/2018] [Indexed: 11/16/2022]
Abstract
Fibroblasts are a key stromal cell in the tumor microenvironment (TME) and promote tumor growth via release of various growth factors. Stromal fibroblasts in cancer, called cancer-associated fibroblasts (CAF), are related to myofibroblasts, an activated form of fibroblast. While investigating the role of stroma fibroblasts on radiation-related carcinogenesis, it was observed following long-term fractionated radiation (FR) that the morphology of human diploid fibroblasts changed from smaller spindle shapes to larger flat shapes. These cells expressed smooth muscle actin (α-SMA) and platelet-derived growth factor receptors, markers of myofibroblasts and CAFs, respectively. Long-term FR induces progressive damage to the fibroblast nucleus and mitochondria via increases in mitochondrial reactive oxygen species (ROS) levels. Here, it is demonstrated that long-term FR-induced α-SMA-positive cells have decreased mitochondrial membrane potential and activated oxidative stress responses. Antioxidant N-acetyl cysteine suppressed radiation-induced mitochondrial damage and generation of myofibroblasts. These results indicate that mitochondrial ROS are associated with the acquisition of myofibroblasts after long-term FR. Mechanistically, mitochondrial ROS activated TGFβ signaling which in turn mediated the expression of α-SMA in radiation-induced myofibroblasts. Finally, in vivo tumor growth analysis in a human tumor xenograft model system revealed that long-term FR-induced myofibroblasts promote tumor growth by enhancing angiogenesis.Implications: Radiation affects malignant cancer cells directly and indirectly via molecular alterations in stromal fibroblasts such as activation of TGFβ and angiogenic signaling pathways. Mol Cancer Res; 16(11); 1676-86. ©2018 AACR.
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Affiliation(s)
- Tsutomu Shimura
- Department of Environmental Health, National Institute of Public Health, Minami, Wako, Saitama, Japan.
| | - Megumi Sasatani
- Department of Experimental Oncology, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, Hiroshima, Japan
| | - Hidehiko Kawai
- Department of Experimental Oncology, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, Hiroshima, Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine (RIRBM), Hiroshima University, Hiroshima, Japan
| | - Junya Kobayashi
- Department of Genome Dynamics, Radiation Biology Center, Kyoto University, Kyoto, Japan
| | - Kenshi Komatsu
- Department of Genome Dynamics, Radiation Biology Center, Kyoto University, Kyoto, Japan
| | - Naoki Kunugita
- Department of Environmental Health, National Institute of Public Health, Minami, Wako, Saitama, Japan
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Yamamoto S, Matsuzawa R, Yoneki K, Harada M, Watanabe T, Shimoda T, Suzuki Y, Matsunaga Y, Kamiya K, Yoshida, Matsunaga A. A cross-sectional study of physical activity on non-dialysis and dialysis days: Association with physical functioning. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.690] [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: 11/25/2022]
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150
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Abe Y, Noji H, Sugai M, Kurosu Y, Ohba T, Yanagi A, Yanai Y, Tsuyama N, Ishikawa T, Miura T, Kamiya K, Yoshida MA, Sakai A. Abstract 853: Investigation of the cumulative number of chromosome aberrations induced by three consecutive CT scans. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose The relationship between radiation exposure by CT and the risk of leukemia and brain tumor has been reported in children, in which the risk of leukemia was tripled at a radiation dose of 60 mGy to bone marrow (Pearce MS, Lancet 2012). Therefore, there is a possibility that CT scans induce chromosome aberrations (CAs) causing malignant tumors. When chromosomes are cleaved by radiation, dicentric chromosomes (Dics) and chromosome translocations (Trs) are formed in the same ratio. We have reported that breakage of chromosomes was induced after a single CT scan in adults by Dic assay (DCA) (Scientific Rep 2015). On the other hand, the number of Trs formed also increased after a single CT scan, but, no significant change of the numbers was observed before and after the CT scan (J Rad Res 2016). We then investigated whether cumulative CAs would be observed when an annual CT scan was performed for 3 years.
Methods Peripheral blood samples were collected from 5 patients (4 males and 1 female; age range 51-73 years; mean age, 64 years) 3 times before and after a CT scan at annual examinations. They included 4 patients with malignant lymphoma who had not been treated for more than 3 years after the end of treatment and 1 patient followed due to an abnormal lung shadow without treatment. We performed analysis of Dic and Tr formation by centromere-FISH and painting-FISH using isolated lymphocytes, respectively, and counted the number of CAs equivalent to 2,000 metaphases per sample. The effective radiation dose of a CT scan was calculated by computational dosimetry system (WAZA-ARI).
Results Regardless of CT scans, the number of Trs formed was higher than that of Dics in all patients. The dose of radiation exposure in one CT scan was 22.0 to 73.5 mSv (mean, 42.3 mSv). Both DCA and Tr analyses showed an increase in Dic and Tr formation after all CT scans, except that their number decreased in one patient after the second CT scan. However, the increase in these CAs decreased after about one year, and no cumulative increase in the number of Dics and Trs formed due to three consecutive CT scans was observed.
Conclusion A single CT scan tended to produce both Dic and Tr formation, but there was no cumulative increase in CAs after three consecutive CT scans. The reason that the number of Trs formed was basically higher than that of Dics is considered to be related to such factors as age, smoking status, and past medical radiation exposure especially in adults because Tr is a stable chromosome.
Citation Format: Yu Abe, Hideyoshi Noji, Misaki Sugai, Yumiko Kurosu, Takashi Ohba, Aki Yanagi, Yukari Yanai, Naohiro Tsuyama, Tetsuo Ishikawa, Tomisato Miura, Kenji Kamiya, Mitsuaki A. Yoshida, Akira Sakai. Investigation of the cumulative number of chromosome aberrations induced by three consecutive CT scans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 853.
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Affiliation(s)
- Yu Abe
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideyoshi Noji
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Misaki Sugai
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yumiko Kurosu
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Ohba
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Aki Yanagi
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukari Yanai
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naohiro Tsuyama
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuo Ishikawa
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomisato Miura
- 2Hirosaki University Graduate School of Health Sciences, Hirosaki, Japan
| | | | | | - Akira Sakai
- 1Fukushima Medical University School of Medicine, Fukushima, Japan
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