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Kohno H, Matsumiya G, Sawa Y, Ono M, Saiki Y, Shiose A, Yamazaki K, Matsui Y, Niinami H, Matsuda H, Kitamura S, Nakatani T, Kyo S. Outcomes of Jarvik 2000 LVAD as a Bridge to Heart Transplantation: Data from the Japanese Registry for Mechanically Assisted Circulatory Support (J-MACS). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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102
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Dolan TJ, Yamazaki K, Sagara A. Helical Fusion Power Plant Economics Studies. FUSION SCIENCE AND TECHNOLOGY 2017. [DOI: 10.13182/fst05-a599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Yamazaki K, Sakai K, Ohashi Y, Nihei H, Itabashi T, Muramatsu M, Kawamura T, Shishido S, Aikawa A. Similar Anemic Control Between Chronic Kidney Diseases in Patients With and Without Transplantation on Entry to Dialysis. Transplant Proc 2017; 49:57-60. [PMID: 28104159 DOI: 10.1016/j.transproceed.2016.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Transplant recipients are supposedly in a more anemic, catabolic, and even inflammatory state at re-entering hemodialysis due to chronic rejection. The goal of this study was to clarify how transplant recipients can re-enter dialysis safely by focusing on control of anemia. METHODS From 2012 to 2014, a total of 29 transplant recipients re-entered hemodialysis because of chronic rejection (ie, the chronic kidney disease with transplant [CKDT] group). At the same time, in 2014, a total of 30 patients with chronic kidney disease without transplantation entered dialysis as the control group (ie, the CKD group). CKDT recipients (mean ± standard deviation age, 41.9 ± 11.8 years; 18 male subjects, 10 female subjects; frequency of diabetes, 10%; duration of graft survival, 12.5 ± 4.3 years) were younger and fewer had diabetes compared with the CKD group (age, 53.2 ± 10.5 years; 21 male subjects, 9 female subjects; frequency of diabetes, 36%). Patient characteristics at entering dialysis in both groups were analyzed according to retrospective chart review. RESULTS At entering dialysis, there were no significant differences between the CKD and CKDT groups in terms of the following: dose of darbepoetin; concentrations of hemoglobin, albumin, and C-reactive protein; cardiothoracic ratio; blood urea nitrogen and creatinine levels; estimated glomerular filtration rate; initial ultrafiltration; and duration of hospitalization for initiation of dialysis. The only difference between groups was mean weight at entry to dialysis (CKDT group, 58.5 ± 15.1 kg; CKD group, 67.1 ± 14.8 kg; P = .03). The darbepoetin dose per kilogram of weight did not differ between groups (CKDT, 2.28 ± 2.03 μg/kg; CKD, 2.12 ± 1.6 μg/kg; P = .95) in the final month before entry to dialysis. CONCLUSIONS Safe re-initiation of dialysis is important for recipient survival. Although anemia is supposedly higher in transplant recipients due to immunosuppression, this single-center analysis found no difference in anemia in CKD with or without transplantation, caused by good use of erythropoietin-stimulating agents in both groups.
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Nakajima T, Ueki-Maruyama K, Oda T, Ohsawa Y, Ito H, Seymour GJ, Yamazaki K. Regulatory T-cells Infiltrate Periodontal Disease Tissues. J Dent Res 2016; 84:639-43. [PMID: 15972593 DOI: 10.1177/154405910508400711] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
CD4+CD25+ regulatory T (Tr) cells are critical in regulating the immune response and thereby play an important role in the defense against infection and control of autoimmune diseases. Our previous studies demonstrated the involvement of autoimmune responses in periodontitis. The aim of this study was to identify CD4+CD25+ Tr cells in periodontitis tissues and compare them with those in gingivitis tissues. Immunohistological analysis of CD4, CD25, and CTLA-4 and the gene expression analysis of FOXP3, TGF-β1, and IL-10 on gingival biopsies revealed the presence of CD4+CD25+ Tr cells in all tissues. In periodontitis, the percentage of CD4+CD25+ Tr cells increased with increasing proportions of B-cells relative to T-cells. FOXP3, a characteristic marker for CD4+CD25+ Tr cells, TGF-β1 and IL-10 were expressed more highly in periodontitis compared with gingivitis. These findings suggest that CD4+CD25+ Tr cells and possibly other regulatory T-cell populations do exist and may play regulatory roles in periodontal diseases.
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Yamazaki K, Kito Y, Esaki T, Satake H, Taniguchi H, Tsuda T, Denda T, Moriwaki T, Mori K. 217TiP Dose-finding phase Ib study of FOLFOXIRI plus ramucirumabas first-line therapy for patients with metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00374-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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106
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Taniguchi H, Narita Y, Kadowaki S, Ura T, Ando M, Muro K, Hamauchi S, Tsushima T, Yokota T, Todaka A, Machida N, Fukutomi A, Onozawa Y, Yasui H, Mori K, Yamazaki K. 218TiP A phase Ib study of irinotecan, bevacizumab and biweekly TAS-102 in Japanese patients with metastatic colorectal cancer refractory to fluoropyrimidine and oxaliplation (MODURATE). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw581.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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107
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Yamazaki K, Kito Y, Esaki T, Satake H, Taniguchi H, Tsuda T, Denda T, Moriwaki T, Mori K. 217TiP Dose-finding phase Ib study of FOLFOXIRI plus ramucirumab as first-line therapy for patients with metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw581.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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108
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Chung H, Chao Y, Lee KW, Kudo M, Yen CJ, Kim T, Yamazaki K, Shih JY, Kim SW, Sohn JH, Cheng R, Zhang Y, Binder P, Mi G, Orlando M, Muro K. 153P Ramucirumab safety in East Asian (EA) compared to non-EA patients: A meta-analysis of adverse events (AEs) in 6 global, randomized, double-blind, phase 3 clinical trials. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw579.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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109
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Taniguchi H, Narita Y, Kadowaki S, Ura T, Ando M, Muro K, Hamauchi S, Tsushima T, Yokota T, Todaka A, Machida N, Fukutomi A, Onozawa Y, Yasui H, Mori K, Yamazaki K. 218TiP A phase Ib study of irinotecan, bevacizumab and biweekly TAS-102 in Japanese patients with metastatic colorectal cancer refractory to fluoropyrimidine and oxaliplation (MODURATE). Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00375-6] [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] Open
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110
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Ishikawa H, Masujima H, Tanaka R, Kamoshida T, Shino M, Yamazaki K. 526P A retrospective study on the protective effect of nonsteroidal anti-inflammatory drugs on panitumumab-related skin symptoms. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw599.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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111
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Obermannová R, Van Cutsem E, Yoshino T, Bodoky G, Prausová J, Garcia-Carbonero R, Ciuleanu T, Garcia Alfonso P, Portnoy D, Cohn A, Yamazaki K, Clingan P, Lonardi S, Kim TW, Yang L, Nasroulah F, Tabernero J. Subgroup analysis in RAISE: a randomized, double-blind phase III study of irinotecan, folinic acid, and 5-fluorouracil (FOLFIRI) plus ramucirumab or placebo in patients with metastatic colorectal carcinoma progression. Ann Oncol 2016; 27:2082-2090. [PMID: 27573561 PMCID: PMC5091322 DOI: 10.1093/annonc/mdw402] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/27/2016] [Accepted: 08/10/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The RAISE phase III clinical trial demonstrated that ramucirumab + FOLFIRI improved overall survival (OS) [hazard ratio (HR) = 0.844, P = 0.0219] and progression-free survival (PFS) (HR = 0.793, P < 0.0005) compared with placebo + FOLFIRI for second-line metastatic colorectal carcinoma (mCRC) patients previously treated with first-line bevacizumab, oxaliplatin, and a fluoropyrimidine. Since some patient or disease characteristics could be associated with differential efficacy or safety, prespecified subgroup analyses were undertaken. This report focuses on three of the most relevant ones: KRAS status (wild-type versus mutant), age (<65 versus ≥65 years), and time to progression (TTP) on first-line therapy (<6 versus ≥6 months). PATIENTS AND METHODS OS and PFS were evaluated by the Kaplan-Meier analysis, with HR determined by the Cox proportional hazards model. Treatment-by-subgroup interaction was tested to determine whether treatment effect was consistent between subgroup pairs. RESULTS Patients with both wild-type and mutant KRAS benefited from ramucirumab + FOLFIRI treatment over placebo + FOLFIRI (interaction P = 0.526); although numerically, wild-type KRAS patients benefited more (wild-type KRAS: median OS = 14.4 versus 11.9 months, HR = 0.82, P = 0.049; mutant KRAS: median OS = 12.7 versus 11.3 months, HR = 0.89, P = 0.263). Patients with both longer and shorter first-line TTP benefited from ramucirumab (interaction P = 0.9434), although TTP <6 months was associated with poorer OS (TTP ≥6 months: median OS = 14.3 versus 12.5 months, HR = 0.86, P = 0.061; TTP <6 months: median OS = 10.4 versus 8.0 months, HR = 0.86, P = 0.276). The subgroups of patients ≥65 versus <65 years also derived a similar ramucirumab survival benefit (interaction P = 0.9521) (≥65 years: median OS = 13.8 versus 11.7 months, HR = 0.85, P = 0.156; <65 years: median OS = 13.1 versus 11.9 months, HR = 0.86, P = 0.098). The safety profile of ramucirumab + FOLFIRI was similar across subgroups. CONCLUSIONS These analyses revealed similar efficacy and safety among patient subgroups with differing KRAS mutation status, longer or shorter first-line TTP, and age. Ramucirumab is a beneficial addition to second-line FOLFIRI treatment for a wide range of patients with mCRC. TRIAL REGISTRATION ClinicalTrials.gov, NCT01183780.
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Yoh K, Doi T, Yamazaki K, Okusaka T, Ikeda M, Guo W, Nakamura A, Ohtsu A. Phase I trial of pimasertib monotherapy in Japanese patients with solid tumors or hepatocellular carcinoma. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw521.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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113
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Kawakami T, Tsushima T, Hayashi K, Shirasu H, Kawahira M, Kawai S, Kito Y, Yoshida Y, Hamauchi S, Todaka A, Machida N, Yamazaki K, Yokota T, Fukutomi A, Onozawa Y, Yasui H. Risk factors for esophageal fistula in esophageal squamous cell carcinoma invading adjacent organs (T4b) treated with definitive chemoradiotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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114
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Sukawa Y, Nosho K, Miura Y, Takano T, Ito M, Yonesaka K, Mori M, Tokunaga S, Kawada J, Okuda H, Sakamoto T, Hirashima Y, Uchino K, Miyata Y, Yoshimura K, Yamazaki K, Hironaka S, Boku N, Hyodo I, Muro K. Clinical significance of serum factors relating to ERBB signal pathways in a phase II trial of S-1 plus cisplatin combined with trastuzumab for HER2-positive advanced gastric or esophagogastric junction cancer: WJOG7212G (T-SPACE) TR study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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115
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Yamaguchi K, Komatsu Y, Oki E, Yoshino T, Yamazaki K, Shibuya K, Oba K, Kato T. APOLLON study: a phase I/II study for the safety and efficacy of panitumumab in combination with TAS-102 for patients with RAS wild-type metastatic colorectal cancer refractory to standard chemotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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116
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Yamazaki K, Yoshino T, Shinozaki E, Komatsu Y, Tsuji Y, Nishina T, Baba H, Denda T, Sugimoto N, Tsuji A, Yamaguchi K, Takayama T, Shimada Y, Hamamoto Y, Muro K, Gotoh M, Tanase T, Ohtsu A. Clinical significance of thymidine kinase 1 expression on TAS-102 treatment in RECOURSE phase III trial of TAS-102 versus placebo for metastatic colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.112] [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] Open
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117
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Nishina T, Kuboki Y, Shinozaki E, Fukuoka S, Kajiwara T, Shitara K, Yamaguchi K, Komatsu Y, Yuki S, Yamazaki K, Hara H, Mochizuki N, Fukutani M, Hasegawa H, Matsuda S, Wakabayashi M, Nomura S, Sato A, Ohtsu A, Yoshino T. A multicentre phase I/II study of TAS-102 with nintedanib in patients with metastatic colorectal cancer refractory to standard therapies (N-TASK FORCE: EPOC1410); Phase I results. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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118
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Nishita Y, Abramov AV, Kosintsev PA, Lin LK, Watanabe S, Yamazaki K, Kaneko Y, Masuda R. Genetic variation of the MHC class II DRB genes in the Japanese weasel, Mustela itatsi, endemic to Japan, compared with the Siberian weasel, Mustela sibirica. ACTA ACUST UNITED AC 2016; 86:431-42. [PMID: 26593752 DOI: 10.1111/tan.12700] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/07/2015] [Accepted: 10/21/2015] [Indexed: 01/19/2023]
Abstract
Major histocompatibility complex (MHC) genes encode proteins that play a critical role in vertebrate immune system and are highly polymorphic. To further understand the molecular evolution of the MHC genes, we compared MHC class II DRB genes between the Japanese weasel (Mustela itatsi), a species endemic to Japan, and the Siberian weasel (Mustela sibirica), a closely related species on the continent. We sequenced a 242-bp region of DRB exon 2, which encodes antigen-binding sites (ABS), and found 24 alleles from 31 M. itatsi individuals and 17 alleles from 21 M. sibirica individuals, including broadly distributed, species-specific and/or geographically restricted alleles. Our results suggest that pathogen-driven balancing selection have acted to maintain the diversity in the DRB genes. For predicted ABS, nonsynonymous substitutions exceeded synonymous substitutions, also indicating positive selection, which was not seen at non-ABS. In a Bayesian phylogenetic tree, two M. sibirica DRB alleles were basal to the rest of the sequences from mustelid species and may represent ancestral alleles. Trans-species polymorphism was evident between many mustelid DRB alleles, especially between M. itatsi and M. sibirica. These two Mustela species divided about 1.7 million years ago, but still share many MHC alleles, indicative of their close phylogenetic relationship.
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Ha DT, Yamazaki K, Wang Y, Alcamí M, Maeda S, Kono H, Martín F, Kukk E. Fragmentation network of doubly charged methionine: Interpretation using graph theory. J Chem Phys 2016; 145:094302. [DOI: 10.1063/1.4962061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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120
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Lonardi S, Cohn A, Yoshino T, Obermannova R, Bodoky G, Prausová J, Garcia-Carbonero R, Ciuleanu T, Garcia-Alfonso P, Portnoy D, Van Cutsem E, Yamazaki K, Clingan P, Polikoff J, Gao L, Yang L, Chang S, Ferry D, Nasroulah F, Tabernero J. Exposure-response (E-R) relationship of Ramucirumab (RAM) from a global, randomized, double-blind, Phase 3 study of patients (Pts) with advanced 2nd line colorectal cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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121
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Yamazaki K. Systemic lupus erythematosus with hepatic aneurysm, Valsalva sinus aneurysm and associated polyangiitis: aneurysmal wall remodeling with dense fibrosis and calcification mediated by residual smooth muscle cells. Lupus 2016; 13:54-9. [PMID: 14870918 DOI: 10.1191/0961203304lu462cr] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Isolated case reports have demonstrated the combination of hepatic aneurysm and systemic lupus erythematosus (SLE). The author experienced a rare autopsy case of a 36-year old Japanese male with SLE, a hepatic aneurysm, a Valsalva sinus aneurysm and associated polyangiitis. In the histopathological and ultrastructural examinations of the postmortem organs, most of the angiitis lesions were in the scar phase associated with the histopathological features of collagenous fibrosis with the diminution of the smooth muscle cells and elastic fibre layers. Massive calcification was seen on the wall and obliterative changes in the lumen with calcified thrombi. In the dense collagenous stroma of the aneurysmal wall, residual atrophic smooth muscle cells with immunohistochemical (HHF35, alpha-smooth-muscle actin, vimentin and desmin almost-) and ultrastructural features (spindle-shapedcells with a few rER and rich intracytoplasmicfilaments with peripheraldense patches)were assumed to be involvedin the histogenesisof the aneurysmalwall. Massivecalcification and degenerationor dynamic remodelingof the extracellularmatrices in the aneurysmalwall might be mediated by the residual smooth muscle cells. It was suspected that the generalized polyangiitis as a complication of SLE might have involved the intrahepatic arteries and Valsalva sinus wall and subsequently generated the aneurysm.
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Yoshino T, Kuboki Y, Nishina T, Shinozaki E, Yamazaki K, Shitara K, Okamoto W, Kajiwara T, Matsumoto T, Tsushima T, Mochizuki N, Fukutani M, Nakamoto M, Hasegawa H, Sugama A, Nomura S, Sato A, Ohtsu A. PD-013 Final survival results of a multicenter phase I/II study of TAS-102 with bevacizumab for metastatic colorectal cancer patients refractory to standard therapies (C-TASK FORCE). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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123
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Yoshino T, Shinozaki E, Yamazaki K, Nishina T, Komatsu Y, Baba H, Tsuji A, Yamaguchi K, Muro K, Sugimoto N, Tsuji Y, Moriwaki T, Esaki T, Hamada C, Tanase T, Ohtsu A. PD-014 Final survival results and onset of neutropenia as an indicator of therapeutic effect in phase 2 of TAS-102 vs placebo with metastatic colorectal cancer (J003-10040030). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tabernero J, Mayer Robert J, Ohtsu A, Yoshino T, Garcia-Carbonero R, Pastorino A, Peeters M, Winkler R, Makris L, Wahba M, Zaniboni A, Shimada Y, Yamazaki K, Komatsu Y, Hochster H, Lenz HJ, Falcone A, Tran B, Van Cutsem E. PD-025 RECOURSE trial: impact of adverse events on quality of life and duration of TAS-102 (trifluridine and tipiracil) treatment. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yao K, Uedo N, Muto M, Ishikawa H, Cardona HJ, Filho ECC, Pittayanon R, Olano C, Yao F, Parra-Blanco A, Ho SH, Avendano AG, Piscoya A, Fedorov E, Bialek AP, Mitrakov A, Caro L, Gonen C, Dolwani S, Farca A, Cuaresma LF, Bonilla JJ, Kasetsermwiriya W, Ragunath K, Kim SE, Marini M, Li H, Cimmino DG, Piskorz MM, Iacopini F, So JB, Yamazaki K, Kim GH, Ang TL, Milhomem-Cardoso DM, Waldbaum CA, Carvajal WAP, Hayward CM, Singh R, Banerjee R, Anagnostopoulos GK, Takahashi Y. Development of an E-learning System for the Endoscopic Diagnosis of Early Gastric Cancer: An International Multicenter Randomized Controlled Trial. EBioMedicine 2016; 9:140-147. [PMID: 27333048 PMCID: PMC4972485 DOI: 10.1016/j.ebiom.2016.05.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/15/2016] [Accepted: 05/16/2016] [Indexed: 01/06/2023] Open
Abstract
Background In many countries, gastric cancer is not diagnosed until an advanced stage. An Internet-based e-learning system to improve the ability of endoscopists to diagnose gastric cancer at an early stage was developed and was evaluated for its effectiveness. Methods The study was designed as a randomized controlled trial. After receiving a pre-test, participants were randomly allocated to either an e-learning or non-e-learning group. Only those in the e-learning group gained access to the e-learning system. Two months after the pre-test, both groups received a post-test. The primary endpoint was the difference between the two groups regarding the rate of improvement of their test results. Findings 515 endoscopists from 35 countries were assessed for eligibility, and 332 were enrolled in the study, with 166 allocated to each group. Of these, 151 participants in the e-learning group and 144 in the non-e-learning group were included in the analysis. The mean improvement rate (standard deviation) in the e-learning and non-e-learning groups was 1·24 (0·26) and 1·00 (0·16), respectively (P < 0·001). Interpretation This global study clearly demonstrated the efficacy of an e-learning system to expand knowledge and provide invaluable experience regarding the endoscopic detection of early gastric cancer (R000012039). This report establishes that an e-learning system on the Internet can improve the diagnostic ability of endoscopists. Countless endoscopists worldwide can access the system to learn how to make an endoscopic diagnosis of early gastric cancer. The e-learning system could be modified to provide education regarding endoscopic diagnosis in other organs.
This is the first report to demonstrate how an e-learning system based on the Internet can improve the diagnostic ability of gastrointestinal endoscopists worldwide. There is no limit to the number of endoscopists who can access the system and benefit from this opportunity to learn how to make an endoscopic diagnosis of early gastric cancer. This e-learning system could be modified to provide education regarding endoscopic diagnosis in other organs such as the large intestine and the esophagus, as well as the stomach. It may contribute to human welfare and health by reducing the mortality from gastrointestinal cancer.
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