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Hinoshita M, Abe T, Sato A, Maeda Y, Takeyoshi M. Modified ESR-based photosafety test (ESR-PT) detecting singlet oxygen and free radical formation. J Appl Toxicol 2024; 44:651-662. [PMID: 38058230 DOI: 10.1002/jat.4569] [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: 10/12/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
The electron spin resonance-based photosafety test (ESR-PT) was modified using a new parameter, photoreactivity index (PRI), to detect singlet oxygen and free radical photoproducts simultaneously. With this modification, the modified ESR-PT is expected to reduce the number of false negative results due to chemicals producing free radical photoproducts other than singlet oxygen. The assay performance of the modified ESR-PT was evaluated using 56 chemicals, including hydrophobic chemicals. When using the PRI cutoff value of 2.0 in the modified ESR-PT, the accuracy relative to photosafety reference data was 91.1%, and the applicability (100%) was better than the other non-animal photosafety test. Among the chemicals producing positive results, bithionol, fenticlor, and doxycycline HCl were considered positive based on the detection of free radical photoproducts, suggesting that these three chemicals may have phototoxic or photoallergic potential via radical reactions. Additionally, this finding demonstrated the fundamental advantage of the modified ESR-PT using ESR spectroscopy, which can detect radicals selectively and quantitatively. Accordingly, the new parameter PRI is effective for photosafety evaluations based on not only singlet oxygen but also free radical photoproducts generated from chemicals. Therefore, the modified ESR-PT has a great potential for a photosafety test method applicable to various chemicals.
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Affiliation(s)
- Masumi Hinoshita
- CERI Osaka, Chemicals Evaluation and Research Institute, Osaka, Japan
| | - Takayuki Abe
- CERI Tokyo, Chemicals Evaluation and Research Institute, Tokyo, Japan
| | - Asako Sato
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Tokyo, Japan
| | - Yosuke Maeda
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Tokyo, Japan
| | - Masahiro Takeyoshi
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute, Tokyo, Japan
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Ninomiya K, Nakaza E, Yamashiro T, Abe T, Ikematsu N, Nagama H, Kakazu K, Fukasawa M. Shaken adult syndrome due to ocean wave: an autopsy case. Forensic Sci Med Pathol 2024; 20:233-238. [PMID: 37659006 DOI: 10.1007/s12024-023-00699-y] [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] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
Severe intracranial trauma during torture or assault is reportedly caused by shaken adult syndrome. However, intracranial traumas caused by natural forces, excluding human factors and collision impact, are extremely rare. We report an autopsy case of shaken adult syndrome caused by ocean wave forces. A man in his 40s without any medical history was washed away by a wave during recreational fishing. He was found approximately 500 m away from the fishing point drifting on the ocean in a state of cardiopulmonary arrest and was confirmed dead, with no response to cardiopulmonary resuscitation, 3 h after the accident. The autopsy revealed no mechanical trauma to the entire body surface, including the head. Both lungs were inflated, and pleural effusion was observed. The brain was swollen and congested, and subarachnoid hemorrhage was observed in the interhemispheric fissure and the convexity of the parietal occipital lobe. Macroscopic and microscopic hemorrhage spots were found in the brain, and the results of the blood alcohol test and urinary toxicological screening were negative. The cause of death was determined as drowning. This case demonstrates a rare but notable mechanism of injury observed in immersed bodies.
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Affiliation(s)
- Kenji Ninomiya
- Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
| | - Eizo Nakaza
- Department of Civil Engineering and Architecture, Graduate School of Engineering and Science, University of the Ryukyus, Okinawa, Japan
| | - Tsuneo Yamashiro
- Department of Radiology, Yokohama City University, Kanagawa, Japan
| | - Takayuki Abe
- Department of Surgery, Chubu Tokusyukai Hospital, Okinawa, Japan
| | - Natsuki Ikematsu
- Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hanae Nagama
- Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kazumichi Kakazu
- Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Maki Fukasawa
- Department of Legal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Tadokoro T, Abe T, Nakano T, Kimura Y, Higaki K, Hayashidani S, Tashiro H. Response to: Adult IgA vasculitis-look for triggers. QJM 2024; 117:86. [PMID: 37756696 DOI: 10.1093/qjmed/hcad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- T Tadokoro
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - T Abe
- Department of Dermatology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - T Nakano
- Department of Rheumatology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - Y Kimura
- Department of Pathology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - K Higaki
- Department of Pathology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - S Hayashidani
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - H Tashiro
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
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Takei H, Takanashi S, Otomo K, Hanaoka H, Kikuchi J, Yamaoka K, Yoshimoto K, Abe T, Takeuchi T, Kaneko Y. Clinical and immunological effects of hydroxychloroquine in patients with active rheumatoid arthritis despite antirheumatic treatment. Mod Rheumatol 2023; 34:50-59. [PMID: 36484525 DOI: 10.1093/mr/roac153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To investigate the efficacy and safety of hydroxychloroquine (HCQ) in patients with rheumatoid arthritis (RA). METHODS Patients with active RA, despite conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), were recruited. HCQ was administered for 24 weeks, in addition to prior treatment. The primary end-point was the proportion of patients achieving American College of Rheumatology (ACR) 20 at Week 24, compared to that of a propensity score-matched historical control group. RESULTS Sixty patients were enrolled and administered HCQ. We also identified 276 patients as candidates for the historical control group. Propensity score matching yielded 46 patients in each group. The proportion of patients achieving ACR20 at Week 24 was significantly higher in the HCQ group than in the control group (54.4% vs. 28.3%, P = .007). The proportion of patients achieving ACR50 and ACR70 at Week 24 were also higher in the HCQ group than in the control group (ACR50, 30.4% vs. 4.3%, P = .006; ACR70, 17.4% vs. 0%, P = .005). Neither HCQ retinopathy nor any new safety signal was observed during the study. CONCLUSION The addition of HCQ to csDMARDs was effective, with no new safety signal in patients with RA.
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Affiliation(s)
- Hiroshi Takei
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Takanashi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kotaro Otomo
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Otomo Rheumatology Clinic, Tokyo, Japan
| | - Hironari Hanaoka
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Kikuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kunihiro Yamaoka
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, Kanagawa, Japan
| | - Keiko Yoshimoto
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- School of Data Science, Yokohama City University, Yokohama, Japan
- Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
- Saitama Medical University, Saitama, Japan
| | - Yuko Kaneko
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
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Deng L, Solichin MR, Adyaksa DNM, Septianastiti MA, Fitri RA, Suwardan GNR, Matsui C, Abe T, Shoji I. Cellular Release of Infectious Hepatitis C Virus Particles via Endosomal Pathways. Viruses 2023; 15:2430. [PMID: 38140670 PMCID: PMC10747773 DOI: 10.3390/v15122430] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Hepatitis C virus (HCV) is a positive-sense, single-stranded RNA virus that causes chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. The release of infectious HCV particles from infected hepatocytes is a crucial step in viral dissemination and disease progression. While the exact mechanisms of HCV particle release remain poorly understood, emerging evidence suggests that HCV utilizes intracellular membrane trafficking and secretory pathways. These pathways include the Golgi secretory pathway and the endosomal trafficking pathways, such as the recycling endosome pathway and the endosomal sorting complex required for transport (ESCRT)-dependent multivesicular bodies (MVBs) pathway. This review provides an overview of recent advances in understanding the release of infectious HCV particles, with a particular focus on the involvement of the host cell factors that participate in HCV particle release. By summarizing the current knowledge in this area, this review aims to contribute to a better understanding of endosomal pathways involved in the extracellular release of HCV particles and the development of novel antiviral strategies.
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Affiliation(s)
- Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
| | - Muchamad Ridotu Solichin
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Dewa Nyoman Murti Adyaksa
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Maria Alethea Septianastiti
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Rhamadianti Aulia Fitri
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
- Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Gede Ngurah Rsi Suwardan
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Bali 80361, Indonesia
| | - Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
| | - Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (L.D.); (D.N.M.A.); (M.A.S.); (T.A.)
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Naganuma M, Kobayashi T, Kunisaki R, Matsuoka K, Yamamoto S, Kawamoto A, Saito D, Nanki K, Narimatsu K, Shiga H, Esaki M, Yoshioka S, Kato S, Saruta M, Tanaka S, Yasutomi E, Yokoyama K, Moriya K, Tsuzuki Y, Ooi M, Fujiya M, Nakazawa A, Abe T, Hisamatsu T. Real-world efficacy and safety of advanced therapies in hospitalized patients with ulcerative colitis. J Gastroenterol 2023; 58:1198-1210. [PMID: 37831183 DOI: 10.1007/s00535-023-02048-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND This multicenter observational cohort study aimed to evaluate the utilization and short-term efficacy of advanced therapy (AT) in hospitalized patients with acute severe ulcerative colitis (ASUC). METHODS In total, 221 patients with ASUC were enrolled between August 2020 and July 2021. The primary endpoint was clinical remission (CR, defined as a patient-reported outcome score < 2 with no blood in the stool) rate on Day 7 and 14 in hospitalized patients who received corticosteroids (CS) and AT. RESULTS Among patients with ASUC, 120 and 101 patients received CS or any AT as first-line treatment, respectively. The CR rates on Day 7 and 14 were 22.5% and 35.0%, respectively, in hospitalized patients who received CS as first-line treatment. Most patients who used ATs had CS-dependent or frequent recurrences. Eight different ATs (apheresis, tacrolimus, infliximab, golimumab, tofacitinib, vedolizumab, ustekinumab, and cyclosporine) were used as first-line treatment in patients with ASUC, and the CR rates on Day 7 and 14 were 16.8% and 29.7%, respectively. Twenty-five patients received the second ATs after hospitalizations, and the CR rates on Day 7 and 14 were 0% and 12%, respectively. The CR rates on Day 14 were significantly higher in patients who changed to AT than in those whose dose of CS increased (34.0% vs 10.7%, p = 0.020) among patients who had already used CS before hospitalization. CONCLUSION Most first-use ATs were effective for patients with ASUC, while second-use ATs might have had limited benefits in inducing CR. These findings may contribute to considerations for the management of hospitalized patients.
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Affiliation(s)
- Makoto Naganuma
- Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan.
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Katsuyoshi Matsuoka
- Division of Gastroenterology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Shojiro Yamamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Ami Kawamoto
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Saito
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Japan
| | - Kosaku Nanki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuyuki Narimatsu
- Department of Internal Medicine, National Defence Medical University, Tokorozawa, Japan
| | - Hisashi Shiga
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Shinichiro Yoshioka
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shingo Kato
- Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Tanaka
- Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Eriko Yasutomi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kaoru Yokoyama
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kei Moriya
- Department of Gastroenterology, Nara Medical University, Kashihara, Nara, Japan
| | - Yoshikazu Tsuzuki
- Department of Gastroenterology, Saitama Medical University, Saitama, Japan
| | - Makoto Ooi
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Mikihiro Fujiya
- Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Hokkaido, Japan
| | - Atsushi Nakazawa
- Department of Gastroenterology, Saiseikai General Hospital, Tokyo, Japan
| | - Takayuki Abe
- School of Data Science, Yokohama City University, Yokohama, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
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Ariffianto A, Deng L, Abe T, Matsui C, Ito M, Ryo A, Aly HH, Watashi K, Suzuki T, Mizokami M, Matsuura Y, Shoji I. Oxidative stress sensor Keap1 recognizes HBx protein to activate the Nrf2/ARE signaling pathway, thereby inhibiting hepatitis B virus replication. J Virol 2023; 97:e0128723. [PMID: 37800948 PMCID: PMC10617466 DOI: 10.1128/jvi.01287-23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
IMPORTANCE The Kelch-like ECH-associated protein 1 (Keap1)/NF-E2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway is one of the most important defense mechanisms against oxidative stress. We previously reported that a cellular hydrogen peroxide scavenger protein, peroxiredoxin 1, a target gene of transcription factor Nrf2, acts as a novel HBV X protein (HBx)-interacting protein and negatively regulates hepatitis B virus (HBV) propagation through degradation of HBV RNA. This study further demonstrates that the Nrf2/ARE signaling pathway is activated during HBV infection, eventually leading to the suppression of HBV replication. We provide evidence suggesting that Keap1 interacts with HBx, leading to Nrf2 activation and inhibition of HBV replication via suppression of HBV core promoter activity. This study raises the possibility that activation of the Nrf2/ARE signaling pathway is a potential therapeutic strategy against HBV. Our findings may contribute to an improved understanding of the negative regulation of HBV replication by the antioxidant response.
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Affiliation(s)
- Adi Ariffianto
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiko Ito
- Department of Virology and Parasitology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akihide Ryo
- Department of Virology III, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hussein Hassan Aly
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koichi Watashi
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
- Research Center for Drug and Vaccine Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsuro Suzuki
- Department of Virology and Parasitology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masashi Mizokami
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Yoshiharu Matsuura
- Center for Infectious Disease Education and Research (CiDER), Osaka University, Osaka, Japan
- Laboratory of Virus Control, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
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Juniastuti, Utsumi T, Yamani LN, Dinana Z, Gunawan E, Maharani AT, Fitria AL, Wahyuni RM, Soetjipto, Doan YH, Shimizu H, Ishii K, Matsui C, Deng L, Abe T, Katayama K, Lusida MI, Shoji I. A household survey of intrafamily norovirus transmission. J Med Virol 2023; 95:e29164. [PMID: 37830640 DOI: 10.1002/jmv.29164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/26/2023] [Accepted: 09/30/2023] [Indexed: 10/14/2023]
Abstract
Norovirus (NoV) is a leading cause of epidemic and sporadic gastroenteritis in people of all ages. Humans are the primary source of NoV and household contact is one of the risk factors for NoV transmission. However, the mechanisms underlying person-to-person NoV transmission are poorly understood. Here we conducted a survey to profile the frequency and characteristics of intrafamily NoV transmission. Stool samples were collected every week from three households between 2016 and 2020; the total number of samples was 1105. The detection of NoV and the genotyping were performed by reverse transcription-polymerase chain reaction targeting the capsid region and direct sequencing methods. NoV was detected in 3.4% of all samples. Eight NoV genotypes were identified. The most common genotype was GII.17, followed in order by GII.6, GI.6, GII.4, GI.3, and GI.2/GI.8/GI.9. Most NoV-positive samples were obtained from asymptomatic individuals. The highest number of NoV transmissions was found in household 3 (6 infections), followed by household 2 (2 infections), while household 1 had no NoV transmission, suggesting that asymptomatic NoV carriers play a major role in infection as NoV reservoirs in the households. Further clarification of the mode of infection will contribute to improved understanding and an appropriate prevention.
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Affiliation(s)
- Juniastuti
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Medical Microbiology, School of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Clinical Microbiology Residency Program, Dr. Soetomo General Hospital, School of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Takako Utsumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Center for Infectious Diseases, Division of Infectious Disease Control, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Laura Navika Yamani
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Zayyin Dinana
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Emily Gunawan
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Aussie Tahta Maharani
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Anisa Lailatul Fitria
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Rury M Wahyuni
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Biochemistry, School of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Yen Hai Doan
- Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Shimizu
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Ishii
- Department of Quality Assurance and Radiological Protection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chieko Matsui
- Center for Infectious Diseases, Division of Infectious Disease Control, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Lin Deng
- Center for Infectious Diseases, Division of Infectious Disease Control, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Abe
- Center for Infectious Diseases, Division of Infectious Disease Control, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiko Katayama
- Laboratory of Viral Infection, Department of Infection Control and Immunology, Ōmura Satoshi Memorial Institute and Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Maria Inge Lusida
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Medical Microbiology, School of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Clinical Microbiology Residency Program, Dr. Soetomo General Hospital, School of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ikuo Shoji
- Center for Infectious Diseases, Division of Infectious Disease Control, Kobe University Graduate School of Medicine, Kobe, Japan
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Kawasaki K, Kondo T, Wakatabe M, Abe T, Orii K. [Anomalous Origin of Right Coronary Artery with Intramural Course, Aortic Valve Stenosis and Coronary Artery Stenosis:Report of a Case]. Kyobu Geka 2023; 76:945-948. [PMID: 38056953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Anomalous origin of the coronary artery is a rare congenital malformation that can cause myocardial ischemia and arrhythmia in patients with or without atherosclerotic lesions. We present a case of aortic stenosis (AS) and coronary artery stenosis complicated by anomalous origin of the right coronary artery (RCA) from the aortic valve sinus and its intramural course. The patient was a 66-year-old woman who was diagnosed with AS 4 years prior, and scheduled for surgery owing to gradual progression of stenosis. Preoperative coronary angiography revealed an abnormal origin of the RCA, and during the surgery, the RCA was found located within the aortic wall close to the aortotomy. Thus, bypass surgery was performed using a great saphenous vein, to prevent ischemia of the RCA territory. The patient had good intraoperative and postoperative course, and a coronary computed tomography scan clearly showed the reconstructed RCA.
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Affiliation(s)
- Kyohei Kawasaki
- Department of Cardiac Surgery, Saitama Prefecture Cardiovascular and Respiratory Center, Kumagaya, Japan
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10
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Tadokoro T, Abe T, Nakano T, Kimura Y, Higaki K, Hayashidani S, Tashiro H. IgA vasculitis. QJM 2023; 116:538-539. [PMID: 36912689 DOI: 10.1093/qjmed/hcad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Affiliation(s)
- T Tadokoro
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - T Abe
- Department of Dermatology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - T Nakano
- Department of Rheumatology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - Y Kimura
- Department of Pathology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - K Higaki
- Department of Pathology, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - S Hayashidani
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
| | - H Tashiro
- Department of Cardiovascular Medicine, St. Mary's Hospital, 422, Tsubukuhonmachi, Kurume, Fukuoka 830-8543, Japan
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11
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Katayama N, Nakagawa A, Umeda S, Terasawa Y, Shinagawa K, Kikuchi T, Tabuchi H, Abe T, Mimura M. Functional connectivity changes between frontopolar cortex and nucleus accumbens following cognitive behavioral therapy in major depression: A randomized clinical trial. Psychiatry Res Neuroimaging 2023; 332:111643. [PMID: 37060839 DOI: 10.1016/j.pscychresns.2023.111643] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/19/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023]
Abstract
Cognitive behavioral therapy (CBT) is a psychotherapy that challenges distorted cognitions; however, the neural mechanisms that underpin CBT remain unclear. Hence, we aimed to assess the treatment-related resting-state functional connectivity (rsFC) changes in the brain regions associated with future thinking and the associations between rsFC changes and clinical improvements. Thirty-eight adult patients with MDD were randomly assigned with equal likelihood to receive 16-week individual CBT or talking control with a 12-month follow-up period. We evaluated the rsFC changes in the frontal regions, nucleus accumbens, amygdala, and limbic structures key to the depression pathophysiology and future thinking with 2 × 2 mixed ANOVA interaction analysis. Pearson's correlation analysis with Bonferroni's correction was also performed to examine the associations with clinical symptoms, such as depression severity and automatic thoughts in follow-up evaluations. Treatment-specific changes include enhancement in frontopolar connectivity with the nucleus accumbens. An increased rsFC was associated with lower negative automatic thoughts postoperatively, together with lower depressive symptoms and higher positive automatic thoughts at follow-up. Conclusively, rsFC changes in the fronto-limbic neural control circuit after CBT, particularly between the frontal pole and nucleus accumbens, may be clinically meaningful functional changes related to the depression recovery process.
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Affiliation(s)
- Nariko Katayama
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan; Department of Neuropsychiatry, School of Medicine, St. Marianna University, Kawasaki, Japan.
| | - Satoshi Umeda
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Yuri Terasawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Kazushi Shinagawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Takayuki Abe
- Department of Neuropsychiatry, School of Medicine, St. Marianna University, Kawasaki, Japan; School of Data Science, Yokohama City University, Yokohama, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
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12
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Abe T, Marutani Y, Deng L, Matsui C, Fukasawa M, Suzuki R, Wakita T, Matsuura Y, Shoji I. Hepatitis C Virus Disrupts Annexin 5-Mediated Occludin Integrity through Downregulation of Protein Kinase Cα (PKCα) and PKCη Expression, Thereby Promoting Viral Propagation. J Virol 2023; 97:e0065523. [PMID: 37272842 PMCID: PMC10308894 DOI: 10.1128/jvi.00655-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023] Open
Abstract
Annexins (ANXs) comprise a family of calcium- and phospholipid-binding proteins and are implicated in the hepatitis C virus (HCV) life cycle. Here, we demonstrate a novel role of ANX5 in the HCV life cycle. Comparative analysis by quantitative PCR in human hepatoma cells revealed that ANX2, ANX4, and ANX5 were highly expressed among the ANX family proteins. Knockdown of ANX5 mRNA resulted in marked enhancement of HCV RNA replication but had no effect on either HCV translation or assembly. Using the HCV pseudoparticle (HCVpp) system, we observed enhancement of HCVpp infectivity in ANX5 knockdown Huh-7OK1 cells, suggesting that ANX5 is involved in suppression of HCV entry. Additionally, we observed that subcellular localizations of tight-junction proteins, such as claudin 1 (CLDN1) and occludin (OCLN), were disrupted in the ANX5 knockdown cells. It was reported that HCV infection was facilitated by disruption of OCLN distribution and that proper distribution of OCLN was regulated by its phosphorylation. Knockdown of ANX5 resulted in a decrease of OCLN phosphorylation, thereby disrupting OCLN distribution and HCV infection. Further analysis revealed that protein kinase C (PKC) isoforms, including PKCα and PKCη, play important roles in the regulation of ANX5-mediated phosphorylation and distribution of OCLN and in the restriction of HCV infection. HCV infection reduced OCLN phosphorylation through the downregulation of PKCα and PKCη expression. Taken together, these results suggest that ANX5, PKCα, and PKCη contribute to restriction of HCV infection by regulating OCLN integrity. We propose a model that HCV disrupts ANX5-mediated OCLN integrity through downregulation of PKCα and PKCη expression, thereby promoting HCV propagation. IMPORTANCE Host cells have evolved host defense machinery to restrict viral infection. However, viruses have evolved counteracting strategies to achieve their infection. In the present study, we obtained results suggesting that ANX5 and PKC isoforms, including PKCα and PKCη, contribute to suppression of HCV infection by regulating the integrity of OCLN. The disruption of OCLN integrity increased HCV infection. We also found that HCV disrupts ANX5-mediated OCLN integrity through downregulation of PKCα and PKCη expression, thereby promoting viral infection. We propose that HCV disrupts ANX5-mediated OCLN integrity to establish a persistent infection. The disruption of tight-junction assembly may play important roles in the progression of HCV-related liver diseases.
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Affiliation(s)
- Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Marutani
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayoshi Fukasawa
- Department of Biochemistry and Cell Biology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ryosuke Suzuki
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takaji Wakita
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshiharu Matsuura
- Center for Infectious Diseases Education and Research (CiDER), Osaka University, Osaka, Japan
- Laboratory of Virus Control, Research Institute for Microbial Diseases (RIMD), Osaka University, Osaka, Japan
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
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13
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Gokon Y, Ohki Y, Ogino T, Hatoyama K, Oikawa T, Shimizu K, Katsura K, Abe T, Sato K. Manual reduction for incarcerated obturator hernia. Sci Rep 2023; 13:5504. [PMID: 37015958 PMCID: PMC10073174 DOI: 10.1038/s41598-023-31634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/15/2023] [Indexed: 04/06/2023] Open
Abstract
Emergent surgery is a common approach for incarcerated obturator hernias, with high morbidity and mortality rates. Moreover, there have been reports of elective surgery cases after noninvasive manual reduction. For a decade, the initial approach in our institution is also manual reduction unless bowel viability is poor. This study aimed to clarify the efficacy and safety of manual reduction followed by elective surgery. We retrospectively reviewed 50 cases of incarcerated obturator hernia from 2010 to 2022 at Iwate Prefectural Iwai Hospital. Manual reduction was attempted in 31 (62%) patients. The reduction was successful in 21 (42%) patients, and most of them received mesh repair using the extraperitoneal approach as elective surgery. However, two patients underwent emergent surgery in the waiting period because of late-onset constriction and a small bowel perforation. Patients with irreducible hernia underwent emergent surgery, except for two patients who received the best supportive care. Postoperative complications were observed in 5% and 22% of reducible and irreducible cases, respectively. Postoperative mortality was zero in both groups. Manual reduction is useful in some cases, but careful observation is needed because late-onset constriction and perforation could occur.
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Affiliation(s)
- Yusuke Gokon
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan.
| | - Yusuke Ohki
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Takahiro Ogino
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Keiichiro Hatoyama
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Takahiro Oikawa
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Kenji Shimizu
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Kazunori Katsura
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Takayuki Abe
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
| | - Koichiro Sato
- Department of Surgery, Iwate Prefectural Iwai Hospital, 17 Odaira, Kozenji, Ichinoseki, 029-0131, Japan
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14
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Yamani LN, Utsumi T, Doan YH, Fujii Y, Dinana Z, Wahyuni RM, Gunawan E, Soegijanto S, Athiyyah AF, Sudarmo SM, Ranuh RG, Darma A, Soetjipto, Juniastuti, Bawono RG, Matsui C, Deng L, Abe T, Shimizu H, Ishii K, Katayama K, Lusida MI, Shoji I. Complete genome analyses of G12P[8] rotavirus strains from hospitalized children in Surabaya, Indonesia, 2017-2018. J Med Virol 2023; 95:e28485. [PMID: 36625390 DOI: 10.1002/jmv.28485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Rotavirus A (RVA) is a major viral cause of acute gastroenteritis (AGE) worldwide. G12 RVA strains have emerged globally since 2007. There has been no report of the whole genome sequences of G12 RVAs in Indonesia. We performed the complete genome analysis by the next-generation sequencing of five G12 strains from hospitalized children with AGE in Surabaya from 2017 to 2018. All five G12 strains were Wa-like strains (G12-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1) and were clustered into lineage-III of VP7 gene phylogenetic tree. STM430 sample was observed as a mixed-infection between G12 and G1 strains: G12/G1-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. A phylogenetic tree analysis revealed that all five Indonesian G12 strains (SOEP379, STM371, STM413, STM430, and STM433) were genetically close to each other in all 11 genome segments with 98.0%-100% nucleotide identities, except VP3 and NSP4 of STM430, suggesting that these strains have originated from a similar ancestral G12 RVA. The VP3 and NSP4 genome segments of STM430-G12P[8] were separated phylogenetically from those of the other four G12 strains, probably due to intra-genotype reassortment between the G12 and G1 Wa-like strains. The change from G12P[6] lineage-II in 2007 to G12P[8] lineage-III 2017-2018 suggests the evolution and diversity of G12 RVAs in Indonesia over the past approximately 10 years.
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Affiliation(s)
- Laura Navika Yamani
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Viral Diarrhea, Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Takako Utsumi
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yen Hai Doan
- Laboratory VIII, Center for Emergency Preparedness and Response, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshiki Fujii
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Zayyin Dinana
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Viral Diarrhea, Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Rury Mega Wahyuni
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Emily Gunawan
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Soegeng Soegijanto
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Alpha Fardah Athiyyah
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Child Health, Soetomo Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Subijanto Marto Sudarmo
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Child Health, Soetomo Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Reza Gunadi Ranuh
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Child Health, Soetomo Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Andy Darma
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Department of Child Health, Soetomo Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Soetjipto
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Viral Diarrhea, Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Juniastuti
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Viral Diarrhea, Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Rheza Gandi Bawono
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Hiroyuki Shimizu
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Koji Ishii
- Department of Quality Assurance and Radiological Protection, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhiko Katayama
- Laboratory of Viral Infection I, Department of Infection Control and Immunology, Ōmura Satoshi Memorial Institute, Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Maria Inge Lusida
- Laboratory of Viral Diarrhea, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Laboratory of Viral Diarrhea, Research Center on Global Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
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15
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Maekawa S, Johnson T, Fujita M, Takata R, Ikarashi D, Matsuura T, Kato R, Kanehira M, Sugimura J, Abe T, Nakagawa H, Obara W. Genomic features of renal cell carcinoma developed during end-stage renal disease and dialysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01082-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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16
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Yamagami J, Kurihara Y, Funakoshi T, Saito Y, Tanaka R, Takahashi H, Ujiie H, Iwata H, Hirai Y, Iwatsuki K, Ishii N, Sakurai J, Abe T, Takemura R, Mashino N, Abe M, Amagai M. Rituximab therapy for intractable pemphigus: A multicenter, open-label, single-arm, prospective study of 20 Japanese patients. J Dermatol 2023; 50:175-182. [PMID: 36196051 PMCID: PMC10091989 DOI: 10.1111/1346-8138.16597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/14/2022] [Accepted: 09/18/2022] [Indexed: 02/04/2023]
Abstract
This was a multicenter clinical trial of rituximab, a chimeric monoclonal IgG antibody directed against CD20, for the treatment of refractory pemphigus vulgaris and pemphigus foliaceus. In total, 20 patients were treated with two doses of rituximab (1000 mg; 2 weeks apart) on days 0 and 14. The primary end point was the proportion of patients who achieved complete or partial remission on day 168 following the first rituximab dose. Of the 20 enrolled patients, 11 (55%) and four (20%) achieved complete and partial remission, respectively; therefore, remission was achieved in a total of 15 patients (75.0% [95% confidence interval, 50.9%-91.3%]). It was demonstrated that the remission rate was greater than the prespecified threshold (5%). In addition, a significant improvement in clinical score (Pemphigus Disease Area Index) and decrease in serum anti-desmoglein antibody level were observed over time. Four serious adverse events (heart failure, pneumonia, radial fracture, and osteonecrosis) were recorded in two patients, of which only pneumonia was considered causally related with rituximab. The level of peripheral blood CD19-positive B lymphocytes was decreased on day 28 after rituximab treatment and remained low throughout the study period until day 168. Our results confirm the efficacy and safety of rituximab therapy for refractory pemphigus in Japanese patients.
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Affiliation(s)
- Jun Yamagami
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.,Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuichi Kurihara
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Takeru Funakoshi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuko Saito
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Tanaka
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hayato Takahashi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroaki Iwata
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yoji Hirai
- Department of Dermatology, Okayama University School of Medicine, Okayama, Japan
| | - Keiji Iwatsuki
- Department of Dermatology, Okayama University School of Medicine, Okayama, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Kurume, Japan
| | - Jun Sakurai
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Takayuki Abe
- Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan.,Yokohama City University School of Data Science, Yokohama, Japan
| | - Ryo Takemura
- Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan
| | - Naomi Mashino
- Prescription Products Development Department, Zenyaku Kogyo Co., Ltd., Tokyo, Japan
| | - Masahiro Abe
- Prescription Products Development Department, Zenyaku Kogyo Co., Ltd., Tokyo, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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17
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Kitago M, Seino S, Shinkai S, Nofuji Y, Yokoyama Y, Toshiki H, Abe T, Taniguchi Y, Amano H, Murayama H, Kitamura A, Akishita M, Fujiwara Y. Cross-Sectional and Longitudinal Associations of Creatinine-to-Cystatin C Ratio with Sarcopenia Parameters in Older Adults. J Nutr Health Aging 2023; 27:946-952. [PMID: 37997714 DOI: 10.1007/s12603-023-2029-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/04/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Accumulating evidence from cross-sectional studies suggests that the serum creatinine-to-cystatin C ratio (CCR) may be a useful biomarker for sarcopenia. This study aimed to assess the cross-sectional and longitudinal associations of CCR with sarcopenia and its parameters in community-dwelling older adults. DESIGN Cross-sectional and longitudinal study. SETTING AND PARTICIPANTS This 6-year prospective cohort study included the repeated measurement data from 1,253 Japanese residents (662 males and 591 females) aged ≥65 years who underwent medical checkups in Kusatsu and Hatoyama, Japan. A total of 4,421 observations were collected. MEASUREMENTS The CCR was grouped into quartiles by sex (Q1-Q4) using Q4 as the reference category. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 algorithm. Skeletal muscle mass index (SMI) measured using segmental multifrequency bioelectrical impedance analysis, handgrip strength (HGS), usual gait speed (UGS), and maximal gait speed (MGS) were measured repeatedly as sarcopenia parameters. The association of the CCR with changes in sarcopenia, SMI, HGS, UGS, and MGS during the 6-year period were analyzed using a generalized linear mixed-effects model. RESULTS The prevalence of sarcopenia at baseline was 13.1% (11.9% in males and 14.5% in females). In a cross-sectional analysis, the CCR quartile was inversely associated with sarcopenia and was positively associated with SMI, HGS, and MGS (P for trend < 0.001). In a longitudinal analysis during the 6 years, a significant increase in sarcopenia in Q2 (B = 1.1% point/year; P = 0.026 for group-by-time interaction) and significant declines in SMI (B = -0.01 kg/m2/year; P = 0.044 for group-by-time interaction) and MGS (B = -0.008 m/sec/year; P = 0.041 for group-by-time interaction) in Q1 were observed compared with Q4. However, the dose-response relationship was significant only for MGS (P = 0.033 for trend). No significant group-by-time interaction was observed for HGS. CCR was not significantly associated with UGS either cross-sectionally or longitudinally. CONCLUSIONS CCR is a useful biomarker regarding the status of sarcopenia. It may be used for sarcopenia screening even in older adults whose physical function is difficult to assess. However, further longitudinal studies are needed to determine whether CCR can be a predictor of future sarcopenia.
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Affiliation(s)
- M Kitago
- Yoshinori Fujiwara, MD, PhD, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan, Phone: +81-3-3964-3241, E-mail:
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Amano M, Katayama N, Umeda S, Terasawa Y, Tabuchi H, Kikuchi T, Abe T, Mimura M, Nakagawa A. The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial. Front Psychiatry 2023; 14:997154. [PMID: 36761867 PMCID: PMC9905738 DOI: 10.3389/fpsyt.2023.997154] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Pessimistic thinking about the future is one of the cardinal symptoms of major depression. Few studies have assessed changes in pessimistic thinking after undergoing cognitive behavioral therapy (CBT). A randomized clinical trial (RCT) was conducted with patients diagnosed with major depressive disorder (MDD) to determine whether receiving a course of CBT affects pessimistic future thinking using a future thinking task. METHODS Thirty-one patients with MDD were randomly assigned to either CBT (n = 16) or a talking control (TC) (n = 15) for a 16-week intervention. The main outcomes were the change in response time (RT) and the ratio of the responses for positive valence, measured by the future thinking task. Secondary outcomes included the GRID-Hamilton Depression Rating Scale, the Beck Depression Inventory-Second Edition (BDI-II), the Dysfunctional Attitude Scale (DAS), and the word fluency test (WFT). RESULTS Regarding the main outcomes, the CBT group showed reduced RT for the positive valence (within-group Cohen's d = 0.7, p = 0.012) and negative valence (within-group Cohen's d = 0.6, p = 0.03) in the distant future condition. The ratio of positive valence responses in both groups for all temporal conditions except for the distant past condition increased within group (distant future: CBT: Cohen's d = 0.5, p = 0.04; TC: Cohen's d = 0.8, p = 0.008; near future: CBT: Cohen's d = 1.0, p < 0.001; TC: Cohen's d = 1.1, p = 0.001; near past: CBT: Cohen's d = 0.8, p = 0.005; TC: Cohen's d = 1.0, p = 0.002). As for secondary outcomes, the CBT group showed greater improvement than the TC group regarding the need for social approval as measured by the DAS (p = 0.012). CONCLUSION Patients with MDD who received CBT showed a reduced RT for the positive and negative valence in the distant future condition. RT in the future thinking task for depressed patients may be a potential objective measure for the CBT treatment process. Because the present RCT is positioned as a pilot RCT, a confirmatory trial with a larger number of patients is warranted to elucidate the CBT treatment process that influences future thinking. CLINICAL TRIAL REGISTRATION https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000021028, identifier UMIN000018155.
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Affiliation(s)
- Mizuki Amano
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Nariko Katayama
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Umeda
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Yuri Terasawa
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- Graduate School of Data Science, Yokohama City University, Yokohama, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan
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Yamada Y, Yamada M, Chubachi S, Yokoyama Y, Matsuoka S, Tanabe A, Niijima Y, Murata M, Abe T, Fukunaga K, Jinzaki M. Comparison of inspiratory and expiratory airway volumes and luminal areas among standing, sitting, and supine positions using upright and conventional CT. Sci Rep 2022; 12:21315. [PMID: 36494466 PMCID: PMC9734674 DOI: 10.1038/s41598-022-25865-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Upright computed tomography (CT) provides physiologically relevant images of daily life postures (sitting and standing). The volume of the human airway in sitting or standing positions remains unclear, and no clinical study to date has compared the inspiratory and expiratory airway volumes and luminal areas among standing, sitting, and supine positions. In this prospective study, 100 asymptomatic volunteers underwent both upright (sitting and standing positions) and conventional (supine position) CT during inspiration and expiration breath-holds and the pulmonary function test (PFT) within 2 h of CT. We compared the inspiratory/expiratory airway volumes and luminal areas on CT among the three positions and evaluated the correlation between airway volumes in each position on CT and PFT measurements. The inspiratory and expiratory airway volumes were significantly higher in the sitting and standing positions than in the supine position (inspiratory, 4.6% and 2.5% increase, respectively; expiratory, 14.9% and 13.4% increase, respectively; all P < 0.001). The inspiratory and expiratory luminal areas of the trachea, bilateral main bronchi, and average third-generation airway were significantly higher in the sitting and standing positions than in the supine position (inspiratory, 4.2‒10.3% increases, all P < 0.001; expiratory, 6.4‒12.8% increases, all P < 0.0001). These results could provide important clues regarding the pathogenesis of orthopnea. Spearman's correlation coefficients between the inspiratory airway volume on CT and forced vital capacity and forced expiratory volume in 1 s on PFT were numerically higher in the standing position than in the supine position (0.673 vs. 0.659 and 0.669 vs. 0.643, respectively); however, no statistically significant differences were found. Thus, the airway volumes on upright and conventional supine CT were moderately correlated with the PFT measurements.
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Affiliation(s)
- Yoshitake Yamada
- grid.26091.3c0000 0004 1936 9959Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Minoru Yamada
- grid.26091.3c0000 0004 1936 9959Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Shotaro Chubachi
- grid.26091.3c0000 0004 1936 9959Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Yoichi Yokoyama
- grid.26091.3c0000 0004 1936 9959Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Shiho Matsuoka
- grid.412096.80000 0001 0633 2119Department of Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Akiko Tanabe
- grid.412096.80000 0001 0633 2119Department of Clinical Laboratory, Keio University Hospital, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Yuki Niijima
- grid.412096.80000 0001 0633 2119Office of Radiation Technology, Keio University Hospital, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Mitsuru Murata
- grid.26091.3c0000 0004 1936 9959Department of Laboratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Takayuki Abe
- grid.268441.d0000 0001 1033 6139School of Data Science, Yokohama City University, 22-2 Seto, Kanazawa-Ku, Yokohama, Kanagawa 236-0027 Japan ,grid.26091.3c0000 0004 1936 9959Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Koichi Fukunaga
- grid.26091.3c0000 0004 1936 9959Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
| | - Masahiro Jinzaki
- grid.26091.3c0000 0004 1936 9959Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582 Japan
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Kishihara Y, Yasuda H, Moriya T, Kashiura M, Koike M, Kotani Y, Kondo N, Sekine K, Shime N, Morikane K, Abe T. A study of the risk factors for phlebitis in patients stratified using the acute physiology and chronic health evaluation II score and admitted to the intensive care unit: A post hoc analysis of the AMOR-VENUS study. Front Med (Lausanne) 2022; 9:965706. [PMID: 36544499 PMCID: PMC9760669 DOI: 10.3389/fmed.2022.965706] [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: 06/10/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Peripheral intravascular catheters (PIVCs) are inserted in most patients admitted to the intensive care unit (ICU). Previous research has discussed various risk factors for phlebitis, which is one of the complications of PIVCs. However, previous studies have not investigated the risk factors based on the patient's severity of illness, such as the Acute Physiology and Chronic Health Evaluation (APACHE) II score. Different treatments can be used based on the relationship of risk factors to the illness severity to avoid phlebitis. Therefore, in this study, we investigate whether the risk factors for phlebitis vary depending on the APACHE II score. Materials and methods This study was a post hoc analysis of the AMOR-VENUS study involving 23 ICUs in Japan. We included patients with age ≥ 18 years and consecutive admissions to the ICU with PIVCs inserted during ICU admission. The primary outcome was phlebitis, and the objective was the identification of the risk factors evaluated by hazard ratio (HR) and 95% confidence interval (CI). The cut-off value of the APACHE II score was set as ≤15 (group 1), 16-25 (group 2), and ≥26 (group 3). Multivariable marginal Cox regression analysis was performed for each group using the presumed risk factors. Results A total of 1,251 patients and 3,267 PIVCs were analyzed. Multivariable marginal Cox regression analysis reveals that there were statistically significant differences among the following variables evaluated HR (95%CI): (i) in group 1, standardized drug administration measures (HR, 0.4 [0.17-0.9]; p = 0.03) and nicardipine administration (HR, 2.25 [1.35-3.75]; p < 0.01); (ii) in group 2, insertion in the upper arm using the forearm as a reference (HR, 0.41 [0.2-0.83]; p = 0.01), specified polyurethane catheter using polyurethane as a reference (HR, 0.56 [0.34-0.92]; p = 0.02), nicardipine (HR, 1.9 [1.16-3.12]; p = 0.01), and noradrenaline administration (HR, 3.0 [1.52-5.88]; p < 0.01); (iii) in group 3, noradrenaline administration (HR, 3.39 [1.14-10.1]; p = 0.03). Conclusion We found that phlebitis risk factors varied according to illness severity. By considering these different risk factors, different treatments may be provided to avoid phlebitis based on the patient's severity of illness.
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Affiliation(s)
- Yuki Kishihara
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hideto Yasuda
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan,Department of Clinical Research Education and Training Unit, Keio University Hospital Clinical and Translational Research Center (CTR), Tokyo, Japan,*Correspondence: Hideto Yasuda,
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masahiro Kashiura
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Midori Koike
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yuki Kotani
- Department of Intensive Care Medicine, Kameda Medical Center, Chiba, Japan
| | - Natsuki Kondo
- Department of Intensive Care Medicine, Chiba Emergency Medical Center, Chiba, Japan
| | - Kosuke Sekine
- Department of Medical Engineer, Kameda Medical Center, Chiba, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keita Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, Japan
| | - Takayuki Abe
- Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan,School of Data Science, Yokohama City University, Kanagawa, Japan
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Abe T, Umemura Y, Ogura H, Kushimoto S, Fujishima S, Saitoh D, Iriyama H, Komori A, Otomo Y, Shiraishi A, Gando S. 276 Relationship Between Fluid Administration in the First Three Hours of Sepsis Resuscitation and Mortality. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Abe T. POS1471-HPR PAIN CATASTROPHIZING AND ITS ASSOCIATION WITH PAIN OF PATIENTS WITH RHEUMATOID ARTHRITIS IN A NON-INFLAMMATORY CONDITION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPain in rheumatoid arthritis (RA) is considered to be linked with non-inflammatory factors, including physical disabilities, psychiatric disorders, and pain catastrophizing (PC) (1.ObjectivesWe investigated the role of PC in the possible link between physical disabilities and psychiatric disorders in RA patients in a non-inflammatory condition.MethodsIn this cross-sectional study, a total of 81 RA patients in a non-inflammatory condition were included; all patients had serum C-reactive protein levels <0.5 mg/dL, without any inflammatory joints. We examined the demographic and clinical data and administered the pain visual analog scale (VAS), the pain catastrophizing scale (PCS), the Health Assessment Questionnaire Disability Index (HAQ-DI), and the patient version of the Brief Scale for Psychiatric Problems in Orthopedic Patients (pBS-POP). A series of multivariate-adjusted multiple regression analyses were performed to examine the associations between PC and pain intensity, physical disabilities, and psychiatric disorders.ResultsWe found associations between all the above-mentioned variables in separate models associated with HAQ-DI, pBS-POP, and PCS scores. However, in the model associated with pain VAS, the PCS score (β=0.34, p=0.0073) emerged as the only variable showing statistically significant association.ConclusionPC is associated with pain in RA patients in a non-inflammatory condition, and this association may be mediated through pathways involving physical disabilities and psychiatric disorders.References[1]Edwards RR, Giles J, Bingham CO, Campbell C, Haythornthwaite JA, Bathon J (2010) Moderators of the negative effects of catastrophizing in arthritis. Pain Med 11:591–599.Table 1.Multiple linear regression analysis of factors associated with each outcomeOutcomeVariablesß95% CIP valuePain VASAge0.044-0.32 to 0.510.66Sex (female)0.0089-4.65 to 5.090.93Stage0.0092-4.34 to 4.700.94Disease duration0.19-0.13 to 0.880.14HAQ-DI0.23-0.23 to 1.760.13pBS-POP0.038-1.06 to 1.450.76PCS0.340.13 to 0.810.0073pBS-POPAge-0.18-0.15 to 0.000.046Sex (female)-0.0081-0.95 to 0.860.93Stage-0.033-0.97 to 0.710.77Disease duration0.10-0.053 to 0.140.40Pain VAS0.033-0.037 to 0.0500.76HAQ-DI0.410.10 to 0.450.0026PCS0.310.02 to 0.160.0088HAQ-DIAge0.160.01 to 0.200.029Sex (female)0.14-0.10 to 2.100.93Stage0.17-0.06 to 2.000.77Disease duration0.220.017 to 0.250.025Pain VAS0.14-0.01 to 0.090.76pBS-POP0.290.15 to 0.700.0026PCS0.260.03 to 0.190.0088PCSAge-0.10-0.42 to 0.120.27Sex (female)-0.21-6.77 to -0.600.02Stage-0.082-4.10 to 1.830.45Disease duration-0.13-0.53 to 0.140.25Pain VAS0.280.06 to 0.350.0073pBS-POP0.300.28 to 1.850.0087HAQ-DI0.360.23 to 1.500.0080ß: standardized regression coefficient; CI: confidence interval; HAQ-DI: Health Assessment Questionnaire Disability Index; pBS-POP: the patient version of the Brief Scale for Psychiatric Problems in Orthopedic Patients; PCS: Pain Catastrophizing Scale; VAS: visual analog scaleDisclosure of InterestsNone declared
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Yasuda H, Rickard CM, Marsh N, Yamamoto R, Kotani Y, Kishihara Y, Kondo N, Sekine K, Shime N, Morikane K, Abe T. Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units. Ann Intensive Care 2022; 12:33. [PMID: 35394571 PMCID: PMC8994002 DOI: 10.1186/s13613-022-01009-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background Phlebitis is an important complication occurring in patients with peripheral intravascular catheters (PIVCs). The risk factors for phlebitis in the intensive care unit (ICU) was examined. Methods A secondary analysis of a prospective multicenter cohort study was conducted, involving 23 ICUs in Japan—the AMOR–VENUS study. Consecutive patients aged ≥ 18 years admitted to the ICU with newly inserted PIVCs after ICU admission were enrolled. Characteristics of the ICU, patients, PIVCs, and the drugs administered via PIVCs were recorded. A marginal Cox regression model was used to identify the risk factors associated with phlebitis. Results A total of 2741 consecutive patients from 23 ICUs were reviewed for eligibility, resulting in 1359 patients and 3429 PIVCs being included in the analysis population. The median dwell time was 46.2 h (95% confidence interval [CI], 21.3–82.9). Phlebitis occurred in 9.1% (95% CI, 8.2–10.1%) of catheters (3.5 cases/100 catheter days). The multivariate analysis revealed that the only factors that increased the risk of developing phlebitis were drugs administered intravenously. This study included 26 drugs, and 4 were associated with increased phlebitis: nicardipine (HR, 1.85; 95% CI, 1.29–2.66), noradrenaline (HR, 2.42; 95% CI, 1.40–4.20), amiodarone (HR, 3.67; 95% CI, 1.75–7.71) and levetiracetam (HR, 5.65; 95% CI, 2.80–11.4). Alternatively, factors significantly associated with a reduced risk of phlebitis were: standardized drug administration measures in the ICU (HR, 0.35; 95% CI, 0.17–0.76), 30≤ BMI (HR, 0.43; 95% CI, 0.20–0.95), catheter inserted by a doctor as nurse reference (HR, 0.55; 95% CI, 0.32–0.94), and upper arm insertion site as forearm reference (HR, 0.52; 95% CI, 0.32–0.85). The nitroglycerin was associated with a reduced phlebitis risk (HR, 0.22; 95% CI, 0.05–0.92). Conclusion Various factors are involved in the development of phlebitis caused by PIVCs in critically ill patients, including institutional, patient, catheter, and drug-induced factors, indicating the need for appropriate device selection or models of care in the ICU. Trial registration: UMIN-CTR, the Japanese clinical trial registry (registration number: UMIN000028019, July 1, 2017). Supplementary Information The online version contains supplementary material available at 10.1186/s13613-022-01009-5.
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Affiliation(s)
- Hideto Yasuda
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saimata Medical Center, 1-847, Amanuma-cho, Oomiya-ku, Saitama-shi, Saitama, 330-8503, Japan. .,Department of Clinical Research Education and Training Unit, Keio University Hospital Clinical and Translational Research Center (CTR), Tokyo, Japan.
| | - Claire M Rickard
- School of Nursing, Midwifery and Social Work, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,School of Nursing and Midwifery, and Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, QLD, Australia.,Herston Infectious Diseases Institute; Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
| | - Nicole Marsh
- School of Nursing, Midwifery and Social Work, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.,School of Nursing and Midwifery, and Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, QLD, Australia.,Herston Infectious Diseases Institute; Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, Australia
| | - Ryohei Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuki Kotani
- Department of Intensive Care Medicine, Kameda Medical Center, Chiba, Japan
| | - Yuki Kishihara
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saimata Medical Center, 1-847, Amanuma-cho, Oomiya-ku, Saitama-shi, Saitama, 330-8503, Japan
| | - Natsuki Kondo
- Department of Intensive Care Medicine, Chiba Emergency Medical Center, Chiba-shi, Japan
| | - Kosuke Sekine
- Department of Medical Engineer, Kameda Medical Center, Chiba, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keita Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, Japan
| | - Takayuki Abe
- Biostatistics, Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan.,School of Data Science, Yokohama City University, Kanagawa, Japan
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Osakada T, Abe T, Itakura T, Mori H, Ishii KK, Eguchi R, Murata K, Saito K, Haga-Yamanaka S, Kimoto H, Yoshihara Y, Miyamichi K, Touhara K. Hemoglobin in the blood acts as a chemosensory signal via the mouse vomeronasal system. Nat Commun 2022; 13:556. [PMID: 35115521 PMCID: PMC8814178 DOI: 10.1038/s41467-022-28118-w] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/05/2022] [Indexed: 11/21/2022] Open
Abstract
The vomeronasal system plays an essential role in sensing various environmental chemical cues. Here we show that mice exposed to blood and, consequently, hemoglobin results in the activation of vomeronasal sensory neurons expressing a specific vomeronasal G protein-coupled receptor, Vmn2r88, which is mediated by the interaction site, Gly17, on hemoglobin. The hemoglobin signal reaches the medial amygdala (MeA) in both male and female mice. However, it activates the dorsal part of ventromedial hypothalamus (VMHd) only in lactating female mice. As a result, in lactating mothers, hemoglobin enhances digging and rearing behavior. Manipulation of steroidogenic factor 1 (SF1)-expressing neurons in the VMHd is sufficient to induce the hemoglobin-mediated behaviors. Our results suggest that the oxygen-carrier hemoglobin plays a role as a chemosensory signal, eliciting behavioral responses in mice in a state-dependent fashion.
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Affiliation(s)
- Takuya Osakada
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Takayuki Abe
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Takumi Itakura
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Hiromi Mori
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Kentaro K Ishii
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Ryo Eguchi
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Ken Murata
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Kosuke Saito
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Sachiko Haga-Yamanaka
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Hiroko Kimoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Yoshihiro Yoshihara
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
- RIKEN Center for Brain Science, Wako, Saitama, 351-0198, Japan
| | - Kazunari Miyamichi
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Kazushige Touhara
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan.
- ERATO Touhara Chemosensory Signal Project, JST, The University of Tokyo, Tokyo, 113-8657, Japan.
- International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study, Tokyo, 113-0033, Japan.
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Katayama N, Nakagawa A, Umeda S, Terasawa Y, Abe T, Kurata C, Sasaki Y, Mitsuda D, Kikuchi T, Tabuchi H, Mimura M. Cognitive behavioral therapy effects on frontopolar cortex function during future thinking in major depressive disorder: A randomized clinical trial. J Affect Disord 2022; 298:644-655. [PMID: 34800568 DOI: 10.1016/j.jad.2021.11.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/25/2021] [Accepted: 11/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite the importance of Beck's theoretical cognitive model of psychopathology, the neural mechanisms underlying future thinking in cognitive behavioral therapy (CBT) remain elusive. Recent neuroimaging studies have shown that the function of the frontopolar cortex (Brodmann area 10 [BA10]) is associated with future thinking. We hypothesized that, compared with unstructured psychotherapy (talking control: TC), CBT may involve different neural responses in BA10 associated with future thinking. METHODS This randomized clinical trial included 38 adult patients with moderate-to-severe major depressive disorder who underwent up to 16 weeks of CBT or TC with a 6-month follow-up period. We evaluated changes in BA10 activation during distant future thinking using functional magnetic resonance imaging with a future-thinking task. We assessed frontal neurocognitive function and clinical symptoms at baseline and post-treatment. Depression severity and automatic thoughts were assessed at the 6-month follow-up. RESULTS We found decreased activation in the frontopolar cortex during distant future thinking after CBT (t = 3.00, df=15, p = 0.009) and no changes after TC. Further, the reduction in BA10 activity significantly correlated with changes in frontal cognitive function after the treatment (r = 0.48, p = 0.007), and in positive automatic thought after 6 months of treatments (r = 0.39; p = 0.03). LIMITATIONS Relatively small sample size and homogenous clinical profile could limit the generalizability. Patients received pharmacotherapy including antidepressant. CONCLUSIONS CBT appears to improve frontopolar cortex function during future thinking in a manner distinct from TC. Larger clinical trials are necessary to provide firm evidence whether BA10 activity may serve as a neuro-marker for monitoring successful depression treatment with CBT.
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Affiliation(s)
- Nariko Katayama
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Atsuo Nakagawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan; Clinical and Translational Research Center, Keio University School of Medicine, Tokyo, Japan.
| | - Satoshi Umeda
- Department of Psychology, Keio University Faculty of Letters, Tokyo, Japan
| | - Yuri Terasawa
- Department of Psychology, Keio University Faculty of Letters, Tokyo, Japan
| | - Takayuki Abe
- Yokohama City University School of Data Science, Yokohama, Japan
| | - Chika Kurata
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yohei Sasaki
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Dai Mitsuda
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshiaki Kikuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
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Hinoshita M, Abe T, Sato A, Maeda Y, Takeyoshi M. False-negative chemicals in ESR-based photosafety test (ESR-PT) and their significance for photosafety evaluations: examples of bithionol, fenticlor and cilnidipine. J Toxicol Sci 2022; 47:503-506. [DOI: 10.2131/jts.47.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
| | - Takayuki Abe
- CERI Tokyo, Chemicals Evaluation and Research Institute
| | - Asako Sato
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute
| | - Yosuke Maeda
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute
| | - Masahiro Takeyoshi
- Chemicals Assessment and Research Center, Chemicals Evaluation and Research Institute
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Abe T, Yoshimua Y, Imai R, Sato Y. A Combined Assessment Method of Phase Angle and Skeletal Muscle Index to Better Predict Functional Recovery after Acute Stroke. J Nutr Health Aging 2022; 26:445-451. [PMID: 35587756 DOI: 10.1007/s12603-022-1777-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We aimed to investigate whether combination assessment of phase angle (PhA) and skeletal muscle index (SMI), was a possible predictor of physical function at discharge from the hospital in patients with acute stroke. RESEARCH METHODS AND PROCEDURES In this retrospective cohort study that was conducted from May 2020 and July 2021, we determined PhA and SMI using bioimpedance analysis (BIA) in patients with acute stroke. Patients were classified as normal, low PhA + SMI group, pre-sarcopenia (low SMI only), and dynapenia (low PhA only) using cut-off points (men: SMI < 7.0 kg/m2, PhA < 4.05 degrees; women: SMI < 5.7 kg/m2, PhA < 3.55 degrees). The main outcome was physical function based on functional independence measure motor (FIM-motor) score at discharge. Multiple regression analysis was used to determine the association between low PhA + SMI and FIM-motor score. RESULTS We included 244 patients (161 men; mean age, 73.9 years). low PhA + SMI was found in 21 (8.6%) patients. Multiple regression analysis showed that low PhA + SMI was independently associated with the FIM-motor score at discharge (β= -0.099, 95%CI: -0.193,-0.005, p = 0.039). The PhA cutoff values for determining good functional results using receiver operating characteristic (ROC) curves were 5.36 for men (sensitivity = 0.769, specificity = 0.586, area under the curve [AUC] = 0.682), and 3.85 for women (sensitivity = It was 0.881, specificity = 0.481, AUC). Further, pearson correlation coefficient showed that PhA was significantly related to FIM-motor score in patients with mild or moderately severe stroke (mild: r = 0.472, p < 0.001; moderate: r = 0.524, p < 0.001). CONCLUSIONS Combination of low PhA and SMI values at baseline, was an independent predictor of physical function at discharge in patients with acute stroke. The findings highlighted the importance of measuring PhA and SMI using BIA in patients with acute stroke.
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Affiliation(s)
- T Abe
- Yoshihiro Yoshimura, Kumamoto Rehabilitation Hospital, Kikuchi, Kumamoto Japan,
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Matsui C, Yuliandari P, Deng L, Abe T, Shoji I. The Role of Chaperone-Mediated Autophagy in Hepatitis C Virus-Induced Pathogenesis. Front Cell Infect Microbiol 2021; 11:796664. [PMID: 34926330 PMCID: PMC8674663 DOI: 10.3389/fcimb.2021.796664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 11/15/2021] [Indexed: 12/24/2022] Open
Abstract
Lysosome incorporate and degrade proteins in a process known as autophagy. There are three types of autophagy; macroautophagy, microautophagy, and chaperone-mediated autophagy (CMA). Although autophagy is considered a nonselective degradation process, CMA is known as a selective degradation pathway. All proteins internalized in the lysosome via CMA contain a pentapeptide KFERQ-motif, also known as a CMA-targeting motif, which is necessary for selectivity. CMA directly delivers a substrate protein into the lysosome lumen using the cytosolic chaperone HSC70 and the lysosomal receptor LAMP-2A for degradation. Hepatitis C virus (HCV) NS5A protein interacts with hepatocyte-nuclear factor 1α (HNF-1α) together with HSC70 and promotes the lysosomal degradation of HNF-1α via CMA, resulting in HCV-induced pathogenesis. HCV NS5A promotes recruitment of HSC70 to the substrate protein HNF-1α. HCV NS5A plays a crucial role in HCV-induced CMA. Further investigations of HCV NS5A-interacting proteins containing CMA-targeting motifs may help to elucidate HCV-induced pathogenesis.
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Affiliation(s)
- Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Putu Yuliandari
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Clinical Microbiology, Faculty of Medicine, Udayana University, Bali, Indonesia
| | - Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
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Saku K, Arimura S, Takagi T, Hoshino S, Abe T, Matsumura Y, Yoshitake M, Nagahori R, Bando K, Kunihara T. Successful Repair of a Forme Fruste Bicuspid Aortic Valve by the Raphe Suspension Technique. Ann Thorac Surg 2021; 114:e117-e119. [PMID: 34921813 DOI: 10.1016/j.athoracsur.2021.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/22/2021] [Indexed: 11/28/2022]
Abstract
A 52-year-old man underwent surgery due to shortness of breath caused by severe aortic regurgitation with right coronary cusp prolapse. Operative findings revealed three symmetrical cusps with small raphe between the right- and non-coronary cusps situated lower than the others, indicating a forme fruste bicuspid aortic valve (BAV). The BAV was successfully repaired by tricuspidization, including raphe suspension, right coronary cusp plication, and double annuloplasty. The postoperative course was uneventful, and echocardiography at 3 months showed mild aortic regurgitation with adequate left ventricular reverse remodeling. Here, we present the technical details of the raphe suspension procedure for forme fruste BAV.
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Affiliation(s)
- Kosuke Saku
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Satoshi Arimura
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomomitsu Takagi
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Hoshino
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoko Matsumura
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Michio Yoshitake
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryuichi Nagahori
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ko Bando
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Kunihara
- Department of Cardiac Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Yu J, Sun X, Tong X, Zhang J, Li J, Li S, Liu Y, Tsubaki N, Abe T, Sun J. Ultra-high thermal stability of sputtering reconstructed Cu-based catalysts. Nat Commun 2021; 12:7209. [PMID: 34893618 PMCID: PMC8664808 DOI: 10.1038/s41467-021-27557-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 07/05/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022] Open
Abstract
The rational design of high-temperature endurable Cu-based catalysts is a long-sought goal since they are suffering from significant sintering. Establishing a barrier on the metal surface by the classical strong metal-support interaction (SMSI) is supposed to be an efficient way for immobilizing nanoparticles. However, Cu particles were regarded as impossible to form classical SMSI before irreversible sintering. Herein, we fabricate the SMSI between sputtering reconstructed Cu and flame-made LaTiO2 support at a mild reduction temperature, exhibiting an ultra-stable performance for more than 500 h at 600 °C. The sintering of Cu nanoparticles is effectively suppressed even at as high as 800 °C. The critical factors to success are reconstructing the electronic structure of Cu atoms in parallel with enhancing the support reducibility, which makes them adjustable by sputtering power or decorated supports. This strategy will extremely broaden the applications of Cu-based catalysts at more severe conditions and shed light on establishing SMSI on other metals.
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Affiliation(s)
- Jiafeng Yu
- grid.423905.90000 0004 1793 300XDalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023 Dalian, China
| | - Xingtao Sun
- grid.423905.90000 0004 1793 300XDalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023 Dalian, China ,grid.410726.60000 0004 1797 8419University of Chinese Academy of Sciences, 100049 Beijing, China
| | - Xin Tong
- grid.423905.90000 0004 1793 300XDalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023 Dalian, China ,grid.410726.60000 0004 1797 8419University of Chinese Academy of Sciences, 100049 Beijing, China
| | - Jixin Zhang
- grid.423905.90000 0004 1793 300XDalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023 Dalian, China
| | - Jie Li
- grid.268415.cSchool of Chemistry and Chemical Engineering, Yangzhou University, 225002 Yangzhou, China
| | - Shiyan Li
- grid.423905.90000 0004 1793 300XDalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023 Dalian, China ,grid.410726.60000 0004 1797 8419University of Chinese Academy of Sciences, 100049 Beijing, China
| | - Yuefeng Liu
- Dalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023, Dalian, China.
| | - Noritatsu Tsubaki
- Department of Applied Chemistry, School of Engineering, University of Toyama, Gofuku 3190, Toyama, 930-8555, Japan.
| | - Takayuki Abe
- grid.267346.20000 0001 2171 836XHydrogen Isotope Research Center, University of Toyama, Gofuku 3190, Toyama, 930-8555 Japan
| | - Jian Sun
- Dalian National Laboratory for Clean Energy, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, 116023, Dalian, China.
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Yamada M, Yamada Y, Nakahara T, Okuda S, Abe T, Kuribayashi S, Jinzaki M. Accuracy of ultra-high-resolution computed tomography with a 0.3-mm detector for quantitative assessment of coronary artery stenosis grading in comparison with conventional computed tomography: A phantom study. J Cardiovasc Comput Tomogr 2021; 16:239-244. [PMID: 34906436 DOI: 10.1016/j.jcct.2021.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/15/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The development of ultra-high-resolution CT (U-HRCT) is expected to improve the accuracy of coronary stenosis evaluation. This study aimed to evaluate the accuracy of the stenosis severities of coronary artery phantoms estimated using U-HRCT by comparing them to those estimated with conventional CT. METHODS Coronary artery phantoms with non-calcified and calcified lesions were scanned with conventional CT (64-row × 0.625 mm) and U-HRCT (32-row × 0.3125 mm). The coronary artery phantoms had lumen diameters of 2.0, 3.0, and 4.0 mm with non-calcified lesions representing 0%, 25%, 50%, and 75% stenosis and 3.0 and 4.0 mm with calcified lesions representing 0%, 25%, 50%, and 75% stenosis. The lumen diameters at the stenotic and non-stenotic regions were measured, and the stenosis severities were compared with the true values. RESULTS For non-calcified lesions, conventional CT significantly underestimated the stenosis severity in the phantom showing 75% stenosis with lumen diameters of 2.0 and 3.0 mm (p < 0.05), while the estimated stenosis severities were not significantly different from the true values at all settings with U-HRCT. For the calcified lesions, conventional CT overestimated the stenosis severities at all settings (p < 0.05), while U-HRCT yielded estimations closer to the true values, although still with some overestimation (p < 0.05). CONCLUSION By using U-HRCT, the estimated stenosis severities of the coronary artery with non-calcified lesion become almost equal to the true value, while those with calcified lesion are still overestimated although they become closer to the true value.
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Affiliation(s)
- Minoru Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shigeo Okuda
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takayuki Abe
- Keio University School of Medicine, Clinical and Translational Research Center, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; Yokohama City University School of Data Science, 22-2, Seto, Kanazawa, Yokohama, Kanagawa, 236-0027, Japan
| | - Sachio Kuribayashi
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan; HIMEDIC Imaging Center at Lake Yamanaka, XIV Yamanakako B2F, 562-12 Hirano, Yamanashi, 401-0502, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Abe T, Okuyama K, Miyazaki R. Non-driving older adults living in a rural hilly area are at high risk for poor physical function. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
While some studies have found an association between built environments and physical function, it is unclear whether living in a hilly area is associated with poor physical function among older adults, and whether this association varies by car driving status. This cross-sectional study investigated the association between hilliness and physical function in community-dwelling older adults and whether it varied according to their car driving status.
Methods
Data were collected from 633 participants aged 60 years and older living in Okinoshima Town, Shimane prefecture, Japan, in 2018. Physical function was objectively assessed; < 1.0 m/s was defined as poor walking speed, and hilliness was measured by mean land slope within a 1000-meter network buffer zone around each participant's home using geographic information system. Logistic regression examined whether hilliness was associated with poor walking speed adjusted for sex, age, body mass index, current smoking, current alcohol consumption, exercise habits, current chronic disease, and living arrangements. A stratified analysis by car driving status was also conducted.
Results
A total of 159 (25.1%) participants had poor walking speed. After adjusting for all confounders, hilliness was positively associated with poor walking speed (OR = 1.07, 95% CI, 1.02-1.12). The stratified analysis by car driving status showed that living in a hilly area was positively associated with poor walking speed among non-drivers (OR = 1.10, 95% CI, 1.03-1.17), though there were no associations among drivers (OR = 1.00, 95% CI 0.92-1.08).
Conclusions
Our study found that a hilly environment was associated with poor walking speed in community-dwelling older adults in Japan. Moreover, car driving status potentially modified the relationship between living in a hilly environment and poor walking speed.
Key messages
Older adults living in a hilly environment were more likely to have poor walking speed, compared to those living in less hilly area. The stratified analysis by car driving status showed that non-driving older adults living in a rural hilly environment may be at high risk for poor physical function.
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Affiliation(s)
- T Abe
- Center for Community-Based Healthcare Research and Education, Shimane University, Izumo, Japan
| | - K Okuyama
- Center for Community-Based Healthcare Research and Education, Shimane University, Izumo, Japan
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - R Miyazaki
- Center for Community-Based Healthcare Research and Education, Shimane University, Izumo, Japan
- Faculty of Human Sciences, Shimane University, Matsue, Japan
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Motohiro A, Abe T, Okuyama K, Kumakura S. Environmental Factors Affecting Cognitive Function Among Community-dwelling Older Adults. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect among older adults living in rural areas. This longitudinal study aimed to investigate the effect of neighborhood environmental factors on cognitive decline among rural older adults.
Methods
The data of 503 older adults aged > 60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were measured using geographic information system. Logistic regression examined the effect of each neighborhood environmental factor (in quartiles: Q1-Q4) on cognitive decline.
Results
A total of 57 (11.3%) participants demonstrated a decrease in cognitive function at follow up. Elevation (Odds ratio (OR): 3.37, 95% Confidence Interval (CI): 1.11-10.20 for Q3 vs. Q1; OR: 5.43, 95% CI: 1.89-15.56 for Q4 vs. Q1) and hilliness (OR: 3.45, 95% CI: 1.46-8.11 for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. Residential density and distance to a community center were not associated with cognitive decline.
Conclusions
Elevated and hilly environments may increase risk of cognitive decline among rural older adults.
Key messages
Residents in mountainous regions tend to have limited accessibility to various living centers. Those who live in elevated and hilly areas within the mountainous regions may have further limited accessibility and availability of locations where they can interact with others.
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Affiliation(s)
- A Motohiro
- Shimane University, Department of Medical Education and Research, Faculty of Medicine, Izumo City, Japan
| | - T Abe
- Shimane University, Center for Community-Based Healthcare Research and Education, Organization for Research and Academic Information, Izumo City, Japan
| | - K Okuyama
- Shimane University, Center for Community-Based Healthcare Research and Education, Organization for Research and Academic Information, Izumo City, Japan
- Lund University, Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Jan Waldenströms gata, Sweden
| | - S Kumakura
- Shimane University, Department of Medical Education and Research, Faculty of Medicine, Izumo City, Japan
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Bawono RG, Abe T, Qu M, Kuroki D, Deng L, Matsui C, Ryo A, Suzuki T, Matsuura Y, Sugiyama M, Mizokami M, Shimotohno K, Shoji I. HERC5 E3 ligase mediates ISGylation of hepatitis B virus X protein to promote viral replication. J Gen Virol 2021; 102. [PMID: 34661519 DOI: 10.1099/jgv.0.001668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ubiquitin and ubiquitin-like protein modification play important roles in modulating the functions of viral proteins in many viruses. Here we demonstrate that hepatitis B virus (HBV) X protein (HBx) is modified by ISG15, which is a type I IFN-inducible, ubiquitin-like protein; this modification is called ISGylation. Immunoblot analyses revealed that HBx proteins derived from four different HBV genotypes accepted ISGylation in cultured cells. Site-directed mutagenesis revealed that three lysine residues (K91, K95 and K140) on the HBx protein, which are well conserved among all the HBV genotypes, are involved in acceptance of ISGylation. Using expression plasmids encoding three known E3 ligases involved in the ISGylation to different substrates, we found that HERC5 functions as an E3 ligase for HBx-ISGylation. Treatment with type I and type III IFNs resulted in the limited suppression of HBV replication in Hep38.7-Tet cells. When cells were treated with IFN-α, silencing of ISG15 resulted in a marked reduction of HBV replication in Hep38.7-Tet cells, suggesting a role of ISG15 in the resistance to IFN-α. In contrast, the silencing of USP18 (an ISG15 de-conjugating enzyme) increased the HBV replication in Hep38.7-Tet cells. Taken together, these results suggest that the HERC5-mediated ISGylation of HBx protein confers pro-viral functions on HBV replication and participates in the resistance to IFN-α-mediated antiviral activity.
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Affiliation(s)
- Rheza Gandi Bawono
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan.,Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Takayuki Abe
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mengting Qu
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Kuroki
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Lin Deng
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chieko Matsui
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Tetsuro Suzuki
- Department of Virology and Parasitology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yoshiharu Matsuura
- Center for Infectious Diseases Education and Research (CiDER), Research Institute for Microbial Diseases (RIMD) Osaka University, Osaka, Japan
| | - Masaya Sugiyama
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masashi Mizokami
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Kunitada Shimotohno
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Ikuo Shoji
- Division of Infectious Disease Control, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
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Shirotani S, Jujo K, Kishihara M, Watanabe S, Endo N, Takada T, Abe T, Minami Y, Hagiwara N. Low serum chloride level gives renin-angiotensin system inhibitor a prognostic impact in heart failure patients with preserved ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0917] [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
Hypochloremia is associated with a poor prognosis of heart failure (HF) patients. This phenomenon is sustained even in HF with preserved ejection fraction (HFpEF). Serum chloride level is known to be affected by serum renin secretion; however, this relationship is one of the least investigated field in HF patients. Renin-angiotensin system (RAS) inhibitor is recommended as a first-line medication for HF patients with reduced left ventricular ejection fraction, but no prior studies of RAS inhibitors have achieved to improve the prognosis of HFpEF patients.
Purpose
We investigated the relationship between baseline serum chloride level and the prognostic impact of RAS inhibitor in HFpEF patients.
Methods
This is an observational study including 1,913 consecutive patients who admitted to hospital due to worsening of HF and discharged alive in a single university hospital. After excluding patients who received regular hemodialysis and whose left ventricular ejection fraction were under 50%, 506 HFpEF patients were ultimately analyzed. They were categorized into tertiles by serum chloride levels at discharge (T1: −100 mEq/L, T2: 101–104 mEq/L, T3: 105- mEq/L), and patients in each category were further divided into subgroups depending on the prescription of RAS inhibitor at discharge (RAS inhibitor group and Non-RAS inhibitor group). The primary endpoint of this study was death from any cause.
Results
During the observation period with 479 days of median follow-up, 77 (15.2%) died. Patients in the RAS inhibitor group had significantly better prognosis than those in the Non-RAS inhibitor group in T1 category (Log-rank: p=0.003, Figure). In contrast, there was no statistical difference in the mortality between the RAS inhibitor group and Non-RAS inhibitor group in T2 and T3 categories (Log-rank: p=0.15, p=0.81, respectively, Figure). Multivariate Cox regression analysis in T1 category revealed that taking RAS inhibitor at discharge was independently associated with a lower mortality rate, even after the adjustment of diverse covariates (hazard ratio: 0.40, 95% confidence interval: 0.20–0.80).
Conclusion
In this observational study, the administration of RAS inhibitor was associated with an improved prognosis of HFpEF patients only in low serum chloride level at discharge. Therapeutic strategy focusing on the chloride level may be one of the promising options to find the light on a unintervenable prognosis of HFpEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Shirotani
- Tokyo Women's Medical University, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Tokyo, Japan
| | - M Kishihara
- Tokyo Women's Medical University, Tokyo, Japan
| | - S Watanabe
- Tokyo Women's Medical University, Tokyo, Japan
| | - N Endo
- Tokyo Women's Medical University, Tokyo, Japan
| | - T Takada
- Tokyo Women's Medical University, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Tokyo, Japan
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Takada T, Jujo K, Kishihara M, Shirotani S, Watanabe S, Abe T, Yoshida A, Minami Y, Hagiwara N. Prognostic advantage of optimal medical therapy is not cancelled in hospitalized heart failure patients receiving regular hemodialysis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0995] [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
As the first-line medications, renin-angiotensin-aldosterone system inhibitor (RAASi) and β-blocker provide prognostic benefits in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). However, the negative inotropic effect of these drugs may destabilize the hemodynamics during hemodialysis (HD) and become prognostically controversial in patients receiving regular HD. Indeed, prior studies have reported the cancellation of the favorable prognostic effects of RAASi and β-blocker in patients with HD. However, it is totally unknown whether the guideline-directed medical therapy affects the prognosis in HF patients receiving regular HD.
Purpose
We aimed to evaluate the prognostic impact of RAASi and β-blocker on the cardiovascular (CV) events in HF patients on regular HD.
Methods
This observational study initially included 1,930 consecutive patients who were hospitalized due to HF and discharged alive. Of these, 151 patients who received regular HD were ultimately analyzed. They were classified into 3 groups depending on the prescribing medications at discharge; patients who received none of RAASi or β-blocker (None group: N=19), either RAASi or β-blocker (Either group: N=56), and both RAASi and β-blocker (Both group: N=76). The primary endpoint was a composite of CV death and readmission due to HF.
Results
During the observation period of median 501 (interquartile range: 197–954) days, the primary endpoint occurred in 61 patients (40%). Kaplan-Meier analysis showed the highest rate of composite endpoint in the None group (log-rank for trend: p<0.001, Figure). After adjusting for covariates of age, sex, LVEF, and systolic blood pressure and heart rate at discharge, the hazard ratio (HR) for a composite endpoint was significantly lower in the Either group or Both group than that in the None group [HR: 0.19, 95% confidence interval (CI): 0.08–0.45; HR: 0.16, 95% CI: 0.06–0.42, respectively].
Conclusions
The prescription of RAASi or β-blocker at discharge was associated with lower adverse CV event rates in patients on regular HD who were hospitalized for HF. In order to improve long-term prognosis of HF patients on HD, we should consider the prescription of RAASi or β-blocker for them if hemodynamics during HD is affordable.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- T Takada
- Tokyo Women's Medical University, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University, Tokyo, Japan
| | - M Kishihara
- Tokyo Women's Medical University, Tokyo, Japan
| | - S Shirotani
- Tokyo Women's Medical University, Tokyo, Japan
| | - S Watanabe
- Tokyo Women's Medical University, Tokyo, Japan
| | - T Abe
- Tokyo Women's Medical University, Tokyo, Japan
| | - A Yoshida
- Tokyo Women's Medical University, Tokyo, Japan
| | - Y Minami
- Tokyo Women's Medical University, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Tokyo, Japan
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Abe T, Jujo K, Watanabe S, Kishihara M, Shirotani S, Takada T, Yoshida A, Saito K, Hagiwara N. Heart failure re-hospitalization differently affects the following mortality in patients with reduced, mid-range and preserved LVEF. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0746] [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
Introduction
The recent advances in the treatment for heart failure with reduced ejection fraction (HFrEF) have been remarkable, while no therapy has convincingly improved the prognosis in HF patients with preserved (HFpEF) and mid-range (HFmrEF) ejection fraction. Frequent decompensations of HF lead to progressive deterioration of cardiac and renal function, and quality of life. Hence, prior studies have reported that the mortality of HFrEF patients increases as hospitalization for HF repeats. However, it is still unclear whether this trend applies for HFpEF and HFmrEF patients.
Purpose
We aimed to compare the prognostic impact of re-hospitalization due to HF on cardiovascular death (CVD) among HFrEF, HFmrEF and HFpEF patients.
Methods
This observational study included 1,930 consecutive patients who were hospitalized for worsening of HF and discharged alive. Of them, patients who have never or have not been hospitalized for HF at least last 2 years, were finally analyzed. Patients were consisted of the population with HFrEF (EF<40%, n=421), HFmrEF (EF 40–49%, n=202) and HFpEF (EF>50%, n=291). Patients in each EF-classified population were divide into 2 subgroups based on whether patients were re-hospitalized for HF during the observational period, respectively. The primary endpoint of this study was CVD.
Results
During the observation period, Kaplan-Meier analysis showed that patients who were re-hospitalized for HF had higher event rate of CVD in HFrEF group (Log-rank p=0.008, Figure). Even after adjusting with multivariate covariates including age, sex, EF, brain natriuretic peptide and estimated glomerular filtration rate, re-hospitalization for HF was an independent predictor for CVD in HFrEF group (HR: 1.95, 95% CI: 1.11–2.86, p=0.029). However, in HFmrEF group and HFpEF group, there was no significant difference in the rates of CVD between 2 subgroups divided whether patients were re-hospitalized for HF or not (p=0.91, p=0.34, respectively).
Conclusion
Re-hospitalization for HF affected the CVD rate in HFrEF group, but not in HFmrEF and HFpEF groups. The prevention of re-hospitalization for HF is important particularly in HFrEF patients in order to improve cardiovascular mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Abe
- Nishiarai Heart Center, Tokyo, Japan
| | - K Jujo
- Tokyo Women's Medical University Medical Center East, Cardiology, Tokyo, Japan
| | - S Watanabe
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - M Kishihara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | | | - T Takada
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - A Yoshida
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
| | - K Saito
- Nishiarai Heart Center, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Cardiology, Tokyo, Japan
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Abstract
BACKGROUND The main goal of enteral nutrition (EN) is to manage malnutrition in order to improve clinical outcomes. However, EN may increase the risks of vomiting or aspiration pneumonia during gastrointestinal dysfunction. Consequently, monitoring of gastric residual volume (GRV), that is, to measure GRV periodically and modulate the speed of enteral feeding according to GRV, has been recommended as a management goal in many intensive care units. Yet, there is a lack of robust evidence that GRV monitoring reduces the level of complications during EN. The best protocol of GRV monitoring is currently unknown, and thus the precise efficacy and safety profiles of GRV monitoring remain to be ascertained. OBJECTIVES To investigate the efficacy and safety of GRV monitoring during EN. SEARCH METHODS We searched electronic databases including CENTRAL, MEDLINE, Embase, and CINAHL for relevant studies on 3 May 2021. We also checked reference lists of included studies for additional information and contacted experts in the field. SELECTION CRITERIA We included randomized controlled trials (RCTs), randomized cross-over trials, and cluster-RCTs investigating the effects of GRV monitoring during EN. We imposed no restrictions on the language of publication. DATA COLLECTION AND ANALYSIS Two review authors independently screened the search results for eligible studies and extracted trial-level information from each included study, including methodology and design, characteristics of study participants, interventions, and outcome measures. We assessed risk of bias for each study using Cochrane's risk of bias tool. We followed guidance from the GRADE framework to assess the overall certainty of evidence across outcomes. We used a random-effects analytical model to perform quantitative synthesis of the evidence. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous and mean difference (MD) with 95% CIs for continuous outcomes. MAIN RESULTS We included eight studies involving 1585 participants. All studies were RCTs conducted in ICU settings. Two studies (417 participants) compared less-frequent (less than eight hours) monitoring of GRV against a regimen of more-frequent (eight hours or greater) monitoring. The evidence is very uncertain about the effect of frequent monitoring of GRV on mortality rate (RR 0.91, 95% CI 0.60 to 1.37; I² = 8%; very low-certainty evidence), incidence of pneumonia (RR 1.08, 95% CI 0.64 to 1.83; heterogeneity not applicable; very low-certainty evidence), length of hospital stay (MD 2.00 days, 95% CI -2.15 to 6.15; heterogeneity not applicable; very low-certainty evidence), and incidence of vomiting (RR 0.14, 95% CI 0.02 to 1.09; heterogeneity not applicable; very low-certainty evidence). Two studies (500 participants) compared no GRV monitoring with frequent (12 hours or less) monitoring. Similarly, the evidence is very uncertain about the effect of no monitoring of GRV on mortality rate (RR 0.87, 95% CI 0.62 to 1.23; I² = 51%; very low-certainty evidence), incidence of pneumonia (RR 0.70, 95% CI 0.43 to 1.13; heterogeneity not applicable; very low-certainty evidence), length of hospital stay (MD -1.53 days, 95% CI -4.47 to 1.40; I² = 0%; very low-certainty evidence), and incidence of vomiting (RR 1.47, 95% CI 1.13 to 1.93; I² = 0%; very low-certainty evidence). One study (322 participants) assessed the impact of GRV threshold (500 mL per six hours) on clinical outcomes. The evidence is very uncertain about the effect of the threshold for GRV at time of aspiration on mortality rate (RR 1.01, 95% CI 0.74 to 1.38; heterogeneity not applicable; very low-certainty evidence), incidence of pneumonia (RR 1.03, 95% CI 0.72 to 1.46; heterogeneity not applicable; very low-certainty evidence), and length of hospital stay (MD -0.90 days, 95% CI -2.60 to 4.40; heterogeneity not applicable; very low-certainty evidence). Two studies (140 participants) explored the effects of returning or discarding the aspirated/drained GRV. The evidence is uncertain about the effect of discarding or returning the aspirated/drained GRV on the incidence of vomiting (RR 1.00, 95% CI 0.06 to 15.63; heterogeneity not applicable; very low-certainty evidence) and volume aspirated from the stomach (MD -7.30 mL, 95% CI -26.67 to 12.06, I² = 0%; very low-certainty evidence) We found no studies comparing the effects of protocol-based EN strategies that included GRV-related criteria against strategies that did not include such criteria. AUTHORS' CONCLUSIONS The evidence is very uncertain about the effect of GRV on clinical outcomes including mortality, pneumonia, vomiting, and length of hospital stay.
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Affiliation(s)
- Hideto Yasuda
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama-shi, Japan
| | - Natsuki Kondo
- Department of Intensive Care Medicine, Chiba Emergency Medical Center, Chiba-shi, Japan
| | - Ryohei Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sadaharu Asami
- Department of Cardiology, Musashino Tokushukai Hospital, Tokyo, Japan
- Graduate School of Public Health, St Luke's International University, Tokyo, Japan
| | - Takayuki Abe
- Department of Preventive Medicine and Pubic Health, Keio University School of Medicine, Shinjyuku-ku, Japan
| | - Hiraku Tsujimoto
- Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Yasushi Tsujimoto
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
- Department of Nephrology and Dialysis, Kyoritsu Hospital, Kawanishi, Japan
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yuki Kataoka
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Miyauchi K, Fujimoto K, Abe T, Takei M, Ogawa K. Cross-sectional assessment of sleep and fatigue in middle-aged Japanese women with primary Sjogren syndrome or rheumatoid arthritis using self-reports and wrist actigraphy. Medicine (Baltimore) 2021; 100:e27233. [PMID: 34664865 PMCID: PMC8448038 DOI: 10.1097/md.0000000000027233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022] Open
Abstract
To investigate fatigue, health-related quality of life (HR-QOL), and sleep quality in women with primary Sjogren syndrome (pSS) or rheumatoid arthritis (RA) as compared with healthy controls using self-reports and wrist actigraphy.In this cross-sectional observational study, we evaluated a total of 25 patients (aged 40-75 years) with pSS, 10 with RA, and 17 healthy control subjects living in Japan. The HR-QOL was assessed using the Short Form-36. Fatigue was evaluated using the Short Form-36 vitality score, visual analog scale (VAS) for fatigue, and 2 questionnaire items using scores based on a 4-point Likert scale. Sleep quality was measured using the Japanese version of the Pittsburgh Sleep Quality Index, VAS for sleep quality, and wrist actigraphy for 14 days.Patients with pSS reported severer fatigue and lower HR-QOL than healthy controls, especially in mental health. Based on the Pittsburgh Sleep Quality Index score, 56% of the patients with pSS were poor sleepers, which was higher than healthy controls (29.4%). Furthermore, the patients with pSS scored significantly lower on the VAS for sleep quality than healthy controls (40.5 vs 63.7, P = .001). Although subjective assessments revealed slight sleep disturbances in patients with pSS, wrist actigraphy revealed no differences when compared with healthy controls for total sleep time (421.8 minutes vs 426.5 minutes), sleep efficiency (95.2% vs 96.4%), number of awakenings (1.4 vs 0.9), and wake after sleep onset (22.4 minutes vs 16.1 minutes). Poor subjective sleep quality was associated with enhanced fatigue. However, sleep efficiency, as determined by actigraphy, was not associated with fatigue. Notably, the patients with RA and healthy controls did not differ significantly in terms of fatigue or sleep quality, although patients with RA experienced more nocturnal awakenings than healthy controls (1.7 vs 0.9, P = .04).Patients with pSS experience severe fatigue, poor HR-QOL, and sleep disturbances, which are associated with fatigue. However, wrist actigraphy did not reveal differences in sleep quality, suggesting that it may not be an appropriate measure of sleep in patients with pSS.
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Affiliation(s)
- Kiyoko Miyauchi
- Department of Nursing, Wayo Women's University, Ichikawa City, Chiba, Japan
- Graduate School of Nursing, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kaoru Fujimoto
- Department of Nursing, Bunkyo Gakuin University, Bunkyo-ku, Tokyo, Japan
| | - Takayuki Abe
- School of Data Science, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Masami Takei
- School of Medicine, Nihon University, Itabashi-ku, Tokyo, Japan
| | - Kukiko Ogawa
- Graduate School of Nursing, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
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Hisa N, Ito H, Kotake R, Akimoto S, Suzuki Y, Takahashi Y, Igarashi C, Ono S, Harada H, Nakata M, Abe T. P–192 Efficacy of postponement of intracytoplasmic sperm injection timing after spindle visualization for Metaphase I oocytes. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does postponement of intracytoplasmic sperm injection (ICSI) timing after spindle visualization for Metaphase I (MI) oocytes improve developmental outcomes of embryos?
Summary answer
Postponement of ICSI timing after spindle visualization for MI oocytes improves blastocyst utility rates.
What is known already
Immature oocytes are generally considered poor developmental outcomes. Meanwhile, the timing of ICSI adjusted by using spindle visualization can improve clinically utilized embryos and live birth rates, but these outcomes remain inferior to those of mature oocytes. In in vitro maturation culture, nuclear maturation is thought to occur before the completion of cytoplasmic maturation, and in immature oocytes, synchronization of nuclear and cytoplasmic maturation may be insufficient for ICSI immediately after spindle visualization.
Study design, size, duration
Data for this retrospective cohort study were obtained 672 oocytes retrieved under mild stimulation cycles using letrozole, in patients aged younger than 39 years between April 2017 and October 2020.Written informed consent was obtained from all patients. This study was approved by the institutional review board.
Participants/materials, setting, methods
As a control group, 464 MetaphaseIIoocytes that underwent ICSI immediately after visualization of the spindle were used. In group A, 103 MI oocytes underwent ICSI immediately after the first polar body release and spindle visualization, and in group B, 105 oocytes underwent ICSI 2–3 hours after spindle visualization. The primary outcomes were fertilization rates, degeneration, cleavage, embryo blastocyst formation, and utility rates. Outcomes were compared among the three groups.
Main results and the role of chance
The baseline fertilization rates of each group (control, A, B) were 82.3% (382/464), 73.8% (76/103), and 83.8% (88/105), respectively. The rate was significantly lower in group A than in the control group (P < 0.05), and also tended to be lower in group A than in group B, although the difference was not significant. There was no significant difference in abnormal fertilization rates, oocyte degeneration rates, cleavage rates, and blastocyst formation rates among the three groups. [control, A, B: abnormal fertilization rate: 4.3% (20/464), 8.7% (9/103), 4.8% (5/105); oocyte degeneration rates: 3.0% (14/464), 1.9% (2/103), 3.8% (4/105); cleavage rates: 95.6% (307/321), 93.8% (61/65), 98.7% (74/75); blastocyst formation rates: 58.6% (177/302), 51.7% (31/60), 55.4% (41/74), respectively]. The blastocyst utility rates of control group and group B were significantly higher than in group A [41.7% (126/302), 45.9% (34/74), 26.7% (16/60), respectively] (P < 0.05). There were no significantly different outcomes between the control group and group B.
Limitations, reasons for caution
The optimal timing of ICSI for MI oocyte cannot be determined by the presence or absence of spindles. In addition, the postponement duration we set was based on reports which reported on final oocyte maturation, and further investigation is needed to establish the optimal ICSI timing for MI oocytes.
Wider implications of the findings: In MI oocytes, postponement of ICSI timing after spindle visualization is essential for synchronization of the nucleus and cytoplasmic maturation.
Trial registration number
none
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Affiliation(s)
- N Hisa
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | - H Ito
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | - R Kotake
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | - S Akimoto
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | - Y Suzuki
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | | | - C Igarashi
- Shinjuku ART Cinic, IVF lab, Tokyo, Japan
| | - S Ono
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - H Harada
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - M Nakata
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - T Abe
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
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Takahashi Y, Hisa N, Kotake R, Suzuki Y, Akimoto S, Igarashi C, Ito H, Harada H, Nakata M, Ono S, Abe T. P–609 The chances of one live birth rates after first ART cycle in minimal stimulation cycle IVF with letrozole only and natural cycle IVF. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Are one live birth rates (LBRs) similar in minimal stimulation cycle IVF with letrozole only and natural cycle IVF for the first ART cycle?
Summary answer
LBRs after first ART cycle in minimal stimulation cycle IVF with letrozole only are superior to natural cycle IVF.
What is known already
The addition of letrozole to gonadotropins in ovarian stimulation (OS) may reduce the risk of OHSS, but there is no significant difference were reported in ongoing pregnancy rate or number of oocytes retrieved in the letrozole + FSH group compared to the FSH only. No differences were also reported in clinical pregnancy rates or number of mature oocytes in the additional of letrozole in an GnRH antagonist protocol group compared to the GnRH antagonist group. There are no previous study comparing LBRs after first ART cycle in minimal stimulation cycle IVF with letrozole and natural cycle IVF.
Study design, size, duration
Data for this retrospective cohort study were obtained 643 women, 30–39 years of age started their first ART cycle at one private fertility clinic between January 2016- December 2019.
Participants/materials, setting, methods
A total of 643 women were scheduled their first oocyte retrieval cycle. 118 women started with letrozole (LE) and 525 women started natural cycle (NC). The main strategy for OS in our center is minimal stimulation and natural cycle IVF. Patients consulted with gynecologists to determine their treatment plan based on patients’ preference or their menstrual cycle. All pregnancies generated from oocyte retrieval during the first IVF cycle including fresh and frozen-thaw cycles were registered.
Main results and the role of chance
The number of retrieved oocytes and the normal fertilization rates were significantly higher in the LE than NC (4.4 vs 3.4, 77.6% vs 71.1%), p < 0.05 respectively). There was no significant difference in the clinical pregnancy rates (CPRs) per embryo transfer (ET) (fresh cleavage stage ET: 32.9% vs 28.0%, frozen-thaw blastocyst ET: 39.4% vs 44.9% ns). However, the CPRs and LBRs per oocyte retrieval (OR) were significantly higher in the LE group (39.0% vs 28.6, 33.9% vs 21.9%, p < 0.05 respectively). In a subsequent regression analyses, LBRs per OR of LE was significantly higher than NC as well. (adjusted OR = 1.63 (95% CI: 1.02–2.58, p = 0.041).
Limitations, reasons for caution
The strength of the present study was the use of a large cohort of women who underwent minimal stimulation IVF with letrozole only. Although our results are promising, limited by retrospective cohort study. These interpretations prompted the need for a perspective cohort study to evaluate the efficacy of letrozole.
Wider implications of the findings: When comparing minimal stimulation IVF with letrozole only and natural cycle IVF, we found significantly higher LBRs per OR in minimal stimulation IVF with letrozole only, despite similar CPRs per ET.
Trial registration number
none
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Affiliation(s)
- Y Takahashi
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - N Hisa
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - R Kotake
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - Y Suzuki
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - S Akimoto
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - C Igarashi
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - H Ito
- Shinjuku ART Clinic, IVF laboratory, Tokyo, Japan
| | - H Harada
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - M Nakata
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - S Ono
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
| | - T Abe
- Shinjuku ART Clinic, Department of Gynecology, Tokyo, Japan
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Fukuoka R, Kohsaka S, Shiraishi Y, Sawano M, Abe T, Levy WC, Nagatomo Y, Nishihata Y, Goda A, Kohno T, Kawamura A, Fukuda K, Yoshikawa T. Sudden cardiac death after acute decompensation in heart failure patients: implications of discharge haemoglobin levels. ESC Heart Fail 2021; 8:3917-3928. [PMID: 34323007 PMCID: PMC8497203 DOI: 10.1002/ehf2.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 11/19/2022] Open
Abstract
Aims Heart failure (HF) patients have a high risk of mortality due to sudden cardiac death (SCD) and non‐SCD, including pump failure death (PFD). Anaemia predicts more severe symptomatic burden and higher morbidity, as noted by markedly increased hospitalizations and readmission rates, and mortality, underscoring its importance in HF management. Herein, we aimed to determine whether haemoglobin (Hb) level at discharge affects the mode of death and influences SCD risk prediction. Methods We evaluated the data of 3020 consecutive acute HF patients from a Japanese prospective multicentre registry. Patients were divided into four groups based on discharge Hb levels. SCD was defined as an unexpected and otherwise unexplained death in a previously stable patient or death due to documented or presumed cardiac arrhythmia without a clear non‐cardiovascular cause. The mode of death (SCD, PFD or other cause) was adjudicated by a central committee. Finally, we investigated whether adding Hb level to the Seattle Proportional Risk Model (SPRM; established risk score utilized to estimate ‘proportion’ of SCD among death events) would affect its performance. Results The mean age of studied patients was 74.3 ± 12.9 years, and 59.8% were male. The mean Hb level was 12.0 ± 2.1 g/dL (61.3% of patients had anaemia defined by World Health Organization criteria). During the 2‐year follow‐up, 474 deaths (15.7%) occurred, including 93 SCDs (3.1%), 171 PFDs (5.7%) and 210 other deaths (7.0%; predominantly non‐cardiac death). Absolute risk of PFD (P < 0.001) or other death (P < 0.001) increased along with the severity of anaemia, whereas the incidence of SCD was low but remained consistent across all four groups (P = 0.440). As a proportion of total deaths in each Hb level group, the contributions from non‐SCD increased and from SCD decreased along with anaemia severity (P = 0.007). Adding Hb level to the SPRM improved the overall discrimination (c‐index: 0.62 [95% confidence interval (CI) 0.56–0.69] to 0.65 [95% CI 0.59–0.71]), regardless of the baseline ejection fraction (EF) (c‐index: 0.64 [95% CI 0.55–0.73] to 0.67 [95% CI 0.58–0.75] for reduced EF and 0.55 [95% CI 0.45–0.66] to 0.61 [95% CI 0.52–0.70] for preserved EF). Conclusions The discharge Hb level provides information about both absolute and proportional risks for each mode of death in acute HF patients, and the addition of Hb level improves the performance of SPRM by identifying more non‐SCD cases. Future ‘proportional’ SCD risk models should incorporate Hb level as a covariate to meet this high performance.
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Affiliation(s)
- Ryoma Fukuoka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.,Department of Cardiology, International University of Health and Welfare, School of Medicine, Chiba, Japan
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyuki Shiraishi
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- School of Data Science, Yokohama City University, Yokohama, Japan
| | - Wayne C Levy
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College, Tokorozawa, Japan
| | - Yosuke Nishihata
- Department of Cardiology, Cardiovascular Centre, St. Luke's International Hospital, Tokyo, Japan
| | - Ayumi Goda
- Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Takashi Kohno
- Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Akio Kawamura
- Department of Cardiology, International University of Health and Welfare, School of Medicine, Chiba, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Nishida Y, Tanaka S, Hatamoto Y, Hatanaka M, Ishikawa-Takata K, Abe T, Higaki Y, Katsukawa F. Impact of walking aids on estimating physical activity using a tri-axial accelerometer in frail older adults. BMJ Open Sport Exerc Med 2021; 7:e001014. [PMID: 34249373 PMCID: PMC8237722 DOI: 10.1136/bmjsem-2020-001014] [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] [Accepted: 06/12/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to compare the estimation error of physical activity level (PAL) estimated using a tri-axial accelerometer between an independent walking group and an assisted walking group with walking aids. Methods Subjects were 6 older adults who could walk independently and 10 older adults requiring walking assistance during gait. Total energy expenditure (TEE) was measured using the doubly labelled water (DLW) method over 2 weeks and PAL was calculated as the measured TEE divided by the basal metabolic rate measured using indirect calorimetry (PALDLW). The participants wore a tri-axial accelerometer (Active style Pro HJA-750C) on the waist simultaneously as the DLW period, and the estimated PAL was derived from it (PALACC). Results The median PAL estimation error in the assisted walking group was −0.30 kcal/day (range: −0.77 to −0.01 kcal/day) and more underestimated than that in the independent walking group (p=0.02). The estimation error of PALACC was significantly correlated with PALDLW (r=−0.80, p<0.01). Conclusions Using the accelerometer, PAL was underestimated for older adults who used walking aids but not for those who walked independently under free-living conditions.
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Affiliation(s)
- Yuki Nishida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Keio University, Yokohama, Japan
| | - Shigeho Tanaka
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.,Kagawa Nutrition University, Sakado, Japan
| | - Yoichi Hatamoto
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Mana Hatanaka
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
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Aydin A, Ahmed K, Abe T, Raison N, Van Hemelrijck M, Ahmed H, Al-Jabir A, Brunckhorst O, Shinohara N, Zhu W, Zeng G, Sfakianos J, Tewari A, Gözen A, Rassweiler J, Skolarikos A, Kunit T, Knoll T, Moltzahn F, Thalmann G, Lantz Powers A, Chew B, Sarica K, Khan M, Dasgupta P. Simulation in urological training and Education (SIMULATE): A randomised controlled clinical and educational trial to determine the effect of simulation-based surgical training. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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45
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Tohi Y, Kato T, Yokomizo A, Mitsuzuka K, Tomida R, Inokuchi J, Matsumoto R, Saito T, Sasaki H, Inoue K, Kinoshita H, Fukuhara H, Maruyama S, Sakamoto S, Tanikawa T, Egawa S, Ichikura H, Abe T, Nakamura M, Kakehi Y, Sugimoto M. Impact of health-related quality of life on repeat protocol biopsy compliance on active surveillance for favorable prostate cancer: Results from a prospective cohort in the PRIAS-JAPAN study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01410-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ito K, Morise M, Wakuda K, Hataji O, Shimokawaji T, Takahashi K, Furuya N, Takeyama Y, Goto Y, Abe T, Kato T, Ozone S, Ikeda S, Kogure Y, Yokoyama T, Kimura M, Yoshioka H, Murotani K, Kondo M, Saka H. A multicenter cohort study of osimertinib compared with afatinib as first-line treatment for EGFR-mutated non-small-cell lung cancer from practical dataset: CJLSG1903. ESMO Open 2021; 6:100115. [PMID: 33984681 PMCID: PMC8134659 DOI: 10.1016/j.esmoop.2021.100115] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 11/27/2020] [Revised: 03/14/2021] [Accepted: 03/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background FLAURA, the prospective trial of osimertinib as a first-line therapy compared with first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), did not show superior survival benefit for osimertinib in either the subgroup of Asians or the subgroup with the L858R mutation. In addition, the superiority of osimertinib compared with second-generation EGFR-TKI is thus far unclear. Patients and methods We reviewed the clinical data of all consecutive patients who were treated with osimertinib or afatinib as first-line therapy between May 2016 and October 2019 from 15 institutions in Japan. We defined the groups based on first-line EGFR-TKI as the afatinib group and the osimertinib group. Outcomes included time to discontinuation of any EGFR-TKI (TD-TKI), overall survival (OS), and time to treatment failure, with propensity score analysis carried out as an exploratory analysis in the survival and subgroup analyses. Results A total of 554 patients were enrolled. Data on 326 patients in the osimertinib group, and 224 patients in the afatinib group were analyzed. TD-TKI adjusted by propensity score in the afatinib and osimertinib groups was 18.6 months (95% confidence interval 15.8 to 22.0) and 20.5 months (95% confidence interval 13.8 to not reached), respectively, without significant difference (P = 0.204). OS adjusted by propensity score favored the afatinib group with a significant difference (P = 0.018). Subgroup analysis with propensity score showed that patients with L858R and without brain metastasis had superior survival benefit with afatinib compared with osimertinib (P < 0.001). Conclusions TD-TKI in the afatinib group was not significantly prolonged compared with the osimertinib group in the practical data. In the exploratory analysis of patients with L858R-mutated non-small-cell lung cancer without brain metastasis, afatinib showed more benefit in OS over osimertinib. The large-scale practical data of 550 patients who were treated with osimertinib or afatinib as first-line therapy were analyzed. The superiority of osimertinib compared with afatinib could not be demonstrated in all populations. Osimertinib therapy showed effectiveness in patients with brain metastasis. Afatinib therapy showed potential benefit in patients with L858R mutation and without brain metastasis.
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Affiliation(s)
- K Ito
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan; Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - M Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
| | - K Wakuda
- Division of Thoracic Oncology, Shizuoka Cancer Center, Suntou-gun, Shizuoka, Japan
| | - O Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan
| | - T Shimokawaji
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - K Takahashi
- Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Aichi, Japan
| | - N Furuya
- Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Y Takeyama
- Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Y Goto
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - T Abe
- Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
| | - T Kato
- Division of Respiratory Medicine and Allergology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - S Ozone
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - S Ikeda
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Kanagawa, Japan
| | - Y Kogure
- Department of Respiratory Medicine, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
| | - T Yokoyama
- Department of Respiratory Medicine, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Aichi, Japan
| | - M Kimura
- Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Aichi, Japan
| | - H Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata, Osaka, Japan
| | - K Murotani
- Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan
| | - M Kondo
- Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - H Saka
- Department of Respiratory Medicine, Matsunami General Hospital, Kasamatsu, Gifu, Japan
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Kobayashi T, Motoya S, Nakamura S, Yamamoto T, Nagahori M, Tanaka S, Hisamatsu T, Hirai F, Nakase H, Watanabe K, Matsumoto T, Tanaka M, Abe T, Suzuki Y, Watanabe M, Hibi T. Discontinuation of infliximab in patients with ulcerative colitis in remission (HAYABUSA): a multicentre, open-label, randomised controlled trial. Lancet Gastroenterol Hepatol 2021; 6:429-437. [PMID: 33887262 DOI: 10.1016/s2468-1253(21)00062-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Received: 12/15/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anti-tumour necrosis factor (TNF) agents are the mainstay of long-term treatment for refractory ulcerative colitis. However, long-term use of anti-TNF therapy might lead to an increased risk of malignancy or infection. To date, no randomised controlled trial has evaluated whether anti-TNF agents can be safely discontinued in patients with ulcerative colitis in remission. We therefore aimed to compare outcomes in these patients who continued infliximab with those who discontinued infliximab. METHODS We did a multicentre, open-label randomised controlled trial at 24 specialist centres in Japan. We enrolled patients with ulcerative colitis who were in remission, had been treated with intravenous infliximab (5 mg/kg) every 8 weeks, and had started infliximab at least 14 weeks before study enrolment. No restrictions regarding age and comorbidities were used to exclude participation. Patients who were confirmed to be in remission for more than 6 months, to be corticosteroid-free, and to have a Mayo Endoscopic Subscore (MES) of 0 or 1 were centrally randomised. An independent organisation randomly assigned patients (1:1) into either the infliximab-continued group or infliximab-discontinued group, using a computer-generated stratified randomisation procedure. The stratified factors were the use of immunomodulators (yes or no) and MES (0 or 1). Neither patients nor health-care providers were masked to the randomisation. The primary endpoint was the remission rate at week 48 in the full analysis set, which was based on the intention-to-treat principle and excluded participants with no efficacy data after randomisation. This study was registered with the University Hospital Medical Information Network Center Trials registry, UMIN000012092. FINDINGS Between June 16, 2014, and July 28, 2017, 122 patients were eligible for screening and a total of 95 patients were randomly assigned to the infliximab-continued group (n=48) or the infliximab-discontinued group (n=47). 92 patients (n=46 for both groups) were included in the full analysis set. 37 (80·4% [95% CI 66·1-90·6]) of 46 patients in the infliximab-continued group and 25 (54·3% [39·0-69·1]) of 46 patients in the infliximab-discontinued group were in remission at week 48. The between-group difference was 26·1% (95% CI 7·7-44·5; p=0·0076) before adjustment and 27·3% (95% CI 8·0-44·1; p=0·0059) after adjustment for stratification factors. Eight (17%) of 48 patients in the infliximab-continued group and six (13%) of 47 in the infliximab-discontinued group developed adverse events (between-group difference 3·9% [95% CI -10·3 to 18·1]; p=0·59). In the infliximab-continued group, one patient had an infusion reaction and two patients had psoriatic skin lesions. Eight (66·7%, 95% CI 34·9-90·1) of the 12 patients in the infliximab-discontinuation group who were re-treated with infliximab after relapsing were in remission within 8 weeks of re-treatment; none had infusion reactions. INTERPRETATION Maintenance of remission was significantly more common in patients who continued infliximab than in those who discontinued. Discontinuing infliximab should therefore be discussed with caution, taking both risk of relapse and efficacy of re-treatment into account. FUNDING Mitsubishi Tanabe Pharma Corporation and the Intractable Disease Project of the Ministry of Health, Labour and Welfare of Japan. TRANSLATION For the Japanese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Satoshi Motoya
- IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan
| | - Shiro Nakamura
- Department of Inflammatory Bowel Disease, Hyogo College of Medicine, Nishinomiya, Japan
| | | | - Masakazu Nagahori
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinji Tanaka
- Department of Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Japan
| | - Fumihito Hirai
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Hiroshi Nakase
- Department of Gastroenterology, Sapporo Medical College, Sapporo, Japan
| | - Kenji Watanabe
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Masanori Tanaka
- Department of Pathology, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Takayuki Abe
- Department of Data Science, Yokohama City University, Yokohama, Japan; Clinical and Translational Research Centre, Keio University School of Medicine, Tokyo, Japan
| | - Yasuo Suzuki
- Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Mamoru Watanabe
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan; Advanced Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
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Nakagome K, Yokoi Y, Nakagawa A, Tani M, Nishioka G, Yoshimura N, Furukawa TA, Watanabe K, Mimura M, Iwanami A, Abe T. Acceptability of escitalopram versus duloxetine in outpatients with depression who did not respond to initial second-generation antidepressants: A randomized, parallel-group, non-inferiority trial. J Affect Disord 2021; 282:1011-1020. [PMID: 33601673 DOI: 10.1016/j.jad.2020.12.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/30/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUNDS Antidepressants are widely used to treat major depressive disorder. First-line treatments with antidepressants are only successful in one-third of patients; however, evidence from randomized controlled trials on second-line treatments is limited. Moreover, recently acceptability is suggested to be a good indicator of overall treatment success. METHODS This is a multi-center two-arm, three-phased randomized controlled trial performed in Japan from December 2013 to March 2017 comparing the acceptability of escitalopram and duloxetine as a second-line drug. Patients, who failed to respond to antidepressants such as sertraline, paroxetine, fluvoxamine, milnacipran or mirtazapine for at least 3 weeks, were randomized to either escitalopram (Group A) or duloxetine (Group B) in Step 1 (8 weeks). In Step 2 (8 weeks), the drug was switched to the other if the first drug failed. The discontinuation rate at the end of Step 1 was the primary endpoint and non-inferiority of escitalopram vs duloxetine was tested. In addition, change in clinical measures from baseline were also assessed at the end of Step 1, 2 and up to 52 weeks. RESULTS At the end of Step 1, Group A (n = 82) was significantly superior to Group B (n = 78) in discontinuation rate (4.9% to 19.2%, P = 0.007). The change in clinical indices from baseline were not different between the groups at either timepoint. LIMITATIONS As the major reason for discontinuation in Group B was the "withdrawal of consent" the concrete reason could not be verified. CONCLUSIONS As a second-line treatment drug, escitalopram was suggested to be non-inferior to duloxetine in acceptability. TRIAL REGISTRATION UMINCTR(UMIN000012367), registered on December 1st, 2013 and last updated on April 4th, 2017.
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Affiliation(s)
- Kazuyuki Nakagome
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan.
| | - Yuma Yokoi
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - Atsuo Nakagawa
- Keio University Hospital Clinical and Translational Research Center, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masayuki Tani
- Oouchi Hospital, 5-41-1, Nishiarai, Adachi-ku, Tokyo 123-0841, Japan
| | - Gentaro Nishioka
- Nishiyama Hospital, 5-1-1, Imasato Nagaokakyo-shi, Kyoto 617-0814, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - Toshiaki A Furukawa
- Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine / School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Koichiro Watanabe
- Departments of Neuropsychiatry, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Akira Iwanami
- Department of Psychiatry, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Takayuki Abe
- Yokohama City University School of Data Science, 22-2, Seto, Kanazawa, Yokohama, Kanagawa 236-0027, Japan
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Hakozaki K, Kikuchi E, Ogihara K, Shigeta K, Abe T, Miyazaki Y, Kaneko G, Maeda T, Yoshimine S, Kanai K, Ide H, Shirotake S, Oyama M, Mizuno R, Oya M. Significance of prophylactic urethrectomy at the time of radical cystectomy for bladder cancer. Jpn J Clin Oncol 2021; 51:287-295. [PMID: 32893303 DOI: 10.1093/jjco/hyaa168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/17/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prophylactic urethrectomy at the time of radical cystectomy is frequently recommended for patients with bladder cancer at a high risk of urethral recurrence without definitive evidence. The present study attempted to clarify the survival benefits of performing prophylactic urethrectomy. METHODS We identified 214 male patients who were treated by radical cystectomy with an incontinent urinary diversion in our seven institutions between 2004 and 2017. We used propensity score matching and ultimately identified 114 patients, 57 of whom underwent prophylactic urethrectomy (prophylactic urethrectomy group) and 57 who did not (non-prophylactic urethrectomy group). RESULTS No significant differences were observed in the 5-year overall survival rate between the prophylactic urethrectomy and non-prophylactic urethrectomy groups in the overall. However, the local recurrence rate was significantly lower in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.015). In the subgroup of 58 patients with multiple tumours and/or concomitant carcinoma in situ at the time of transurethral resection of bladder tumour, the 5-year overall survival rate was significantly higher in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.021). A multivariate analysis revealed that performing prophylactic urethrectomy was the only independent predictor of the overall survival rate (P = 0.016). In those patients who were treated without neoadjuvant chemotherapy (n = 38), the 5-year overall survival rate was significantly higher in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.007). CONCLUSIONS Prophylactic urethrectomy at the time of radical cystectomy may have a survival benefit in patients with multiple tumours and/or concomitant carcinoma in situ, particularly those who do not receive neoadjuvant chemotherapy.
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Affiliation(s)
- Kyohei Hakozaki
- Department of Urology, Keio University School of Medicine, Tokyo, Japan.,Department of Urology, National Hospital Organization Saitama National Hospital, Saitama
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan.,Department of Urology, St. Marianna University School of Medicine, Kanagawa
| | - Koichiro Ogihara
- Department of Urology, Keio University School of Medicine, Tokyo, Japan.,Department of Urology, Kawasaki Municipal Hospital, Kanagawa
| | - Keisuke Shigeta
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Abe
- Department of Clinical and Translational Research Center, Keio University School of Medicine, Tokyo.,Yokohama City University, School of Data Science, Kanagawa
| | - Yasumasa Miyazaki
- Department of Urology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa
| | - Gou Kaneko
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama
| | - Takahiro Maeda
- Department of Urology, Kawasaki Municipal Hospital, Kanagawa
| | | | - Kunimitsu Kanai
- Department of Urology, National Hospital Organization Saitama National Hospital, Saitama
| | - Hiroki Ide
- Department of Urology, Saiseikai Central Hospital, Tokyo
| | - Suguru Shirotake
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
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Yasuda H, Sanui M, Nishimura T, Kamo T, Nango E, Abe T, Roberts R, Takebayashi T, Hashimoto S, Lefor AK. Optimal Upper Limits of Plateau Pressure for Patients With Acute Respiratory Distress Syndrome During the First Seven Days: A Meta-Regression Analysis. J Clin Med Res 2021; 13:48-63. [PMID: 33613800 PMCID: PMC7869567 DOI: 10.14740/jocmr4390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background The effects of plateau pressure during the initial days of mechanical ventilation on outcomes for patients with acute respiratory distress syndrome have not been fully examined. We conducted meta-regression analysis of plateau pressure during the first 7 days using randomized control trials to investigate the optimal upper limits of plateau pressure on different days of mechanical ventilation. Methods Randomized controlled trials comparing two mechanical ventilation strategies with lower and higher plateau pressures in patients with acute respiratory distress syndrome were included. Meta-regression analysis was performed to determine the association of plateau pressure with mortality on days 1, 3, and 7 of mechanical ventilation. Results After evaluation of 2,975 citations from a comprehensive search across electronic databases, 14 studies were included in the final qualitative analysis. A total of 4,984 patients were included in the quantitative analysis. As a result of the pairwise comparison, overall short-term mortality was significantly higher for patients with plateau pressures over 32 cm H2O during the first 3 days after intensive care unit (ICU) admission (day 1: relative risk (RR), 0.77; 95% confidence interval (CI), 0.66 - 0.89; I2 = 0%; day 3: RR, 0.76; 95% CI, 0.64 - 0.90; I2 = 0%), but not on day 7 (RR, 0.82; 95% CI, 0.65 - 1.04; I2 = 16%). Plateau pressures below 27 cm H2O and 30 cm H2O were not associated with an absolute risk reduction of short-term mortality. According to univariable meta-regression analysis, mortality was significantly associated with plateau pressure on day 1 (β = 0.01 (95% CI, 0.002 - 0.024), P = 0.02). On days 3 and 7, however, no significant difference was detected. When the cutoffs were set at 27, 30 and 32 cm H2O on day 1, which showed a significant difference, plateau pressure tended to be associated with increased mortality at pressures above the cut-off values, and there were no significant differences at pressures below the cut-off values, regardless of the cutoff used. Conclusions This study suggests that the optimal cut-off value for plateau pressure may be 27 cm H2O especially during the initial period of mechanical ventilation, although this association may not continue during the latter period of mechanical ventilation.
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Affiliation(s)
- Hideto Yasuda
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama-shi, Saitama 330-8503, Japan.,Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama-shi, Saitama 330-8503, Japan
| | - Tetsuro Nishimura
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka-City, Osaka 545-8585, Japan
| | - Tetsuro Kamo
- Department of Respiratory Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Eishu Nango
- Department of Family Medicine, JCHO Tokyo Joto Hospital, 9-13-1, Kameido, Koutou-ku, Tokyo 136-0071, Japan
| | - Takayuki Abe
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Biostatistics Unit at Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Rachel Roberts
- Biostatistics Unit at Clinical and Translational Research Center, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Satoru Hashimoto
- Department of Anesthesiology and Intensive Care, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto-shi, Kyoto 602-8566, Japan
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi-ken 329-0498, Japan
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