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Hiromoto K, Yamada T, Tsuchiya M, Kawame H, Nanba E, Goto Y, Kosugi S. Difficulties in disclosing secondary findings by facilities performing comprehensive germline genetic testing for rare diseases in Japan. Congenit Anom (Kyoto) 2024. [PMID: 38530047 DOI: 10.1111/cga.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/04/2024] [Accepted: 03/10/2024] [Indexed: 03/27/2024]
Abstract
In Japan, a limited number of laboratories perform comprehensive genetic testing for rare diseases; this study investigated the attitudes of these laboratories toward the disclosure of secondary finding (SF). Following a preliminary survey, we identified laboratories conducting comprehensive genetic testing for participation. Subsequently, an online survey involving 20 selected facilities was conducted. The response rate was 80% (16/20). Of the 14 facilities, 71.4% had SFs. While 42.9% of them had a policy to disclose SFs with clinical utility, only 14.3% actively searched for actionable variants that could be included in the American College of Medical Genetics and Genomics list. Japan was less enthusiastic than the USA regarding SF disclosure. With regard to the reasons for not disclosing SFs, the factors "the thought that participants may have a low desire for SFs" and "uncertainty regarding their wish" were considered more important than in the USA. A content analysis of what was sought as a solution to this difficulty revealed a need to improve databases on pathogenicity and actionability and collect public thoughts on the issue. The factor "to promote entry in research" was not considered a critical reason for disclosing SFs, indicating that the thirst for information was not possibly due to anxiety but rather due to scientific interest. Japanese medical professionals may not be confident that society requires the disclosure of SFs. To improve the environment, it is necessary to survey the public regarding their thoughts on SF disclosure and discuss this issue in society.
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Affiliation(s)
- Kana Hiromoto
- Department of Clinical Genetics, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
| | | | - Hiroshi Kawame
- Tohoku University Tohoku Medical Megabank Organization, Miyagi, Japan
- Department of Clinical Genetics, Jikei University, Tokyo, Japan
| | - Eiji Nanba
- Organization for Research Initiative and Promotion, Tottori University, Tottori, Japan
| | - Yuichi Goto
- Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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2
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Sogawa R, Wada T, Yamashita N, Kochi M, Futagawa M, Kato F, Urakawa Y, Tanimura Y, Yamamoto H, Tomida S, Kosugi S, Hirasawa A. When and how to enlighten citizens on genetics and hereditary cancer: a web survey of online video viewers. J Community Genet 2023; 14:575-581. [PMID: 37715866 PMCID: PMC10725408 DOI: 10.1007/s12687-023-00663-x] [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: 02/06/2023] [Accepted: 08/08/2023] [Indexed: 09/18/2023] Open
Abstract
With the rapid expansion of genomic medicine, more citizens are compelled to think about genetics in their daily lives. This study aims to explore appropriate types of educational media and methods to enlighten activities for genetics and hereditary cancer. We presented an 18-min YouTube video on genetics and hereditary cancer to participants at a scientific event, Science Agora 2020, and administered a web questionnaire to investigate their opinions about when and how citizens should start learning about genetics and hereditary cancer. We recruited 133 participants who watched the video, and 26.3% (35/133) responded to the questionnaire. Most of them were evaluated to understand and appreciate the contents of the video. They identified websites, or videos as suitable learning media, irrespective of their sex, age, or profession. They highlighted upper elementary school or junior high school as appropriate educational stages to start learning about genetics and hereditary cancer to facilitate collecting their own genetic information by themselves. Our findings show that educational institutions should provide opportunities to learn about genetics and hereditary cancers, especially for upper elementary school and junior high school students, using learning media, such as videos, depending on their level or demand.
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Affiliation(s)
- Reimi Sogawa
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
- Department of Medical Ethics and Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahito Wada
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Noriyuki Yamashita
- Center for Education in Medicine and Health Sciences, Okayama University, Okayama, Japan
| | - Mariko Kochi
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Mashu Futagawa
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Fumino Kato
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Yusaku Urakawa
- Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Yayoi Tanimura
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
- Department of Nursing, Okayama University Hospital, Okayama, Japan
| | - Hideki Yamamoto
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
- Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Shuta Tomida
- Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akira Hirasawa
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, Okayama, Japan
- Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Haruyama S, Torishima M, Kawasaki H, Wada T, Kosugi S. Decision-making processes behind seeking regular cardiac checkups for individuals with Marfan syndrome: A grounded theory study. J Genet Couns 2023. [PMID: 37965685 DOI: 10.1002/jgc4.1832] [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: 04/30/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023]
Abstract
Patients with Marfan syndrome (MFS) present with various symptoms, such as aortic aneurysm/dissection, tall stature, and lens deviation. Among them, acute aortic dissection is a complication that leads to sudden death. Some individuals with MFS are reluctant to see a cardiologist and discontinue regular checkups until they develop life-threatening complications. We conducted a grounded theory study to investigate how individuals with MFS decided whether to adhere to healthcare recommendations, specifically to attend cardiology appointments. The study recruited individuals with a clinical or genetic diagnosis of MFS from a Japanese university hospital and individuals from a support group. Semi-structured interviews were conducted with 28 consenting participants. In this study, we identified the decision-making processes of individuals with MFS concerning their cardiology visits. We extracted "perception of the gap between their health status and medical recommendations" as the central category. This decision-making process consisted of three parts: (A) the process by which an individual with MFS sees a cardiologist for the first time, (B) the process by which an individual with MFS keeps up with cardiology checkups, and (C) the process by which parents bring their children with MFS to the cardiologist. Individuals who learned of the possibility of MFS decided whether to adhere to medical recommendations depending on how they perceived the gap between their health status and the medical recommendations. In addition to medical information and treatment experience, adaptation to MFS, which changed through interactions with others, influenced the perception of the gap. This study suggests the role of genetic counseling and molecular genetic diagnosis as factors that may facilitate adaptation to MFS. The involvement of genetic counselors is important for helping individuals with MFS keep up with regular checkups while affirming their own experiences. These results provide insight into adherence to medical recommendations for individuals with MFS.
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Affiliation(s)
- Sayoko Haruyama
- Department of Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masako Torishima
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Hidenori Kawasaki
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Takahito Wada
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
- Department of Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
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Hiromoto K, Nishigaki M, Kosugi S, Yamada T. Reproductive decision-making following the diagnosis of an inherited metabolic disorder via newborn screening in Japan: a qualitative study. Front Reprod Health 2023; 5:1098464. [PMID: 37273777 PMCID: PMC10232871 DOI: 10.3389/frph.2023.1098464] [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: 11/15/2022] [Accepted: 04/17/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction The aim of the study was to describe the factors influencing the reproductive decision-making of carrier parents after the diagnosis of an inherited metabolic disorder in newborn screening in Japan. Methods We conducted a semi-structured interview with 12 parents and analyzed data based on content analysis methodology. Results We identified 11 factors, including personal evaluation of recurrence risk, understanding of hereditary phenomena, concerns and desires for future planned children, concerns for older siblings, perceptions of diseases, degree of acceptance and denial of diseases, the opinions of others on having another child, optimism/faith in positive outcomes, self-evaluation of parental capability, factors unrelated to the disease, and the "right" time to expand the family. Discussion Perceptions and acceptance of disease are both important factors in reproductive decision-making, though these factors fluctuate continuously during the childbearing period. Therefore, effective reproductive genetic counseling will be considerate of the parents' fluctuating perceptions on reproduction. To ensure that the decision-making process is for the benefit of the parents and future children, long-term involvement of health care professionals is needed to assess the client's acceptance of the disease and their understanding of genetic phenomena and recurrence rates.
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Affiliation(s)
- Kana Hiromoto
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masakazu Nishigaki
- Department of Human Health Sciences, School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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Kawaguchi-Sakita N, Senda N, Inagaki-Kawata Y, Murakami H, Honda S, Yamada T, Kataoka Y, Takahara S, Tsuyuki S, Yamagami K, Moriguchi Y, Torii M, Kato T, Suwa H, Tsuji W, Suzuki E, Yamauchi A, Okamura R, Kosugi S, Toi M. Abstract P2-05-02: Potential Empowerment and risk of Genetic Counseling with Genetic Breast cancer risk assessment in Personalized Health Care: Prospective Cohort Study using Genetic Counseling Outcome Scale (GCOS-24). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p2-05-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
[Introduction] Personalized health care is recommended for the prevention and early detection of breast cancer. Advances in technology have made it possible to estimate genetic risk, PGV (pathogenic/likely-pathogenic germline variant) or PRS (polygenic risk score), in practice. However, linkage after risk assessment to personalized health care is still developing. One of the issues is how to tell the result especially in case of newly diagnosed PGV after Genetic Panel Testing or PRS. In this study, we evaluated genetic counseling (GC) using an established patient-reported outcome measure for clinical genetics services scale (Genetic Counseling Outcome Scale24 (GCOS24)) at genetic counseling for disclosure the results of the previous study, and examined the association with management after GC. [Method] We performed targeted sequencing for 11 breast cancer-related genes using peripheral blood DNA from 1995 female breast cancer patients. Of 1995 cases, 101 patients were PGV carriers, who were candidates of this study. Participants were referred to the Clinical Genetics unit, Kyoto University Hospital from 10 institutions (January 2018-March 2022). GCOS24 and relating questionaries were asked before and after GC. GCOS24 is a scale consisting of 24 items that assess five factors: decision control, cognitive control, behavioral control, emotional regulation, and hope. (In light of the current status of hereditary breast cancer care in Japan, 23 items were used.) Each item is rated on a scale of 1-7 points, for a total score of 23-161. In addition, we reviewed medical records to evaluate the post-GC management. [Results] Of the 101 cases, 38 cases were enrolled. The reasons of 63 not-enrolled cases were: 30 cases without follow-up (deaths or transfer to another hospital), 11 cases already diagnosed in clinical practice, 18 cases that did not wish to know their results, and 4 cases whose hospital were developing for hereditary breast cancer care. Median age at the time of genetic GC was 55 (min-max 30-83) years. Details of PGV cases were: BRCA2 23 cases, BRCA1 2, PALB2 4, PTEN 3, TP53 3, ATM 1, CHEK2 1 and NF1 1. GCOS24 after GC were improved than before GC. (Average 99 (min-max 17-124) vs 114 (91-138), Mean difference 23.9, 95% Confidence intervals (CI) 29.6 to 18.3). Thirty patients (79%) had higher increase in scores than 10.3, which was the previously reported Minimum Clinically Important Difference (MCID) of this scale. In all items except 4 items (#6,11,13,21), GCOS24 after GC were significantly improved than before GC. In post-GC management, 8 patients received or planned RRSO (risk reducing salpingo-oophorectomy) among 25 BRCA1/2 cases. There was a case with dysplastic cells detected in the resected ovary. After GC, average of GCOS24 in RRSO cases was 120 (95% CI 110 to 129), while average of GCOS24 of other BRCA1/2 cases was 110 (95% CI 104 to 116). On the other hand, two patients stopped visiting to the hospital because of fear after GC. Average of GCOS24 of 15 junior-high/high school graduate cases were 111 (95% CI 105 to 117), while average of GCOS24 of 23 college graduate cases were 117 (95% CI 111 to 122). [Discussion] In patients diagnosed with hereditary breast cancer by genetic panel testing, GC worked well except for 4 items. These 4 items (#6,11,13,21) were related to emotion. This study revealed there was also a risk to reject surveillance due to fear, suggesting that it is necessary to provide psychological support in some cases. Although the limitation of this study is the small number of cases, GCOS24 were high in RRSO cases, suggesting that GC played an important role when proceeding with intervention. We believe that the findings are helpful for the future implementation of genetic panel testing or PRS testing in healthy subjects for personalized health care.
Citation Format: Nobuko Kawaguchi-Sakita, Noriko Senda, Yukiko Inagaki-Kawata, Hiromi Murakami, Sayaka Honda, Takahiro Yamada, Yuki Kataoka, Shoko Takahara, Shigeru Tsuyuki, Kazuhiko Yamagami, Yoshio Moriguchi, Masae Torii, Tatsushi Kato, Hirofumi Suwa, Wakako Tsuji, Eiji Suzuki, Akira Yamauchi, Ryuji Okamura, Shinji Kosugi, Masakazu Toi. Potential Empowerment and risk of Genetic Counseling with Genetic Breast cancer risk assessment in Personalized Health Care: Prospective Cohort Study using Genetic Counseling Outcome Scale (GCOS-24) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-05-02.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Masae Torii
- 12Japanese Red Cross Wakayama Medical Center, Wakayama, Wakayama, Japan
| | | | - Hirofumi Suwa
- 14Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | | | | | | | | | | | - Masakazu Toi
- 20Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Sakai E, Yamada T, Funaki T, Iwakuma M, Osawa H, Morimoto K, Kosugi S. Fundamental knowledge taught in compulsory education for effective genetic counseling: a qualitative study of descriptions in textbooks. J Community Genet 2023:10.1007/s12687-023-00641-3. [PMID: 36853589 DOI: 10.1007/s12687-023-00641-3] [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: 09/03/2022] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
In genetic counseling, information must be provided in ways that the client and general public can understand to ensure that decisions are made autonomously. To realize this, we must assess the extent of knowledge held by the general public regarding genetics. To identify the client's original knowledge before genetic counseling, we explored the fundamental knowledge related to genetic counseling that is taught in Japanese compulsory education. A qualitative study was conducted. We selected 50 textbooks for compulsory education (Japanese, social studies, science, health and physical education, technology and home economics, morality, and life) that had been used in more than half of the districts in Japan. The text data were analyzed using qualitative content analysis, and quantitative data were analyzed for methodological triangulation. Codes, subcategories, and categories were generated from the contexts that met the following criteria: the contents included in the official textbook for clinical geneticists, contents derived from such descriptions that were related to genetic counseling, and contents clearly related to genetics. Among the 50 textbooks, 33 textbooks contained fundamental knowledge regarding genetic counseling. A qualitative content analysis identified four major categories: (1) basics of genetics, (2) understanding and control of diseases, (3) efforts and barriers to the realization of a harmonious society, and (4) technology and humans. We found that fundamental knowledge related to genetic counseling is directly or indirectly taught in compulsory education. Our results are an important resource for understanding the client's knowledge baseline and will be helpful for effective genetic counseling.
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Affiliation(s)
- Eri Sakai
- Medical Ethics/Medical Genetics, School of Public, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan
| | - Takahiro Yamada
- Medical Ethics/Medical Genetics, School of Public, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan.
| | - Tomomi Funaki
- Kyoto Prefectural University of Medicine Graduate School, Kyoto, Japan
| | - Miho Iwakuma
- Medical Communication, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Harumo Osawa
- Medical Ethics/Medical Genetics, School of Public, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan
| | - Kana Morimoto
- Medical Ethics/Medical Genetics, School of Public, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan
| | - Shinji Kosugi
- Medical Ethics/Medical Genetics, School of Public, Kyoto University Graduate School of Medicine, Yoshidakonoe-cho, Sakyo-ku, Kyoto, Kyoto, 606-8501, Japan
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Hiromoto K, Yamada T, Tsuchiya M, Kawame H, Nanba E, Goto Y, Kosugi S. Challenges of secondary finding disclosure in genomic medicine in rare diseases: A nation-wide survey of Japanese facilities outsourcing comprehensive genetic testing. J Hum Genet 2023; 68:1-9. [PMID: 36192516 DOI: 10.1038/s10038-022-01084-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/23/2022] [Accepted: 09/12/2022] [Indexed: 01/07/2023]
Abstract
Comprehensive genome analysis may reveal secondary findings (SFs) including pathogenic variants of genes other than those originally targeted. Comprehensive genetic analysis of rare diseases is generally performed as research in Japan. Therefore, the status and difficulties in SF disclosure remain unclear. To obtain information for the appropriate disclosure of SFs in rare diseases, we conducted a survey on how SFs are handled in clinical practice by facilities that outsource comprehensive genetic testing to other facilities. The response rate was 66.7% (40/60). Among the responding facilities, 55% had a policy of disclosing SFs with clinical utility and considered targeting actionable SFs with high penetrance. These facilities had difficulties in determining the disclosure targets (51%) and in genetic counseling (38%). Improving genetic literacy, establishment of surveillance systems, and providing insurance coverage for medical care to unaffected carriers were commonly cited as solutions to these difficulties. A comparison of the willingness to disclose SFs between overseas and in Japan showed more reluctance in Japan (86% vs. 65% for actionable SFs and 62% vs. 16% for non-actionable SFs). The group with difficulty in determining disclosure targets was significantly more likely to discuss this at conferences with other facilities and to refer guidelines. This suggests that the group with difficulties was unable to make decisions solely at their own facility and sought collaboration with other facilities. These findings suggest the necessity for a system that allows consultation with experts across facilities and guidelines that set forth policies for determining SFs.
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Affiliation(s)
- Kana Hiromoto
- Department of Genome Medical Center, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.
| | | | - Hiroshi Kawame
- Tohoku University Tohoku Medical Megabank Organization, Miyagi, Japan.,Department of Clinical Genetics, Jikei University, Tokyo, Japan
| | - Eiji Nanba
- Research Strategy Division, Organization for Research Initiative and Promotion, Tottori University, Tottori, Japan
| | - Yuichi Goto
- Medical Genome Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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Koike K, Nishigaki M, Wada T, Kosugi S. Implementation of Molecular Autopsy for Sudden Cardiac Death in Japan - Focus Group Study of Stakeholders. Circ J 2022; 87:123-129. [PMID: 36372399 DOI: 10.1253/circj.cj-22-0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We assessed the awareness of multidisciplinary healthcare professionals of the challenges related to implementation of molecular autopsy (MA) for sudden cardiac death (SCD) among children and young adults.Methods and Results: We conducted 11 focus groups with 31 multidisciplinary healthcare professionals, and categorized them into 2 themes: values, and challenges of MA implementation. The participants recognized 2 different values of MA: discovering the unknown cause of SCD, and SCD prevention among family members of victims. The coexistence of these values makes the MA process and role of professionals more complex. Participants were concerned about the psychological burden for bereaved family members and mentioned challenges in each process of the MA delivery system: obtaining consent, cause of death investigation, disclosing results, and preventive intervention. CONCLUSIONS MA is a valuable procedure both in terms of forensic and preventive medicine. However, the dual meanings and complex characteristics of genetic information is a potential source of concern and confusion among healthcare professionals as well as bereaved family members. Increasing awareness among healthcare professionals of the MA process is essential for connecting all related areas of expertise.
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Affiliation(s)
- Kanako Koike
- Department of Medical Genetics, International University of Health and Welfare Graduate School.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health.,Department of Medical Genetics, Sakakibara Heart Institute
| | - Masakazu Nishigaki
- Department of Medical Genetics, International University of Health and Welfare Graduate School
| | - Takahito Wada
- Department of Genomic Medicine, Kyoto University School of Public Health
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health
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Kondo T, Yamamoto Y, Fukuyama K, Kanai M, Yamada A, Matsubara J, Quy PN, Yoshioka M, Yamada T, Minamiguchi S, Matsumoto S, Kosugi S, Muto M. Germline sequencing for presumed germline pathogenic variants via tumor-only comprehensive genomic profiling. Int J Clin Oncol 2022; 27:1256-1263. [PMID: 35567649 DOI: 10.1007/s10147-022-02176-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 04/17/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The European Society for Medical Oncology Precision Medicine Working Group (ESMO-PMWG) published recommendations regarding confirmatory germline testing for presumed germline pathogenic variants (PGPVs) in tumor-only comprehensive genomic profiling (CGP). However, the clinical validity of these recommendations has not been investigated in a real-world practice. METHODS Medical records of 180 consecutive patients who obtained the results of a tumor-only CGP (FoundationOne® CDx, Foundation Medicine, Inc, Cambridge, MA, USA) between October 2018 and March 2020, were retrospectively reviewed. After excluding patients with no reported variants in 45 actionable genes (n = 6), or no archived germline DNA samples (n = 31), 143 patients were investigated. The PGPVs were selected from the CGP report and germline sequencing were performed using DNA samples archived in Clinical Bioresource Center in Kyoto University Hospital (Kyoto, Japan). RESULTS A total of 195 variants were classified as PGPV based on the conventional criteria. Germline sequencing disclosed that 12 variants (6.2%) were of germline origin. In contrast, after filtering these 195 variants through the ESMO-PMWG recommendation criteria for confirmatory germline testing, following seven PGPVs, BRCA2 (n = 2), BRIP1 (n = 1), BAP1 (n = 1), PMS2 (n = 1), MSH2 (n = 1), and SDHB (n = 1) remained and six variants (85.7%) were confirmed to be of germline origin. CONCLUSION Our current data suggested that the application of ESMO-PMWG criteria is helpful in selecting PGPVs with a high likelihood of germline origin in a tumor-only CGP in daily clinical practice.
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Affiliation(s)
- Tomohiro Kondo
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Research Fellow of Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.,Clinical Genetics Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yoshihiro Yamamoto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Keita Fukuyama
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masashi Kanai
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Atsushi Yamada
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Junichi Matsubara
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Pham Nguyen Quy
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masahiro Yoshioka
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Clinical Genetics Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takahiro Yamada
- Clinical Genetics Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shigemi Matsumoto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shinji Kosugi
- Clinical Genetics Unit, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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10
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Takahashi Y, Date H, Oi H, Adachi T, Imanishi N, Kimura E, Takizawa H, Kosugi S, Matsumoto N, Kosaki K, Matsubara Y, Mizusawa H. Six years' accomplishment of the Initiative on Rare and Undiagnosed Diseases: nationwide project in Japan to discover causes, mechanisms, and cures. J Hum Genet 2022; 67:505-513. [PMID: 35318459 PMCID: PMC9402437 DOI: 10.1038/s10038-022-01025-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 11/09/2022]
Abstract
The identification of causative genetic variants for hereditary diseases has revolutionized clinical medicine and an extensive collaborative framework with international cooperation has become a global trend to understand rare disorders. The Initiative on Rare and Undiagnosed Diseases (IRUD) was established in Japan to provide accurate diagnosis, discover causes, and ultimately provide cures for rare and undiagnosed diseases. The fundamental IRUD system consists of three pillars: IRUD diagnostic coordination, analysis centers (IRUD-ACs), and a data center (IRUD-DC). IRUD diagnostic coordination consists of clinical centers (IRUD-CLs) and clinical specialty subgroups (IRUD-CSSs). In addition, the IRUD coordinating center (IRUD-CC) manages the entire IRUD system and temporarily operates the IRUD resource center (IRUD-RC). By the end of March 2021, 6301 pedigrees consisting of 18,136 individuals were registered in the IRUD. The whole-exome sequencing method was completed in 5136 pedigrees, and a final diagnosis was established in 2247 pedigrees (43.8%). The total number of aberrated genes and pathogenic variants was 657 and 1718, among which 1113 (64.8%) were novel. In addition, 39 novel disease entities or phenotypes with 41 aberrated genes were identified. The 6-year endeavor of IRUD has been an overwhelming success, establishing an all-Japan comprehensive diagnostic and research system covering all geographic areas and clinical specialties/subspecialties. IRUD has accurately diagnosed diseases, identified novel aberrated genes or disease entities, discovered many candidate genes, and enriched phenotypic and pathogenic variant databases. Further promotion of the IRUD is essential for determining causes and developing cures for rare and undiagnosed diseases.
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Affiliation(s)
- Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hidetoshi Date
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Hideki Oi
- Department of Clinical Data Science, Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takeya Adachi
- Keio Frontier Research & Education Collaborative Square (K-FRECS) at Tonomachi, Keio University, Kawasaki, Japan.,Department of Medical Regulatory Science, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.,Japan Agency for Medical Research and Development (AMED), Tokyo, Japan
| | - Noriaki Imanishi
- Japan Agency for Medical Research and Development (AMED), Tokyo, Japan.,Department of Research Promotion and Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - En Kimura
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.,Japan Agency for Medical Research and Development (AMED), Tokyo, Japan.,Astellas Pharma Incorporated, Tokyo, Japan
| | - Hotake Takizawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.,Japan Agency for Medical Research and Development (AMED), Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | | | | | - Hidehiro Mizusawa
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.
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11
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Kosugi S. [Hereditary Tumor Medical Care in the Age of Cancer Genomic Medicine]. Gan To Kagaku Ryoho 2022; 49:237-242. [PMID: 35299173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
How to efficiently suspect a germline gene variant(presumed germline pathogenic variant: PGPV)in comprehensive tumor-profiling tests using only cancer tissue(cells)as a sample is an important issue. This is because a few percent are derived from germline variants, which leads to the diagnosis of hereditary tumor syndromes and is useful information for the health management of patients and relatives. Clues include allele frequency, gene type, germline founder mutation, age of onset, present illness and past history, cancer type, family history, and tumor cell proportion. More than 97% of patients want to know such secondary findings before the test, but only about 23% of patients undergo confirmation tests even if PGPV is detected, and it is necessary to improve this in the future.
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Affiliation(s)
- Shinji Kosugi
- Dept. of Medical Ethics/Medical Genetics, Kyoto University School of Public Health
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12
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Yamaguchi Y, Yamada T, Goto M, Kawasaki H, Wada T, Ikeda-Sakai Y, Saito Y, Hayashi M, Tanaka S, Takahashi R, Nakayama T, Murashima A, Kosugi S. Analysis of triptan use during pregnancy in Japan: A case series. Congenit Anom (Kyoto) 2022; 62:78-81. [PMID: 34981573 DOI: 10.1111/cga.12456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/27/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
To evaluate the safety of triptan use during pregnancy in a Japanese population, we descriptively analyzed the data on pregnancy and fetal outcomes from 128 pregnant women using triptans for migraine treatment at two Japanese facilities that provided counseling on drug exposure in pregnancy between 2001 and 2017. The risks of miscarriage, low birth weight, and preterm birth were similar to those reported in the demographic statistics in Japan. The incidence proportion of malformation was also within the baseline risk range. Accumulated data suggest that exposure to triptans during pregnancy does not clearly increase the risk of negative pregnancy and fetal outcomes. This finding can help reduce anxiety in pregnant women with migraines who are taking triptans.
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Affiliation(s)
- Yuko Yamaguchi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.,Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Mikako Goto
- National Center for Child Health and Development, The Japan Drug Information Institute in Pregnancy, Tokyo, Japan
| | - Hidenori Kawasaki
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahito Wada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yasuko Ikeda-Sakai
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Health Informatics, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Yoshiyuki Saito
- Department of Health Informatics, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | | | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Atsuko Murashima
- National Center for Child Health and Development, The Japan Drug Information Institute in Pregnancy, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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13
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Inaba A, Yoshida A, Maeda A, Kawai K, Kosugi S, Takahashi M. Perception of genetic testing among patients with inherited retinal disease: Benefits and challenges in a Japanese population. J Genet Couns 2022; 31:860-867. [PMID: 35106875 DOI: 10.1002/jgc4.1556] [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: 12/07/2020] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/10/2022]
Abstract
Inherited retinal disease (IRD) is clinically and genetically heterogeneous. Awareness of the importance of genetic testing for IRD in the clinical setting is increasing with the recent development of new therapeutic strategies, such as gene therapy. Here, the perception of genetic testing, including its benefits and potential challenges, among patients with IRD was investigated to establish strategies for IRD genetic testing and counseling practices that can meet the requirements of the patients in Japan. An anonymous self-administered questionnaire was distributed to 275 patients with IRD who underwent genetic testing after clinical consultation and genetic counseling to investigate the motivations for genetic testing, benefits, challenges, status of communication of results to family, and attitude to timing of genetic testing. In total, 228 (82.9%) responses were analyzed. Several major motivations for genetic testing were identified, including gaining information on future treatment options and clarification of the inheritance pattern, among others. No association was found between the sharing of results with family members and the results of genetic testing. Moreover, according to patients who received positive results, the benefits of genetic testing included information on the inheritance pattern, additional information on the diagnosis, and mental preparation for the future. Even patients who received negative or inconclusive (variant of uncertain significance) results reported certain informative and psychological benefits. Altogether, these findings suggest that provisions for genetic testing and genetic counseling are necessary within a certain period after clinical diagnosis and it is necessary to facilitate appropriate family communication about genetic testing results while paying attention to the background of family relationships. Moreover, the benefits of genetic testing can be influenced by the careful interpretation and information provided on the test results during genetic counseling and consultation.
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Affiliation(s)
- Akira Inaba
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan.,Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Yoshida
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Akiko Maeda
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Kanako Kawai
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayo Takahashi
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
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14
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Nakagawa S, Takahashi Y, Nakayama T, Muro S, Mishima M, Sekine A, Tabara Y, Matsuda F, Kosugi S. Gender Differences in Smoking Initiation and Cessation Associated with the Intergenerational Transfer of Smoking across Three Generations: The Nagahama Study. Int J Environ Res Public Health 2022; 19:ijerph19031511. [PMID: 35162532 PMCID: PMC8835433 DOI: 10.3390/ijerph19031511] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022]
Abstract
Global tobacco policies lowered overall and male smoking rates, but female smoking rates have remained unchanged. Parent–child studies revealed the effects of parental smoking, but gender differences had mixed results. We investigated the effects of long-term smoking behavior in families over three generations in order to clarify gender differences. A cross-sectional study in a community-based genome cohort was conducted using a self-reported questionnaire. A total of 8652 respondents were stratified by gender regarding smoking initiation. A logistic regression analysis was performed to analyze the family smoking history. A total of 2987 current smokers and ever-smokers were compared regarding smoking cessation. With respect to smoking initiation, women were affected by their smoking mothers (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.8–3.2) and grandmothers (OR, 1.7; CI, 1.1–2.4). Women who continued smoking were affected only by their smoking mothers (OR, 1.6; CI, 1.05–2.49). In conclusion, gender differences in smoking initiation and cessation are possibly associated with family smoking history. Mothers and grandmothers were shown to have a strong influence on women with respect to both smoking initiation and cessation. Future research should focus on providing evidence for effective gender-specific intervention programs to curb long-term smoking in women.
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Affiliation(s)
- Sachiko Nakagawa
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto 606-8501, Japan;
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan; (Y.T.); (T.N.)
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto 606-8501, Japan; (Y.T.); (T.N.)
| | - Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, Nara 634-8521, Japan;
| | - Michiaki Mishima
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan;
| | - Akihiro Sekine
- Center for Preventive Medical Science, Chiba University, Chiba 260-8670, Japan;
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan; (Y.T.); (F.M.)
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan; (Y.T.); (F.M.)
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto 606-8501, Japan;
- Correspondence: ; Tel.: +81-75-753-4647
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15
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Uemura H, Tanji M, Natsuhara H, Takeuchi Y, Hoki M, Sugimoto A, Minamiguchi S, Kawasaki H, Torishima M, Kosugi S, Mineharu Y, Arakawa Y, Yoshida K, Miyamoto S. The association of ectopic craniopharyngioma in the fourth ventricle with familial adenomatous polyposis: illustrative case. Journal of Neurosurgery: Case Lessons 2022; 3:CASE21572. [PMID: 36130581 PMCID: PMC9379701 DOI: 10.3171/case21572] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Craniopharyngioma (CP) often arises in the sellar and suprasellar areas; ectopic CP in the posterior fossa is rare. Familial adenomatous polyposis (FAP) is a genetic disorder involving the formation of numerous adenomatous polyps in the gastrointestinal tract, and it is associated with other extraintestinal manifestations. OBSERVATIONS The authors reported the case of a 63-year-old woman with FAP who presented with headache and harbored a growing mass in the fourth ventricle. Magnetic resonance imaging (MRI) findings revealed a well-circumscribed mass with high intensity on T1-weighted images and low intensity on T2-weighted images and exhibited no contrast enhancement. Gross total resection was performed and histopathology revealed an adamantinomatous CP (aCP). The authors also reviewed the previous reports of ectopic CP in the posterior fossa and found a high percentage of FAP cases among the ectopic CP group, thus suggesting a possible association between the two diseases. LESSONS An ectopic CP may be reasonably included in the differential diagnosis in patients with FAP who present with well-circumscribed tumors in the posterior fossa.
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Affiliation(s)
- Hiroya Uemura
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Tanji
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Natsuhara
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuhide Takeuchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Masahito Hoki
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Akihiko Sugimoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan; and
| | | | | | - Shinji Kosugi
- Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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16
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Akiyama N, Shimura M, Yamazaki T, Harashima H, Fushimi T, Tsuruoka T, Ebihara T, Ichimoto K, Matsunaga A, Saito-Tsuruoka M, Yatsuka Y, Kishita Y, Kohda M, Namba A, Kamei Y, Okazaki Y, Kosugi S, Ohtake A, Murayama K. Author Correction: Prenatal diagnosis of severe mitochondrial diseases caused by nuclear gene defects: a study in Japan. Sci Rep 2021; 11:22682. [PMID: 34785734 PMCID: PMC8595386 DOI: 10.1038/s41598-021-02108-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Nana Akiyama
- Center for Medical Genetics, Chiba Children's Hospital, Chiba, Japan.,Department of Medical Genetics/Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masaru Shimura
- Department of Metabolism, Chiba Children's Hospital, 579‑1 Heta‑cho, Midori‑ku, Chiba, 266‑0007, Japan
| | - Taro Yamazaki
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Hiroko Harashima
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takuya Fushimi
- Department of Metabolism, Chiba Children's Hospital, 579‑1 Heta‑cho, Midori‑ku, Chiba, 266‑0007, Japan
| | - Tomoko Tsuruoka
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Tomohiro Ebihara
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Keiko Ichimoto
- Department of Metabolism, Chiba Children's Hospital, 579‑1 Heta‑cho, Midori‑ku, Chiba, 266‑0007, Japan
| | - Ayako Matsunaga
- Department of Metabolism, Chiba Children's Hospital, 579‑1 Heta‑cho, Midori‑ku, Chiba, 266‑0007, Japan
| | - Megumi Saito-Tsuruoka
- Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - Yukiko Yatsuka
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshihito Kishita
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Department of Life Science, Faculty of Science and Engineering, Kindai University, Osaka, Japan
| | - Masakazu Kohda
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akira Namba
- Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan.,Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Yoshimasa Kamei
- Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Genetics/Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
| | - Akira Ohtake
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan. .,Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan. .,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan.
| | - Kei Murayama
- Center for Medical Genetics, Chiba Children's Hospital, Chiba, Japan. .,Department of Metabolism, Chiba Children's Hospital, 579‑1 Heta‑cho, Midori‑ku, Chiba, 266‑0007, Japan. .,Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
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17
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Yamada A, Matsuoka Y, Minamiguchi S, Yamamoto Y, Kondo T, Sunami T, Horimatsu T, Kawada K, Seno H, Torishima M, Murakami H, Yamada T, Kosugi S, Sugano K, Muto M. Real-world outcome of universal screening for Lynch syndrome in Japanese patients with colorectal cancer highlights the importance of targeting patients with young-onset disease. Mol Clin Oncol 2021; 15:247. [PMID: 34712484 DOI: 10.3892/mco.2021.2409] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/16/2021] [Indexed: 01/01/2023] Open
Abstract
Despite the recommendations of the latest guidelines, the practical efficacy of universal screening for identifying Lynch syndrome (LS) among patients with colorectal cancer (CRC) may be limited in the real world due to infrequent referrals and the difficulties of genetic testing. Thus, the present study aimed to retrospectively analyze the results of universal screening of patients with CRC at a referral hospital in Japan. Immunohistochemistry was performed for mismatch repair proteins [including DNA mismatch repair protein MSH6 (MSH6), mismatch repair endonuclease PMS2 (PMS2), DNA mismatch repair protein Msh2 (MSH2) and DNA mismatch repair protein Mlh1 (MLH1)] and BRAF V600E mutation. Tumors that showed the following were considered to indicate LS and patients with such tumors were designated as genetic testing candidates (GTCs): i) Loss of MSH6/MSH2; ii) loss of MSH6 alone; iii) loss of PMS2 alone; and iv) loss of PMS2/MLH1 with negative BRAF V600E. MLH1 methylation and BRAF V600E mutation were analyzed in deficient mismatch repair (dMMR) tumors retrospectively. The frequency of dMMR and GTCs in an independent cohort of patients with young-onset CRC were also investigated. Universal screening revealed dMMR tumors, GTCs and LS probands in 7.3, 3.9 and 0.4%, respectively, of 463 patients with CRC. Although dMMR tumors were observed in both younger (<50 years) and older (≥60 years) patients, the GTCs were enriched in younger individuals. Evaluation of mismatch repair status in an independent cohort confirmed the high rate of GTCs in patients with young-onset CRC. The low detection rate of LS demonstrated in this study questions the implementation of routine universal screening in regions with low prevalence of LS. Considering the enrichment of GTCs in young-onset CRCs, age-restricted strategies may be simple and efficient practical alternatives to universal screening in the real world.
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Affiliation(s)
- Atsushi Yamada
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan.,Department of Clinical Data Science Oncology, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto 606-8507, Japan
| | - Yui Matsuoka
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto 606-8507, Japan
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto 606-8507, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Tomohiro Kondo
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Tomohiko Sunami
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Takahiro Horimatsu
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Kenji Kawada
- Department of Surgery, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto 606-8507, Japan
| | - Masako Torishima
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Hiromi Murakami
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Takahiro Yamada
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Shinji Kosugi
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
| | - Kokichi Sugano
- Oncogene Research Unit and Cancer Prevention Unit, Tochigi Cancer Center Research Institute, Utsunomiya, Tochigi 320-0834, Japan
| | - Manabu Muto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto City, Kyoto 606-8507, Japan
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18
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Matsukawa M, Torishima M, Satoh C, Honda S, Kosugi S. Japanese women's reasons for accompaniment status to hereditary breast and ovarian cancer-focused genetic counseling. J Genet Couns 2021; 31:497-509. [PMID: 34661949 DOI: 10.1002/jgc4.1519] [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: 01/10/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/08/2022]
Abstract
Genetic counselors routinely assess and understand clients' needs at the beginning of a session. Attending a genetic counseling session with or without companions is an objective sign that genetic counselors can easily notice. This study focused on clients' reasons for their accompaniment status for genetic counseling, which we categorize into attending with or without a companion(s). A questionnaire survey and interviews were conducted using snowball sampling, starting with the chief executive officer (CEO) of the Japanese hereditary breast and ovarian cancer (HBOC) support group. Of 32 participants, 19 continued with an in-depth interview after answering the questionnaire. Five themes were identified from the interview: (1) personal confidence, (2) decision-making style, (3) family members' habits and time availability, (4) considerations and conflicts with family members, and (5) healthcare provider's suggestion. Our data suggested that the clients expected their companion(s) to play certain roles. This indicates that the reasons of accompaniment status will be helpful for genetic counselors to understand both clients' and their families' motivations, personalities, habits, and psychosocial backgrounds. In a high-context culture such as that of Japan, accompaniment status may be a helpful sign to understand clients' true worries. In addition, some companions may be future clients in genetic counseling, due to the genetic nature of the disease. In conclusion, our study indicated that it is important for genetic counselors to record accompaniment status before the initial genetic counseling and to pay attention to its reasons at the beginning of the session, which may lead them to understand the client's psychosocial background to facilitate better client-centered genetic counseling.
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Affiliation(s)
- Manami Matsukawa
- Department of Medical Genetics and Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Clinical Genetics, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Masako Torishima
- Department of Genomic Medicine, Kyoto University School of Public Health, Kyoto, Japan.,Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Chika Satoh
- Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan
| | - Sayaka Honda
- Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Genetics and Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Clinical Genetics Units, Kyoto University Hospital, Kyoto, Japan
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19
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Kondo T, Kanai M, Yamamoto Y, Fukuyama K, Matsubara J, Nguyen QP, Yoshioka M, Yamada T, Kosugi S, Muto M. 1780P Clinical utility of the ESMO Precision Medicine Working Group recommendation on indication for germline follow-up testing in tumour-only sequencing. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Sasaki Y, Yamada T, Tanaka S, Sekizawa A, Hirose T, Suzumori N, Kaji T, Kawaguchi S, Hasuo Y, Nishizawa H, Matsubara K, Hamanoue H, Fukushima A, Endo M, Yamaguchi M, Kamei Y, Sawai H, Miura K, Ogawa M, Tairaku S, Nakamura H, Sanui A, Mizuuchi M, Okamoto Y, Kitagawa M, Kawano Y, Masuyama H, Murotsuki J, Osada H, Kurashina R, Samura O, Ichikawa M, Sasaki R, Maeda K, Kasai Y, Yamazaki T, Neki R, Hamajima N, Katagiri Y, Izumi S, Nakayama S, Miharu N, Yokohama Y, Hirose M, Kawakami K, Ichizuka K, Sase M, Sugimoto K, Nagamatsu T, Shiga T, Tashima L, Taketani T, Matsumoto M, Hamada H, Watanabe T, Okazaki T, Iwamoto S, Katsura D, Ikenoue N, Kakinuma T, Hamada H, Egawa M, Kasamatsu A, Ida A, Kuno N, Kuji N, Ito M, Morisaki H, Tanigaki S, Hayakawa H, Miki A, Sasaki S, Saito M, Yamada N, Sasagawa T, Tanaka T, Hirahara F, Kosugi S, Sago H. Evaluation of the clinical performance of noninvasive prenatal testing at a Japanese laboratory. J Obstet Gynaecol Res 2021; 47:3437-3446. [PMID: 34355471 DOI: 10.1111/jog.14954] [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: 04/13/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 12/17/2022]
Abstract
AIM We aimed to evaluate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of noninvasive prenatal testing (NIPT) in high-risk pregnant women. METHODS Pregnant women who underwent GeneTech NIPT, the most commonly used NIPT in Japan, between January 2015 and March 2019, at Japan NIPT Consortium medical sites were recruited for this study. The exclusion criteria were as follows: pregnant women with missing survey items, multiple pregnancy/vanishing twins, chromosomal abnormalities in the fetus other than the NIPT target disease, and nonreportable NIPT results. Sensitivity and specificity were calculated from the obtained data, and maternal age-specific PPV and NPV were estimated. RESULTS Of the 45 504 cases, 44 263 cases fulfilling the study criteria were included. The mean maternal age and gestational weeks at the time of procedure were 38.5 years and 13.1 weeks, respectively. Sensitivities were 99.78% (95% confidence interval [95% CI]: 98.78-99.96), 99.12% (95% CI: 96.83-99.76), and 100% (95% CI: 88.30-100) for trisomies 21, 18, and 13, respectively. Specificities were more than 99.9% for trisomies 21, 18, and 13, respectively. Maternal age-specific PPVs were more than 93%, 77%, and 43% at the age of 35 years for trisomies 21, 18, and 13, respectively. CONCLUSION The GeneTech NIPT data showed high sensitivity and specificity in the detection of fetal trisomies 21, 18, and 13 in high-risk pregnant women, and maternal age-specific PPVs were obtained. These results could provide more accurate and improved information regarding NIPT for genetic counseling in Japan.
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Affiliation(s)
- Yuna Sasaki
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiko Sekizawa
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Tatsuko Hirose
- Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan
| | - Nobuhiro Suzumori
- Division of Clinical and Molecular Genetics, Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Takashi Kaji
- Department of Obstetrics and Gynecology, University of Tokushima Faculty of Medicine, Tokushima, Japan
| | - Satoshi Kawaguchi
- Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Yasuyuki Hasuo
- Department of Obstetrics and Gynecology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Haruki Nishizawa
- Department of Obstetrics and Gynecology, Fujita Health University, Aichi, Japan
| | - Keiichi Matsubara
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan
| | - Haruka Hamanoue
- Department of Clinical Genetics, Yokohama City University Hospital, Kanagawa, Japan
| | - Akimune Fukushima
- Department of Clinical Genetics, School of Medicine, Iwate Medical University, Iwate, Japan
| | - Masayuki Endo
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masayuki Yamaguchi
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshimasa Kamei
- Departments of Obstetrics and Gynecology, Saitama Medical University School of Medicine, Saitama, Japan
| | - Hideaki Sawai
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Hyogo, Japan
| | - Kiyonori Miura
- Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaki Ogawa
- Perinatal Medical Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Shinya Tairaku
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Nakamura
- Department of Genetic Medicine, Osaka City General Hospital, Osaka, Japan
| | - Ayako Sanui
- Departments of Obstetrics and Gynecology, Fukuoka University Hospital, Fukuoka, Japan
| | - Masahito Mizuuchi
- Department of Obstetrics and Gynecology, Sapporo Medical University, Hokkaido, Japan
| | - Yoko Okamoto
- Department of Maternal Fetal Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
| | | | - Yukie Kawano
- Department of Molecular Pathology, Faculty of Medicine, Oita University, Oita, Japan
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Jun Murotsuki
- Department of Maternal and Fetal Medicine, Tohoku University Graduate School of Medicine, Miyagi Children's Hospital, Miyagi, Japan
| | - Hisao Osada
- Department of Reproductive Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ryuhei Kurashina
- Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan
| | - Osamu Samura
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mayuko Ichikawa
- Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan
| | - Rumi Sasaki
- Department of Obstetrics and Gynecology, Kumamoto University, Kumamoto, Japan
| | - Kazuhisa Maeda
- Perinatal medical center, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Yasuyo Kasai
- Department of Obstetrics and Gynecology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Tomomi Yamazaki
- Department of Obstetrics and Gynecology, Hiroshima University, Hiroshima, Japan
| | - Reiko Neki
- Division of Counseling for Medical Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Naoki Hamajima
- Division of Clinical Genetics and Genomics, Nagoya City University West Medical Center, Aichi, Japan
| | - Yukiko Katagiri
- Department of Obstetrics and Gynecology, Toho University Omori Medical Center, Tokyo, Japan
| | - Shunichiro Izumi
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | | | - Norio Miharu
- Department of Obstetrics and Gynecology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Yuko Yokohama
- Department of Obstetrics and Gynecology, Asahikawa Medical University, Hokkaido, Japan
| | - Masaya Hirose
- Departments of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Kosuke Kawakami
- Departments of Obstetrics and Gynecology, Kokura Medical Center, National Hospital Organization, Fukuoka, Japan
| | - Kiyotake Ichizuka
- Department of Obstetrics and Gynaecology, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Masakatsu Sase
- Department of Obstetrics and Gynaecology, Yamaguchi Prefectural Grand Medical Center, Yamagichi, Japan
| | - Kohei Sugimoto
- Reproduction Center, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Takeshi Nagamatsu
- Departments of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
| | - Tomomi Shiga
- Departments of Obstetrics and Gynecology, Gifu University, Gifu, Japan
| | - Lena Tashima
- Departments of Obstetrics and Gynecology, Kansai Rosai Hospital, Hyogo, Japan
| | | | - Mariko Matsumoto
- Departments of Obstetrics and Gynecology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hironori Hamada
- Departments of Obstetrics and Gynecology, Adachi Hospital, Kyoto, Japan
| | - Takafumi Watanabe
- Department of Obstetrics and Gynaecology, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Okazaki
- Division of Clinical Genetics, Tottori University Hospital, Tottori, Japan
| | - Sadahiko Iwamoto
- Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Daisuke Katsura
- Department of Obstetrics and Gynaecology, Shiga University of Medical Science, Shiga, Japan
| | - Nobuo Ikenoue
- Department of Obstetrics and Gynaecology, Kochi University, Kochi, Japan
| | - Toshiyuki Kakinuma
- Department of Obstetrics and Gynaecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hiromi Hamada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Makiko Egawa
- Department of Nutrition and Metabolism in Cardiovascular Disease, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Kasamatsu
- Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan
| | - Akinori Ida
- Department of Obstetrics and Gynecology, Kobe Adventist Hospital, Hyogo, Japan
| | - Naohiko Kuno
- Department of Obstetrics and Gynecology, AOI Nagoya Hospital, Aichi, Japan
| | - Naoaki Kuji
- Department of Obstetrics and Gynecology, Tokyo Medical University, Tokyo, Japan
| | - Mika Ito
- Department of Obstetrics and Gynaecology, University of Toyama, Toyama, Japan
| | - Hiroko Morisaki
- Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Shinji Tanigaki
- Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan
| | - Hiromi Hayakawa
- Department of Obstetrics, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Akinori Miki
- Department of Obstetrics and Gynecology, Kitasato University Medical Center, Saitama, Japan
| | - Shoko Sasaki
- Department of Obstetrics and Gynecology, Mitsubishi Kyoto Hospital, Kyoto, Japan
| | - Makoto Saito
- Department of Pediatrics, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Naoki Yamada
- Department of Obstetrics and Gynecology, Mito Saiseikai General Hospital, Ibaraki, Japan
| | - Toshiyuki Sasagawa
- Department of Obstetrics and Gynecology, Kanazawa Medical University, Ishikawa, Japan
| | - Toshitaka Tanaka
- Department of Obstetrics and Gynecology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Fumiki Hirahara
- Department of Clinical Genetics, Yokohama City University Hospital, Kanagawa, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
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21
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Senda N, Kawaguchi-Sakita N, Kawashima M, Inagaki-Kawata Y, Yoshida K, Takada M, Kataoka M, Torii M, Nishimura T, Kawaguchi K, Suzuki E, Kataoka Y, Matsumoto Y, Yoshibayashi H, Yamagami K, Tsuyuki S, Takahara S, Yamauchi A, Shinkura N, Kato H, Moriguchi Y, Okamura R, Kan N, Suwa H, Sakata S, Mashima S, Yotsumoto F, Tachibana T, Tanaka M, Togashi K, Haga H, Yamada T, Kosugi S, Inamoto T, Sugimoto M, Ogawa S, Toi M. Optimization of prediction methods for risk assessment of pathogenic germline variants in the Japanese population. Cancer Sci 2021; 112:3338-3348. [PMID: 34036661 PMCID: PMC8353892 DOI: 10.1111/cas.14986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022] Open
Abstract
Predicting pathogenic germline variants (PGVs) in breast cancer patients is important for selecting optimal therapeutics and implementing risk reduction strategies. However, PGV risk factors and the performance of prediction methods in the Japanese population remain unclear. We investigated clinicopathological risk factors using the Tyrer‐Cuzick (TC) breast cancer risk evaluation tool to predict BRCA PGVs in unselected Japanese breast cancer patients (n = 1,995). Eleven breast cancer susceptibility genes were analyzed using target‐capture sequencing in a previous study; the PGV prevalence in BRCA1, BRCA2, and PALB2 was 0.75%, 3.1%, and 0.45%, respectively. Significant associations were found between the presence of BRCA PGVs and early disease onset, number of familial cancer cases (up to third‐degree relatives), triple‐negative breast cancer patients under the age of 60, and ovarian cancer history (all P < .0001). In total, 816 patients (40.9%) satisfied the National Comprehensive Cancer Network (NCCN) guidelines for recommending multigene testing. The sensitivity and specificity of the NCCN criteria for discriminating PGV carriers from noncarriers were 71.3% and 60.7%, respectively. The TC model showed good discrimination for predicting BRCA PGVs (area under the curve, 0.75; 95% confidence interval, 0.69‐0.81). Furthermore, use of the TC model with an optimized cutoff of TC score ≥0.16% in addition to the NCCN guidelines improved the predictive efficiency for high‐risk groups (sensitivity, 77.2%; specificity, 54.8%; about 11 genes). Given the influence of ethnic differences on prediction, we consider that further studies are warranted to elucidate the role of environmental and genetic factors for realizing precise prediction.
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Affiliation(s)
- Noriko Senda
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | | | | | | | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Masae Torii
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | | | | | - Eiji Suzuki
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Yuki Kataoka
- Department of Healthcare Epidemiology, School of Public Health, in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Hiroshi Yoshibayashi
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Kazuhiko Yamagami
- Department of Breast Surgery and Oncology, Shinko Hospital, Kobe, Japan
| | - Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | | | - Akira Yamauchi
- Department of Breast Surgery, Kitano Hospital, Osaka, Japan
| | - Nobuhiko Shinkura
- Department of Surgery, Ijinkai Takeda General Hospital, Kyoto, Japan
| | - Hironori Kato
- Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Ryuji Okamura
- Department of Breast Surgery, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | | | - Hirofumi Suwa
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shingo Sakata
- Department of Breast Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Susumu Mashima
- Department of Surgery, Japan Community Health Care Organization, Yamato Koriyama Hospital, Yamato Koriyama, Japan
| | - Fumiaki Yotsumoto
- Department of Breast Surgery, Shiga General Hospital, Moriyama, Japan
| | | | - Mitsuru Tanaka
- Department of Surgery, Hirakata Kohsai Hospital, Hirakata, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics/Medical Genetics, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University, Kyoto, Japan
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - Masahiro Sugimoto
- Health Promotion and Preemptive Medicine, Research and Development Center for Minimally Invasive Therapies, Tokyo Medical University, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
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22
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Komatsu-Fujii T, Murata T, Adachi E, Kaku Y, Wada T, Nakagawa N, Kosugi S, Uehara T, Kosaki K, Kataoka T, Egawa G, Dainichi T, Kabashima K. Sterile abscesses possibly stem from acantholytic folliculitis in comedonal Darier disease: a case report. Br J Dermatol 2021; 185:667-669. [PMID: 33914923 DOI: 10.1111/bjd.20418] [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] [Received: 05/08/2020] [Revised: 04/24/2021] [Accepted: 04/24/2021] [Indexed: 11/30/2022]
Affiliation(s)
- T Komatsu-Fujii
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Dermatology, Tenri Hospital, Tenri, Japan
| | - T Murata
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - E Adachi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Dermatology, Kitano Hospital, Osaka, Japan
| | - Y Kaku
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Dermatology, Kagawa University Graduate School of Medicine, Kita-gun, Japan
| | - T Wada
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - N Nakagawa
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - S Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - T Uehara
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - K Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - T Kataoka
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - G Egawa
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T Dainichi
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Dermatology, Kagawa University Graduate School of Medicine, Kita-gun, Japan
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Singapore Immunology Network (SIgN) and Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore
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23
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Kondo T, Yamada T, Yoshioka M, Nishigaki M, Yamamoto Y, Kou T, Matsubara J, Kanai M, Matsumoto S, Muto M, Kosugi S. Confirmatory germline testing for presumed germline pathogenic variants using tumor-only testing. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e22524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22524 Background: Presumed germline pathogenic variants (PGPVs) can be detected in tumor tissues using comprehensive genomic profiling. Clinicians and patients can decide whether to conduct confirmatory germline testing or not. However, the promoting and obstructive factors for confirmatory germline testing are unclear. Methods: This single institutional retrospective study aimed to identify factors related to confirmatory germline testing in patients with PGPVs. Between April 2015 and April 2019, 270 consecutive patients with cancers of unknown primary site, rare tumors, or solid tumors refractory to standard chemotherapy, who underwent tumor-only comprehensive genomic profiling were reviewed. PGPVs were proposed to be disclosed as variants to the patients by our institutional molecular tumor board. Univariate logistic regression analysis was conducted to investigate the relationship between each patient’s characteristics and confirmatory germline testing. Factors showing a statistical relationship (p < 0.10 in univariate analyses) were included in multivariate logistic regression analysis with a backward selection of variables. Statistical significance was set at p < 0.05. Results: Of the 270 patients who underwent tumor-only comprehensive genomic profiling, 77 possessed PGPVs. The most common PGPVs were TP53 (n = 56), APC (n = 9), PTEN (n = 7), RB1 (n = 6), and BRCA2 (n = 6). Among the 77 patients, only 11 (14.3%) chose to undergo confirmatory germline testing. Multivariate logistic regression analysis revealed that the person disclosing the results (experienced oncologists with knowledge of cancer genome medicine vs. others, odds ratio [OR]: 27.7, 95% confidence interval [CI]: 4.60–167) and study period (OR: 0.110, 95% CI: 0.015–0.787) were independently and significantly associated with confirmatory germline testing. Conclusions: These findings indicate that fostering genomic competency in oncologists and collaborating with genetic experts would facilitate cancer patients and their families to receive genetic medical services in the process of cancer genomic profiling.
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Affiliation(s)
- Tomohiro Kondo
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masahiro Yoshioka
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Yoshihiro Yamamoto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadayuki Kou
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junichi Matsubara
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Kanai
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shigemi Matsumoto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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24
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Shimada S, Yamada T, Kosugi S. [Factors Influencing the Decision‒Making Process in Secondary Findings Disclosure in Next‒Generation Sequencing-A Literature Review]. Gan To Kagaku Ryoho 2021; 48:667-671. [PMID: 34006710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With the increased availability of comprehensive genetic testing, the number of cases where secondary findings(SF)are identified has also increased. Since not only patients, but also healthcare professionals influence the decision‒making process in SF disclosure, understanding their attitude toward disclosure is vital. Therefore, a literature review using PubMed and Japan Medical Abstracts Society was conducted. We searched for original qualitative studies focusing on clinical genome analysis. Consequently, 12 articles that focus on 3 main stakeholders were identified: patients and/or their families, genetics professionals, and the general public. Relevant findings were synthesized and chronologically categorized into 27 subcategories, 11 categories, and 3 main themes, namely(1)"at the time of consent,"(2)"when results are returned,"and(3) "after the return of results."All categories in theme(3)were found in patients. Most subcategories found in the general public were also present in patients. The general public is unique because they considered receiving SF for the first time after participating in the study. The result suggests that people are aware of what might happen after receiving SF at the time of providing consent. This awareness will improve patient attitude toward receiving SF. Therefore, it is important to inform patients about the continuous support at the time of providing consent.
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Affiliation(s)
- Saki Shimada
- Dept. of Medical Ethics/Medical Genetics, School of Public Health, Kyoto University Graduate School of Medicine
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25
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Akiyama N, Shimura M, Yamazaki T, Harashima H, Fushimi T, Tsuruoka T, Ebihara T, Ichimoto K, Matsunaga A, Saito-Tsuruoka M, Yatsuka Y, Kishita Y, Kohda M, Namba A, Kamei Y, Okazaki Y, Kosugi S, Ohtake A, Murayama K. Prenatal diagnosis of severe mitochondrial diseases caused by nuclear gene defects: a study in Japan. Sci Rep 2021; 11:3531. [PMID: 33574353 PMCID: PMC7878886 DOI: 10.1038/s41598-021-81015-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/28/2020] [Indexed: 12/05/2022] Open
Abstract
Prenatal diagnoses of mitochondrial diseases caused by defects in nuclear DNA (nDNA) or mitochondrial DNA have been reported in several countries except for Japan. The present study aimed to clarify the status of prenatal genetic diagnosis of mitochondrial diseases caused by nDNA defects in Japan. A comprehensive genomic analysis was performed to diagnose more than 400 patients, of which, 13 families (16 cases) had requested prenatal diagnoses. Eight cases diagnosed with wild type homozygous or heterozygous variants same as either of the heterozygous parents continued the pregnancy and delivered healthy babies. Another eight cases were diagnosed with homozygous, compound heterozygous, or hemizygous variants same as the proband. Of these, seven families chose to terminate the pregnancy, while one decided to continue the pregnancy. Neonatal- or infantile-onset mitochondrial diseases show severe phenotypes and lead to lethality. Therefore, such diseases could be candidates for prenatal diagnosis with careful genetic counseling, and prenatal testing could be a viable option for families.
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Affiliation(s)
- Nana Akiyama
- Center for Medical Genetics, Chiba Children's Hospital, Chiba, Japan.,Department of Medical Genetics/Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masaru Shimura
- Department of Metabolism, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan
| | - Taro Yamazaki
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Hiroko Harashima
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takuya Fushimi
- Department of Metabolism, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan
| | - Tomoko Tsuruoka
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Tomohiro Ebihara
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Keiko Ichimoto
- Department of Metabolism, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan
| | - Ayako Matsunaga
- Department of Metabolism, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan
| | - Megumi Saito-Tsuruoka
- Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - Yukiko Yatsuka
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshihito Kishita
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Department of Life Science, Faculty of Science and Engineering, Kindai University, Osaka, Japan
| | - Masakazu Kohda
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akira Namba
- Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan.,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan.,Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Yoshimasa Kamei
- Department of Obstetrics and Gynecology, Saitama Medical University Hospital, Saitama, Japan
| | - Yasushi Okazaki
- Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Genetics/Medical Ethics, Kyoto University School of Public Health, Kyoto, Japan
| | - Akira Ohtake
- Department of Pediatrics, Faculty of Medicine, Saitama Medical University, Saitama, Japan. .,Department of Clinical Genomics, Faculty of Medicine, Saitama Medical University, Saitama, Japan. .,Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan.
| | - Kei Murayama
- Center for Medical Genetics, Chiba Children's Hospital, Chiba, Japan. .,Department of Metabolism, Chiba Children's Hospital, 579-1 Heta-cho, Midori-ku, Chiba, 266-0007, Japan. .,Diagnostics and Therapeutics of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
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26
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Tozawa T, Nishimura A, Ueno T, Shikata A, Taura Y, Yoshida T, Nakagawa N, Wada T, Kosugi S, Uehara T, Takenouchi T, Kosaki K, Chiyonobu T. Complex hereditary spastic paraplegia associated with episodic visual loss caused by ACO2 variants. Hum Genome Var 2021; 8:4. [PMID: 33500398 PMCID: PMC7838304 DOI: 10.1038/s41439-021-00136-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/09/2022] Open
Abstract
Most patients with homozygous or compound heterozygous pathogenic ACO2 variants present with muscular hypotonia features, namely, infantile cerebellar-retinal degeneration. Recently, two studies reported rare familial cases of ACO2 variants presenting as complex hereditary spastic paraplegia (HSP) with broad clinical spectra. Here, we report the case of a 20-year-old Japanese woman with complex HSP caused by compound heterozygous ACO2 variants, revealing a new phenotype of episodic visual loss during febrile illness.
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Affiliation(s)
- Takenori Tozawa
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. .,Department of Pediatrics, Ayabe City Hospital, Ayabe, Japan.
| | - Akira Nishimura
- Department of Neonatology, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tamaki Ueno
- Department of Pediatrics, Ayabe City Hospital, Ayabe, Japan.,Department of Pediatrics, Tokai Central Hospital, Kakamigahara, Japan
| | - Akane Shikata
- Kyoto Prefectural Maizuru Rehabilitation Center for Children, Maizuru, Japan
| | - Yoshihiro Taura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Yoshida
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoko Nakagawa
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahito Wada
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Tomoko Uehara
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Tomohiro Chiyonobu
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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27
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Kosugi S, Ueda Y, Abe H, Mishima T, Shinouchi K, Ozaki T, Takayasu K, Iida Y, Ohashi T, Toriyama C, Nakamura M, Date M, Uematsu M, Koretsune Y. Angioscopic evaluation of vascular healing at 1 and 12 months after drug-coated stent implantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Polymer- and carrier-free Biolimus-A9-coated stent (DCS) is expected better vascular healing compared with conventional durable polymer drug-eluting stents (DES). Moreover, DCS had been demonstrated in clinical trials to allow one-month short dual antiplatelet therapy, which might achieve sufficient healing at only 1 month after implantation. However, the process of vascular healing after DCS implantation has not been elucidated by angioscopic observation.
Purpose
To evaluate the process of vascular healing at 1 month and 12 months after DCS implantation.
Methods
This study included 57 patients treated with DCS or durable polymer everolimus-eluting stents (EES) in our hospital from April 2017 to April 2019. Firstly, the angioscopic findings of DCS at 1 month (n=16) and 12 months (n=14) after implantation were respectively compared with EES at 12 months after implantation (EES-12, n=35) as a standard healing status of DES. Secondary, angioscopic findings of DCS at 1 month and 12 months after implantation were compared among the serially observed eight patients. Neointimal coverage (NIC) grade, yellow colour grade, and the presence of thrombus were evaluated. NIC grade was classified as grade 0 (no neointimal coverage), grade 1 (struts were bulged into lumen but covered), grade 2 (struts were embedded in the neointima but visible), or grade 3 (struts were fully embedded and invisible). Yellow colour grade was classified as grade 0 (white), grade 1 (light yellow), grade 2 (yellow), or grade 3 (intensive yellow).
Results
At 1 month after DCS implantation, dominant NIC grade was lower (0.3±0.5 vs. 1.5±0.7, p<0.001) and the frequency of thrombus was higher (38% vs. 6%, p=0.008) than EES-12. On the other hands, at 12 months after DCS implantation, dominant NIC grade was higher (2.1±0.6 vs. 1.5±0.7, p=0.013) and the frequency of thrombus was not different (7% vs. 6%, p=1.000) in comparison with EES-12. By serial observation of DCS, dominant NIC grade was higher at 12 months than at 1 month (2.3±0.5 vs. 0.4±0.5, p<0.001), while yellow colour grade (1.0±0.5 vs. 1.5±1.2, p=0.227) and the frequency of thrombus adhesion (0% vs. 38%, p=0.200) were not different.
Conclusion
Compared with EES-12, vascular healing of DCS was inferior at 1 month but superior at 12 months.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Kosugi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Ueda
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - H Abe
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Mishima
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Shinouchi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ozaki
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - K Takayasu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Iida
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - T Ohashi
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - C Toriyama
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Nakamura
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Date
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - M Uematsu
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
| | - Y Koretsune
- National Hospital Organization Osaka National Hospital, Cardiovascular Division, Osaka, Japan
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28
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Kawasaki H, Yamada T, Wada T, Kosugi S. Current status and legal/ethical problems in the research use of the tissues of aborted human fetuses in Japan. Congenit Anom (Kyoto) 2020; 60:166-174. [PMID: 32572995 DOI: 10.1111/cga.12381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/12/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022]
Abstract
To date, there is no law regulating the research use of human aborted fetuses in Japan. The aim was to review the current status with historical background and legal/ethical problems limiting the research use of the tissues of aborted human fetuses. We reviewed literature via PubMed, Web of Science, Scopus, Japana Centra Revuo Medicina and CiNii, reports from various committees and research groups from Ministry of Health, Labour and Welfare (MHLW), and domestic books. Aborted human fetal tissues used for research purposes were first documented in the 1920s. The first guideline, the Peel Code was released in 1972. Since then, in Western countries, the research use of aborted fetuses has been less restricted compared with that of embryos, due to the following guidelines outlined by expert groups. Currently, aborted fetal tissues are commercially available for research purposes in the United States. In Japan, only four indications are presented in "a public statement permitting research use of deceased fetuses' and 'neonates' organs, etc." (1987). In the 2000s, expert committees of the MHLW concluded that research use of human aborted fetuses should be discontinued, and that comprehensive rules and independent regulations should be implemented. This issue has not been discussed in the Japanese legislature since 2003. Establishment of laws and guidelines for this issue is insufficient not only in Japan but also in other countries. It is important to secure transparency for making laws and guidelines and in obtaining public understanding.
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Affiliation(s)
- Hidenori Kawasaki
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahito Wada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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29
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Inaba A, Maeda A, Yoshida A, Kawai K, Hirami Y, Kurimoto Y, Kosugi S, Takahashi M. Truncating Variants Contribute to Hearing Loss and Severe Retinopathy in USH2A-Associated Retinitis Pigmentosa in Japanese Patients. Int J Mol Sci 2020; 21:ijms21217817. [PMID: 33105608 PMCID: PMC7659936 DOI: 10.3390/ijms21217817] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023] Open
Abstract
USH2A is a common causal gene of retinitis pigmentosa (RP), a progressive blinding disease due to retinal degeneration. Genetic alterations in USH2A can lead to two types of RP, non-syndromic and syndromic RP, which is called Usher syndrome, with impairments of vision and hearing. The complexity of the genotype–phenotype correlation in USH2A-associated RP (USH2A-RP) has been reported. Genetic and clinical characterization of USH2A-RP has not been performed in Japanese patients. In this study, genetic analyses were performed using targeted panel sequencing in 525 Japanese RP patients. Pathogenic variants of USH2A were identified in 36 of 525 (6.9%) patients and genetic features of USH2A-RP were characterized. Among 36 patients with USH2A-RP, 11 patients had syndromic RP with congenital hearing problems. Amino acid changes due to USH2A alterations were similarly located throughout entire regions of the USH2A protein structure in non-syndromic and syndromic RP cases. Notably, truncating variants were detected in all syndromic patients with a more severe retinal phenotype as compared to non-syndromic RP cases. Taken together, truncating variants could contribute to more serious functional and tissue damages in Japanese patients, suggesting important roles for truncating mutations in the pathogenesis of syndromic USH2A-RP.
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Affiliation(s)
- Akira Inaba
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan;
| | - Akiko Maeda
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
- Correspondence: ; Tel.: +81-(0)78-306-3305
| | - Akiko Yoshida
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
| | - Kanako Kawai
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
| | - Yasuhiko Hirami
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
| | - Yasuo Kurimoto
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan;
| | - Masayo Takahashi
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo 650-0047, Japan; (A.I.); (A.Y.); (K.K.); (Y.H.); (Y.K.); (M.T.)
- Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Hyogo 650-0047, Japan
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30
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Takahashi N, Takahashi Y, Tabara Y, Kawaguchi T, Kuriyama A, Ueshima K, Kosugi S, Sekine A, Yamada R, Matsuda F, Nakayama T. Descriptive epidemiology of high frequency component based on heart rate variability from 10-second ECG data and daily physical activity among community adult residents: the Nagahama Study. Biosci Trends 2020; 14:241-247. [PMID: 32624526 DOI: 10.5582/bst.2020.03146] [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
Characteristics of high frequency (HF) component based on heart rate variability (HRV) in a large general population remain unclear, particularly on the relationship with daily physical activity. We aimed to characterize the distribution of HF component and examine the association with daily physical activity among community residents. We performed spectral analysis of HRV from 10-second ECG recordings among 9135 residents aged 30 to 74 years in Nagahama City, Japan. HF components were log-transformed to consider the distribution. Simple correlations between HF and age were determined. Age-adjusted mean values of HF component were calculated for each questionnaire item related to daily physical activity. Multiple regression analysis was performed to examine the effect of daily physical activity on HF component value. Mean values of logarithmically-transformed HF component (lnHF) were higher in women than in men (p < 0.001). lnHF was inversely associated with age (r = -0.40, -0.49 for men, women, respectively). Adjusted mean lnHF for physically active people was significantly higher than that in inactive people (p < 0.001). HF components from 10-second ECG recordings were moderately and negatively correlated with age in both sexes, and positively correlated with daily physical activity in the general adult population. Maintaining the level of daily physical activity, especially to exercise regularly could keep the parasympathetic function high.
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Affiliation(s)
- Naomi Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Kuriyama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Kenji Ueshima
- Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Akihiro Sekine
- Department of Omics-based Medicine, Clinical Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ryo Yamada
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
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31
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Kawasaki H, Yamada T, Takahashi Y, Nakayama T, Wada T, Kosugi S. The short-term mortality and morbidity of very low birth weight infants with trisomy 18 or trisomy 13 in Japan. J Hum Genet 2020; 66:273-285. [PMID: 32943740 DOI: 10.1038/s10038-020-00825-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/09/2022]
Abstract
Trisomy 18 (T18) and trisomy 13 (T13) are major concerns in prenatal genetic testing due to their poor prognosis; very low birth weight (VLBW) is also a concern in neonatology. The aim of this study was to investigate the mortality and morbidity of VLBW infants diagnosed with T18/T13 in Japan, compared with those with no birth defects (BD-). Maternal and neonatal data were collected prospectively from infants weighing <1501 g and were admitted to centers of the Neonatal Research Network of Japan during 2003 to 2016. Among 60,136 infants, 563 and 60 was diagnosed with T18 and T13, respectively. Although the age of mothers of infants with T18/T13 was higher, the frequency of maternal complications was lower than those with BD-. With maternal and neonatal characteristic adjustments, T18/T13 had a higher incidence of each morbidity when compared with BD-. Mortality rates in the NICU were 70, 77, and 5.8% for T18, T13, and BD-, respectively, while the survival discharge rates of T18 and T13 were 29.5 and 23.3%, respectively, which was significantly higher than previous reports. This was the first nationwide survey for VLBW infants with T18/T13 in Japan; this novel data will be relevant and useful for prenatal genetic counseling and perinatal management. Although T18/T13 were considered to be fatal in the past, with proper epidemiological information, discussions with affected families, and compassionate patient care, the mortality rate of T18/T13 can be improved.
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Affiliation(s)
- Hidenori Kawasaki
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.
| | - Yoshimitsu Takahashi
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahito Wada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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32
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Kosugi S. [Management of Secondary Findings]. Gan To Kagaku Ryoho 2020; 47:1153-1157. [PMID: 32829346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Paradigm shift on the era of next generation sequencing(NGS): NGS completely changed the volume and acquiring speed of the genetic information. Secondary findings obtained by cancer profiling genomic testing should be handled by cooperation of genetic medicine and cancer medicine. Recommendations of the Communication Process on Genomic Medicine was announced for clinical sequencing using Next Generation Sequencer by Japan Agency for Medical Research and Development( AMED)Research Team. Secondary findings to be disclosed are listed up by American College of Medical Genetics and Genomics. Actionability of these 59 genes to be re-accessed on the conditions in Japan.
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Affiliation(s)
- Shinji Kosugi
- Dept. of Medical Ethics/Medical Genetics, Kyoto University School of Public Health
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33
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Tsuchiya M, Yamada T, Akaishi R, Hamanoue H, Hirasawa A, Hyodo M, Imoto I, Kosho T, Kurosawa K, Murakami H, Nakatani K, Nomura F, Sasaki A, Shimizu K, Tamai M, Umemura H, Watanabe A, Yoshida A, Yoshihashi H, Yotsumoto J, Kosugi S. Attitudes toward and current status of disclosure of secondary findings from next-generation sequencing: a nation-wide survey of clinical genetics professionals in Japan. J Hum Genet 2020; 65:1045-1053. [PMID: 32661284 DOI: 10.1038/s10038-020-0802-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 11/09/2022]
Abstract
The management of secondary findings (SFs), which are beyond the intended purpose of the analysis, from clinical comprehensive genomic analysis using next generation sequencing (NGS) presents challenges. Policy statements regarding their clinical management have been announced in Japan and other countries. In Japan, however, the current status of and attitudes of clinical genetics professionals toward reporting them are unclear. We conducted a questionnaire survey of clinical genetics professionals at two time points (2013 and 2019) to determine the enforcement of the SF management policy in cases of comprehensive genetic analysis of intractable diseases and clinical cancer genome profiling testing. According to the survey findings, 40% and 70% of the respondents stated in the 2013 and 2019 surveys, respectively, that they had an SF policy in the field of intractable diseases, indicating that SF policy awareness in Japan has changed significantly in recent years. Furthermore, a total of 80% of respondents stated that their facility had established a policy for clinical cancer genome profiling testing in the 2019 survey. In both surveys, the policies included the selection criteria for genes to be disclosed and the procedure to return SFs, followed by recommendations and proposals regarding SFs in Japan and other countries. To create a better list of the genes to be disclosed, further examination is needed considering the characteristics of each analysis.
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Affiliation(s)
- Mio Tsuchiya
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan. .,The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.
| | - Rina Akaishi
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Haruka Hamanoue
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Clinical Genetics, Yokohama City University Hospital, Yokohama, Japan
| | - Akira Hirasawa
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Maki Hyodo
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Obstetrics and Gynecology, Hiroshima University Graduate School of Medicine, Hiroshima, Japan
| | - Issei Imoto
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Molecular Genetics, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Tomoki Kosho
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kenji Kurosawa
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiromi Murakami
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.,The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan
| | - Kaname Nakatani
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Central Laboratory, Mie University Hospital, Tsu, Japan
| | - Fumio Nomura
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Divisions of Clinical Mass Spectrometry and Clinical Genetics, Chiba University Hospital, Chiba, Japan
| | - Aiko Sasaki
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kenji Shimizu
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Division of Medical Genetics, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Mariko Tamai
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroshi Umemura
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Division of Laboratory Medicine, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Atsushi Watanabe
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Division of Clinical Genetics, Kanazawa University Hospital, Kanazawa, Japan
| | - Akiko Yoshida
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Hiroshi Yoshihashi
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,Department of Medical Genetics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Junko Yotsumoto
- The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan.,International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.,The Social, Ethical and Legal Issues Committee, Japanese Society for Genetic Counseling, Tokyo, Japan
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34
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Tabara Y, Ikezoe T, Setoh K, Sugimoto K, Kawaguchi T, Kosugi S, Nakayama T, Ichihashi N, Tsuboyama T, Matsuda F. Comparison of diagnostic significance of the initial versus revised diagnostic algorithm for sarcopenia from the Asian Working Group for Sarcopenia. Arch Gerontol Geriatr 2020; 89:104071. [DOI: 10.1016/j.archger.2020.104071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/01/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022]
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35
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Tabara Y, Ikezoe T, Yamanaka M, Setoh K, Segawa H, Kawaguchi T, Kosugi S, Nakayama T, Ichihashi N, Tsuboyama T, Matsuda F. Advanced Glycation End Product Accumulation Is Associated With Low Skeletal Muscle Mass, Weak Muscle Strength, and Reduced Bone Density: The Nagahama Study. J Gerontol A Biol Sci Med Sci 2020; 74:1446-1453. [PMID: 30329028 DOI: 10.1093/gerona/gly233] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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: 06/14/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The accumulation of advanced glycation end product (AGE) might exert deleterious effects on musculoskeletal properties. Our study aims to clarify this possible association in a large general population. METHODS This study investigated a general population of 9,203 patients (mean age, 57.8 years). Skeletal muscle mass was measured by bioelectrical impedance analysis, whereas accumulation of AGEs was assessed by skin autofluorescence (SAF-AGE). The muscle strength of upper and lower limbs and usual gait speed were measured in a portion of older (≥60 years of age) participants (n = 1,934). The speed of sound (SOS) in the calcaneal bone was assessed via a quantitative ultrasound technique. RESULTS In the total population, the frequency of low skeletal muscle mass linearly increased with the SAF-AGE quartiles (Q1: 14.2%, Q2: 16.1%, Q3: 21.1%, Q4: 24.8%; p < .001), and this association was independent of covariates including glycemic traits (Q4: odds ratio [OR] = 1.48, p < .001). The association between the highest SAF-AGE quartile and low skeletal muscle mass remained significant in the older subpopulation (OR = 1.85, p = .002). A similar but weak association was observed for low SOS (Q1: 8.9%, Q2: 8.3%, Q3: 10.4%, Q4: 12.2%; p < .001). Similar inverse associations were also observed with grip strength (OR = 1.98, p = .003), hip flexion strength (OR = 1.50, p = .012), and hip abduction strength (OR = 1.78, p = .001), but not with usual gait speed. CONCLUSION Accumulation of AGEs might be a deleterious factor for musculoskeletal properties.
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Affiliation(s)
- Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan
| | - Tome Ikezoe
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Japan
| | | | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan
| | | | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Japan
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36
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Kosugi S, Koike F, Iizawa M, Oura M, Gejo T, Tamasaku K, Harries JR, Guillemin R, Piancastelli MN, Simon M, Azuma Y. Fluorescence Time Delay in Multistep Auger Decay as an Internal Clock. Phys Rev Lett 2020; 124:183001. [PMID: 32441980 DOI: 10.1103/physrevlett.124.183001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/14/2020] [Indexed: 06/11/2023]
Abstract
Differences in postcollision interaction (PCI) effects on Kr L_{3}M_{4,5}M_{4,5} Auger electron spectra were observed, depending on whether the initial photoionization occurred slightly above the K threshold or slightly above the L_{3} threshold. For the former, KL fluorescence emission most likely happens and then Auger processes due to the L_{3} hole follow. The time delay due to fluorescence causes a reduced shift of the Auger peak and tailing toward lower energy, since the Auger overtaking of the photoelectron happens later in time and at a location farther away from the ionic core, compared to the case for the simple one-step L_{3}M_{4,5}M_{4,5} Auger decay after L-shell photoionization. Time-dependent theory for PCI in multistep processes agrees well with experiment, illustrating the effect as an internal clock for the time-sequence of the dynamical process.
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Affiliation(s)
- S Kosugi
- Department of Materials and Life Sciences, Sophia University, Tokyo 102-8554, Japan
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - F Koike
- Department of Materials and Life Sciences, Sophia University, Tokyo 102-8554, Japan
| | - M Iizawa
- Department of Materials and Life Sciences, Sophia University, Tokyo 102-8554, Japan
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - M Oura
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - T Gejo
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
- Graduate School of Materials Science, University of Hyogo, Kamigori-cho, Ako-gun 678-1297, Japan
| | - K Tamasaku
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
| | - J R Harries
- National Institutes for Quantum and Radiological Science and Technology, SPring-8, 1-1-1 Kouto, Sayo, Hyogo 679-5148, Japan
| | - R Guillemin
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique-Matière et Rayonnement, F-75005 Paris, France
| | - M N Piancastelli
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique-Matière et Rayonnement, F-75005 Paris, France
- Department of Physics and Astronomy, Uppsala University, Box 516, SE-75120 Uppsala, Sweden
| | - M Simon
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
- Sorbonne Université, CNRS, UMR 7614, Laboratoire de Chimie Physique-Matière et Rayonnement, F-75005 Paris, France
| | - Y Azuma
- Department of Materials and Life Sciences, Sophia University, Tokyo 102-8554, Japan
- RIKEN SPring-8 Center, 1-1-1 Kouto, Sayo-cho, Sayo-gun, Hyogo 679-5148, Japan
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37
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Tabara Y, Yamanaka M, Setoh K, Segawa H, Kawaguchi T, Kosugi S, Nakayama T, Matsuda F. Advanced Glycation End Product Accumulation is Associated with Lower Cognitive Performance in an Older General Population: The Nagahama Study. J Alzheimers Dis 2020; 74:741-746. [DOI: 10.3233/jad-190878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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)
- Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku Kyoto, Japan
| | | | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku Kyoto, Japan
| | | | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Sakyo-ku Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Sakyo-ku Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Sakyo-ku Kyoto, Japan
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Kondo T, Pham Nguyen Q, Matsubara J, Fukuyama K, Nomura M, Funakoshi T, Funakoshi M, Sakamoto H, Ashida K, Mukai K, Uemoto S, Sakai Y, Seno H, Minamiguchi S, Haga H, Kosugi S, Kanai M, Matsumoto S, Muto M. Comprehensive genomic profiling for chemotherapy-naïve advanced gastrointestinal malignancies. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
832 Background: From June, 2019, two comprehensive genomic profiling (CGP) assays, "FoundationOne CDx" and “OncoGuide NCC Oncopanel”, were reimbursed by the national insurance system in Japan for patients who were refractory to standard chemotherapy. However, their clinical utility for chemotherapy-naïve cancer patients is unknown. Methods: We conducted a single institutional prospective observational study to evaluate the clinical utility of FoundationOne CDx assay (Cambridge, MA, USA) for the patients with chemotherapy-naïve advanced gastrointestinal malignancies. Patients with adequate H.E. sample were registered in this study. Primary outcome was the detection rate of at least one actionable/druggable cancer genomic alterations. The evidence levels were classified according to clinical practice guidance for next-generation sequencing in cancer diagnosis and treatment (Edition 1.0) (Sunami K. Cancer Sci. 2018). Results: From October 2018 to June 2019, a total of 238 patients were screened and the following 158 patients were registered: colorectal cancer (n = 60), gastric cancer (n = 19), esophageal cancer (n = 23), pancreatic cancer (n = 30), biliary tract cancer (n = 11), rare gastrointestinal malignancies (n = 15). The CGP data were obtained for 113 patients . Median turn-around time was 14 days (range 10-247 days). Actionable/druggable cancer genomic alterations were observed in 113 patients (100%)/ 65 patients (57.5%), respectively. Clinically relevant biomarkers and genomic alterations were identified in 22 patients (19.5%); BRCA2 (n = 4), ERBB2 (n = 4) , BRAF (n = 3) , EGFR (n = 3), FGFR2 (n = 2), MET (n = 2), NTRK (n = 2) , MSI-H (n = 2 ), TMB-high (n = 2), ALK (n = 1) , KIT (n = 1) and ROS1 (n = 1). Of note, novel biomarkers such as ROS1- GOPC fusion and PALB2 rearrangement were obtained in the patients with esophageal squamous cell carcinoma. Conclusions: This is the first study to evaluate the clinical utility of CGP in patient with chemotherapy-naïve advanced gastrointestinal malignancies. Our result indicated that CGP might provide a chance of potentially effective drugs as a novel approach in precision cancer medicine. Clinical trial information: UMIN000034830.
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Affiliation(s)
- Tomohiro Kondo
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Quy Pham Nguyen
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Junichi Matsubara
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Keita Fukuyama
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Motoo Nomura
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Taro Funakoshi
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Mari Funakoshi
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Hitomi Sakamoto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Kanami Ashida
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Kumi Mukai
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Kyoto, Japan
| | - Yoshiharu Sakai
- Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kyoto, Japan
| | | | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masashi Kanai
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Shigemi Matsumoto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Manabu Muto
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
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Torishima M, Urao M, Nakayama T, Kosugi S. Negative recollections regarding doctor-patient interactions among men receiving a prostate cancer diagnosis: a qualitative study of patient experiences in Japan. BMJ Open 2020; 10:e032251. [PMID: 31964666 PMCID: PMC7044962 DOI: 10.1136/bmjopen-2019-032251] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To explore the negative recollections of prostate cancer patients regarding the attitudes and language used by the doctors in delivering their diagnoses in Japan, in order to improve patient-centred communication. DESIGN AND SETTING This is a qualitative secondary analysis of the prostate cancer narrative data from the Database of Individual Patients' Experiences-Japan archives. A thematic analysis was conducted regarding negative recollections of doctors' words/attitudes when delivering a cancer diagnosis. Recruitment was based on maximum variation sampling. Participants were recruited from medical institutions, patient associations and through media advertisements. PARTICIPANTS Men with a diagnosis of prostate cancer (n=51). FINDINGS Of the 51 participants, 17 had negative recollections of the doctors' words/attitudes during the delivery of the cancer diagnosis. After thematic analysis, 11 categories emerged: 'Surprised by the abrupt disclosure of the diagnosis', 'Displeased by the direct disclosure of the diagnosis to the patient in the absence of family members', 'Unable to accept the doctor's negative words in the explanations', 'Unable to understand the doctor's technical jargon', 'Distrust due to failure in diagnosis based on previous examinations', 'Aggrieved at the doctor's unwillingness to allow questions', 'Dissatisfied with explanations involving facts only', 'Indignant over the unexpected disclosure of life expectancy', 'Unable to accept the doctor's blame for the delay in the initial hospital visit', 'Uncomfortable with the usage of inappropriate metaphors' and 'Pessimistic thoughts despite optimistic explanations'. CONCLUSIONS It is clear that patients have recollections of a variety of negative experiences regarding the words/attitudes of their doctors at the time they received their prostate cancer diagnosis. Thus, the use of narrative data would facilitate the appropriate application of commonly used guidelines for the delivery of cancer diagnoses tailored to individual patients in clinical practice.
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Affiliation(s)
- Masako Torishima
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Sakyo-ku, Japan
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Sakyo-ku, Japan
| | - Michiko Urao
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Sakyo-ku, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Sakyo-ku, Japan
| | - Shinji Kosugi
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Sakyo-ku, Japan
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Sakyo-ku, Japan
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40
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Toriyama C, Abe H, Nishida H, Nakamura M, Ohashi T, Iida Y, Kosugi S, Ozaki T, Shinouchi K, Mishima T, Date M, Ueda Y, Uematsu M, Koretsune Y. P92 A novel method of correcting the left ventricular stroke volume by Doppler echocardiography: comparison with multidetector computed tomography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although transthoracic Doppler echocardiography is widely used for estimating left ventricular stroke volume (SV), accelerated blood flow in the left ventricular (LV) outflow tract may lead to overestimation. SV can be calculated accurately from left ventricular end-systolic and end-diastolic volume determined by multi-detector computed tomography (MDCT). However, radiation exposure as well as the use of contrast medium hampers its routine use.
Purpose
The purpose of this study was to examine whether the correction of SV measured by pulsed wave Doppler echocardiography (SVdop) can accurately predicts SV obtained by MDCT (SVct).
Methods: We enrolled consecutive 61 patients who underwent both MDCT and transthoracic echocardiography. Patients with moderate or severe valvular diseases and valve replacement surgery were excluded. Correction of SV was explored with SVct as a reference.
Results: Univariate analysis showed that SVdop (r = 0.42, P = 0.0007) and patient age (r=-0.50, P < 0.0001) were significantly correlated with SVct. On the other hand, left ventricular ejection fraction calculated by Teicholz method (EFteich) (r = 0.19, P = 0.14), systolic blood pressure (r = 0.07, P = NS), and LV mass index (r=-0.02, P = NS) were not correlated with SVct. Multivariate analysis showed that SVdop, patient age and EFteich were the independent predictive factors for SVct (R2 = 0.49, P < 0.0001). Based on these correlations, we postulated SV as: corrected SV = SVdop × 0.40 + EFteich × 0.46 – age × 0.67 + 44.77. As expected, the correlation between corrected SV and SVct significantly improved (r = 0.70, P < 0.0001). Bland-Altman plot analysis showed that corrected SV significantly reduced the variation between SVdop and SVct, and diminished the overestimation of SVdop (Figure).
Conclusion: The new correction formula of SVdop may correct the overestimation of SV obtained by pulsed wave Doppler echocardiography, although the formula remains to be validated in a separate cohort of patients.
Abstract P92 Figure
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Affiliation(s)
| | - H Abe
- Osaka National Hospital, Osaka, Japan
| | - H Nishida
- Osaka National Hospital, Osaka, Japan
| | | | - T Ohashi
- Osaka National Hospital, Osaka, Japan
| | - Y Iida
- Osaka National Hospital, Osaka, Japan
| | - S Kosugi
- Osaka National Hospital, Osaka, Japan
| | - T Ozaki
- Osaka National Hospital, Osaka, Japan
| | | | - T Mishima
- Osaka National Hospital, Osaka, Japan
| | - M Date
- Osaka National Hospital, Osaka, Japan
| | - Y Ueda
- Osaka National Hospital, Osaka, Japan
| | - M Uematsu
- Osaka National Hospital, Osaka, Japan
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41
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Yamamoto Y, Kanai M, Kou T, Sugiyama A, Nakamura E, Miyake H, Yamada T, Nishigaki M, Kondo T, Murakami H, Torishima M, Matsumoto S, Kosugi S, Muto M. Clinical significance of TP53 variants as possible secondary findings in tumor-only next-generation sequencing. J Hum Genet 2019; 65:125-132. [PMID: 31628423 PMCID: PMC6917569 DOI: 10.1038/s10038-019-0681-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/24/2019] [Indexed: 12/16/2022]
Abstract
In tumor-only next-generation sequencing (NGS), identified variants have the potential to be secondary findings (SFs), but they require verification through additional germline testing. In the present study, 194 patients with advanced cancer who underwent tumor-only NGS between April 2015 and March 2018 were enrolled, and the incidences of possible and true SFs were evaluated. Among them, 120 patients (61.9%) harbored at least one possible SF. TP53 was the most frequent gene in which 97 variants were found in 91 patients (49.5%). Nine patients provided informed consent to undergo additional germline testing, and a total of 14 variants (BRCA1, n = 1; BRCA2, n = 2; PTEN, n = 2; RB1, n = 1; SMAD4, n = 1; STK11, n = 1; TP53, n = 6) were analyzed. Three variants (BRCA1, n = 1; BRCA2, n = 2) were confirmed to be SFs, whereas TP53 variants were confirmed to be somatic variants. To confirm the low prevalence of SFs in TP53, we analyzed 24 patients with TP53 variants who underwent a paired tumor–normal NGS assay. As expected, all TP53 variants were confirmed to be somatic variants. A total of 30 patients were tested for germline variants in TP53, but none of them resulted in true SFs, suggesting the low prevalence of SFs in this gene. Therefore, the significance of additional germline testing for TP53 variants appears to be relatively low in daily clinical practice using a tumor-only NGS assay, unless patients have any relevant medical or family history.
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Affiliation(s)
- Yoshihiro Yamamoto
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Kanai
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Tadayuki Kou
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Aiko Sugiyama
- DSK Project, Medical Innovation Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Eijiro Nakamura
- DSK Project, Medical Innovation Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidehiko Miyake
- Faculty of Core Research, Natural Science Division, Ochanomizu University, Tokyo, Japan.,Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan
| | - Takahiro Yamada
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Masakazu Nishigaki
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan.,Department of Human Health Sciences, School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomohiro Kondo
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan
| | - Hiromi Murakami
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan
| | | | - Shigemi Matsumoto
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Clinical Genetics Unit, Kyoto University Hospital, Kyoto, Japan.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Manabu Muto
- Department of Medical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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42
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Tabara Y, Matsumoto T, Murase K, Setoh K, Kawaguchi T, Nagashima S, Funada S, Kosugi S, Hirai T, Nakayama T, Wakamura T, Chin K, Matsuda F. Lifestyle habits associated with nocturnal urination frequency: The Nagahama study. Neurourol Urodyn 2019; 38:2359-2367. [DOI: 10.1002/nau.24156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/18/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeshi Matsumoto
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuya Setoh
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takahisa Kawaguchi
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Shunsuke Nagashima
- Department of Human Health ScienceKyoto University Graduate School of Medicine Kyoto Japan
| | - Satoshi Funada
- Department of UrologyKyoto University Hospital Kyoto Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical GeneticsKyoto University School of Public Health Kyoto Japan
| | - Toyohiro Hirai
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeo Nakayama
- Department of Health InformaticsKyoto University School of Public Health Kyoto Japan
| | - Tomoko Wakamura
- Department of Human Health ScienceKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
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43
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Tabara Y, Ikezoe T, Matsumoto T, Murase K, Setoh K, Funada S, Kawaguchi T, Nagashima S, Kosugi S, Hirai T, Nakayama T, Wakamura T, Chin K, Ichihashi N, Tsuboyama T, Matsuda F. Association of weak hip abduction strength with nocturia in older women: The Nagahama study. Geriatr Gerontol Int 2019; 19:1010-1016. [DOI: 10.1111/ggi.13761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/22/2019] [Accepted: 07/31/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Yasuharu Tabara
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Tome Ikezoe
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeshi Matsumoto
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuya Setoh
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Satoshi Funada
- Department of UrologyKyoto University Hospital Kyoto Japan
| | - Takahisa Kawaguchi
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Shunsuke Nagashima
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical GeneticsKyoto University School of Public Health Kyoto Japan
| | - Toyohiro Hirai
- Department of Respiratory MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Takeo Nakayama
- Department of Health InformaticsKyoto University School of Public Health Kyoto Japan
| | - Tomoko Wakamura
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control MedicineKyoto University Graduate School of Medicine Kyoto Japan
| | - Noriaki Ichihashi
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
| | - Tadao Tsuboyama
- Department of Human Health SciencesKyoto University Graduate School of Medicine Kyoto Japan
- School of Health SciencesBukkyo University Kyoto Japan
| | - Fumihiko Matsuda
- Center for Genomic MedicineKyoto University Graduate School of Medicine Kyoto Japan
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44
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Sawai H, Oka K, Ushioda M, Nishimura G, Omori T, Numabe H, Kosugi S. National survey of prevalence and prognosis of thanatophoric dysplasia in Japan. Pediatr Int 2019; 61:748-753. [PMID: 31247124 PMCID: PMC6852317 DOI: 10.1111/ped.13927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/14/2018] [Accepted: 01/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thanatophoric dysplasia (TD) is a rare congenital disease of the skeletal system, with an incidence of 1.68-8.3 per 100 000 births, but statistical data on the estimated number of TD patients across Japan are not available. The aim of this study was therefore to investigate the prevalence and prognosis of TD in Japan. METHODS A nationwide primary questionnaire survey was conducted. RESULTS A total of 127 obstetric, 186 pediatric, and 115 orthopedic facilities provided responses. Excluding duplications, we identified 73 patients with TD. Of the 73 cases, 15 were abortions, four were stillbirths, 51 were live births, and three had unknown details. Of the 51 live newborns, 27 died ≤7 days after birth, with an early neonatal mortality rate of 56%. Of the 24 newborns who survived the early neonatal period, 16 survived for ≥1 year. All of the 24 newborns received respiratory management and survived during the early neonatal period. Of the 51 live newborns, 25 did not receive respiratory management and died ≤2 days after birth. CONCLUSIONS The prevalence of TD in Japan is estimated to be at 1.1 (95%CI: 0.84-1.37) per 100 000 births, but the actual incidence is expected to be higher. To our knowledge, we have confirmed for the first time that newborns with TD may not always die during the early neonatal period but can survive the early neonatal period with appropriate respiratory management. Therefore, the term "thanatophoric dysplasia" does not accurately reflect the nature of the disease.
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Affiliation(s)
- Hideaki Sawai
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan.,Genetic Counsellor Course, Kyoto University School of Public Health, Kyoto, Japan
| | - Kaname Oka
- Genetic Counsellor Course, Kyoto University School of Public Health, Kyoto, Japan
| | - Mariko Ushioda
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Gen Nishimura
- Intractable Disease Center, Saitama Medical University Hospital, Moroyama, Saitama, Japan
| | - Takashi Omori
- Division of Biostatistics, Department of Social/Community Medicine and Health Science, Kobe University School of Medicine, Kobe, Japan
| | - Hironao Numabe
- Genetic Counsellor Course, Kyoto University School of Public Health, Kyoto, Japan.,Department of Medical Genetics, Tokyo Medical University, Tokyo, Japan
| | - Shinji Kosugi
- Genetic Counsellor Course, Kyoto University School of Public Health, Kyoto, Japan.,Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
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45
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Funakoshi T, Miyamoto S, Kakiuchi N, Nikaido M, Setoyama T, Yokoyama A, Horimatsu T, Yamada A, Torishima M, Kosugi S, Yamada H, Sugimura H, Haga H, Sakai Y, Ogawa S, Seno H, Muto M, Chiba T. Genetic analysis of a case of Helicobacter pylori-uninfected intramucosal gastric cancer in a family with hereditary diffuse gastric cancer. Gastric Cancer 2019; 22:892-898. [PMID: 30542785 DOI: 10.1007/s10120-018-00912-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/05/2018] [Indexed: 02/07/2023]
Abstract
Germline mutations in CDH1, encoding E-cadherin, are known to be the causative mechanism of hereditary diffuse gastric cancer (HDGC). We encountered two cases of gastric cancer in a Japanese family with HDGC. A 28-year-old man (Case 1) died of advanced gastric cancer. His younger sister aged 27 (Case 2) was diagnosed with intramucosal signet ring cell carcinoma (SRCC). Both had identical germline CDH1 mutations, but Case 1 was positive for Helicobacter pylori infection, whereas Case 2 was negative. Case 2 underwent total gastrectomy. Whole-exome sequencing of an intramucosal SRCC in Case 2 revealed seven somatic mutations including one in CDH1. The six non-CDH1 mutations were classified as non-driver mutations. Decreased expression of E-cadherin in intramucosal SRCC was confirmed by immunohistochemistry. Our report demonstrated that CDH1 mutation was the only active driver mutation in Helicobacter pylori-uninfected intramucosal SRCC.
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Affiliation(s)
- Taro Funakoshi
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shin'ichi Miyamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54, Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Nobuyuki Kakiuchi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54, Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Mitsuhiro Nikaido
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54, Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takeshi Setoyama
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Akira Yokoyama
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Horimatsu
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Yamada
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masako Torishima
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiharu Sakai
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Seno
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54, Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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46
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Matsumoto T, Tabara Y, Murase K, Setoh K, Kawaguchi T, Nagashima S, Kosugi S, Nakayama T, Wakamura T, Hirai T, Matsuda F, Chin K. Association between sleep disturbance and nocturnal blood pressure profiles by a linear mixed model analysis: the Nagahama study. Sleep Med 2019; 61:104-109. [PMID: 31402214 DOI: 10.1016/j.sleep.2019.01.049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 01/04/2019] [Accepted: 01/28/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES We aimed to analyze associations of sleep disturbance, including sleep disordered breathing, sleep fragmentation, and sleep efficiency, with abnormal nocturnal blood pressure (BP) profiles that may be risk factors for adverse cardiovascular outcomes. METHODS The study included 5854 community residents with 20,725 multi-day measurements. Sleep fragmentation and efficiency were evaluated using a wrist-worn activity monitor. Sleep disordered breathing was assessed using the 3% oxygen desaturation index corrected for actigraphy-determined sleep duration. A timer-equipped standard cuff-oscillometric device was used for home and sleep BP monitoring. RESULTS Mean nocturnal systolic BP (SBP) change was -8.6 ± 9.7% (-11.1 ± 12.6 mmHg), and inter-day correlation coefficient of the nocturnal SBP change was 0.443. Results of a linear mixed model analysis using daily measured values identified lower sleep efficiency (coefficient = -0.130, p < 0.001) as a determinant for decreased nocturnal SBP dipping beyond the interday variations of these parameters. Number of nocturnal urinations was another strong determinant (coefficient = 1.191, p < 0.001), although the association of sleep efficiency was independent of nocturnal urination, awake SBP, and sleep disordered breathing (coefficient = -0.102, p < 0.001). Sleep efficiency was also independently associated with sleep SBP level (coefficient = -0.138, p < 0.001). Estimated differences in nocturnal SBP dipping and sleep SBP level as a function of the degree of sleep efficiency (less than 80%) reached 1.63% (1.09-2.17%) and 2.16 mmHg (1.49-2.82%), respectively. CONCLUSION More attention should be paid to sleep efficiency as a factor in maintaining circadian BP rhythm.
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Affiliation(s)
- Takeshi Matsumoto
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Gnomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuya Setoh
- Center for Gnomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Gnomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunsuke Nagashima
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Tomoko Wakamura
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Gnomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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47
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Mano F, Ikeda K, Sato T, Nakayama T, Tanaka D, Joo E, Takahashi Y, Kosugi S, Sekine A, Tabara Y, Matsuda F, Inagaki N. Reduction in Gastroesophageal Reflux Disease Symptoms Is Associated with Miso Soup Intake in a Population-Based Cross-Sectional Study: The Nagahama Study. J Nutr Sci Vitaminol (Tokyo) 2019; 64:367-373. [PMID: 30381627 DOI: 10.3177/jnsv.64.367] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/27/2022]
Abstract
Dietary habits and lifestyles are considered to affect the frequency of epigastric symptoms. In our previous study, we found that three amino acids in Japanese broth promoted gastric emptying. We hypothesized that a higher consumption of miso soup which was mainly composed of Japanese broth and miso paste would be associated with a lower frequency of epigastric symptoms. We conducted a cross-sectional study of the association between frequency of miso soup intake and reflux or dyspepsia symptoms in a general Japanese population. Sixteen items of dietary habits were assessed using a self-reported questionnaire, and epigastric symptoms were evaluated using the Frequency Scale for Symptoms of Gastroesophageal Reflux Disease (FSSG). We fitted generalized linear models to analyze the association between miso soup intake and FSSG, reflux, or dyspepsia scores adjusted by age, sex, body mass index (BMI), another 15 dietary habits, smoking, drinking alcohol, and unfavorable dietary behaviors. A total of 9,364 subjects were included in the analysis. Trend analysis revealed that higher frequency of miso soup intake was associated with lower FSSG scores (p<0.001). In a generalized linear model, daily intake of miso soup was associated with lower FSSG, reflux, and dyspepsia scores independent of age, sex, BMI, other 15 dietary habits, smoking, drinking alcohol, and unfavorable dietary behaviors (estimate=-0.46, -0.22, and -0.27, respectively; 95% CI=-0.83, -0.12; -0.38, -0.07; and -0.47, and -0.08, respectively). Dairy intake of miso soup was associated with lower epigastric symptoms.
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Affiliation(s)
- Fumika Mano
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Tosiya Sato
- Department of Biostatistics, Kyoto University School of Public Health
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health
| | - Daisuke Tanaka
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | - Erina Joo
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
| | | | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health
| | | | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Graduate School of Medicine, Kyoto University
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48
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Tabara Y, Masaki M, Ikezoe T, Setoh K, Kato T, Kawaguchi T, Kosugi S, Nakayama T, Ichihashi N, Tsuboyama T, Matsuda F. Small Degree of Lumbar Lordosis as an Overlooked Determinant for Orthostatic Increases in Blood Pressure in the Elderly: The Nagahama Study. Am J Hypertens 2019; 32:61-69. [PMID: 30265274 DOI: 10.1093/ajh/hpy137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/09/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Orthostatic hypertension was associated with worse cardiovascular outcomes, although the factors responsible for an orthostatic rise in blood pressure (BP) are uncertain. We investigated a possible relationship between a stooping posture and orthostatic BP change. METHODS Study participants consisted of 1,992 older individuals. Orthostatic BP change was calculated by systolic BP measured at sitting position, and again 1 and 3 minutes after standing up. Spinal alignment and curvature was assessed by guiding the SpinalMouse device on the surface of the skin along the spine. RESULTS Mean lumbar lordosis at standing position was 13.4° ± 12.4°. The degree of lumbar lordosis was significantly smaller in orthostatic hypertensive individuals (systolic BP change, ≥+20 mm Hg: 3.3° ± 15.6°, ≥+10 mm Hg: 10.4° ± 14.3°) than in individuals who were orthostatic normotensive (14.2° ± 11.9°). Multiple linear regression analysis identified lumbar lordosis (β = -0.171, P < 0.001) and thoracic kyphosis (β = 0.062, P = 0.007), but not sacral inclination (β = 0.033, P = 0.303), as independent determinants for orthostatic BP change. As waist circumference was another independent determinant, the frequency of orthostatic hypertensive individuals was linearly increased with the combination of abdominal obesity and small degree of lumbar lordosis (control: 9.9%, abdominal obesity: 17.4%, small degree of lordosis: 19.4%, both: 24.1%, P < 0.001). Participants who sustained orthostatic hypertension for 3 minutes after standing up had the smallest degree of lumbar lordosis (5.2° ± 16.4°). CONCLUSION Stooped posture was an overlooked determinant for orthostatic increases in BP.
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Affiliation(s)
- Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan
| | - Mitsuhiro Masaki
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tome Ikezoe
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan
| | - Takehiro Kato
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto Japan
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Tabara Y, Matsumoto T, Murase K, Setoh K, Kawaguchi T, Nagashima S, Kosugi S, Nakayama T, Wakamura T, Hirai T, Chin K, Matsuda F. Day-to-Day Home Blood Pressure Variability and Orthostatic Hypotension: The Nagahama Study. Am J Hypertens 2018; 31:1278-1285. [PMID: 30239598 DOI: 10.1093/ajh/hpy131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/09/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study is to clarify associations between orthostatic blood pressure (BP) change, as well as possible physiological factors, and day-to-day home BP variability, a promising risk factor for cardiovascular outcomes. METHODS Study participants were 6,465 community residents (age 58.3 years). Home BP was measured every morning and evening for 7 days. Orthostatic BP was calculated as the maximum difference between BP measured while sitting and remeasured after 1 and 3 minutes standing. RESULTS Frequency of individuals who showed orthostatic BP decline was as follows: systolic BP (SBP) change ≥-20 mm Hg: 2.6%, ≥-10 mm Hg: 14.1%. These subgroups showed larger home SBP variability (average real variability: 11.3 ± 5.3, 8.7 ± 3.9 mm Hg) when compared with orthostatic normotensives (7.6 ± 3.7 mm Hg) (all P < 0.001). Multiple linear regression analysis adjusted for major covariates, including seated BP, identified orthostatic BP drop as an independent determinant for morning BP variability (≥-20 mm Hg: β = 0.037, P = 0.003; ≥-10 mm Hg: β = 0.026, P = 0.036) but not for evening BP variability. Carotid hypertrophy was significantly associated with home BP variability (morning: β = 0.052, P = 0.001; evening: β = 0.065, P < 0.001) and showed a U-shaped association with orthostatic BP change. Plasma B-type natriuretic peptide level, a previously suggested factor for BP variability, did not show significant association with morning and evening BP variability. CONCLUSION Orthostatic BP decline was significantly associated with morning BP variability. Large artery atherosclerosis was a common risk factor.
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Affiliation(s)
- Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Matsumoto
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kimihiko Murase
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuya Setoh
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunsuke Nagashima
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Tomoko Wakamura
- Department of Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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50
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Yamashita M, Tabara Y, Higo Y, Setoh K, Kawaguchi T, Takahashi Y, Kosugi S, Nakayama T, Matsuda F, Wakamura T. Association between socioeconomic factors and urinary sodium-to-potassium ratio: the Nagahama Study. Hypertens Res 2018; 41:973-980. [DOI: 10.1038/s41440-018-0101-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 12/11/2022]
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