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Park SB, Yang Y, Bang SI, Kim TS, Cho D. AESIS-1, a Rheumatoid Arthritis Therapeutic Peptide, Accelerates Wound Healing by Promoting Fibroblast Migration in a CXCR2-Dependent Manner. Int J Mol Sci 2024; 25:3937. [PMID: 38612747 PMCID: PMC11012285 DOI: 10.3390/ijms25073937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
In patients with autoimmune disorders such as rheumatoid arthritis (RA), delayed wound healing is often observed. Timely and effective wound healing is a crucial determinant of a patient's quality of life, and novel materials for skin wound repair, such as bioactive peptides, are continuously being studied and developed. One such bioactive peptide, AESIS-1, has been studied for its well-established anti-rheumatoid arthritis properties. In this study, we attempted to use the anti-RA material AESIS-1 as a therapeutic wound-healing agent based on disease-modifying antirheumatic drugs (DMARDs), which can help restore prompt wound healing. The efficacy of AESIS-1 in wound healing was assessed using a full-thickness excision model in diabetic mice; this is a well-established model for studying chronic wound repair. Initial observations revealed that mice treated with AESIS-1 exhibited significantly advanced wound repair compared with the control group. In vitro studies revealed that AESIS-1 increased the migration activity of human dermal fibroblasts (HDFs) without affecting proliferative activity. Moreover, increased HDF cell migration is mediated by upregulating chemokine receptor expression, such as that of CXC chemokine receptor 2 (CXCR2). The upregulation of CXCR2 through AESIS-1 treatment enhanced the chemotactic reactivity to CXCR2 ligands, including CXC motif ligand 8 (CXCL8). AESIS-1 directly activates the ERK and p38 mitogen-activated protein kinase (MAPK) signaling cascades, which regulate the migration and expression of CXCR2 in fibroblasts. Our results suggest that the AESIS-1 peptide is a strong wound-healing substance that increases the movement of fibroblasts and the expression of CXCR2 by turning on the ERK and p38 MAPK signaling cascades.
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Affiliation(s)
- Seung Beom Park
- Department of Life Sciences, College of Life Sciences and Biotechnology, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Yoolhee Yang
- Kine Sciences, 6F, 24, Eonju-ro85gil, Gangnam-gu, Seoul 06221, Republic of Korea; (Y.Y.); (D.C.)
| | - Sa Ik Bang
- Department of Plastic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Gangnam-gu, Seoul 06351, Republic of Korea;
| | - Tae Sung Kim
- Department of Life Sciences, College of Life Sciences and Biotechnology, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Republic of Korea;
| | - Daeho Cho
- Kine Sciences, 6F, 24, Eonju-ro85gil, Gangnam-gu, Seoul 06221, Republic of Korea; (Y.Y.); (D.C.)
- Institute of Convergence Science, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, Republic of Korea
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2
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Mitish VA, Khamidulin GV, Paskhalova YS, Demidova VS, Alkhimova LG. [Complex surgical treatment of recurrent post-injection abscess in a patient with systemic autoimmune disease]. Khirurgiia (Mosk) 2023:123-133. [PMID: 38088850 DOI: 10.17116/hirurgia2023121123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The authors present complex surgical treatment of a patient with rheumatoid arthritis and persistent wound in the right gluteal region after previous surgical treatment of post-injection abscess. According to these data, active surgical treatment of wounds and purulent-necrotic lesions of any etiology and localization, augmented by modern agents for local and systemic therapy (including phage therapy) provide favorable functional and cosmetic results even in patients with systemic autoimmune diseases receiving glucocorticosteroids. It is important to assess the wound process considering not only clinical data, but also objective information of qualitative and quantitative microbiological and cytological examinations.
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Affiliation(s)
- V A Mitish
- Vishnevsky National Medical Research Center for Surgery, Moscow, Russia
- Russian Peoples' Friendship University, Moscow, Russia
| | | | - Yu S Paskhalova
- Vishnevsky National Medical Research Center for Surgery, Moscow, Russia
- Russian Peoples' Friendship University, Moscow, Russia
| | - V S Demidova
- Vishnevsky National Medical Research Center for Surgery, Moscow, Russia
| | - L G Alkhimova
- Russian Peoples' Friendship University, Moscow, Russia
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Li J, Jia G, Dong W, Zhao F, Zhao Z, Yu X, Zhu C, Li J, Liu S, Jiang X, Liu G. Incidence and risk factors of delayed wound healing in patients who underwent unicompartmental knee arthroplasty. Int Wound J 2022; 20:508-515. [PMID: 35941751 PMCID: PMC9885450 DOI: 10.1111/iwj.13898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 02/03/2023] Open
Abstract
Unicompartmental knee arthroplasty (UKA) has been proven as an ideal alternative surgical procedure to treat symptomatic isolated knee osteoarthritis, and recently this technique has gained its popularity. However, postoperative complications would inevitably compromise the effectiveness and patients' satisfaction. The objective of this study is to demonstrate the incidence and risk factors of delayed wound healing (DWH) after UKA. This retrospective cohort study was conducted from February 2021 to May 2022 and a total of 211 patients were enrolled. Demographic characteristics, operation-related variables, and laboratory indexes were extracted. Receiver operating characteristic analysis was performed to detect the optimum cut-off value for continuous variables. Univariate and multivariate logistic regression analysis was performed to demonstrate the risk factors of DWH. There were 155 female and 56 male patients with an average age of 64. 6 ± 6.9 years included in this study. After 6.6 ± 4.9 months' follow-up, 12 cases of DWH were observed which indicated an incidence of DWH of 5.7%, mean wound healing duration for 12 patients was 43.1 ± 19.3 days. In the univariate analysis, age > 62.5 years, postoperative hospital stay < 5.5 days, surgical incision < 10.5 cm, barbed suture, body mass index (BMI) > 32.0 kg/m2 , operation duration > 102.5 minutes, intraoperative blood loss > 102.5 mL, preoperative white blood cell count > 5.95*109 /L, preoperative seroglobulin (GLB) > 29.6 g/L, postoperative total protein < 63.4 g/L, postoperative serum albumin < 36.4 g/L, and postoperative GLB > 26.8 g/L were significantly different between patients with and without DWH (P < .05). In final multivariate logistic analysis, results showed that intraoperative blood loss > 102.5 mL (odds ratio [OR], 3.09; P = .001), postoperative hospital stay < 5.5 days (OR, 1.74; P = .014), surgical incision < 10.5 cm (OR, 1.67; P = .000), and BMI > 32.0 kg/m2 (OR, 4.47; P = .022) were independent risk factors for DWH. DWH prolongs hospital stay in UKA patients and increases healthcare expenditure; also affected the implementation schedule of postoperative functional exercise plans. Surgeons should identify patients at risk, meanwhile, make timely and correct clinical interventions to decrease the incidence of this complication.
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Affiliation(s)
- Jia Li
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Guoxing Jia
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Wei Dong
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Feng Zhao
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Zhenshuan Zhao
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Xiaoguang Yu
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Chaohua Zhu
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Jun Li
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Sen Liu
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
| | - Xiangming Jiang
- Lingshui Hospital of First Hospital of Hebei Medical UniversityLingshuiHainanPR China
| | - Guobin Liu
- Department of Orthopedic SurgeryThe First Hospital of Hebei Medical UniversityShijiazhuangHebeiPR China
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Ohashi H, Nishida K, Nasu Y, Saiga K, Nakahara R, Horita M, Okita S, Ozaki T. A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147520. [PMID: 34299970 PMCID: PMC8303857 DOI: 10.3390/ijerph18147520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022]
Abstract
Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (−0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.
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Affiliation(s)
- Hideki Ohashi
- Department of Orthopaedic Surgery, Takahashi Central Hospital, Okayama 716-0033, Japan;
| | - Keiichiro Nishida
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.H.); (T.O.)
- Correspondence: ; Tel.: +81-86-235-7273
| | - Yoshihisa Nasu
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan; (Y.N.); (K.S.); (R.N.)
| | - Kenta Saiga
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan; (Y.N.); (K.S.); (R.N.)
| | - Ryuichi Nakahara
- Department of Orthopaedic Surgery, Okayama University Hospital, Okayama 700-8558, Japan; (Y.N.); (K.S.); (R.N.)
| | - Masahiro Horita
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.H.); (T.O.)
| | - Shunji Okita
- Department of Orthopaedic Surgery, Okayama City Hospital, Okayama 700-0962, Japan;
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; (M.H.); (T.O.)
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Abstract
Wound healing is affected by several factors. Preexisting diagnoses may significantly alter, delay, or inhibit normal wound healing. This is most commonly seen with chronic disorders, such as diabetes and renal failure, but also occurs secondary to aging and substance abuse. Less commonly, genetic or inflammatory disorders are the cause of delayed wound healing. In some cases, it is not the illness, but the treatment that can inhibit wound healing. This is seen in patients getting chemotherapy, radiation, steroids, methotrexate, and a host of other medications. Understanding these processes may help treat or avoid wound healing problems.
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Affiliation(s)
- Robel T Beyene
- Department of Surgery, Vanderbilt University Medical Center, 1310 24th Avenue South, Nashville, TN 37212, USA
| | - Stephen Lentz Derryberry
- Department of Surgery, Vanderbilt University Medical Center, 1310 24th Avenue South, Nashville, TN 37212, USA
| | - Adrian Barbul
- Department of Surgery, Vanderbilt University Medical Center, 1310 24th Avenue South, Nashville, TN 37212, USA; Department of Surgery, Nashville Veterans Administration Hospital, 1310 24th Avenue South, Nashville, TN 37212, USA.
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Ohta K, Fukushi JI, Ikemura S, Kamura S, Miyahara HA, Nakashima Y. Preoperative Japanese Society for the Surgery of the Foot Lesser toe score and erythrocyte sedimentation rate influence wound healing following rheumatoid forefoot surgery. Mod Rheumatol 2020; 31:380-385. [PMID: 32476570 DOI: 10.1080/14397595.2020.1775960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Delayed wound healing is one of the most common complications following forefoot surgery in patients with rheumatoid arthritis. We aimed to identify the risk factors for delayed wound healing following rheumatoid forefoot surgery. METHODS Consecutive patients who underwent primary rheumatoid forefoot surgery (86 feet; 53 patients) between April 2008 and February 2019 were retrospectively evaluated. Clinical data, including smoking history, duration of the disease, presence of diabetes mellitus, medication, white blood cell count, erythrocyte sedimentation rate (ESR), C-reactive protein, the surgical procedure performed, and the Japanese Society for Surgery of the Foot (JSSF) scores, were collected. RESULTS Delayed wound healing was identified in 20 of 86 (23.3%) feet. In univariate analysis, participants showing delayed healing were older at the time of surgery (p = .04), their ESR was higher (p = .0006), and their total (p = .019) and pain (p = .016) scores on the JSSF Lesser toe scale were lower than those showing normal healing. In multivariable analysis, both the total preoperative JSSF Lesser toe scale score (p = .0239) and ESR (p = .0126) remained significant risk factors for delayed wound healing. CONCLUSIONS After rheumatoid forefoot surgery, surgeons should pay more attention to wound care in patients with lower preoperative JSSF Lesser toe score and high ESR.
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Affiliation(s)
- Koji Ohta
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.,Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun-Ichi Fukushi
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Ikemura
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoshi Kamura
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hisa-Aki Miyahara
- Department of Rheumatology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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7
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Toyoshima Y, Maeda T, Kijima T, Namiki O, Nemoto T, Inagaki K. Therapeutic failure and eventual solution for skin necrosis and exposed tendon of the dorsum of the foot: A case report. Clin Case Rep 2018; 6:1600-1603. [PMID: 30147913 PMCID: PMC6099008 DOI: 10.1002/ccr3.1697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/08/2018] [Indexed: 11/18/2022] Open
Abstract
For the treatment of skin necrosis with exposed tendons in rheumatoid arthritis (RA) foot, we should perform microvascular free flap surgery at an early stage without conservative treatment considering the increased risk of infection and the decreased physical activity.
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Affiliation(s)
- Yoichi Toyoshima
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
| | - Toshio Maeda
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
| | - Takeshi Kijima
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
| | - Osamu Namiki
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
| | - Tetsuya Nemoto
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
| | - Katsunori Inagaki
- Department of Orthopaedic SurgeryShowa University School of MedicineShinagawa‐ku, TokyoJapan
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8
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Abstract
PURPOSE OF REVIEW The purpose of this review is to guide providers on how best to optimize the health of patients with rheumatoid arthritis (RA) planning surgery, to reduce risk and complications and achieve the best outcomes. RECENT FINDINGS The American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) have issued a recent guideline on perioperative management of antirheumatic medications in patients with RA. Patients with RA will continue to need surgery. Newer literature is helping to plan the perioperative period to help reduce complications and improve outcomes.
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Affiliation(s)
- Alana Sigmund
- Department of Medicine/Perioperative Medicine, Hospital for Special Surgery, Weill Cornell Medicine, 541 East 71st Street, Pavillion, 3rd Floor, New York, NY, 10021, USA
| | - Linda A Russell
- Department of Medicine/Perioperative Medicine, Hospital for Special Surgery, Weill Cornell Medicine, 535 East 70th Street, 6th Floor, New York, NY, 10021, USA.
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Meyr AJ, Mirmiran R, Naldo J, Sachs BD, Shibuya N. American College of Foot and Ankle Surgeons ® Clinical Consensus Statement: Perioperative Management. J Foot Ankle Surg 2017; 56:336-356. [PMID: 28231966 DOI: 10.1053/j.jfas.2016.10.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Indexed: 02/07/2023]
Abstract
A wide range of factors contribute to the complexity of the management plan for an individual patient, and it is the surgeon's responsibility to consider the clinical variables and to guide the patient through the perioperative period. In an effort to address a number of important variables, the American College of Foot and Ankle Surgeons convened a panel of experts to derive a clinical consensus statement to address selected issues associated with the perioperative management of foot and ankle surgical patients.
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Affiliation(s)
- Andrew J Meyr
- Committee Chairperson and Clinical Associate Professor, Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.
| | | | - Jason Naldo
- Assistant Professor, Department of Orthopedic Surgery, Virginia Tech Carilion School of Medicine, Roanoke, VA
| | - Brett D Sachs
- Private Practice, Rocky Mountain Foot & Ankle Center, Wheat Ridge, CO; Faculty, Podiatric Medicine and Surgery Program, Highlands-Presbyterian St. Luke's Medical Center, Denver, CO
| | - Naohiro Shibuya
- Professor, Department of Surgery, Texas A&M, College of Medicine, Temple, TX
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Delayed wound healing and postoperative surgical site infections in patients with rheumatoid arthritis treated with or without biological disease-modifying antirheumatic drugs. Clin Rheumatol 2016; 35:1475-81. [DOI: 10.1007/s10067-016-3274-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 12/19/2022]
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Yano K, Ikari K, Takatsuki Y, Taniguchi A, Yamanaka H, Momohara S. Longer operative time is the risk for delayed wound healing after forefoot surgery in patients with rheumatoid arthritis. Mod Rheumatol 2015; 26:211-5. [DOI: 10.3109/14397595.2015.1071456] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Koichiro Yano
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
| | - Katsunori Ikari
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
- CREST, JST, Shinjuku, Tokyo Japan
| | - Yoshihito Takatsuki
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
| | - Atsuo Taniguchi
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
| | - Hisashi Yamanaka
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
| | - Shigeki Momohara
- Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo Japan
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