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Nomura S, Eguchi A, Ghaznavi C, Yamasaki L, Rauniyar SK, Tanoue Y, Kawashima T, Yoneoka D, Kohsaka S, Suzuki M, Hashizume M. Changes in cerebrovascular disease-related deaths and their location during the COVID-19 pandemic in Japan. Public Health 2023; 218:176-179. [PMID: 37060737 PMCID: PMC10011032 DOI: 10.1016/j.puhe.2023.03.006] [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] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023]
Abstract
Objective The COVID-19 pandemic placed an enormous strain on healthcare systems and raised concerns for delays in the management of patients with acute cerebrovascular events. In this study, we investigated cerebrovascular excess deaths in Japan. Study design Vital mortality statistics from January 2012 to May 2022 were obtained from the Japanese Ministry of Health, Labour and Welfare. Methods Using quasi-Poisson regression models, we estimated the expected weekly number of cerebrovascular deaths in Japan from January 2020 through May 2022 by place of death. Estimates were calculated for deaths in all locations, as well as for deaths in hospitals, in geriatric health service facilities, and at home. The age subgroups of ≥75 and <75 years were also considered. Weeks with a statistically significant excess of cerebrovascular deaths were determined when the weekly number of observed deaths exceeded the upper bound of 97.5% prediction interval. Results Excess deaths were noted in June 2021 and became more pronounced from February 2022 onwards. The trend was notable among those aged ≥75 years and for those who died in hospitals. With respect to the location of deaths, the excess was significant in geriatric health services facilities from April 2020 to June 2021, while no evidence of excess hospital deaths was observed during the same period. Conclusions Beginning in late 2021, excess cerebrovascular deaths coincided with the spread of the Omicron variant and may be associated with increased healthcare burden. In 2020, COVID-19 altered the geography of cerebrovascular deaths, with fewer people dying in hospitals and more dying in geriatric health service facilities and at home.
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Affiliation(s)
- S Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
| | - A Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - C Ghaznavi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Medical Education Program, Washington University School of Medicine in St Louis, Saint Louis, United States
| | - L Yamasaki
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; School of Medicine, Nagasaki University, Nagasaki, Japan
| | - S K Rauniyar
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Ocean Policy Research Institute, Sasakawa Peace Foundation, Tokyo, Japan
| | - Y Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - T Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - D Yoneoka
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - S Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - M Suzuki
- Infectious Disease Surveillance Center at the National Institute of Infectious Diseases, Tokyo, Japan
| | - M Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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2
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Nomura S, Eguchi A, Tanoue Y, Yoneoka D, Kawashima T, Suzuki M, Hashizume M. Excess deaths from COVID-19 in Japan and 47 prefectures from January through June 2021. Public Health 2021; 203:15-18. [PMID: 35016070 PMCID: PMC8742134 DOI: 10.1016/j.puhe.2021.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/12/2021] [Accepted: 11/27/2021] [Indexed: 11/18/2022]
Abstract
Objectives In Japan, several studies have reported no excess all-cause deaths (the difference between the observed and expected number of deaths) during the coronavirus disease 2019 (COVID-19) pandemic in 2020. This study aimed to estimate the weekly excess deaths in Japan's 47 prefectures for 2021 until June 27. Study design Vital statistical data on deaths were obtained from the Ministry of Health, Labour and Welfare of Japan. For this analysis, we used data from January 2012 to June 2021. Methods A quasi-Poisson regression was used to estimate the expected weekly number of deaths. Excess deaths were expressed as the range of differences between the observed and expected number of all-cause deaths and the 95% upper bound of the one-sided prediction interval. Results Since January 2021, excess deaths were observed for the first time in the week corresponding to April 12–18 and have continued through mid-June, with the highest excess percentage occurring in the week corresponding to May 31–June 6 (excess deaths: 1431–2587; excess percentage: 5.95–10.77%). Similarly, excess deaths were observed in consecutive weeks from April to June 2021 in 18 of 47 prefectures. Conclusions For the first time since February 2020, when the first COVID-19 death was reported in Japan, excess deaths possibly related to COVID-19 were observed in April 2021 in Japan, during the fourth wave. This may reflect the deaths of non-infected people owing to the disruption that the pandemic has caused.
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Affiliation(s)
- S Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan.
| | - A Eguchi
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Y Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan
| | - D Yoneoka
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan; Tokyo Foundation for Policy Research, Tokyo, Japan
| | - T Kawashima
- Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - M Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - M Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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3
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Vicedo-Cabrera AM, Scovronick N, Sera F, Royé D, Schneider R, Tobias A, Astrom C, Guo Y, Honda Y, Hondula DM, Abrutzky R, Tong S, de Sousa Zanotti Stagliorio Coelho M, Saldiva PHN, Lavigne E, Correa PM, Ortega NV, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola JJK, Ryti N, Pascal M, Schneider A, Katsouyanni K, Samoli E, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Diaz MH, De La Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Ruscio FD, Carrasco-Escobar G, Seposo X, Silva S, Madureira J, Holobaca IH, Fratianni S, Acquaotta F, Kim H, Lee W, Iniguez C, Forsberg B, Ragettli MS, Guo YLL, Chen BY, Li S, Armstrong B, Aleman A, Zanobetti A, Schwartz J, Dang TN, Dung DV, Gillett N, Haines A, Mengel M, Huber V, Gasparrini A. The burden of heat-related mortality attributable to recent human-induced climate change. Nat Clim Chang 2021; 11:492-500. [PMID: 34221128 PMCID: PMC7611104 DOI: 10.1038/s41558-021-01058-x] [Citation(s) in RCA: 196] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/20/2021] [Indexed: 05/19/2023]
Abstract
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
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Affiliation(s)
- A. M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - N. Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - F. Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Statistics, Computer Science and Applications ‘G. Parenti’, University of Florence, Florence, Italy
| | - D. Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - R. Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- European Centre for Medium-Range Weather Forecast (ECMWF), Reading, UK
| | - A. Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - C. Astrom
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Y. Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Y. Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - D. M. Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - R. Abrutzky
- Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - S. Tong
- Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | | | | | - E. Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - P. Matus Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - N. Valdes Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - H. Kan
- School of Public Health, Fudan University, Shanghai, China
| | - S. Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - J. Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - A. Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - H. Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - E. Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - J. J. K. Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Finnish Meteorological Institute, Helsinki, Finland
| | - N. Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - M. Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - A. Schneider
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - K. Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- MRC-PHE Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - E. Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - F. Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - A. Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - P. Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | - A. Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - P. Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - F. de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - M. Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - B. Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - M. Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - C. De La Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - A. Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova
| | - D. Houthuijs
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - C. Ameling
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S. Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - F. Di Ruscio
- Norwegian Institute of Public Health, Oslo, Norway
| | - G. Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - X. Seposo
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - S. Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - J. Madureira
- Department of Enviromental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - I. H. Holobaca
- Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania
| | - S. Fratianni
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - F. Acquaotta
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - H. Kim
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - W. Lee
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - C. Iniguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research, Universitat de Valencia, Valencia, Spain
| | - B. Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M. S. Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Y. L. L. Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - B. Y. Chen
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - S. Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - B. Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - A. Aleman
- Department of Preventive Medicine, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - A. Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - J. Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - T. N. Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - D. V. Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N. Gillett
- Canadian Centre for Climate Modelling and Analysis, Environment and Climate Change Canada, Victoria, British Colombia, Canada
| | - A. Haines
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
| | - M. Mengel
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - V. Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain
| | - A. Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
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4
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Acuti Martellucci C, Nomura S, Yoneoka D, Ueda P, Brotherton J, Canfell K, Palmer M, Manzoli L, Giorgi Rossi P, De Togni A, Palmonari C, Califano A, Saito E, Hashizume M, Shibuya K. Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study. BJOG 2020; 128:532-539. [PMID: 32779381 DOI: 10.1111/1471-0528.16429] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the effectiveness of an HPV vaccination programme in reducing the risk of cervical abnormalities identified at subsequent screening. DESIGN Retrospective cohort study using administrative health data. SETTING General population of Ferrara Province, Italy. POPULATION Female residents born in 1986-1993 and participating in the organized cervical screening programme in 2011-2018, who were eligible for HPV vaccination in catch-up cohorts. METHODS Logistic regression to evaluate the potential association between abnormal cervical cytology and one, two, three or at least one dose of HPV vaccine. MAIN OUTCOME MEASURES Cervical abnormalities, as predicted by low-grade or high-grade cytology, by number of vaccine doses, stratified by age. RESULTS The sample consisted of 7785 women (mean age 27.5 years, SD 2.3). Overall, 391 (5.0%) were vaccinated with ≥1 dose and 893 (11.5%) had abnormal cytology. Women receiving at least one vaccine dose were significantly less likely to have an abnormal cytology (adjusted odds ratio 0.52; 95% confidence interval 0.34-0.79). Similar results were observed for women receiving a single dose, for both bivalent and quadrivalent vaccines, and applying buffer periods (excluding cytological outcomes within 1 month, 6 months and 1 year of the first dose). CONCLUSIONS In the context of an organised cervical screening programme in Italy, catch-up HPV vaccination almost halved the risk of cytological abnormalities. TWEETABLE ABSTRACT Among Ferrara women, vaccination against human papillomavirus halved the risk of screening cervical abnormalities.
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Affiliation(s)
- C Acuti Martellucci
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - S Nomura
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - D Yoneoka
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan.,Division of Biostatistics and Bioinformatics, Graduate School of Public Health, St. Luke's International University, Chuo City, Tokyo, Japan
| | - P Ueda
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Jml Brotherton
- VCS Foundation, Carlton, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - K Canfell
- Cancer Research Division, Cancer Council NSW, Woolloomooloo, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - M Palmer
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan.,Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - L Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - P Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - A De Togni
- Epidemiology and Public Health Department, Azienda Unità Sanitaria Locale Ferrara, Ferrara, Italy
| | - C Palmonari
- Epidemiology and Public Health Department, Azienda Unità Sanitaria Locale Ferrara, Ferrara, Italy
| | - A Califano
- Epidemiology and Public Health Department, Azienda Unità Sanitaria Locale Ferrara, Ferrara, Italy
| | - E Saito
- Division of Cancer Statistics Integration, Centre for Cancer Control and Information Services, National Cancer Center, Chuo City, Tokyo, Japan
| | - M Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - K Shibuya
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Tokyo, Japan
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5
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Nio M, Tajima K, Sugaya N, Ishiwata T, Iwase T, Kato H, Hashizume M. AB0435 RISK OF SERIOUS INFECTION IN LUPUS NEPHRITIS AND RHEUMATOID ARTHRITIS MEASURED USING THE JAPANESE REAL WORLD HOSPITAL CLAIMS DATABASE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Patients with lupus nephritis (LN) and rheumatoid arthritis (RA) are at risk of serious infections (SIs) due to the impact of the disease itself and treatments that modulate immune system. Though the epidemiology of RA has been well-established by developing many targeted DMARDs (tDMARDs) including biologics and targeted synthesized DMARDs, LN is a very rare disease. Therefore, a large sample size with a significant number of cases is required to determine the exact risk of SIs in LN.Objectives:To compare the incidence rates of SIs resulting in an inpatient claim in adult patients with LN compared with RA with or without tDMARDs using hospital claims data in Japan.Methods:LN and RA were identified using claims data provided by Medical Data Vision Co., Ltd (Tokyo, Japan) between April 2008 and June 2019 which was extracted 5thSeptember 2019. Data between January 2010 and December 2018 was used for analysis. Patients with LN and RA were identified using modifications to algorithms developed before [1, 2]. LN patients were required to have continuous insurance claim for both systemic lupus erythematosus (SLE) and LN for ≥ 6 months after index date and then RA patients had continuous insurance claim for RA for ≥ 6 months after index date. First incident SIs were defined as those that resulted in an inpatient claim for a pre-specified set of ICD-10 code. Incidence rates (IRs) were calculated along with 95% confidence intervals (CI).Results:The LN, RA, RA treated with tDMARDs and RA treated without tDMARDs cohorts included 6,403, 108,317, 16,450, and 91,867 patients, respectively. As anticipated, the LN and RA cohorts were predominantly female and the RA cohort was generally older than the LN cohorts. IRs per 1,000 person-year(PY) [95% CI] for pneumocystis carini pneumonia were 28.2 [26.0-30.4] in LN, 8.5 [8.2-8.8] in RA, 12.6 [11.7-13.5] in RA with tDMARDs and 7.7 [7.4-8.0] in RA without tDMARDs. IRs per 1,000 PY for septicaemia infection were 23.3 [21.3-25.3] in LN, 12.1 [11.7-12.4] in RA, 13.3 [12.3-14.2] in RA with tDMARDs and 11.8 [11.5-12.2] in RA without tDMARDs. IRs per 1,000 PY for cytomegalovirus infection were 13.4 [11.9-14.9] in LN, 4.4 [4.2-4.6] in RA, 6.2 [5.6-6.8] in RA with tDMARDs and 4.1 [3.8-4.3] in RA without tDMARDs. IRs per 1,000 PY for tuberculosis were 7.2 [6.0-8.3] in LN, 6.7 [6.5-7.0] in RA, 18.2 [17.1-19.3] in RA with tDMARDs and 4.4 [4.2-4.7] in RA without tDMARDs.Conclusion:In this population-based analysis of claims data from Japan, the IRs of SI such as pneumocystis carini pneumonia, septicemia infection and cytomegalovirus infection were higher in LN than in RA. And also, the incidence of tuberculosis in RA treated with tDMARDs was highest among these cohorts. These findings demonstrate the relative contribution of age, immunosuppressive therapies and disease-related factors in LN and RA.References:[1]Pawar A, et al. Ann Rheum Dis. 2019 Apr;78(4):456-464. [2] ChibnikLB et al. Lupus, 2010. May;19(6):741-3.Table 1.Description of study populationLNRAtDMARDsNon tDMARDsN%N%N%N%Age (years) 18-34170026.690158.3182811.171877.8 35-44174327.21666215.4281617.11384615.1 45-54156324.42995527.7445227.12550327.8 55-64139721.85268548.6735444.74533149.3Gender Female538584.17841972.41265376.96576671.6 Male101815.92989827.6379723.12610128.4Table 2.IRs per 1,000 PY [95% CI] of SI for LN and RA patientsLN total PY = 22065RA total PY = 365033tDMARDsNon tDMARDstotal PY = 60999total PY = 304034Pneumocystis carinipneumonia28.2 [26.0-30.4]8.5 [8.2-8.8]12.6 [11.7-13.5]7.7 [7.4-8.0]Septicaemia23.3 [21.3-25.3]12.1 [11.7-12.4]13.3 [12.3-14.2]11.8 [11.5-12.2]Cytomegalovirusinfection13.4 [11.9-14.9]4.4 [4.2-4.6]6.2 [5.6-6.8]4.1 [3.8-4.3]Tuberculosis7.2 [6.0-8.3]6.7 [6.5-7.0]18.2 [17.1-19.3]4.4 [4.2-4.7]Mycosis5.1 [4.1-6.0]2.7 [2.6-2.9]4.6 [4.1-5.1]2.4 [2.2-2.5]Aspergillosis4.7 [3.8-5.6]2.7 [2.5-2.9]2.1 [1.7-2.5]2.8 [2.6-3.0]Herpes3.3 [2.5-4.0]2.4 [2.2-2.6]2.9 [2.5-3.3]2.3 [2.1-2.5]Disclosure of Interests:Mariko Nio Employee of: Chugai Pharmaceutical Co., Ltd., Kosei Tajima Employee of: Chugai Pharmaceutical Co., Ltd., Naofumi Sugaya Employee of: Chugai Pharmaceutical Co., Ltd., Tomoyuki Ishiwata Employee of: Chugai Pharmaceutical Co., Ltd., Tatsuhiko Iwase Employee of: Chugai Pharmaceutical Co., Ltd., hiroyuki kato Employee of: Chugai Pharmaceutical Co., Ltd., Misato Hashizume Employee of: Chugai Pharmaceutical Co., Ltd.
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Ikeda T, Aida M, Yoshida Y, Matsumoto S, Tanaka M, Nakayama J, Nagao Y, Nakata R, Oki E, Akahoshi T, Okano S, Nomura M, Hashizume M, Maehara Y. Alteration in faecal bile acids, gut microbial composition and diversity after laparoscopic sleeve gastrectomy. Br J Surg 2020; 107:1673-1685. [DOI: 10.1002/bjs.11654] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/02/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022]
Abstract
Abstract
Background
Laparoscopic sleeve gastrectomy (LSG) is a well established treatment for severe obesity and type 2 diabetes. Although the gut microbiota is linked to the efficacy of LSG, the underlying mechanisms remain elusive. The effect of LSG for morbid obesity on the gut microbiota and bile acids was assessed here.
Methods
Severely obese subjects who were candidates for LSG were included and followed until 6 months after surgery. The composition and abundance of the microbiota and bile acids in faeces were assessed by 16S ribosomal RNA sequencing, quantitative PCR and liquid chromatography–mass spectrometry.
Results
In total, 28 patients with a mean(s.d.) BMI of 44·2(6·6) kg/m2 were enrolled. These patients had achieved excess weight loss of 53·2(19·0) per cent and showed improvement in metabolic diseases by 6 months after LSG, accompanied by an alteration in the faecal microbial community. The increase in α-diversity and abundance of specific taxa, such as Rikenellaceae and Christensenellaceae, was strongly associated with reduced faecal bile acid levels. These changes had a significant positive association with excess weight loss and metabolic alterations. However, the total number of faecal bacteria was lower in patients before (mean(s.d.) 10·26(0·36) log10 cells per g faeces) and after (10·39(0·29) log10 cells per g faeces) operation than in healthy subjects (10·83(0·27) log10 cells per g faeces).
Conclusion
LSG is associated with a reduction in faecal bile acids and greater abundance of specific bacterial taxa and α-diversity that may contribute to the metabolic changes.
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Affiliation(s)
- T Ikeda
- Department of Integration of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
- Department of Oral Medicine Research Centre, Fukuoka, Japan
| | - M Aida
- Yakult Central Institute, Tokyo, Japan
| | - Y Yoshida
- Yakult Central Institute, Tokyo, Japan
| | | | - M Tanaka
- Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School, Fukuoka, Japan
| | - J Nakayama
- Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School, Fukuoka, Japan
| | - Y Nagao
- Department of Integration of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - R Nakata
- Department of Integration of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Akahoshi
- Department of Integration of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - S Okano
- Department of Pathology, Fukuoka Dental College, Fukuoka, Japan
| | - M Nomura
- Department of Medicine and Bioregulatory Science, Fukuoka, Japan
| | - M Hashizume
- Department of Integration of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan
| | - Y Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Mizuno Y, Mizuta R, Hashizume M, Taguchi T. Enhanced sealing strength of a hydrophobically-modified Alaska pollock gelatin-based sealant. Biomater Sci 2017; 5:982-989. [DOI: 10.1039/c6bm00829a] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A novel tissue sealant composed of hydrophobically-modified Alaska pollock gelatin and polyethylene glycol-based crosslinker showed higher sealing effect than commercially available tissue sealant.
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Affiliation(s)
- Y. Mizuno
- Graduate School of Pure and Applied Sciences
- University of Tsukuba
- Tsukuba
- Japan
- Polymeric Biomaterials Group
| | - R. Mizuta
- Graduate School of Pure and Applied Sciences
- University of Tsukuba
- Tsukuba
- Japan
- Polymeric Biomaterials Group
| | - M. Hashizume
- Faculty of Engineering
- Tokyo University of Science
- Shinjuku
- Japan
| | - T. Taguchi
- Graduate School of Pure and Applied Sciences
- University of Tsukuba
- Tsukuba
- Japan
- Polymeric Biomaterials Group
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Torata N, Kubo M, Miura D, Ohuchida K, Miyazaki T, Fujimura Y, Hayakawa E, Kai M, Oda Y, Mizumoto K, Hashizume M, Nakamura M. Abstract P5-05-04: MALDI mass spectrometry imaging profile of low molecular metabolites in breast carcinoma tissues embedded in frozen tissue microarray. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-05-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
[Background]
Metabolomics is now widely utilized for searching disease markers or identification of new drug targets. In common method, tissue samples originated in human resected specimens are stored by formalin-fixed, paraffin-embedded (FFPE) blocks. However, these samples are inadequate to measure low molecular metabolites or lipids. Furthermore, extraction process that is required for conventional mass-spectrometry causes the loss of information on the spatial localization of the metabolites. In this study, we directly analyzed breast carcinoma tissues embedded in frozen tissue microarray (fTMA) using MALDI mass spectrometry imaging (MALDI-MSI). With our original method, we could obtain profiles of low molecular metabolite and mapping images of several tissues at one time.
[Method]
Six fTMA blocks were constructed by 119 breast tissues (carcinoma 84, normal 35) from 99 patients and sectioned at 10 um thickness. MADLI-MSI were performed by AXIMA Confidence (Shimadzu, Japan) with 9-aminoacridine as a matrix (m/z range:50∼1000, Negative Ion mode). Carcinoma and normal area in individual tissues were confirmed by H&E staining of slide grasses after MADLI-MSI analysis. Acquired MSI data were processed with the freely available software BioMap (Novartis, Switzerland).
[Result]
We could detected 1,915 peaks derive from endogenous metabolite by direct tissue MALDI-MSI analysis of breast carcinoma fTMA. Among them, 185 peaks that could be commonly detected were subjected to further analysis. Among these peaks, we could identify 18 metabolites related to energy metabolism such as ATP. By comparison of metabolite profiles obtained from carcinoma with normal tissues, we found that the energy charge (EC; which is related to ATP, ADP and AMP concentrations) and the sum of adenosine phosphate compound intensities (AXP) were significantly higher than that of normal tissue (EC; T : N = 0.56 : 0.35, AXP; 17453 : 2066, p<0.0001), but there were no significant difference with lymph node metastasis, tumor histological type and tumor size. In comparison with tumor subtype, higher EC was observed in ER(+)/ Her2(-) tumor than others but AXP showed no significant among all subtypes including Ki-67 labeling index.
[Conclusion]
A combination of fTMA and MALDI-MSI is promising approach for biomarker discovery because it can achieve high throughput metabolic mapping without obvious artifact or other problem. In this study, even though high EC value were indicated in carcinoma tissue than normal but newly biomarker candidate was indeterminate at this moment. Identification of the candidates of novel carcinoma tissue biomarker is now underway.
Citation Format: Torata N, Kubo M, Miura D, Ohuchida K, Miyazaki T, Fujimura Y, Hayakawa E, Kai M, Oda Y, Mizumoto K, Hashizume M, Nakamura M. MALDI mass spectrometry imaging profile of low molecular metabolites in breast carcinoma tissues embedded in frozen tissue microarray. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-05-04.
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Affiliation(s)
- N Torata
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - M Kubo
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - D Miura
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - K Ohuchida
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - T Miyazaki
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - Y Fujimura
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - E Hayakawa
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - M Kai
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - Y Oda
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - K Mizumoto
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - M Hashizume
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
| | - M Nakamura
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Innovation Center for Medical Redox Navigation, Kyushu University, Fukuoka, Japan; Kyushu University Hospital Cancer Center, Fukuoka, Japan; Advanced Medicine Innovation Center Kyushu University, Fukuoka, Japan
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Gasparrini A, Leone M, Guo Y, Lavigne E, Zanobetti A, Schwartz J, Tobias A, Tong S, Bell ML, Guo YLL, Wu CF, Kan H, Yi SM, Hashizume M, Honda Y, Kim H, Armstrong B. Attributable Mortality Risk of Temperature: A Multi-Country Study. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv097.239] [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: 11/12/2022] Open
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Suzuki M, Yoshida H, Hashizume M, Tanaka K, Matsumoto Y. Blockade of interleukin-6 receptor enhances the anti-arthritic effect of glucocorticoids without decreasing bone mineral density in mice with collagen-induced arthritis. Clin Exp Immunol 2015. [PMID: 26201536 DOI: 10.1111/cei.12685] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 01/04/2023] Open
Abstract
In a mouse arthritis model, we investigated whether interleukin-6 receptor (IL-6R) blockade would enhance the anti-arthritic effect of glucocorticoids (GCs). DBA/1J mice were immunized with type II collagen (CII), and were treated with prednisolone (PSL) and/or anti-mouse IL-6R antibody (MR16-1). Also, the effects of IL-6 on gene expression and the nuclear translocation of glucocorticoid receptors (GRs) were examined in cultured cells treated with dexamethasone (DEX). PSL reduced the arthritis score dose-dependently in the collagen-induced arthritis (CIA) mouse model. The arthritis score in the PSL (3 mg/kg) + MR16-1 group was lower than in the PSL (3 mg/kg) group, and at the same level as in the PSL (6 mg/kg) group. Lumbar vertebra bone mineral density (BMD) was decreased significantly in CIA mice and was higher in the PSL (3 mg/kg) + MR16-1 group than in the PSL (6 mg/kg) group. In the in-vitro synovial cells, IL-6 pretreatment attenuated the inhibitory effect of DEX on cyclooxygenase (COX)-2 expression and inhibited the nuclear translocation of GR induced by DEX. In contrast, in MC3T3-E1 osteoblastic cells, IL-6 pretreatment exacerbated the decrease in expression of osteocalcin and the increase in expression of receptor activator of nuclear factor kappa-B ligand (RANKL) by DEX. We demonstrated that IL-6 signalling blockade by an anti-IL-6R antibody can augment the anti-arthritic effect of GCs and inhibit the bone loss they cause.
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Affiliation(s)
- M Suzuki
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Company Ltd, Gotemba, Shizuoka, Japan
| | - H Yoshida
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Company Ltd, Gotemba, Shizuoka, Japan
| | - M Hashizume
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Company Ltd, Gotemba, Shizuoka, Japan
| | - K Tanaka
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Company Ltd, Gotemba, Shizuoka, Japan
| | - Y Matsumoto
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Company Ltd, Gotemba, Shizuoka, Japan
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Suzuki M, Bi Y, Yoshida H, Tanaka K, Hashizume M, Matsumoto Y. THU0061 The Effect of Anti-IL-6 Receptor Antibody on Cartilage Destruction in a Mouse Model of Collagen-Induced Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2637] [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: 11/04/2022]
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12
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Akahoshi T, Sugimori H, Kaku N, Tokuda K, Nagata T, Noda E, Morita M, Hashizume M, Maehara Y. Comparison of recombinant human thrombomodulin and gabexate mesylate for treatment of disseminated intravascular coagulation (DIC) with sepsis following emergent gastrointestinal surgery: a retrospective study. Eur J Trauma Emerg Surg 2014; 41:531-8. [PMID: 26038004 DOI: 10.1007/s00068-014-0478-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/06/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Recombinant thrombomodulin (rTM) has been available in Japan since 2008, but there is concern about its association with postoperative hemorrhage. The efficacy and safety of rTM were examined in patients with disseminated intravascular coagulation (DIC) caused by a septic condition after gastrointestinal surgery. METHODS Forty-two patients were emergently admitted to the intensive care unit after emergent gastrointestinal surgery in Kyushu University Hospital from May 2008 to April 2013. Of these patients, 22 had DIC (defined as an acute DIC score ≥ 4). All but three patients received treatment with gabexate mesylate (GM) (n = 9) or rTM (n = 10). The causes of sepsis were peritonitis with colorectal perforation, anastomotic leakage, and intestinal necrosis. Acute DIC score, sepsis-related organ failure assessment score, platelet count, and a variety of biochemical parameters were compared between rTM and GM recipients after treatment administration. RESULTS There were no significant differences between the groups for any parameter except C-reactive protein levels. The CRP level tended to be lower in the rTM group than in the GM group. Acute DIC score in the rTM group resolved significantly earlier than that in the GM group. No patient stopped the administration of rTM because of postoperative bleeding. CONCLUSION rTM may be an effective therapeutic drug for the treatment of septic patients with DIC following emergent gastrointestinal surgery.
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Affiliation(s)
- T Akahoshi
- Department of Disaster and Emergency Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Emergency and Critical Care Center, Kyushu University, Fukuoka, Japan. .,Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - H Sugimori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - N Kaku
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - K Tokuda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - T Nagata
- Department of Disaster and Emergency Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - E Noda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - M Morita
- Emergency and Critical Care Center, Kyushu University, Fukuoka, Japan
| | - M Hashizume
- Department of Disaster and Emergency Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Maehara
- Emergency and Critical Care Center, Kyushu University, Fukuoka, Japan.,Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Koreeda Y, Obata S, Nishio Y, Miura S, Kobayashi Y, Kawamura K, Souzaki R, Ieiri S, Hashizume M, Fujie MG. Development and testing of an endoscopic pseudo-viewpoint alternating system. Int J Comput Assist Radiol Surg 2014; 10:619-28. [PMID: 24950746 PMCID: PMC4411650 DOI: 10.1007/s11548-014-1083-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 01/10/2014] [Accepted: 05/27/2014] [Indexed: 11/28/2022]
Abstract
Purpose An endoscopic system is needed that presents informative images irrespective of the surgical situation and the number of degrees of freedom in endoscopic manipulation. This goal may be achieved with a virtual reality view for a region of interest from an arbitrary viewpoint. An endoscopic pseudo-viewpoint alternation system for this purpose was developed and tested. Method Surgical experts and trainees from an endoscopic surgery training course at the minimally invasive surgery training center of Kyushu University were enrolled in a trial of a virtual reality system. The initial viewpoint was positioned to approximate the horizontal view often seen in laparoscopic surgery, with \documentclass[12pt]{minimal}
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\begin{document}$$20^{\circ }$$\end{document}20∘ between the optical axis of the endoscope and the task surface. A right-to-left suturing task with right hand, based on a task from the endoscopic surgery training course, was selected for testing. We compared task outcomes with and without use of a new virtual reality-viewing system. Result There was a 0.37 mm reduction in total error (\documentclass[12pt]{minimal}
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\begin{document}$$p = 0.02$$\end{document}p=0.02) with use of the proposed system. Error reduction was composed of 0.1 mm reduction on the y-axis and 0.27 mm reduction on the x-axis. Experts benefited more than novices from use of the proposed system. Most subjects worked at a pseudo-viewpoint of around 34\documentclass[12pt]{minimal}
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\begin{document}$$^\circ $$\end{document}∘. Discussion Suturing performance improved with the new virtual reality endoscopic display system. Viewpoint alternation resulted in an overview that improved depth perception and allowed subjects to better aim the marker. This suggests the proposed method offers users better visualization and control in endoscopic surgery.
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Affiliation(s)
- Y Koreeda
- Graduate School of Science and Engineering, Waseda University, 59-309, 3-4-1, Okubo, Shinjuku Ward, Tokyo, Japan,
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Hashizume M, Kikuchi J, Izumi K, Kaneko Y, Yoshimoto K, Takeuchi T. SAT0241 Increasing Regulatory T Cells by TOCILIZUMAB Correlates with Clinical Response in Rheumatoid Arthritis Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3999] [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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Izumi K, Kaneko Y, Hashizume M, Nishina N, Kikuchi J, Yoshimoto K, Takeuchi T. FRI0008 Baseline Osteopontin Levels PREDICT the Clinical Efficacy of TOCILIZUMAB not Infliximab in Bio-Naive Rheumatoid Arthritis Patients: the Keio First BIO Cohort at 1 Year. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2778] [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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Nishina N, Kikuchi J, Hashizume M, Yoshimoto K, Kameda H, Takeuchi T. FRI0001 Baseline soluble interleukin-6 receptor levels predict the clinical effectiveness of tocilizumab in patients with rheumatoid arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-eular.1129] [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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Agatsuma H, Takeda T, Eguchi T, Saito G, Hashizume M, Toishi M, Shiina T, Yoshida K. P-198COMPARATIVE ANALYSIS OF VIDEO-ASSISTED THORACOSCOPIC TOTAL THYMECTOMY VERSUS OPEN TOTAL THYMECTOMY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.198] [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: 11/13/2022] Open
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Hashizume M, Tanaka K, Yoshida H, Suzuki M, Shiina M, Mori K, Mihara M. FRI0048 Interleukin-6 increases the number of osteoclast precursors in femur bone marrow via up-regulation of sphingosine-1-phosphate receptor 2 in inflammatory arthritic mice. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2505] [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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Yoshida H, Suzuki M, Hashizume M, Tanaka K, Shiina M, Matsumoto I, Sumida T, Matsumoto Y. THU0079 Anti-IL-6 Receptor Antibody Suppresses Systemic Bone Loss by not Only Normalizing Bone Resorption but also Enhancing Bone Formation in a Mouse Model of Collagen-Induced Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.607] [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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Suzuki M, Shiina M, Yoshida H, Hashizume M, Tanaka K, Mihara M. AB0097 IL-6 blockade enhances the therapeutic effect of steroids. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.97] [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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Yoshida H, Suzuki M, Tanaka K, Hashizume M, Shiina M, Matsumoto I, Sumida T, Mihara M. AB0158 Anti-interleukin-6 receptor antibody suppresses loss of trabecular bone volume in mice with glucose-6-phosphate isomerase-induced arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.158] [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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Kikuchi J, Shiina M, Hashizume M, Mihara M, Yoshimoto K, Kameda H, Takeuchi T. AB0163 Factors associated with the expansion of TH17 cells in peripheral blood of ra patients: Possible different effect between anti-IL-6 and anti-TNF therapies. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.163] [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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Hashizume M, Nishina N, Kikuchi J, Yoshimoto K, Kameda H, Takeuchi T. AB0054 A rapid and marked reduction of serum vegf via blocking il-6 signal was associated with early clinical responses to tocilizumab and infliximab in patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2377] [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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Inoue D, Cho B, Mori M, Kikkawa Y, Amano T, Nakamizo A, Yoshimoto K, Mizoguchi M, Tomikawa M, Hong J, Sasaki T, Hashizume M. Preliminary Study on the Clinical Application of Augmented Reality Neuronavigation. J Neurol Surg A Cent Eur Neurosurg 2013; 74:71-6. [DOI: 10.1055/s-0032-1333415] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- D. Inoue
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - B. Cho
- Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M. Mori
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y. Kikkawa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T. Amano
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A. Nakamizo
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K. Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M. Mizoguchi
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M. Tomikawa
- Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - J. Hong
- Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Korea
| | - T. Sasaki
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M. Hashizume
- Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Eguchi T, Yoshida K, Miura K, Agatsuma H, Sakaizawa T, Saito G, Hashizume M, Toishi M, Shiina T, Koizumi T. Utility of 18F-Fluorodeoxyglucose Positron Emission Tomography for Distinguishing between the Histologic Types of Early Stage Thymic Epithelial Tumors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32447-9] [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: 10/25/2022] Open
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Hashizume M, Douen T, Murakami M, Yamamoto A, Takada K, Muranishi S. Improvement of Large Intestinal Absorption of Insulin by Chemical Modification with Palmitic Acid in Rats. J Pharm Pharmacol 2011; 44:555-9. [PMID: 1357133 DOI: 10.1111/j.2042-7158.1992.tb05463.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [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: 11/29/2022]
Abstract
Abstract
The intestinal absorption of 125I-labelled palmitoyl insulin was examined following administration into in-situ closed large intestinal loops of rats. When mono- and dipalmitoyl insulins (Palins-1 and Palins-2, respectively) were administered in polyoxyethylene hydrogenated castor oil (HCO 60) micellar system into intestinal loops, a marked increase in plasma radioactivity and a corresponding disappearance of residual radioactivity in the intestinal lumen were observed in the following rank order: Palins-2 > Palins-1 > native insulin. In addition, the derivatives were more stable than native insulin in the mucosal tissue homogenates of the large intestine. These results suggest that chemical modification of insulin with palmitic acid may not only increase the lipophilicity of insulin but also reduce its degradation, resulting in the increased transfer of insulin across the large intestinal mucous membrane. The linoleic acid-HCO 60 mixed micelles system did not have a significant effect on the large intestinal absorption of radioactivity associated with the lipophilic insulin analogues.
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Affiliation(s)
- M Hashizume
- Department of Biopharmaceutics, Kyoto Pharmaceutical University, Japan
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Tsutsumi N, Tomikawa M, Uemura M, Akahoshi T, Hong J, Ieiri S, Kakeji Y, Hashizume M, Maehara Y. Image-Guided Laparoscopic Surgery And Its Environments in Open MRI Therapeutic Room. J Surg Res 2011. [DOI: 10.1016/j.jss.2010.11.583] [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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30
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Suzuki M, Hashizume M, Yoshida H, Shiina M, Mihara M. Intercellular adhesion molecule-1 on synovial cells attenuated interleukin-6-induced inhibition of osteoclastogenesis induced by receptor activator for nuclear factor κB ligand. Clin Exp Immunol 2010; 163:88-95. [PMID: 21039424 DOI: 10.1111/j.1365-2249.2010.04276.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In a co-culture of osteoclast precursor cells and synovial cells, interleukin-6 (IL-6) induces osteoclast formation. In contrast, in a monoculture of osteoclast precursor cells, IL-6 directly suppresses receptor activator for nuclear factor κB ligand (RANKL)-induced differentiation of osteoclast precursor cells into osteoclasts. In the present study, we explored why the effect of IL-6 differed between the monoculture and the co-culture systems. In the monoculture, mouse osteoclast precursor cell line, RAW 264·7 (RAW) cells were cultured with soluble RANKL (sRANKL) for 24 h or 3 days. sRANKL increased both expression of osteoclastogenesis marker, tartrate-resistant acid phosphatase isoform 5b (TRAP5b) and nuclear factor of activated T cells cytoplasmic 1 (NFATc1), whereas the co-addition of IL-6 decreased them both in a dose-dependent manner. In the co-culture, RAW cells and human synovial cell line, SW982 cells were cultured with IL-6+soluble IL-6 receptor (sIL-6R) for 3 days. TRAP5b and NFATc1 expression reduced by IL-6 was increased by the addition of SW982 cells in a manner dependent upon the number of added cells. IL-6+sIL-6R treatment significantly induced RANKL production in SW982 cells, and anti-RANKL antibody inhibited IL-6+sIL-6R-induced osteoclastogenesis. SW982 cells expressed high levels of ICAM-1 originally, and ICAM-1 expression was increased significantly by IL-6+sIL-6R. Anti-ICAM-1 antibody suppressed IL-6-induced osteoclastogenesis. Finally, in the monoculture system, addition of sICAM-1 dose-dependently restored the expression of TRAP5b reduced by IL-6. Similar results were obtained when the formation of TRAP-positive multi-nuclear cells were examined using mouse bone marrow cells. In conclusion, IL-6 gave different results in the co-culture and monoculture systems because in the co-culture, ICAM-1 from the synovial cells restored osteoclastogenesis suppressed by IL-6.
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Affiliation(s)
- M Suzuki
- Product Research Department, Fuji-Gotemba Research Laboratories, Chugai Pharmaceutical Co. Ltd., 1-135 Komakado, Gotemba, Shizuoka, Japan
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Onimaru M, Ohuchida K, Egami T, Mizumoto K, Nagai E, Cui L, Toma H, Matsumoto K, Hashizume M, Tanaka M. Gemcitabine synergistically enhances the effect of adenovirus gene therapy through activation of the CMV promoter in pancreatic cancer cells. Cancer Gene Ther 2010; 17:541-9. [DOI: 10.1038/cgt.2010.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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32
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Shukla S, Lawrence A, Aggarwal A, Naik S, Gullick NJ, Evans HG, Jayaraj D, Kirkham BW, Taams LS, Judah SM, Nixon N, Dawes P, Mattey DL, Yeo L, Schmutz C, Toellner KM, Salmon M, Filer AD, Buckley C, Raza K, Scheel-Toellner D, Hashizume M, Yoshida H, Koike N, Suzuki M, Mihara M, Stavropoulos-Kalinoglou A, Metsios GS, Douglas KM, Panoulas VF, Koutedakis Y, Kitas GD, Church LD, Filer AD, Hildago E, Howlett K, Thomas A, Rapecki S, Scheel-Toellner D, Buckley CD, Raza K, Juarez M, Kolasinski J, Govindan J, Quilter A, Williamson L, Collins DA, Price EJ, Gasparyan AY, Stavropoulos-Kalinoglou A, Toms TE, Douglas K, Kitas GD, Lachmann HJ, Kuemmerle-Deschner JB, Hachulla E, Hoyer J, Smith J, Leslie K, Kone-Paut I, Braun J, Widmer A, Patel N, Preiss R, Hawkins PN. Cytokines and Inflammatory Mediators [30-39]: 30. The LPS Stimulated Production of Interleukin-10 is not Associated with -819C/T and -592C/A Promoter Polymorphisms in Healthy Indian Subjects. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq715] [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: 11/13/2022] Open
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33
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Hashizume M, Shimoda T, Sasaki S, Kunii O, Caypil W, Dauletbaev D, Chiba M. Anaemia in relation to low bioavailability of dietary iron among school-aged children in the Aral Sea region, Kazakhstan. Int J Food Sci Nutr 2009; 55:37-43. [PMID: 14630590 DOI: 10.1080/09637480310001642466] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [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: 10/26/2022]
Abstract
This study investigates anaemia related to the sufficiency of dietary iron intake of school-aged children in the Kzyl-Orda region of Kazakhstan. We conducted a cross-sectional study of 97 school-aged children living in Kzyl-Orda. Blood samples were collected for measuring haemoglobin. Dietary intake data were obtained from 24-h dietary recalls. Iron bioavailability was estimated with algorithms adjusting for absorption enhancers (meat, fish and poultry, and vitamin C) and inhibitors (tea and phytates) consumed in the same meal. The median total iron intakes were adequate compared with the median basal iron requirement; however, the median bioavailable iron intakes were well below the median absorbed iron requirement. Available iron was 6.9-7.2% of the total iron intake after adjusting for the absorption enhancers, and was reduced by 3.1-4.4% after adjusting for both enhancers and inhibitors. After adjustment for energy intake, higher iron intake was significantly associated with a decreased prevalence of anaemia (odds ratio, 0.39; 95% confidence interval, 0.16-0.93; P=0.034). Some evidence suggested an association between bioavailable iron intake after adjustment of absorption enhancers and inhibitors (odds ratio, 0.43; 95% confidence interval, 0.18-1.01; P=0.053). In conclusion, low bioavailability of dietary iron seems related to anaemia in the region. Although iron fortification or supplementation programmes can be useful for promoting the anaemia prevention control programme, further efforts for nutritional education suited for family level dietary practice are necessary.
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Affiliation(s)
- M Hashizume
- Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Abstract
BACKGROUND Although multiple combinations of weather factors may contribute to an increased incidence of Mycoplasma pneumoniae pneumonia, few studies have investigated the association between weather factors and cases of M pneumoniae pneumonia. METHODS Data on cases of M pneumoniae pneumonia and weather factors in Fukuoka, Japan from 1999 to 2007 were obtained and time-series analysis was used to assess the effects of weather variables on M pneumoniae pneumonia cases, adjusting for confounding factors. A total of 13 056 M pneumoniae pneumonia cases were reported during the 9-year study period, of which 12 234 (93.7%) were under 15 years of age. RESULTS The weekly number of M pneumoniae pneumonia cases increased by 16.9% (95% CI 11.3% to 22.8%) for every 1 degrees C increase in the average temperature and by 4.1% (95% CI 2.7% to 5.5%) for every 1% increase in relative humidity. CONCLUSIONS From 1999 to 2007, cases of M pneumoniae pneumonia increased significantly with increased average temperature and relative humidity in Fukuoka, Japan.
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Affiliation(s)
- D Onozuka
- Department of Planning Information and Administration, Fukuoka Institute of Health and Environmental Sciences, Dazaifu-shi, Fukuoka, Japan.
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35
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Ogura G, Nakamura R, Muragaki Y, Hashizume M, Iseki H. Development of an articulating ultrasonically activated device for laparoscopic surgery. Surg Endosc 2008; 23:2138-42. [PMID: 19116745 DOI: 10.1007/s00464-008-0248-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 10/17/2008] [Indexed: 12/16/2022]
Abstract
BACKGROUND Ultrasonically activated devices (USADs) offer excellent coagulating dissection performance and are broadly used, particularly in endoscopic operations. Traditional USADs, however, have fixed linear shape and are thus limited in the directions from which organs can be approached. We have developed a small USAD transducer attached to the tip of an articulating device, offering a new kind of USAD in which the tip can bend as desired. We describe herein an evaluation of the coagulating dissection performance of this new articulating USAD and an in vivo confirmation of clinical usefulness. METHODS To evaluate coagulating dissection performance, we compared coagulating shearing on porcine splenic arteries between the articulating USAD and a Harmonic Scalpel II (HSII), representing a traditional USAD. Changing the amplitude of vibration between 60 microm and 80 microm and grip force among 1, 2, and 3 N, we measured the time required for division and bursting pressure of coagulating dissection. An in vivo experiment in a pig was also used to confirm the usefulness of the articulating USAD in laparoscopic operations. RESULTS Division time did not differ significantly between the articulating USAD and HSII with an 80-microm amplitude of vibration and a grip force of 2 or 3 N. Bursting pressure of blood vessels showed no significant difference between articulating USAD and HSII under all experimental conditions. In the in vivo experiment, the new bendable tip of the articulating USAD displayed coagulating dissection performance equivalent to that of the traditional USAD. CONCLUSIONS We have developed a new articulating USAD that can broaden the range of methods and approaches available for USADs and improve usefulness and safety.
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Affiliation(s)
- G Ogura
- Faculty of Advanced Techno-Surgery, Department of Advanced Biomedical Engineering and Science, Graduate School of Medical Science, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
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36
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Hashizume M, Hayakawa N, Mihara M. IL-6 trans-signalling directly induces RANKL on fibroblast-like synovial cells and is involved in RANKL induction by TNF- and IL-17. Rheumatology (Oxford) 2008; 47:1635-40. [DOI: 10.1093/rheumatology/ken363] [Citation(s) in RCA: 234] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Tanoue K, Ieiri S, Konishi K, Yasunaga T, Okazaki K, Yamaguchi S, Yoshida D, Kakeji Y, Hashizume M. Effectiveness of endoscopic surgery training for medical students using a virtual reality simulator versus a box trainer: a randomized controlled trial. Surg Endosc 2007; 22:985-90. [PMID: 17710487 DOI: 10.1007/s00464-007-9554-8] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 07/19/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND The first step toward increasing the level of patient safety in endoscopic surgery is for all endoscopic surgeons to acquire fundamental skills, including psychomotor skills, in the preoperation stage of training. The current study aimed to evaluate the effectiveness of virtual reality (VR) simulator training and box training for training the fundamental skills of endoscopic surgery. METHODS For this study, 35 medical students at Kyushu University were divided into three groups: simulator (SIM) group (n = 20), box trainer (BOX) group (n = 20), and control group (n = 15). None of the students had any experience assisting with endoscopic surgery or any previous training for endoscopic surgery. The students in the SIM group underwent training using a VR simulator, the Procedicus MIST, 2 h per day for 2 days. The students in the BOX group underwent training using a box trainer 2 h per day for 2 days. The students in the control group watched an educational video for 30 min. The endoscopic surgical skills of all the students were evaluated before and after training with a task of suturing and knot tying using a box trainer. RESULTS Although no significant differences were found between the three groups in the total time taken to complete the evaluation task before training, there were significant improvements in the SIM and BOX groups after training compared with the control group. Box training increased errors during the task, but simulator training did not. CONCLUSION The findings showed that box training and VR training have different outcomes. The authors expect that the best curriculum for their training center would involve a combination that uses the merits of both methods.
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Affiliation(s)
- K Tanoue
- Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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Katsuragi N, Shiraishi Y, Kita H, Hashizume M, Miyasaka Y, Tanaka S. [21-year-old man with squamous cell carcinoma of the lung]. Kyobu Geka 2007; 60:529-32. [PMID: 17642212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Lung cancer among people in their twenties is rare and accounts for only 0.1-0.4% of all cases. We describe a case of squamous cell carcinoma of the lung in a 21-year-old man. The otherwise healthy patient presented with a 1 month history of cough. Chest radiography showed a well-defined round mass 5 cm in size in the right lower lobe. Computed tomography also showed a 3 cm hilar lymph node. Bronchoscopy revealed a white polypoid mass obstructing the right basal bronchus. Transbronchial biopsy revealed poorly differentiated squamous cell carcinoma of the lung. Clinical diagnosis was T2N1M0, stage IIB lung cancer. Right lower lobectomy with mediastinal lymph node dissection was performed. Lymph node metastases were proven histologically in the pretracheal, subcarinal, hilar, and intrapulmonary regions. Pathological diagnosis was T2N2M0, stage IIIA lung cancer. Endobronchial and mediastinal lymph node metastases were found 2 months after surgery. He received 3 rounds of chemotherapy with cisplatin and docetaxel and irradiation to the right hilum and mediastinum at a total dose of 60 Gy in 30 fractions. He is alive 6 months after surgery.
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Affiliation(s)
- N Katsuragi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan
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Kakeji Y, Konishi K, Ieiri S, Yasunaga T, Nakamoto M, Tanoue K, Baba H, Maehara Y, Hashizume M. Robotic laparoscopic distal gastrectomy: a comparison of the da Vinci and Zeus systems. Int J Med Robot 2007; 2:299-304. [PMID: 17520647 DOI: 10.1002/rcs.104] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [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: 12/24/2022]
Abstract
BACKGROUND The robotic surgical systems working on a master-slave principle have been developed and used in the worldwide in cardiac, urologic, and general surgery. METHODS The two robotic systems, the da Vinci and the Zeus Robotic Surgical System (Intuitive Surgical, Calif., USA), were compared with the aim of evaluating operative feasibility and technical efficacy in distal gastrectomy. RESULTS During laparoscopic gastrectomy, the da Vinci System (n = 2) had a shorter total operative time (445 versus 656 minutes; p = 0.09) and less blood loss (65 versus 277 mL; p = 0.08) compared with the Zeus System (n = 3). The articulated instruments of both systems were useful in lymph node dissection, isolation of vessels in fat tissue, ligation of vessels, and intraabdominal anastomosis of the gastrointestinal tract. Robotic laparoscopic procedures can be performed effectively using either the da Vinci or Zeus System. CONCLUSION In this limited study, the robotic instruments, especially those of da Vinci system, made it easier to complete tissue dissection including lymph nodes, complicated endoscopic anastomoses, and ligatures in a closed cavity.
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Affiliation(s)
- Y Kakeji
- Department of Surgery and Science, Kyushu University, Higashi-ku, Fukuoka, Japan
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Katsuragi N, Shiraishi Y, Kita H, Hashizume M, Miyasaka Y, Tanaka S. [Endobronchial neurinoma treated with left lower lobectomy]. Kyobu Geka 2007; 60:104-8. [PMID: 17305074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Benign endobronchial tumors are rare, and among these endobronchial neurinoma is extremely rare. We describe a case of endobronchial neurinoma successfully treated with left lower lobectomy. A 58-year-old man presented with an 8-month history of cough. During this period he was repeatedly treated with antibiotics for pneumonia of the left lower lobe. Chest X-ray showed atelectasis of the left lower lobe. Computed tomography (CT) of the chest showed a mass in the left main and lower lobe bronchi. Bronchoscopy revealed the mass almost completely obstructing the left main bronchus. Although transbronchial biopsy was inconclusive and yielded necrotic tissue with Aspergillus hyphae, lung cancer was highly suspected based on clinical and radiographic findings. He underwent left lower lobectomy and was discharged 14 days after surgery in good condition. Pathological diagnosis was an endobronchial neurinoma 4 cm in size arising from the left basal bronchus. On immunohistochemical staining, the tumor was positive for S-100 protein and negative for a-smooth muscle actin. He took itraconazole at a daily dose of 200 mg orally for 6 months. He remains well 52 months after surgery without any evidence of recurrence.
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Affiliation(s)
- N Katsuragi
- Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan
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Hong J, Nakashima H, Konishi K, Ieiri S, Tanoue K, Nakamuta M, Hashizume M. Interventional navigation for abdominal therapy based on simultaneous use of MRI and ultrasound. Med Biol Eng Comput 2006; 44:1127-34. [PMID: 17102954 DOI: 10.1007/s11517-006-0133-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Accepted: 10/23/2006] [Indexed: 10/23/2022]
Abstract
An interventional navigation system designed for percutaneous abdominal therapies was proposed, and a pilot study was carried out to assess the proposed system. Integration of US to MRI-based segmentation and 3D display of tumours can help physicians deal with instabilities such as respiratory motion and soft tissue shift that are inherent in abdominal interventions. In addition to the 3D display of the needle and tumours, we adapted the system for the abdominal applications and incorporated a process to correct the mismatch in needle path between MRI and US. The preliminary results of phantom and animal experiments indicated that the proposed method could combine the advantages of both MRI and US. The time required to determine the optimal needle insertion path by using this system was significantly less than that required when either US or MRI guidance alone was employed. The developed system was applied in two patients who underwent PEIT therapy, and its clinical feasibility was partially confirmed.
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Affiliation(s)
- J Hong
- Department of Nanobiomedicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
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42
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Kakeji Y, Yamaguchi S, Yoshida D, Tanoue K, Ueda M, Masunari A, Utsunomiya T, Imamura M, Honda H, Maehara Y, Hashizume M. Development and assessment of morphologic criteria for diagnosing gastric cancer using confocal endomicroscopy: an ex vivo and in vivo study. Endoscopy 2006; 38:886-90. [PMID: 16981104 DOI: 10.1055/s-2006-944735] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS The Confocal Endomicroscopy System (Optiscan Pty Ltd. and Pentax Corp.) is a newly developed imaging tool that uses laser light and optical technology to visualize living tissue at the cellular level. Digital images of cells magnified 1000-fold appear in real time on a computer screen, which enables immediate detection of changes in cellular structure without the need for a biopsy. The aim of this study was to assess the features of the cellular architecture of cancerous tissue that can be used in the differential diagnosis of cancerous tissue and normal mucosa using this system's image-processing software. PATIENTS AND METHODS A total of 27 gastric cancers were examined ex vivo using confocal endomicroscopy. A fluorescent contrast agent, acriflavine, was applied topically to normal and to cancerous mucosa. In vivo imaging of the gastric mucosa after intravenous injection of fluorescein sodium was also performed in nine patients with gastritis or gastric cancer. RESULTS The nuclear area in the ex vivo specimens was calculated using Scion Image software. The mean nuclear area of cancer cells was found to be significantly larger than that of normal cells in 18/27 gastric cancers (67 %). The mean nuclear area of the cancers tended to be larger than that of normal mucosa, especially in cases of differentiated adenocarcinoma. In more than half the cases, it was possible to diagnose malignancy automatically using confocal endomicroscopy and image-processing software without the need for biopsy and pathological examination. In vivo imaging of cancerous lesions showed irregularity in cellularity and vascularity. CONCLUSION The ability of this imaging device to differentiate between normal tissue and cancerous tissues gives it potential value as a new screening tool for early detection of malignancy.
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Affiliation(s)
- Y Kakeji
- Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Hayashi K, Asahina S, Kugahara A, Watabe H, Hashizume M, Nakano K, Tsuboi K. P36.44 Research into the panic disorder with EEG abnormalities, about characteristic symptoms and findings. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.06.653] [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: 11/29/2022]
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44
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Makino M, Hashizume M, Tsuboi K, Yasushi M, Dennerstein L. Comparative study of attitudes to eating between male and female students in the People's Republic of China. Eat Weight Disord 2006; 11:111-7. [PMID: 17075237 DOI: 10.1007/bf03327555] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE This study was conducted to compare eating attitudes and lifestyles of male and female college students in China (Beijing). SUBJECTS AND METHODS The subjects of this study consisted of 217 male and 177 female college students. They were asked to fill out the Eating Attitudes Test-26 (EAT-26) and a lifestyle questionnaire. RESULTS The percentages of those above the cutoff point on the EAT-26 for abnormal eating attitudes were 4.7% of male and 6.2% of female students. Body perception of being fat (distorted body image) was the factor most associated with abnormal eating attitudes. DISCUSSION Weight related concern was prevalent amongst the Chinese students. This suggests that the culture of the beauty of thinness is common among young students in Beijing, particularly female students.
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Affiliation(s)
- M Makino
- Office for Gender and Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
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45
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Makino M, Hashizume M, Yasushi M, Tsuboi K, Dennerstein L. Factors associated with abnormal eating attitudes among female college students in Japan. Arch Womens Ment Health 2006; 9:203-8. [PMID: 16625319 DOI: 10.1007/s00737-006-0128-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [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: 09/04/2005] [Accepted: 03/11/2006] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To determine the prevalence rates of abnormal eating attitudes and associated risk factors among female Japanese college students. SUBJECTS AND METHODS The study population was 7812 female college students in Tokyo. They were asked to fill out the Japanese version of EAT-26 and lifestyle questionnaires. RESULTS 5.1% of the subjects had a total EAT-26 score above the cutoff point (>20). Multiple regression analysis found the most important factors associated with abnormal eating attitudes were distorted body image, fewer sleeping hours, irregular meal habits, cigarette smoking and more exercise. DISCUSSION The prevalence of abnormal eating attitudes among female college students in this study was lower than that of Japanese female high school students and lower than that reported for college students of both western and non-western countries. Our results suggest that body image dissatisfaction may be the most important factor associated with abnormal eating behavior.
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Affiliation(s)
- M Makino
- Department of Psychosomatic Medicine, Toho University, Tokyo, Japan
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46
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Hashizume M, Kondo H, Murakami T, Kodama M, Nakahara S, Lucas MES, Wakai S. Use of rapid diagnostic tests for malaria in an emergency situation after the flood disaster in Mozambique. Public Health 2006; 120:444-7. [PMID: 16530797 DOI: 10.1016/j.puhe.2005.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Revised: 09/19/2005] [Accepted: 11/05/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine how diagnosis of malaria may be improved by combining the use of rapid diagnostic tests (RDTs) for Plasmodium falciparum malaria with clinical diagnosis by the presence or history of fever compared with clinical diagnosis alone in emergency situations with flood-affected displaced populations in Mozambique. STUDY DESIGN A cross-sectional study conducted at the emergency outpatient clinic in a village in the Chòkwè district of Gaza Province, 3 weeks after Cyclone Eline hit Mozambique in February 2000. METHODS A hundred and thirty children aged less than 15 years with clinical malaria were selected for examination by RDT and fluorescent microscopy using acridine orange as a reference test. The diagnosis of clinical malaria was made by a history of fever in the last three days or axillary temperature above 37.0 degrees C at the time of attending the emergency outpatient clinic. Two positive predictive values were calculated; RDTs combined with clinical diagnosis and clinical diagnosis alone. RESULTS Positive predictive values of RDTs combined with clinical diagnosis by the presence of fever or history of fever were 87.6% (92/105) (95% confidence interval (CI) 80.8-92.8) compared with 74.6% (97/130) (95% CI 66.2-81.8) for clinical diagnosis alone. Five patients were diagnosed false negative. CONCLUSION RDTs combined with clinical diagnosis has sufficient positive predictive value to be used in emergency situations, while RDTs could result in increasing failure to treat when they are used for decisions of treatment compared with clinical diagnosis alone.
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Affiliation(s)
- M Hashizume
- Department of International Community Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Katsurago N, Shiraishi Y, Hashizume M, Miyasaka Y. [Long-term survival following multimodality treatment of metachronous metastases (parotid gland, adrenal gland, brain and mediastinal lymph node) after resection of non-small cell lung cancer; report of a case]. Kyobu Geka 2006; 59:168-71. [PMID: 16482916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We describe a case of long-term survival following multimodality treatment of metachronous metastases (parotid gland, adrenal gland, brain and mediastinal lymph node) after resection of non-small cell lung cancer. A 72-year-old man had a past history of right upper lobectomy for pT3N0M0 tubular adenocarcinoma of the lung 12 years ago and left lower lobectomy for pT3N1M0 papillary adenocarcinoma of the lung 42 months ago, and left parotidectomy and irradiation to the neck for parotid metastasis 20 months ago. A progressive increase in serum CEA level during the follow-up period revealed a 5 cm left adrenal mass and small (1 cm or less) multiple brain metastases, and a 2 cm mediastinal lymph node. He underwent adrenalectomy and gamma knife surgery and received irradiation to the mediastinum, and was administered gefitinib as first-line chemotherapy for about a year. Brain metastases recurred despite 4 more rounds of gamma knife surgery and 4 cycles of docetaxel hydrate as second-line chemotherapy, and 1 cycle of vinorelbine ditartrate as third-line chemotherapy. He died of multiple brain metastases 65 months postoperatively. We confirm the possibility of long-term survival following multimodality treatment even though multiple organ metastases were found after resection of non-small cell lung cancer.
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Suzuki S, Suzuki N, Hattori A, Hayashibe M, Konishi K, Kakeji Y, Hashizume M. Tele-surgery simulation with a patient organ model for robotic surgery training. Int J Med Robot 2006; 1:80-8. [PMID: 17518408 DOI: 10.1002/rcs.60] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance.
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Affiliation(s)
- S Suzuki
- Institute for High Dimensional Medical Imaging, The Jikei University School of Medicine, Tokyo, Japan.
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Tanoue K, Yasunaga T, Kobayashi E, Miyamoto S, Sakuma I, Dohi T, Konishi K, Yamaguchi S, Kinjo N, Takenaka K, Maehara Y, Hashizume M. Laparoscopic cholecystectomy using a newly developed laparoscope manipulator for 10 patients with cholelithiasis. Surg Endosc 2005; 20:753-6. [PMID: 16341570 DOI: 10.1007/s00464-005-0177-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Accepted: 09/27/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Laparoscopic surgery has continued to gain popularity in almost all fields of abdominal surgery, and robotic systems have been introduced in general surgery. Naviot is a new remote-controlled laparoscope manipulator system controlled by the operator's hand. This study assessed its introduction into clinical practice. METHODS A group of 10 consecutive patients with cholelithiasis underwent laparoscopic cholecystectomy assisted by the Naviot system (Naviot group). Another group of 41 patients who underwent laparoscopic cholecystectomy with a conventional human camera holder (human camera group) were selected for a comparison of their operative results with those of the Naviot group. RESULTS The operative time of 89.3 +/- 27.1 min for the Naviot group was significantly longer than that of 74.8 +/- 28.1 min for the human camera group (p < 0.05). However, when the setup time for the Naviot system was excluded, the operative time was not significantly different from that for the human camera group. Other operative results showed no significant difference between the two groups. CONCLUSIONS The authors believe that the new Naviot system is feasible for clinical use, and that it enables surgeons to perform solo gastrointestinal surgery.
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Affiliation(s)
- K Tanoue
- Department of Innovative Medical Technology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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Katsuragi N, Nakajima Y, Shiraishi Y, Hashizume M, Takahashi N. [Chronic tuberculous methicillin-resistant Staphylococcus aureus (MRSA) empyema with bronchopleural fistulae treated by open window thoracostomy followed by thoracoplasty and latissimus dorsi muscle transposition]. Kyobu Geka 2005; 58:1121-4. [PMID: 16359009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We describe a case of chronic tuberculous methicillin-resistant Staphylococcus aureus (MRSA) empyema with bronchopleural fistulae successfully treated by open window thoracostomy followed by thoracoplasty and transposition of the latissimus dorsi muscle. A 69-year old man with a history of artificial pneumothorax for pulmonary tuberculosis was referred to our hospital with fever and purulent bloody sputum. He was diagnosed as having right chronic tuberculous empyema with bronchopleural fistulae. Immediate tube thoracostomy markedly relieved symptoms except for low-grade fever. Sputum and empyema cavity cultures were repeatedly positive for MRSA. Open window thoracostomy (5th to 7th ribs resection) was performed to control the infection. The empyema cavity was cleaned with no residual calcified pleura. His condition gradually improved and he underwent thoracoplasty and transposition of the latissimus dorsi muscle 22 months after the initial surgery. He was discharged 25 days postoperatively in good condition. Seventeen months after the curative surgery, he remains well with no evidence of recurrence. A two-stage operation, open window thoracostomy to control infection followed by thoracoplasty and transposition of the latissimus dorsi muscle, is useful in cases of chronic tuberculous MRSA empyema with bronchopleural fistulae.
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