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Fukaya S, Iwata S, Tsuda K, Hirose A, Kinoshita M, Saitoh S, Iwata O. Body Size, Cerebral Blood Flow, Ambient Temperature, and Relative Brain Temperatures in Newborn Infants under Incubator Care. Biosensors (Basel) 2024; 14:209. [PMID: 38667202 PMCID: PMC11048025 DOI: 10.3390/bios14040209] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Subtle changes in body temperature affect the outcomes of ill newborns. However, the temperature profile of neonatal brains remains largely unknown. In open-cot care, increased cerebral perfusion is correlated with higher superficial brain temperatures. This study investigated the dependence of brain temperature (relative to rectal temperature) on ambient temperature, body size, cerebral perfusion, and metabolism in infants receiving incubator care. Rectal, scalp, and brain temperatures, superior vena cava flow, and brain oxygenation were assessed using echocardiography, thermo-compensatory temperature monitoring, and near-infrared spectroscopy in 60 newborns. These infants had a mean postconceptional age of 36.9 (2.2) weeks and weighed 2348 (609) g at the time of evaluation. The ambient temperature was maintained at 30.0 (1.0) °C. A higher rectal temperature was associated with greater postconceptional age (p = 0.002), body weight (p < 0.001), and head circumference (p < 0.001). Relative scalp, superficial brain, and deep brain temperatures were associated with smaller head circumference (p < 0.001, p = 0.030, and p = 0.015, respectively) and superior vena cava flow (p = 0.002, p = 0.003, and p = 0.003, respectively). In infants receiving incubator care, larger head sizes and increased brain perfusion were associated with lower relative scalp and brain temperatures. When considered alongside previous reports, cerebral perfusion may contribute to maintaining stable cerebral tissue temperature against ambient temperature changes.
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Affiliation(s)
- Satoko Fukaya
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan (S.S.)
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan (S.S.)
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan (S.S.)
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Akiko Hirose
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Masahiro Kinoshita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan (S.S.)
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan (S.S.)
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume 830-0011, Japan
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Hisano T, Okada J, Tsuda K, Iwata S, Saitoh S, Iwata O. Control variables of serum ferritin concentrations in hospitalized newborn infants: an observational study. Sci Rep 2023; 13:8424. [PMID: 37225866 DOI: 10.1038/s41598-023-35404-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 05/17/2023] [Indexed: 05/26/2023] Open
Abstract
Both iron excess and deficiency are deleterious to cellular and organ homeostasis. Serum ferritin levels serve as a biomarker of iron storage; however, their distribution and determinants in sick newborn infants remain unclear. This study aimed to investigate the reference range and independent variables of serum ferritin in hospitalized newborn infants. All newborn infants who were hospitalized at a tertiary neonatal center within 24 h of birth were retrospectively reviewed for the period of April 2015 through March 2017. Serum ferritin levels were assessed using venous blood samples obtained at admission and their independent variables were explored. The study population comprised 368 infants (36.2 ± 2.8 weeks gestation and 2319 ± 623 g at birth), whose median serum ferritin level was 149 µg/L (inter-quartile range: 81-236). The multivariable model used to explain serum ferritin values comprised hemoglobin, lactate dehydrogenase, blood pH, and maternal hypertensive disorders in pregnancy (all p < 0.01, adjusted for sex and birth weight). Serum ferritin values in hospitalized newborn infants were comparable to those previously reported using umbilical cord blood. Our novel findings indicated the association between blood pH, lactate dehydrogenase, and ferritin levels, suggesting the influence of antenatal hypoxia-ischemia and stress to serum ferritin levels.
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Affiliation(s)
- Tadashi Hisano
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Junichiro Okada
- Division of Neonatology, St. Mary's Hospital, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.
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Tsuda K, Shibasaki J, Takeuchi A, Mukai T, Sugiyama Y, Isayama T, Ioroi T, Takahashi A, Yutaka N, Iwata O. Prolonged requirements for mechanical ventilation and tube feeding support predicted 18-month outcomes for neonatal encephalopathy. Acta Paediatr 2023; 112:734-741. [PMID: 36708079 DOI: 10.1111/apa.16687] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/29/2023]
Abstract
AIM We evaluated the predictive ability of prolonged requirements for mechanical ventilation or tube feeding support for 18-month composite outcomes in infants with hypoxic-ischaemic encephalopathy treated with hypothermia. METHODS This retrospective, nationwide, observational study focused on newborn infants registered in Japan's Baby Cooling Registry between 1 January 2012 and 31 December 2016. The adverse outcomes were defined as death or survival with cerebral palsy, visual or auditory impairment or the requirement for mechanical ventilation or tube feeding at 18 months of age. RESULTS Adverse outcomes occurred in 165 (28%) of the 591 children in the final cohort. These were predicted by prolonged dependence on mechanical ventilation or tube feeding for more than seven and more than 14 days. The respective values were positive predictive value 0.34 (95% CI 0.33-0.34) and 0.60 (95% CI 0.56-0.62), negative predictive value 0.97 (95% CI 0.91-0.99) and 0.93 (95% CI 0.90-0.95) and area under the curve 0.59 (95% CI 0.54-0.64) and 0.81 (95% CI 0.77-0.85). CONCLUSION Prolonged dependence on mechanical ventilation or tube feeding for more than 14 days may be useful in predicting 18-month outcomes in newborn infants who have received therapeutic hypothermia.
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Affiliation(s)
- Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takeo Mukai
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuichiro Sugiyama
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, Japan
| | - Tetsuya Isayama
- Division of Neonatology, Center of Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoaki Ioroi
- Department of Pediatrics, Perinatal Medical Center, Himeji Red Cross Hospital, Hyogo, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan
| | - Nanae Yutaka
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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Aoki H, Shibasaki J, Tsuda K, Yamamoto K, Takeuchi A, Sugiyama Y, Isayama T, Mukai T, Ioroi T, Yutaka N, Takahashi A, Tokuhisa T, Nabetani M, Iwata O. Predictive value of the Thompson score for short-term adverse outcomes in neonatal encephalopathy. Pediatr Res 2023; 93:1057-1063. [PMID: 35908094 DOI: 10.1038/s41390-022-02212-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 10/24/2021] [Revised: 06/30/2022] [Accepted: 07/12/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND To explore the predictive value of the Thompson score during the first 4 days of life for estimating short-term adverse outcomes in neonatal encephalopathy. METHODS This observational study evaluated infants with neonatal encephalopathy (≥36 weeks of gestation) registered in a multicenter cohort of cooled infants in Japan. The Thompson score was evaluated at 0-24, 24-48, 48-72, and 72-90 h of age. Adverse outcomes included death, survival with respiratory impairment (requiring tracheostomy), or survival with feeding impairment (requiring gavage feeding) at discharge. RESULTS Of the 632 infants, 21 (3.3%) died, 59 (9.3%) survived with respiratory impairment, and 113 (17.9%) survived with feeding impairment. The Thompson score throughout the first 4 days accurately predicted death, respiratory impairment, or feeding impairment. The 72-90 h score showed the highest accuracy. A cutoff of ≥15 had a sensitivity of 0.85 and specificity of 0.92 for death or respiratory impairment, while a cutoff of ≥14 had a sensitivity of 0.71 and a specificity of 0.92 for death, respiratory or feeding impairment. CONCLUSION A high Thompson score during the first 4 days of life, especially at 72-90 h could thus be useful for estimating the need for prolonged life support. IMPACT The Thompson score on days 1-4 of age was useful in predicting death and respiratory or feeding impairments. The 72-90 h Thompson score showed the highest predictive capability. Owing to the rarity of withdrawal of life-sustaining treatment in Japan, 43% of infants with persistent severe encephalopathy with a Thompson score of ≥15 at 72-90 h of age could regain spontaneous breathing, be extubated, and survive without tracheostomy. Meanwhile, approximately 50% of infants who survived without tracheostomy required gavage feeding. Our results could provide useful information for clinical decision making regarding infants with persistent severe encephalopathy.
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Affiliation(s)
- Hirosato Aoki
- Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan.
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kouji Yamamoto
- Department of Biostatistics, School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yuichiro Sugiyama
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, Japan
| | - Tetsuya Isayama
- Division of Neonatology, Center for Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Takeo Mukai
- Center for Advanced Medical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Tomoaki Ioroi
- Department of Pediatrics, Perinatal Medical Center, Himeji Red Cross Hospital, Hyogo, Japan
| | - Nanae Yutaka
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan
| | - Takuya Tokuhisa
- Department of Neonatology, Perinatal Medical Center, Imakiire General Hospital, Kagoshima, Japan
| | - Makoto Nabetani
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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Iwata S, Katayama R, Tsuda K, Lin YC, Kurata T, Kinoshita M, Kawase K, Kato T, Kato S, Hisano T, Oda M, Ohmae E, Takashima S, Araki Y, Saitoh S, Iwata O. Near-infrared light scattering and water diffusion in newborn brains. Ann Clin Transl Neurol 2022; 9:1417-1427. [PMID: 35943446 PMCID: PMC9463954 DOI: 10.1002/acn3.51641] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022] Open
Abstract
Objective MRI provides useful information regarding brain maturation and injury in newborn infants. However, MRI studies are generally restricted during acute phase, resulting in uncertainty around upstream clinical events responsible for subtle cerebral injuries. Time‐resolved near‐infrared spectroscopy non‐invasively provides the reduced scattering coefficient (μs′), which theoretically reflects tissue structural complexity. This study aimed to test whether μs′ values of the newborn head reflected MRI findings. Methods Between June 2009 and January 2015, 77 hospitalised newborn infants (31.7 ± 3.8 weeks gestation) were assessed at 38.8 ± 1.3 weeks post‐conceptional age. Associations of μs′ values with MRI scores, mean diffusivity and fractional anisotropy were assessed. Results Univariable analysis showed that μs′ values were associated with gestational week (p = 0.035; regression coefficient [B], 0.065; 95% confidence interval [CI], 0.005–0.125), fractional anisotropy in the cortical grey matter (p = 0.020; B, −5.994; 95%CI, −11.032 to −0.957), average diffusivity in the cortical grey matter (p < 0.001; B, −4.728; 95%CI, −7.063 to −2.394) and subcortical white matter (p = 0.001; B, −2.071; 95%CI, −3.311 to −0.832), subarachnoid space (p < 0.001; B, −0.289; 95%CI, −0.376 to −0.201) and absence of brain abnormality (p = 0.042; B, −0.422; 95%CI, −0.829 to −0.015). The multivariable model to explain μs′ values comprised average diffusivity in the subcortical white matter (p < 0.001; B, −2.066; 95%CI, −3.200 to −0.932), subarachnoid space (p < 0.001; B, −0.314; 95%CI, −0.412 to −0.216) and absence of brain abnormality (p = 0.021; B, −0.400; 95%CI, −0.739 to −0.061). Interpretation Light scattering was associated with brain structure indicated by MRI‐assessed brain abnormality and diffusion‐tensor‐imaging‐assessed water diffusivity. When serially assessed in a larger population, μs′ values might help identify covert clinical events responsible for subtle cerebral injury.
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Affiliation(s)
- Sachiko Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.,Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Reiji Katayama
- Centre for the Study of Medical Education, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.,Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, 70457, Taiwan
| | - Tsuyoshi Kurata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Koya Kawase
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Takenori Kato
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Shin Kato
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Tadashi Hisano
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Motoki Oda
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, 434-8601, Japan
| | - Etsuko Ohmae
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Shizuoka, 434-8601, Japan
| | - Sachio Takashima
- Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare, Yanagawa, Fukuoka, 832-0813, Japan
| | - Yuko Araki
- Graduate School of Information Sciences, Tohoku University, Sendai City, Miyagi, 980-8579, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8601, Japan.,Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
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Kato S, Iwata O, Iwata S, Yamada T, Tsuda K, Tanaka T, Saitoh S. Admission temperature of very low birth weight infants and outcomes at three years old. Sci Rep 2022; 12:11912. [PMID: 35831444 PMCID: PMC9279326 DOI: 10.1038/s41598-022-15979-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/01/2022] [Indexed: 11/09/2022] Open
Abstract
The lower body temperature of preterm newborns at admission to neonatal intensive care units (NICUs) is inversely associated with their morbidities and mortalities before discharge. This retrospective cohort study aimed to determine whether admission rectal temperature in very low birth weight infants (VLBWIs) is independently associated with a composite outcome of death or moderate-to-severe neurodevelopmental impairments as defined by a performance developmental quotient of < 70 at three years of age. VLBWIs admitted to the NICU between April 2010 and March 2016 were assesed. Developmental assessment was completed in 216 newborns. Nine and two infants died before and after discharge, respectively. A higher admission temperature was associated with a lower incidence of death or moderate-to-severe neurodevelopmental impairments with adjustment for gestational age, sex, antenatal steroid use, Apgar score, severe intraventricular hemorrhage, and severe bronchopulmonary dysplasia (odds ratio [OR] 0.424; 95% confidence interval [CI] 0.250-0.717; p = 0.001). The admission temperature remained as an independent variable of adverse outcome at three years of age even when the study cohort was limited to surviving infants (OR 0.448; 95% CI 0.259-0.774; p = 0.004). Further studies are needed to assess whether avoiding low body temperature at admission results in better long-term neurodevelopmental outcomes in VLBWIs.
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Affiliation(s)
- Shin Kato
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
| | - Osuke Iwata
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Sachiko Iwata
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
| | - Takaharu Yamada
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Kennosuke Tsuda
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.,Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Taihei Tanaka
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan
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Okuda R, Osaki M, Saeki Y, Okano T, Tsuda K, Nakamura T, Morio Y, Nagashima H, Hagino H. Effect of coordinator-based osteoporosis intervention on quality of life in patients with fragility fractures: a prospective randomized trial. Osteoporos Int 2022; 33:1445-1455. [PMID: 35195752 DOI: 10.1007/s00198-021-06279-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
UNLABELLED We examined the effects of the coordinator-based intervention on quality of life (QOL) in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL. The coordinator-based interventions mitigated the decrease in QOL. Secondary fracture after primary fracture, however, was a significant predictor of lower QOL. PURPOSE This study aimed to determine the effects of the coordinator-based intervention on QOL in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL, in an Asian population. METHODS Patients with new fractures in the intervention group received the coordinator-based intervention by a designated nurse certified as a coordinator, within 3 months of injury. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) scale before the fracture (through patient recollections) and at 0.5, 1, and 2 years after the primary fracture. RESULTS Data for 141 patients were analyzed: 70 in the liaison intervention (LI) group and 71 in the non-LI group. Significant intervention effects on QOL were observed at 6 months after the fracture; the QOL score was 0.079 points higher in the LI group than in the non-LI group (p=0.019). Further, the LI group reported significantly less pain/discomfort at 2 years after the fracture, compared to the non-LI group (p=0.037). In addition, secondary fractures were found to significantly prevent improvement and maintenance of QOL during the recovery period (p=0.015). CONCLUSION Short-term intervention effects were observable 6 months after the primary fracture, with the LI group mitigated the decrease in QOL. Few patients in the LI group reported pain/discomfort 2 years after the fracture, but there is uncertainty regarding its clinical significance. Secondary fracture after initial injury was a significant predictor of lower QOL after a fracture.
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Affiliation(s)
- R Okuda
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan.
| | - M Osaki
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
| | - Y Saeki
- Orthopedic Surgery Hospital Ward, Tottori University Hospital, Yonago, Tottori, Japan
| | - T Okano
- Department of Orthopedic Surgery, San-in Rosai Hospital, Yonago, Tottori, Japan
| | - K Tsuda
- Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Sakaiminato, Tottori, Japan
| | - T Nakamura
- Department of Orthopedic Surgery, Hakuai Hospital, Yonago, Tottori, Japan
| | - Y Morio
- Department of Orthopedic Surgery, Misasa Onsen Hospital, Misasa, Tottori, Japan
| | - H Nagashima
- Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
| | - H Hagino
- School of Health Science, Faculty of Medicine, Tottori University, 86 Nishi-Cho, Yonago, Tottori, 683-8503, Japan
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
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8
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Tsuda K, Shibasaki J, Isayama T, Takeuchi A, Mukai T, Ioroi T, Takahashi A, Sano H, Yutaka N, Iwata S, Nabetani M, Sobajima H, Hosono S, Tamura M, Iwata O. Body temperature, heart rate and long-term outcome of cooled infants: an observational study. Pediatr Res 2022; 91:921-928. [PMID: 33846554 DOI: 10.1038/s41390-021-01502-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 11/03/2020] [Revised: 03/13/2021] [Accepted: 03/16/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Therapeutic hypothermia is a standard of care for neonatal encephalopathy; however, approximately one in two newborn infants fails to respond to this treatment. Recent studies have suggested potential relationships between body temperature, heart rate and the outcome of cooled infants. METHODS The clinical data of 756 infants registered to the Baby Cooling Registry of Japan between January 2012 and December 2016 were analysed to assess the relationship between body temperature, heart rate and adverse outcomes (death or severe impairment at 18 months corrected age). RESULTS A lower body temperature at admission was associated with adverse outcomes in the univariate analysis (P < 0.001), the significance of which was lost when adjusted for the severity of encephalopathy and other covariates. A higher body temperature during cooling and higher heart rate before and during cooling were associated with adverse outcomes in both univariate (all P < 0.001) and multivariate (P = 0.012, P < 0.001 and P < 0.001, respectively) analyses. CONCLUSIONS Severe hypoxia-ischaemia might be a common causative of faster heart rates before and during cooling and low body temperature before cooling, whereas causal relationships between slightly higher temperatures during cooling and adverse outcomes need to be elucidated in future studies. IMPACT In a large cohort of encephalopathic newborn infants, dual roles of body temperature to the outcome were shown; adverse outcomes were associated with a lower body temperature at admission and higher body temperature during cooling. A higher heart rate before and during cooling were associated with adverse outcomes. Severe hypoxia-ischaemia might be a common causative of faster heart rates before and during cooling and low body temperature before cooling. The exact mechanism underlying the relationship between slightly higher body temperature during cooling and adverse outcomes remains unknown, which needs to be elucidated in future studies.
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Affiliation(s)
- Kennosuke Tsuda
- Department of Pediatrics, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan.,Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Tetsuya Isayama
- Division of Neonatology, Center of Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takeo Mukai
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomoaki Ioroi
- Department of Pediatrics, Perinatal Medical Center, Himeji Red Cross Hospital, Hyogo, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan
| | - Hiroyuki Sano
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Nanae Yutaka
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Makoto Nabetani
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Hisanori Sobajima
- Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shigeharu Hosono
- Division of Neonatology, Department of Perinatal and Neonatal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masanori Tamura
- Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan.
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9
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Saikusa M, Kinoshita M, Tsuda K, Hisano T, Okada J, Iwata S, Fujino H, Maeno Y, Yamashita Y, Iwata O. Revisions of clinical protocols using the Plan Do Check Act cycle improved outcomes of extremely preterm infants at 2 years. Acta Paediatr 2021; 110:2100-2109. [PMID: 33711173 PMCID: PMC8360062 DOI: 10.1111/apa.15840] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Abstract
AIM Clinical quality improvement is often cumbersome due to established protocols. We aimed to investigate whether outcomes of preterm infants improve with protocol revisions using iteration cycles. METHODS Preterm infants born <28 weeks gestation between January 2006 and December 2015 were retrospectively analysed. Protocols were revised using Plan Do Check Act cycle. Death and serious adverse events at term were reviewed in six-monthly quality improvement meetings. Adverse outcome of death or motor/sensory impairments at two years was compared before and after two major protocol changes, which were implemented in January 2008 and January 2012. RESULTS Based on the appraisal for period 2006-2007, strategies for surfactant, narcotics, parenteral nutrition, respiratory gas humidity and prophylactic indomethacin and antibiotics were changed for period 2008-2011. For period 2012-2015, stabilisation of infants was accelerated via very early catheterisation. Of 162 infants (84 males, 25.5 ± 1.5 weeks gestation) within the whole cohort, 63 developed adverse outcomes, which were fewer for periods 2008-2011 (p = 0.013) and 2012-2015 (p = 0.035) compared with period 2006-2007 (adjusted for gestational age, Apgar scores and sex). CONCLUSION Careful bottom-up revisions of protocols using iteration cycles, accounting for local settings, successfully improved the outcomes of preterm infants.
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Affiliation(s)
- Mamoru Saikusa
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Tadashi Hisano
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Junichiro Okada
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Sachiko Iwata
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
| | - Hiroshi Fujino
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Yasuki Maeno
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Yushiro Yamashita
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
| | - Osuke Iwata
- Department of Paediatrics and Child HealthKurume University School of MedicineKurumeFukuokaJapan
- Center for Human Development and Family ScienceDepartment of Pediatrics and NeonatologyNagoya City University Graduate School of Medical SciencesNagoyaAichiJapan
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10
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Aryal B, Morikawa D, Tsuda K, Terauchi M. Improvement of precision in refinements of structure factors using convergent-beam electron diffraction patterns taken at Bragg-excited conditions. Acta Crystallogr A Found Adv 2021; 77:289-295. [PMID: 34196291 DOI: 10.1107/s2053273321004137] [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] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/17/2021] [Indexed: 11/11/2022]
Abstract
A local structure analysis method based on convergent-beam electron diffraction (CBED) has been used for refining isotropic atomic displacement parameters and five low-order structure factors with sin θ/λ ≤ 0.28 Å-1 of potassium tantalate (KTaO3). Comparison between structure factors determined from CBED patterns taken at the zone-axis (ZA) and Bragg-excited conditions is made in order to discuss their precision and sensitivities. Bragg-excited CBED patterns showed higher precision in the refinement of structure factors than ZA patterns. Consistency between higher precision and sensitivity of the Bragg-excited CBED patterns has been found only for structure factors of the outer zeroth-order Laue-zone reflections with larger reciprocal-lattice vectors. Correlation coefficients among the refined structure factors in the refinement of Bragg-excited patterns are smaller than those of the ZA ones. Such smaller correlation coefficients lead to higher precision in the refinement of structure factors.
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Affiliation(s)
- B Aryal
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980-8577, Japan
| | - D Morikawa
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980-8577, Japan
| | - K Tsuda
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Terauchi
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai 980-8577, Japan
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11
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Nakane S, Tsuda K, Kinoshita M, Kato S, Iwata S, Lin YC, Mizuno M, Saitoh S, Iwata O. Airway gas temperature within endotracheal tube can be monitored using rapid response thermometer. Sci Rep 2021; 11:9537. [PMID: 33953212 PMCID: PMC8100119 DOI: 10.1038/s41598-021-88787-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
Inappropriate preparation of respiratory gases is associated with serious complications during mechanical ventilation. To develop a temperature monitoring system of respiratory gases within the endotracheal tube, four newborn piglets were studied using an ultra-rapid-response thermometer attached to the closed endotracheal tube suction system. Respiratory gas temperatures were monitored at the mouth-corner level of the endotracheal tube using three thermocouples (Tairway, inserted into the endotracheal tube via the closed suction system; Ttube_centre and Ttube_wall, embedded within the endotracheal tube 0.5 mm and 1.6 mm from the tube wall, respectively). Univariate analysis showed that inspiratory Ttube_centre and inspiratory Ttube_wall were positively correlated with inspiratory Tairway (both p < 0.001). Multivariate analysis showed the dependence of inspiratory Tairway on inspiratory Ttube_centre and Ttube_wall and deflation of endotracheal tube cuff (p < 0.001, p = 0.001 and p = 0.046, respectively). Inspiratory gas temperature within the endotracheal tube can be monitored using a thermometer attached to the closed endotracheal tube suction system. Our system, with further validation, might help optimise respiratory gas humidification during mechanical ventilation.
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Affiliation(s)
- Shigeharu Nakane
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan.,Department of Paediatrics, Daido Hospital, Nagoya, Japan
| | - Kennosuke Tsuda
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Shin Kato
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Sachiko Iwata
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Yung-Chieh Lin
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan.,Department of Paediatrics, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Mihoko Mizuno
- Department of Paediatrics, Daido Hospital, Nagoya, Japan
| | - Shinji Saitoh
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Osuke Iwata
- Department of Paediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, Nagoya, Japan.
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12
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Osaki M, Okuda R, Saeki Y, Okano T, Tsuda K, Nakamura T, Morio Y, Nagashima H, Hagino H. Efficiency of coordinator-based osteoporosis intervention in fragility fracture patients: a prospective randomized trial. Osteoporos Int 2021; 32:495-503. [PMID: 33483796 PMCID: PMC7929967 DOI: 10.1007/s00198-021-05825-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/04/2021] [Indexed: 11/26/2022]
Abstract
UNLABELLED We examined the effectiveness of coordinators' interventions to prevent secondary fractures in patients with fragility fractures. These coordinator-based interventions improved bone density assessment implementation and treatment rates, and enhanced treatment persistence rates in the early stages following fractures. INTRODUCTION This study aimed to determine the efficiency of coordinator-based osteoporosis intervention in fragility fracture patients during a 2-year period. METHODS A prospective intervention randomized control study was conducted at seven medical facilities from January 2015 to March 2017. Postmenopausal women and men over 50 years old with fragility fractures were randomly divided into the coordinator intervention (LI; 70 patients) and without intervention (non-LI; 71 patients) groups. The osteoporosis treatment rate, osteoporosis treatment persistence rate, fall rate, fracture incidence rate, and bone density measurement rate 3 months, 6 months, 1 year, and 2 years after registration were compared between the two groups. Non-parametric tests were used to analyze data at each inspection period. RESULTS The osteoporosis treatment initiation rate was significantly higher in the LI group than in the non-LI group (85.7% vs. 71.8%; p = 0.04). The LI group had significantly higher bone density assessment implementation rates than the non-LI group at the time of registration (90.0% vs. 69.0%; p = 0.00) and 6 months after registration (50.0% vs. 29.6%; p = 0.01), but not 1 or 2 years after registration. In addition, no significant differences in fall or fracture incidence rates were found between the two groups. CONCLUSION The coordinator-based interventions for fragility fractures improved bone density assessment implementation and treatment rates and enhanced treatment persistence rates in the early stages following bone fractures. The findings suggest that liaison intervention may help both fracture and osteoporosis physicians for the evaluation of osteoporosis and initiation and continuation of osteoporosis medication.
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Affiliation(s)
- M Osaki
- Rehabilitation Division, Tottori University Hospital, Tottori, 683-8504, Japan.
| | - R Okuda
- School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Y Saeki
- Orthopedic Surgery Hospital Ward, Tottori University Hospital, Tottori, Japan
| | - T Okano
- Department of Orthopedic Surgery, San-in Rosai Hospital, Tottori, Japan
| | - K Tsuda
- Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Tottori, Japan
| | - T Nakamura
- Department of Orthopedic Surgery, Hakuai Hospital, Tottori, Japan
| | - Y Morio
- Department of Orthopedic Surgery, Misasa Onsen Hospital, Tottori, Japan
| | - H Nagashima
- Department of Orthopedic Surgery, Tottori University, Tottori, Japan
| | - H Hagino
- Rehabilitation Division, Tottori University Hospital, Tottori, 683-8504, Japan
- School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan
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13
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Hayashida T, Uemura Y, Kimura K, Matsuoka S, Morikawa D, Hirose S, Tsuda K, Hasegawa T, Kimura T. Visualization of ferroaxial domains in an order-disorder type ferroaxial crystal. Nat Commun 2020; 11:4582. [PMID: 32917897 PMCID: PMC7486364 DOI: 10.1038/s41467-020-18408-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/20/2020] [Accepted: 08/22/2020] [Indexed: 11/12/2022] Open
Abstract
Ferroaxial materials that exhibit spontaneous ordering of a rotational structural distortion with an axial vector symmetry have gained growing interest, motivated by recent extensive studies on ferroic materials. As in conventional ferroics (e.g., ferroelectrics and ferromagnetics), domain states will be present in the ferroaxial materials. However, the observation of ferroaxial domains is non-trivial due to the nature of the order parameter, which is invariant under both time-reversal and space-inversion operations. Here we propose that NiTiO3 is an order-disorder type ferroaxial material, and spatially resolve its ferroaxial domains by using linear electrogyration effect: optical rotation in proportion to an applied electric field. To detect small signals of electrogyration (order of 10−5 deg V−1), we adopt a recently developed difference image-sensing technique. Furthermore, the ferroaxial domains are confirmed on nano-scale spatial resolution with a combined use of scanning transmission electron microscopy and convergent-beam electron diffraction. Our success of the domain visualization will promote the study of ferroaxial materials as a new ferroic state of matter. The presence of ferroaxial domain states is recently experimentally demonstrated by a nonlinear optical technique, which lacks high spatial resolution to visualize ferroaxial domains. Here, the authors visualize spatial distributions of ferroaxial domains in NiTiO3 showing an order-disorder type ferroaxial transition.
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Affiliation(s)
- T Hayashida
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - Y Uemura
- Department of Applied Physics, University of Tokyo, Tokyo, 113-8656, Japan
| | - K Kimura
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan
| | - S Matsuoka
- Department of Applied Physics, University of Tokyo, Tokyo, 113-8656, Japan
| | - D Morikawa
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, 2-1-1, Katahira,Aoba-ku, Sendai, 980-8577, Japan
| | - S Hirose
- Murata Manufacturing Co., Ltd., Nagaokakyo-shi, Kyoto, 617-8555, Japan
| | - K Tsuda
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, 6-3, Aramaki Aoba, Aoba-ku, Sendai, 980-8578, Japan
| | - T Hasegawa
- Department of Applied Physics, University of Tokyo, Tokyo, 113-8656, Japan
| | - T Kimura
- Department of Advanced Materials Science, University of Tokyo, Kashiwa, Chiba, 277-8561, Japan.
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14
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Shibasaki J, Mukai T, Tsuda K, Takeuchi A, Ioroi T, Sano H, Yutaka N, Takahashi A, Sobajima H, Tamura M, Hosono S, Nabetani M, Iwata O. Outcomes related to 10-min Apgar scores of zero in Japan. Arch Dis Child Fetal Neonatal Ed 2020; 105:64-68. [PMID: 31092676 DOI: 10.1136/archdischild-2019-316793] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Received: 01/03/2019] [Revised: 04/02/2019] [Accepted: 04/16/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Apgar scores of zero at 10 min strongly predict mortality and morbidity in infants. However, recent data reported improved outcomes among infants with Apgar scores of zero at 10 min. We aimed to review the mortality rate and neurodevelopmental outcomes of infants with Apgar scores of zero at 10 min in Japan. DESIGN Observational study. PATIENTS Twenty-eight of 768 infants registered in the Baby Cooling Registry of Japan between 2012 and 2016, at >34 weeks' gestation, with Apgar scores of zero at 10 min who were treated with therapeutic hypothermia. INTERVENTIONS We investigated the time of first heartbeat detection in infants with favourable outcomes and who had neurodevelopmental impairments or died. MAIN OUTCOME MEASURES Clinical characteristics, mortality rate and neurodevelopmental outcomes at 18-22 months of age were evaluated. RESULTS Nine (32%) of the 28 infants died before 18 months of age; 16 (57%) survived, but with severe disabilities and 3 (11%) survived without moderate-to-severe disabilities. At 20 min after birth, 14 of 27 infants (52%) did not have a first heartbeat, 13 of them died or had severe disabilities and one infant, who had the first heartbeat at 20 min, survived without disability. CONCLUSION Our study adds to the recent evidence that neurodevelopmental outcomes among infants with Apgar scores of zero at 10 min may not be uniformly poor. However, in our study, all infants with their first heartbeat after 20 min of age died or had severe disabilities.
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Affiliation(s)
- Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Takeo Mukai
- Center for Advanced Medical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
| | - Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | - Hiroyuki Sano
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Nanae Yutaka
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan
| | - Hisanori Sobajima
- Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Masanori Tamura
- Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Shigeharu Hosono
- Department of Perinatal and Neonatal Medicine, Jichi Ika University Saitama Medical Center, Saitama, Japan
| | - Makoto Nabetani
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
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15
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Harada E, Kinoshita M, Iwata S, Saikusa M, Tsuda K, Shindou R, Sahashi T, Kato S, Yamada Y, Saitoh S, Iwata O. Visual function scale for identification of infants with low respiratory compliance. Pediatr Neonatol 2019; 60:611-616. [PMID: 30905442 DOI: 10.1016/j.pedneo.2019.02.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/02/2018] [Accepted: 02/26/2019] [Indexed: 11/18/2022] Open
Abstract
AIM Precise estimation of respiratory function is essential to optimise neonatal respiratory care. However, current clinical scores have not been validated with quantitative measures of respiratory function. The aim of this study was to develop a physiological scoring system to predict low respiratory dynamic compliance of <0.6 ml/cmH2O/kg. METHODS Forty-four newborn infants were studied before (dynamic compliance) and shortly after scheduled extubation (physiological signs). A novel scoring system was developed based on the association between physiological signs and dynamic compliance. RESULTS The respiratory rate was identified as the primary independent variable for dynamic compliance in the univariate analysis. The prediction score for low dynamic compliance comprised the presence of nasal flaring, see-saw respiration, suprasternal/intercostal retraction, and the respiratory rate ranks (0-3). The area under the receiver-operating characteristics curve of the composite score had discriminatory capability of 0.86 (95% confidence interval: 0.75-0.97) to predict low dynamic compliance with the optimal cut-off value of ≥3 (sensitivity, 0.882; specificity, 0.667). CONCLUSION Our novel scoring system might help predict newborn infants with low dynamic compliance, who may require escalation of respiratory support, or transfer to higher level units.
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Affiliation(s)
- Eimei Harada
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sachiko Iwata
- Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Ryota Shindou
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takeshi Sahashi
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Division of Neonatology, Ichinomiya Municipal Hospital, Ichinomiya, Aichi, Japan
| | - Shin Kato
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yasumasa Yamada
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan; Perinatal and Neonatal Center, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
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16
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Funabashi S, Kataoka Y, Harada-Shiba M, Hori M, Doi T, Ogura M, Hirayama A, Nishikawa R, Tsuda K, Noguchi T, Yasuda S. P938Extensive formation of atherosclerotic cardiovascular disease in subjects with severe familial hypercholesterolemia defined by the international atherosclerosis society criteria. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0532] [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
Introduction
The International Atherosclerosis Society (IAS) has proposed “severe familial hypercholesterolemia (FH)” as a FH phenotype with the highest cardiovascular risk. Coronary artery disease (CAD) represents a major atherosclerotic change in FH patients. Given their higher LDL-C level and atherogenic clinical features, more extensive formation of atherosclerosis cardiovascular disease including not only CAD but stroke/peripheral artery disease (PAD) may more frequently occur in severe FH.
Methods
481 clinically-diagnosed heterozygous FH subjects were analyzed. Severe FH was defined as untreated LDL-C>10.3 mmol/l, LDL-C>8.0 mmol/l+ 1 high-risk feature, LDL-C>4.9 mmol/l + 2 high-risk features or presence of clinical ASCVD according to IAS proposed statement. Cardiac (cardiac death and ACS) and non-cardiac (stroke and peripheral artery disease) events were compared in severe and non-severe FH subjects.
Results
Severe FH was identified in 50.1% of study subjects. They exhibit increased levels of LDL-C and Lipoprotein (a) with a higher frequency of LDLR mutation. Furthermore, a proportion of %LDL-C reduction>50% was greater in severe FH under more lipid-lowering therapy (Table). However, during the observational period (median=6.3 years), severe FH was associated with a 5.9-fold (95% CI, 2.05–25.2; p=0.004) and 5.8-fold (95% CI, 2.02–24.7; p=0.004) greater likelihood of experiencing cardiac-death/ACS and stroke/PAD, respectively (picture). Multivariate analysis demonstrated severe FH as an independent predictor of both cardiac-death/ACS (hazard ratio=3.39, 95% CI=1.12–14.7, p=0.02) and stroke/PAD (hazard ratio=3.38, 95% CI=1.16–14.3, p=0.02) events.
Clinical characteristics of severe FH Non-severe FH Severe FH P-value Baseline LDL-C (mmol/l) 5.3±1.5 6.6±2.0 <0.0001 Lp(a) (mg/dl) 15 [8–28] 21 [10–49] <0.0001 LDLR mutation (%) 49.6% 58.9% 0.00398 On-treatment LDL-C (mmol) 133 [106–165] 135 [103–169] 0.9856 %LDL-C reduction>50% 21.3% 49.8% <0.0001 High-intensity statin (%) 13.3% 42.3% <0.0001 PCSK9 inhibitor (%) 6.3% 21.2% <0.0001
Clinical outcome
Conclusions
Severe FH subjects exhibit substantial atherosclerotic risks for coronary, carotid and peripheral arteries despite lipid lowering therapy. Our finding underscore the screening of systemic arteries and the adoption of further stringent lipid management in severe FH patients.
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Affiliation(s)
- S Funabashi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Harada-Shiba
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - M Hori
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - M Ogura
- National Cerebral and Cardiovascular Center, Molecular Innovation in Lipidology, Osaka, Japan
| | - A Hirayama
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - R Nishikawa
- Sapporo Medical University, Renal and Metabolic Medicine, Sapporo, Japan
| | - K Tsuda
- Osaka Medical College, Cardiology, Takatsuki, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Hosoda H, Honda S, Fujino M, Yoneda S, Otsuka F, Nakao K, Tahara Y, Asaumi Y, Noguchi T, Yasuda S. P1561An elevated risk of heart failure and stroke events in octogenarian Japanese patients with acute myocardial infarction who received percutaneous coronary intervention. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0321] [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
The proportion of the octogenarian population is expanding especially in Eastern society. Due to the clustering of risk factors, acute myocardial infarction (AMI) represents a major cardiovascular complication in octogenarian subjects. This suggests the need to further optimize their therapeutic management to prevent future cardiac events after AMI. However, analysis of clinical characteristics and cardiovascular outcomes in octogenarian subjects with AMI who received the current established medical therapies is limited.
Purpose
To investigate clinical features and prognosis in octogenarian AMI subjects treated with percutaneous coronary intervention (PCI).
Methods
We analyzed 1547 AMI subjects underwent PCI between 2007 and 2017. Baseline characteristics and the occurrence of composite major adverse cardiovascular events (cardiac death, non-fatal MI, revascularization, heart failure and stroke) were compared in octogenarian and non-octogenarian subjects.
Results
22.0% (340/1547) of study subjects was octogenarian. They were more likely to have chronic kidney disease (CKD) and a lower level of LDL-C on admission (Table). Moreover, a higher prevalence of severer Killip class and LVEF <30% were observed in octogenarians (Table). However, they were not optimally treated with the established medical therapies at discharge (Table). During the observational period (median=3.1 years), the composite of cardiovascular events more frequently occurred in octogenarian subjects. Of note, they exhibited a 2.15-fold and 3.01-fold increased risk for heart failure and stroke events, respectively (Figure).
Table 1 Non-Octogenarian (n=1207) Octogenarian (n=340) P-value CKD* (%) 33.8 63.2 <0.0001 LVEF <30% (%) 5.7 10.3 0.02 Killip class 1.33±0.03 1.55±0.05 <0.0001 LDL-C (mmol/L) 3.20±0.03 2.80±0.05 <0.0001 Statin (%) 86.3 78.2 0.0006 Beta-blocker (%) 74.0 65.8 0.005 ACE-I/ARB (%) 87.3 76.6 <0.0001 DAPT (%) 86.0 88.6 0.42 *CKD is defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2.
Figure 1
Conclusions
Octogenarian subjects with AMI were high-risk group associated with heart failure and stroke events. Their distinct clinical backgrounds may affect the adoption of optimal medical therapies, potentially resulting in worse cardiovascular outcomes. Further intensified management should be applied to octogenarian subjects with AMI.
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Affiliation(s)
- K Tsuda
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - R Nishikawa
- Sapporo Medical University, Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - H Hosoda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Honda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yoneda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - F Otsuka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
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18
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Tsuda K, Kanzaki Y, Maeda D, Akamatsu K, Nakayama S, Horai R, Sakane K, Ozeki T, Fujita S, Fujisaka T, Sohmiya K, Hoshiga M. P6257Low systolic blood pressure on admission as a predictor of outcome in octogenarian patients with heart failure and preserved ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0857] [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
Background
Heart failure (HF) is an epidemic in healthcare worldwide including Asia. It appears that HF will become more serious with aging of the population. The patients with heart failure and preserved ejection fraction (HFpEF) were older, more often female, and frequently have comorbidities including hypertension. However, lower systolic blood pressure (SBP) on admission is associated with poor outcomes in patients with HF. It remains unclear whether this association is similar in very elderly patients with HFpEF.
Purpose
To investigate clinical features and prognosis in octogenarian HFpEF subjects.
Methods
We analyzed 87 consecutive subjects aged 80 years or older who were hospitalized for acute decompensated HF with left ventricular ejection fraction (LVEF) ≥50% between 2015 and 2017. Clinical characteristics and a composite event of cardiac death and HF hospitalization were compared in two groups according to SBP cut-off of 140 mmHg on admission.
Results
The prevalence of lower SBP subjects (mean BP = 118 mmHg) and higher SBP (mean BP = 166 mmHg) subjects were 41.4% and 58.6%, respectively. Lower SBP subjects were more comorbid with atrial fibrillation (72.2 vs. 45.1%, p=0.01). In the lower SBP group, diuretics, mineralocorticoid receptor antagonists (MRA), beta-blockers and ACE inhibitors/ARBs were more commonly used than higher SBP group (Table). During the observational period (median = 1.0 year), lower SBP on admission was associated with a 2.65-fold [95% confidence interval (CI): 1.29–5.55, p=0.009] greater likelihood of experiencing the composite events of cardiac death and rehospitalization for HF (Figure). This observation was still consistent even after adjusting clinical demographics and comorbidity [hazard ratio = 2.95, 95% CI: 1.30–6.87, p=0.01].
Table 1 Lower SBP group (n=36) Higher SBP group (n=51) P-value Atrial fibrillation (%) 72.2 0.01 0.01 Loop diuretic (%) 97.1 83.7 0.08 MRA (%) 47.1 24.5 0.04 Beta-blocker (%) 52.9 44.9 0.51 ACE inhibitor/ARB (%) 59.2 29.4 0.01
Figure 1
Conclusions
In octogenarian patients with acute decompensated HF and preserved LVEF, SBP on admission less than 140 mmHg is significantly associated with poor outcomes. Future studies need to prospectively evaluate optimal SBP treatment goals in very elderly patients with HFpEF.
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Affiliation(s)
- K Tsuda
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - Y Kanzaki
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - D Maeda
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - K Akamatsu
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - S Nakayama
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - R Horai
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - K Sakane
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - T Ozeki
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - S Fujita
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - T Fujisaka
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - K Sohmiya
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
| | - M Hoshiga
- Osaka Medical College, Department of Cardiology, Takatsuki, Japan
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Iwata S, Kinoshita M, Okamura H, Tsuda K, Saikusa M, Harada E, Saitoh S, Iwata O. Intrauterine growth and the maturation process of adrenal function. PeerJ 2019; 7:e6368. [PMID: 30746307 PMCID: PMC6368969 DOI: 10.7717/peerj.6368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/27/2018] [Accepted: 12/28/2018] [Indexed: 11/20/2022] Open
Abstract
Backgrounds Environmental factors during early life alter the hypothalamus-pituitary-adrenal (HPA) axis regulation and increase the risk of diseases in later life. However, adrenal function at each developmental stage has not fully been investigated in relation to pathological antenatal conditions. Cortisol levels of newborns with intrauterine growth restriction (IUGR) are elevated during the neonatal period; however, when studied during early childhood, cortisol levels are reduced compared with their peers, suggesting that the HPA axis regulation might be altered from activation to suppression, the timing of which remains uncertain. Aim The aim of this study was to assess the presence of an interaction between intrauterine growth and postnatal age on cortisol levels in newborns hospitalised at a neonatal intensive care unit. Methods We performed a secondary analysis using a dataset from saliva samples of 62 newborns collected between 30 and 40 weeks corrected age. Interactions between postnatal age and clinical variables with regard to cortisol levels were assessed. Results The z-score of the birth weight and IUGR showed significant interactions with postnatal age on cortisol levels; cortisol levels were higher ≤5 days of birth and lower >14 days of birth than those in their peers without IUGR. Conclusion The adrenal function of newborns with IUGR might be altered from activation to suppression within the first several weeks of life. Longitudinal studies need to address when/how IUGR alters adrenal functions, and how these responses are associated with diseases during adulthood.
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Affiliation(s)
- Sachiko Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Masahiro Kinoshita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hisayoshi Okamura
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Eimei Harada
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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20
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Kinoshita M, Iwata S, Okamura H, Tsuda K, Saikusa M, Harada E, Yamashita Y, Saitoh S, Iwata O. Feeding-Induced Cortisol Response in Newborn Infants. J Clin Endocrinol Metab 2018; 103:4450-4455. [PMID: 30085188 DOI: 10.1210/jc.2018-01052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/31/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Understanding the biological rhythms and stress response in sick newborns is important to minimize the negative effects of intensive care. Salivary cortisol has been used as a noninvasive surrogate marker of adrenal function; however, understanding of its control variables is insufficient. OBJECTIVE To investigate the presence of feeding-induced cortisol response and its control variables in newborns. DESIGN, SETTING, AND PATIENTS Fifty-three newborn infants, who were between 30 and 40 weeks' corrected age and were on 3-hourly regular oral/enteral feeding, were recruited between January 2013 and June 2014. MAIN OUTCOME MEASURE Saliva samples were collected before and 1 hour after regular feeding. Dependence of cortisol levels (adjusted for postnatal age) and their feeding-related elevation on clinical variables was assessed by using generalized estimating equations. RESULTS Higher cortisol levels were associated with corrected age ≥37 weeks and saliva samples collected after feeding (both P < 0.001). Oral feeding was associated with a greater feeding-induced cortisol response compared with exclusive enteral feeding (P = 0.034), whereas a prolonged feeding duration (≥30 minutes) was associated with a reduced cortisol response compared with brief feeding (<30 minutes) (P < 0.001). Gestational age, corrected age, antenatal/postnatal glucocorticoids, type of milk, and daily feeding volume had no effect on cortisol response. CONCLUSIONS Feeding-induced cortisol response was observed in newborns. The cortisol response was more prominent following oral feeding and was reduced with prolonged feeding. Future studies may investigate whether feeding-induced cortisol response plays a role in the acquisition of adrenal ultradian and diurnal rhythms.
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Affiliation(s)
- Masahiro Kinoshita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Hisayoshi Okamura
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Mamoru Saikusa
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Eimei Harada
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Yushiro Yamashita
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Osuke Iwata
- Centre for Developmental and Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
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21
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Chirichilli I, Irace F, Weltert L, Tsuda K, Scaffa R, Salica A, Galea N, De Paulis R. OC45 MORPHOLOGICAL MODIFICATION OF THE AORTIC ANNULUS IN TRICUSPID AND BICUSPID VALVES AFTER AORTIC VALVE REIMPLANTATION PROCEDURE. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549891.25617.f6] [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: 11/05/2022]
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22
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Tsuda K, Iwata S, Mukai T, Shibasaki J, Takeuchi A, Ioroi T, Sano H, Yutaka N, Takahashi A, Takenouchi T, Osaga S, Tokuhisa T, Takashima S, Sobajima H, Tamura M, Hosono S, Nabetani M, Iwata O. Body Temperature, Heart Rate, and Short-Term Outcome of Cooled Infants. Ther Hypothermia Temp Manag 2018; 9:76-85. [PMID: 30230963 PMCID: PMC6434598 DOI: 10.1089/ther.2018.0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/28/2022] Open
Abstract
Therapeutic hypothermia following neonatal encephalopathy is neuroprotective. However, approximately one in two cooled infants still die or develop permanent neurological impairments. Further understanding of variables associated with the effectiveness of cooling is important to improve the therapeutic regimen. To identify clinical factors associated with short-term outcomes of cooled infants, clinical data of 509 cooled infants registered to the Baby Cooling Registry of Japan between 2012 and 2014 were evaluated. Independent variables of death during the initial hospitalization and survival discharge from the cooling hospital at ≤28 days of life were assessed. Death was associated with higher Thompson scores at admission (p < 0.001); higher heart rates after 3-72 hours of cooling (p < 0.001); and higher body temperature after 24 hours of cooling (p = 0.002). Survival discharge was associated with higher 10 minutes Apgar scores (p < 0.001); higher blood pH and base excess (both p < 0.001); lower Thompson scores (at admission and after 24 hours of cooling; both p < 0.001); lower heart rates at initiating cooling (p = 0.003) and after 24 hours of cooling (p < 0.001) and lower average values after 3-72 hours of cooling (p < 0.001); higher body temperature at admission (p < 0.001); and lower body temperature after 24 hours and lower mean values after 3-72 hours of cooling (both p < 0.001). Survival discharge was best explained by higher blood pH (p < 0.05), higher body temperature at admission (p < 0.01), and lower body temperature and heart rate after 24 hours of cooling (p < 0.01 and <0.001, respectively). Lower heart rate, higher body temperature at admission, and lower body temperature during cooling were associated with favorable short-term outcomes.
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Affiliation(s)
- Kennosuke Tsuda
- 1 Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences , Aichi, Japan
| | - Sachiko Iwata
- 1 Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences , Aichi, Japan
| | - Takeo Mukai
- 2 Center for Advanced Medical Research, Institute of Medical Science, University of Tokyo , Tokyo, Japan
| | - Jun Shibasaki
- 3 Department of Neonatology, Kanagawa Children's Medical Center , Kanagawa, Japan
| | - Akihito Takeuchi
- 4 Division of Neonatology, National Hospital Organization Okayama Medical Center , Okayama, Japan
| | - Tomoaki Ioroi
- 5 Department of Pediatrics, Perinatal Medical Center , Himeji Red Cross Hospital, Hyogo, Japan
| | - Hiroyuki Sano
- 6 Department of Pediatrics, Yodogawa Christian Hospital , Osaka, Japan
| | - Nanae Yutaka
- 6 Department of Pediatrics, Yodogawa Christian Hospital , Osaka, Japan
| | - Akihito Takahashi
- 7 Department of Pediatrics, Kurashiki Central Hospital , Okayama, Japan
| | - Toshiki Takenouchi
- 8 Department of Pediatrics, Keio University School of Medicine , Tokyo, Japan
| | - Satoshi Osaga
- 9 Clinical Research Management Center, Nagoya City University Hospital , Aichi, Japan
| | - Takuya Tokuhisa
- 10 Division of Neonatology, Perinatal Medical Center , Kagoshima City Hospital, Kagoshima, Japan
| | - Sachio Takashima
- 11 Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare , Fukuoka, Japan
| | - Hisanori Sobajima
- 12 Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University , Saitama, Japan
| | - Masanori Tamura
- 13 Department of Pediatrics, Saitama Medical Center, Saitama Medical University , Saitama, Japan
| | - Shigeharu Hosono
- 14 Division of Neonatology, Nihon University Itabashi Hospital , Tokyo, Japan
| | - Makoto Nabetani
- 6 Department of Pediatrics, Yodogawa Christian Hospital , Osaka, Japan
| | - Osuke Iwata
- 1 Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences , Aichi, Japan
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23
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Yoshizuka T, Kinoshita M, Iwata S, Tsuda K, Kato T, Saikusa M, Shindou R, Hara N, Harada E, Takashima S, Takeshige N, Saitoh S, Yamashita Y, Iwata O. Estimation of elevated intracranial pressure in infants with hydroce-phalus by using transcranial Doppler velocimetry with fontanel compression. Sci Rep 2018; 8:11824. [PMID: 30087390 PMCID: PMC6081432 DOI: 10.1038/s41598-018-30274-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/31/2018] [Accepted: 07/24/2018] [Indexed: 11/09/2022] Open
Abstract
For infants with acute progressive hydrocephalus, invasive drainage of cerebrospinal fluid (CSF) is performed until a ventriculo-peritoneal shunt can be inserted. Surrogate markers of intracranial pressure (ICP) may help optimise the timing of invasive procedures. To assess whether RI with/without fontanel compression helps distinguish between infants with normal (<5 cmH2O), mild (5-11 cmH2O), and moderate (>11 cmH2O) ICP elevation, 74 ICP measures before/after CSF removal and 148 related Doppler measures of the middle cerebral artery were assessed. Higher RI was associated with fontanel compression, elevated ICP, and their interaction (all p < 0.001). Without compression, differences in RI were observed between normal and moderate (p < 0.001) and between mild and moderate ICP elevation (p = 0.033). With compression, differences in RI were observed for all pairwise comparisons among normal, mild, and moderate ICP elevation (all p < 0.001). Without compression, areas under the receiver-operating characteristic curve for prediction of mild and moderate ICP elevation were 0.664 (95% confidence interval (CI), 0.538-0.791; p = 0.020) and 0.727 (95% CI, 0.582-0.872; p = 0.004), respectively, which improved to 0.806 (95% CI, 0.703-0.910; p < 0.001) and 0.814 (95% CI, 0.707-0.921; p < 0.001), respectively, with compression. RI with fontanel compression provides improved discrimination of infants with absent, mild, and moderate ICP elevation.
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Affiliation(s)
- Teiko Yoshizuka
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachiko Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Kennosuke Tsuda
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Takenori Kato
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryota Shindou
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoko Hara
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Eimei Harada
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Sachio Takashima
- Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare, Fukuoka, Japan
| | - Nobuyuki Takeshige
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
| | - Yushiro Yamashita
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
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24
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Kawakami S, Fujino M, Nakao K, Nishihira K, Tahara Y, Asaumi Y, Noguchi T, Yasuda S. P906Diminished response to statin therapy predicts future occurrence of heart failure in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p906] [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: 11/13/2022] Open
Affiliation(s)
- K Tsuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Kataoka
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - R Nishikawa
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Doi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Nakashima
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Kawakami
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - M Fujino
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nakao
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - K Nishihira
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Tahara
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - Y Asaumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - T Noguchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Suita, Osaka, Japan
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25
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Kino H, Yoshitake T, Wada R, Tahara K, Tsuda K. 3-DOF planar parallel-wire driven robot with an active balancer and its model-based adaptive control. Adv Robot 2018. [DOI: 10.1080/01691864.2018.1493397] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- H. Kino
- Department of Intelligent Mechanical Engineering, Fukuoka Institute of Technology, Higashi-ku, Fukuoka, Japan
| | - T. Yoshitake
- Department of Intelligent Mechanical Engineering, Fukuoka Institute of Technology, Higashi-ku, Fukuoka, Japan
| | - R. Wada
- Department of Intelligent Mechanical Engineering, Fukuoka Institute of Technology, Higashi-ku, Fukuoka, Japan
| | - K. Tahara
- Department of Mechanical Engineering, Kyushu University, Nishi-ku, Fukuoka, Japan
| | - K. Tsuda
- Department of Systems Innovation, Osaka University, Toyonaka, Osaka, Japan
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26
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Nakayama M, Teramoto Y, Sasayama R, Tsuda K, Matsuda A, Sakai Y. Six-month effectiveness of low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy in upper limb hemiparesis after stroke. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1108] [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: 11/30/2022]
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27
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Tsuda K, Natori T, Simuzu M, Narumi S, Oura K, Kamata A, Yoshida M, Ishigaku Y, Terayama Y. Assessment of thrombin-induced platelet aggregation using an automatic coagulation analyzer. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3144] [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: 10/18/2022]
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28
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Doi T, Kataoka Y, Asaumi Y, Hori M, Nishikawa R, Tsuda K, Ogura M, Noguchi T, Harada-Shiba M, Yasuda S. P631Sex-related differences in clinical characteristics, low-density lipoprotein cholesterol control and cardiovascular outcomes in familial hypercholesterolemia. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Nishikawa R, Kataoka Y, Doi T, Tsuda K, Ogura M, Hori M, Asaumi Y, Noguchi T, Harada-Shiba M, Yasuda S. P1507Substantial cardiovascular risks in heterozygous familial hypercholesterolemia patients with acute myocardial infraction who exhibited multi-vessel disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1507] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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30
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Tsuda K, Kataoka Y, Nishikawa R, Doi T, Nakashima T, Kawakami S, Fujino M, Nakao K, Nishihira K, Kanaya T, Tahara Y, Asaumi Y, Noguchi T, Goto Y, Yasuda S. P6236Clinical characteristics and cardiovascular outcomes in subjects who developed acute myocardial infarction despite statin therapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6236] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Tsuda K, Mukai T, Iwata S, Shibasaki J, Tokuhisa T, Ioroi T, Sano H, Yutaka N, Takahashi A, Takeuchi A, Takenouchi T, Araki Y, Sobajima H, Tamura M, Hosono S, Nabetani M, Iwata O. Therapeutic hypothermia for neonatal encephalopathy: a report from the first 3 years of the Baby Cooling Registry of Japan. Sci Rep 2017; 7:39508. [PMID: 28051172 PMCID: PMC5209702 DOI: 10.1038/srep39508] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 09/30/2016] [Accepted: 11/22/2016] [Indexed: 01/14/2023] Open
Abstract
Therapeutic hypothermia is recommended for moderate and severe neonatal encephalopathy, but is being applied to a wider range of neonates than originally envisaged. To examine the clinical use of therapeutic hypothermia, data collected during the first 3 years (2012-2014) of the Baby Cooling Registry of Japan were analysed. Of 485 cooled neonates, 96.5% were ≥36 weeks gestation and 99.4% weighed ≥1,800 g. Severe acidosis (pH < 7 or base deficit ≥16 mmol/L) was present in 68.9%, and 96.7% required resuscitation for >10 min. Stage II/III encephalopathy was evident in 88.3%; hypotonia, seizures and abnormal amplitude-integrated electroencephalogram were observed in the majority of the remainder. In-hospital mortality was 2.7%; 90.7% were discharged home. Apgar scores and severity of acidosis/encephalopathy did not change over time. The time to reach the target temperature was shorter in 2014 than in 2012. The proportion undergoing whole-body cooling rose from 45.4% to 81.6%, while selective head cooling fell over time. Mortality, duration of mechanical ventilation and requirement for tube feeding at discharge remained unchanged. Adherence to standard cooling protocols was high throughout, with a consistent trend towards cooling being achieved more promptly. The mortality rate of cooled neonates was considerably lower than that reported in previous studies.
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Affiliation(s)
- Kennosuke Tsuda
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Takeo Mukai
- Center for Advanced Medical Research, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Sachiko Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.,Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Fukuoka, Japan
| | - Jun Shibasaki
- Department of Neonatology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Takuya Tokuhisa
- Division of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan
| | - Tomoaki Ioroi
- Department of Pediatrics, Perinatal Medical Center, Himeji Red Cross Hospital, Hyogo, Japan
| | - Hiroyuki Sano
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Nanae Yutaka
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Akihito Takahashi
- Department of Pediatrics, Kurashiki Central Hospital, Okayama, Japan
| | - Akihito Takeuchi
- Division of Neonatology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Araki
- Faculty of Informatics, Shizuoka University, Shizuoka, Japan
| | - Hisanori Sobajima
- Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Masanori Tamura
- Division of Neonatology, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shigeharu Hosono
- Division of Neonatology, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Makoto Nabetani
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan.,Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, Fukuoka, Japan
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32
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Murakami T, Kurachi H, Nakamura H, Tsuda K, Miyake A, Tomoda K, Hori S, Kozuka T. Cervical Invasion of Endometrial Carcinoma — Evaluation by Parasagittal MR Imaging. Acta Radiol 2016. [DOI: 10.1177/028418519503600307] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Twenty-seven consecutive patients were examined by T2-(1 800/70 ms) and postcontrast T1-weighted (600/15) spin echo (SE) or dynamic (200/15) SE MR imaging to determine the usefulness of parasagittal MR imaging in assessing cervical invasion of endometrial carcinoma. The images were obtained in a direction parallel to the longitudinal axis of the uterus (parasagittal). The cervical epithelium, being hyperintense on the late phase dynamic and postcontrast T1-weighted SE images, had disappeared partially or totally in all 4 patients with cervical invasion. The enhanced cervical epithelium was completely seen in one patient with the tumor protruding into the cervical canal in a polyp-like form without cervical epithelial invasion. The same was also seen in the 22 patients with the tumor remaining in the corpus cavity. The enhanced parasagittal MR images facilitated the evaluation of the extent of the endometrial carcinoma.
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Murakami T, Kim T, Hori M, Takamura M, Tsuda K, Takahashi S, Narumi Y, Nakamura H. Multishot Echo-Planar Imaging with Gadopentetate Dimeglumine: Preliminary study of efficacy for detection of hypovascular metastatic liver tumors. Acta Radiol 2016. [DOI: 10.1080/028418500127345217] [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: 10/26/2022]
Abstract
Objective: To evaluate the usefulness of sequential T2-weighted spin-echo type multishot echo-planar (T2-EP) imaging with gadopentetate dimeglumine for the detection of hypovascular metastatic liver tumors. Material and Methods: Fifteen consecutive patients with 56 proven hypovascular metastatic liver tumors were included in the study. Three observers blindly and independently read the whole-liver images obtained with T2-weighted spin-echo, T2-weighted single-shot fast spin-echo, T1-weighted fast multiplanar spoiled GRASS and T2-EP images obtained before and 25, 60, 90 and 120 s after injection of 0.2 mmol/kg b.w. of gadopentetate dimeglumine. The diagnostic accuracy was estimated by calculating the area under the observer-specific binomial receiver operating characteristics curves (Az). Results: T2-EP images obtained 60 s after contrast injection showed significantly higher contrast-to-noise (C/N) ratios than the other imaging techniques. A combination of all phases of the T2-EP images produced the highest sensitivity and specificity. In terms of the Az value, the diagnostic accuracy for tumor detection achieved with a combination of all phases of the T2-EP images was significantly higher than that with T1-SPGR and T2-SSFSE images ( p < 0.01). The Az values of the T2-EP images (Az = 0.975) were higher than those of T2-CSE images (Az = 0.948), but the difference was not significant. Conclusion: Our preliminary study revealed that sequential imaging with enhanced T2-EP images was useful for the detection of hypovascular metastatic liver tumors because of its superior C/N ratio and sensitivity.
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Affiliation(s)
- T. Murakami
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - T. Kim
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - M. Hori
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - M. Takamura
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - K. Tsuda
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - S. Takahashi
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - Y. Narumi
- Department of Radiology, Osaka University Medical School, Osaka, Japan
| | - H. Nakamura
- Department of Radiology, Osaka University Medical School, Osaka, Japan
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Murakami T, Nakamura H, Hori S, Tomoda K, Mitani T, Nakanishi K, Hashimoto T, Tsuda K, Kozuka T, Monden M, Wakasa K. Detection of Viable Tumor Cells in Hepatocellular Carcinoma following Transcatheter Arterial Chemoembolization with Iodized Oil. Acta Radiol 2016. [DOI: 10.1177/028418519303400419] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To evaluate the effect of transcatheter arterial chemoembolization (TACE) with iodized oil for hepatocellular carcinoma (HCC), dynamic turbo-fast low angle shot (turbo-FLASH) (TR/TE/flip angle/TI, 8.5/4.6/10/200) MR imaging with gadopentetate dimeglumine was performed in 10 patients with HCC after TACE with iodized oil and before partial hepatectomy. Immediately after 0.05 mmol/kg b.w. of gadopentetate dimeglumine was administered intravenously, 10 images were obtained in the first 20 s (early phase). Then, one image every 30 s from 1 to 3 min (late phase), and images at 5 min and 7 min (delayed phase) were obtained serially. In the early phase, HCC showed no enhancement in 5 patients, partial hyperintense enhancement in 4, and total hyperintense enhancement in one. Viable regions of the tumor, evaluated at histopathology, showed hyperintense enhancement relative to the surrounding liver parenchyma in the early phase, while necrotic regions showed no enhancement. Both viable and necrotic regions showed lower signal intensities than the surrounding liver parenchyma in both late and delayed phases. By using dynamic turbo-FLASH MR imaging, we were able to accurately evaluate the effect of TACE with iodized oil for HCC in 8 of the 10 patients. In 2 patients, in whom small viable cells were seen in the HCC, viable regions could not be detected with our technique. It is concluded that turbo-FLASH dynamic MR imaging was useful for evaluating the effect of TACE for HCC.
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35
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Kurata T, Iwata S, Tsuda K, Kinoshita M, Saikusa M, Hara N, Oda M, Ohmae E, Araki Y, Sugioka T, Takashima S, Iwata O. Physiological and pathological clinical conditions and light scattering in brain. Sci Rep 2016; 6:31354. [PMID: 27511644 PMCID: PMC4980768 DOI: 10.1038/srep31354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/18/2016] [Indexed: 11/15/2022] Open
Abstract
MRI of preterm infants at term commonly reveals subtle brain lesions such as diffuse white matter injury, which are linked with later cognitive impairments. The timing and mechanism of such injury remains unclear. The reduced scattering coefficient of near-infrared light (μs’) has been shown to correlate linearly with gestational age in neonates. To identify clinical variables associated with brain μs’, 60 preterm and full-term infants were studied within 7 days of birth. Dependence of μs’ obtained from the frontal head on clinical variables was assessed. In the univariate analysis, smaller μs’ was associated with antenatal glucocorticoid, emergency Caesarean section, requirement for mechanical ventilation, smaller gestational age, smaller body sizes, low 1- and 5-minute Apgar scores, higher cord blood pH and PO2, and higher blood HCO3− at the time of study. Multivariate analysis revealed that smaller gestational age, requirement for mechanical ventilation, and higher HCO3− at the time of study were correlated with smaller μs’. Brain μs’ depended on variables associated with physiological maturation and pathological conditions of the brain. Further longitudinal studies may help identify pathological events and clinical conditions responsible for subtle brain injury and subsequent cognitive impairments following preterm birth.
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Affiliation(s)
- Tsuyoshi Kurata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.,Community Medical Support Institute, Saga University School of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Sachiko Iwata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Kennosuke Tsuda
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.,Division of Neonatology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Masahiro Kinoshita
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Mamoru Saikusa
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoko Hara
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Motoki Oda
- Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-8601, Japan
| | - Etsuko Ohmae
- Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu, Shizuoka, 434-8601, Japan
| | - Yuko Araki
- Faculty of Informatics, Shizuoka University, 3-5-1 Johoku Naka-ku, Hamamatsu, Shizuoka, 432-8011, Japan
| | - Takashi Sugioka
- Community Medical Support Institute, Saga University School of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Sachio Takashima
- Yanagawa Institute for Developmental Disabilities, International University of Health and Welfare, 218-1 Tano-machi Mitsuhashi-machi, Yanagawa, Fukuoka, 832-0813, Japan
| | - Osuke Iwata
- Department of Paediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
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36
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Akashi K, Saegusa J, Sendo S, Nishimura K, Tsuda K, Naka I, Okano T, Takahashi S, Nishida M, Ueda Y, Morinobu A. OP0297 Knockout of Endothelin Type B Receptor Signaling Attenuates Bleomycin-Induced Skin Sclerosis in Mice. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2613] [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: 11/03/2022]
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37
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Kageyama G, Onishi A, Ueda Y, Kamei Y, Yamada H, Ichise Y, Waki D, Naka I, Tsuda K, Okano T, Takahashi S, Nishida M, Akashi K, Nishimura K, Sendo S, Kogata Y, Saegusa J, Morinobu A. THU0611 Subjective Well-Being of Japanese RA Patients Who Reach Treatment Target Is Higher than The Japanese Average. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1119] [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: 11/04/2022]
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38
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Kageyama G, Onishi A, Ueda Y, Kamei Y, Yamada H, Ichise Y, Waki D, Naka I, Tsuda K, Okano T, Takahashi S, Nishida M, Akashi K, Nishimura K, Sendo S, Kogata Y, Saegusa J, Morinobu A. AB0192 Some of The Painful RA Patients Underrate Global Health VAS at Hospitals. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1312] [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: 11/04/2022]
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Abstract
To study the mechanism of autonomic regulation in the larynx, intralaryngeal local ganglia of the cat were investigated using immunohistochemical techniques. Small intralaryngeal ganglia were found in the peripheral portions of internal branches of the superior laryngeal nerve. Ninety-one percent of the ganglionic neurons were immunoreactive (IR) to vasoactive intestinal polypeptide (VIP), and 10% of the VIP-IR cells were also immunoreactive to enkephalin (ENK) and/or substance P (SP). The immunoreactivity of neuronal cell bodies remained unchanged even after denervation of the bilateral superior and recurrent laryngeal nerves. A dense distribution of calcitonin gene-related peptide (CGRP)-IR nerve fibers was found around almost all neuronal cells in the intralaryngeal. ganglia. A few VIP-IR, ENK-IR, and SP-IR nerve fibers were also observed. Only the CGRP-IR fibers disappeared after the denervation experiments. in the laryngeal glands and mucosal arterioles, VIP-IR nerve terminals were found that were also immunoreactive to ENK and/or SP. However, these Immunoreactive nerve endings in the glands and arterioles remained after the denervation experiments. The results of our study indicate that laryngeal exocrine secretion and blood flow are regulated by postganglionic autonomic parasympathetic fibers from intralaryngeal ganglia that contain VIP alone or VIP with ENK and/or SP, and that these ganglionic neurons may be innervated by CGRP-IR extrinsic nerve fibers.
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Affiliation(s)
- K Tsuda
- Department of Otolaryngology, Saga Medical School, Japan
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40
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Tanaka S, Iwata S, Kinoshita M, Tsuda K, Sakai S, Saikusa M, Shindo R, Harada E, Okada J, Hisano T, Kanda H, Maeno Y, Araki Y, Ushijima K, Sakamoto T, Yamashita Y, Iwata O. Use of Normothermic Default Humidifier Settings Causes Excessive Humidification of Respiratory Gases During Therapeutic Hypothermia. Ther Hypothermia Temp Manag 2016; 6:180-188. [PMID: 27167667 DOI: 10.1089/ther.2016.0005] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Adult patients frequently suffer from serious respiratory complications during therapeutic hypothermia. During therapeutic hypothermia, respiratory gases are humidified close to saturated vapor at 37°C (44 mg/L) despite that saturated vapor reduces considerably depending on temperature reduction. Condensation may cause serious adverse events, such as bronchial edema, mucosal dysfunction, and ventilator-associated pneumonia during cooling. To determine clinical variables associated with inadequate humidification of respiratory gases during cooling, humidity of inspiratory gases was measured in 42 cumulative newborn infants who underwent therapeutic hypothermia. Three humidifier settings of 37-default (chamber outlet, 37°C; distal circuit, 40°C), 33.5-theoretical (chamber outlet, 33.5°C; distal circuit, 36.5°C), and 33.5-adjusted (optimized setting to achieve 36.6 mg/L using feedback from a hygrometer) were tested to identify independent variables of excessively high humidity >40.7 mg/L and low humidity <32.9 mg/L. The mean (SD) humidity at the Y-piece was 39.2 (5.2), 33.3 (4.1), and 36.7 (1.2) mg/L for 37-default, 33.5-theoretical, and 33.5-adjusted, respectively. The incidence of excessive high humidity was 10.3% (37-default, 31.0%; 33.5-theoretical, 0.0%; 33.5-adjusted, 0.0%), which was positively associated with the use of a counter-flow humidifier (p < 0.001), 37-default (compared with 33.5-theoretical and 33.5-adjusted, both p < 0.001) and higher fraction of inspired oxygen (p = 0.003). The incidence of excessively low humidity was 17.5% (37-default, 7.1%; 33.5-theoretical, 45.2%; 33.5-adjusted, 0.0%), which was positively associated with the use of a pass-over humidifier and 33.5-theoretical (both p < 0.001). All patients who used a counter-flow humidifier achieved the target gas humidity at the Y-piece (36.6 ± 0.5 mg/L) required for 33.5-adjusted with 33.5-theoretical. During cooling, 37-default is associated with excessively high humidity, whereas 33.5-theoretical leads to excessively low humidity. Future studies are needed to assess whether a new regimen with optimized Y-piece temperature and humidity control reduces serious respiratory adverse events during cooling.
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Affiliation(s)
- Shoichiro Tanaka
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Sachiko Iwata
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Masahiro Kinoshita
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Kennosuke Tsuda
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Sayaka Sakai
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Mamoru Saikusa
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Ryota Shindo
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Eimei Harada
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Junichiro Okada
- 2 Division of Neonatology, St. Mary's Hospital , Fukuoka, Japan
| | - Tadashi Hisano
- 2 Division of Neonatology, St. Mary's Hospital , Fukuoka, Japan
| | - Hiroshi Kanda
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Yasuki Maeno
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Yuko Araki
- 3 Department of Informatics, Graduate School of Integrated Science and Technology, Shizuoka University , Shizuoka, Japan
| | - Kazuo Ushijima
- 4 Department of Anaesthesiology, Kurume University School of Medicine , Fukuoka, Japan
| | - Teruo Sakamoto
- 5 Advanced Emergency Medical Service Centre, Kurume University Hospital , Fukuoka, Japan
| | - Yushiro Yamashita
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
| | - Osuke Iwata
- 1 Department of Pediatrics and Child Health, Centre for Developmental and Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
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Kageyama G, Saegusa J, Irino Y, Tanaka S, Tsuda K, Takahashi S, Sendo S, Morinobu A. Metabolomics analysis of saliva from patients with primary Sjögren's syndrome. Clin Exp Immunol 2015. [PMID: 26201380 DOI: 10.1111/cei.12683] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The recent development of salivary proteomics has led to the identification of potential biomarkers for diagnosing patients with primary Sjögren's syndrome (pSS). Here we sought to identify differentially produced salivary metabolites from pSS patients and healthy controls (HCs) that might be used to characterize this disease. We obtained salivary samples from 12 female pSS patients (mean age 44.2 ± 13.01) and 21 age-matched female HCs. The metabolite profiles of saliva were analysed by gas chromatography-mass spectrometry. The total metabolite levels in each of the samples were calculated and compared across the study participants. A total of 88 metabolites were detected across the study samples, 41 of which were observed at reduced levels in the samples from pSS patients. Principal component analysis (PCA) revealed a loss in salivary metabolite diversity in the pSS patient samples compared to the HC samples. The reduced presence of glycine, tyrosine, uric acid and fucose, which may reflect salivary gland destruction due to chronic sialoadenitis, contributed to the loss of diversity. Comparative PCA of the pSS patients revealed the presence of two subpopulations based on their metabolite profiles, and these two subpopulations showed a significant difference in the prevalence of major salivary glanditis (P = 0.014). In this study, we found that the salivary metabolite profile of pSS patients was less diverse than that of HCs and that the metabolite profiles in pSS patients were affected by the presence of major salivary glanditis.
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Affiliation(s)
- G Kageyama
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - J Saegusa
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - Y Irino
- Division of Evidence-Based Laboratory Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - S Tanaka
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - K Tsuda
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - S Takahashi
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - S Sendo
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
| | - A Morinobu
- Department of Rheumatology, Kobe University Hospital, Kobe, Japan
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Iwata O, Takenouchi T, Iwata S, Nabetani M, Mukai T, Shibasaki J, Tsuda K, Tokuhisa T, Sobajima H, Tamura M. The baby cooling project of Japan to implement evidence-based neonatal cooling. Ther Hypothermia Temp Manag 2015; 4:173-9. [PMID: 25260150 DOI: 10.1089/ther.2014.0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Therapeutic hypothermia was first recommended as a standard of care by international guidelines in 2010. However, at that time, the number of centers capable of providing standard cooling was limited even in Japan. The aim of this project was to implement a nationwide network of evidence-based cooling within 3 years. A taskforce was formed in June 2010 to undergo the primary nationwide practice survey, design of action plans, and the appraisal of interventions by involving all registered level-II/III neonatal intensive care units in Japan. Based on findings from the primary survey, aggressive action plans were introduced that focused on the formulation of clinical recommendations, facilitation of educational events, and opening of an online case registry. Findings from the follow-up survey (January 2013) were compared with the results from the primary survey (June 2010). Four workshops and three consensus meetings were held to formulate clinical recommendations, which were followed by the publication of practical textbooks, large-scale education seminars, and implementation of a case registry. A follow-up survey covering 253 units (response rate: 89.1%) showed that cooling centers increased from 89 to 135. Twelve prefectures had no cooling centers in 2010, whereas all 47 prefectures had at least one in 2013. In cooling centers, adherence to the standard cooling protocols and the use of servo-controlled cooling devices improved from 20.7% to 94.7% and from 79.8% to 98.5%, respectively. A rapid improvement in the national provision of evidence-based cooling was achieved. International consensus guidelines coupled with domestic interventions might be effective in changing empirical approaches to evidence-based practice.
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Affiliation(s)
- Osuke Iwata
- 1 Department of Pediatrics & Child Health, Centre for Developmental & Cognitive Neuroscience, Kurume University School of Medicine , Fukuoka, Japan
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Tsuda K, Shiiya N, Takahashi D, Ohkura K, Yamashita K, Kando Y. 250 * TRANSOESOPHAGEAL SPINAL CORD STIMULATION FOR MOTOR-EVOKED POTENTIAL MONITORING: FEASIBILITY, SAFETY AND STABILITY. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.250] [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: 11/12/2022] Open
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Shimizu M, Nagashima H, Sano K, Hashimoto K, Ozeki M, Tsuda K, Hatta H. Molecular Stability of Chicken and Rabbit Immunoglobulin G. Biosci Biotechnol Biochem 2014; 56:270-4. [PMID: 1368302 DOI: 10.1271/bbb.56.270] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Molecular stability of chicken egg yolk immunoglobulin G (IgY) and that of rabbit IgG were compared by measuring antibody activities and conformational changes. Stability of rabbit IgG to acid denaturation was much higher than that of IgY. Conformation of the IgY molecule was readily changed in acidic conditions, resulting in a rapid loss of antibody activity. Much less stable natures of IgY to heat-treatment and guanidine-HCl denaturation than rabbit IgG were also observed. Differences in the structure between the two immunoglobulins that might participate in their different stability were inferred from their amino acid sequence data. Importance of the intramolecular disulfide linkage in the rabbit light chain and some other structural differences were suggested.
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Affiliation(s)
- M Shimizu
- School of Food and Nutritional Sciences, University of Shizuoka, Japan
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45
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Kageyama G, Saegusa J, Tanaka S, Takahashi S, Nishida M, Tsuda K, Yamamoto Y, Okano T, Akashi K, Nishimura K, Sendo S, Kogata Y, Kawano S, Morinobu A. FRI0379 Salivary Metabolomics of Primary SjÖGren's Syndrome. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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46
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Kageyama G, Okano T, Yamamoto Y, Sugiyama D, Tsuji G, Tsuda K, Takahashi S, Nishida M, Akashi K, Nishimura K, Sendo S, Kogata Y, Saegusa J, Kawano S, Kumagai S, Morinobu A. SAT0469 Ineffective Fracture Prevention by Bisphosphonate in Patients Undergoing High Dose Glucocorticoid Therapy with A Frax Ten Year Probability Greater than 5.8%. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1344] [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: 11/03/2022]
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47
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Nagano Y, Hori M, Shimizu Y, Takahashi S, Tsuda K, Miki H, Uchiyama E. INJURY PREVENTION PRACTICE IN FEMALE BASKETBALL PLAYERS IN THE JAPANESE TOP LEAGUE: AN INTERVENTIONAL STUDY OVER 7 SEASONS. Br J Sports Med 2014. [DOI: 10.1136/bjsports-2014-093494.221] [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: 11/04/2022]
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48
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Block G, Bell* G, Pickthorn K, Huang S, Martin K, Tentori F, Bieber B, Morgenstern H, Jacobson S, Andreucci V, Fukagawa M, Mendelssohn D, Pisoni R, Robinson B, De Schutter T, Neven E, Behets G, Peter M, Steppan S, Passlick-Deetjen J, D'haese P, Senatore F, Manning A, Nakajima S, Ushirogawa Y, Tsuda K, Egawa H, Lucisano G, Seiler S, Ege P, Romero de Vorsmann F, Klingele M, Lerner-Graber AK, Fliser D, Heine GH, Molony D, Bellasi A, Bellizzi V, Russo D, DI Iorio B. Bone and mineral diseases - 2. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs202] [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: 11/14/2022] Open
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Kakeda M, Yamanaka K, Kitagawa H, Tsuda K, Akeda T, Kurokawa I, Gabazza EC, Mizutani H. Heat-killed bacillus Calmette-Guérin and Mycobacterium kansasii antigen 85B combined vaccination ameliorates dermatitis in a mouse model of atopic dermatitis by inducing regulatory T cells. Br J Dermatol 2012; 166:953-63. [PMID: 22136598 DOI: 10.1111/j.1365-2133.2011.10763.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a recurrent inflammatory skin disease characterized by dominant T-helper (Th) 2 cytokine response. Bacillus Calmette-Guérin (BCG) has been used for preventing tuberculosis, and is regarded as a strong Th1 cytokine inducer. Antigen (Ag) 85B is a secretory protein present in Mycobacterium species that induces Th1 cytokine production. OBJECTIVES We investigated the effects of combined vaccination of heat-killed BCG (hkBCG) and Mycobacterium kansasii Ag85B in an AD mouse model. METHODS For the AD model, keratin 14 promoter-derived caspase-1 overexpressing mice (KCASP1Tg) were used. The mice received a combination therapy of hkBCG at age 3 weeks and Ag85B twice weekly for 11 weeks from the 4th week; Ag85B monotherapy from the 4th week; hkBCG monotherapy at the 3rd week; or control saline. Areas of skin lesions, cytokine mRNA expression and serum interleukin (IL)-18 and immunoglobulin (Ig) E levels were analysed. Inducible Foxp3+ regulatory T cells (iTreg), IL-10-producing T cells (Tr1), and interferon (IFN)-γ/IL-4/IL-17-producing T cells were evaluated in the spleen. RESULTS Saline-treated mice and hkBCG monotherapy mice spontaneously developed severe dermatitis. However, combined therapy with hkBCG and Ag85B significantly suppressed the development of skin lesions and mast cell infiltrations. Elevations of the serum IgE and IL-18 levels were significantly suppressed with combined therapy. Mice treated with hkBCG and Ag85B had a normal number of iTreg in the spleen, and decreased number of both IL-4- and IL-17-producing CD4+ T cells. The effect of Ag85B monotherapy was limited. CONCLUSIONS Combined vaccination with hkBCG and Ag85B decreases AD skin lesions by inducing regulatory T cells, suggesting that this vaccination is a potent and novel therapeutic strategy for AD.
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Affiliation(s)
- M Kakeda
- Department of Dermatology Immunology, Mie University, Tsu, Mie, Japan
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Tsuda K, Iwasaki S, Horiguchi H, Mori M, Nishimaki S, Seki K, Taguri M, Yokota S, Ishiwada N. Immune response to Haemophilus influenzae type b conjugate vaccine in preterm infants. Pediatr Int 2012; 54:64-7. [PMID: 22044495 DOI: 10.1111/j.1442-200x.2011.03505.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 11/29/2022]
Abstract
BACKGROUND Haemophilus influenzae type b (Hib) vaccine became available for use in Japan in December 2008. The aim of the present study was to evaluate the immunogenicity of Hib vaccine in Japanese preterm infants. METHODS Serum samples were obtained from 54 preterm infants before the first vaccination and 1 month after the third. Anti-polyribosylribitol phosphate (PRP) antibodies were measured using an enzyme-linked immunosorbent assay method. Antibody positivity was defined as levels >1 µg/mL. RESULTS Of the 54 preterm infants, 46 (85.2%) achieved antibody levels >1 µg/mL. This compares with the 92.4% reported in full-term infants. The antibody seroconversion rate of infants starting vaccination at 2 months of age was close to being significantly lower than when vaccination was started at 3 months of age (P= 0.060). In addition, the percentage of infants achieving a positive response in the group with a history of antenatal steroid exposure was significantly higher than in those not exposed (P= 0.046). Thus, risk factors for lower Hib antibody concentrations after three doses of vaccine were age at first vaccination and lack of use of antenatal steroids. CONCLUSIONS There is a possibility that perinatal factors and the environment unique to preterm infants are related to their lower antibody positivity rates compared to full-term infants. It may therefore be preferable to modify the proposed immunization schedule.
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Affiliation(s)
- Kennosuke Tsuda
- Perinatal Center for Maternity and Neonate Department of Pediatrics, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan.
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