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Han BH, Orozco MA, Miyoshi M, Doland H, Moore AA, Jones KF. Experiences of Aging with Opioid Use Disorder and Comorbidity in Opioid Treatment Programs: A Qualitative Analysis. J Gen Intern Med 2024:10.1007/s11606-024-08676-z. [PMID: 38436883 DOI: 10.1007/s11606-024-08676-z] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND The number of older adults entering opioid treatment programs (OTPs) to treat opioid use disorder (OUD) is increasing. However, the lived experiences of aging in OTPs have not been examined. OBJECTIVE To explore the aging experience with OUD and barriers to medical care for older adults who receive care in OTPs. DESIGN From November 2021 to July 2022, we conducted 1-to-1, semi-structured qualitative interviews in English and Spanish, audio-recorded, transcribed, systematically coded, and analyzed to identify key themes regarding the challenges of aging with OUD and managing chronic diseases. PARTICIPANTS Thirty-six adults aged ≥ 55 enrolled in OTPs in San Diego, California. APPROACH A descriptive qualitative approach was used. Major themes and subthemes were identified through thematic analysis until thematic saturation was reached. KEY RESULTS All participants were on methadone and had a mean age of 63.4 (SD 5.1) years; 11 (30.6%) identified as female, 14 (39%) as Hispanic/Latino, and 11 (36%) as Black, with a mean duration of methadone treatment of 5.6 years. Chronic diseases were common, with 21 (58.3%) reporting hypertension, 9 (25%) reporting untreated hepatitis C, and 32 (88.9%) having ≥ 2 chronic diseases. Three major themes emerged: (1) avoidance of medical care due to multiple intersectional stigmas, including those related to drug use, substance use disorder (SUD) treatment, ageism, and housing insecurity; (2) increasing isolation with aging and loss of family and peer groups; (3) the urgent need for integrating medical and aging-focused care with OUD treatment in the setting of increasing health and functional challenges. CONCLUSIONS Older adults with OUD reported increasing social isolation and declining health while experiencing multilevel stigma and discrimination. The US healthcare system must transform to deliver age-friendly care that integrates evidence-based geriatric models of care incorporated with substance use disorder treatment and addresses the intersectional stigma this population has experienced in healthcare settings.
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Affiliation(s)
- Benjamin H Han
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Mirella A Orozco
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Mari Miyoshi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Heidi Doland
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Alison A Moore
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Katie Fitzgerald Jones
- New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Jamaica Plain, MA, USA
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2
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Kim DJ, Lee HJ, Baik J, Hwang MJ, Miyoshi M, Kang Y. Improved Blood Suppression of Motion-Sensitized Driven Equilibrium in High-Resolution Whole-Brain Vessel Wall Imaging: Comparison of Contrast-Enhanced 3D T1-Weighted FSE with Motion-Sensitized Driven Equilibrium and Delay Alternating with Nutation for Tailored Excitation. AJNR Am J Neuroradiol 2022; 43:1713-1718. [PMID: 36265890 DOI: 10.3174/ajnr.a7678] [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] [Received: 05/12/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE High-resolution vessel wall MR imaging is prone to slow-flow artifacts, particularly when gadolinium shortens the T1 relaxation time of blood. This study aimed to determine the optimal preparation pulses for contrast-enhanced high-resolution vessel wall MR imaging. MATERIALS AND METHODS Fifty patients who underwent both motion-sensitized driven equilibrium and delay alternating with nutation for tailored excitation (DANTE) preparation pulses with contrast-enhanced 3D-T1-FSE were retrospectively included. Qualitative analysis was performed using a 4-grade visual scoring system for black-blood performance in the small-sized intracranial vessels, overall image quality, severity of artifacts, and the degree of blood suppression in all cortical veins as well as transverse sinuses. Quantitative analysis of the M1 segment of the MCA was also performed. RESULTS The qualitative analysis revealed that motion-sensitized driven equilibrium demonstrated a significantly higher black-blood score than DANTE in contrast-enhanced 3D-T1-FSE of the A3 segment (3.90 versus 3.58, P < .001); M3 (3.72 versus 3.26, P = .004); P2 to P3 (3.86 versus 3.64, P = .017); the internal cerebral vein (3.72 versus 2.32, P < .001); and overall cortical veins (3.30 versus 2.74, P < .001); and transverse sinuses (2.82 versus 2.38, P < .001). SNRlumen, contrast-to noise ratiowall-lumen, and SNRwall in the M1 vessel were not significantly different between the 2 preparation pulses (all, P > .05). CONCLUSIONS Motion-sensitized driven equilibrium demonstrated improved blood suppression on contrast-enhanced 3D-T1-FSE in the small intracranial arteries and veins compared with DANTE. Motion-sensitized driven equilibrium is a useful preparation pulse for high-resolution vessel wall MR imaging to decrease venous contamination and suppress slow-flow artifacts when using contrast enhancement.
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Affiliation(s)
- D J Kim
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - H-J Lee
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - J Baik
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.,Department of Radiology (J.B.), Good Gang-An Hospital, Busan, South Korea
| | - M J Hwang
- GE Healthcare Korea (M.J.H.), Seoul, South Korea
| | - M Miyoshi
- GE Healthcare Japan (M.M.), Tokyo, Japan
| | - Y Kang
- From the Department of Radiology (D.J.K., H.-J.L., J.B., Y.K.), Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Suetani Y, Iida Y, Hirose K, Shichijo K, Yamamoto S, Fukui T, Kuramoto M, Arita Y, Saeki H, Miyoshi M, Okada M, Ogasawara N. Urine osmolality predicts worsening renal function and poor prognosis in acute decompensated heart failure. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Purpose
Worsening renal function (WRF) can sometimes occur in the patients with acute decompensated heart failure (ADHF) and increase the risk of morbidity and mortality (1). In a previous study, it was reported that fractional excretion of sodium (FENa) reflects net sodium reabsorption from nephron segments and predicts WRF during treating ADHF (2). On the other hand, recently the new drugs which approach urine concentration mechanism and affect urine osmolality (U-OSM), such as tolvaptan and sodium-glucose cotransporter-2 inhibitor, have begun to be widely used as treatment of heart failure. Thus, we focused on U-OSM, which reflects not only sodium handling but also water excretion controlled by the collecting duct, and evaluated the association between WRF and U-OSM. Moreover, previous studies have demonstrated that FENa, fractional excretion of urea nitrogen and transtubular potassium concentration gradient are markers for long-term prognosis in patients with ADHF (3–5). Therefore, we also studied whether U-OSM can predict prognosis in ADHF.
Methods
A total of 157 patients admitted to our hospital because of a primary diagnosis of ADHF from February 2020 through July 2021 were retrospectively reviewed. U-OSM in the spot urinary samples were examined within 72 hours after admission. U-OSM was calculated based on the following validated formula (6): U-OSM = 1.07 × {2 × [urine sodium (mEq/L)] + [urine urea nitrogen (mg/dL)]/2.8 + [urine creatinine (mg/dl)] × 2/3} + 16.2. The primary outcome was the occurrence of WRF during hospitalization. WRF was defined as increased serum creatinine ≥0.3 mg/dL from baseline (7). The secondary outcome was the occurrence of ADHF readmission and all-cause death within 180 days after discharge.
Results
Primary Outcome. WRF developed in 46% of all patients. In the patients that developed WRF during hospitalization, U-OSM was significantly lower than in the patients without WRF (366±106 mOsm/L versus 430±128 mOsm/L; P<0.001). Receiver operating characteristic curve analysis revealed the optimal cutoff values of U-OSM was 403 mOsm/L (AUC 0.64; 95% CI: 0.56–0.72; P<0.001) to predict the WRF (Figure 1). On multivariable logistic regression analysis, U-OSM (OR, 1.99, 95% CI: 1.27–3.12; p=0.003) and serum creatinine (OR, 1.00, 95% CI: 0.99–1.00; P=0.009) were independent predictors of WRF.
Secondary Outcome. There were 34 patients (22%) readmitted and 9 patients (6%) died within 180 days after discharge. ROC curve analysis revealed the optimal cutoff values of U-OSM as 349 mOsm/L (C-statistic 0.74; 95% CI: 0.65–0.83; P<0.001) to predict ADHF readmission and all-cause death within 180 days (Figure 2A). On Kaplan-Meier analysis, the secondary outcome was significantly higher in patients with U-OSM<349 mOsm/L (u-OSM≥349, 57%, U-OSM<349, 43%; HR, 0.99; 95% CI: 0.99–1.00, P<0.001) (Figure 2B).
Conclusion
U-OSM on admission may be a predictor of WRF and a prognostic marker in ADHF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Suetani
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - Y Iida
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - K Hirose
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - K Shichijo
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - S Yamamoto
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - T Fukui
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Kuramoto
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - Y Arita
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - H Saeki
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Miyoshi
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - M Okada
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
| | - N Ogasawara
- Japan Community Healthcare Organization Osaka Hospital , Osaka , Japan
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Matsumoto H, Kida H, Nakanishi R, Miyoshi M. Usefulness of the synthesized 18-lead ECG in identify the origin of premature ventricular contractions. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
There are have been reports on the 12-lead ECG waveforms used to identify ventricular premature contractions (VPCs), but there are not enough algorithms. On the other hand, the synthesized 18-lead ECG adds the right-side chest leads (V3R, V4R, and V5R) and back leads (V7, V8, and V9) to the 12-lead ECG.
Purpose
This aim of this study was to evaluate whether the waveforms of the 18-lead ECG are useful in predicting the origin of VPCs.
Methods
We studied 86 consecutive patients (age :61.8±16.0 years, male: 54.5%) enrolled from multicenter who underwent radiofrequency catheter ablation for VPCs. We retrospectively investigated the association between origin of the VPCs and characteristics of the synthetic 18-leads ECG.
Results
The 18-lead ECG showed a specific pattern for the VPC originating near the His-bundle. In 17 cases, the QRS morphology in V5R exhibited a QS pattern, and 13 of 17 cases had VPCs originating near the His-bundle. In the other 69 cases, V5R did not exhibit a QS pattern. ROC curve analysis showed that the QS pattern in V5R predicted VPC originating near the His-bundle with high accuracy: sensitivity 100.0%, specificity 94.5%, and AUC 0.98. Furthermore, the positive predictive value was 76.5% and negative predictive value 100.0%.
Conclusion
The QS pattern shown in V5R of the 18-lead ECG was a useful parameter for identifying VPCs originating near the His-bundle, which might be a good reference indicator during radiofrequency catheter ablation for VPCs.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Matsumoto
- Japan Community Healthcare Organization Osaka Hospital, Department of Clinical Engineering , Osaka , Japan
| | - H Kida
- Osaka General Medical Center, Department of Clinical Engineer , Osaka , Japan
| | - R Nakanishi
- Nara Prefectural Seiwa Medical Center, Department of Clinical Engineer , Nara , Japan
| | - M Miyoshi
- Japan Community Healthcare Organization Osaka Hospital, Department of Cardiology , Osaka , Japan
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Kaufmann CN, Kim A, Miyoshi M, Han BH. Patterns of Medical Cannabis Use Among Older Adults from a Cannabis Dispensary in New York State. Cannabis Cannabinoid Res 2022; 7:224-230. [PMID: 33998868 PMCID: PMC9070740 DOI: 10.1089/can.2020.0064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 02/01/2023] Open
Abstract
Background: Cannabis use has increased among older adults. Few epidemiological studies have examined the medical diseases reported for cannabis use, routes of cannabis administration, and methods of consumption among older adults, and how they differ from younger adults. Methods: We analyzed invoice data on purchases of cannabis products from a large medical cannabis dispensary in New York State between January 1, 2016 and December 31, 2017. Data came from n=11,590 patients stratified by ages 18-49 (n=4,606), 50-64 (n=3,993), and ≥65 years (n=2,991). We assessed differences in groups by demographic characteristics of patients, qualifying conditions and symptoms for cannabis use, cannabis product dosing of THC and CBD, THC:CBD ratios, and cannabis delivery methods. Results: Among cannabis patients, 25.8% were aged ≥65 years, and 34.5% were ages 50-64. Across all age groups, severe or chronic pain was the predominant symptom for cannabis use, although older patients were more likely to use cannabis for cancer and Parkinson's disease among other conditions. Older adults were more likely to use sublingual tincture versus other consumption methods, to use products with a lower THC:CBD ratio, and to begin cannabis treatment with a lower THC and higher CBD dose compared with younger age groups. However, all age groups demonstrated a similar increase in THC dosing over time. Conclusion: Analysis of medical cannabis invoices from a dispensary in New York State showed that although there are similarities in patterns of cannabis use across all groups, there are key characteristics unique to the older adult medical cannabis user.
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Affiliation(s)
- Christopher N. Kaufmann
- Division of Geriatrics and Gerontology, Department of Medicine, University of California San Diego School of Medicine, San Diego, California, USA.,Address correspondence to: Christopher N. Kaufmann, PhD, MHS, Division of Geriatrics and Gerontology, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive, No. 0665, La Jolla, San Diego, CA 92093, USA
| | - Arum Kim
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Mari Miyoshi
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Benjamin H. Han
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, New York, USA
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6
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Okada M, Inoue K, Tanaka N, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Sunaga A, Sotomi Y, Dohi T, Shungo H, Sakata Y. Impact of heart rate reduction on recurrence after catheter ablation of persistent atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Johnson & Johnson KK
OnBehalf
OCVC Arrhythmia Investigators
Background
Predicting heart rate (HR) after restoration of sinus rhythm (SR) remains one of the challenges when performing catheter ablation (CA) of persistent atrial fibrillation (AF).
Purpose
To evaluate the association between pre-ablation HR during AF and post-ablation HR during SR, and whether the HR reduction is associated with AF recurrence.
Methods
The analysis was performed from the EARNEST-PVI trial, a randomized controlled trial designed to assess a CA strategy for persistent AF, which was conducted in the Osaka region of Japan. After excluding patients with beta-blocker prescription, a total of 216 patients (median age, 67 years; 20% female; 23% long-standing persistent AF) with AF rhythm at baseline and SR at discharge were enrolled in this study. Baseline HR during AF and post-ablation HR during SR was measured on admission and at discharge using the 12-lead electrocardiograms, respectively.
Results
There was a mild correlation between baseline HR (median 82 [interquartile range 72-95] bpm) and post-ablation HR (78 [48-117] bpm) (r = 0.27, p <0.001). Reduction in HR was positively associated with baseline HR (r = 0.79, p <0.001) and was negatively associated with post-ablation HR (r = - 0.37, p <0.001). During the follow-up of 1 year, 56 patients (25.9%) experienced AF recurrence. HR reduction had the higher diagnostic accuracy in predicting AF recurrence than HR at baseline and HR after CA (area under the curve, 0.625; 95% confidence interval, 0.557–0.690; p = 0.003). AF recurrence rate was significantly higher in 141 patients with smaller HR reduction (cut-off, <14bpm) than those with larger HR reduction (31.9% vs. 14.7%, p = 0.009). After adjustment of age, gender, long-standing persistent AF, and CA strategy, HR reduction of <14 bpm was a significant predictor of AF recurrence (hazard ratio, 2.32; 95% confidence interval, 1.20–4.51; p = 0.013).
Conclusions
There was a mild correlation between HR during AF and HR after restoration of SR in patients underwent CA of persistent AF. HR reduction after restoration of SR predicted AF recurrence.
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Affiliation(s)
- M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Osaka, Japan
| | | | | | - M Miyoshi
- Osaka Kouseinenkin Hospital, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - H Shungo
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Okada M, Inoue K, Tanaka N, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Reappraising the role of baseline plasma C-reactive protein levels on recurrence after catheter ablation of persistent atrial fibrillation: insight from EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Subclinical inflammation is an important pathogenesis of developing and sustaining atrial fibrillation (AF). Because AF itself contribute to the inflammatory response, the role of baseline subclinical inflammation on AF recurrence after catheter ablation (CA) remains controversial in patients with persistent AF.
Purpose
To evaluate whether baseline plasma C-reactive protein (CRP) levels, a sensitive marker of inflammation, are associated with AF recurrence following CA.
Methods
The analysis was performed from the EARNEST-PVI trial, a randomized controlled trial designed to assess a CA strategy for persistent AF, which was conducted in the Osaka region of Japan. A total of 441 patients (median age, 67 years; 26% female; 25% long-standing persistent AF) whose plasma CRP levels were measured at baseline were included in this study.
Results
At baseline, a median (interquartile range) of plasma CRP level was 0.10 [0.06–0.19] mg/dl. Plasma CRP levels significantly increased at discharge (0.83 [0.21–1.84] mg/dl, p<0.001) and decreased 1 year after CA (0.10 [0.05–0.20] mg/dl, p=0.040) compared to the baseline value. During the follow-up of 1 year, 115 patients (26%) experienced AF recurrence, and the incidence was significantly higher in 124 patients with low CRP levels at baseline (cut-off ≤0.06 mg/dl) than the other 317 patients (33.9% vs. 23.0%, p=0.017). After adjustment of age, gender, body mass index, long-standing persistent AF, CA strategy, and plasma brain natriuretic peptide levels, low plasma CRP levels was a significant predictor of AF recurrence (hazard ratio, 1.51; 95% confidence interval, 1.02–2.24; p=0.042).
Conclusions
Low plasma CRP levels at baseline predicted AF recurrence in the EARNEST-PVI trial. Reappraising the role of CRP on AF recurrence may be needed in patients with persistent AF.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Johnson & Johnson KK
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Affiliation(s)
- M Okada
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - N Tanaka
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Osaka, Japan
| | | | | | - M Miyoshi
- Osaka Kouseinenkin Hospital, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Osaka, Japan
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Tanaka N, Inoue K, Masuda M, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Okada M, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Renal function and arrhythmia outcomes in persistent atrial fibrillation patients after catheter ablation: subanalysis of the EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) reduces the renal function. Renal dysfunction and AF often coexist. Catheter ablation (CA) of persistent AF can maintain a sinus rhythm and may improve the renal function.
Purpose
We sought to elucidate whether the estimated glomerular filtration rate (eGFR) in patients with persistent AF was increased after CA, especially with the presence of an AF recurrence.
Methods
We enrolled 487 persistent AF patients whose eGFR data were available both before and 1-year after the CA out of 512 patients in the EARNEST-PVI trial.
Results
The mean age was 65±9 year and 113 patients (24.8%) had long-standing persistent AF. We compared the eGFR at baseline with that 1-year after the CA. AF recurrences were recognized in 118 patients (25.8%). The eGFR was similar between the group without recurrence and that with recurrence at baseline (without AF recurrence vs. with AF recurrence; 63.8±14.3 vs. 62.7±13.6 mL/min/1.73m2, p=0.46). In patients without AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 13 (3.8%), 198 (58.4%), 98 (28.9%), 26 (7.7%), 3 (0.9%), and 1 (0.3%), respectively at baseline. In the patients with AF recurrence, the G1, G2, G3a, G3b, G4, and G5 were 3 (2.5%), 68 (57.8%), 38 (32.2%), 6 (5.1%), 3 (2.5%), and 0 (0%), respectively at baseline. The ΔeGFR was significantly higher in the patients without AF recurrence than in those with AF recurrence (without AF recurrence vs. with AF recurrence; 5.1 [−0.3, 10.8] vs. 3.0 [−3.0, 7.6], p=0.0033). In the patients without AF recurrence, a better eGFR class at 1-year after the CA than in those before the CA was recognized in 75 patients (22.1%), while it was recognized in 19 patients (16.1%) with AF recurrences.
Conclusion
Successful catheter ablation in patients with persistent AF led to a better renal outcome.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): This study was funded by Medtronic, Johnson & Johnson, and Abbott.
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Affiliation(s)
- N Tanaka
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - M Masuda
- Kansai Rosai Hospital, Amagasaki, Japan
| | - Y Furukawa
- Osaka General Medical Center, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Sakai, Japan
| | - T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | | | - M Miyoshi
- Osaka Hospital, Japan Community Healthcare Organization, Osaka, Japan
| | - M Okada
- Sakurabashi-Watanabe Hospital, Cardiovascular Center, Osaka, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Suita, Japan
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9
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Kanda T, Masuda M, Inoue K, Furukawa Y, Hirata A, Egami Y, Watanabe T, Minamiguchi H, Miyoshi M, Matsuda Y, Sunaga A, Sotomi Y, Dohi T, Hikoso S, Sakata Y. Differences in quality of life improvement with pulmonary vein isolation alone vs. more extensive ablation of persistent atrial fibrillation: insights from the EARNEST-PVI trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Improving the quality of life (QoL) is one of the main purposes of catheter ablation (CA) of persistent atrial fibrillation (AF). QoL improvement in persistent AF patients has not been fully clarified. The EARNEST-PVI trial was a multi-center randomized trial comparing clinical outcomes of pulmonary vein isolation (PVI) alone and more intensive ablation in addition to PVI including complex fractionated atrial electrogram (CFAE) and linear ablation (PVI plus).
Purpose
To investigate the QoL change after persistent AF ablation and the differences between the PVI-alone strategy and the PVI plus strategy.
Methods
In the EARNEST-PVI trial, patients with persistent AF who underwent an initial catheter ablation (n=512) were randomly assigned in a 1:1 ratio to either PVI alone or PVI plus. Quality of life was assessed at baseline and at 12 months after ablation for AF using the 36-Item Short Form Health Survey. Scores were also converted to a physical health component summary (PCS), a mental health component summary (MCS) and a role/social component summary (RCS).
Results
In the EARNEST-PVI trial, the PVI alone strategy was associated with higher recurrence rate compared with the PVI plus additional ablation strategy. After excluding 68 patients for whom preoperative or postoperative QoL assessment was not available, 222 patients were evaluated respectively. Overall, significant improvements in PCS (46.2±11.4 to 48.7±11.4]), MCS (50.1±8.8 to 54.3±8.6) and RCS (44.6±13.3 to 48.6±11.3) occurred 12 months after ablation (P<0.001, respectively). Although significant QoL improvement occurred in both PVI alone and PLI plus strategies, the changes in PCS was greater in the PVI-plus than that in PVI-alone (3.5±10.3 vs 1.5±10.6, P=0.04).
Conclusions
Ablation for persistent atrial fibrillation improved both physical and mental quality of life. The PVI-plus strategy showed greater improvement in physical QoL.
Funding Acknowledgement
Type of funding sources: None. QoL improvement
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Affiliation(s)
- T Kanda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Masuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Cardiovascular center, Osaka, Japan
| | - Y Furukawa
- Osaka General Medical Center, Division of Cardiology, Osaka, Japan
| | - A Hirata
- Osaka Police Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Egami
- Osaka Rosai Hospital, Division of Cardiology, Osaka, Japan
| | - T Watanabe
- Yao Municipal Hospital, Division of Cardiology, Yao, Japan
| | - H Minamiguchi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - M Miyoshi
- Japan Community Health care Organization Osaka Hospital, Division of Cardiology, Osaka, Japan
| | - Y Matsuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - A Sunaga
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - T Dohi
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiovascular Medicine, Suita, Japan
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10
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Han BH, Miyoshi M, Palamar JJ. Substance Use Among Middle-Aged and Older Lesbian, Gay, and Bisexual Adults in the United States, 2015 to 2017. J Gen Intern Med 2020; 35:3740-3741. [PMID: 32483690 PMCID: PMC7728927 DOI: 10.1007/s11606-020-05635-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/04/2019] [Accepted: 01/03/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Benjamin H Han
- Department of Medicine, Division of Geriatric Medicine and Palliative Care, New York University School of Medicine, New York, NY, USA. .,Department of Population Health, New York University School of Medicine, New York, NY, USA. .,Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, USA.
| | - Mari Miyoshi
- John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, USA
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11
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Ishikawa M, Nomura M, Miyoshi M, Nishi N, Yokoyama T, Miura H. A self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of non-communicable disease in Fiji. BMC Health Serv Res 2019; 19:838. [PMID: 31727066 PMCID: PMC6857309 DOI: 10.1186/s12913-019-4695-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background According to the World Health Organization, an estimated 80% or more deaths in Pacific island countries, including Fiji, were related to non-communicable diseases (NCDs). Although competency-based approaches have been effective for developing healthcare workers’ capabilities, there are only a few reports on competency scales of healthcare workers for NCD prevention. We aimed to develop a self-reported measurement scale on a potential component of competency in the healthcare staff engaged in the prevention and control of NCDs in Fiji. Methods There were 378 Ministry of Health and Medical Services staff members working on NCD prevention and control in Fiji included in this study, which was a cross-sectional survey of social factors, working situation factors, and competency. Exploratory factor analysis was conducted to assess potential competency components, whereas Cronbach’s α coefficient and analysis of variance were used to assess the validity and reliability of the scale items, respectively. Multivariate regression analyses were conducted to analyze the respondents’ factor scores relative to social status and work situations. Results The factor analysis revealed 16 items that identified competency in four work types: 1) work management, 2) monitoring and evaluation, 3) community partnership, and 4) community diagnosis. The monitoring and evaluation roles were related to ethnic background, community partnership was related to religion, and community diagnosis was related to academic qualifications. Conclusions Based on the results, we developed a competency scale for the four work types. This scale can help healthcare workers engage in better management of residents with NCDs in Fiji.
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Affiliation(s)
- M Ishikawa
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - M Nomura
- Department of International Health and Collaboration, National Institute of Public Health, 3-6 Wako, Saitama, 351-0197, Japan
| | - M Miyoshi
- Department of Nutrition, Faculty of Health Sciences, Aomori University of Health and Welfare, 58-1, Mase, Hamadate, Aomori, 030-8505, Japan
| | - N Nishi
- International Center for Nutrition and Information, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - T Yokoyama
- Department of Health Promotion, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - H Miura
- Department of International Health and Collaboration, National Institute of Public Health, 3-6 Wako, Saitama, 351-0197, Japan
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12
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Abe I, Terabayashi T, Teshima Y, Ishii Y, Miyoshi M, Kira S, Kondo H, Saito S, Yufu K, Takahashi N, Ishizaki T. 1181Role of rho-mdia1 signaling to maintain cardiac function in response to pressure overload in mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac hypertrophy is a compensatory response to pressure overload that leads to heart failure. Recent studies have shown that Rho signaling has crucial regulatory roles in actin cytoskeleton rearrangement during cardiac hypertrophic responses. Rho is rapidly activated in response to pressure overload, but the mechanisms by which Rho and its downstream proteins control actin dynamics during hypertrophic responses remain unclear.
Objective
To identify the essential roles of mDia1 (Rho-effector molecule) in pressure overload-induced ventricular hypertrophy.
Methods and results
Male wild-type (WT) and mDia1-knockout (mDia1KO) mice (10–12 weeks old) were subjected to transverse aortic constriction (TAC) or a sham operation. The heart weight/tibia length ratio, cardiomyocyte cross-sectional area, left ventricular wall thickness, and expression of hypertrophy-specific genes were significantly decreased in mDia1KO mice 3 weeks after TAC, and the mortality rate was higher at 12 weeks. Echocardiography and the pressure-volume loop indicated that mDia1 deletion increased the severity of heart failure 8 weeks after TAC. Microarray gene expression profiling showed that the induction of immediate early genes due to the TAC operation was significantly lower in mDia1KO mice than WT mice, as was the activation of extracellular signal-regulated kinase (ERK) and focal adhesion kinase (FAK). We examined the role of mDia1 in neonatal rat ventricular cardiomyocytes (NRVMs) exposed to mechanical stress. The siRNA-mediated silencing of mDia1 attenuated stretch-induced ERK and FAK phosphorylation, and gene expression of c-fos. Importantly, loss of mDia1 suppressed an increase in the F/G-actin ratio in response to pressure overload in the mice. In addition, increases in nuclear myocardin-related transcription factors (MRTFs) and serum response factor (SRF) were perturbed in response to pressure overload in mDia1KO mice and to mechanical stretch in mDia1 depleted NRVMs.
Conclusions
Rho-mDia1, through actin dynamics, plays critical roles in pressure overload-induced hypertrophy by regulating ERK and FAK phosphorylation and the transcriptional activity of MRTF-SRF.
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Affiliation(s)
- I Abe
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - T Terabayashi
- Oita University, Department of Pharmacology, Yufu, Japan
| | - Y Teshima
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - Y Ishii
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - M Miyoshi
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - S Kira
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - H Kondo
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - S Saito
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - K Yufu
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - N Takahashi
- Faculty of Medicine, Oita University, Department of Cardiology and Clinical Examination, Oita, Japan
| | - T Ishizaki
- Oita University, Department of Pharmacology, Yufu, Japan
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13
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Ishii Y, Yufu K, Kira S, Miyoshi M, Abe I, Oniki T, Kondo H, Saito S, Fukui A, Okada N, Akioka H, Shinohara T, Teshima Y, Nakagawa M, Takahashi N. 4090Maximum standardized uptake value of pericardial fat for prediction of ventricular arrhythmias in patients with cardiac sarcoidosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac sarcoidosis is a cause of epicarditis and sustained life-threatening ventricular arrhythmias. These arrhythmias occasionally arise from epicardial. Positron emission tomogramphy-comututed tomography (PET-CT) is useful for diagnosis with sarcoidosis. However, the usefulness for prediction of ventricular arrhythmias in patients with cardiac sarcoidosis is unknown.
Objective
We hypothesized that the evaluation of pericardial fat inflammation could identify high-risk sarcoidosis patients for ventricular arrhythmias.
Methods
We enrolled 20 consecutive patients with cardiac sarcoidosis performed PET-CT between August 2016 and December 2018. In each case, we measured the maximum standardized uptake value (SUVmax) of pericardial fat around the left atrium, both ventricules, atrioventricular groove, and left main coronary.
Results
Seven patients experienced ventricular tachycardia (VT) or ventricular fibrillation (VF). VT/VF patients had significantly more complete right bundle branch block (P=0.035), larger left atrial dimension (P=0.021), larger left ventricular end-diastolic dimension (P=0.005), lower ejection fraction (P=0.007), and higher E/e' (P=0.004). SUVmax of pericardial fat in the roof of left atrium (LA) and left ventricular (LV) with VT/VF patients were significantly higher than non-VT/VF patients (LA: 1.63 vs 1.32, P=0.0311; LV: 1.84 vs 1.26, P=0.045). The cut-off values of SUVmax derived from the ROC curve in the roof of LA and LV are 1.47 and 1.59 respectively. The Kaplan Meire estimator showed that high SUVmax patients in the roof of LA had significantly more detection of NSVT.
Conclusions
Our results suggest the relationship between SUVmax and VT/VF occurrence in patients with cardiac sarcoidosis. The evaluateon of SUVmax may be useful for VT/VF risk stratification.
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Affiliation(s)
- Y Ishii
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - K Yufu
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - S Kira
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - M Miyoshi
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - I Abe
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - T Oniki
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - H Kondo
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - S Saito
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - A Fukui
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - N Okada
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - H Akioka
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - T Shinohara
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - Y Teshima
- Oita University, Department of Cardiology and Clinical Examination, Faculty of Medicine, Yufu, Japan
| | - M Nakagawa
- Oita University, Department of Medical Education Center, Faculty of Medicine, Yufu, Japan
| | - N Takahashi
- Oita University, Department of Medical Education Center, Faculty of Medicine, Yufu, Japan
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14
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Kira S, Abe I, Teshima Y, Ishii Y, Miyoshi M, Oniki T, Fukui A, Shinohara T, Shimada T, Yufu K, Nakagawa M, Takahashi N. P1628Angiopoietin-like protein (Angptl) 2 secreted from epicardial adipose tissue induces atrial myocardial fibrosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Using excised human left atrial appendage samples, we previously demonstrated that epicardial adipose tissue (EAT) are highly associated with atrial myocardial fibrosis as a substrate of atrial fibrillation (AF). We also reported the relationship between Angptl2 in EAT and atrial fibrosis. However, the mechanism is not clear. The purpose is to clarify the mechanisms underlying the effect of EAT on the atrial myocardium.
Methods
Human peri-left atrial EAT and abdominal subcutaneous adipose tissue (SAT) samples were obtained from 6 cases (2 females, 70.2±13.2 years). 50 mg of EAT and SAT were quickly washed with PBS and centrifuged 1min at 1200rpm. After 3 times this procedures, adipose tissues were cultured in DMEM F12 medium with Fetal bovine Serum (FBS) overnight.
After pre-incubation, EAT and SAT tissues were washed and centrifuge d three times and cultured in medium without FBS for 24hours. Finally, we collected oozed medium (conditioned medium) and used for experiments.
Concentrations of Angptl2 in conditioned medium were measured by ELISA.
To study the effects of conditioned medium, we used “organo-culture” system. Isolated atrium from 8week old male Sprague-Dawley rats were placed on the porous membrane with the endothelial face toward the membrane. After that, loading medium (conditioned medium:culture medium = 1:4), culture medium (control), or recombinant Angptl2 were dropped onto the epicardial face of the atrium once a day and incubated for 7 days (37°C, 5% CO2).
Then, histological and immunohistochemical analysis were performed. We also performed quantitative reverse transcription–polymerase chain reaction (RT–PCR) analysis.
Next, we isolated and cultured neonatal rat fibroblast and loaded Angptl2 for 24 hours.After collected these cells, we performed western blotting analysis.
Results
Atria organo-culture incubated for 7 days with conditioned medium showed global fibrosis. At epicardial side, fibrotic area of EAT group was significantly greater compared to that of SAT and control group (P<0.05).
mRNA of Col1a1, col3a1 and TGFβ1 were significantly increased in EAT group compared with the SAT and control group.
And, the concentration of conditioned medium created from EAT was significant higher than that from SAT (P<0.05).
Then, we dropped 500 ng/ml of recombinant Angptl2 onto the rat atria. Fibrotic area of Angptl22 group significantly greater than that of control with increasing number of α-SMA positive cells, and mRNA of col3a1 and TGFβ1 were significantly increased in Angptl2 group compared with control group.
In cultured fibroblasts, α-SMA and p-ERK expression were increased in Angptl2 group measured by western blotting analysis.
Conclusions
Our results demonstrated that EAT rather than SAT induces atrial myocardial fibrosis. There is a possibility that Angptl2 effused from EAT plays a part in atrial fibrosis thought EAT paracrine effect.
Acknowledgement/Funding
ONO PHARMACEUTICAL CO
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Affiliation(s)
- S Kira
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - I Abe
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - Y Teshima
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - Y Ishii
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - M Miyoshi
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - T Oniki
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - A Fukui
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - T Shinohara
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - T Shimada
- Oita College of Judo Therapy & Acupuncture & Moxibustion, Oita, Japan
| | - K Yufu
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
| | - M Nakagawa
- Oita University, Medical Education Center, Yufu, Japan
| | - N Takahashi
- Oita University, Cardiology and Clinical Examination, Yufu, Japan
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15
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Mikajiri R, Fukunaga A, Miyoshi M, Maeshige N, Kido Y, Usami M. MON-PO637: Dietary Intervention for Systemic Metal Allergy Patients on Clinical Symptom and Urinary Metal Excretion. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32470-7] [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: 10/26/2022]
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16
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Miyoshi M, Nishiyama Y, Kai M, Maeshige N, Shinohara M, Fueda Y, Usami M. SUN-PO005: Soleus Muscle Contains Higher Lipid Mediators than Extensor Digitorum Longus: Slow/Fast Fiber-Specific Analysis in Endotoxemia Using LC-MS/MS. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32642-1] [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: 10/26/2022]
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17
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Yonishi T, Minamiguchi J, Shiraki T, Matsuda Y, Ozu K, Kanda T, Masuda M, Miyoshi M, Mizote I, Mizuno Y, Hikoso S, Sakata Y. P6599Clinical impact of thyroxin levels on recurrence of atrial fibrillation after catheter ablation for patients without thyroid dysfunction: a multicenter study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Yonishi
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - J Minamiguchi
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - T Shiraki
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - Y Matsuda
- Kansai Rosai Hospital, Department of Cardiology, Amagasaki, Japan
| | - K Ozu
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - T Kanda
- Kansai Rosai Hospital, Department of Cardiology, Amagasaki, Japan
| | - M Masuda
- Kansai Rosai Hospital, Department of Cardiology, Amagasaki, Japan
| | - M Miyoshi
- JCHO Osaka Hospital, Department of Cardiology, Osaka, Japan
| | - I Mizote
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - Y Mizuno
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine, Department of Cardiology, Osaka, Japan
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18
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Haresaku S, Monji M, Miyoshi M, Kubota K, Kuroki M, Aoki H, Yoshida R, Machishima K, Makino M, Naito T. Factors associated with a positive willingness to practise oral health care in the future amongst oral healthcare and nursing students. Eur J Dent Educ 2018; 22:e634-e643. [PMID: 29877022 DOI: 10.1111/eje.12369] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The purpose of this study was to identify the weak points in the knowledge and attitudes of first-year oral health care and nursing students towards oral health care and to identify the factors associated with their positive willingness to practise oral health care after becoming a health professional in order to develop oral healthcare curricula. MATERIALS AND METHODS The subjects were 88 first-year dental students (DSs), 64 dental hygiene students (DHSs) and 119 nursing students (NSs) enrolled in schools in Japan, as of April 2017. A questionnaire was distributed to subjects in each school to assess their knowledge and attitudes towards oral health care. RESULTS Less than half knew that oral health care was also provided in cancer hospitals, hospices, acute care hospitals, maternity wards and psychiatric wards. Only 46.2% knew that oral health care was effective in the prevention of aspiration pneumonia. The level of knowledge and attitudes in NSs regarding oral health care were likely to be lowest amongst the student groups. Only NSs' high interest towards oral health care was associated with their positive willingness to practise oral health care in the future although oral health students' high perceptions and interest regarding oral health care were associated with the willingness. CONCLUSION This study showed oral healthcare and nursing students' weak points regarding their attitudes and knowledge of oral health care at early stages. Oral health academic staff and professionals should develop effective oral healthcare curricula for oral healthcare students and help nursing staff develop a collaborative nursing oral healthcare curriculum to motivate nursing students.
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Affiliation(s)
- S Haresaku
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - M Monji
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - M Miyoshi
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - K Kubota
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - M Kuroki
- Department of Dental Hygiene, Fukuoka College of Health Sciences, Fukuoka, Japan
| | - H Aoki
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - R Yoshida
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - K Machishima
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - M Makino
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - T Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
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19
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Nakano N, Mori M, Umebayashi H, Iwata N, Kobayashi N, Masunaga K, Imagawa T, Murata T, Kinjo N, Nagai K, Miyoshi M, Takei S, Yokota S, Ishii E. Characteristics and outcome of intractable vasculitis syndrome in children: Nation-wide survey in Japan. Mod Rheumatol 2017; 28:697-702. [PMID: 29219653 DOI: 10.1080/14397595.2017.1404700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Primary systemic vasculitis (PSV) is a rare disorder in children and difficult to distinguish from other diseases. However, appropriate diagnosis and prompt treatment will affect on the morbidity and mortality of intractable PSV. In this study, we conducted a nationwide survey in Japan, to clarify epidemiology and clinical outcome of PSV. METHODS We had sent survey questionnaires to most of the Japanese institutions that employed pediatricians, requesting the number of patients with refractory PSV who were diagnosed and treated between 2007 and 2011. Respondents were asked to provide detailed information on the clinical and laboratory features of each case they had managed. Those with Kawasaki disease or Henoch-Shönlein purpura vasculitis (IgA vasculitis) were excluded. RESULTS Of all the institutions surveyed, 1123 (37.3%) patients responded, finally, total of 49 patients with intractable PSV, defined by those with resistant to treatment and steroid-dependent, or with any complication associated with prognosis, were selected. The diagnosis was Takayasu arteritis in 31, polyarteritis nodosa in 11, granulomatosis with polyangitis in 2, microscopic polyangitis in 1, and ANCA negative microscopic polyangitis in 1. In those with Takayasu arteritis, 67% were treated with an immunosuppressive agent, 22% with biological modifiers, and 16% with surgical procedures. In other types of disease, 88% of the patients were treated with an immunosuppressive agent, and 12% with biological modifiers. Two with Takayasu arteritis died being terminally ill. CONCLUSION This nationwide survey establishes the heterogeneous characteristics of PSV in children. Although questionnaire-based, the results of our analysis should be useful in planning prospective studies to identify the most effective therapy for each subtype of multifaceted disease.
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Affiliation(s)
- Naoko Nakano
- a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan
| | - Masaaki Mori
- b Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University , Tokyo , Japan
| | - Hiroaki Umebayashi
- c Department of General Pediatrics , Miyagi Children's Hospital , Miyagi , Japan
| | - Naomi Iwata
- d Department of Immunology and Infectious Diseases , Aichi Children's Health and Medical Center , Aichi , Japan
| | - Norimoto Kobayashi
- e Department of Pediatrics , Shinshu University School of Medicine , Nagano , Japan
| | - Kenji Masunaga
- f Department of Pediatrics , Kurume University School of Medicine , Fukuoka , Japan
| | - Tomoyuki Imagawa
- g Division of Infection, Immunology and Rheumatology , Kanagawa Children's Medical Center , Kanagawa , Japan
| | - Takuji Murata
- h Department of Pediatrics , Osaka Medical College , Osaka , Japan
| | - Noriko Kinjo
- i Department of Pediatrics , University of the Ryukyu , Okinawa , Japan
| | - Kazushige Nagai
- j Department of Pediatrics , Sapporo Medical University School of Medicine , Hokkaido , Japan
| | - Mari Miyoshi
- k Department of Allergy and Immunology , Hyogo Prefectural Kobe Children's Hospital , Hyogo , Japan
| | - Syuji Takei
- l School of Health Science, Faculty of Medicine , Kagoshima University , Kagoshima , Japan
| | - Shumpei Yokota
- m Department of Pediatrics , Yokohama City University , Kanagawa , Japan
| | - Eiichi Ishii
- a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan
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Aida I, Miyoshi M, Endo H, Tobinaga M, Ikeda T, Oota K, Yonemochi Y, Takahara M, Kanaya H, Ozawa T, Nakajima T. Percutaneous endoscopic gastrostomy procedure in patients with advanced duchenne muscular dystrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Morishita T, Uzui H, Amaya N, Kaseno K, Ishida K, Fukuoka Y, Ikeda H, Hasegawa K, Tama N, Shiomi Y, Sato Y, Miyoshi M, Kataoka T, Tsuji T, Tada H. P1550CHADS2, CHA2DS2-VASc and SYNTAX scores in the prediction of clinical outcomes in patients with acute coronary syndrome after percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Miyoshi M, Kondo H, Shinohara T, Takahashi N. P778Pulmonary vein antrum isolation by radiofrequency catheter ablation depresses baroreflex sensitivity in association with heart rate variability in patients with paroxysmal atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kakuta K, Dohi K, Okuyama K, Miyoshi M, Yamanaka T, Kawamura M, Masuda J, Kurita T, Yamada N, Sumida Y, Ito M. P6479Impact of renal function on the underlying pathophysiology of coronary plaque composition in patients with type 2 diabetes mellitus. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kondo H, Shinohara T, Miyoshi M, Ishii Y, Otsubo T, Takahashi N. P4592Baroreflex sensitivity could predicts the presence of left atrial low voltage zone and atrial fibrillation recurrence after pulmonary vein isolation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hisazaki K, Kaseno K, Hasegawa K, Amaya N, Sato Y, Miyoshi M, Shiomi Y, Tama N, Ikeda H, Fukuoka Y, Morishita T, Ishida K, Uzui H, Tada H. P872How to predict phrenic nerve injury during cryoballoon ablation of atrial fibrillation?: Importance of the CMAP amplitude and cryoballoon temperature monitoring. Europace 2017. [DOI: 10.1093/ehjci/eux151.054] [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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Suzuki K, Sunami K, Ohashi K, Iida S, Mori T, Handa H, Matsue K, Miyoshi M, Bleickardt E, Matsumoto M, Taniwaki M. Randomized phase 3 study of elotuzumab for relapsed or refractory multiple myeloma: ELOQUENT-2 Japanese patient subanalysis. Blood Cancer J 2017; 7:e540. [PMID: 28282035 PMCID: PMC5380903 DOI: 10.1038/bcj.2017.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- K Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - K Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - K Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - S Iida
- Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan
| | - T Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - H Handa
- Integrative Center of Internal Medicine, Division of Hematology, Gunma University Hospital, Gunma, Japan
| | - K Matsue
- Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - M Miyoshi
- Bristol-Myers Squibb K.K, Tokyo, Japan
| | - E Bleickardt
- Oncology Clinical Development, Bristol-Myers Squibb, Princeton, NJ, USA
| | - M Matsumoto
- Department of Hematology, National Hospital Organisation, Shibukawa Medical Center, Shibukawa, Japan
| | - M Taniwaki
- Department of Hematology, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Matsuo M, Miyoshi M, Ueno M, Yamashita H, Kajita A, Takahashi M, Yamamoto M, Shiba Y, Uchida J, Nakashima S, Yamanishi M, Wakida K, Tabuchi S, Mikajiri R, Yamamoto I, Usami M, Sakamoto N. MON-P133: Analysis of the Body Composition Distribution by Confidence Ellipse of RXC Graph for Japanese Diabetes Mellitus Patients. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30767-1] [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: 10/21/2022]
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Kajita A, Miyoshi M, Kai M, Nishiyama Y, Yamashita H, Ueno M, Matsuo M, Shinohara M, Usami M. MON-P039: Impact Of Oral Tributyrin Treatment on LC-MS/MS Based Lipid Mediator Profiles in Endotoxin Induced Hepatic Injury. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30673-2] [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: 10/21/2022]
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Ueno M, Miyoshi M, Matsuo M, Yamashita H, Kajita A, Hamada Y, Takahashi M, Yamamoto M, Yamamoto I, Mikajiri R, Tabuchi S, Wakida K, Yamanishi M, Hirai M, Usami M. SUN-P007: Effect of Dietary Fatty Acids and Micronutrients Intake on Serum Diamine Oxidase Activity in Healthy Women. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30350-8] [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: 12/01/2022]
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Kai M, Fujiwara M, Miyoshi M, Nishiyama Y, Aoyama-Ishikawa M, Maeshige N, Inoue T, Uemura M, Yamashita H, Koga Y, Usami M. SUN-PP039: Up-Regulation of Hepatic Ppara and Pparγ in Endotoxemic Rats by Feeding Lard-Rich High-Fat Diet for 12 Weeks. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30190-4] [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: 11/28/2022]
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Nishiyama Y, Miyoshi M, Kai M, Aoyama-Ishikawa M, Maeshige N, Inoue T, Uemura M, Yamashita H, Koga Y, Usami M. SUN-PP074: Skeletal Muscle Atrophy is Induced at Early Phase in Endotoxemic Rats and Oral Administration of Tributyrin Attenuates the Atrophy. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30225-9] [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: 11/28/2022]
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Kobayashi N, Takezaki S, Kobayashi I, Iwata N, Mori M, Nagai K, Nakano N, Miyoshi M, Kinjo N, Murata T, Masunaga K, Umebayashi H, Imagawa T, Agematsu K, Sato S, Kuwana M, Yamada M, Takei S, Yokota S, Koike K, Ariga T. Clinical and laboratory features of fatal rapidly progressive interstitial lung disease associated with juvenile dermatomyositis. Rheumatology (Oxford) 2014; 54:784-91. [PMID: 25288783 DOI: 10.1093/rheumatology/keu385] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Rapidly progressive interstitial lung disease (RP-ILD) is a rare but potentially fatal complication of JDM. The aim of this study was to establish markers for the prediction and early diagnosis of RP-ILD associated with JDM. METHODS The clinical records of 54 patients with JDM were retrospectively reviewed: 10 had RP-ILD (7 died, 3 survived), 19 had chronic ILD and 24 were without ILD. Routine tests included a high-resolution CT (HRCT) scan of the chest and measurement of serum levels of creatine phosphokinase, ferritin and Krebs von den Lungen-6 (KL-6). Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies and IL-18 levels were measured by ELISA. RESULTS No differences were found in the ratio of juvenile clinically amyopathic DM between the three groups. Initial chest HRCT scan findings were variable and could not distinguish between RP-ILD and chronic ILD. Anti-MDA5 antibodies were positive in all 8 patients with RP-ILD and 10 of 14 with chronic ILD, but none of the patients without ILD. Serum levels of anti-MDA5 antibody, ferritin, KL-6 and IL-18 were significantly higher in the RP-ILD group than in the chronic ILD and non-ILD groups. Serum levels of IL-18 positively correlated with serum KL-6 (R = 0.66, P < 0.001). CONCLUSION High serum levels of IL-18, KL-6, ferritin and anti-MDA5 antibodies (e.g. >200 units by ELISA) are associated with RP-ILD. These can be used as an indication for early intensive treatment. Both alveolar macrophages and autoimmunity to MDA5 are possibly involved in the development of RP-ILD associated with JDM.
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Affiliation(s)
- Norimoto Kobayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shunichiro Takezaki
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Ichiro Kobayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Naomi Iwata
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masaaki Mori
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kazushige Nagai
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Naoko Nakano
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mari Miyoshi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Noriko Kinjo
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Takuji Murata
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kenji Masunaga
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroaki Umebayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tomoyuki Imagawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kazunaga Agematsu
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shinji Sato
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masataka Kuwana
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masafumi Yamada
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shuji Takei
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shumpei Yokota
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Kenichi Koike
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Tadashi Ariga
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Department of Immunology and Infectious Diseases, Aichi Children's Health and Medical Center, Ohbu, Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Department of Pediatrics, Ehime University Graduate School of Medicine, Matsuyama, Department of Allergy & Immunology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Department of Pediatrics, University of the Ryukyus, Naha, Department of Pediatrics, Osaka Medical College, Takatsuki, Department of Pediatrics, Kurume University School of Medicine, Kurume, Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Division of Infection, Immunology and Rheumatology, Kanagawa Children's Medical Center, Yokohama, Department of Infection and Host Defense, Shinshu University Graduate School of Medicine, Matsumoto, Department of Rheumatology, Tokai University School of Medicine, Isehara, Department of Rheumatology, Keio University School of Medicine, Tokyo and School of Health Science, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Miyoshi M, Fujiwara M, Aoyama-Ishikawa M, Nishiokada A, Kai M, Nishiyama Y, Maeshige N, Usami M. PP079-SUN: Oral Administration of Tributyrin Attenuates Lipopolysaccharide-Induced Intestinal Injury in Rat. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50121-5] [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: 10/24/2022]
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Nishiokada A, Miyoshi M, Fujiwara M, Aoyama-Ishikawa M, Nishiyama Y, Kai M, Maeshige N, Takahashi M, Hamada Y, Usami Y, Arita M, Usami M. PP010-SUN: Changes of Hepatic Lipid Mediators Associated with Intake of High-Fat Diet for 12 Weeks in Endotoxemic Rats using LC-ESI-MS/MS. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50052-0] [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: 11/28/2022]
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Abstract
Macrophage activation syndrome (MAS) is a severe and potential life-threatening complication of childhood systemic inflammatory disorders. Corticosteroids are commonly used as the first-line therapy for MAS. We report four patients with MAS who were successfully treated with dexamethasone palmitate (DexP), a liposome-incorporated dexamethasone, much more efficient than free corticosteroids. DexP effectively inhibited inflammation in MAS patients in whom the response to pulse methylprednisolone was not sufficient to manage their diseases. DexP was also effective as the first-line therapy for MAS. Based on these findings, DexP is an effective therapy in treating MAS patients.
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Affiliation(s)
- Yasuo Nakagishi
- a Department of Pediatric Rheumatology , Hyogo Prefectural Kobe Children's Hospital , Kobe , Hyogo , Japan
| | - Masaki Shimizu
- b Department of Pediatrics , School of Medicine, Institute of Medical Pharmaceutical, and Health Sciences, Kanazawa University , Kanazawa , Japan
| | - Kazuko Kasai
- a Department of Pediatric Rheumatology , Hyogo Prefectural Kobe Children's Hospital , Kobe , Hyogo , Japan
| | - Mari Miyoshi
- a Department of Pediatric Rheumatology , Hyogo Prefectural Kobe Children's Hospital , Kobe , Hyogo , Japan
| | - Akihiro Yachie
- b Department of Pediatrics , School of Medicine, Institute of Medical Pharmaceutical, and Health Sciences, Kanazawa University , Kanazawa , Japan
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Yokota S, Imagawa T, Mori M, Miyamae T, Takei S, Iwata N, Umebayashi H, Murata T, Miyoshi M, Tomiita M, Nishimoto N, Kishimoto T. Longterm Safety and Effectiveness of the Anti-interleukin 6 Receptor Monoclonal Antibody Tocilizumab in Patients with Systemic Juvenile Idiopathic Arthritis in Japan. J Rheumatol 2014; 41:759-67. [DOI: 10.3899/jrheum.130690] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To assess the longterm safety and effectiveness of tocilizumab (TCZ) in systemic-onset juvenile idiopathic arthritis (sJIA).Methods.The longterm extension phase of 2 pivotal studies (phase II with 11 patients and phase III with 56 patients) in patients with active sJIA was analyzed. Patients received open-label TCZ (8 mg/kg, every 2 weeks) without concomitant use of disease-modifying antirheumatic drugs.Results.In total, 67 patients were enrolled. All patients received corticosteroid at baseline. Median duration of exposure to TCZ was 3.4 years. Nine patients withdrew from the study [4 because of adverse events (AE), 4 because of the development of anti-TCZ antibodies, and 1 because of inadequate response]. Rates of AE and serious AE were 803.7/100 patient-years (PY) and 34.7/100 PY, respectively. The most common serious AE were infections (13.2/100 PY). No cases of malignancy or death were reported. Two serious infusion reactions were reported in patients testing negative for anti-TCZ antibodies. One definite macrophage activation syndrome (MAS) case and 1 potential MAS case were identified. American College of Rheumatology (ACR) response rates attained early in the TCZ treatment period were maintained throughout the study: at Week 168, JIA ACR 30, 50, 70, 90, and 100 response rates were 80.3%, 80.3%, 75.4%, 60.7%, and 18.0%, respectively. In total, 22 of 67 patients (32.8%) completely discontinued corticosteroids without flare.Conclusion.TCZ has demonstrated durability of effectiveness in the longterm treatment of children with sJIA and has shown good tolerability and a low discontinuation rate associated with AE, development of anti-TCZ antibodies, or inadequate response. (ClinicalTrials.govNCT00144599 and NCT00144612).(First Release March 15 2014; J Rheumatol 2014;41:759-67; doi:10.3899/jrheum.130690)
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Imagawa T, Yokota S, Mori M, Miyamae T, Takei S, Imanaka H, Nerome Y, Iwata N, Murata T, Miyoshi M, Nishimoto N, Kishimoto T. Safety and efficacy of tocilizumab, an anti-IL-6-receptor monoclonal antibody, in patients with polyarticular-course juvenile idiopathic arthritis. Mod Rheumatol 2014. [DOI: 10.3109/s10165-011-0481-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fukushima Y, Takeda A, Matsutani T, Fukushima F, Furihata T, Maezawa R, Miyoshi M, Hirata H, Sugiyama K, Okada M, Fukuda T. Involvement of antigen-driven mechanisms in interstitial pneumonia with polymyositis. Rheumatology (Oxford) 2013; 52:1537-40. [DOI: 10.1093/rheumatology/ket003] [Citation(s) in RCA: 3] [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: 11/12/2022] Open
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Yokota S, Imagawa T, Mori M, Miyamae T, Takei S, Iwata N, Umebayashi H, Murata T, Miyoshi M, Tomiita M, Nishimoto N, Kishimoto T. Long-term treatment of systemic juvenile idiopathic arthritis with tocilizumab: results of an open-label extension study in Japan. Ann Rheum Dis 2012. [DOI: 10.1136/annrheumdis-2012-202310] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [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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Imagawa T, Takei S, Umebayashi H, Yamaguchi K, Itoh Y, Kawai T, Iwata N, Murata T, Okafuji I, Miyoshi M, Onoe Y, Kawano Y, Kinjo N, Mori M, Mozaffarian N, Kupper H, Santra S, Patel G, Kawai S, Yokota S. Efficacy, pharmacokinetics, and safety of adalimumab in pediatric patients with juvenile idiopathic arthritis in Japan. Clin Rheumatol 2012; 31:1713-21. [PMID: 23053683 PMCID: PMC3505492 DOI: 10.1007/s10067-012-2082-5] [Citation(s) in RCA: 54] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 08/01/2012] [Accepted: 08/28/2012] [Indexed: 11/29/2022]
Abstract
The objective of this study was to evaluate the efficacy, pharmacokinetics, and safety of adalimumab in patients with polyarticular juvenile idiopathic arthritis (JIA) in Japan. Patients aged 4 to 17 years were enrolled in a single-arm, open-label, multicentre study of adalimumab. Patients weighing <30 kg received 20 mg every other week (eow), and those ≥30 kg received 40 mg eow. Concomitant methotrexate (MTX) was allowed (≤10 mg/m2 per week). The primary efficacy outcome was the percent of patients with American College of Rheumatology Pediatric 30 response (ACR Pedi 30) at week 16. JIA core variables, serum adalimumab concentrations, and anti-adalimumab antibodies (AAAs) were analysed. Patients were monitored for adverse events (AEs). Twenty-five patients (20 with concomitant MTX at baseline and 5 without) were enrolled: 24 patients completed 16 weeks of therapy and 22 patients completed 60 weeks. At week 16, 90 % of patients with MTX and 100 % without MTX achieved ACR Pedi 30; response rates were maintained through week 60 in 94 and 80 % of patients, respectively. Each JIA core variable improved over time. Six patients became AAA positive (two each at weeks 8, 16, and 60), some of which were transient. All six AAA-positive patients achieved ACR Pedi 30 at week 16, and four maintained that response at week 60. Six patients (all with MTX) experienced nine serious AEs (JIA, pyrexia, arthralgia, pneumonia, hepatitis B infection, pharyngitis, dehydration, pharyngeal pain, and pneumonia). In pediatric patients with polyarticular JIA in Japan, adalimumab was safe and effective for reducing disease activity for up to 60 weeks.
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Shimizu M, Nakagishi Y, Kasai K, Yamasaki Y, Miyoshi M, Takei S, Yachie A. Tocilizumab masks the clinical symptoms of systemic juvenile idiopathic arthritis-associated macrophage activation syndrome: the diagnostic significance of interleukin-18 and interleukin-6. Cytokine 2012; 58:287-94. [PMID: 22398373 DOI: 10.1016/j.cyto.2012.02.006] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/01/2012] [Accepted: 02/07/2012] [Indexed: 10/28/2022]
Abstract
Macrophage-activation syndrome (MAS) is a potentially life-threatening complication of systemic juvenile idiopathic arthritis (s-JIA). Tocilizumab (TCZ), a humanized anti-IL-6 receptor monoclonal antibody, is an effective cytokine inhibitor for the treatment of s-JIA. We described the clinical courses of five cases of MAS during TCZ therapy and demonstrated the need for monitoring serum interleukin (IL)-18 and IL-6 concentrations. Clinical symptoms of patients with s-JIA receiving TCZ were apparently mild compared to those not receiving TCZ. Furthermore, serum CRP concentrations never increased during TCZ therapy, even in MAS. Serum IL-6 concentrations increased during s-JIA flare-up and with the complication of infection. Serum IL-18 concentrations increased persistently before the other measures of disease activity. The clinical symptoms of MAS and s-JIA could be masked during TCZ therapy; hence, monitoring serum concentrations of IL-18 and IL-6 is recommended for the evaluation of disease activity in s-JIA and to detect the complication of infection.
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Affiliation(s)
- Masaki Shimizu
- Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan.
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Kinoshita K, Delcroix M, Nakatani T, Miyoshi M. Suppression of Late Reverberation Effect on Speech Signal Using Long-Term Multiple-step Linear Prediction. ACTA ACUST UNITED AC 2009. [DOI: 10.1109/tasl.2008.2009015] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Yagi S, Okada H, Takenaka R, Miyoshi M, Suzuki S, Toyokawa T, Kawahara Y, Yamamoto K. Influence of Helicobacter pylori eradication on reflux esophagitis in Japanese patients. Dis Esophagus 2009; 22:361-7. [PMID: 19191852 DOI: 10.1111/j.1442-2050.2008.00933.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The relationship between Helicobacter pylori eradication and reflux esophagitis is controversial. We analyzed the development of reflux esophagitis and the change in the grade of pre-existing reflux esophagitis after eradication. Enrolled were 559 Japanese patients who received eradication therapy for H. pylori. The grade of reflux esophagitis by endoscopy before and after therapy was evaluated retrospectively. No esophagitis was present before eradication in 526 patients. H. pylori was and was not eradicated in 429 and 97, respectively. Reflux esophagitis developed in 40 of the eradication group and in three of the treatment failure group, with prevalence higher with successful eradication (P = 0.04). Successful eradication and hiatus hernia were significant risk factors for reflux esophagitis development. Twenty-seven of 33 patients with pre-existing reflux esophagitis had successful eradication and six treatment failure. The reflux esophagitis grade worsened in two (Los Angeles classification from A to B) and improved in 14 patients after eradication. With treatment failure, reflux esophagitis worsened in none and improved in three patients. There showed no significant change in the grade of pre-existing reflux esophagitis after H. pylori eradication but the sample size was too small to evaluate the difference. In conclusion, the eradication of H. pylori increases the prevalence of reflux esophagitis, and hiatus hernia was a significant risk factor for the development of reflux esophagitis.
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Affiliation(s)
- S Yagi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
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Yagi S, Okada H, Takenaka R, Miyoshi M, Suzuki S, Toyokawa T, Kawahara Y, Yamamoto K. Influence of Helicobacter pylori eradication on reflux esophagitis in Japanese patients. Dis Esophagus 2009. [PMID: 19191852 DOI: 10.1111/j.1442-2050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The relationship between Helicobacter pylori eradication and reflux esophagitis is controversial. We analyzed the development of reflux esophagitis and the change in the grade of pre-existing reflux esophagitis after eradication. Enrolled were 559 Japanese patients who received eradication therapy for H. pylori. The grade of reflux esophagitis by endoscopy before and after therapy was evaluated retrospectively. No esophagitis was present before eradication in 526 patients. H. pylori was and was not eradicated in 429 and 97, respectively. Reflux esophagitis developed in 40 of the eradication group and in three of the treatment failure group, with prevalence higher with successful eradication (P = 0.04). Successful eradication and hiatus hernia were significant risk factors for reflux esophagitis development. Twenty-seven of 33 patients with pre-existing reflux esophagitis had successful eradication and six treatment failure. The reflux esophagitis grade worsened in two (Los Angeles classification from A to B) and improved in 14 patients after eradication. With treatment failure, reflux esophagitis worsened in none and improved in three patients. There showed no significant change in the grade of pre-existing reflux esophagitis after H. pylori eradication but the sample size was too small to evaluate the difference. In conclusion, the eradication of H. pylori increases the prevalence of reflux esophagitis, and hiatus hernia was a significant risk factor for the development of reflux esophagitis.
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Affiliation(s)
- S Yagi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
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Mima T, Ishikawa S, Aoki C, Yoshio-Hoshino N, Adachi Y, Imagawa T, Mori M, Tomiita M, Iwata N, Murata T, Miyoshi M, Takei S, Aihara Y, Yokota S, Matsubara K, Nishimoto N. Interleukin 11 and paired immunoglobulin-like type 2 receptor α expression correlates with the number of joints with active arthritis in systemic juvenile idiopathic arthritis. Ann Rheum Dis 2009; 68:286-7. [DOI: 10.1136/ard.2008.091041] [Citation(s) in RCA: 2] [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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Miyoshi M, Shimono M, Hasenaka T, Sano T, Fukuoka T. Determination of boron and other elements in volcanic rocks by prompt gamma-ray analysis: An application to magma genesis in Kyushu island, SW-Japan. J Radioanal Nucl Chem 2008. [DOI: 10.1007/s10967-008-9607-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ishikawa S, Mima T, Aoki C, Yoshio-Hoshino N, Adachi Y, Imagawa T, Mori M, Tomiita M, Iwata N, Murata T, Miyoshi M, Takei S, Aihara Y, Yokota S, Matsubara K, Nishimoto N. Abnormal expression of the genes involved in cytokine networks and mitochondrial function in systemic juvenile idiopathic arthritis identified by DNA microarray analysis. Ann Rheum Dis 2008; 68:264-72. [DOI: 10.1136/ard.2007.079533] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objectives:Systemic juvenile idiopathic arthritis (sJIA) is a rheumatic disease in childhood characterised by systemic symptoms and a relatively poor prognosis. Peripheral leukocytes are thought to play a pathological role in sJIA although the exact cause of the disease is still obscure. In this study, we aimed to clarify cellular functional abnormalities in sJIA.Methods:We analysed the gene expression profile in peripheral leukocytes from 51 patients with sJIA, 6 patients with polyarticular type JIA (polyJIA) and 8 healthy children utilising DNA microarrays. Gene ontology analysis and network analysis were performed on the genes differentially expressed in sJIA to clarify the cellular functional abnormalities.Result:A total of 3491 genes were differentially expressed in patients with sJIA compared to healthy individuals. They were functionally categorised mainly into a defence response group and a metabolism group according to gene ontology, suggesting the possible abnormalities in these functions. In the defence response group, molecules predominantly constituting interferon (IFN)γ and tumour necrosis factor (TNF) network cascades were upregulated. In the metabolism group, oxidative phosphorylation-related genes were downregulated, suggesting a mitochondrial disorder. Expression of mitochondrial DNA-encoded genes including cytochrome c oxidase subunit 1(MT-CO1) and MT-CO2 were suppressed in patients with sJIA but not in patients with polyJIA or healthy children. However, nuclear DNA-encoded cytochrome c oxidases were intact.Conclusion:Our findings suggest that sJIA is not only an immunological disease but also a metabolic disease involving mitochondria disorder.
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Yokota S, Imagawa T, Mori M, Miyamae T, Aihara Y, Takei S, Iwata N, Umebayashi H, Murata T, Miyoshi M, Tomiita M, Nishimoto N, Kishimoto T. Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled, withdrawal phase III trial. Lancet 2008; 371:998-1006. [PMID: 18358927 DOI: 10.1016/s0140-6736(08)60454-7] [Citation(s) in RCA: 577] [Impact Index Per Article: 36.1] [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] [Indexed: 01/09/2023]
Abstract
BACKGROUND Systemic-onset juvenile idiopathic arthritis does not always respond to available treatments, including antitumour necrosis factor agents. We investigated the efficacy and safety of tocilizumab, an anti-interleukin-6-receptor monoclonal antibody, in children with this disorder. METHODS 56 children (aged 2-19 years) with disease refractory to conventional treatment were given three doses of tocilizumab 8 mg/kg every 2 weeks during a 6-week open-label lead-in phase. Patients achieving an American College of Rheumatology Pediatric (ACR Pedi) 30 response and a C-reactive protein concentration (CRP) of less than 5 mg/L were randomly assigned to receive placebo or to continue tocilizumab treatment for 12 weeks or until withdrawal for rescue medication in a double-blind phase. The primary endpoint of the double-blind phase was an ACR Pedi 30 response and CRP concentration of less than 15 mg/L. Patients responding to tocilizumab and needing further treatment were enrolled in an open-label extension phase for at least 48 weeks. The analysis was done by intention to treat. This study is registered with ClinicalTrials.gov, numbers NCT00144599 (for the open-label lead-in and double-blind phases) and NCT00144612 (for the open-label extension phase). FINDINGS At the end of the open-label lead-in phase, ACR Pedi 30, 50, and 70 responses were achieved by 51 (91%), 48 (86%), and 38 (68%) patients, respectively. 43 patients continued to the double-blind phase and were included in the efficacy analysis. Four (17%) of 23 patients in the placebo group maintained an ACR Pedi 30 response and a CRP concentration of less than 15 mg/L compared with 16 (80%) of 20 in the tocilizumab group (p<0.0001). By week 48 of the open-label extension phase, ACR Pedi 30, 50, and 70 responses were achieved by 47 (98%), 45 (94%), and 43 (90%) of 48 patients, respectively. Serious adverse events were anaphylactoid reaction, gastrointestinal haemorrhage, bronchitis, and gastroenteritis. INTERPRETATION Tocilizumab is effective in children with systemic-onset juvenile idiopathic arthritis. It might therefore be a suitable treatment in the control of this disorder, which has so far been difficult to manage.
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MESH Headings
- Adolescent
- Adult
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Arthritis, Juvenile/drug therapy
- Arthritis, Juvenile/physiopathology
- C-Reactive Protein/drug effects
- C-Reactive Protein/metabolism
- Child
- Child, Preschool
- Dose-Response Relationship, Drug
- Double-Blind Method
- Female
- Humans
- Japan
- Male
- Receptors, Interleukin-6/antagonists & inhibitors
- Treatment Outcome
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Affiliation(s)
- Shumpei Yokota
- Department of Paediatrics, Yokohama City University School of Medicine, Yokohama, Japan.
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Otsuka T, Ito H, Takahashi H, Takano H, Arakawa R, Okumura M, Kodaka F, Miyoshi M, Sekine M, Seki C, Suhara T, Halldin C, Farde L. Quantitative analysis of dopamine D2 receptor binding in human brain using PET with an agonist radioligand [11C]MNPA. Neuroimage 2008. [DOI: 10.1016/j.neuroimage.2008.04.102] [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: 10/21/2022] Open
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Takenaka R, Okada H, Kato J, Makidono C, Hori S, Kawahara Y, Miyoshi M, Yumoto E, Imagawa A, Toyokawa T, Sakaguchi K, Shiratori Y. Helicobacter pylori eradication reduced the incidence of gastric cancer, especially of the intestinal type. Aliment Pharmacol Ther 2007; 25:805-12. [PMID: 17373919 DOI: 10.1111/j.1365-2036.2007.03268.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [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: 12/19/2022]
Abstract
BACKGROUND Although Helicobacter pylori infection is closely associated with gastric cancer development, follow-up studies after H. pylori eradication are still scarce. AIM To clarify the cancer preventive effect of H. pylori eradication, with special attention to differences in effect according to histology. METHODS Patients who underwent H. pylori eradication therapy and were followed-up endoscopically for at least 1 year were analysed. The incidence of gastric cancer and factors associated with cancer development were investigated. RESULTS A total of 1807 patients were enrolled. Six of 1519 H. pylori eradicated and five of 288 persistent subjects developed gastric cancer. Four of the eradicated subjects developed the intestinal type and two the diffuse type, while four of the persistent subjects developed the intestinal type and one the diffuse type. Kaplan-Meier analysis indicated a significantly lower incidence in eradicated patients than in persistent patients. The incidence of intestinal type was significantly lower than in eradicated patients, while the diffuse type could not be evaluated because of the low incidence. CONCLUSIONS Helicobacter pylori-eradicated patients had a reduced incidence of gastric cancer compared with H. pylori-persistent patients, particularly the intestinal type, suggesting that H. pylori is strongly associated with intestinal-type gastric cancer.
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Affiliation(s)
- R Takenaka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
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