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Uemura H, Uchida Y, Kouyama JI, Naiki K, Tsuji S, Sugawara K, Nakao M, Motoya D, Nakayama N, Imai Y, Tomiya T, Mochida S. NS5A-P32 deletion as a factor involved in virologic failure in patients receiving glecaprevir and pibrentasvir. J Gastroenterol 2019; 54:459-470. [PMID: 30612205 DOI: 10.1007/s00535-018-01543-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 12/27/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study sought to clarify the factors involved in virologic failure in patients with HCV receiving retreatment with glecaprevir/pibrentasvir (GLE/PIB) in real-world practice. METHODS Forty-two patients who had previously received direct-acting antivirals (DAAs) therapies consisting of 35, 3, 3, and 1 patient(s) with genotype (GT)-1b, GT-2a, GT-2b, and GT-3b HCV, respectively, received GLE/PIB for 12 weeks. Resistance-associated substitutions (RASs) at baseline were evaluated, and the dynamics of NS5A-RASs were assessed by deep sequencing in patients showing virologic failure. RESULTS Baseline NS5A-RASs were found in all the patients with GT-1b HCV including 16 patients with NS3-RASs. In contrast, both NS5A-RASs and NS3-RASs were absent in 3 and 2 patients with GT-2a and GT-2b HCV, respectively. Virologic failure occurred in 3 patients with GT-1b HCV with NS5A-P32del, while a sustained virologic response (SVR) was achieved in the remaining 39 patients including those with GT-1b HCV carrying NS5A-L31V + Y93H and NS5A-A92K. Virologic failure even occurred in a patient in whom the NS5A-P32del HCV strains had become undetectable by direct sequencing, and the percentage of such strains relative to the total HCV strains was 10%, as determined by deep sequencing. In the other patient with GT-1b HCV with NS5A-P32del, NS3-A156A/V/S were found at 4 weeks after GLE/PIB therapy, but had disappeared at 11 weeks, as determined by direct sequencing. CONCLUSIONS GLE/PIB was effective for patients with HCV who failed to achieve an SVR after prior DAA therapies except in those with GT-1b HCV carrying NS5A-P32del even when such strains became undetectable by direct sequencing.
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Ichinose K, Kitamura M, Sato S, Eguchi M, Okamoto M, Endo Y, Tsuji S, Takatani A, Shimizu T, Umeda M, Fukui S, Sumiyoshi R, Koga T, Kawashiri S, Iwamoto N, Igawa T, Tamai M, Nakamura H, Origuchi T, Nishino T, Kawakami A. Complete renal response at 12 months after induction therapy is associated with renal relapse-free rate in lupus nephritis: a single-center, retrospective cohort study. Lupus 2019; 28:501-509. [DOI: 10.1177/0961203319829827] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Lupus nephritis (LN) is a major risk factor for overall morbidity and mortality in systemic lupus erythematosus (SLE). Methods We retrospectively analyzed cases of proliferative and membranous LN patients who underwent a renal biopsy at our hospital in 1993–2016. We analyzed the association between complete renal response (CR) rates at 12 months after induction therapy and predictive factors for CR and their association with renal flares. Results Of the 95 cases analyzed, we were able to track the therapeutic responses of 81 patients at 12 months after their induction therapy. The median follow-up duration after renal biopsy was 51 months (interquartile range: 16.5–154.5 months). The Cox proportional hazards model showed that, compared to not attaining CR at 12 months, the attainment of CR at 12 months was correlated with being free from renal flares. The multivariate logistic analysis revealed that the predictive factors for CR at 12 months were the anti-La/SSB antibodies (U/ml) (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.01–1.63, p = 0.0220), blood urea nitrogen (BUN) (OR 0.68, 95% CI 0.44–0.90, p = 0.00048) and serum β2 microglobulin (MG) (OR 0.26, 95% CI 0.06–0.74, p = 0.00098) levels. Conclusions Among LN patients, being free from renal flares was associated with attaining CR at 12 months after induction therapy. Anti-La/SSB antibodies were a positive predictive factor, and BUN and serum β2MG levels were negative predictive factors of CR at 12 months.
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Tsuji S, Horiuchi A, Tamaki M, Ichise Y, Kajiyama M, Tanaka N. Effectiveness and safety of a new regimen of polyethylene glycol plus ascorbic acid for same-day bowel cleansing in constipated patients. Acta Gastroenterol Belg 2018; 81:485-489. [PMID: 30645916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND STUDY AIMS In an exploratory study we compared a new regimen of low-volume polyethylene glycol plus ascorbic acid (PEG-Asc) with the standard regimen for same-day bowel cleansing in constipated patients. PATIENTS AND METHODS Between January and June 2015 we studied consecutive patients with constipation (Rome III constipation criteria) scheduled for colonoscopy. The initial group received the standard regimen of PEG-Asc. The subsequent group received the new regimen. The new regimen involved ingestion of 10 mL of sodium picosulfate and 50g of magnesium citrate dissolved in 0.2 L of water followed by 0.2 L of PEG-Asc +0.2 L of water given 6 or 7 times over 3 hours. Bowel cleansing was prospectively evaluated using the Boston bowel preparation scale (BBPS). Bowel cleansing, adenoma detection rates and adverse events were reviewed using electronic medical records and endoscopic filing system. RESULTS Sixty-two patients used the standard regimen and sixty used the new regimen. The basic characteristics of the two groups were similar. The mean volume of PEG-Asc and total liquid intake was less with the new regimen compared to the standard regimen (1.3 L vs. 2.0 L, P<0.001; 2.6 L vs. 3.0 L, P<0.001). The proportion of patients with a BBPS score ≥ 6 was significantly greater with the new than the standard regimen (93% vs. 76%, P=0.008). Nausea and/or vomiting was also significantly less frequent than with the standard regimen (5% vs. 16%, P=0.046). CONCLUSIONS The new regimen of PEG-Asc gave improved same-day bowel cleansing for colonoscopy in constipated patients.
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Tani K, Houchi H, Kosaka S, Kaji M, Tsuji S, Higuchi K, Isobe Y, Honda Y, Kouzai M, Yamashita S. P3.07-14 Collaborations of Pharmacists with Lung Cancer Treatment by Prepared Patients Controlled Analgesia (PCA) for Perioperative Pain Control. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tsuji S, Shortliffe EH. Graphical Access to Medical Expert Systems: I. Design of a Knowledge Engineer’s Interface. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryOptimal construction of medical expert systems demands a powerful interactive environment for knowledge base management by knowledge engineers. Key requirements include techniques for (a) examining existing information, (b) adding new knowledge and editing preexisting data structures, and (c) examining dynamic internal system behavior to facilitate debugging during consideration of actual cases. This article addresses design considerations in the development of such knowledge engineering tools. The emphasis is on the use of professional workstations with high density graphics interfaces since that technology is rapidly becoming a predominant environment for knowledge engineering activities. To illustrate the points made, examples are drawn from an experimental knowledge base management tool designed for knowledge engineers constructing the knowledge base of ONCOCIN, an expert system to advise in the management of cancer patients.
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Shortliffe E, Tsuji S. Graphical Access to Medical Expert Systems: I. Design of a Knowledge Engineer’s Interface. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryOptimal construction of medical expert systems demands a powerful interactive environment for knowledge base management by knowledge engineers. Key requirements include techniques for (a) examining existing information, (b) adding new knowledge and editing preexisting data structures, and (c) examining dynamic internal system behavior to facilitate debugging during consideration of actual cases. This article addresses design considerations in the development of such knowledge engineering tools. The emphasis is on the use of professional workstations with high density graphics interfaces since that technology is rapidly becoming a predominant environment for knowledge engineering activities. To illustrate the points made, examples are drawn from an experimental knowledge base management tool designed for knowledge engineers constructing the knowledge base of ONCOCIN, an expert system to advise in the management of cancer patients.
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Ozaki K, Doi H, Mitsui J, Sato N, Yamane K, Majima T, Irioka T, Ishiura H, Doi K, Morishita S, Koyama K, Miura Y, Matsumoto N, Tanaka F, Tsuji S, Mizusawa H, Yokota T, Ishikawa K. Clinicoradiological characteristics of SCA34 patients with the hot cross bun sign caused by the P.TRP246GLY mutation in ELOVL4. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kubota A, Sato N, Ishiura H, Mitsui J, Sakuishi K, Iwata A, Yamamoto T, Nishino I, Tsuji S, Shimizu J. Double immunofluorescence study is sensitive for detection of protein mislocalization in biopsied muscle specimen, and useful for diagnosis of muscular dystrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kanda J, Nagashima Y, Ishiura H, Hayashi T, Shimizu J, Goto J, Kanbayashi T, Kira J, Tsuji S. DNMT1 p.Y495H mutation is frequently associated with cerebellar ataxia compared with p.Y495C mutation. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kainaga M, Ohtomo G, Taira K, Tanaka M, Kubota A, Hamada M, Sakuishi K, Hayashi T, Shimizu J, Tsuji S. A rare clinical presentation of neurogenic muscle weakness, ataxia, and retinitis pigmentosa (NARP) accompanied with spinal cord atrophy: A case report. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tokushige S, Matsuda S, Oyama G, Shimo Y, Umemura A, Sekimoto S, Sasaki T, Inomata-Terada S, Yugeta A, Hamada M, Ugawa Y, Hattori N, Tsuji S, Terao Y. How deep brain stimulation affects saccades in visual scanning in Parkinson's disease patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tanaka M, Ishiura H, Mitsui J, Shimizu J, Tsuji S. Comprehensive genetic testing for mitochondrial disorders using sanger sequencing, southern blotting, whole exome sequencing, and whole mitochondrial genome sequencing. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ishiura H, Matsukawa M, Tanaka M, Higashihara M, Ichikawa Y, Takahashi Y, Abe K, Sakiyama Y, Otsuka M, Ueki A, Kaida K, Mitsui J, Suzuki Y, Sugano S, Shinichi M, Goto J, Tsuji S. Linkage and haplotype analyses of families with benign adult familial myoclonic epilepsy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ichikawa Y, Miyazaki T, Shibuya H, Nagai K, Tanaka M, Uchibori A, Ishiura H, Mitsui J, Tsuji S, Chiba A. A Japanese consanguineous family with early-onset dementia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Matsushita T, Nakamura Y, Niino M, Fukaura H, Tanaka M, Ochi H, Kanda T, Yokota T, Matsui M, Kusunoki S, Terayama Y, Kawachi I, Ohashi T, Shimohama S, Nishiyama K, Nakatsuji Y, Suzumura A, Ochi K, Yamamoto K, Yamasaki R, Kawano Y, Tsuji S, Hinomura A, Tada M, Matsuyama A, Shimizu Y, Nagaishi A, Okada K, Shinoda K, Isobe N, Kira J. Clinical and genetic features of Japanese patients with multiple sclerosis and neuromyelitis optica spectrum disorder based on Japan multiple sclerosis biobank. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kadoya M, Taira K, Ikenaga C, Uchio N, Kubota A, Mimori T, Kaida K, Tsuji S, Shimizu J. Evaluation for the clinical significance of cancer-association in anti-SRP antibody-positive myopathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ikenaga C, Masato K, Uchio N, Taira K, Kubota A, Tsuji S, Shimizu J. Usefulness of cytoplasmic 5’ - nucleotidase 1A autoantibodies for the diagnosis of inclusion body myositis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sato N, Ishiura H, Mitsui J, Tanaka M, Kubota A, Shimizu J, Morishita S, Tsuji S. Interpretation of sequence variants called by whole exome sequencing in the clinical sequence of muscular diseases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Unuma A, Kadoya M, Hida A, Taira K, Uchio N, Ikenaga C, Kubota A, Tsuji S, Shimizu J. Analysis of the risk of cancer among myositis patients without anti-TIF1-γ OR –HMGCR antibodies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bannai T, Ohtomo R, Mano T, Tsuji S, Iwata A. Chronic cerebral hypoperfusion accelerates amyloid beta deposits in app/ps1 transgenic mice. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hatano K, Ishiura H, Date H, Tanaka M, Mitsui J, Goto J, Yoshimura J, Doi K, Morishita S, Tsuji S. Search for target genes of transcriptional regulation by Dentatorubral-pallidoluysian atrophy protein that acts as a transcriptional co-regulator. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kawasaki R, Sakuishi K, Kubota A, Kaneko K, Takahashi T, Hayashi T, Shimizu J, Tsuji S. Single institutional study on the clinical features of anti-MOG antibody-associated brain lesions. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Naruse H, Ishiura H, Mitsui J, Takahashi Y, Doi K, Yoshimura J, Morishita S, Goto J, Tsuji S. Mutational analysis of sporadic amyotrophic lateral sclerosis (ALS) with loss of function mutations in ALS-related genes in the Japanese population. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kurihara M, Sugiyama Y, Tanaka M, Ishiura H, Kubota A, Hayashi T, Shimizu J, Tsuji S. Diagnostic role of aerobic exercise tests on cycle ergometry in clinical settings. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Koh K, Ishiura H, Ichikawa Y, Matsukawa T, Goto J, Mitsui J, Takahashi Y, Kawabe Matsukawa M, Doi K, Yoshimura J, Namekawa M, Morishita S, Ogawa T, Sunada Y, Kurisaki H, Hasegawa K, Tsuji S, Takiyama Y. Clinical characteristics and detailed haplotype analysis of patients with SCA36 in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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