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Konoshita N, Onishi H, Mizukami Y, Ikeda R, Tanaka T, Tsubouchi H, Kishimoto T, Hayashi H, Yamamura O. Can bone mass measured via bioelectrical impedance analysis be used to diagnose sarcopenia? J Clin Biochem Nutr 2024; 74:154-161. [PMID: 38510684 PMCID: PMC10948344 DOI: 10.3164/jcbn.23-88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 03/22/2024] Open
Abstract
The simplification of diagnostic criteria is critical to promoting interventions for sarcopenia. This study aimed to evaluate the relationship between sarcopenia and bone mass [measured by bioelectrical impedance analysis (BIA)], as well as to identify new indicators associated with this disease. Basic interviews and measurement of physical function were performed on 474 community-dwelling older adults (aged 77.1 ± 7.6 years), including older adult patients with sarcopenia, in Wakasa Town, Fukui Prefecture. The findings led to 363, 71, and 40 participants being classified as 'normal', 'pre-sarcopenia', and 'having sarcopenia', respectively. An Ordinal Logistic Regression Analysis showed that age, bone mass phase angle (lower limb), Fat-free Mass Index, and leg muscle score were aggravating factors for sarcopenia in both men and women. A receiver operating characteristic analysis of bone mass and sarcopenia status showed that the area under the curve and cut-off value, as well as its sensitivity and specificity, in men were 0.915 [95% confidence interval (CI): 0.853-0.977], 2.2 kg, 81%, and 87%, respectively, and 0.913 (95% CI: 0.858-0.968), 1.6 kg, 91%, and 88%, respectively, in women. This study revealed that the BIA method of measuring bone mass has excellent accuracy in detecting sarcopenia in both males and females.
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Affiliation(s)
- Naohiro Konoshita
- Eiheiji Town Home Visit Care Clinic, 38-45 Matsuokakenjoujima, Yoshida-gun, Eiheiji-cho, Fukui 910-1142, Japan
- Department of Family Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1104, Japan
| | - Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1193, Japan
| | - Yasutaka Mizukami
- Department of Family Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1104, Japan
- Department of Rehabilitation, Fukui Kosei Hospital, 1-6-1 Shimorokujo-cho, Fukui 918-8135, Japan
| | - Ryouko Ikeda
- Department of Health and Nutrition, Faculty of Human Life Studies, Jin-ai University, 3-1-1 Ode-cho, Echizen City, Fukui 915-0015, Japan
| | - Tokuharu Tanaka
- Department of Family Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1104, Japan
| | - Hiromasa Tsubouchi
- Department of Radiotechnology, Fukui Ken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui 918-8503, Japan
| | - Takahiro Kishimoto
- Department of Radiology, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1193, Japan
| | - Hiroyuki Hayashi
- Department of Family Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1104, Japan
- Department of Emergency, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1193, Japan
| | - Osamu Yamamura
- Department of Family Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Yoshida-gun, Eiheiji-cho, Fukui 910-1104, Japan
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Hata T, Goto T, Yamanaka S, Matsumoto T, Yamamura O, Hayashi H. Prognostic value of initial serum sodium level in predicting disease severity in patients with COVID-19: A multicenter retrospective study. J Infect Chemother 2024; 30:181-187. [PMID: 37802152 DOI: 10.1016/j.jiac.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/09/2023] [Accepted: 10/02/2023] [Indexed: 10/08/2023]
Abstract
INTRODUCTION Early prediction of coronavirus disease (COVID-19) severity is crucial. Hyponatremia has been linked to poor outcomes in hospitalized COVID-19 patients, but its association with mild cases is unclear. This study aimed to investigate whether initial serum sodium level is a risk factor for COVID-19 severity in patients with mild-to-moderate disease. METHODS A multicenter retrospective cohort study was conducted in 10 hospitals in Fukui City, Japan, from July 1, 2020, to October 31, 2021. The study included 1055 adult patients with asymptomatic, mild, or moderate COVID-19 confirmed by a positive RT-PCR test. The primary outcome was the need for oxygen therapy after hospitalization, and the secondary outcome was the composite of in-hospital death and critical care interventions. The association between initial serum sodium level (at the emergency department or on admission) and outcomes was examined, adjusting for age, sex, hypertension, and pneumonia presence. RESULTS Of the 1267 patients diagnosed with COVID-19 during the study period, 1055 were eligible (median age: 45 years; 54 % male). Hyponatremia was observed in 5.2 % of patients upon admission. A lower initial serum sodium level was associated with an increased risk of the need for oxygen therapy after hospitalization (adjusted odds ratio [OR] per 1 mmol/L lower, 1.12 [95 % confidence interval {CI}, 1.05-1.19]) and the composite of critical care and in-hospital death (adjusted OR per 1 mmol/L lower, 1.09 [95 % CI, 0.99-1.20]). CONCLUSIONS Among patients with mild COVID-19, lower initial serum sodium level was a risk factor for COVID-19 progression.
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Affiliation(s)
- Tatsuhiko Hata
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tadahiro Goto
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan; TXP Medical, Co. Ltd., Tokyo, Japan.
| | - Syunsuke Yamanaka
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
| | - Tatsuki Matsumoto
- School of Knowledge and Information Systems, College of Sustainable System Sciences, Osaka Metropolitan University, Osaka, Japan.
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan; Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan.
| | - Hiroyuki Hayashi
- Department of Emergency Medicine & General Internal Medicine, University of Fukui, Fukui, Japan.
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Mizukami Y, Onishi H, Mifuku Y, Kubota M, Ikeda R, Hayashi H, Yamamura O. The role of fat indices as factors leading to sarcopenia in older adults residing in underpopulated areas. J Clin Biochem Nutr 2024; 74:70-73. [PMID: 38292122 PMCID: PMC10822752 DOI: 10.3164/jcbn.23-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/22/2023] [Indexed: 02/01/2024] Open
Abstract
Simplifying the diagnostic criteria for sarcopenia is key to establishing effective interventions. Herein, we aimed to clarify novel diagnostic factors. We calculated novel fat indices [total fat index (TFI) and limb fat index (LFI)] and clarified factors leading to pre-sarcopenia and sarcopenia in 594 enrolled older adults. Physical measurements [height, weight, body mass index (BMI), gait speed, grip strength, and skeletal muscle mass] were performed. Sarcopenia was determined using established diagnostic criteria (pre-sarcopenia, n = 102; sarcopenia, n = 42). Age was associated with sarcopenia status. BMI, TFI, and LFI were lower in patients with pre-sarcopenia and sarcopenia. Logistic regression analysis showed the following odds ratios (ORs) for pre-sarcopenia: BMI [OR: 0.787, 95% confidence interval (CI): 0.7-0.885], LFI (OR: 0.589, 95% CI: 0.402-0.863), and age (OR: 1.06, 95% CI: 1.02-1.1). ORs for sarcopenia (vs pre-sarcopenia) were as follows: LFI (OR: 50.6, 95% CI: 10.2-250.0), age (OR: 1.1, 95% CI: 1.0-1.2), and BMI (OR: 0.418, 95% CI: 0.28-0.608). Our findings contribute to informing medical guidelines.
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Affiliation(s)
- Yasutaka Mizukami
- Department of Family Medicine, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
- Fukui Kosei Hospital, Fukui, Fukui 918-8135, Japan
| | - Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Yoshida-gun, Fukui 910-1193, Japan
| | - Yuta Mifuku
- Department of Rehabilitation, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
| | - Masafumi Kubota
- Department of Rehabilitation Science, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa 920-0942, Japan
| | - Ryouko Ikeda
- Department of Health and Nutrition, Faculty of Human Life Studies, Jin-ai University, Echizen, Fukui 915-0015, Japan
| | - Hiroyuki Hayashi
- Department of Family Medicine, University of Fukui Hospital, Yoshida-gun, Fukui 910-1104, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Yoshida-gun, Fukui 910-1193, Japan
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Onishi H, Yamamura O, Sakamaki I, Miyashita H, Iwasaki H. A Consideration of the Relationship in COVID-19 Infection Status and Previously Reported Anti-SARS-CoV-2 Nucleocapsid (N). Asia Pac J Public Health 2023; 35:580-582. [PMID: 37675575 DOI: 10.1177/10105395231198602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Affiliation(s)
- Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Japan
| | - Ippei Sakamaki
- Department of Infectious Diseases, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Japan
| | - Hirofumi Miyashita
- Department of Health and Welfare, Fukui Prefectural Government, Fukui, Japan
| | - Hiromichi Iwasaki
- Division of Infection and Clinical Immunology, University of Fukui Hospital, Eiheiji-cho, Japan
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Kobuchi T, Onishi H, Yamamura O, Sakamaki I, Iwasaki H, Hayashi H. Frequency and Risk Factors for Persistent and Concomitant Symptoms after Hospital Discharge for Coronavirus Disease 2019 in the Pre-omicron Period: An Exploratory Longitudinal Study. JMA J 2023; 6:437-447. [PMID: 37941692 PMCID: PMC10628324 DOI: 10.31662/jmaj.2023-0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/18/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Many countries have reported persistent and concomitant symptoms of coronavirus disease 2019 (COVID-19). This study aimed to identify persistent COVID-19 and concomitant symptoms in discharged patients and identify the risk factors for such symptoms. Methods This study enrolled patients with COVID-19 who were admitted to the University of Fukui Hospital, Japan, and discharged between April 3, 2020, and August 19, 2021. Persistent and concomitant symptoms were confirmed based on medical examinations approximately 2 weeks after discharge. Patient characteristics and symptoms were collected from the patients' medical records by a technical assistant. Results This study included 120 patients (60 men and 60 women; mean age, 53.5 ± 17.0 years). Persistent COVID-19 symptoms were observed in 62 patients (51.7%). The most common persistent symptom was weakened physical function, manifesting as physical weakness (48.4%) and muscle weakness (29.0%). Binary logistic regression analysis revealed that cough with expectoration within the acute phase of COVID-19 was a risk factor predisposing patients to COVID-19 sequelae (odds ratio: 2.94, 95% confidence interval: 1.300 - 6.630, p = 0.009). Conclusions The study findings suggest that productive cough in the acute phase is associated with subsequent physical and muscle weaknesses in the subacute phase.
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Affiliation(s)
| | - Hidenori Onishi
- Department of Community Medicine, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Department of Community Medicine, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ippei Sakamaki
- Department of Infectious Diseases, School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiromichi Iwasaki
- Department of Infection Control and Prevention, University of Fukui Hospital, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Emergency, University of Fukui Hospital, Fukui, Japan
- Department of Family Medicine, University of Fukui Hospital, Fukui, Japan
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Kitazaki Y, Yamamura O, Usui K, Ueno A, Sanada S, Sasaki H, Endo Y, Enomoto S, Ikawa M, Nakamoto Y, Hamano T. Anti-Kv1.4 Antibody-positive Nivolumab-induced Myasthenia Gravis and Myositis Presenting with Bilateral Ptosis and Demonstrating Different Pathophysiologies. Intern Med 2023; 62:3013-3020. [PMID: 37839874 PMCID: PMC10641203 DOI: 10.2169/internalmedicine.0739-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/21/2022] [Indexed: 10/17/2023] Open
Abstract
Nivolumab blocks inhibitors of T-cell activation and restores antitumor immunity but promotes T-cell activity in host tissues by blocking inhibition of the T-cell function, resulting in immune-related adverse effects. We herein report an 80-year-old man presenting with nivolumab-related myasthenia gravis with anti-muscular voltage-gated potassium channel-complex (Kv1.4) antibodies. On day 29 after nivolumab administration, he simultaneously developed rapidly progressing right ptosis and left facial paralysis. Nivolumab administration was discontinued. He subsequently presented with bulbar paralysis, dyspnea, and muscle weakness and received intravenous immunoglobulin, methylprednisolone, and plasma exchange. The severity of nivolumab-related myasthenia gravis with anti-Kv1.4 antibodies presented with diverse clinical findings.
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Affiliation(s)
- Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, Japan
| | - Kojiro Usui
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan
| | - Sayaka Sanada
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yoshinori Endo
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan
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Kitazaki Y, Ikawa M, Hamano T, Sasaki H, Yamaguchi T, Enomoto S, Shirafuji N, Hayashi K, Yamamura O, Tsujikawa T, Okazawa H, Kimura H, Nakamoto Y. Magnetic resonance imaging arterial spin labeling hypoperfusion with diffusion-weighted image hyperintensity is useful for diagnostic imaging of Creutzfeldt-Jakob disease. Front Neurol 2023; 14:1242615. [PMID: 37885479 PMCID: PMC10598551 DOI: 10.3389/fneur.2023.1242615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Background and objectives Magnetic resonance imaging with arterial spin labeling (ASL) perfusion imaging is a noninvasive method for quantifying cerebral blood flow (CBF). We aimed to evaluate the clinical utility of ASL perfusion imaging to aid in the diagnosis of Creutzfeldt-Jakob disease (CJD). Methods This retrospective study enrolled 10 clinically diagnosed with probable sporadic CJD (sCJD) based on the National CJD Research & Surveillance Unit and EuroCJD criteria and 18 healthy controls (HCs). Diffusion-weighted images (DWIs), CBF images obtained from ASL, N-isopropyl-(123I)-p-iodoamphetamine (123IMP)-single-photon emission computed tomography (SPECT) images, and 18F-fluorodeoxyglucose (18FDG)-positron emission tomography (PET) images were analyzed. First, the cortical values obtained using volume-of-interest (VOI) analysis were normalized using the global mean in each modality. The cortical regions were classified into DWI-High (≥ +1 SD) and DWI-Normal (< +1 SD) regions according to the DWI-intensity values. The normalized cortical values were compared between the two regions for each modality. Second, each modality value was defined as ASL hypoperfusion (< -1 SD), SPECT hypoperfusion (< -1 SD), and PET low accumulation (< -1 SD). The overall agreement rate of DWIs with ASL-CBF, SPECT, and PET was calculated. Third, regression analyses between the normalized ASL-CBF values and normalized SPECT or PET values derived from the VOIs were performed using a scatter plot. Results The mean values of ASL-CBF (N = 10), 123IMP-SPECT (N = 8), and 18FDG-PET (N = 3) in DWI-High regions were significantly lower than those in the DWI-Normal regions (p < 0.001 for all); however, HCs (N = 18) showed no significant differences in ASL-CBF between the two regions. The overall agreement rate of DWI (high or normal) with ASL-CBF (hypoperfusion or normal) (81.8%) was similar to that of SPECT (85.2%) and PET (78.5%) in CJD. The regression analysis showed that the normalized ASL-CBF values significantly correlated with the normalized SPECT (r = 0.44, p < 0.001) and PET values (r = 0.46, p < 0.001) in CJD. Discussion Patients with CJD showed ASL hypoperfusion in lesions with DWI hyperintensity, suggesting that ASL-CBF could be beneficial for the diagnostic aid of CJD.
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Affiliation(s)
- Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
- Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Aging and Dementia (DAD), University of Fukui, Fukui, Japan
- Life Science Innovation Center, University of Fukui, Fukui, Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kouji Hayashi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Tanaka T, Yamamura O, Onishi H, Ikawa M, Hayashi H, Hamano T. Ten-year follow up of incidental spontaneous extracranial internal carotid artery dissection in a Japanese asymptomatic older man: A case report. Sci Prog 2023; 106:368504231214119. [PMID: 38105490 PMCID: PMC10729627 DOI: 10.1177/00368504231214119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This report presents a unique finding of an incidental right internal carotid artery dissection in an asymptomatic 69-year-old man. The report highlights the possible trigger and long-term outcomes of this condition. The patient had participated in Japanese archery competitions for many years. His medical history included hypertension and a prior ischemic stroke in the left lateral medulla, resulting in Wallenberg syndrome. During a routine visit, head magnetic resonance angiography revealed right internal carotid artery dissection. He was managed conservatively with antiplatelet therapy and close monitoring. Follow-up imaging after 10 years showed no changes, and the patient remained asymptomatic. Therefore, routine screening for incidental findings is important even in asymptomatic patients. Archery competitions may be a possible trigger for internal carotid artery dissection. The presence of re-entry in the lesion at the time of onset can be a predictor of a good long-term prognosis.
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Affiliation(s)
- Tokuharu Tanaka
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan
| | - Osamu Yamamura
- Regional Medicine Promotion Course, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Neurology, University of Fukui Hospital, Fukui, Japan
| | - Hidenori Onishi
- Regional Medicine Promotion Course, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Department of Neurology, University of Fukui Hospital, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan
| | - Tadanori Hamano
- Department of Neurology, University of Fukui Hospital, Fukui, Japan
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Yamaguchi T, Kubota M, Naruse H, Matsumine A, Yamamura O, Tsuchiya H. A 6-Month Follow-up Study on Adherence and Satisfaction with Lower Limb Prostheses and Orthoses Delivered to Community-Dwelling People in Japan. Prog Rehabil Med 2023; 8:20230034. [PMID: 37766813 PMCID: PMC10520559 DOI: 10.2490/prm.20230034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
Abstract Introduction We aimed to evaluate adherence and satisfaction with prostheses and orthoses (POs) of the lower extremities delivered to community-dwelling patients and to assess the relationship of adherence and satisfaction with patient background factors, including medical status, physical findings, and level of participation. Methods : We conducted a descriptive cohort study. Consecutive patients with disability who applied for lower extremity POs were invited to enroll. The patients' background information was collected at enrolment, and they were asked at 6 months after PO delivery whether they were using their PO as expected prior to its delivery, and, on a numerical rating scale (NRS, 0 - 10), if they were satisfied with their POs. Furthermore, the relationship between usage/satisfaction and the participants' backgrounds was evaluated and the participants' comments regarding their POs were summarized. Results : This study analyzed the data of 51 participants (mean age, 56.5 ± 19 years). At the 6-month follow-up, 45 participants used POs as much as they had expected before delivery; this group was younger than their counterparts (52.7 versus 69.2 years). The median satisfaction score using the NRS was 8.5. Older participants (r = - 0.33), participants who were able to attach and remove their POs, and those who were independent in locomotion scored lower on satisfaction. Other background factors were not different regarding adherence or satisfaction. Conclusions : This study demonstrated the difficulty in predicting the usage and satisfaction with lower limb POs from users' backgrounds. Producer-user communication, particularly with patients of older age and/or a higher level of participation, may improve adherence and satisfaction.
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Affiliation(s)
- Tomoko Yamaguchi
- Division of Physical Therapy and Rehabilitation, University
of Fukui Hospital, Yoshida-Gunn, Fukui, Japan
| | - Masafumi Kubota
- Department of Physical Therapy, Graduate Course of
Rehabilitation Science, School of Health Sciences, College of Medical, Pharmaceutical, and
Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiroaki Naruse
- Division of Physical Therapy and Rehabilitation, University
of Fukui Hospital, Yoshida-Gunn, Fukui, Japan
| | - Akihiko Matsumine
- Department of Orthopaedics and Rehabilitation Medicine,
Faculty of Medical Sciences, University of Fukui, Yoshida-Gunn, Fukui, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical
Sciences, University of Fukui, Yoshida-Gunn, Fukui, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of
Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
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Nomiya H, Hamano T, Takaku N, Sasaki H, Usui K, Sanada S, Yamaguchi T, Kitazaki Y, Endo Y, Kamisawa T, Enomoto S, Shirafuji N, Matsunaga A, Ueno A, Ikawa M, Yamamura O, Hasegawa M, Kimura H, Nishino I, Nakamoto Y. Magnetic resonance imaging findings of the lower limb muscles in anti-mitochondrial M2 antibody-positive myositis. Neuromuscul Disord 2023; 33:74-80. [PMID: 37652755 DOI: 10.1016/j.nmd.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/19/2023] [Accepted: 07/21/2023] [Indexed: 09/02/2023]
Abstract
Anti-mitochondrial M2 antibody (AMA-M2)-positive myositis is an idiopathic inflammatory myopathy (IIM). Of all patients with myositis, 2.5-19.5% have AMA-M2 antibodies. However, the detailed distribution of muscles affected in AMA-positive myositis is unknown. Therefore, we examined lower muscle magnetic resonance imaging (MRI) findings of patients with AMA-positive myositis. Among the 63 patients with IIM at our institute, 5 (7.9%) were positive for AMA-M2 antibodies. However, one was also positive for anti-Jo1 antibodies; therefore, four patients were finally participated in this study. All patients had high-intensity MRI signals in the proximal muscles, including the gluteus maximus and iliopsoas muscles, and in the thigh muscles, including the vastus lateralis, vastus medialis, adductor magnus, and semimembranosus muscles. Lower leg muscles were relatively spared. Fascial edema was observed in all patients and was also present in the lower leg muscles. Subcutaneous edema was observed, particularly in the proximal portion of the lower limbs. In AMA-positive myositis, proximal muscles, including the gluteus maximus, vastus lateralis, adductor magnus, and the semimembranosus, were markedly affected, while the lower leg muscles were relatively preserved. Additionally, fascial edema was evident even in lower leg muscles. Therefore, muscle MRI can be a useful diagnostic aid for AMA-positive myositis.
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Affiliation(s)
- Hirotaka Nomiya
- Clinical Training Center, University of Fukui Hospital, Fukui, Japan; Department of Cell Biology and Biochemistry, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan; Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan; Life Science Innovation Center, University of Fukui, Fukui, Japan.
| | - Naoko Takaku
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Kojiro Usui
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Sayaka Sanada
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Yoshinori Endo
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Tomoko Kamisawa
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Akiko Matsunaga
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Minoru Hasegawa
- Department of Dermatology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
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11
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Yamamura O, Onishi H, Sakamaki I, Fujita R, Miyashita H, Iwasaki H. Infection rate among close contacts of patients with coronavirus disease in Japan: a descriptive study and literature review. ASIAN BIOMED 2023; 17:115-123. [PMID: 37818161 PMCID: PMC10561678 DOI: 10.2478/abm-2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
Background In Japan, on April 20, 2020, the definition of a close contact regarding coronavirus disease (COVID-19) was changed from a long-term contact time to a specified contact time of 15 min and from a contact distance of 2 m to 1 m. Objectives We aimed to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate among close contacts of patients with COVID-19 and determine the impact of the infection on transmission among close contacts. Methods The numbers of SARS-CoV-2 tests, SARS-CoV-2-positive cases, and close contacts of patients with COVID-19 were assessed between March 2020 and February 2021 in Fukui Prefecture, Japan. The study period was subdivided into 3 periods. The second and third period contained data with the changed definition of close contact. Results Overall, 32,238 SARS-CoV-2 tests were performed. There were 545 patients with COVID-19 and 1487 close contacts, of whom 267 tested positive. The highest infection rate occurred in period 3. Distance, protective measures, and contact time with COVID-19 patients influenced the increased infection rate. The infection rate showed a rising trend from 11.1% in period 1 to 19.2% and 20.0% in periods 2 and 3, respectively (Cochran-Armitage test; P < 0.004). Multivariate analysis revealed that female sex was an independent risk factor for infection of close contacts (odds ratio: 2.23; 95% confidence interval: 1.700-2.930). Conclusions Female sex is a risk factor for transmission by close contacts. The rate of infection among close contacts may be associated with contact time, contact distance, and protective measures.
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Affiliation(s)
- Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Fukui910-1193, Japan
| | - Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Fukui910-1193, Japan
| | - Ippei Sakamaki
- Department of Infectious Diseases, Faculty of Medical Sciences, University of Fukui, Fukui910-1193, Japan
| | - Ryousuke Fujita
- Department of Biostatistics, Faculty of Medical Science, University of Fukui, Fukui910-1193, Japan
| | - Hirofumi Miyashita
- Department of Health and Welfare, Fukui Prefecture, Fukui910-8580, Japan
| | - Hiromichi Iwasaki
- Department of Infection Prevention and Control, University of Fukui Hospital, Fukui910-1193, Japan
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12
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Tsubouchi H, Onishi H, Maeno K, Hayashi H, Yamamura O. Two cases of acute pulmonary artery embolism triggered by fresh and chronic mixed-vein thrombosis with a "Blowfish sign". J Clin Ultrasound 2023; 51:711-714. [PMID: 36929489 DOI: 10.1002/jcu.23451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/14/2023] [Accepted: 03/01/2023] [Indexed: 05/03/2023]
Abstract
Ultrasonography and computed tomography of the lower extremities revealed fresh and chronic mixed-vein thrombosis (FCMVTs) presenting the "Blowfish sign," accompanied by pulmonary embolism. FCMVTs presenting the "Blowfish sign" may increase the risk of fatal pulmonary embolism, and its detection by ultrasonography is important for preventing pulmonary embolism.
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Affiliation(s)
- Hiromasa Tsubouchi
- Department of Radiotechnology, Fukui-Ken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui-City, Fukui, 918-8503, Japan
| | - Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1104, Japan
| | - Koji Maeno
- Division of Cardiology, Department of Internal Medicine, Fukui-Ken Saiseikai Hospital, 7-1 Funabashi, Wadanaka-cho, Fukui-City, Fukui, 918-8503, Japan
| | - Hiroyuki Hayashi
- Department of Emergency Medicine and General Medicine, University of Fukui Hospital, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1104, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1104, Japan
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13
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Hamano T, Nagata M, Matsubara R, Ikebata Y, Ito T, Ibe A, Fujita Y, Kusaka Y, Tokunaga T, Enomoto S, Endo Y, Ueno A, Shirafuji N, Ikawa M, Hayashi K, Yamamura O, Nakamoto Y. Effectiveness of a self-reporting yes/no survey for dementia screening-trial in Fukui, Japan. Front Aging Neurosci 2023; 14:1029614. [PMID: 36688170 PMCID: PMC9845620 DOI: 10.3389/fnagi.2022.1029614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023] Open
Abstract
Background: Early intervention for dementia patients is extremely important for the prevention of dementia. However, so far, it is not clear as to what kind of screening will be useful for the early detection of dementia. Objective: We aimed to investigate the relationship between the results of a short self-reporting yes/no survey selected in Kihon Checklist, developed by the Japanese Ministry of Health, Labor and Welfare to identify older adults who are at risk of requiring support/care, and other original items developed by Dementia Prevention Team, Fukui, Japan, and Mini-Mental State Examination (MMSE) scores, and determine the diagnostic efficacy of the self-reporting yes/no survey. Methods: Self-reporting yes/no surveys were conducted for 87,687 individuals aged ≥65 years, living in Fukui, Japan, and did not have Long-Term Care Insurance, Japan. According to the survey results, selected individuals were advised to visit a local hospital to be assessed with MMSE. Results: Individuals who could not make a call by looking up phone numbers and manage their own deposits and savings at the bank or automatic teller machine (ATM) had an increased risk of low MMSE score (≤23; odds ratio: 2.74 [1.89-3.97]; 95% confidence interval: 2.12 [1.46-3.07]). Conclusions: Self-reporting yes/no survey could effectively screen for dementia. Not being able to make a call by looking up phone numbers and not being able to manage their own deposits and savings at the bank or ATM are signs of dementia.
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Affiliation(s)
- Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan,Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan,Life Science Innovation Center, University of Fukui, Fukui, Japan,*Correspondence: Tadanori Hamano
| | - Miwako Nagata
- Department of Neurology, Nakamura Hospital, Echizen-city, Japan
| | | | | | - Tatsuhiko Ito
- Department of Psychiatry, Sukoyaka Silver Hospital, Fukui, Japan
| | - Akihiro Ibe
- Department of Internal Medicine, Ibe Hospital, Echizen-cho, Japan
| | - Youshi Fujita
- Department of Neurology, Fujita Neurological Hospital, Fukui, Japan
| | - Yukinori Kusaka
- Department of Environmental Health, University of Fukui, Fukui, Japan
| | - Takahiro Tokunaga
- Research Promotion Office, Shinseikai Toyama Hospital, Toyama, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan,Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yoshinori Endo
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kouji Hayashi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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14
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Ueno A, Ikawa M, Maeda K, Tai K, Ito T, Shirafuji N, Yamamura O, Nakamoto Y, Hamano T. Persistent Severe Cerebral Edema with Neutrophil Infiltration Following Listeria Meningitis. Intern Med 2022; 61:3431-3434. [PMID: 35466161 PMCID: PMC9751728 DOI: 10.2169/internalmedicine.8291-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
A 51-year-old man was admitted to the hospital with a diagnosis of Listeria monocytogenes meningitis. Diffuse cerebral edema appeared after improvement of meningitis with appropriate treatment and worsened for two months. Due to brain herniation, brain tissue leaked through the incision made during the drain insertion in a hydrocephalus surgery. We found pathological evidence of significant neutrophil infiltration with a few lymphocytes without bacterial detection in the degraded brain tissue. The present case indicates that fatal cerebral edema with significant neutrophil infiltration may develop even after appropriate treatment for L. monocytogenes meningitis.
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Affiliation(s)
- Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Japan
| | - Kenichiro Maeda
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan
| | - Katsuhide Tai
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tomomi Ito
- Division of Diagnostic Pathology, University of Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Japan
- Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan
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15
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Onishi H, Yamamura O, Sakamaki I, Miyashita H, Iwasaki H. Can the Brinkman Index Predict the Need for Treatment in Patients With COVID-19? Asia Pac J Public Health 2022; 34:692-694. [PMID: 35856278 DOI: 10.1177/10105395221113773] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hidenori Onishi
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ippei Sakamaki
- Department of Infectious Diseases, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hirofumi Miyashita
- Department of Health and Welfare, Fukui prefectural government, Fukui, Japan
| | - Hiromichi Iwasaki
- Division of Infection and Clinical Immunology, University of Fukui Hospital, Fukui, Japan
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16
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Yamanaka S, Morikawa K, Azuma H, Yamanaka M, Shimada Y, Wada T, Matano H, Yamada N, Yamamura O, Hayashi H. Machine-Learning Approaches for Predicting the Need of Oxygen Therapy in Early-Stage COVID-19 in Japan: Multicenter Retrospective Observational Study. Front Med (Lausanne) 2022; 9:846525. [PMID: 35280897 PMCID: PMC8904892 DOI: 10.3389/fmed.2022.846525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/27/2022] [Indexed: 12/23/2022] Open
Abstract
Background Early prediction of oxygen therapy in patients with coronavirus disease 2019 (COVID-19) is vital for triage. Several machine-learning prognostic models for COVID-19 are currently available. However, external validation of these models has rarely been performed. Therefore, most reported predictive performance is optimistic and has a high risk of bias. This study aimed to develop and validate a model that predicts oxygen therapy needs in the early stages of COVID-19 using a sizable multicenter dataset. Methods This multicenter retrospective study included consecutive COVID-19 hospitalized patients confirmed by a reverse transcription chain reaction in 11 medical institutions in Fukui, Japan. We developed and validated seven machine-learning models (e.g., penalized logistic regression model) using routinely collected data (e.g., demographics, simple blood test). The primary outcome was the need for oxygen therapy (≥1 L/min or SpO2 ≤ 94%) during hospitalization. C-statistics, calibration slope, and association measures (e.g., sensitivity) evaluated the performance of the model using the test set (randomly selected 20% of data for internal validation). Among these seven models, the machine-learning model that showed the best performance was re-evaluated using an external dataset. We compared the model performances using the A-DROP criteria (modified version of CURB-65) as a conventional method. Results Of the 396 patients with COVID-19 for the model development, 102 patients (26%) required oxygen therapy during hospitalization. For internal validation, machine-learning models, except for the k-point nearest neighbor, had a higher discrimination ability than the A-DORP criteria (P < 0.01). The XGboost had the highest c-statistic in the internal validation (0.92 vs. 0.69 in A-DROP criteria; P < 0.001). For the external validation with 728 temporal independent datasets (106 patients [15%] required oxygen therapy), the XG boost model had a higher c-statistic (0.88 vs. 0.69 in A-DROP criteria; P < 0.001). Conclusions Machine-learning models demonstrated a more significant performance in predicting the need for oxygen therapy in the early stages of COVID-19.
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Affiliation(s)
- Syunsuke Yamanaka
- Department of Emergency Medicine and General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | | | - Hiroyuki Azuma
- Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan
| | - Maki Yamanaka
- Department of Emergency Medicine, Tannan Regional Medical Center, Sabae, Japan
| | - Yoshimitsu Shimada
- Department of Emergency Medicine, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - Toru Wada
- Department of Emergency Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Obama, Japan
| | - Hideyuki Matano
- Department of Emergency Medicine, Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Naoki Yamada
- Department of Emergency Medicine and General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medicine, University of Fukui Hospital, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Emergency Medicine and General Internal Medicine, University of Fukui Hospital, Fukui, Japan
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17
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Yamanaka S, Morikawa K, Morita H, Huh JY, Yamamura O. Calibration-Free Cuffless Blood Pressure Estimation Based on a Population With a Diverse Range of Age and Blood Pressure. Front Med Technol 2022; 3:695356. [PMID: 35047937 PMCID: PMC8757748 DOI: 10.3389/fmedt.2021.695356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
This study presents a new blood pressure (BP) estimation algorithm utilizing machine learning (ML). A cuffless device that can measure BP without calibration would be precious for portability, continuous measurement, and comfortability, but unfortunately, it does not currently exist. Conventional BP measurement with a cuff is standard, but this method has various problems like inaccurate BP measurement, poor portability, and painful cuff pressure. To overcome these disadvantages, many researchers have developed cuffless BP estimation devices. However, these devices are not clinically applicable because they require advanced preparation before use, such as calibration, do not follow international standards (81060-1:2007), or have been designed using insufficient data sets. The present study was conducted to combat these issues. We recruited 127 participants and obtained 878 raw datasets. According to international standards, our diverse data set included participants from different age groups with a wide variety of blood pressures. We utilized ML to formulate a BP estimation method that did not require calibration. The present study also conformed to the method required by international standards while calculating the level of error in BP estimation. Two essential methods were applied in this study: (a) grouping the participants into five subsets based on the relationship between the pulse transit time and systolic BP by a support vector machine ensemble with bagging (b) applying the information from the wavelet transformation of the pulse wave and the electrocardiogram to the linear regression BP estimation model for each group. For systolic BP, the standard deviation of error for the proposed BP estimation results with cross-validation was 7.74 mmHg, which was an improvement from 17.05 mmHg, as estimated by the conventional pulse-transit-time-based methods. For diastolic BP, the standard deviation of error was 6.42 mmHg for the proposed BP estimation, which was an improvement from 14.05mmHg. The purpose of the present study was to demonstrate and evaluate the performance of the newly developed BP estimation ML method that meets the international standard for non-invasive sphygmomanometers in a population with a diverse range of age and BP.
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Affiliation(s)
- Syunsuke Yamanaka
- Department of Emergency Medicine, General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | | | - Hiroshi Morita
- Department of Emergency Medicine, General Internal Medicine, University of Fukui Hospital, Fukui, Japan
| | - Ji Young Huh
- Emergency and Critical Care Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, University of Fukui Hospital, Fukui, Japan
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18
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Kitazaki Y, Shirafuji N, Takaku N, Yamaguchi T, Enomoto S, Ikawa M, Yamamura O, Nakamoto Y, Hamano T. Autoimmune basal ganglia encephalitis associated with anti-recoverin antibodies: A case report. eNeurologicalSci 2021; 25:100382. [PMID: 34877416 PMCID: PMC8628202 DOI: 10.1016/j.ensci.2021.100382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/25/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022] Open
Abstract
Autoimmune basal ganglia encephalitis causes neurological symptoms such as parkinsonism associated with basal ganglia lesions. Here, we report a case of autoimmune basal ganglia encephalitis without retinal lesions or malignancy harboring anti-recoverin antibodies. The patient was a 67-year-old Japanese woman who developed anorexia, parkinsonism, and disturbance of consciousness 7 days before admission. Brain magnetic resonance imaging showed hyperintense bilateral basal ganglia lesions on fluid-attenuated inversion recovery images. 18F-fluorodeoxyglucose-positron emission tomography showed no malignancy in the trunk, and dopamine transporter single-photon emission computed tomography with dopamine transporters revealed reduced radiotracer uptake in the basal ganglia. Further, anti-recoverin IgG antibodies were detected in serum immunoblot. Based on the clinical and imaging findings, the patient was diagnosed with autoimmune basal ganglia encephalitis with anti-recoverin antibodies and administered high-dose immunoglobulins (HD-IVIG), which led to an improvement in clinical symptoms. Anti-recoverin antibodies are paraneoplastic antibodies that explicitly bind to Ca2+-binding proteins in the retina and cause retinopathy. This pathological sequence is defined as cancer-associated retinopathy (CAR). However, in our case, autoimmune basal ganglia encephalitis developed without CAR syndrome or malignancy. Clinicians should be aware of the possibility of autoimmune basal ganglia encephalitis showing anti-recoverin antibodies but no CAR syndrome or malignancy, which should be treated with HD-IVIG therapy. Autoimmune basal ganglia encephalitis causes parkinsonism related to basal ganglia. We report an autoimmune basal ganglia encephalitis with anti-recoverin antibodies. Anti-recoverin Abs are paraneoplastic antibodies and cause retinopathy. Autoimmune encephalitis with anti-recoverin Abs developed without retinopathy. Autoimmune encephalitis with anti-recoverin Abs should be treated with HD-IVIG.
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Affiliation(s)
- Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Naoko Takaku
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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19
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Asano R, Hamano T, Yen S, Sasaki H, Yamaguchi T, Endo Y, Enomoto S, Shirafuji N, Ikawa M, Yamamura O, Nakamoto Y. Lithium chloride inhibits phosphorylation of tau protein. Alzheimers Dement 2021. [DOI: 10.1002/alz.054807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rei Asano
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD) Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Shu‐Hui Yen
- Mayo Clinic Jacksonville Jacksonville FL USA
| | - Hirohito Sasaki
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Yoshinori Endo
- Second Department of Internal Medicine University of Fukui Fukui Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD) Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD) Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine Faculty of Medical Sciences University of Fukui Fukui Japan
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20
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Onishi H, Yamamura O, Tsubouchi H, Hirobe T, Enomoto S, Yamamoto T, Daitoku S, Mizukami Y, Kishimoto T, Kai Y, Hashimoto Y, Hamano T, Kaku B, Terasawa H. Hypertension treatment status and ultrasonic cardiography findings in temporary housing residents after the Kumamoto earthquake: a cross-sectional study. Arterial Hypertension 2021. [DOI: 10.5603/ah.a2021.0010] [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: 11/25/2022] Open
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21
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Ito Y, Goto T, Huh JY, Yamamura O, Hamano T, Kikuta KI, Hayashi H. Development of a Scoring System to Predict Prolonged Post-Stroke Dysphagia Remaining at Discharge from a Subacute Care Hospital to the Home. J Stroke Cerebrovasc Dis 2021; 30:105804. [PMID: 33906072 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/24/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prolonged dysphagia is an important stroke-related complication that imposes a substantial burden on patients and families. However, simple scoring tool to predict prolonged dysphagia is not existing. MATERIALS AND METHODS This retrospective cohort study used data from April 2010 to March 2016. Adult patients with first-ever stroke were included. The outcome was swallowing function at discharge from the subacute care hospital to the patient's home. We collected the following factors obtained at discharge from the University of Fukui Hospital: age, sex, type of stroke, comorbidities, smoking status, alcohol use, denture use, functional dependency in daily living before admission, National Institutes of Health Stroke Scale score (NIHSS) at admission, and Functional Independence Measure(FIM). Data were divided into a training set (70%) and test set (30%). Lasso and logistic regression were used for feature selection, a scoring system was then developed, and its prediction performance evaluated. RESULTS This study enrolled 462 patients with acute stroke. Using lasso and logistic regression, three variables (functional dependency before admission, Functional Independence Measure [FIM]-cognitive and FIM-motor scores at transfer) remained statistically significant predictors of prolonged dysphagia. Risk scores were categorized as low risk (0-2), moderate risk (3-4), and high risk (5-7), with dysphagia rates of 0%-1%, 13%-29%, and 50%-100%, respectively. A newly developed score ≥3 was the optimal cutoff for identifying patients with the potential risk of prolonged dysphagia (C-statistics, 0.92 in the test set). CONCLUSION The developed scoring system is simple and has a high performance in predicting prolonged dysphagia after acute stroke.
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Affiliation(s)
- Yukiko Ito
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan.
| | - Tadahiro Goto
- TXP Medical Co. Ltd., Tokyo, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Ji Young Huh
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science,University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Department of Neurology, University of Fukui Hospital, Fukui, Japan
| | - Ken-Ichiro Kikuta
- Department of Neurosurgery, University of Fukui Hospital, Fukui, Japan
| | - Hiroyuki Hayashi
- Department of Family and Emergency Medicine, University of Fukui Hospital, Fukui, Japan
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22
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Onishi H, Yamamura O, Ueda S, Shibata M, Enomoto S, Maeda F, Tsubouchi H, Hirobe T, Shimizu S, Kishimoto T, Chiba H, Sasaki K, Hanzawa K, Hamano T, Nakamoto Y, Kaku B, Terasawa H. Deep-vein thrombosis detection rates and consideration of the living environment in a tsunami disaster area during the disaster reconstruction phase: A cross-sectional study. Acta Angiologica 2021. [DOI: 10.5603/aa.2020.0025] [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: 11/25/2022] Open
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23
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Kitazaki Y, Asano R, Hayashi K, Yamamura O, Tanabe S, Hamano T. [A case of asymptomatic Stanford type A aortic dissection with multiple perforator infarcts due to pseudointracavitary thrombus]. Rinsho Shinkeigaku 2020; 60:874-877. [PMID: 33229835 DOI: 10.5692/clinicalneurol.cn-001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 56-year-old man presented to our hospital as he presented progressive hemiplegia of the right upper limb with no other symptoms, including chest pain. Inter-arm blood pressure difference was not observed. Laboratory investigations revealed an elevated D-dimer value (2.4 μg/ml). Chest X-ray study showed normal findings without widened mediastinum. Brain MRI showed acute multiple brain infarcts in the left posterior limb of the internal capsule and right pons on diffusion-weighted imaging. Bilateral internal carotid arteries were non-occlusive in MRA. Carotid duplex ultrasonography revealed normal internal carotid artery flow velocities bilaterally. Because ischemic lesions were found in multiple vascular territories, and D-dimer value was elevated, the patient underwent thoracic contrast-enhanced-CT to exclude malignant tumors. Stanford type A aortic dissection limited to the ascending aorta was detected. As the plaque had accumulated in the false lumen, we suspected that plaque in the false lumen could be an embolic source. After ascending aortic replacement surgery, brain infarction did not recur during hospitalization. In cases of ischemic stroke wherein multiple vascular territories are detected, and D-dimer value is elevated, even in patients without chest pain, the possibility of painless Stanford type A aortic dissection should be ruled out as an embolic source.
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Affiliation(s)
- Yuki Kitazaki
- Department of Neurology, University of Fukui Hospital
| | - Rei Asano
- Department of Neurology, University of Fukui Hospital
| | - Kouji Hayashi
- Department of Neurology, University of Fukui Hospital.,Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University
| | | | - Sawaka Tanabe
- Department of Cardiovascular Surgery, University of Fukui Hospital
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24
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Yamaguchi T, Hamano T, Sada K, Kanaan NM, Sasaki H, Yen S, Asano R, Enomoto S, Shirafuji N, Ueno A, Ikawa M, Yamamura O, Nakamoto Y. Syk inhibitor reduces oligomeric tau associated with GSK3β inactivation and autophagy activation. Alzheimers Dement 2020. [DOI: 10.1002/alz.042633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Kiyonao Sada
- Department of Genome Science and Microbiology, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Nicholas M. Kanaan
- Michigan State University, College of Human Medicine Grand Rapids MI USA
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Shu‐Hui Yen
- Mayo Clinic Jacksonville Jacksonville FL USA
| | - Rei Asano
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
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25
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Zhu F, Lin G, Hamano T, Kanaan NM, Yen S, Asano R, Shirafuji N, Sasaki H, Enomoto S, Yamaguchi T, Ueno A, Ikawa M, Yamamura O, Nakamoto Y. Clioquinol reduces tau phosphorylation and oligomerization. Alzheimers Dement 2020. [DOI: 10.1002/alz.044356] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Feiyan Zhu
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Neurology Tongde Hospital of Zhejiang Province Zhejiang China
| | - Gaoping Lin
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Zhejiang Provincial People's Hospital Zhejiang China
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Nicholas M. Kanaan
- Michigan State University, College of Human Medicine Grand Rapids MI USA
| | - Shu‐Hui Yen
- Mayo Clinic Jacksonville Jacksonville FL USA
| | - Rei Asano
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Hirohito Sasaki
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
- Department of Aging and Dementia (DAD), Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences University of Fukui Fukui Japan
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26
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Nakane S, Mizoguchi K, Abe K, Atsuta N, Iguchi Y, Ikeda Y, Kaji R, Kamei S, Kitagawa K, Kimura K, Suzuki M, Takashima H, Terayama Y, Nishiyama K, Furuya H, Matsubara E, Muramatsu SI, Yamamura O, Takeda A, Ito H. [Role of the liaison officer in disaster countermeasures implemented by the Japanese Society of Neurology: Hope for the best and prepare for the worst]. Rinsho Shinkeigaku 2020; 60:643-652. [PMID: 32814728 DOI: 10.5692/clinicalneurol.cn-001493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Disaster countermeasures have been implemented by the Japanese Society of Neurology based on the experience of support to the areas affected by the Great East Japan Earthquake on March 11, 2011. The countermeasures activity began at the end of 2011. We, the Committee for Measures Against Disaster, officially started work in 2014. We developed a support network to urgently deal with patients with intractable neurological disease at the time of disaster and strengthen disaster measures, including effective disaster countermeasure training. During the 2016 Kumamoto earthquake, we realized the need to prepare for natural disasters, leading to a state of emergency, at normal times. A list of vulnerable people should be prepared and the individual support plan for disaster should be confirmed during normal times. Furthermore, during disaster, livelihood support is required for patients with intractable neurological disease living in evacuation centers in affected areas. Therefore, we compiled and published the book, titled "The manual of disaster countermeasures," in 2017. The Committee for Measures Against Disaster in the Japanese Society of Neurology has appointed a liaison officer for patients with intractable neurological disease in each prefecture. The liaison's role of is gathering and disseminating information on the disaster-hit areas, arranging medical support, and coordinating health activities, when natural disasters occur. It is hoped that the liaison officer will play an active role both at normal times and during disaster, even unforeseen ones. Although we hope for the best, we aim to be prepared for the worst.
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Affiliation(s)
- Shunya Nakane
- Department of Molecular Neurology & Therapeutics, Kumamoto University Hospital
| | - Kouichi Mizoguchi
- Department of Neurology, National Hospital Organization Shizuoka Medical Center
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Naoki Atsuta
- Department of Neurology, Nagoya University Graduate School of Medicine
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine
| | - Yoshio Ikeda
- Department of Neurology, Gunma University Graduate School of Medicine
| | - Ryuji Kaji
- Department of Neurology, National Hospital Organization Utano National Hospital
| | - Satoshi Kamei
- Center for Neuro-infections, Department of Neurology, Ageo Central General Hospital
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University School of Medicine
| | | | - Masahiko Suzuki
- Department of Neurology, The Jikei University Katsushika Medical Center
| | - Hiroshi Takashima
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences
| | | | | | | | | | - Shin-Ichi Muramatsu
- Division of Neurological Gene Therapy, Center for Open Innovation, Jichi Medical University
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui
| | - Atsushi Takeda
- Department of Neurology, National Hospital Organization Sendai-Nishitaga Hospital
| | - Hidefumi Ito
- Department of Neurology, Wakayama Medical University
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27
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Kitazaki Y, Ikawa M, Enomoto S, Shirafuji N, Hayashi K, Yamamura O, Yamada S, Arishima H, Noriki S, Nakamoto Y, Hamano T. An autopsy case of tuberculous meningitis undiagnosed by nested-PCR of CSF samples and brain biopsy. J Neurol Sci 2020; 415:116968. [PMID: 32534371 DOI: 10.1016/j.jns.2020.116968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
Nested polymerase chain reaction (PCR) testing of cerebrospinal fluid (CSF) has higher diagnostic sensitivity with regard to tuberculous meningitis (TBM) than conventional methods. Herein we describe the autopsy case of a 70-year-old woman with TBM that could not be diagnosed via nested PCR in CSF, even though it was performed three times. The clinical course, magnetic resonance imaging results, and elevated adenosine deaminase levels in CSF were consistent with TBM. We also performed a brain biopsy from the thickened leptomeninges of the patient, which showed granulomatous leptomeningitis consistent with TBM. However, we were not able to identify tuberculous bacilli by the acid-fast bacterial staining, single PCR test, and culture of the biopsy preparations. We finally diagnosed TBM in this case by the positive results of both the fourth PCR test and culture of her CSF, which were taken 7 days before her death. This case suggests that even the combination of repetitive nested PCR in CSF and brain biopsy lacks adequate sensitivity to exclude TBM in some patients.
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Affiliation(s)
- Yuki Kitazaki
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
| | - Soichi Enomoto
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kouji Hayashi
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Shinsuke Yamada
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hidetaka Arishima
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Sakon Noriki
- Department of Pathology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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28
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Lee S, Fujita K, Morishita T, Negoro E, Oiwa K, Tsukasaki H, Yamamura O, Ueda T, Yamauchi T. Prognostic utility of a geriatric nutritional risk index in combination with a comorbidity index in elderly patients with diffuse large B cell lymphoma. Br J Haematol 2020; 192:100-109. [PMID: 32410224 DOI: 10.1111/bjh.16743] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
Reflecting the increasing risk in elderly patients with diffuse large B cell lymphoma (DLBCL), prognostic predictors other than the International Prognostic Index have attracted more attention. This study presents the first analysis of the prognostic utility of the Geriatric Nutritional Risk Index (GNRI) in combination with the Charlson Comorbidity Index (CCI) for overall survival (OS) in elderly DLBCL patients. A multicentre retrospective was conducted on a cohort of 451 patients (≥65 years). The GNRI and CCI were independent predictors in a multivariate Cox proportional hazard model. There was a nonlinear correlation between the GNRI and OS in a Cox model with restricted cubic spline. Multivariate receiver operating characteristic curves showed a significant improvement in prediction accuracy when the GNRI was added to CCI. Adding the GNRI to CCI yielded a significant category-free net reclassification improvement (0·556; 95% CI: 0·378-0·736, P < 0·001) and integrated discrimination improvement (0·094; 95% CI: 0·067-0·122, P < 0·001). The decision curve analysis demonstrated the clinical net benefit associated with the adoption of the GNRI. The GNRI was not only a predictor of OS but also remarkably improved the prognosis prediction accuracy when incorporated with the CCI, having the ability to stratify the prognosis of elderly DLBCL patients.
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Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Hikaru Tsukasaki
- Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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29
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Kitazaki Y, Ikawa M, Yamaguchi T, Enomoto S, Kishitani T, Shirafuji N, Hayashi K, Yamamura O, Nakamoto Y, Hamano T. Autoimmune Encephalitis Associated with Anti-gamma-aminobutyric Acid B Receptor Antibodies Mimicking Syncope. Intern Med 2020; 59:843-847. [PMID: 31813910 PMCID: PMC7118379 DOI: 10.2169/internalmedicine.3652-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Autoimmune encephalitis associated with autoantibodies to the gamma-aminobutyric acid B receptor (GABABR-AE) typically involves limbic symptoms with limbic abnormalities visible in brain magnetic resonance imaging (MRI). We herein report a case of a 48-year-old man with GABABR-AE whose initial presentation was limited to syncope without limbic symptoms or MRI abnormalities. Interestingly, serial MRI also revealed no abnormalities even after the appearance of limbic symptoms. Our findings suggest that GABABR-AE can initially mimic common syncope and that MRI findings may remain normal throughout the clinical course. Even if patients have normal MRI findings, GABABR-AE should be considered if limbic symptoms worsen.
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Affiliation(s)
- Yuki Kitazaki
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
- Department of Advanced Medicine for Community Healthcare, Faculty of Medical Sciences, University of Fukui, Japan
| | - Tomohisa Yamaguchi
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
- Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan
| | - Toru Kishitani
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Norimichi Shirafuji
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Koji Hayashi
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Japan
- Department of Aging and Dementia, Faculty of Medical Sciences, University of Fukui, Japan
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30
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Endo Y, Hayashi K, Ikawa M, Yamamura O, Ookura K, Hamano T. [A case of neuromyelitis optica spectrum disorder with persistent nausea and repeated syncope]. Rinsho Shinkeigaku 2020; 60:142-145. [PMID: 31956194 DOI: 10.5692/clinicalneurol.cn-001345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A 22-year-old woman was admitted to our hospital with persistent nausea and no apparent cause. There was no preceding infection. The patient lost consciousness for several seconds. Based on an electrocardiographic diagnosis of paroxysmal sinus arrest (PSA), a temporary pacemaker was implanted. She did not develop syncope, but vertigo, nystagmus, diplopia, and limb paresthesia were observed. Brain MRI revealed a high-intensity lesion in the dorsal medulla on FLAIR images. As the serum anti-aquaporin 4 (AQP4) antibody was positive, the patient was diagnosed with neuromyelitis optica spectrum disorder (NMOSD). After she received steroid pulse therapy (methylprednisolone at 1,000 mg/day for three days) twice, her symptoms markedly improved. In this patient, PSA was considered to be a symptom of area postrema syndrome of NMOSD. Therefore, NMOSD should be considered as a possible cause of PSA.
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Affiliation(s)
- Yoshinori Endo
- Department of Neurology, Fukui-ken Saiseikai Hospital.,Department of Neurology, University of Fukui Hospital
| | - Kouji Hayashi
- Department of Neurology, Fukui-ken Saiseikai Hospital.,Department of Neurology, University of Fukui Hospital.,Department of Rehabilitation, Faculty of Health Science, Fukui Health Science University
| | | | | | | | - Tadanori Hamano
- Department of Neurology, University of Fukui Hospital.,Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui
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31
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Hamano T, Shirafuji N, Yen SH, Yoshida H, Kanaan NM, Hayashi K, Ikawa M, Yamamura O, Fujita Y, Kuriyama M, Nakamoto Y. Rho-kinase ROCK inhibitors reduce oligomeric tau protein. Neurobiol Aging 2019; 89:41-54. [PMID: 31982202 DOI: 10.1016/j.neurobiolaging.2019.12.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/21/2022]
Abstract
Neurofibrillary tangles, one of the pathological hallmarks of Alzheimer's disease, consist of highly phosphorylated tau proteins. Tau protein binds to microtubules and is best known for its role in regulating microtubule dynamics. However, if tau protein is phosphorylated by activated major tau kinases, including glycogen synthase kinase 3β or cyclin-dependent kinase 5, or inactivated tau phosphatase, including protein phosphatase 2A, its affinity for microtubules is reduced, and the free tau is believed to aggregate, thereby forming neurofibrillary tangles. We previously reported that pitavastatin decreases the total and phosphorylated tau protein using a cellular model of tauopathy. The reduction of tau was considered to be due to Rho-associated coiled-coil protein kinase (ROCK) inhibition by pitavastatin. ROCK plays important roles to organize the actin cytoskeleton, an expected therapeutic target of human disorders. Several ROCK inhibitors are clinically applied to prevent vasospasm postsubarachnoid hemorrhage (fasudil) and for the treatment of glaucoma (ripasudil). We have examined the effects of ROCK inhibitors (H1152, Y-27632, and fasudil [HA-1077]) on tau protein phosphorylation in detail. A human neuroblastoma cell line (M1C cells) that expresses wild-type tau protein (4R0N) by tetracycline-off (TetOff) induction, primary cultured mouse neurons, and a mouse model of tauopathy (rTG4510 line) were used. The levels of phosphorylated tau and caspase-cleaved tau were reduced by the ROCK inhibitors. Oligomeric tau levels were also reduced by ROCK inhibitors. After ROCK inhibitor treatment, glycogen synthase kinase 3β, cyclin-dependent kinase 5, and caspase were inactivated, protein phosphatase 2A was activated, and the levels of IFN-γ were reduced. ROCK inhibitors activated autophagy and proteasome pathways, which are considered important for the degradation of tau protein. Collectively, these results suggest that ROCK inhibitors represent a viable therapeutic route to reduce the pathogenic forms of tau protein in tauopathies, including Alzheimer's disease.
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Affiliation(s)
- Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Life Science Innovation Center, University of Fukui, Fukui, Japan.
| | - Norimichi Shirafuji
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Aging and Dementia (DAD), Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | | | - Hirotaka Yoshida
- National Center for Geriatrics and Gerontology (NCGG), Aichi, Japan
| | - Nicholas M Kanaan
- Department of Translational Science and Molecular Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Kouji Hayashi
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Youshi Fujita
- Department of Neurology, Fujita Neurology Hospital, Fukui, Japan
| | | | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Ueno A, Hamano T, Enomoto S, Shirafuji N, Nagata M, Yamaguchi T, Sasaki H, Kamisawa T, Ikawa M, Yamamura O, Kuriyama M, Nakamoto Y. P2-040: VITAMIN B12 SUPPLEMENTATION IMPROVES HYPERHOMOCYSTEINEMIA AND COGNITIVE IMPAIRMENT IN PATIENTS WITH VITAMIN B12 DEFICIENCY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.1262] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Tadanori Hamano
- University of Fukui; Fukui Japan
- Department of Aging and Dementia (DAD); University of Fukui; Fukui Japan
| | - Soichi Enomoto
- University of Fukui; Fukui Japan
- Department of Aging and Dementia (DAD); University of Fukui; Fukui Japan
| | - Norimichi Shirafuji
- University of Fukui; Fukui Japan
- Department of Aging and Dementia (DAD); University of Fukui; Fukui Japan
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Yamaguchi T, Yamamura O, Hamano T, Murakita K, Nakamoto Y. Premorbid physical activity is modestly associated with gait independence after a stroke: an exploratory study. Eur Rev Aging Phys Act 2019; 15:18. [PMID: 30603050 PMCID: PMC6305997 DOI: 10.1186/s11556-018-0208-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/17/2018] [Indexed: 11/10/2022] Open
Abstract
Background Regaining physical function after a stroke is important for independence and for performing activities of daily living. Particularly, cerebrovascular disease, which includes stroke, is not entirely avoidable. In the present study, we aimed to observe the association between premorbid physical activities and gait independence after a stroke. Methods Consecutive cerebrovascular stroke patients were asked to fill a questionnaire regarding their premorbid physical activities. The association between gait independence at the completion of in-hospital rehabilitation and premorbid physical activities, as well as age, stroke type, lesion size, and comorbidities, was investigated statistically. Results Of 130 consecutive patients with stroke who answered the questionnaire regarding their premorbid physical activities, 97 regained gait independence. Ambulation and occupational or household activities were most frequently performed by all the participants before stroke onset. Participants who acquired gait independence tended to indicate various premorbid activities compared to participants who did not recover gait independence. Estimating premorbid physical activities in metabolic equivalents suggested that moderate to vigorous activities were associated with an increased probability of post-stroke independent gait but this tendency was dismissed after multivariate analysis including age and history of stroke. Conclusions Premorbid physical activity is associated with gait independence after a stroke, but this association is not as strong as those of age or history of stroke. Electronic supplementary material The online version of this article (10.1186/s11556-018-0208-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tomoko Yamaguchi
- 1Department of Community Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Osamu Yamamura
- 2Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui. Fukui, Shimoaizuki 23, Matsuoka, 9101193 Japan
| | - Tadanori Hamano
- 2Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui. Fukui, Shimoaizuki 23, Matsuoka, 9101193 Japan
| | | | - Yasunari Nakamoto
- 2Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui. Fukui, Shimoaizuki 23, Matsuoka, 9101193 Japan
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Onishi H, Yamamura O, Matsuo S, Tanaka T, Daitoku S, Konokawa S, Tsubouchi H, Chiba H, Sone M, Kaku B, Enomoto S, Yamamoto T, Hashimoto Y, Hamano T, Hayashi H, Terasawa H. Localized Right Subclavian Artery Dissection Detected by Accident on an Ultrasound Examination: A Case Report and Literature Review. Intern Med 2019; 58:73-78. [PMID: 30146598 PMCID: PMC6367090 DOI: 10.2169/internalmedicine.1451-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Right subclavian artery dissection was detected in a 78-year-old female victim of the Kumamoto earthquake during a carotid artery ultrasound examination. She was subsequently taken to hospital and diagnosed with localized subclavian artery dissection (LSAD) by contrast-enhanced computed tomography. There have been no previous reports of LSAD detected at a medical checkup. LSAD may progress and become severe, even in asymptomatic patients or patients with mild symptoms, and careful long-term follow-up is therefore required in all patients diagnosed with LSAD.
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Affiliation(s)
- Hidenori Onishi
- Department of Medical Technology, Kitasato Junior College of Health and Hygienic Sciences, Japan
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui Hospital, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, Japan
- Department of Community Medicine, University of Fukui, Japan
| | - Seiya Matsuo
- Department of Emergency, University of Fukui, Japan
| | - Tokuharu Tanaka
- Department of Internal Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Japan
| | - Satoshi Daitoku
- Department of Radiological Technology, Faculty of Medical Technology, Niigata University of Health and Welfare, Japan
| | | | | | - Hiroshi Chiba
- Division of Clinical Laboratory, Morioka Municipal Hospital, Japan
| | - Maiko Sone
- Department of Cardiology, Saiseikai Kurihashi Hospital, Japan
| | - Bunji Kaku
- Department of Cardiology, Toyama Red Cross Hospital, Japan
| | - Souichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui Hospital, Japan
| | - Tami Yamamoto
- Department of Clinical Laboratory, Saiseikai Kumamoto Hospital, Japan
| | | | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui Hospital, Japan
| | - Hiroyuki Hayashi
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui Hospital, Japan
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Tanaka T, Nishiyama K, Yamamura O, Watase H, Yokoyama Y, Horiguchi T, Konishi T, Hayashi H. Geriatric Nutritional Risk Index for independent walking function in maintenance hemodialysis patients: A single-facility retrospective cohort study. Geriatr Gerontol Int 2018; 18:1556-1561. [PMID: 30311409 DOI: 10.1111/ggi.13524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/06/2018] [Accepted: 07/30/2018] [Indexed: 12/16/2022]
Abstract
AIM The target Geriatric Nutritional Risk Index (GNRI) for patients on chronic maintenance hemodialysis is unclear. We aimed to determine the relationship between the GNRI and independent walking ability in such patients. METHODS In the present retrospective cohort study, 90 patients receiving chronic maintenance hemodialysis were included. Logistic regression analyses were carried out to evaluate the relationship between the GNRI and independent walking ability. Receiver operating characteristic curve analysis was carried out to determine the cut-off GNRI for predicting independent walking ability. RESULTS Multivariate logistic regression analysis showed significant differences in age (odds ratio [OR] 0.8, 95% confidence interval [CI] 0.6-0.9), creatinine generation rate percentage (OR 1.1, 95% CI 1.0-1.2), GNRI (OR 1.4, 95% CI 1.1-1.8; P < 0.01) and urea removal rate (OR 0.3, 95% CI 0.1-0.9; P < 0.05). The cut-off GNRI for independent walking ability was 86.7 (area under the curve 0.80, sensitivity 92.1%, specificity 66.7%, positive hit ratio 86.6%, negative hit ratio 78.3%). The factors correlated with survival in the univariate analysis were the GNRI, equilibrated Kt/V, urea removal rate, clear space rate, salt intake amount (P < 0.01), number of days of hospitalization and %creatinine generation rate (P < 0.05). The Cox proportional hazard regression model showed an OR of 0.77 (95% CI 0.32-1.8) at a GNRI <86/GNRI ≥86. In the multivariate survival analysis, we observed no significant differences in any of the factors. CONCLUSIONS GNRI was correlated with walking ability, which indicated that GNRI might predict future walking ability; also, a GNRI of 87 might be the target for maintaining walking ability. Geriatr Gerontol Int 2018; 18: 1556-1561.
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Affiliation(s)
- Tokuharu Tanaka
- Department of Internal Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Obama, Japan
| | - Kei Nishiyama
- Critical Care Center, Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Regional Medicine Promotion Course, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroko Watase
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Yoshinari Yokoyama
- Department of Nephrology, Sugita Genpaku Memorial Obama Municipal Hospital, Obama, Japan
| | - Takayasu Horiguchi
- Department of Nephrology, Sugita Genpaku Memorial Obama Municipal Hospital, Obama, Japan
| | - Takashi Konishi
- Department of Internal Medicine, Sugita Genpaku Memorial Obama Municipal Hospital, Obama, Japan
| | - Hiroyuki Hayashi
- Department of Emergency and General Medicine, University of Fukui Hospital, Fukui, Japan
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Kamekawa Y, Yamamura O. OSNC11: The Effect of Bite Raising on Swallowing Sounds. J Indian Prosthodont Soc 2018; 18:S33. [PMID: 30532449 PMCID: PMC6238427 DOI: 10.4103/0972-4052.244652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Yoshiki Kamekawa
- Department of Prosthodontics, Division of Oral Functional Science and Rehabilitations, Asahi University School of Dentistry, Gifu, Japan
| | - Osamu Yamamura
- Department of Prosthodontics, Division of Oral Functional Science and Rehabilitations, Asahi University School of Dentistry, Gifu, Japan
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Onishi H, Yamamura O, Ueda S, Shibata M, Enomoto S, Maeda F, Tsubouchi H, Hirobe T, Shimizu S, Hanzawa K, Hamano T, Nakamoto Y, Hayashi H, Terasawa H. Ultrasound cardiography examinations detect victims' long-term realized and potential consequences after major disasters: a case-control study. Environ Health Prev Med 2018; 23:37. [PMID: 30103685 PMCID: PMC6090717 DOI: 10.1186/s12199-018-0721-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/15/2018] [Indexed: 12/05/2022] Open
Abstract
Background An increase in cardiovascular diseases has been reported following major disasters. Previous work has shown that ultrasonographic findings from ultrasound cardiography examination (UCG) increased until the 44th month after the tsunami caused by the Great East Japan Earthquake. The present study conducted UCG among victims in the tsunami disaster area and investigated the frequency of disaster-related cardiovascular diseases and changes over time until the 55th month after the disaster. Methods The subjects were residents of temporary housing complexes and neighboring housing in Watari-gun, Miyagi Prefecture, Japan. There were 207 subjects in the 18th month, 125 in the 30th month, 121 in the 44th month, and 106 in the 55th month after the disaster. Data were collected through UCG and self-report questionnaire. Results Significant changes were observed among subjects with clinical findings from the UCG, which increased over the study period—from 42.0 to 60.8, 72.7, and 73.6% beginning in the 18th month after the disaster (p < 0.0001). Conclusions It is possible that the UCG can become a useful examination to visualize the potential impact of a major disaster on the cardiac function of victims. Victims with clinical findings continued increasing not only during the acute phase after a disaster but also in the long term. We therefore need to keep this in mind, and note that it is important to establish a support system to control cardiovascular diseases from the early stage of disaster. Trial registration UMIN; ID000029802. R000034050. 2 November 2017.
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Affiliation(s)
- Hidenori Onishi
- Department of Medical Technology, Kitasato Junior College of Health and Hygienic Sciences, Niigata, Japan.,Department of General Medicine, University of Fukui Hospital, Fukui, Japan
| | - Osamu Yamamura
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan. .,Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan.
| | - Shinsaku Ueda
- Department of Thoracic Surgery, Ishinomaki Red Cross Hospital, Miyagi, Japan
| | | | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan
| | - Fumie Maeda
- Department of Clinical Laboratory, University of Fukui Hospital, Fukui, Japan
| | - Hiromasa Tsubouchi
- Department of Radiotechnology, Fukui Ken Saiseikai Hospital, Fukui, Japan
| | - Takeshi Hirobe
- Department of Clinical Laboratory, Fukui Prefectural Hospital, Fukui, Japan
| | - Sadao Shimizu
- Department of Research Laboratory, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Kazuhiko Hanzawa
- Department of Respiratory Surgery, Graduate School of Medicine, University of Niigata, Niigata, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan
| | - Yasunari Nakamoto
- Second Department of Internal Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan
| | - Hiroyuki Hayashi
- Department of General Medicine, University of Fukui Hospital, Fukui, Japan
| | - Hidekazu Terasawa
- Department of Community Medicine, Faculty of Medical Science, University of Fukui, 23-3 Matsuokashimoaizuki Yoshida-gun Eiheiji-cho, Fukui, 910-1104, Japan
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Kitazaki Y, Hamano T, Ueno A, Asano R, Sasaki H, Enomoto S, Shirafuji N, Matsunaga A, Ikawa M, Hayashi K, Yamamura O, Nakamoto Y. P1‐261: CSF TAU PROTEIN IN AUTOIMMUNE ENCEPHALITIS PATIENTS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.267] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Shibata M, Chiba H, Sasaki K, Ueda S, Yamamura O, Hanzawa K. The utility of on-site ultrasound screening in population at high risk for deep venous thrombosis in temporary housing after the great East Japan Earthquake. J Clin Ultrasound 2017; 45:566-574. [PMID: 28556184 DOI: 10.1002/jcu.22505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND To evaluate the diagnostic performance of ultrasonography for screening of a population at risk for deep vein thrombosis (DVT) in a post-disaster setting. METHODS Ultrasonography was applied as a screening technique to the residents of a temporary housing facility who were displaced following the Great East Japan Earthquake. Thirty DVT screening sessions were held from April 2013 to June 2015. Individuals were invited to participate if they were identified as "high risk" for DVT, defined as those with low activity levels, a history of lower limb trauma, baseline lower limb pain or swelling, a cancer-bearing status, or a history of venous thromboembolic event. Ultrasonographic examinations were performed from the calf to the popliteal veins using portable devices. RESULTS Of the 3,316 subjects screened (682 men and 2,634 women) with a mean age of 71 ± 9.7 years, DVT was diagnosed in 382 (11.5%). DVT was more likely in older, symptomatic, or female patients with a history of venous thromboembolism and attempting to perform daily exercise. The rate of DVT diagnosis increased from 9.9% in 2013 to 13.5% in 2015. CONCLUSIONS Ultrasonography is efficient for screening at-risk populations in challenging settings. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:566-574, 2017.
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Affiliation(s)
- Muneichi Shibata
- Department of Cardiology, Makabe Hospital, Higashimatsushima, Japan
| | - Hiroshi Chiba
- Division of Clinical Laboratory, Morioka Municipal Hospital, Morioka, Japan
| | - Kazuhiro Sasaki
- Department of Neurology, Morioka Municipal Hospital, Morioka, Japan
| | - Shinsaku Ueda
- Department of Thoracic Surgery, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Osamu Yamamura
- Department of Community Health Care Promotion, University of Fukui, Eiheiji, Japan
| | - Kazuhiko Hanzawa
- Division of Thoracic and Cardiovascular Surgery, Niigata University, Niigata, Japan
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Yamamura O, Nakamura T, Ibuki W, Katsuaki T, Haba T, Hamano T. The effect of malnutrition on discharge outcome of stroke - Examination in convalescent rehabilitation ward of single hospital –. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3174] [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: 11/25/2022]
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Hamano T, Hayashi K, Nagata M, Matsubara R, Ikebata Y, Ito T, Ibe A, Fujita Y, Kusaka Y, Shirafuji N, Sasaki H, Kitazaki Y, Yamaguchi T, Enomoto S, Endo Y, Ueno A, Matsunaga A, Ikawa M, Yamamura O, Nakamoto Y. Efficacy of short questionnaire for screening of early stage of dementia. Trial in Fukui prefecture, Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hayashi K, Hamano T, Asano R, Sasaki H, Kitasaki Y, Endo Y, Enomoto S, Shirafuji N, Matsunaga A, Ueno A, Ikawa M, Yamamura O, Nakamoto Y. Reduction of serum cholinesterase by cholinesterase inhibitor (Donepezil, Galantamine, or Rivastigmine). J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.936] [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: 11/26/2022]
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Hamano T, Hayashi K, Ueno A, Shirafuji N, Fujita Y, Nakajima H, Fujita Y, Enomoto S, Endo Y, Yamaguchi T, Sasaki H, Ikawa M, Yamamura O, Kuriyama M, Nakamoto Y. [P1–081]: EFFECTIVENESS OF PITAVASTATIN IN PATIENTS WITH MILD ALZHEIMER'S DISEASE AND HYPERLIPIDEMIA. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.148] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | - Youshi Fujita
- University of FukuiFukuiJapan
- Fujita Neurological HospitalFukuiJapan
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Kishitani T, Matsunaga A, Ikawa M, Hayashi K, Yamamura O, Hamano T, Watanabe O, Tanaka K, Nakamoto Y, Yoneda M. Limbic encephalitis associated with anti-NH2-terminal of α-enolase antibodies: A clinical subtype of Hashimoto encephalopathy. Medicine (Baltimore) 2017; 96:e6181. [PMID: 28272206 PMCID: PMC5348154 DOI: 10.1097/md.0000000000006181] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Several types of autoantibodies have been reported in autoimmune limbic encephalitis (LE), such as antibodies against the voltage-gated potassium channel (VGKC) complex including leucine-rich glioma inactivated 1 (LGI1). We recently reported a patient with autoimmune LE and serum anti-NH2-terminal of α-enolase (NAE) antibodies, a specific diagnostic marker for Hashimoto encephalopathy (HE), who was diagnosed with HE based on the presence of antithyroid antibodies and responsiveness to immunotherapy. This case suggests that LE patients with antibodies to both the thyroid and NAE could be diagnosed with HE and respond to immunotherapy. The aim of this study was to clarify the clinicoimmunological features and efficacy of immunotherapy in LE associated with anti-NAE antibodies to determine whether the LE is a clinical subtype of HE.We examined serum anti-NAE antibodies in 78 LE patients with limbic abnormality on magnetic resonance imaging and suspected HE based on positivity for antithyroid antibodies. Nineteen of the 78 patients had anti-NAE antibodies; however, 5 were excluded because they were double positive for antibodies to the VGKC complex including LGI1. No antibodies against the N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (Caspr2), γ-aminobutyric acid-B receptor (GABABR), or α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptor (AMPAR) were detected in the 19 patients. Among the remaining 14 who were positive only for anti-NAE antibodies, the median age was 62.5 (20-83) years, 9 (64%) were women, and 8 (57%) showed acute onset, with less than 2 weeks between onset and admission. Consciousness disturbance (71%) and memory disturbance (64%) were frequently observed, followed by psychiatric symptoms (50%) and seizures (43%). The frequency of these symptoms significantly differed between the acute- and subacute-onset groups. Abnormalities in cerebrospinal fluid and electroencephalogram were commonly observed (92% for both). Tumors were not identified in any cases. All patients responded to immunotherapy or spontaneously remitted, thereby fulfilling the criteria of HE.This study demonstrated that LE associated with anti-NAE antibodies is a nonparaneoplastic LE and various limbic symptoms that depend on the onset type. Favorable therapeutic efficacy suggests that this LE can be considered a clinical subtype of HE and that anti-NAE antibodies may be a promising indicator of the need for immunotherapy.
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Affiliation(s)
- Toru Kishitani
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Akiko Matsunaga
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Masamichi Ikawa
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Kouji Hayashi
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Osamu Yamamura
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Tadanori Hamano
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Osamu Watanabe
- Department of Neurology and Geriatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima
| | - Keiko Tanaka
- Department of Neurology, Kanazawa Medical University, Ishikawa
| | - Yasunari Nakamoto
- The Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui
| | - Makoto Yoneda
- Faculty of Nursing and Social Welfare Sciences, Fukui Prefectural University, Fukui, Japan
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Hayashi K, Hamano T, Kawamura Y, Kimura H, Matsunaga A, Ikawa M, Yamamura O, Mutoh T, Higuchi I, Kuriyama M, Nakamoto Y. Muscle MRI of the Upper Extremity in the Myotonic Dystrophy Type 1. Eur Neurol 2016; 76:87-94. [DOI: 10.1159/000448328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/08/2016] [Indexed: 11/19/2022]
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Kawano T, Nishiyama K, Morita H, Yamamura O, Hiraide A, Hasegawa K. Association between shelter crowding and incidence of sleep disturbance among disaster evacuees: a retrospective medical chart review study. BMJ Open 2016; 6:e009711. [PMID: 26769785 PMCID: PMC4735147 DOI: 10.1136/bmjopen-2015-009711] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES We determined whether crowding at emergency shelters is associated with a higher incidence of sleep disturbance among disaster evacuees and identified the minimum required personal space at shelters. DESIGN Retrospective review of medical charts. SETTING 30 shelter-based medical clinics in Ishinomaki, Japan, during the 46 days following the Great Eastern Japan Earthquake and Tsunami in 2011. PARTICIPANTS Shelter residents who visited eligible clinics. OUTCOME MEASURES Based on the result of a locally weighted scatter-plot smoothing technique assessing the relationship between the mean space per evacuee and cumulative incidence of sleep disturbance at the shelter, eligible shelters were classified into crowded and non-crowded shelters. The cumulative incidence per 1000 evacuees was compared between groups, using a Mann-Whitney U test. To assess the association between shelter crowding and the daily incidence of sleep disturbance per 1000 evacuees, quasi-least squares method adjusting for potential confounders was used. RESULTS The 30 shelters were categorised as crowded (mean space per evacuee <5.0 m(2), 9 shelters) or non-crowded (≥ 5.0 m(2), 21 shelters). The study included 9031 patients. Among the eligible patients, 1079 patients (11.9%) were diagnosed with sleep disturbance. Mean space per evacuee during the study period was 3.3 m(2) (SD, 0.8 m(2)) at crowded shelters and 8.6 m(2) (SD, 4.3 m(2)) at non-crowded shelters. The median cumulative incidence of sleep disturbance did not differ between the crowded shelters (2.3/1000 person-days (IQR, 1.6-5.4)) and non-crowded shelters (1.9/1000 person-days (IQR, 1.0-2.8); p=0.20). In contrast, after adjusting for potential confounders, crowded shelters had an increased daily incidence of sleep disturbance (2.6 per 1000 person-days; 95% CI 0.2 to 5.0/1000 person-days, p=0.03) compared to that at non-crowded shelters. CONCLUSIONS Crowding at shelters may exacerbate sleep disruptions in disaster evacuees; therefore, appropriate evacuation space requirements should be considered.
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Affiliation(s)
- Takahisa Kawano
- Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, Japan
| | - Kei Nishiyama
- Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto Prefecture, Japan
| | - Hiroshi Morita
- Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, Japan
| | - Osamu Yamamura
- Department of Community Health Care Promotion, University of Fukui Hospital, Fukui Prefecture, Japan
| | - Atsuchi Hiraide
- Department of Acute Medicine, Faculty of Medicine, Kinki University, Osaka Prefecture, Japan
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Lin G, Hamano T, Shirafuji N, Ishida A, Hayashi K, Yen SH, Fujita Y, Yamamura O, Nakamoto Y. P2‐051: Clioquinol decreases phosphorylation levels of tau protein. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.588] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Gaoping Lin
- Zhejiang Provincial People's HospitalZhejiangChina
- University of FukuiFukuiJapan
| | | | | | | | | | | | - Youshi Fujita
- University of FukuiFukuiJapan
- Fujita Neurology HospitalFukuiJapan
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Hayashi K, Hamano T, Ishida A, Fujita Y, Hama Y, Yamamura O, Nakamoto Y. P3‐295: Reduction of serum cholinesterase by cholinesterase inhibitor (donepezil, galantamine, or rivastigmine). Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1668] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Youshi Fujita
- University of FukuiFukuiJapan
- Fujita Neurology HospitalFukuiJapan
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Ikawa M, Okazawa H, Tsujikawa T, Matsunaga A, Yamamura O, Mori T, Hamano T, Kiyono Y, Nakamoto Y, Yoneda M. Increased oxidative stress is related to disease severity in the ALS motor cortex: A PET study. Neurology 2015; 84:2033-9. [DOI: 10.1212/wnl.0000000000001588] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/15/2015] [Indexed: 11/15/2022] Open
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Saito Y, Matsunaga A, Yamamura O, Ikawa M, Hamano T, Yoneda M. [A case of left hemi-facial metamorphopsia induced by infarction of the right side of the splenium of the corpus callosum]. Rinsho Shinkeigaku 2014; 54:637-42. [PMID: 25142534 DOI: 10.5692/clinicalneurol.54.637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We describe a patient, 61-year-old left-handed Japanese woman, who presented with left hemi-facial metamorphopsia after infarct that extended from the splenium of the corpus callosum to the major forceps on the right side. Past medical history revealed a right putaminal hemorrhage with amnesic aphasia. She complained that the right side of people's faces, that is, the left side when visualized by her, seemed distorted. When she looked at other people's faces, the right half of the faces looked smaller than the left half, and the eyes, noses, and mouths appeared to be hanging toward the center of their faces. This phenomenon was observed for whomever she visualized. She stated that objects other than the face looked normal. Her visual acuity and visual field were normal. Callosal disconnection syndrome was not presented. Magnetic resonance imaging of the brain on diffusion weighted image revealed a high intensity area that extended from the splenium of the corpus callosum to the major forceps on the right side. Electroencephalography did not show any epileptic discharge. Her visual symptoms improved gradually. The mechanism of hemi-facial metamorphopsia remains obscure. We hypothesized that this patient developed left hemi-facial metamorphopsia because of the disrupted transfer of visual information of the left side of face at the splenium of the corpus callosum and the major forceps, which may be the responsible lesion of hemi-facial metamorphopsia.
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Affiliation(s)
- Yuki Saito
- Department of Neurology, Faculty of Medical Sciences, University of Fukui Hospital
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