1
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Iwata N, Nishimura K, Hara R, Imagawa T, Shimizu M, Tomiita M, Umebayashi H, Takei S, Seko N, Wakabayashi R, Yokota S. Long-term efficacy and safety of canakinumab in the treatment of systemic juvenile idiopathic arthritis in Japanese patients: Results from an open-label Phase III study. Mod Rheumatol 2023; 33:1162-1170. [PMID: 36399020 DOI: 10.1093/mr/roac128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/07/2022] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The objective of the study was to report the efficacy and safety of canakinumab treatment in Japanese patients with systemic juvenile idiopathic arthritis (sJIA) over a 48-week study period. METHODS Patients were administered canakinumab 4 mg/kg (maximum dose 300 mg) every 4 weeks, with no dose adjustments. The key outcome measures included adapted American College of Rheumatology paediatric (aACR pedi) 30/50/70/90/100 response, proportion of patients with inactive disease, and corticosteroid (CS) tapering. RESULTS In total, 16/19 (84.2%) patients received canakinumab for ≥96 weeks reaching end-of-study (EOS) visit without premature discontinuation. Regardless of the level of joint involvement at baseline, high aACR pedi responses were observed throughout the study; at the EOS, aACR pedi 90/100 response rates were 84.2%/63.2%, respectively. The proportion of patients who successfully tapered CSs at EOS was 66.7% (12/18), of which 10 patients were steroid-free. The most common adverse events were infections (238.3 events/100 patient-years). Serious adverse events were observed in 52.6%. The event (n=1) adjudicated as possible macrophage activation syndrome was preceded by sJIA flare. No deaths were reported. CONCLUSIONS Canakinumab treatment resulted in a sustained treatment response in sJIA patients over 48 weeks and was associated with CS tapering in majority of patients. No new safety findings were reported.
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Affiliation(s)
- Naomi Iwata
- Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryoki Hara
- Department of Pediatrics, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Tomoyuki Imagawa
- Department of Infection and Immunology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masaki Shimizu
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Minako Tomiita
- Department of Clinical Research/Pediatric Allergy and Rheumatology Center, National Hospital Organisation Shimoshizu National Hospital, Chiba, Japan
| | - Hiroaki Umebayashi
- Department of Rheumatology and Infectious disease, Miyagi Children's Hospital, Sendai, Japan
| | - Syuji Takei
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | - Shumpei Yokota
- Tokyo University and Graduate School of Social Welfare, Isesaki, Japan
- Yokohama City University, Yokohama, Japan
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2
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Kistler LM, Asamura K, Kasahara S, Miyoshi Y, Mouikis CG, Keika K, Petrinec SM, Stevens ML, Hori T, Yokota S, Shinohara I. The variable source of the plasma sheet during a geomagnetic storm. Nat Commun 2023; 14:6143. [PMID: 37903790 PMCID: PMC10616164 DOI: 10.1038/s41467-023-41735-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/12/2023] [Indexed: 11/01/2023] Open
Abstract
Both solar wind and ionospheric sources contribute to the magnetotail plasma sheet, but how their contribution changes during a geomagnetic storm is an open question. The source is critical because the plasma sheet properties control the enhancement and decay rate of the ring current, the main cause of the geomagnetic field perturbations that define a geomagnetic storm. Here we use the solar wind composition to track the source and show that the plasma sheet source changes from predominantly solar wind to predominantly ionospheric as a storm develops. Additionally, we find that the ionospheric plasma during the storm main phase is initially dominated by singly ionized hydrogen (H+), likely from the polar wind, a low energy outflow from the polar cap, and then transitions to the accelerated outflow from the dayside and nightside auroral regions, identified by singly ionized oxygen (O+). These results reveal how the access to the magnetotail of the different sources can change quickly, impacting the storm development.
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Affiliation(s)
- L M Kistler
- University of New Hampshire, Durham, NH, USA.
- Nagoya University, Nagoya, Japan.
| | - K Asamura
- Japan Aerospace Exploration Agency, Sagamihara, Japan
| | | | | | - C G Mouikis
- University of New Hampshire, Durham, NH, USA
| | - K Keika
- University of Tokyo, Tokyo, Japan
| | - S M Petrinec
- Lockheed Martin Advanced Technology Center, Palo Alto, CA, USA
| | - M L Stevens
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA, USA
| | - T Hori
- Nagoya University, Nagoya, Japan
| | - S Yokota
- Osaka University, Toyonaka, Japan
| | - I Shinohara
- Japan Aerospace Exploration Agency, Sagamihara, Japan
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3
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Yokota S, Kaji K, Yonezawa T, Momoi Y, Maeda S. CD204⁺ tumor-associated macrophages are associated with clinical outcome in canine pulmonary adenocarcinoma and transitional cell carcinoma. Vet J 2023; 296-297:105992. [PMID: 37164121 DOI: 10.1016/j.tvjl.2023.105992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/04/2023] [Accepted: 05/07/2023] [Indexed: 05/12/2023]
Abstract
Tumor-associated macrophages are abundant infiltrating cells in the tumor microenvironment (TME). Macrophages can be classified into several types of subsets based on their immune responses. Among those subsets, M2 macrophages contribute to anti-inflammatory responses and create an immunosuppressive environment that promotes tumor cell proliferation. In a previous study, human cancer patients with high M2 macrophages showed a worse prognosis for many types of tumors. However, studies examining the relationship between M2 macrophages and clinical outcomes in canine tumors are limited. In the previous human and canine studies, CD204 has been used as the marker for detecting M2 macrophages. Then we evaluated CD204+ and total macrophages infiltration and its association with clinical outcomes in canine solid tumors. In this study, we examined dogs with oral malignant melanoma (OMM), pulmonary adenocarcinoma (PA), hepatocellular carcinoma (HCC), and transitional cell carcinoma (TCC). Compared to healthy tissues, CD204+ and total macrophages were increased in OMM, PA, and TCC, but not in HCC. High CD204+ macrophage levels were significantly associated with lung metastasis in TCC (P = 0.030). Kaplan-Meier analysis revealed that high CD204+ macrophage levels were associated with shorter overall survival (OS) in canine patients with PA (P = 0.012) and TCC (P = 0.0053). These results suggest that CD204+ macrophages contribute to tumor progression and could be a prognostic factor in dogs with PA and TCC.
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Affiliation(s)
- S Yokota
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - K Kaji
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - T Yonezawa
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Y Momoi
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - S Maeda
- Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan.
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4
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Yamasaki J, Nonaka M, Yokota S, Shimamura K. Development of inverted pendulum thrust stand with spring-shaped wire for high power electric thrusters. Rev Sci Instrum 2023; 94:034501. [PMID: 37012807 DOI: 10.1063/5.0087076] [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] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 01/31/2023] [Indexed: 06/19/2023]
Abstract
Pendulum thrust stands are used to measure the thrust of electric propulsion systems for spacecraft. A thruster is mounted on a pendulum and operated, and the pendulum displacement due to thrust is measured. In this type of measurement, the pendulum is also affected by nonlinear tensions due to wiring and piping that deteriorate the accuracy of the measurement. This influence cannot be ignored in high power electric propulsion systems because complicated piping and thick wirings are required. Therefore, to reduce the influence of tension due to wires and tubes, we developed an inverted pendulum-type thrust stand with pipes and wirings as springs. In this paper, we first derive the design guidelines for spring-shaped wires; the necessary conditions for sensitivity, responsivity, spring shape, and electric wire were formulated. Next, a thrust stand was designed and fabricated based on these guidelines, and the performance of the stand was evaluated through calibration and thrust measurements using a 1 kW-class magneto-plasma-dynamics thruster. The sensitivity of the thrust stand was 17 mN/V, the normalized standard deviation of the variation of the measured values owing to the structure of the thrust stand was 1.8 × 10-3, and the thermal drift during the long-time operation was ∼4.5 × 10-3 mN/s.
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Affiliation(s)
- J Yamasaki
- Department of Science and Technology, University of Tsukuba, Tennodai, 305-0047 Tsukuba, Ibaraki, Japan
| | - M Nonaka
- Department of Science and Technology, University of Tsukuba, Tennodai, 305-0047 Tsukuba, Ibaraki, Japan
| | - S Yokota
- Department of Science and Technology, University of Tsukuba, Tennodai, 305-0047 Tsukuba, Ibaraki, Japan
| | - K Shimamura
- Department of Science and Technology, University of Tsukuba, Tennodai, 305-0047 Tsukuba, Ibaraki, Japan
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5
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Persson M, Aizawa S, André N, Barabash S, Saito Y, Harada Y, Heyner D, Orsini S, Fedorov A, Mazelle C, Futaana Y, Hadid LZ, Volwerk M, Collinson G, Sanchez-Cano B, Barthe A, Penou E, Yokota S, Génot V, Sauvaud JA, Delcourt D, Fraenz M, Modolo R, Milillo A, Auster HU, Richter I, Mieth JZD, Louarn P, Owen CJ, Horbury TS, Asamura K, Matsuda S, Nilsson H, Wieser M, Alberti T, Varsani A, Mangano V, Mura A, Lichtenegger H, Laky G, Jeszenszky H, Masunaga K, Signoles C, Rojo M, Murakami G. BepiColombo mission confirms stagnation region of Venus and reveals its large extent. Nat Commun 2022; 13:7743. [PMID: 36522338 PMCID: PMC9755131 DOI: 10.1038/s41467-022-35061-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022] Open
Abstract
The second Venus flyby of the BepiColombo mission offer a unique opportunity to make a complete tour of one of the few gas-dynamics dominated interaction regions between the supersonic solar wind and a Solar System object. The spacecraft pass through the full Venusian magnetosheath following the plasma streamlines, and cross the subsolar stagnation region during very stable solar wind conditions as observed upstream by the neighboring Solar Orbiter mission. These rare multipoint synergistic observations and stable conditions experimentally confirm what was previously predicted for the barely-explored stagnation region close to solar minimum. Here, we show that this region has a large extend, up to an altitude of 1900 km, and the estimated low energy transfer near the subsolar point confirm that the atmosphere of Venus, despite being non-magnetized and less conductive due to lower ultraviolet flux at solar minimum, is capable of withstanding the solar wind under low dynamic pressure.
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Affiliation(s)
- M. Persson
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - S. Aizawa
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - N. André
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - S. Barabash
- grid.425140.60000 0001 0706 1867Swedish Institute of Space Physics, Kiruna, Sweden
| | - Y. Saito
- grid.62167.340000 0001 2220 7916Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Kyoto, Japan
| | - Y. Harada
- grid.258799.80000 0004 0372 2033Department of Geophysics, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - D. Heyner
- grid.6738.a0000 0001 1090 0254Institute for Geophysics and Extraterrestrial Physics, Technische Universität Braunschweig, Braunschweig, Germany
| | - S. Orsini
- grid.4293.c0000 0004 1792 8585Institute of Space Astrophysics and Planetology, Istituto Nazionale di Astrofisica, Rome, Italy
| | - A. Fedorov
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - C. Mazelle
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - Y. Futaana
- grid.425140.60000 0001 0706 1867Swedish Institute of Space Physics, Kiruna, Sweden
| | - L. Z. Hadid
- grid.508893.fLaboratoire de Physique des Plasmas (LPP), Centre National de la Recherche Scientifique, Observatoire de Paris, Sorbonne Université, Université Paris Saclay, École Polytechnique, Institut Polytechnique de Paris, Paris, France
| | - M. Volwerk
- grid.4299.60000 0001 2169 3852Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - G. Collinson
- grid.133275.10000 0004 0637 6666National Aeronautic and Space Administration, Goddard Space Flight Center, Greenbelt, MD USA
| | - B. Sanchez-Cano
- grid.9918.90000 0004 1936 8411School of Physics and Astronomy, University of Leicester, Leicester, UK
| | - A. Barthe
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - E. Penou
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - S. Yokota
- grid.136593.b0000 0004 0373 3971Department of Earth and Space Science, Graduate School of Science, Osaka University, Osaka, Japan
| | - V. Génot
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - J. A. Sauvaud
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - D. Delcourt
- grid.508893.fLaboratoire de Physique des Plasmas (LPP), Centre National de la Recherche Scientifique, Observatoire de Paris, Sorbonne Université, Université Paris Saclay, École Polytechnique, Institut Polytechnique de Paris, Paris, France
| | - M. Fraenz
- grid.435826.e0000 0001 2284 9011Max-Planck-Institute for Solar System Research, Göttingen, Germany
| | - R. Modolo
- Laboratoire Atmosphères, Milieux, Observations Spatiales, Institut Pierre Simon Laplace, Université Versailles Saint Quentin en Yvelines, Université Paris-Saclay, Université Pierre Marie Curie, Centre National de la Recherche Scientifique, Guyancourt, France
| | - A. Milillo
- grid.4293.c0000 0004 1792 8585Institute of Space Astrophysics and Planetology, Istituto Nazionale di Astrofisica, Rome, Italy
| | - H.-U. Auster
- grid.6738.a0000 0001 1090 0254Institute for Geophysics and Extraterrestrial Physics, Technische Universität Braunschweig, Braunschweig, Germany
| | - I. Richter
- grid.6738.a0000 0001 1090 0254Institute for Geophysics and Extraterrestrial Physics, Technische Universität Braunschweig, Braunschweig, Germany
| | - J. Z. D. Mieth
- grid.6738.a0000 0001 1090 0254Institute for Geophysics and Extraterrestrial Physics, Technische Universität Braunschweig, Braunschweig, Germany
| | - P. Louarn
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - C. J. Owen
- grid.83440.3b0000000121901201Mullard Space Science Laboratory, University College London, Holmbury St. Mary, UK
| | - T. S. Horbury
- grid.7445.20000 0001 2113 8111Imperial College London, South Kensington Campus, London, UK
| | - K. Asamura
- grid.62167.340000 0001 2220 7916Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Kyoto, Japan
| | - S. Matsuda
- grid.9707.90000 0001 2308 3329Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, Japan
| | - H. Nilsson
- grid.425140.60000 0001 0706 1867Swedish Institute of Space Physics, Kiruna, Sweden
| | - M. Wieser
- grid.425140.60000 0001 0706 1867Swedish Institute of Space Physics, Kiruna, Sweden
| | - T. Alberti
- grid.4293.c0000 0004 1792 8585Institute of Space Astrophysics and Planetology, Istituto Nazionale di Astrofisica, Rome, Italy
| | - A. Varsani
- grid.4299.60000 0001 2169 3852Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - V. Mangano
- grid.4293.c0000 0004 1792 8585Institute of Space Astrophysics and Planetology, Istituto Nazionale di Astrofisica, Rome, Italy
| | - A. Mura
- grid.4293.c0000 0004 1792 8585Institute of Space Astrophysics and Planetology, Istituto Nazionale di Astrofisica, Rome, Italy
| | - H. Lichtenegger
- grid.4299.60000 0001 2169 3852Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - G. Laky
- grid.4299.60000 0001 2169 3852Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - H. Jeszenszky
- grid.4299.60000 0001 2169 3852Space Research Institute, Austrian Academy of Sciences, Graz, Austria
| | - K. Masunaga
- grid.62167.340000 0001 2220 7916Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Kyoto, Japan
| | - C. Signoles
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - M. Rojo
- grid.15781.3a0000 0001 0723 035XInstitut de Recherche en Astrophysique et Planétologie, Centre National de la Recherche Scientifique, Centre National d’Etudes Spatiales, Université Paul Sabatier—Toulouse III, Toulouse, France
| | - G. Murakami
- grid.62167.340000 0001 2220 7916Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Kyoto, Japan
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6
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Kitamura N, Amano T, Omura Y, Boardsen SA, Gershman DJ, Miyoshi Y, Kitahara M, Katoh Y, Kojima H, Nakamura S, Shoji M, Saito Y, Yokota S, Giles BL, Paterson WR, Pollock CJ, Barrie AC, Skeberdis DG, Kreisler S, Le Contel O, Russell CT, Strangeway RJ, Lindqvist PA, Ergun RE, Torbert RB, Burch JL. Direct observations of energy transfer from resonant electrons to whistler-mode waves in magnetosheath of Earth. Nat Commun 2022; 13:6259. [PMID: 36307443 PMCID: PMC9616889 DOI: 10.1038/s41467-022-33604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 09/22/2022] [Indexed: 11/30/2022] Open
Abstract
Electromagnetic whistler-mode waves in space plasmas play critical roles in collisionless energy transfer between the electrons and the electromagnetic field. Although resonant interactions have been considered as the likely generation process of the waves, observational identification has been extremely difficult due to the short time scale of resonant electron dynamics. Here we show strong nongyrotropy, which rotate with the wave, of cyclotron resonant electrons as direct evidence for the locally ongoing secular energy transfer from the resonant electrons to the whistler-mode waves using ultra-high temporal resolution data obtained by NASA’s Magnetospheric Multiscale (MMS) mission in the magnetosheath. The nongyrotropic electrons carry a resonant current, which is the energy source of the wave as predicted by the nonlinear wave growth theory. This result proves the nonlinear wave growth theory, and furthermore demonstrates that the degree of nongyrotropy, which cannot be predicted even by that nonlinear theory, can be studied by observations. Excitation of whistler-mode waves by cyclotron instability is considered as the likely generation process of the waves. Here, the authors show direct observational evidence for locally ongoing secular energy transfer from the resonant electrons to the whistler-mode waves in Earth’s magnetosheath.
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Affiliation(s)
- N Kitamura
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Japan. .,Department of Earth and Planetary Science, Graduate School of Science, the University of Tokyo, Tokyo, Japan.
| | - T Amano
- Department of Earth and Planetary Science, Graduate School of Science, the University of Tokyo, Tokyo, Japan
| | - Y Omura
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, Japan
| | - S A Boardsen
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,Goddard Planetary Heliophysics Institute, University of Maryland, Baltimore County, MD, USA
| | - D J Gershman
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Y Miyoshi
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Japan
| | - M Kitahara
- Department of Geophysics, Graduate school of Science, Tohoku University, Sendai, Japan
| | - Y Katoh
- Department of Geophysics, Graduate school of Science, Tohoku University, Sendai, Japan
| | - H Kojima
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, Japan
| | - S Nakamura
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Japan
| | - M Shoji
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Japan
| | - Y Saito
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, Japan
| | - S Yokota
- Department of Earth and Space Science, Graduate School of Science, Osaka University, Toyonaka, Japan
| | - B L Giles
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - W R Paterson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - A C Barrie
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,Aurora Engineering, Potomac, MD, USA
| | - D G Skeberdis
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,a.i. solutions Inc, Lanham, MD, USA
| | - S Kreisler
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,Aurora Engineering, Potomac, MD, USA
| | - O Le Contel
- Laboratoire de Physique des Plasmas, CNRS/Sorbonne Université/Université Paris-Saclay/Observatoire de Paris/Ecole Polytechnique Institut Polytechnique de Paris, Paris, France
| | - C T Russell
- Department of Earth, Planetary, and Space Science, University of California, Los Angeles, CA, USA
| | - R J Strangeway
- Department of Earth, Planetary, and Space Science, University of California, Los Angeles, CA, USA
| | | | - R E Ergun
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO, USA
| | - R B Torbert
- Department of Physics, University of New Hampshire, Durham, NH, USA.,Southwest Research Institute, San Antonio, TX, USA
| | - J L Burch
- Southwest Research Institute, San Antonio, TX, USA
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7
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Yokota S, Kakuuchi M, Yokoi A, Kawada T, Uemura K, Ishida E, Sakamoto K, Todaka K, Saku K. Intravenous vagal stimulation catheter, JOHAKU, rapidly decreases heart rate and myocardial oxygen consumption without worsening hemodynamics. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.566] [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
Rapid reduction of heart rate (HR) is the most evident physiological response of vagal nerve stimulation (VNS). Since HR reduction is the most potent factor to decrease myocardial oxygen consumption rate (MVO2), the appropriate VNS can exert cardio-protective effects. It is also known that VNS reduces inflammation, oxidative stress, and sympathetic overload. In addition, the VNS during ischemia-reperfusion is known to attenuate myocardial damage by studies in various animal species. Despite the presence of preclinical evidence of VNS benefits, the lack of the device has limited the translation of this technology to clinical practice. We have recently developed an intravenous VNS catheter (JOHAKU, Neuroceuticals Inc.) that can stimulate the right vagal nerve via superior vena cava (SVC) (Figure 1) on temporary basis.
Purpose
We aimed to confirm the feasibility of JOHAKU as a device to modulate heart rate and MVO2 rapidly by a canine experiment.
Methods
In eight beagle dogs, JOHAKU was inserted from the right femoral vein and placed at the SVC level. The stimulation intensity was adjusted to 10–20 V (20 Hz). We simultaneously recorded electrocardiogram and intraarterial blood pressure (BP). In three of eight dogs, we measured the left anterior descending coronary artery flow and oxygen saturations of arterial and coronary sinus blood to calculate MVO2. We compared HR, BP, and MVO2 during JOHAKU stimulation to ones at baseline.
Results
As shown in Figure 2, JOHAKU attenuated HR immediately after stimulation. Compared with baseline, JOHAKU significantly reduced HR (baseline: 135±13 vs. 5 min on stimulation: 107±13 bpm, p<0.05), and did not affect mean BP significantly (96.2±22.8 vs. 89.4±26.6 mmHg, P=0.59). HR promptly recovered to baseline level after JOHAKU stopped. JOHAKU also reduced MVO2 (0.57±0.43 vs. 0.48±0.38 ml/min, p<0.05).
Conclusion
JOHAKU rapidly attenuated cardiac metabolism burden via the rapid HR reduction. The controllability of HR by JOHAKU without affecting BP enables us to apply the VNS even for patients with hemodynamic instability, such as heart failure and acute myocardial infarction.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical and Research Development
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Affiliation(s)
- S Yokota
- National Cerebral and Cardiovascular Center , Osaka , Japan
| | - M Kakuuchi
- National Cerebral and Cardiovascular Center , Osaka , Japan
| | - A Yokoi
- National Cerebral and Cardiovascular Center , Osaka , Japan
| | - T Kawada
- National Cerebral and Cardiovascular Center , Osaka , Japan
| | - K Uemura
- National Cerebral and Cardiovascular Center , Osaka , Japan
| | - E Ishida
- Kyushu University , Fukuoka , Japan
| | - K Sakamoto
- Kyushu University Hospital , Fukuoka , Japan
| | - K Todaka
- Kyushu University Hospital , Fukuoka , Japan
| | - K Saku
- National Cerebral and Cardiovascular Center , Osaka , Japan
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8
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Miyoshi Y, Shinohara I, Ukhorskiy S, Claudepierre SG, Mitani T, Takashima T, Hori T, Santolik O, Kolmasova I, Matsuda S, Kasahara Y, Teramoto M, Katoh Y, Hikishima M, Kojima H, Kurita S, Imajo S, Higashio N, Kasahara S, Yokota S, Asamura K, Kazama Y, Wang SY, Jun CW, Kasaba Y, Kumamoto A, Tsuchiya F, Shoji M, Nakamura S, Kitahara M, Matsuoka A, Shiokawa K, Seki K, Nosé M, Takahashi K, Martinez-Calderon C, Hospodarsky G, Colpitts C, Kletzing C, Wygant J, Spence H, Baker DN, Reeves GD, Blake JB, Lanzerotti L. Collaborative Research Activities of the Arase and Van Allen Probes. Space Sci Rev 2022; 218:38. [PMID: 35757012 PMCID: PMC9213325 DOI: 10.1007/s11214-022-00885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/23/2022] [Indexed: 06/15/2023]
Abstract
This paper presents the highlights of joint observations of the inner magnetosphere by the Arase spacecraft, the Van Allen Probes spacecraft, and ground-based experiments integrated into spacecraft programs. The concurrent operation of the two missions in 2017-2019 facilitated the separation of the spatial and temporal structures of dynamic phenomena occurring in the inner magnetosphere. Because the orbital inclination angle of Arase is larger than that of Van Allen Probes, Arase collected observations at higher L -shells up to L ∼ 10 . After March 2017, similar variations in plasma and waves were detected by Van Allen Probes and Arase. We describe plasma wave observations at longitudinally separated locations in space and geomagnetically-conjugate locations in space and on the ground. The results of instrument intercalibrations between the two missions are also presented. Arase continued its normal operation after the scientific operation of Van Allen Probes completed in October 2019. The combined Van Allen Probes (2012-2019) and Arase (2017-present) observations will cover a full solar cycle. This will be the first comprehensive long-term observation of the inner magnetosphere and radiation belts.
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Affiliation(s)
- Y. Miyoshi
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - I. Shinohara
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210 Japan
| | - S. Ukhorskiy
- Applied Physics Laboratory, The Johns Hopkins University, 11101 Johns Hopkins Rd, Laurel, MD 20723 USA
| | - S. G. Claudepierre
- Department of Atmospheric and Oceanic Sciences, University of California, Los Angeles, 7115 Math Sciences Bldg., Los Angeles, CA 90095 USA
| | - T. Mitani
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210 Japan
| | - T. Takashima
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210 Japan
| | - T. Hori
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - O. Santolik
- Faculty of Mathematics an Physics, Charles University, V Holesovickach 2, 18000 Prague, Czechia
- Dept. of Space Physics, Institute of Atmospheric Physics, Czech Academy of Sciences, Bocni II 1401, 14100 Prague, Czechia
| | - I. Kolmasova
- Faculty of Mathematics an Physics, Charles University, V Holesovickach 2, 18000 Prague, Czechia
- Dept. of Space Physics, Institute of Atmospheric Physics, Czech Academy of Sciences, Bocni II 1401, 14100 Prague, Czechia
| | - S. Matsuda
- Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, 920-1192 Japan
| | - Y. Kasahara
- Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, 920-1192 Japan
| | - M. Teramoto
- Graduate School of Engineering, Kyushu Institute of Technology, Kitakyusyu, 804-8550 Japan
| | - Y. Katoh
- Graduate School of Science, Tohoku University, Sendai, 980-8578 Japan
| | - M. Hikishima
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210 Japan
| | - H. Kojima
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, 611-0011 Japan
| | - S. Kurita
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, 611-0011 Japan
| | - S. Imajo
- Graduate School of Science, Kyoto University, Kyoto, 606-8502 Japan
| | - N. Higashio
- Strategic Planning and Management Department, Japan Aerospace Exploration Agency, Tokyo, 101-8008 Japan
| | - S. Kasahara
- Graduate School of Science, University of Tokyo, Tokyo, 113-0033 Japan
| | - S. Yokota
- Graduate School of Science, Osaka University, Toyonaka, 560-0043 Japan
| | - K. Asamura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, 252-5210 Japan
| | - Y. Kazama
- Institute of Astronomy and Astrophysics, Academia Sinica, No. 1, Sec. 4, Roosevelt Rd, Taipei, 10617 Taiwan
| | - S.-Y. Wang
- Institute of Astronomy and Astrophysics, Academia Sinica, No. 1, Sec. 4, Roosevelt Rd, Taipei, 10617 Taiwan
| | - C.-W. Jun
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - Y. Kasaba
- Graduate School of Science, Tohoku University, Sendai, 980-8578 Japan
| | - A. Kumamoto
- Graduate School of Science, Tohoku University, Sendai, 980-8578 Japan
| | - F. Tsuchiya
- Graduate School of Science, Tohoku University, Sendai, 980-8578 Japan
| | - M. Shoji
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - S. Nakamura
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
- Institute for Advanced Research, Nagoya University, Nagoya, 464-8601 Japan
| | - M. Kitahara
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
- Graduate School of Science, Tohoku University, Sendai, 980-8578 Japan
| | - A. Matsuoka
- Graduate School of Science, Kyoto University, Kyoto, 606-8502 Japan
| | - K. Shiokawa
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - K. Seki
- Graduate School of Science, University of Tokyo, Tokyo, 113-0033 Japan
| | - M. Nosé
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - K. Takahashi
- Applied Physics Laboratory, The Johns Hopkins University, 11101 Johns Hopkins Rd, Laurel, MD 20723 USA
| | - C. Martinez-Calderon
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601 Japan
| | - G. Hospodarsky
- Department of Physics and Astronomy, University of Iowa, Van Allen Hall (VAN), Iowa City, IA 52242 USA
| | - C. Colpitts
- School of Physics and Astronomy, University of Minnesota, 116 Church St. SE, Minneapolis, MN 55455 USA
| | - Craig Kletzing
- Department of Physics and Astronomy, University of Iowa, Van Allen Hall (VAN), Iowa City, IA 52242 USA
| | - J. Wygant
- School of Physics and Astronomy, University of Minnesota, 116 Church St. SE, Minneapolis, MN 55455 USA
| | - H. Spence
- Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, 8 College Road, Durham, NH 03824 USA
| | - D. N. Baker
- Laboratory for Atmospheric and Space Physics, University of Colorado, 3665 Discovery Drive, 600 UCB, Boulder, CO 80303 USA
| | - G. D. Reeves
- Inteligence & Space Reserarch Division, Los Alamos National Laboratory, PO Box 1663, Los Alamos, NM USA
| | - J. B. Blake
- The Aerospace Corporation, P.O. Box 92957, Los Angeles, CA 90009-2957 USA
| | - L. Lanzerotti
- Department of Physics, New Jersey Institute of Technology, Newark, NJ 07102 USA
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9
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Miyoshi Y, Hosokawa K, Kurita S, Oyama SI, Ogawa Y, Saito S, Shinohara I, Kero A, Turunen E, Verronen PT, Kasahara S, Yokota S, Mitani T, Takashima T, Higashio N, Kasahara Y, Matsuda S, Tsuchiya F, Kumamoto A, Matsuoka A, Hori T, Keika K, Shoji M, Teramoto M, Imajo S, Jun C, Nakamura S. Penetration of MeV electrons into the mesosphere accompanying pulsating aurorae. Sci Rep 2021; 11:13724. [PMID: 34257336 PMCID: PMC8277844 DOI: 10.1038/s41598-021-92611-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 03/16/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
Pulsating aurorae (PsA) are caused by the intermittent precipitations of magnetospheric electrons (energies of a few keV to a few tens of keV) through wave-particle interactions, thereby depositing most of their energy at altitudes ~ 100 km. However, the maximum energy of precipitated electrons and its impacts on the atmosphere are unknown. Herein, we report unique observations by the European Incoherent Scatter (EISCAT) radar showing electron precipitations ranging from a few hundred keV to a few MeV during a PsA associated with a weak geomagnetic storm. Simultaneously, the Arase spacecraft has observed intense whistler-mode chorus waves at the conjugate location along magnetic field lines. A computer simulation based on the EISCAT observations shows immediate catalytic ozone depletion at the mesospheric altitudes. Since PsA occurs frequently, often in daily basis, and extends its impact over large MLT areas, we anticipate that the PsA possesses a significant forcing to the mesospheric ozone chemistry in high latitudes through high energy electron precipitations. Therefore, the generation of PsA results in the depletion of mesospheric ozone through high-energy electron precipitations caused by whistler-mode chorus waves, which are similar to the well-known effect due to solar energetic protons triggered by solar flares.
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Affiliation(s)
- Y Miyoshi
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan.
| | - K Hosokawa
- Graduate School of Communication Engineering and Informatics, University of Electro-Communications, Chofu, 182-8585, Japan
| | - S Kurita
- Research Institute for Sustainable Humanosphere, Kyoto University, Uji, 611-0011, Japan
| | - S-I Oyama
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan.,National Institute of Polar Research, Tachikawa, 190-8518, Japan.,University of Oulu, Pentti Kaiteran katu 1, Linnanmaa, Oulu, Finland
| | - Y Ogawa
- National Institute of Polar Research, Tachikawa, 190-8518, Japan.,The Graduate University for Advanced Studies, SOKENDAI, Hayama, 240-0193, Japan.,Joint Support-Center for Data Science Research, Research Organization of Information and Systems, Tachikawa, 190-8518, Japan
| | - S Saito
- National Institute of Information and Communications Technology, Tokyo, 184-8795, Japan
| | - I Shinohara
- Japan Aerospace Exploration Agency (JAXA), Sagamihara, 252-5210, Japan
| | - A Kero
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland
| | - E Turunen
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland
| | - P T Verronen
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland.,Space and Earth Observation Centre, Finnish Meteorological Institute, Helsinki, Finland
| | - S Kasahara
- Graduate School of Science, University of Tokyo, Tokyo, 113-0033, Japan
| | - S Yokota
- Graduate School of Science, Osaka University, Toyonaka, 560-0043, Japan
| | - T Mitani
- Japan Aerospace Exploration Agency (JAXA), Sagamihara, 252-5210, Japan
| | - T Takashima
- Japan Aerospace Exploration Agency (JAXA), Sagamihara, 252-5210, Japan
| | - N Higashio
- Japan Aerospace Exploration Agency (JAXA), Sagamihara, 252-5210, Japan
| | - Y Kasahara
- Graduate School of Natural Science and Technology, Kanazawa University, Kanazawa, 920-1192, Japan
| | - S Matsuda
- Japan Aerospace Exploration Agency (JAXA), Sagamihara, 252-5210, Japan
| | - F Tsuchiya
- Graduate School of Science, Tohoku University, Sendai, 980-8578, Japan
| | - A Kumamoto
- Graduate School of Science, Tohoku University, Sendai, 980-8578, Japan
| | - A Matsuoka
- Graduate School of Science, Kyoto University, Kyoto, 606-8502, Japan
| | - T Hori
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan
| | - K Keika
- Graduate School of Science, University of Tokyo, Tokyo, 113-0033, Japan
| | - M Shoji
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan
| | - M Teramoto
- Graduate School of Engineering, Kyushu Institute of Technology, Fukuoka, 820-8501, Japan
| | - S Imajo
- Graduate School of Science, Kyoto University, Kyoto, 606-8502, Japan
| | - C Jun
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan
| | - S Nakamura
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, 464-8601, Japan
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10
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Yokota S, Miyamae T, Kuroiwa Y, Nishioka K. Novel Coronavirus Disease 2019 (COVID-19) and Cytokine Storms for More Effective Treatments from an Inflammatory Pathophysiology. J Clin Med 2021; 10:jcm10040801. [PMID: 33671159 PMCID: PMC7922214 DOI: 10.3390/jcm10040801] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 12/15/2022] Open
Abstract
The Novel Coronavirus Disease 2019 (COVID-19) has swept the world and caused a global pandemic. SARS-CoV-2 seems to have originated from bats as their reservoir hosts over time. Similar to SARS-CoV, this new virus also exerts its action on the human angiotensin-converting enzyme 2. This action causes infections in cells and establishes an infectious disease, COVID-19. Against this viral invasion, the human body starts to activate the innate immune system in producing and releasing proinflammatory cytokines such as IL-6, IL-1β, IL-8, TNF-α, and other chemokines, such as G-CSF, IP10 and MCPl, which all develop and increase the inflammatory response. In cases of COVID-19, excessive inflammatory responses occur, and exaggerated proinflammatory cytokines and chemokines are detected in the serum, resulting in cytokine release syndrome or cytokine storm. This causes coagulation abnormalities, excessive oxidation developments, mitochondrial permeability transition, vital organ damage, immune system failure and eventually progresses to disseminated intravascular coagulation and multiple organ failure. Additionally, the excessive inflammatory responses also cause mitochondrial dysfunction due to progressive and persistent stress. This damages cells and mitochondria, leaving products containing mitochondrial DNA and cell debris involved in the excessive chronic inflammation as damage-associated molecular patterns. Thus, the respiratory infection progressively leads to disseminated intravascular coagulation from acute respiratory distress syndrome, including vascular endothelial cell damage and coagulation-fibrinolysis system disorders. This condition causes central nervous system disorders, renal failure, liver failure and, finally, multiple organ failure. Regarding treatment for COVID-19, the following are progressive and multiple steps for mitigating the excessive inflammatory response and subsequent cytokine storm in patients. First, administering of favipiravir to suppress SARS-CoV-2 and nafamostat to inhibit ACE2 function should be considered. Second, anti-rheumatic drugs (monoclonal antibodies), which act on the leading cytokines (IL-1β, IL-6) and/or cytokine receptors such as tocilizumab, should be administered as well. Finally, melatonin may also have supportive effects for cytokine release syndrome, resulting in mitochondrial function improvement. This paper will further explore these subjects with reports mostly from China and Europe.
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Affiliation(s)
- Shumpei Yokota
- Department of Pediatrics, Yokohama City University, Yokohama 236-0004, Japan;
- Fuji-Toranomon Children’s Center, Gotemba 412-0045, Japan
- Japan Medical Research Foundation (JMRF), Tokyo 135-0063, Japan;
- Japan College of Fibromyalgia Investigation (JCFI), Tokyo 160-0022, Japan
- Correspondence:
| | - Takako Miyamae
- Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo 162-0054, Japan;
| | - Yoshiyuki Kuroiwa
- Department of Pediatrics, Yokohama City University, Yokohama 236-0004, Japan;
- Chairman of Stroke Center, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki 192-0395, Japan
- Japan Society of Neurovegetative Research (JSNR), Tokyo 170-0002, Japan
| | - Kusuki Nishioka
- Japan Medical Research Foundation (JMRF), Tokyo 135-0063, Japan;
- Global Health Innovation Policy Program (GHIPP), National Graduate Institute for Policy Studies (GRIPS), Tokyo 106-0032, Japan
- American College of Rheumatology (ACR), Atlanta, GA 30319, USA
- St. Marianna University, Kawasaki 216-8511, Japan
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11
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Shono A, Matsumoto K, Yamada N, Kusunose K, Suzuki M, Sumimoto K, Tanaka Y, Yamashita K, Shibata N, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Impaired preload reserve is an important haemodynamic characteristics that discriminates between physiological ageing and overt heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ageing process per se is a major risk factor for heart failure (HF). In fact, the incidence of HF with preserved ejection fraction (HFpEF) dramatically increases with age. Although ageing plays a central role in the development of HFpEF, not all the elderly patients develop clinical HFpEF. Multiple abnormalities in the cardiovascular system have been proposed to contribute to the development of HFpEF. However, the pathophysiology that discriminates between physiological ageing and overt HFpEF is incompletely understood.
Purpose
The purpose of this study was to assess the effects of ageing on the cardiac structures and haemodynamics. Moreover, we evaluated the determinant factor that discriminates between physiological ageing and overt HFpEF by non-invasive preload increasing manoeuvre using leg-positive pressure (LPP) stress echocardiography.
Methods
A total of 91 subjects were prospectively recruited in this study: 22 patients with HFpEF and 69 healthy controls. Normal controls were further stratified into 3 age groups: young (n = 19, 20-40 years of age), middle-aged (N = 25, 40-65 years) and elderly (n = 25, >65 years). All subjects underwent LPP stress with a continuous external pressure of 90 mmHg around both lower limbs using dedicated airbags (Fig.).
Results
The left ventricular mass index (LVMI; young, 68 ± 19 g/m²; middle-age, 70 ± 18 g/m²; elderly, 84 ± 21 g/m²) and also the relative wall thickness (RWT; young, 0.34 ± 0.09; middle-age, 0.41 ± 0.06; elderly 0.55 ± 0.10) increased with ageing, which was accelerated in HFpEF (LVMI: 111 ± 32 g/m², RWT; 0.63 ± 0.19, ANOVA P < 0.001, respectively). Although baseline LV ejection fraction and cardiac output were quite comparable between groups, E/e’ ratio significantly increased with with ageing (ANOVA P < 0.001, Fig.). During LPP stress, E/e’ ratio significantly increased in the middle-aged and elderly groups (from 8.8 ± 2.7 to 9.7 ± 3.3, and from 11.4 ± 2.4 to 13.0 ± 2.2, P < 0.05, respectively), which was further deteriorated in HFpEF (from 16.8 ± 5.8 to 18.0 ± 7.6, P < 0.05). On the other hand, stroke volume index (SVi) significantly increased in each healthy group during LPP stress (young; from 45 ± 10 to 50 ± 11 mL/m², middle-age; from 39 ± 7 to 44 ± 6 mL/m² and elderly; from 37 ± 7 to 43 ± 8 mL/m², all P < 0.001), while SVi failed to increase in the HFpEF group (from 45 ± 13 to 45 ± 14 mL/m², P = 0.60). In a multivariate logistic regression analysis, LVMI (hazard ratio; HR 1.055, P < 0.05), baseline E/e’ (HR 1.444; P < 0.05), and ΔSVi (HR 0.755; P < 0.05) during LPP stress were the independent parameters that characterised overt HFpEF.
Conclusions
Striking parallels between structure-function alterations were observed in the physiological cardiovascular ageing process, which was further accelerated in patients with HFpEF. Not only structural remodeling and impaired diastolic function, but also impaired systolic reserve during preload stress is important haemodynamic feature that characterise the pathophysiology of HFpEF.
Abstract Figure.
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Affiliation(s)
- A Shono
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Yamada
- Tokushima University Hospital, Tokushima, Japan
| | - K Kusunose
- Tokushima University Hospital, Tokushima, Japan
| | - M Suzuki
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Sumimoto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - Y Tanaka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Yamashita
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - N Shibata
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - S Yokota
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - M Suto
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Dokuni
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hirata
- Kobe University Graduate School of Medicine, Kobe, Japan
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12
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Shibata N, Yokota S, Suto M, Dokuni K, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity.
Purpose
Our purpose was to investigate the impact of baseline risk factors on left ventricular (LV) function in patients with preserved LV ejection fraction (LVEF) who have undergone chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59 ± 13 years and LVEF was 67 ± 5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥ 240mg/m², (2) age ≥ 65-year-old, (3) body mass index ≥ 30kg/m², (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥ 100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (-9.3 ± 10.8% vs. -2.2 ± 10.2%; p = 0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p = 0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3 ± 29.0g/m² vs. 83.2 ± 21.0g/m², p < 0.001), lower global longitudinal strain (18.4 ± 2.8% vs. 20.0 ± 2.6%, p = 0.06) and higher E/e’ (10.4 (8.9-13.0) vs. 9.0 (7.4-10.9), p = 0.06) compared to those without.
Furthermore, receiver-operator characteristics curve analysis showed that an optimal cut off value of a cumulative total doxorubicin dose for developing LV dysfunction in patients with more than any of four risk factors was lower than that in those without (180 mg/m² vs. 280 mg/m²).
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Abstract Figure.
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Affiliation(s)
| | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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13
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Shibata N, Matsumoto K, Shiraki H, Yamauchi Y, Yoshigai Y, Shono A, Sumimoto K, Suzuki M, Tanaka Y, Yamashita K, Yokota S, Suto M, Dokuni K, Tanaka H, Hirata K. Preload stress echocardiography by using dynamic postural alteration can identify high risk patients with heart failure with reduced ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Haemodynamic assessment during stress testing is not commonly performed for patients with heart failure with reduced ejection fraction (HFrEF) due to its invasiveness, less feasibility, and safety concerns. Passive leg-lifting (PLL) manoeuvres have been introduced as a simple alternative for non-invasive preload stress testing; however, the haemodynamic load imposed on the cardiovascular system is unsatisfactory, which precludes the accurate assessment of the preload reserve for patients with HF.
Purpose
The purpose of this study was to assess the haemodynamic characteristics of patients with HFrEF in response to a preload stress during dynamic postural alterations by combining the semi-sitting position (SSP) and PLL. We also evaluated whether combined postural stress could be used for risk stratification for these patients.
Methods
For this study, 101 patients with HFrEF and 35 age- and sex-matched normal controls were prospectively recruited. At each postural position (i.e., baseline, SSP, and PLL), all standard echocardiographic and Doppler variables were obtained. Adverse cardiac events were prespecified as the combined endpoints of death from or hospitalisation for deteriorated HF, or sudden cardiac death. Clinical follow-up was conducted for a median of 7 months.
Results
During PLL stress, the stroke volume index (SVi) significantly increased in both controls (from 40 ± 6 to 43 ± 6 mL/m², P = 0.03) and HFrEF patients (from 31 ± 9 to 34 ± 10 mL/m², P = 0.03). Conversely, during SSP stress, the SVi significantly decreased for both controls (from 40 ± 6 to 37 ± 6 mL/m², P = 0.03) and HFrEF patients (31 ± 9 to 28 ± 8 mL/m², P = 0.03). During the follow-up period, 16 patients developed cardiac events. In patients without events, the Frank-Starling mechanism was well preserved (Fig. A). Namely, the SVi significantly increased from 31 ± 9 to 35 ± 10 mL/m² (P = 0.02) during PLL stress, while the SVi significantly decreased from 31 ± 8 to 28 ± 8 mL/m² (P = 0.02) during SSP stress. In contrast, for patients with cardiac events, the SVi did not change during postural alterations (n.s), which indicated that the failing heart operates on the flat portion of the Frank-Starling curve (Fig. A). When patients were divided into three equal sub-groups based on the total difference in the SVi during dynamic postural stress, patients with impaired preload reserve (third trimester, ΔSVi ≤ 3.0 mL/m²) showed significantly worse event-free survival than the other two sub-groups (Fig. B; P < 0.001). In a Cox proportional-hazard analysis, baseline LVEF (hazard ratio 0.93; P = 0.04), and ΔSVi during postural stress (hazard ratio 0.76; P = 0.004) were predictors of future cardiac events.
Conclusions
The combined assessment of dynamic postural stress during PLL and SPP is a simple, time-saving, and easy-to-use clinical tool for the assessment of preload reserve for patients with HFrEF. Moreover, postural stress echocardiography proved to contribute to the risk stratification for these patients.
Abstract Figure.
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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14
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Dokuni K, Matsumoto K, Tatsumi K, Shono A, Suzuki M, Sumimoto K, Tanaka Y, Yamashita K, Shibata N, Yokota S, Sutou M, Tanaka H, Kiuchi K, Fukuzawa K, Hirata K. Cardiac resynchronization therapy improves left atrial reservoir function through resynchronization of the left atrium in patients with heart failure. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The structural remodeling of the left atrium (LA) has been proposed as an important determinant of adverse outcomes in patients with heart failure (HF). However, little is known about the potential impact of LA mechanical dyssynchrony on its reservoir function and the prognosis of patients with HF. In addition, it has not been fully investigated whether cardiac resynchronization therapy (CRT) is also beneficial to LA function.
Purposes
The purposes of this study were to test whether left ventricular (LV) dyssynchrony may negatively affect LA synchronicity and reservoir function, and to assess whether residual LA dyssynchrony after CRT affects the prognosis in patients with HF with reduced ejection fraction (HFrEF).
Methods
This study included total of 90 subjects: 40 HFrEF with a wide-QRS complex (≧130 ms), 28 HFrEF with a narrow-QRS, and 22 age- and sex-matched normal controls. LA global longitudinal strain (LA-GLS) and LA dyssynchrony were quantified using speckle-tracking strain analysis. LA dyssynchrony was defined as the maximal difference of time-to-peak strain (LA time-diff). All wide-QRS HFrEF received CRT, and event-free survival was tracked for 24 months.
Results
At baseline, HFrEF patients showed significant LA remodeling coupled with the reduced LA reservoir function, as evidenced by larger LA volume index (LAVi: 46 ± 16 vs. 30 ± 14 mL/m², P < 0.01) and smaller LA-GLS (13.0 ± 4.8 vs. 30.6 ± 10.7%, P < 0.01). Of note was that, not only LV dyssynchrony (381 ± 178 vs. 177 ± 62 ms, P < 0.01) but also LA dyssynchrony (298 ± 136 vs. 186 ± 78 ms, P < 0.01) were significantly larger in patients with HFrEF compared to normal subjects and this applied even more to patients with a wide-QRS complex. All patients with a wide-QRS complex underwent CRT, and only responders exhibited the significant decrease in LA time-diff (from 338 ± 123 to 245 ± 141 ms, P < 0.05) and increase in LA-GLS (from 11.9 ± 4.7 to 19.6 ± 10.1%, P < 0.05) in parallel with the reduction in LAVi (from 48 ± 17 to 37 ± 18 mL/m², P < 0.05) at 6 months after CRT. Receiver operating characteristic curve analysis identified the optimal cut-off value of LA time-diff at 6 months after CRT as 202 ms (P < 0.05) and that of LA-GLS as 14.6% (P < 0.05) for predicting adverse cardiac events. The patients whose LA time-diff reduced <202 ms after CRT showed significantly favorable event-free survival than the others. Similarly, the patients whose LA-GLS improved >14.6% after CRT exhibited significantly favorable event-free survival than the others (P < 0.05, respectively). Of note was that, when the patients were restricted to CRT responders only, those who showed LA time-diff less than 202 ms at 6 months after CRT almost never experienced cardiac events (P < 0.05).
Conclusions
The improved LV coordination by CRT also resulted in resynchronization of discoordinated LA wall motion and a consecutive improvement of LA reservoir function, which ultimately lead to the favorable outcome for HFrEF patients with wide-QRS complex.
Abstract Figure.
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Affiliation(s)
| | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | | | | | - M Sutou
- Kobe University, Kobe, Japan
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Suzuki M, Tanaka Y, Yamashita K, Shono A, Sumimoto K, Shibata N, Yokota S, Dokuni K, Suto M, Hisamatsu E, Matsumoto K, Tanaka H, Hirata K. preoperative right ventricular overwork is a major determinant of residual pulmonary arterial hypertension in patients with repaired arterial septal defect. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The haemodynamic effect of atrial septal defect (ASD) is a chronic volume overload of the right heart and pulmonary vasculature. Pulmonary overcirculation is generally compensated for by the right ventricular (RV) and pulmonary arterial (PA) reserve. However, in a subset of patients, prolonged pulmonary overcirculation insidiously induces obstructive pulmonary vasculopathy, which results in postoperative residual pulmonary arterial hypertension (PAH) after ASD closure. Postoperative PAH is a major concern because it is closely associated with poor outcomes and impaired quality of life. However, to date, no clinically robust predictors of postoperative residual PAH have been clearly identified.
Purpose
This study sought to assess the haemodynamic characteristics of ASD patients in terms of mechano-energetic parameters and to identify the predictors of postoperative residual PAH in these patients.
Methods
A total of 120 ASD patients (age: 58 ± 17 years) and 46 normal controls were recruited. As previously reported, the simplified RV contraction pressure index (sRVCPI) was calculated as an index of RV external work by multiplying the tricuspid annular plane systolic excursion (TAPSE) by the pressure gradient between the RV and right atrium. RV- PA coupling was evaluated using TAPSE divided by PA systolic pressure as an index of the RV length-force relationship. These parameters were measured both at baseline and 6 months after ASD closure.
Results
As expected, baseline sRVCPI was significantly greater in patients with ASD than in controls (775 ± 298 vs. 335 ± 180 mm Hg • mm, P < 0.01), which indicated significant "RV overwork". As a result, RV-PA coupling in ASD patients was significantly impaired compared to that in controls (0.9 ± 0.8 vs. 3.5 ± 1.7 mm/mm Hg, P < 0.01). All 120 ASD patients underwent transcatheter or surgical shunt closure; 15 of them had residual PAH after closure. After 6 months, RV-PA coupling index significantly improved in patients without residual PAH, from 0.96 ± 0.81 to 1.27 ± 1.24 mm/mm Hg (P = 0.02). Furthermore, RV load was markedly reduced, with sRVCPI falling from 691 ± 258 to 434 ± 217 mm Hg • mm, P < 0.01). However, in patients with residual PAH, RV-PA coupling index deteriorated from 0.64 ± 0.23 to 0.53 ± 0.12 mm/mm Hg (P < 0.01). As a result, RV overload was not significantly relieved (sRVCPI; from 971 ± 382 to 783 ± 166 mm Hg • mm, P = 0.22). In a multivariate analysis, baseline pulmonary vascular resistance (hazard ratio 1.009; P < 0.01) and preoperative sRVPCI (hazard ratio 1.003; P < 0.01) revealed to be independent predictors of residual PAH.
Conclusion
In terms of mechano-energetic function, preoperative "RV overwork" can be used as a robust predictor of an impaired RV-PA relationship in ASD patients. Moreover, periodic assessment of sRVPCI may contribute to the better management for patients with unrepaired ASD.
Abstract Figure.
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Affiliation(s)
| | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | | | | | - M Suto
- Kobe University, Kobe, Japan
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16
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Nakaoka Y, Isobe M, Tanaka Y, Ishii T, Ooka S, Niiro H, Tamura N, Banno S, Yoshifuji H, Sakata Y, Kawakami A, Atsumi T, Furuta S, Kohsaka H, Suzuki K, Hara R, Maejima Y, Tsukamoto H, Takasaki Y, Yamashita K, Okada N, Yamakido S, Takei S, Yokota S, Nishimoto N. Long-term efficacy and safety of tocilizumab in refractory Takayasu arteritis: final results of the randomized controlled phase 3 TAKT study. Rheumatology (Oxford) 2021; 59:2427-2434. [PMID: 31951279 PMCID: PMC7449811 DOI: 10.1093/rheumatology/kez630] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/25/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the long-term efficacy and safety of the IL-6 receptor antibody tocilizumab in patients with Takayasu arteritis (TAK). Methods Patients completing the randomized, double-blind, placebo-controlled period of the TAKT (Takayasu arteritis Treated with Tocilizumab) trial were followed up during open-label extended treatment with weekly s.c. tocilizumab 162 mg for up to 96 weeks or longer, with oral glucocorticoid tapering performed at the investigators’ discretion. Endpoints of the extension analysis included steroid-sparing effects of tocilizumab, imaging data, patient-reported outcomes (36-Item Short Form Health Survey) and safety. Results All 36 patients enrolled in the double-blind period entered the open-label extension; 28 patients received tocilizumab for 96 weeks. The median glucocorticoid dose was 0.223 mg/kg/day at the time of relapse before study entry, 0.131 mg/kg/day (interquartile range 0.099, 0.207) after 48 weeks and 0.105 mg/kg/day (interquartile range 0.039, 0.153) after 96 weeks. Overall, 46.4% of patients reduced their dose to <0.1 mg/kg/day, which was less than half the dose administered at relapse before study entry (mean difference –0.120 mg/kg/day; 95% CI −0.154, −0.087). Imaging evaluations indicated that most patients’ disease was improved (17.9%) or stable (67.9%) after 96 weeks compared with baseline. Mean 36-Item Short Form Health Survey physical and mental component summary scores and 7 of 8 domain scores were clinically improved from baseline and maintained over 96 weeks of tocilizumab treatment. No unexpected safety issues were reported. Conclusion These results in patients with Takayasu arteritis provide evidence of a steroid-sparing effect and improvements in well-being during long-term treatment with once-weekly tocilizumab 162 mg, with no new safety concerns. Trial registration JAPIC Clinical Trials Information, http://www.clinicaltrials.jp/user/cteSearch_e.jsp, JapicCTI-142616.
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Affiliation(s)
- Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Suita Japan.,Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka Japan
| | | | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai Japan
| | - Seido Ooka
- Division of Rheumatology and Allergology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki Japan
| | - Hiroaki Niiro
- Department of Medical Education, Faculty of Medical Sciences, Kyushu University, Fukuoka Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, Tokyo Japan
| | - Shogo Banno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute Japan
| | - Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto Kyoto, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki Japan
| | - Tatsuya Atsumi
- Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo Japan
| | - Shunsuke Furuta
- Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba Japan
| | - Hitoshi Kohsaka
- Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo Japan
| | - Katsuya Suzuki
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo Japan
| | - Ryoki Hara
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama Japan
| | - Yasuhiro Maejima
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo Japan
| | | | - Yoshinari Takasaki
- Juntendo University Koshigaya Hospital, Juntendo University Faculty of Medicine, Saitama Japan
| | | | | | | | - Syuji Takei
- Pediatrics and Developmental Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima Japan
| | - Shumpei Yokota
- Pediatric Rheumatology, Fuji Toranomon Orthopedics Hospital, Shizuoka, Japan
| | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Diseases, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity following treatment with chemotherapy. However, the association between clinical risk factors and left ventricular (LV) function in breast cancer patients is currently unclear.
Purpose
Our purpose was to investigate the impact of baseline risk factors on LV function in patients with preserved LV ejection fraction (LVEF) who have undergone anthracycline or trastuzumab chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59±13 years and LVEF was 67±5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥240 mg/m2, (2) age ≥65-year-old, (3) body mass index ≥30 kg/m2, (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (−9.3±10.8% vs. −2.2±10.2%; p=0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p=0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3±29.0 g/m2 vs. 83.2±21.0g /m2, p<0.001), lower global longitudinal strain (18.4±2.8% vs. 20.0±2.6%, p=0.06) and higher E/e' (10.4 (8.9–13.0) vs. 9.0 (7.4–10.9), p=0.06) compared to those without.
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | - M Suto
- Kobe University, Kobe, Japan
| | - J Mukai
- Kobe University, Kobe, Japan
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18
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Shiraki H, Tanaka H, Yamashita K, Tanaka Y, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Fukuzawa K, Hirata K. Consideration of non-valvular atrial fibrillation with left atrial appendage thrombus formation despite under appropriate oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0071] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most frequently sustained cardiac arrhythmia, with a prevalence of about 2–3% in the general population. In accordance with CHADS2 or CHA2DS2-VASc score, appropriate oral anticoagulation therapy such as warfarin or direct oral anticoagulants (DOAC) significantly reduced the risk of thromboembolic events. However, left atrial (LA) thrombus can be detected in the LA appendage (LAA) in AF patients despite appropriate oral anticoagulation therapy.
Purpose
Our purpose was to investigate the associated factors of LAA thrombus formation in non-valvular atrial fibrillation (NVAF) patients despite under appropriate oral anticoagulation therapy.
Methods
We retrospectively studied consecutive 286 NVAF patients for scheduled catheter ablation or electrical cardioversion for AF in our institution between February 2017 and September 2019. Mean age was 67.1±9.4 years, 79 patients (29.5%) were female, and 140 (52.2%) were paroxysmal AF. All patients underwent transthoracic and transesophageal echocardiography before catheter ablation or electrical cardioversion. All patients received appropriate oral anticoagulation therapy including warfarin or DOAC for at least 3 weeks prior to transesophageal echocardiography based on the current guidelines. LAA thrombus was defined as an echodense intracavitary mass distinct from the underlying endocardium and not caused by pectinate muscles by at least three senior echocardiologists.
Results
Of 286 NVAF patients with under appropriate oral anticoagulation therapy, LAA thrombus was observed in 9 patients (3.3%). Univariate logistic regression analysis showed that age, paroxysmal AF, CHADS2 score ≥3, left ventricular end-diastolic volume index (LVEDVI), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), LA volume index (LAVI), mitral inflow E and mitral e' annular velocities ratio (E/e'), and LAA flow were associated with LAA thrombus formation. It was noteworthy that multivariate logistic regression analysis showed that LAA flow was independent predictor of LAA thrombus (OR: 0.72, 95% CI: 0.59–0.89, p<0.005) as well as LVEF. Furthermore, receiver operating characteristic (ROC) curve analysis identified the optimal cutoff value of LAA flow for predicting LAA thrombus as ≤15cm/s, with a sensitivity of 88%, specificity of 93%, and area under the curve (AUC) of 0.95.
Conclusions
LAA flow was strongly associated with LAA thrombus formation even in NVAF patients with appropriate oral anticoagulation therapy. According to our findings, further strengthen of oral anticoagulation therapy or percutaneous transcatheter closure of the LAA may be considered in NVAF patients with appropriate oral anticoagulation therapy but low LAA flow, especially <15cm/s.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | - M Suto
- Kobe University, Kobe, Japan
| | - J Mukai
- Kobe University, Kobe, Japan
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Nishimura K, Hara R, Umebayashi H, Takei S, Iwata N, Imagawa T, Shimizu M, Tomiita M, Seko N, Kitawaki T, Yokota S. Efficacy and safety of canakinumab in systemic juvenile idiopathic arthritis: 48-week results from an open-label phase III study in Japanese patients. Mod Rheumatol 2020; 31:226-234. [PMID: 32552266 DOI: 10.1080/14397595.2020.1783163] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To assess the efficacy and safety of canakinumab in Japanese patients with systemic juvenile idiopathic arthritis (sJIA). METHODS This was an open-label, single-arm active treatment study. sJIA patients, aged ≥2 to <20 years, were administered canakinumab 4 mg/kg every 4 weeks for ≤48 weeks. The co-primary endpoints were the proportion of patients who achieved an adapted American College of Rheumatology pediatric (ACR pedi) 30 criteria at week 8, and the proportion of patients who successfully tapered corticosteroids at week 28. Herein, the efficacy and safety results up to 48 weeks are reported. RESULTS Of the 19 patients enrolled, 15 (78.9%) had previously used tocilizumab. All patients achieved ACR pedi 30 at week 8 and 73.7% (14/19) successfully tapered corticosteroids at week 28. At week 48, ACR pedi 50/70/90/100 responses were achieved by 100.0%/100.0%/87.5%/68.8% of patients. The most common adverse events (AEs) were infections (271.6 patient-years), 42.1% (8/19) patients had serious AEs. Two potential cases of macrophage activation syndrome were identified. No deaths were reported. CONCLUSION Canakinumab was efficacious in Japanese patients with sJIA and was associated with substantial corticosteroid dose reduction in the majority of patients. The safety profile of canakinumab was consistent with that observed from previous studies. CLINICALTRIALS.GOV (IDENTIFIER NCT02396212).
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Affiliation(s)
- Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Umebayashi
- Department of Rheumatology and Infectious Disease, Miyagi Children's Hospital, Sendai, Japan
| | - Syuji Takei
- School of Medical and Dental Sciences Pediatrics, Kagoshima University Graduate, Kagoshima, Japan
| | - Naomi Iwata
- Department of Infection and Immunology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Tomoyuki Imagawa
- Department of Infection and Immunology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masaki Shimizu
- Department of Pediatrics, Kanazawa University Hospital, Kanazawa, Japan
| | - Minako Tomiita
- Department of Pediatrics, Pediatric Allergy and Rheumatology Center, National Hospital Organization Shimoshizu National Hospital, Chiba, Japan
| | | | | | - Shumpei Yokota
- Children's Intractable Disease Rheumatism Center, Fuji Toranomon Orthopedics Hospital, Shizuoka, Japan
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Takei S, Iwata N, Kobayashi I, Igarashi T, Yoshinaga Y, Matsubara N, Sunaga N, Ito A, Yokota S. Safety and effectiveness of adalimumab in Japanese patients with juvenile idiopathic arthritis: Results from a real-world postmarketing study. Mod Rheumatol 2020; 31:421-430. [PMID: 32340508 DOI: 10.1080/14397595.2020.1761075] [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: 10/24/2022]
Abstract
OBJECTIVES This study was conducted to assess the real-world safety and effectiveness of adalimumab in patients with juvenile idiopathic arthritis (JIA). METHODS In this all-case, postmarketing surveillance study (NCT01412021) conducted in Japan, patients receiving adalimumab for JIA affecting multiple joints were observed for 24 weeks. The safety (adverse drug reactions [ADRs]/serious ADRs) and effectiveness (4-variable Disease Activity Score in 28 joints using erythrocyte sedimentation rate [DAS28-4/ESR] remission rate) were assessed. RESULTS In the safety population (n = 356), 90.3% (65/72; weight, ≥15-<30 kg) of patients received adalimumab 20 mg every 2 weeks (q2w) and 98.3% (236/240; weight ≥30 kg) received 40 mg q2w. Incidence of ADRs and serious ADRs was 29.8% (106/356) and 3.4% (12/356), respectively. Incidence of ADRs was significantly higher in patients aged <15 years vs. ≥15 years (34.6% vs. 21.1%, p = .0072), those with comorbidities vs. without (38.3% vs. 25.7%, p = .0155), and those receiving dose <40 mg q2w vs. ≥40 mg q2w (38.8% vs. 26.9%, p = .0418). DAS28-4/ESR remission rate improved from 21.7% (36/166) at baseline to 74.7% (112/150) at week 24. CONCLUSIONS Adalimumab was well tolerated and had acceptable safety and effectiveness in patients with JIA in the real-world setting.
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Affiliation(s)
- Syuji Takei
- Department of Pediatrics, Kagoshima University, Kagoshima, Japan
| | - Naomi Iwata
- Aichi Children's Health and Medical Center, Obu, Aichi, Japan
| | | | - Toru Igarashi
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | | | | | | | | | - Shumpei Yokota
- Fuji Toranomon Orthopedic Hospital, Gotemba, Shizuoka, Japan
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Amano T, Katou T, Kitamura N, Oka M, Matsumoto Y, Hoshino M, Saito Y, Yokota S, Giles BL, Paterson WR, Russell CT, Le Contel O, Ergun RE, Lindqvist PA, Turner DL, Fennell JF, Blake JB. Observational Evidence for Stochastic Shock Drift Acceleration of Electrons at the Earth's Bow Shock. Phys Rev Lett 2020; 124:065101. [PMID: 32109113 DOI: 10.1103/physrevlett.124.065101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/18/2019] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
The first-order Fermi acceleration of electrons requires an injection of electrons into a mildly relativistic energy range. However, the mechanism of injection has remained a puzzle both in theory and observation. We present direct evidence for a novel stochastic shock drift acceleration theory for the injection obtained with Magnetospheric Multiscale observations at the Earth's bow shock. The theoretical model can explain electron acceleration to mildly relativistic energies at high-speed astrophysical shocks, which may provide a solution to the long-standing issue of electron injection.
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Affiliation(s)
- T Amano
- Department of Earth and Planetary Science, University of Tokyo, Tokyo 113-0033, Japan
| | - T Katou
- Department of Earth and Planetary Science, University of Tokyo, Tokyo 113-0033, Japan
| | - N Kitamura
- Department of Earth and Planetary Science, University of Tokyo, Tokyo 113-0033, Japan
| | - M Oka
- Space Sciences Laboratory, University of California, Berkeley, California 94720, USA
| | - Y Matsumoto
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - M Hoshino
- Department of Earth and Planetary Science, University of Tokyo, Tokyo 113-0033, Japan
| | - Y Saito
- Institute of Space and Astronautical Science, Sagamihara 252-5210, Japan
| | - S Yokota
- Department of Earth and Space Science, Osaka University, Toyonaka 560-0043, Japan
| | - B L Giles
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - W R Paterson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - C T Russell
- Department of Earth, Planetary, and Space Sciences, University of California, Los Angeles, California 90095, USA
| | - O Le Contel
- Laboratoire de Physique des Plasmas, CNRS/Ecole Polytechnique/Sorbonne Université/Univ. Paris-Sud/Obs. de Paris, Paris F-75252, France
| | - R E Ergun
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, Colorado 80303, USA
| | - P-A Lindqvist
- KTH Royal Institute of Technology, Stockholm 11428, Sweden
| | - D L Turner
- Space Sciences Department, The Aerospace Corporation, El Segundo, California 90245, USA
| | - J F Fennell
- Space Sciences Department, The Aerospace Corporation, El Segundo, California 90245, USA
| | - J B Blake
- Space Sciences Department, The Aerospace Corporation, El Segundo, California 90245, USA
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22
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Tamura T, Yokota S, Ando M, Kubo Y, Nishiwaki K. A triple-blinded randomized trial comparing spinal morphine with posterior quadratus lumborum block after cesarean section. Int J Obstet Anesth 2019; 40:32-38. [DOI: 10.1016/j.ijoa.2019.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/16/2019] [Accepted: 06/16/2019] [Indexed: 10/26/2022]
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23
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Yokota S, Tobita K, Hayashi T, Mashimo Y, Miyashita H, Yokoyama H, Nishimoto T, Shishido K, Yamanaka F, Mizuno S, Murakami M, Tanaka Y, Takahashi S, Saito S. P6524The comparison of radial artery occlusion rate after distal radial artery puncture between hemodialysis and non-hemodialysis patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1114] [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
In recent years it has been attempted to use a distal radial artery (DRA) as a puncture site for cardiac catheterization and intervention. A patency of radial artery is important in hemodialysis patients because the radial artery is source as an arteriovenous shunt. However, the incidence of radial artery occlusion (RAO) is not known after DRA puncture.
Purpose
To compare RAO rates after DRA puncture between dialysis and non-dialysis patients.
Method
This was retrospective, observational and single center study. All consecutive 1,533 patients undergoing DRA puncture were analyzed. The primary endpoint is RAO rates. The secondary endpoint is composite bleeding adverse event rates. These endpoints were evaluated by a vascular echocardiography several hours or the next day after the procedure.
Result
Among 1,533 patients, 26 were dialysis patients and 1,504 were non-dialysis patients. 1,386 people (90.5%) succeeded in puncture. Radial artery occlusion occurred in 7 patients (0.4%), all of whom were non-dialysis patients. There was no significant difference of RAO rate in dialysis patients and non-dialysis patients.
Conclusion
When performing DRA puncture, the probability of radial artery occlusion is not higher in dialysis patients than non-dialysis patients. The DRA puncture may be one of the option as puncture site even in dialysis patients.
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Affiliation(s)
- S Yokota
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - K Tobita
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - T Hayashi
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - Y Mashimo
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - H Miyashita
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - H Yokoyama
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - T Nishimoto
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - K Shishido
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - F Yamanaka
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - S Mizuno
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - M Murakami
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - Y Tanaka
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - S Takahashi
- Shonan Kamakura General Hospital, Kamakura, Japan
| | - S Saito
- Shonan Kamakura General Hospital, Kamakura, Japan
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24
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Hara R, Umebayashi H, Takei S, Okamoto N, Iwata N, Yamasaki Y, Nakagishi Y, Kizawa T, Kobayashi I, Imagawa T, Kinjo N, Amano N, Takahashi Y, Mori M, Itoh Y, Yokota S. Intravenous abatacept in Japanese patients with polyarticular-course juvenile idiopathic arthritis: results from a phase III open-label study. Pediatr Rheumatol Online J 2019; 17:17. [PMID: 31039807 PMCID: PMC6492394 DOI: 10.1186/s12969-019-0319-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/17/2018] [Accepted: 04/11/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To investigate efficacy and safety of intravenous abatacept in Japanese patients with active polyarticular-course juvenile idiopathic arthritis (pJIA). METHODS In this phase III, open-label, multicenter, single-arm study, patients with pJIA aged 4-17 years who failed ≥1 biologic or methotrexate received weight-tiered (< 75 kg: 10 mg/kg; 75-100 kg: 750 mg; > 100 kg: 1000 mg) intravenous abatacept at Weeks 0, 2, 4, and every 4 weeks thereafter. The study comprised a short-term period (16 weeks) and ongoing long-term period. Primary endpoint: Week 16 JIA-American College of Rheumatology criteria 30 (JIA-ACR30) response rate. Secondary endpoints/outcomes included Week 16 JIA-ACR50/70/90 response and inactive disease rates, Childhood Health Assessment Questionnaire-Disability Index (CHAQ-DI), pharmacokinetics, safety, and immunogenicity. Proportions of patients achieving Juvenile Arthritis Disease Activity Score in 27 joints using C-reactive protein (JADAS27-CRP) remission (score < 1) and minimal disease activity (MDA; score < 3.8), were among exploratory endpoints. RESULTS All 20 patients who received study medication completed the short-term period. During the long-term period, two patients discontinued due to insufficient efficacy or patient decision. Median age and disease duration at baseline were 10.5 and 0.75 years, respectively. Week 16 JIA-ACR30 response rate (primary endpoint) was 90.0% (18/20). JIA-ACR50/70/90 response and inactive disease rates at Week 16 were 75.0% (15/20), 70.0% (14/20), 35.0% (7/20), and 25.0% (5/20), respectively. At Week 52, JIA-ACR30/50/70/90 response and inactive disease rates were observed by 88.9% (16/18), 88.9% (16/18), 83.3% (15/18), 66.7% (12/18) and 44.4% (8/18), respectively. CHAQ-DI improved after Week 12. JADAS27-CRP remission and MDA were achieved by 15.0% (3/20) and 45.0% (9/20) of patients at Week 16, and by 50.0% (9/18) and 78.0% (14/18) of patients at Week 52, respectively. The mean abatacept pre-dose serum concentration was above the target therapeutic exposure (10 μg/ml) from Week 8 through Week 16. All adverse events were of mild/moderate intensity, except for one case of severe gastroenteritis. No deaths, malignancies, or autoimmune disorders were observed. No antidrug antibodies were detected through Week 16; one patient had a positive immunogenic response during the cumulative period. CONCLUSION Intravenous abatacept was efficacious and well tolerated in Japanese patients with active pJIA. TRIAL REGISTRATION ClinicalTrials.gov: NCT01835470 . Date of registration: April 19, 2013.
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Affiliation(s)
- Ryoki Hara
- Department of Pediatrics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama-shi, Kanagawa, 236-0004, Japan.
| | - Hiroaki Umebayashi
- 0000 0004 0471 4457grid.415988.9Department of General Pediatrics, Miyagi Children’s Hospital, 4-3-17 Ochiai, Aoba-ku, Sendai-shi, Miyagi 989-3126 Japan
| | - Syuji Takei
- 0000 0004 0377 8088grid.474800.fDepartment of Pediatrics, Kagoshima University Medical and Dental Hospital, 8−35−1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8544 Japan
| | - Nami Okamoto
- 0000 0001 2109 9431grid.444883.7Department of Pediatrics, Graduate School of Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka, 569-8686 Japan
| | - Naomi Iwata
- Department of Immunology and Infectious Diseases, Aichi Children’s Health and Medical Center, 1-2 Osakata, Morioka-cho, Oobu-shi, Aichi 474-8710 Japan
| | - Yuichi Yamasaki
- 0000 0004 0377 8088grid.474800.fDepartment of Pediatrics, Kagoshima University Medical and Dental Hospital, 8−35−1 Sakuragaoka, Kagoshima-shi, Kagoshima, 890-8544 Japan
| | - Yasuo Nakagishi
- grid.415413.6Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minamimachi, Minatojima, Chuo-ku, Kobe-shi, Hyogo 650-0047 Japan
| | - Toshitaka Kizawa
- Department of Pediatrics, Japan Community Health Care Organization Sapporo Hokushin Hospital, 1-2, 2-jo, 6-chrome, Atsubetsu-chuo, Atsubetsu-ku, Sapporo-shi, Hokkaido 004-8618 Japan
| | - Ichiro Kobayashi
- 0000 0004 0378 6088grid.412167.7Department of Pediatrics, Hokkaido University Hospital, North-15, West-7, Sapporo-shi, Hokkaido 060-8638 Japan
| | - Tomoyuki Imagawa
- 0000 0004 0377 7528grid.414947.bDivision of Infection, Immunology and Rheumatology, Kanagawa Prefectural Hospital Organisation Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama-shi, Kanagawa 232-8555 Japan
| | - Noriko Kinjo
- grid.412961.9Department of Pediatrics, University of the Ryukyus Hospital, 207 Aza Uehara, Nishihara-cho, Nakagami-gun, Okinawa, 903-0215 Japan
| | - Norihito Amano
- Bristol-Myers Squibb K.K, 6-5-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 163-1328 Japan
| | - Yoko Takahashi
- Bristol-Myers Squibb K.K, 6-5-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 163-1328 Japan
| | - Masaaki Mori
- 0000 0001 1014 9130grid.265073.5Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510 Japan
| | - Yasuhiko Itoh
- 0000 0001 2173 8328grid.410821.eDepartment of Pediatrics, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Shumpei Yokota
- Fuji Toranomon Orthopaedics Hospital, 1067-1 Kawashimata, Gotenba-shi, Shizuoka, 412-0045 Japan
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25
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Okamoto N, Yokota S, Takei S, Okura Y, Kubota T, Shimizu M, Nozawa T, Iwata N, Umebayashi H, Kinjo N, Kunishima T, Yasumura J, Mori M. Clinical practice guidance for juvenile idiopathic arthritis (JIA) 2018. Mod Rheumatol 2018; 29:41-59. [PMID: 30126298 DOI: 10.1080/14397595.2018.1514724] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 01/22/2023]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common disease in pediatric rheumatism. There is no specific symptom or examination finding for JIA, and the diagnosis is made by exclusion and differentiation. Because non-pediatric rheumatologists are sometimes involved in medical care, 'proposal for JIA guidance on diagnosis and treatment for primary care pediatricians and non-pediatric rheumatologists' was first published in 2007. In these 10 years, a number of new findings on pathophysiology and treatment of JIA have been published; therefore, we propose this guidance of 2018th edition aiming at updating and standardization of JIA medical care in Japan. This edition included the management of uveitis, macrophage activation syndrome, infectious diseases before and during treatment. Moreover, details of biologics are also described. Although this guidance is tailored to adaptation of examinations and drugs, we do not purpose to limit the physicians' discretion in clinical practice. This guidance should be viewed as recommendations and be individualized according to the condition of the patient. We hope that medical care for JIA will advance and more patients will get benefit based on this guidance. Then, further revisions are needed due to changes in future conditions.
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Affiliation(s)
- Nami Okamoto
- a Department of Pediatrics, Faculty of Medicine , Osaka Medical College , Takatsuki , Japan
| | - Shumpei Yokota
- b Laboratory of Pediatric Research , Institute of Tokyo Medical School , Tokyo , Japan
| | - Syuji Takei
- c Department of Pediatrics, Graduate School of Medical and Dental Sciences , Kagoshima University , Kagoshima , Japan
| | - Yuka Okura
- d Department of Pediatrics , KKR Sapporo Medical Center , Sapporo , Japan
| | - Tomohiro Kubota
- c Department of Pediatrics, Graduate School of Medical and Dental Sciences , Kagoshima University , Kagoshima , Japan
| | - Masaki Shimizu
- e Department of Pediatrics, Graduate School of Medical Sciences , Kanazawa University , Kanazawa , Japan
| | - Tomo Nozawa
- f Department of Pediatrics , Yokohama City University Graduate School of Medicine , Yokohama , Japan
| | - Naomi Iwata
- g Department of Infection and Immunology , Aichi Children's Health and Medical Center , Obu , Japan
| | - Hiroaki Umebayashi
- h Department of General Pediatrics , Miyagi Children's Hospital , Sendai , Japan
| | - Noriko Kinjo
- i Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan
| | - Tomoko Kunishima
- i Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine , University of the Ryukyus , Nishihara , Japan
| | - Junko Yasumura
- j Department of Pediatrics , Hiroshima University Graduate School of Biomedical & Health Sciences , Hiroshima , Japan
| | - Masaaki Mori
- k Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University , Tokyo , Japan
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26
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Kitamura N, Kitahara M, Shoji M, Miyoshi Y, Hasegawa H, Nakamura S, Katoh Y, Saito Y, Yokota S, Gershman DJ, Vinas AF, Giles BL, Moore TE, Paterson WR, Pollock CJ, Russell CT, Strangeway RJ, Fuselier SA, Burch JL. Direct measurements of two-way wave-particle energy transfer in a collisionless space plasma. Science 2018; 361:1000-1003. [PMID: 30190400 DOI: 10.1126/science.aap8730] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 07/04/2018] [Indexed: 11/02/2022]
Abstract
Particle acceleration by plasma waves and spontaneous wave generation are fundamental energy and momentum exchange processes in collisionless plasmas. Such wave-particle interactions occur ubiquitously in space. We present ultrafast measurements in Earth's magnetosphere by the Magnetospheric Multiscale spacecraft that enabled quantitative evaluation of energy transfer in interactions associated with electromagnetic ion cyclotron waves. The observed ion distributions are not symmetric around the magnetic field direction but are in phase with the plasma wave fields. The wave-ion phase relations demonstrate that a cyclotron resonance transferred energy from hot protons to waves, which in turn nonresonantly accelerated cold He+ to energies up to ~2 kilo-electron volts. These observations provide direct quantitative evidence for collisionless energy transfer in plasmas between distinct particle populations via wave-particle interactions.
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Affiliation(s)
- N Kitamura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, Japan. .,Department of Earth and Planetary Science, Graduate School of Science, the University of Tokyo, Tokyo, Japan
| | - M Kitahara
- Department of Geophysics, Graduate School of Science, Tohoku University, Sendai, Japan
| | - M Shoji
- Institute for Space-Earth Environmental Research (ISEE), Nagoya University, Nagoya, Japan
| | - Y Miyoshi
- Institute for Space-Earth Environmental Research (ISEE), Nagoya University, Nagoya, Japan
| | - H Hasegawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, Japan
| | - S Nakamura
- Research Institute for Sustainable Humanosphere (RISH), Kyoto University, Uji, Japan
| | - Y Katoh
- Department of Geophysics, Graduate School of Science, Tohoku University, Sendai, Japan
| | - Y Saito
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara, Japan
| | - S Yokota
- Department of Earth and Space Science, Graduate School of Science, Osaka University, Toyonaka, Japan
| | - D J Gershman
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - A F Vinas
- NASA Goddard Space Flight Center, Greenbelt, MD, USA.,Department of Physics, American University, Washington, DC, USA
| | - B L Giles
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - T E Moore
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - W R Paterson
- NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | | | - C T Russell
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
| | - R J Strangeway
- Institute of Geophysics and Planetary Physics, University of California, Los Angeles, CA, USA
| | - S A Fuselier
- Southwest Research Institute, San Antonio, TX, USA.,University of Texas at San Antonio, San Antonio, TX, USA
| | - J L Burch
- Southwest Research Institute, San Antonio, TX, USA
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27
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Kono K, Okada Y, Onimaru H, Yokota S, Arima Y, Fukushi I, Koizumi K, Hasebe Y, Yoshizawa M, Kise H, Hoshiai M, Sugita K, Toda T. P1859Functional and anatomical connectivity from the dorsomedial hypothalamus to the ventral medullary cardiovascular regions: possible neural substrate mediating stress-induced sympathoexcitation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Kono
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - Y Okada
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Tokyo, Japan
| | - H Onimaru
- Showa University, Department of Physiology, Tokyo, Japan
| | - S Yokota
- Shimane University School of Medicine, Department of Anatomy and Morphological Neuroscience, Shimane, Japan
| | - Y Arima
- Shimane University School of Medicine, Department of Anatomy and Morphological Neuroscience, Shimane, Japan
| | - I Fukushi
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Tokyo, Japan
| | - K Koizumi
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - Y Hasebe
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - M Yoshizawa
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - H Kise
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - M Hoshiai
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - K Sugita
- University of Yamanashi, Pediatrics, Yamanashi, Japan
| | - T Toda
- University of Yamanashi, Pediatrics, Yamanashi, Japan
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28
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Suto M, Matsumoto K, Shibata N, Yokota S, Mukai J, Hisamatsu E, Takada H, Soga F, Dokuni K, Hatani Y, Hatazawa K, Matsuzoe H, Tanaka H, Hirata K. P1610Non-invasive assessment of preload reserve using the leg-positive pressure manoeuvre in patients with repaired tetralogy of Fallot. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Suto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Shibata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - S Yokota
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - J Mukai
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - E Hisamatsu
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Takada
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - F Soga
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Dokuni
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - Y Hatani
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hatazawa
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Matsuzoe
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hirata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
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29
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Hasebe Y, Yokota S, Takeda K, Sugama S, Kono Y, Koizumi K, Fukushi I, Hoshiai M, Kakinuma Y, Pokorski M, Horiuchi J, Sugita K, Okada Y. P4780Activation of astrocytes is requred for the persistence of post-stress blood pressure elevation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Hasebe
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - S Yokota
- Shimane University, Anatomy and Morphological Neuroscience, Izumo, Japan
| | - K Takeda
- Fujita Health University, Faculty of Rehabilitation, School of Health Sciences, Mie, Japan
| | - S Sugama
- Nippon Medical School, Department of Physiology, Tokyo, Japan
| | - Y Kono
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - K Koizumi
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - I Fukushi
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Musashimurayama, Tokyo, Japan
| | - M Hoshiai
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - Y Kakinuma
- Nippon Medical School, Department of Physiology, Tokyo, Japan
| | - M Pokorski
- Opole Medical School, Faculty of Physiotherapy, Opole, Poland
| | - J Horiuchi
- Toyo University, Department of Biomedical Engineering, Graduate School of Science & Engineering, Saitama, Japan
| | - K Sugita
- University of Yamanashi, Department of Pediatrics, Graduate School of Medicine, Yamanashi, Japan
| | - Y Okada
- National Hospital Organization Murayama Medical Center, Clinical Research Center, Musashimurayama, Tokyo, Japan
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30
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Mohri H, Yamazaki E, Suzuki Z, Takano T, Yokota S, Okubo T. Autoantibody Selectively Inhibits Binding of von Willebrand Factor to Glycoprotein Ib. Recognition Site Is Located in the A1 Loop of von Willebrand Factor. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1656047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA 20-year-old man with severe von Willebrand disease recently presented a progressive bleeding tendency, characterized recurrent subcutaneous hemorrhages and cerebral hemorrhage. Mixing and infusion studies suggested the presence of an inhibitor directed against vWF:RCo activity of von Willebrand factor (vWF) without significant inhibition of the FVIII:C. The inhibitor was identified as an antibody of IgG class. The inhibitor inhibited the interaction of vWF in the presence of ristocetin and that of asialo-vWF with GPIb while it partially blocked botrocetin-mediated interaction of vWF to GPIb. The inhibitor reacted with native vWF, the 39/34kDa fragment (amino acids [aa] 480/ 481-718) and the recombinant vWF fragment (MalE-rvWF508-704), but not with Fragment III-T2 (heavy chains, aa 273-511; light chains, aa 674-728). A synthetic peptide (aa 514-542) did not inhibit vWF-inhibitor complex formation. We conclude that this is the first autoantibody of class IgG from human origin that recognizes the sequence in the A1 loop of vWF, resulting in a virtual absence of functional vWF and a concomitant severe bleeding tendency although recognition site is different from the residues 514-542 which is crucial for vWF-GPIb interaction.
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Affiliation(s)
- Hiroshi Mohri
- The First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama
| | - Etsuko Yamazaki
- The First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama
| | - Zekou Suzuki
- The Department of Clinical Laboratory, Iwate Medical School, Morioka
| | - Toshikuni Takano
- The Department of Pediatrics, Iwate Medical School, Morioka, Japan
| | - Shumpei Yokota
- The Department of Pediatrics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takao Okubo
- The First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama
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Kasahara S, Miyoshi Y, Yokota S, Mitani T, Kasahara Y, Matsuda S, Kumamoto A, Matsuoka A, Kazama Y, Frey HU, Angelopoulos V, Kurita S, Keika K, Seki K, Shinohara I. Pulsating aurora from electron scattering by chorus waves. Nature 2018; 554:337-340. [PMID: 29446380 DOI: 10.1038/nature25505] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/21/2017] [Indexed: 11/09/2022]
Abstract
Auroral substorms, dynamic phenomena that occur in the upper atmosphere at night, are caused by global reconfiguration of the magnetosphere, which releases stored solar wind energy. These storms are characterized by auroral brightening from dusk to midnight, followed by violent motions of distinct auroral arcs that suddenly break up, and the subsequent emergence of diffuse, pulsating auroral patches at dawn. Pulsating aurorae, which are quasiperiodic, blinking patches of light tens to hundreds of kilometres across, appear at altitudes of about 100 kilometres in the high-latitude regions of both hemispheres, and multiple patches often cover the entire sky. This auroral pulsation, with periods of several to tens of seconds, is generated by the intermittent precipitation of energetic electrons (several to tens of kiloelectronvolts) arriving from the magnetosphere and colliding with the atoms and molecules of the upper atmosphere. A possible cause of this precipitation is the interaction between magnetospheric electrons and electromagnetic waves called whistler-mode chorus waves. However, no direct observational evidence of this interaction has been obtained so far. Here we report that energetic electrons are scattered by chorus waves, resulting in their precipitation. Our observations were made in March 2017 with a magnetospheric spacecraft equipped with a high-angular-resolution electron sensor and electromagnetic field instruments. The measured quasiperiodic precipitating electron flux was sufficiently intense to generate a pulsating aurora, which was indeed simultaneously observed by a ground auroral imager.
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Affiliation(s)
- S Kasahara
- Department of Earth and Planetary Science, School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Y Miyoshi
- Institute for Space-Earth Environmental Research, Nagoya University, Furo-cho, Chikusa-ku, 24105 Nagoya, Aichi, Japan
| | - S Yokota
- Department of Earth and Space Science, Graduate School of Science, Osaka University, 1-1 Machikaneyama-cho, Toyonaka, Osaka, Japan
| | - T Mitani
- Institute of Space and Astronautical Science, 3-1-1 Yoshinodai, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - Y Kasahara
- Graduate School of Natural Science and Technology, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa, Japan
| | - S Matsuda
- Institute for Space-Earth Environmental Research, Nagoya University, Furo-cho, Chikusa-ku, 24105 Nagoya, Aichi, Japan
| | - A Kumamoto
- Graduate School of Science, Tohoku University, 6-3 Aoba, Aramaki, Aoba-ku, Sendai 980-8578 Japan
| | - A Matsuoka
- Institute of Space and Astronautical Science, 3-1-1 Yoshinodai, Chuo-ku, Sagamihara, Kanagawa, Japan
| | - Y Kazama
- Academia Sinica Institute of Astronomy and Astrophysics, 11F Astronomy-Mathematics Building, AS/NTU, No. 1, Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - H U Frey
- Space Sciences Laboratory, University of California, Berkeley, California 94720-7450, USA
| | - V Angelopoulos
- Department of Earth, Planetary and Space Sciences, University of California, Los Angeles, California 90095-1567, USA
| | - S Kurita
- Institute for Space-Earth Environmental Research, Nagoya University, Furo-cho, Chikusa-ku, 24105 Nagoya, Aichi, Japan
| | - K Keika
- Department of Earth and Planetary Science, School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - K Seki
- Department of Earth and Planetary Science, School of Science, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - I Shinohara
- Institute of Space and Astronautical Science, 3-1-1 Yoshinodai, Chuo-ku, Sagamihara, Kanagawa, Japan
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Aratani S, Fujita H, Kuroiwa Y, Usui C, Yokota S, Nakamura I, Nishioka K, Nakajima T. Retraction: Murine hypothalamic destruction with vascular cell apoptosis subsequent to combined administration of human papilloma virus vaccine and pertussis toxin. Sci Rep 2018; 8:46971. [PMID: 29749388 PMCID: PMC5946160 DOI: 10.1038/srep46971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This corrects the article DOI: 10.1038/srep36943.
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Shiraishi T, Yokota S, Sato Y, Ito T, Fukiya S, Yamamoto S, Sato T, Yokota A. Lipoteichoic acids are embedded in cell walls during logarithmic phase, but exposed on membrane vesicles in Lactobacillus gasseri JCM 1131 T. Benef Microbes 2018; 9:653-662. [PMID: 29633638 DOI: 10.3920/bm2017.0124] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Lipoteichoic acid (LTA) is a cell surface molecule specific to Gram-positive bacteria. How LTA localises on the cell surface is a fundamental issue in view of recognition and immunomodulation in hosts. In the present study, we examined LTA localisation using strain JCM 1131T of Lactobacillus gasseri, which is a human intestinal lactic acid bacterium, during various growth phases by immunoelectron microscopy. We first evaluated the specificity of anti-LTA monoclonal antibody clone 55 used as a probe. The glycerophosphate backbone comprising almost intact size (20 to 30 repeating units) of LTA was required for binding. The antibody did not bind to other cellular components, including wall-teichoic acid. Immunoelectron microscopy indicated that LTA was embedded in the cell wall during the logarithmic phase, and was therefore not exposed on the cell surface. Similar results were observed for Lactobacillus fermentum ATCC 9338 and Lactobacillus rhamnosus ATCC 7469T. By contrast, membrane vesicles were observed in the logarithmic phase of L. gasseri with LTA exposed on their surface. In the stationary and death phases, LTA was exposed on cell wall-free cell membrane generated by autolysis. The dramatic alternation of localisation in different growth phases and exposure on the surface of membrane vesicles should relate with complicated interaction between bacteria and host.
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Affiliation(s)
- T Shiraishi
- 1 Department of Microbiology, Sapporo Medical University School of Medicine, Minami 1 Nishi 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | - S Yokota
- 1 Department of Microbiology, Sapporo Medical University School of Medicine, Minami 1 Nishi 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | - Y Sato
- 2 Laboratory of Microbial Physiology, Research Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo, Hokkaido 060-8589, Japan
| | - T Ito
- 3 Electron Microscope Laboratory, Research Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo, Hokkaido 060-8589, Japan
| | - S Fukiya
- 2 Laboratory of Microbial Physiology, Research Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo, Hokkaido 060-8589, Japan
| | - S Yamamoto
- 1 Department of Microbiology, Sapporo Medical University School of Medicine, Minami 1 Nishi 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | - T Sato
- 1 Department of Microbiology, Sapporo Medical University School of Medicine, Minami 1 Nishi 17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan
| | - A Yokota
- 2 Laboratory of Microbial Physiology, Research Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo, Hokkaido 060-8589, Japan
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Yokota S, Ottervanger JP, Mouden M, de Boer MJ, Jager PL, Timmer JR. Predictors of severe stenosis at invasive coronary angiography in patients with normal myocardial perfusion imaging. Neth Heart J 2018; 26:192-202. [PMID: 29500790 PMCID: PMC5876173 DOI: 10.1007/s12471-018-1091-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose Normal myocardial perfusion imaging (MPI) is associated with excellent prognosis. However, in patients with persisting symptoms, it may be difficult to determine the patients in whom invasive angiography is justified to rule out false negative MPI. We evaluated predictors for severe stenosis at invasive angiography in patients with persisting symptoms after normal MPI. Methods 229 consecutive patients with normal MPI, without previous bypass surgery, underwent invasive angiography within 6 months. Older age was defined as >65 years. Multivariable analyses were performed to adjust for differences in baseline variables. Results Mean age was 62 ± 11 years, 48% were women. Severe stenosis was observed in 34%, and of these patients 60% had single-vessel disease (not left main coronary artery disease). After adjusting for several variables, including diabetes, smoking status, hypertension and hypercholesterolaemia, predictors of severe stenosis were male gender, odds ratio (OR) 2.7 (95% confidence interval (CI) 1.5–4.9), older age, OR 1.9 (95% CI 1.02–3.54) previous PCI, OR 2.0 (95% CI 1.0–4.3) and typical angina, OR 2.5 (95% CI 1.4–4.6). Conclusions Increasing age, male gender, previous PCI and typical symptoms are predictors of severe stenosis at invasive coronary angiography in patients with normal MPI. The majority of these patients have single-vessel disease.
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Affiliation(s)
- S Yokota
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - J P Ottervanger
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands.
| | - M Mouden
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
| | - M J de Boer
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P L Jager
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - J R Timmer
- Department of Cardiology, Isala Hospital, Zwolle, The Netherlands
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Nakano N, Mori M, Umebayashi H, Iwata N, Kobayashi N, Masunaga K, Imagawa T, Murata T, Kinjo N, Nagai K, Miyoshi M, Takei S, Yokota S, Ishii E. Characteristics and outcome of intractable vasculitis syndrome in children: Nation-wide survey in Japan. Mod Rheumatol 2017; 28:697-702. [PMID: 29219653 DOI: 10.1080/14397595.2017.1404700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Primary systemic vasculitis (PSV) is a rare disorder in children and difficult to distinguish from other diseases. However, appropriate diagnosis and prompt treatment will affect on the morbidity and mortality of intractable PSV. In this study, we conducted a nationwide survey in Japan, to clarify epidemiology and clinical outcome of PSV. METHODS We had sent survey questionnaires to most of the Japanese institutions that employed pediatricians, requesting the number of patients with refractory PSV who were diagnosed and treated between 2007 and 2011. Respondents were asked to provide detailed information on the clinical and laboratory features of each case they had managed. Those with Kawasaki disease or Henoch-Shönlein purpura vasculitis (IgA vasculitis) were excluded. RESULTS Of all the institutions surveyed, 1123 (37.3%) patients responded, finally, total of 49 patients with intractable PSV, defined by those with resistant to treatment and steroid-dependent, or with any complication associated with prognosis, were selected. The diagnosis was Takayasu arteritis in 31, polyarteritis nodosa in 11, granulomatosis with polyangitis in 2, microscopic polyangitis in 1, and ANCA negative microscopic polyangitis in 1. In those with Takayasu arteritis, 67% were treated with an immunosuppressive agent, 22% with biological modifiers, and 16% with surgical procedures. In other types of disease, 88% of the patients were treated with an immunosuppressive agent, and 12% with biological modifiers. Two with Takayasu arteritis died being terminally ill. CONCLUSION This nationwide survey establishes the heterogeneous characteristics of PSV in children. Although questionnaire-based, the results of our analysis should be useful in planning prospective studies to identify the most effective therapy for each subtype of multifaceted disease.
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Affiliation(s)
- Naoko Nakano
- a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan
| | - Masaaki Mori
- b Department of Lifetime Clinical Immunology, Graduate School of Medical and Dental Sciences , Tokyo Medical and Dental University , Tokyo , Japan
| | - Hiroaki Umebayashi
- c Department of General Pediatrics , Miyagi Children's Hospital , Miyagi , Japan
| | - Naomi Iwata
- d Department of Immunology and Infectious Diseases , Aichi Children's Health and Medical Center , Aichi , Japan
| | - Norimoto Kobayashi
- e Department of Pediatrics , Shinshu University School of Medicine , Nagano , Japan
| | - Kenji Masunaga
- f Department of Pediatrics , Kurume University School of Medicine , Fukuoka , Japan
| | - Tomoyuki Imagawa
- g Division of Infection, Immunology and Rheumatology , Kanagawa Children's Medical Center , Kanagawa , Japan
| | - Takuji Murata
- h Department of Pediatrics , Osaka Medical College , Osaka , Japan
| | - Noriko Kinjo
- i Department of Pediatrics , University of the Ryukyu , Okinawa , Japan
| | - Kazushige Nagai
- j Department of Pediatrics , Sapporo Medical University School of Medicine , Hokkaido , Japan
| | - Mari Miyoshi
- k Department of Allergy and Immunology , Hyogo Prefectural Kobe Children's Hospital , Hyogo , Japan
| | - Syuji Takei
- l School of Health Science, Faculty of Medicine , Kagoshima University , Kagoshima , Japan
| | - Shumpei Yokota
- m Department of Pediatrics , Yokohama City University , Kanagawa , Japan
| | - Eiichi Ishii
- a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan
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Shimosato Y, Tanoshima R, Tsujimoto SI, Takeuchi M, Sasaki K, Kajiwara R, Goto H, Nagai J, Yanagimachi MD, Ito S, Yokota S. Association of isochromosome (7)(q10) in Shwachman-Diamond syndrome with the severity of cytopenia. Clin Case Rep 2017; 6:125-128. [PMID: 29375851 PMCID: PMC5771925 DOI: 10.1002/ccr3.1249] [Citation(s) in RCA: 5] [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: 07/13/2016] [Revised: 03/06/2017] [Accepted: 09/26/2017] [Indexed: 11/06/2022] Open
Abstract
We report two male siblings with SDS. They have the same compound heterozygous mutations. Only one of the siblings acquired cytogenetic abnormality of i(7q) 2 years after diagnosis, became transfusion-dependent, and underwent allogeneic hematopoietic stem cell transplantation. These cases indicate that i(7q) is associated with significant cytopenia in SDS patients.
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Affiliation(s)
- Yuko Shimosato
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Reo Tanoshima
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Shin-Ichi Tsujimoto
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Masanobu Takeuchi
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Koji Sasaki
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Ryosuke Kajiwara
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Hiroaki Goto
- Kanagawa Children's Medical Center Yokohama Japan
| | | | | | - Shuichi Ito
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
| | - Shumpei Yokota
- Department of Pediatrics Yokohama City University School of Medicine Yokohama Japan
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Nakaoka Y, Isobe M, Takei S, Tanaka Y, Ishii T, Yokota S, Nomura A, Yoshida S, Nishimoto N. Efficacy and safety of tocilizumab in patients with refractory Takayasu arteritis: results from a randomised, double-blind, placebo-controlled, phase 3 trial in Japan (the TAKT study). Ann Rheum Dis 2017; 77:348-354. [PMID: 29191819 PMCID: PMC5867398 DOI: 10.1136/annrheumdis-2017-211878] [Citation(s) in RCA: 220] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the efficacy and safety of the interleukin-6 receptor antibody tocilizumab in patients with Takayasu arteritis (TAK). METHODS Patients with TAK who had relapsed within the previous 12 weeks were induced into remission with oral glucocorticoid therapy. In this double-blind, placebo-controlled trial, patients were randomly assigned 1:1 to receive weekly tocilizumab 162 mg or placebo subcutaneously, and oral glucocorticoids were tapered 10 %/week from week 4 to a minimum of 0.1 mg/kg/day until 19 patients relapsed. The primary endpoint was time to relapse of TAK, defined as ≥2 of the following: objective systemic symptoms, subjective systemic symptoms, elevated inflammation markers, vascular signs and symptoms or ischaemic symptoms. RESULTS The intent-to-treat and safety populations included 18 tocilizumab-treated and 18 placebo-treated patients. The per-protocol set (PPS) included 16 tocilizumab-treated and 17 placebo-treated patients. HRs for time to relapse of TAK were 0.41 (95.41% CI 0.15 to 1.10; p=0.0596) in the intent-to-treat population (primary endpoint) based on relapse in eight tocilizumab-treated and 11 placebo-treated patients and 0.34 (95.41% CI 0.11 to 1.00; p=0.0345) in the PPS. The secondary endpoints, time to relapse assessed by Kerr's definition and clinical symptoms only, were consistent with the primary endpoint. Serious adverse events were reported in one tocilizumab-treated and two placebo-treated patients. There were no serious infections and no deaths. CONCLUSION Although the primary endpoint was not met, the results suggest favour for tocilizumab over placebo for time to relapse of TAK without new safety concerns. Further investigation is warranted to confirm the efficacy of tocilizumab in patients with refractory TAK. TRIAL REGISTRATION NUMBER JapicCTI-142616.
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Affiliation(s)
- Yoshikazu Nakaoka
- Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Syuji Takei
- Faculty of Medicine, School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tomonori Ishii
- Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Japan
| | - Shumpei Yokota
- Laboratory of Pediatric Research, Institute of Tokyo Medical School, Tokyo, Japan
| | | | | | - Norihiro Nishimoto
- Department of Molecular Regulation for Intractable Disease, Institute of Medical Science, Tokyo Medical University, Tokyo, Japan
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Yokota S, Imagawa T, Nishikomori R, Takada H, Abrams K, Lheritier K, Heike T, Hara T. Long-term safety and efficacy of canakinumab in cryopyrin-associated periodic syndrome: results from an open-label, phase III pivotal study in Japanese patients. Clin Exp Rheumatol 2017; 35 Suppl 108:19-26. [PMID: 27974104] [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] [Received: 12/04/2015] [Accepted: 07/22/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To assess the long-term safety and efficacy of canakinumab in Japanese patients with cryopyrin-associated periodic syndrome (CAPS). METHODS In this open-label phase 3 study, Japanese patients aged ≥2 years with CAPS received canakinumab 2-8 mg/kg subcutaneously every 8 weeks. The duration of the core treatment phase was 24 weeks followed by 22 months extension phase. The primary objective was the proportion of patients free of clinical and serologic relapse at week 24. RESULTS The study enrolled 19 Japanese patients (median age, 14 years; range, 2-48 years) with CAPS [MWS, 7 (36.8%); NOMID, 12 (63.2%)] for a median of 109 weeks. Fifteen patients (79%) achieved a complete response by day 15, 18 (94.7%) by week 24 and all by week 48. At the end of the study, 18 (95%) were free from relapse and 11 (57.9%) were assessed as having no disease activity by the PGA. Thirteen (68%) patients (MWS, 4; NOMID, 9) had their canakinumab dose increased during the trial. All patients experienced at least one adverse event (AE), the most common being infections (100%) and 5 (26.3%) reported serious AEs. No deaths were reported and the only patient who discontinued the study early withdrew consent. CONCLUSIONS Regular canakinumab treatment every 8 weeks at dose levels from 2-8 mg/kg, based on the clinical need, represents a successful strategy to induce rapid and complete response while maintain long-term disease control in Japanese patients with CAPS. The safety profile of canakinumab was consistent with that observed from previous studies.
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Affiliation(s)
- Shumpei Yokota
- Laboratory of Paediatric Research, Medical Research Institute of Tokyo Medical School, Japan.
| | - Tomoyuki Imagawa
- Laboratory of Paediatric Research, Medical Research Institute of Tokyo Medical School, Japan
| | | | | | - Ken Abrams
- Novartis Pharmaceutical Corporation, East Hanover, NJ, USA
| | | | - Toshio Heike
- Department of Paediatrics, Kyoto University, Kyoto, Japan
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Yokota S, Borren N, Ottervanger J, Mouden M, Timmer J, Knollema S, Jager P. P901Overestimates fractional flow reserve severity of LAD lesions? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lomakina O, Alekseeva E, Valieva S, Bzarova T, Nikishina I, Zholobova E, Rodionovskaya S, Kaleda M, Nakagishi Y, Shimizu M, Mizuta M, Yachie A, Sugita Y, Okamoto N, Shabana K, Murata T, Tamai H, Smith EM, Yin P, Jorgensen AL, Beresford MW, Smith EM, Eleuteri A, Goilav B, Lewandowski L, Phuti A, Wahezi D, Rubinstein T, Jones C, Newland P, Marks S, Corkhill R, Ekdawy D, Pilkington C, Tullus K, Putterman C, Scott C, Fisher AC, Beresford MW, Smith EM, Lewandowski L, Phuti A, Jorgensen A, Scott C, Beresford MW, Batu ED, Kosukcu C, Taskiran E, Akman S, Ozturk K, Sozeri B, Unsal E, Ekinci Z, Bilginer Y, Alikasifoglu M, Ozen S, Lythgoe H, Beresford MW, Brunner HI, Gulati G, Jones JT, Altaye M, Eaton J, Difrancesco M, Yeo JG, Leong J, Bathi LDT, Arkachaisri T, Albani S, Abdelrahman N, Beresford MW, Leone V, Groot N, Shaikhani D, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Wright RD, Smith EM, Beresford MW, Abdawani R, Al Shaqshi L, Al Zakwani I, Gormezano NW, Kern D, Pereira OL, Esteves GCC, Sallum AM, Aikawa NE, Pereira RM, Silva CA, Bonfa E, Beckmann J, Bartholomä N, Foeldvari I, Bohnsack J, Milojevic D, Rabinovich C, Kingsbury D, Marzan K, Quartier P, Minden K, Chalom E, Horneff G, Venhoff N, Kuester RM, Dare J, Heinrich M, Kupper H, Kalabic J, Martini A, Brunner HI, Consolaro A, Horneff G, Burgos-Vargas R, Henneke P, Constantin T, Foeldvari I, Vojinovic J, Dehoorne J, Panaviene V, Susic G, Stanevica V, Kobusinska K, Zuber Z, Mouy R, Salzer U, Rumba-Rozenfelde I, Dolezalova P, Job-Deslandre C, Wulffraat N, Pederson R, Bukowski J, Hinnershitz T, Vlahos B, Martini A, Ruperto N, Janda A, Keskitalo P, Kangas S, Vähäsalo P, Valencia RAC, Martino D, Munro J, Ponsonby AL, Chiaroni-Clarke R, Meyer B, Allen RC, Boteanu AL, Akikusa JD, Craig JM, Saffrey R, Ellis JA, Davì S, Minoia F, Horne A, Wulffraat N, Wouters C, Wallace C, Corral SG, Uziel Y, Sterba G, Schneider R, Russo R, Ramanan AV, Schmid JP, Ozen S, Nichols KE, Miettunen P, Lovell DJ, Giraldo AS, Lehmberg K, Kitoh T, Khubchandani R, Ilowite NT, Henter JI, Grom AA, De Benedetti F, Behrens EM, Avcin T, Aricò M, Gámir MG, Martini A, Ruperto N, Cron RQ, Ravelli A, Grevich S, Lee P, Ringold S, Leroux B, Leahey H, Yuasa M, Mendoza AZ, Foster J, Sokolove J, Lahey L, Robinson W, Newson J, Stevens A, Shoop SJW, Hyrich KL, Verstappen SMM, Thomson W, Adrovic A, McDonagh JE, Beukelman T, Kimura Y, Natter M, Ilowite N, Mieszkalski K, Burrell G, Best B, Bristow H, Carr S, Dedeoglu R, Dennos A, Kaufmann R, Schanberg L, Parissenti I, Insalaco A, Taddio A, Mauro A, Pardeo M, Ricci F, Simonini G, Sahin S, Cattalini M, Montesano P, Parissenti I, Ricci F, Bonafini B, Medeghini V, Lancini F, Cattalini M, Gerbaux M, Lê PQ, Barut K, Goffin L, Badot V, La C, Caspers L, Willermain F, Ferster A, Ceci M, Licciardi F, Turco M, Santarelli F, Koka A, Montin D, Toppino C, Maggio MC, Alizzi C, Papia B, Vergara B, Corpora U, Messina L, Corsello G, Tsinti M, Oztunc F, 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Tzaribachev N, Braga ALF, Foeldvari I, Horneff G, Kingsbury D, Koskova E, Smolewska E, Vehe RK, Zuber Z, Martini A, Lovell D, Kubota T, Sallum AME, Shimizu M, Yasumura J, Nakagishi Y, Kizawa T, Yashiro M, Wakiguchi H, Yamatou T, Yamasaki Y, Takei S, Kawano Y, Campos LMDA, Nykvist UJ, Magnusson B, Wicksell R, Palmblad K, Olsson GL, Ziaee V, Modaressi M, Moradinejad MH, Seraya V, Zholobova E, Pereira LAA, Vitebskaya A, Moshe V, Amarilyo G, Harel L, Hashkes PJ, Mendelson A, Rabinowicz N, Reis Y, Uziel Y, Dāvidsone Z, Lichtenfels AJDFC, Lazareva A, Šantere R, Bērziņa D, Staņēviča V, Varnier GC, Consolaro A, Pilkington C, Maillard S, Ferrari C, Zaffarano S, Silva CA, Martini A, Ravelli A, Wienke J, Enders FB, van den Hoogen LL, Mertens JS, Radstake TR, Hotten HG, Fritsch R, de Jager W, Farhat SCL, Wedderburn L, Nistala K, Pilkington C, Prakken B, van Royen-Kerkhof A, van Wijk F, Alhemairi M, Muzaffer M, Van Dijkhuizen P, Deakin CT, Acar B, Simou S, Wedderburn LR, De Iorio M, Wu Q, Amin T, 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Batu ED, Hügle B, Arslan N, Solyom A, Mitchell J, Schuchman E, Ozen S, Nourse P, Magnusson B, Malagon C, Gomez P, Mosquera C, Gonzalez T, Yepez R, Vargas C, Amorim RA, Len CA, Molina J, Lewandowski L, Moreira G, Santos FH, Fraga M, Keppeke L, Silva VM, Hirotsu C, Tufik S, Terreri MT, Braga VL, Fonseca MB, Arango C, Len CA, Fraga M, Schinzel V, Terreri MTR, Molina J, Len CA, Jorge L, Guerra L, Santos FH, Terreri MT, Mosquera AC, Junior EA, Fonseca MB, Braga VL, Len CA, Fraga M, Schinzel V, Terreri MTR, Alizzi C, Maggio MC, Castiglione MC, Malagon C, Tricarico A, Corsello G, Boulter E, Schultz A, Murray K, Falcini F, Lepri G, Stagi S, Bellucci E, Matucci-Cerinic M, Sakamoto AP, Grein IHR, Groot N, Pileggi G, Pinto NBF, de Oliveira AL, Wulffraat N, Chyzheuskaya I, Belyaeva L, Filonovich R, Khrustaleva H, Silva CA, Zajtseva L, Ilisson J, Pruunsild C, Kostik M, Kopchak O, Mushkin A, Maletin A, Gilliaux O, Corazza F, Lelubre C, Silva MFCD, Ferster A, Suárez RG, Morel Z, Espada G, Malagon C, C CSM, Lira L, Ladino M, Eraso R, Arroyo I, Lopes AS, Sztajnbok F, Silva C, Rose C, Russo GCS, Sallum AEM, Kozu K, Bonfá E, Saad-Magalhães C, Pereira RMR, Len CA, Terreri MT, Suri D, Didel S, Rawat A, Singh S, Maritsi D, Onoufriou MA, Vougiouka O, Tsolia M, Bosak EP, Vidović M, Lamot M, Lamot L, Harjaček M, Van Nieuwenhove E, Liston A, Wouters C, Tahghighi F, Ziaee V, Raeeskarami SR, Aguiar F, Pereira S, Rodrigues M, Moura C, Rocha G, Guimarães H, Brito I, Aguiar F, Fonseca R, Rodrigues M, Brito I, Horneff G, Klein A, Minden K, Huppertz HI, Weller-Heinemann F, Kuemmerle-Deschner J, Haas JP, Hospach A, Menendez-Castro R, Huegle B, Haas JP, Swart J, Giancane G, Bovis F, Castagnola E, Groll A, Horneff G, Huppertz HI, Lovell DJ, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, Marafon DP, Ailioaie C, Tsitsami E, Kamphuis S, Herlin T, Doležalová P, Susic G, Flatø B, Sztajnbok F, Pistorio A, Martini A, Wulffraat N, Ruperto N, Gattorno M, Brucato A, Finetti M, Lazaros G, Maestroni S, Carraro M, Cumetti D, Carobbio A, Lorini M, Rimini A, Marcolongo R, Valenti A, Erre GL, Belli R, Gaita F, Sormani MP, Ruperto N, Imazio M, Martini A, Abinun M, Smith N, Rapley T, McErlane F, Kearsley-Fleet L, Hyrich KL, Foster H, Ruperto N, Lovell DJ, Tzaribachev N, Zeft A, Cimaz R, Stanevicha V, Horneff G, Bohnsack J, Griffin T, Carrasco R, Trachana M, Dare J, Foeldvari I, Vehe R, Bovis F, Simon T, Martini A, Brunner H, Verazza S, Davì S, Consolaro A, Insalaco A, Gerloni V, Cimaz R, Zulian F, Pastore S, Corona F, Conti G, Barone P, Cattalini M, Cortis E, Breda L, Olivieri AN, Civino A, Podda R, Rigante D, La Torre F, D’Angelo G, Jorini M, Gallizzi R, Maggio MC, Consolini R, De Fanti A, Alpigiani MG, Martini A, Ravelli A, Sozeri B, Kısaarslan AP, Gunduz Z, Dusunsel R, Dursun I, Poyrazoglu H, Kuchinskaya E, Abduragimova F, Kostik M, Sundberg E, Omarsdottir S, Klevenvall L, Erlandsson-Harris H, Basbozkurt G, Erdemli O, Simsek D, Yazici F, Karsioglu Y, Tezcaner A, Keskin D, Ozkan H, Acikel C, Ozen S, Demirkaya E, Orbán I, Sevcic K, Brodszky V, Kiss E, Tekko IA, Rooney M, McElnay J, Taggart C, McCarthy H, Donnelly RF, Abinun M, Slatter M, Nademi Z, Friswell M, Foster H, Jandial S, McErlane F, Flood T, Hambleton S, Gennery A, Cant A, Finetti M, Bovis F, Swart J, Doležalová P, Tsitsami E, Trachana M, Demirkaya E, Duong PN, Koné-Paut I, Vougiouka O, Marafon DP, Cimaz R, Filocamo G, Gamir ML, Stanevicha V, Sanner H, Carenini L, Wulffraat N, Martini A, Ruperto N, Topdemir M, Basbozkurt G, Karslioglu Y, Ozkan H, Acikel C, Demirkaya E, Gok F, Zholobova E, Tsurikova N, Ligostaeva E, Ramchurn NR, Friswell M, Kostareva O, Nikishina I, Arsenyeva S, Rodionovskaya S, Kaleda M, Alexeev D, Dursun ID, Sozeri B, Kısaarslan AP, Dusunsel R, Poyrazoglu H, Poyrazoglu H, Murias S, Barral E, Alcobendas R, Enriquez E, Remesal A, de Inocencio J, Castro TM, Lotufo SA, Freye T, Carlomagno R, Zumbrunn T, Bonhoeffer J, Schneider EC, Kaiser D, Hofer M, Hentgen V, Woerner A, Schwarz T, Klotsche J, Niewerth M, Horneff G, Haas JP, Hospach A, Huppertz HI, Ganser G, Minden K, Jeyaratnam J, ter Haar N, Kasapcopur O, Rigante D, Dedeoglu F, Baris E, Vastert S, Wulffraat N, Frenkel J, Hausmann JS, Lomax KG, Shapiro A, Durrant KL, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Leon K, Wei X, Laxer RM, Signa S, Rusmini M, Campione E, Chiesa S, Grossi A, Omenetti A, Caorsi R, Viglizzo G, Martini A, Ceccherini I, Gattorno M, Federici S, Frenkel J, Ozen S, Lachmann H, Finetti M, Martini A, Ruperto N, Gattorno M, Federici S, Vanoni F, Ozen S, Hofer M, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Gomes SM, Omoyinmi E, Arostegui JI, Gonzalez-Roca E, Eleftheriou D, Klein N, Brogan P, Volpi S, Santori E, Picco P, Pastorino C, Caorsi R, Rice G, Tesser A, Martini A, Crow Y, Candotti F, Gattorno M, Barut K, Sahin S, Adrovic A, Sinoplu AB, Yucel G, Pamuk G, Kasapcopur O, Damian LO, Lazea C, Sparchez M, Vele P, Muntean L, Albu A, Rednic S, Lazar C, Mendonça LO, Pontillo A, Kalil J, Castro FM, Barros MT, Pardeo M, Messia V, De Benedetti F, Insalaco A, Malighetti G, Gorio C, Ricci F, Parissenti I, Montesano P, Bonafini B, Medeghini V, Cattalini M, Giordano L, Zani G, Ferraro R, Vairo D, Giliani S, Cattalini M, Maggio MC, Luppino G, Corsello G, Fernandez MIG, Montesinos BL, Vidal AR, Gorospe JIA, Penades IC, Rafiq NK, Wynne K, Hussain K, Brogan PA, Ang E, Ng N, Kacar A, Gucenmez OA, Makay B, Unsal SE, Sahin Y, Barut K, Kutlu T, Cullu-Cokugras F, Sahin S, Adrovic A, Ayyildiz-Civan H, Kasapcopur O, Erkan T, Abdawani R, Al Zuhbi S, Abdalla E, Russo RA, Katsicas MM, Caorsi R, Minoia F, Viglizzo G, Grossi A, Chiesa S, Picco P, Ravelli A, Gattorno M, Bhattad S, Rawat A, Gupta A, Suri D, Pandiarajan V, Nada R, Tiewsoh K, Hawkins P, Rowczenio D, Singh S, Fingerhutova S, Franova J, Prochazkova L, Hlavackova E, Dolezalova P, Evrengül H, Yüksel S, Doğan M, Gürses D, Evrengül H, De Pauli S, Pastore S, Bianco AM, Severini GM, Taddio A, Tommasini A, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Salugina SO, Fedorov E, Kamenets E, Zaharova E, Kaleda M, Sleptsova T, Alexeeva E, Savostyanov K, Pushkov A, Bzarova T, Valieva S, Denisova R, Isayeva K, Chistyakova E, Lomakina O, Soloshenko M, Kaschenko E, Kaneko U, Imai C, Saitoh A, Teixeira VA, Ramos FO, Costa M, Aviel YB, Fahoum S, Brik R, Özçakar ZB, Çakar N, Uncu N, Celikel BA, Yalcinkaya F, Schiappapietra B, Davi’ S, Mongini F, Giannone L, Bava C, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Lazarevic DS, Vojinovic J, Susic G, Basic J, Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Alongi A, Civino A, Quartulli L, Consolaro A, Martini A, Ravelli A, Januskeviciute G, van Dijkhuizen P, Muratore V, Giancane G, Schiappapietra B, Martini A, Ravelli A, Consolaro A, Groot N, van Dijk W, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Groot N, Kardolus A, Bultink IEM, Bijl M, Dolhain RJEM, Teng YKO, Zirkzee E, de Leeuw K, Fritsch-Stork R, Kamphuis SSM, Suárez RG, Nordal EB, Rypdal VG, Berntson L, Ekelund M, Aalto K, Peltoniemi S, Zak M, Nielsen S, Glerup M, Herlin T, Arnstad ED, Fasth A, Rygg M, Duarte AC, Sousa S, Teixeira L, Cordeiro A, Santos MJ, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Mourão AF, Santos MJ, Eusébio M, Lopes A, Oliveira-Ramos F, Salgado M, Estanqueiro P, Melo-Gomes J, Martins F, Costa J, Furtado C, Figueira R, Brito I, Branco JC, Fonseca JE, Canhão H, Coda A, Cassidy S, West K, Hendry G, Grech D, Jones J, Hawke F, Grewal DS, Coda A, Jones J, Grech D, Grewal DS, Foley C, Killeen O, MacDermott E, Veale D, Fearon U, Konukbay D, Demirkaya E, Tarakci E, Arman N, Barut K, Şahin S, Adrovic A, Kasapcopur O, Munro J, Consolaro A, Morgan E, Riebschleger M, Horonjeff J, Strand V, Bingham C, Collante MTM, Ganeva M, Stefanov S, Telcharova A, Mihaylova D, Saraeva R, Tzveova R, Kaneva R, Tsakova A, Temelkova K, Picarelli MMC, Danzmann LC, Barbé-Tuana F, Grun LK, Jones MH, Frković M, Ištuk K, Birkić I, Sršen S, Jelušić M, Smith N, Jandial S, Easton A, Quarmby R, Khubchandani R, Chan M, Rapley T, Foster H, Srp R, Kobrova K, Franova J, Fingerhutova S, Nemcova D, Hoza J, Uher M, Saifridova M, Linkova L, Dolezalova P, Charuvanij S, Leelayuwattanakul I, Pacharapakornpong T, Vallipakorn SAO, Lerkvaleekul B, Vilaiyuk S, Muratore V, Giancane G, Lanni S, Alongi A, Alpigiani MG, Martini A, Ravelli A, Consolaro A, Alongi A, Bovis F, Minoia F, Davì S, Martini A, Ruperto N, Cron RQ, Ravelli A, Passarelli C, Pardeo M, Pisaneschi E, Novelli A, De Benedetti F, Bracaglia C, Bracaglia C, Marafon DP, Caiello I, de Graaf K, Guilhot F, Ferlin W, Davi’ S, Schulert G, Ravelli A, Grom AA, Nelson R, de Min C, De Benedetti F, Holzinger D, Kessel C, Fall N, Grom A, de Jager W, Vastert S, Strippoli R, Bracaglia C, Sundberg E, Horne A, Ehl S, Ammann S, Lehmberg K, De Benedetti F, Beutel K, Foell D, Minoia F, Horne A, Bovis F, Davì S, Pagani L, Espada G, Gao YJ, Insalaco A, Lehmberg K, Sanner H, Shenoi S, Weitzman S, Ruperto N, Martini A, Cron RQ, Ravelli A, Prencipe G, Caiello I, Pascarella A, Bracaglia C, Ferlin WG, Chatel L, Strippoli R, de Min C, De Benedetti F, Jacqmin P, De Graaf K, Ballabio M, Nelson R, Johnson Z, Ferlin W, Lapeyre G, de Benedetti F, Cristina DM, Wakiguchi H, Hasegawa S, Hirano R, Okazaki F, Nakamura T, Kaneyasu H, Ohga S, Yamazaki K, Nozawa T, Kanetaka T, Ito S, Yokota S, McLellan K, MacGregor I, Martin N, Davidson J, Kuemmerle-Deschner J, Hansmann S, Wulffraat N, Eikelberg A, Haug I, Schuller S, Benseler SM, Nazarova LS, Danilko KV, Malievsky VA, Viktorova TV, Mauro A, Omoyinmi E, Barnicoat A, Brogan P, Foley C, Killeen O, MacDermott E, Veale D, Foley C, Killeen O, MacDermott E, Veale D, Gomes SM, Omoyinmi E, Hurst J, Canham N, Eleftheriou D, Klein N, Lacassagne S, Brogan P, Wiener A, Hügle B, Denecke B, Costa-Filho I, Haas JP, Tenbrock K, Popp D, Boltjes A, Rühle F, Herresthal S, de Jager W, van Wijk F, Schultze J, Stoll M, Klotz L, Vogl T, Roth J, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Sánchez AMM, Borrell RP, Barril SM, Gallo MM, Caballero CM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Chyzheuskaya I, Byelyaeva LM, Filonovich RM, Khrustaleva HK, Zajtseva LI, Yuraga TM, Giner T, Hackl L, Albrecht J, Würzner R, Brunner J, Pastore S, Minute M, Parentin F, Tesser A, Nocerino A, Taddio A, Tommasini A, Nørgaard M, Herlin T, Alberdi-Saugstrup M, Zak MS, Nielsen SM, Herlin T, Nordal E, Berntson L, Fasth A, Rygg M, Müller KG, Avramovič MZ, Dolžan V, Toplak N, Avčin T, Ruperto N, Lovell DJ, Wallace C, Toth M. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part two. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461533 DOI: 10.1186/s12969-017-0142-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mori M, Sugiyama N, Morishima Y, Sugiyama N, Kokubo T, Takei S, Yokota S. Safety and effectiveness of etanercept for treatment of juvenile idiopathic arthritis: Results from a postmarketing surveillance. Mod Rheumatol 2017; 28:101-107. [PMID: 28448193 DOI: 10.1080/14397595.2017.1310704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objectives of this surveillance were to determine safety and effectiveness of etanercept in patients with juvenile idiopathic arthritis (JIA). METHODS In this postmarketing surveillance, patients aged 5-16 years with active polyarthritis JIA were treated with etanercept at the doses approved in the Japanese package insert. The occurrence and seriousness of adverse events (AEs) were assessed using the Japanese Medical Dictionary for Regulatory Activities version 15.1. Effectiveness was determined as the improvement from baseline in disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate (ESR), remission, and physician's assessment of overall improvement. The number of responders was expressed as a percentage. The last observation carried forward method was used to impute missing data. RESULTS Safety analysis included 102 patients; 22 patients experienced 36 treatment-related AEs, three of which were unexpected. None of the AEs were deemed to need special safety warnings. Effectiveness analysis included 87 patients. At 24 weeks, 29/46 (63.0%) patients demonstrated either good or moderate response in DAS28-4/ESR and treatment was assessed to be markedly effective or effective by physicians in 79/83 (95.2%) patients. CONCLUSIONS These data are consistent with earlier reports showing that etanercept was effective and demonstrated no safety signals in patients with JIA.
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Affiliation(s)
- Masaaki Mori
- a Department of Lifetime Clinical Immunology , Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan
| | | | | | | | | | - Syuji Takei
- c Department of Maternal and Child Health Nursing , School of Health Sciences, Faculty of Medicine, Kagoshima University , Kagoshima , Japan
| | - Shumpei Yokota
- d Fuji Toranomon Orthopedics Hospital , Shizuoka , Japan
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Takeuchi H, Taki Y, Hashizume H, Asano K, Asano M, Sassa Y, Yokota S, Kotozaki Y, Nouchi R, Kawashima R. Impact of videogame play on the brain's microstructural properties: cross-sectional and longitudinal analyses. Mol Psychiatry 2016; 21:1781-1789. [PMID: 26728566 PMCID: PMC5116480 DOI: 10.1038/mp.2015.193] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 10/08/2015] [Accepted: 10/21/2015] [Indexed: 11/17/2022]
Abstract
Videogame play (VGP) has been associated with numerous preferred and non-preferred effects. However, the effects of VGP on the development of microstructural properties in children, particularly those associated with negative psychological consequences of VGP, have not been identified to date. The purpose of this study was to investigate this issue through cross-sectional and longitudinal prospective analyses. In the present study of humans, we used the diffusion tensor imaging mean diffusivity (MD) measurement to measure microstructural properties and examined cross-sectional correlations with the amount of VGP in 114 boys and 126 girls. We also assessed correlations between the amount of VGP and longitudinal changes in MD that developed after 3.0±0.3 (s.d.) years in 95 boys and 94 girls. After correcting for confounding factors, we found that the amount of VGP was associated with increased MD in the left middle, inferior and orbital frontal cortex; left pallidum; left putamen; left hippocampus; left caudate; right putamen; right insula; and thalamus in both cross-sectional and longitudinal analyses. Regardless of intelligence quotient type, higher MD in the areas of the left thalamus, left hippocampus, left putamen, left insula and left Heschl gyrus was associated with lower intelligence. We also confirmed an association between the amount of VGP and decreased verbal intelligence in both cross-sectional and longitudinal analyses. In conclusion, increased VGP is directly or indirectly associated with delayed development of the microstructure in extensive brain regions and verbal intelligence.
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Affiliation(s)
- H Takeuchi
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan,Division of Developmental Cognitive Neuroscience, Institute of Development, Ageing and Cancer, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai 980-8575, Japan. E-mail:
| | - Y Taki
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan,Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan,Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - H Hashizume
- Research Administration Office, Kyoto University, Kyoto, Japan
| | - K Asano
- Department of Neurology, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - M Asano
- Department of Child and Adolescent Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Y Sassa
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - S Yokota
- Division of Developmental Cognitive Neuroscience, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Y Kotozaki
- Division of Clinical Research, Medical-Industry Translational Research Center, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - R Nouchi
- Human and Social Response Research Division, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - R Kawashima
- Division of Medical Neuroimaging Analysis, Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan,Department of Functional Brain Imaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan,Smart Ageing International Research Centre, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
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43
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Aratani S, Fujita H, Kuroiwa Y, Usui C, Yokota S, Nakamura I, Nishioka K, Nakajima T. Murine hypothalamic destruction with vascular cell apoptosis subsequent to combined administration of human papilloma virus vaccine and pertussis toxin. Sci Rep 2016; 6:36943. [PMID: 27833142 PMCID: PMC5105142 DOI: 10.1038/srep36943] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/24/2016] [Indexed: 12/29/2022] Open
Abstract
Vaccination is the most powerful way to prevent human beings from contracting infectious diseases including viruses. In the case of the human papillomavirus (HPV) vaccine, an unexpectedly novel disease entity, HPV vaccination associated neuro-immunopathetic syndrome (HANS), has been reported and remains to be carefully verified. To elucidate the mechanism of HANS, we applied a strategy similar to the active experimental autoimmune encephalitis (EAE) model - one of the most popular animal models used to induce maximum immunological change in the central nervous system. Surprisingly, mice vaccinated with pertussis toxin showed neurological phenotypes that include low responsiveness of the tail reflex and locomotive mobility. Pathological analyses revealed the damage to the hypothalamus and circumventricular regions around the third ventricle, and these regions contained apoptotic vascular endothelial cells. These data suggested that HPV-vaccinated donners that are susceptible to the HPV vaccine might develop HANS under certain environmental factors. These results will give us the new insight into the murine pathological model of HANS and help us to find a way to treat of patients suffering from HANS.
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Affiliation(s)
- Satoko Aratani
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Physician, Student and Researcher Support Center, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hidetoshi Fujita
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yoshiyuki Kuroiwa
- Department of Neurology and Stroke Center, Mizonokuchi Hospital, Teikyo University School of Medicine, Kawasaki, Japan
| | - Chie Usui
- Department of Psychiatry, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Shumpei Yokota
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Ikuro Nakamura
- Japan Medical Research Foundation, Chiyoda-ku, Tokyo, Japan
| | - Kusuki Nishioka
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Toshihiro Nakajima
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.,Integrated Gene Editing Section (iGES), Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
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Affiliation(s)
- Takako Miyamae
- 1 Institute of Rheumatology, Tokyo Women's Medical University , Tokyo, Japan
| | - Jintaro Isozaki
- 2 Department of Pediatric Psychology, Yokohama City University , Yokohama, Japan
| | - Masako Kikuchi
- 3 Department of Pediatrics, Yokohama City University , Yokohama, Japan
| | - Shumpei Yokota
- 3 Department of Pediatrics, Yokohama City University , Yokohama, Japan
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Sato A, Kikuchi N, Yokota S. Inadequate sociomedical evaluation of possible abusive head trauma in Yokohama. Pediatr Int 2016; 58:445-9. [PMID: 26513132 DOI: 10.1111/ped.12840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 09/11/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND There have been no previous studies on the adequacy of combined evaluation of possible abusive head trauma cases by frontline medical personnel, hospital-based child protection teams, and child protective services in local districts of Japan. METHODS We conducted a questionnaire survey of hospitalized patients under 24 months old with a diagnosis of intracranial hemorrhage (ICH) from January 2011 to December 2013. Eleven large-scale general hospitals in Yokohama, Japan were surveyed, which provide centralized inpatient care to moderately-severely ill children. RESULTS A total of 51 ICH patients were listed from eight hospitals. Median patient age was 7 months, and 84% were younger than 12 months. The most common diagnosis on computed tomography was subdural hematoma (n = 26; 51%). Of a total of 51 cases, 31 (61%) occurred inside the home; the injury scene was unknown in six cases (12%). We reviewed these 37 cases from the viewpoint of evaluation with concern for suspected child abuse. Three out of 37 patients (8%) were not examined for inflicted skin lesions, and skeletal surveys and funduscopy were not conducted in 14 (38%) and 15 (41%), respectively. Thirteen out of 37 cases (35%) were not reported to hospital-based child protection teams and 22 (59%) were not reported to regional child protective services. CONCLUSION The sociomedical evaluation of possible child abuse appears to be systematically inadequate in Yokohama.
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Affiliation(s)
- Atsuo Sato
- Yokohama Medical Network for Maltreated Children, Child and Youth Bureau, Yokohama Municipal Government, Yokohama, Kanagawa, Japan.,Department of Pediatrics, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Nobuyuki Kikuchi
- Yokohama Medical Network for Maltreated Children, Child and Youth Bureau, Yokohama Municipal Government, Yokohama, Kanagawa, Japan.,Department of Pediatrics, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa, Japan
| | - Shumpei Yokota
- Yokohama Medical Network for Maltreated Children, Child and Youth Bureau, Yokohama Municipal Government, Yokohama, Kanagawa, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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46
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Nozawa T, Mori M, Nishimura K, Sakurai N, Kikuchi M, Hara R, Yokota S. Usefulness of two interferon-γ release assays for rheumatic disease. Pediatr Int 2016; 58:347-52. [PMID: 26670306 DOI: 10.1111/ped.12885] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 10/08/2015] [Accepted: 10/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the performance of two interferon-γ release assays (IGRA), QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB, for pediatric patients with rheumatic disease in Japan and to analyze the frequencies of indeterminate test results with these kits. METHODS An IGRA was performed in 108 patients <20 years old in order to exclude tuberculosis infection at the time of first application of or change of biological agents and immunosuppressants in Yokohama City University Hospital. RESULTS None of the 108 patients tested had active tuberculosis during the 50 month observation period. Indeterminate results of QFT-GIT and T-SPOT.TB tests were obtained in 9.9% and in 0% of cases, respectively. Indeterminate results were obtained significantly more frequently in patients on prednisolone >0.5 mg/kg and in patients with active underlying disease. Use of biologicals and other immunosuppressants had no effect on these measurements. CONCLUSIONS IGRA are very useful for excluding tuberculosis infection in patients with rheumatic disease before starting new immunosuppressant therapy. Furthermore, the T-SPOT.TB test was suitable for evaluating latent tuberculosis infection even under immunosuppression, when TB tests are generally hard to perform.
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Affiliation(s)
- Tomo Nozawa
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Masaaki Mori
- Department of Pediatrics, Yokohama City University Medical Center, Kanagawa, Japan
| | - Kenichi Nishimura
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Nodoka Sakurai
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Masako Kikuchi
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Ryoki Hara
- Department of Pediatrics, Yokohama City University Hospital, Kanagawa, Japan
| | - Shumpei Yokota
- Department of Pediatrics, International University of Health and Welfare Atami Hospital, Shizuoka, Japan
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Ishibashi M, Yokosuka T, Yanagimachi MD, Iwasaki F, Tsujimoto SI, Sasaki K, Takeuchi M, Tanoshima R, Kato H, Kajiwara R, Tanaka F, Goto H, Yokota S. Clinical Courses of Two Pediatric Patients with Acute Megakaryoblastic Leukemia Harboring the CBFA2T3-GLIS2 Fusion Gene. Turk J Haematol 2016; 33:331-334. [PMID: 27094503 PMCID: PMC5204189 DOI: 10.4274/tjh.2016.0008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Acute megakaryoblastic leukemia (AMKL) in children without Down syndrome (DS) has an extremely poor outcome with 3-year survival of less than 40%, whereas AMKL in children with DS has an excellent survival rate. Recently, a novel recurrent translocation involving CBFA2T3 and GLIS2 was identified in about 30% of children with non-DS AMKL, and the fusion gene was reported as a strong poor prognostic factor in pediatric AMKL. We report the difficult clinical courses of pediatric patients with AMKL harboring the CBFA2T3-GLIS2 fusion gene.
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Yanagimachi M, Ohya T, Yokosuka T, Kajiwara R, Tanaka F, Goto H, Takashima T, Morio T, Yokota S. The Potential and Limits of Hematopoietic Stem Cell Transplantation for the Treatment of Autosomal Dominant Hyper-IgE Syndrome. J Clin Immunol 2016; 36:511-6. [DOI: 10.1007/s10875-016-0278-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/29/2016] [Indexed: 12/13/2022]
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Yokota S, Itoh Y, Morio T, Origasa H, Sumitomo N, Tomobe M, Tanaka K, Minota S. Tocilizumab in systemic juvenile idiopathic arthritis in a real-world clinical setting: results from 1 year of postmarketing surveillance follow-up of 417 patients in Japan. Ann Rheum Dis 2015; 75:1654-60. [PMID: 26644233 PMCID: PMC5013079 DOI: 10.1136/annrheumdis-2015-207818] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/03/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the safety and effectiveness of tocilizumab (TCZ) in patients with systemic juvenile idiopathic arthritis (sJIA) in real-world clinical settings in Japan. METHODS Paediatric patients with sJIA initiating TCZ between April 2008 and February 2012 and those previously enrolled in clinical trials who initiated TCZ before April 2008 were enrolled in a Japanese registry surveillance programme. Safety and effectiveness parameters were collected for 52 weeks. RESULTS Of 417 patients enrolled, mean age was 11.2 years and 48.0% were female. TCZ exposure was 407.0 patient-years (PYs). Baseline corticosteroid use was higher than in clinical trials. Rates of total adverse events (AEs) and serious AEs (SAEs) were 224.3/100 PYs and 54.5/100 PYs, respectively, with SAEs higher than previously reported. The most frequent AEs and SAEs were infections and infestations (69.8/100 PYs and 18.2/100 PYs, respectively). 74 serious infections occurred in 55 patients (18.2/100 PYs); higher than previously reported. 26 macrophage activation syndrome events were reported in 24 patients (6.4/100 PYs). Fever and rash symptoms improved from baseline to week 52 (54.6% to 5.6% and 43.0% to 5.6%, respectively). At 4 weeks, 8 weeks and 52 weeks, 90.5%, 96.2% and 99.0% of patients achieved normal C reactive protein levels (<0.3 mg/dL), respectively. CONCLUSIONS These first real-world data demonstrated that TCZ was well tolerated, with acceptable safety and effectiveness in patients with sJIA. Higher incidences of SAEs and serious infections may be due to differences, such as corticosteroid use and concomitant diseases, between patient populations enrolled in previously reported clinical trials and this study.
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Affiliation(s)
- Shumpei Yokota
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Yokohama City University School of Medicine, Kanagawa, Japan
| | - Yasuhiko Itoh
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Tomohiro Morio
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hideki Origasa
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Division of Biostatistics and Clinical Epidemiology, University of Toyama School of Medicine, Toyama, Japan
| | - Naokata Sumitomo
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Saitama International Medical Center, Saitama, Japan
| | | | | | - Seiji Minota
- Chugai Tocilizumab JIA Safety Evaluation Comittee, Kanagawa, Japan Jichi Medical School, Tochigi, Japan
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50
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Kuroiwa Y, Nishioka K, Yokota S, Hirai T, Nishioka K, Fujino K, Iguchi Y. Subacute autonomic, endocrine, and cognitive disorders in Japanese girls at puberty after human papillomavirus vaccination. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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