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Awano H, Nambu Y, Itoh C, Kida A, Yamamoto T, Lee T, Takeshima Y, Nozu K, Matsuo M. Longitudinal data of serum creatine kinase levels and motor, pulmonary, and cardiac functions in 337 patients with Duchenne muscular dystrophy. Muscle Nerve 2024; 69:604-612. [PMID: 38511270 DOI: 10.1002/mus.28073] [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: 04/16/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION/AIMS Duchenne muscular dystrophy (DMD) presents with skeletal muscle weakness, followed by cardiorespiratory involvement. The need for longitudinal data regarding DMD that could serve as a control for determining treatment efficacy in clinical trials has increased notably. The present study examined the longitudinal data of Japanese DMD patients collectively and assessed individual patients with pathogenic variants eligible for exon-skipping therapy. METHODS Patients with DMD who visited Kobe University Hospital between March 1991 and March 2019 were enrolled. Data between the patients' first visit until age 20 years were examined. RESULTS Three hundred thirty-seven patients were included. Serum creatine kinase levels showed extremely high values until the age of 6 years and a rapid decline from ages 7-12 years. Both the median 10-m run/walk velocity and rise-from-floor velocity peaked at the age of 4 years and declined with age. The values for respiratory function declined from the age of 11 years. The median left ventricular ejection fraction was >60% until the age of 12 years and rapidly declined from ages 13-15 years. Examination of the relationship between pathogenic variants eligible for exon-skipping therapy and longitudinal data revealed no characteristic findings. DISCUSSION We found that creatine kinase levels and motor, respiratory, and cardiac functions each exhibited various changes over time. These findings provide useful information about the longitudinal data of several outcome measures for patients with DMD not receiving corticosteroids. These data may serve as historical controls in comparing the natural history of DMD patients not on regular steroid use in appropriate clinical trials.
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Affiliation(s)
- Hiroyuki Awano
- Research Initiative Center, Organization for Research Initiative and Promotion, Tottori University, Yonago, Japan
| | - Yoshinori Nambu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chieko Itoh
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | - Akihiro Kida
- Division of Rehabilitation Medicine, Kobe University Hospital, Kobe, Japan
| | | | - Tomoko Lee
- Department of Pediatrics, Hyogo Medical University, Nishinomiya, Japan
| | | | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masafumi Matsuo
- Faculty of Health Sciences, Kobe Tokiwa University, Kobe, Japan
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Hirota S, Tateishi U, Nakamoto Y, Yamamoto H, Sakurai S, Kikuchi H, Kanda T, Kurokawa Y, Cho H, Nishida T, Sawaki A, Ozaka M, Komatsu Y, Naito Y, Honma Y, Takahashi F, Hashimoto H, Udo M, Araki M, Nishidate S. English version of Japanese Clinical Practice Guidelines 2022 for gastrointestinal stromal tumor (GIST) issued by the Japan Society of Clinical Oncology. Int J Clin Oncol 2024:10.1007/s10147-024-02488-1. [PMID: 38609732 DOI: 10.1007/s10147-024-02488-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/12/2024] [Indexed: 04/14/2024]
Abstract
The Japan Society of Clinical Oncology Clinical Practice Guidelines 2022 for gastrointestinal stromal tumor (GIST) have been published in accordance with the Minds Manual for Guideline Development 2014 and 2017. A specialized team independent of the working group for the revision performed a systematic review. Since GIST is a rare type of tumor, clinical evidence is not sufficient to answer several clinical and background questions. Thus, in these guidelines, we considered that consensus among the experts who manage GIST, the balance between benefits and harms, patients' wishes, medical economic perspective, etc. are important considerations in addition to the evidence. Although guidelines for the treatment of GIST have also been published by the National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO), there are some differences between the treatments proposed in those guidelines and the treatments in the present guidelines because of the differences in health insurance systems among countries.
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Affiliation(s)
- Seiichi Hirota
- Department of Surgical Pathology, Hyogo Medical University School of Medicine, Nishinomiya, Japan.
| | - Ukihide Tateishi
- Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidetaka Yamamoto
- Department of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Shinji Sakurai
- Department of Diagnostic Pathology, Japan Community Healthcare Organization Gunma Central Hospital, Maebashi, Japan
| | - Hirotoshi Kikuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tatsuo Kanda
- Department of Gastroenterology, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Haruhiko Cho
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Toshirou Nishida
- Department of Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - Akira Sawaki
- Department of Medical Oncology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Masato Ozaka
- Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoshito Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Yoichi Naito
- Department of General Internal Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Morioka, Japan
| | | | - Midori Udo
- Nursing Department, Osaka Police Hospital, Osaka, Japan
| | - Minako Araki
- Association of Chubu GIST Patients and Their Families, Nagoya, Japan
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Nonaka H, Kondo T, Suga M, Yamanaka R, Sagara Y, Tsukita K, Mitsutomi N, Homma K, Saito R, Miyoshi F, Ohzeki H, Okuyama M, Inoue H. Induced pluripotent stem cell-based assays recapture multiple properties of human astrocytes. J Cell Mol Med 2024; 28:e18214. [PMID: 38509731 PMCID: PMC10955154 DOI: 10.1111/jcmm.18214] [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: 09/22/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
The majority of the population of glial cells in the central nervous system consists of astrocytes, and impairment of astrocytes causes various disorders. It is useful to assess the multiple astrocytic properties in order to understand their complex roles in the pathophysiology. Although we can differentiate human astrocytes from induced pluripotent stem cells (iPSCs), it remains unknown how we can analyse and reveal the multiple properties of astrocytes in complexed human disease conditions. For this purpose, we tested astrocytic differentiation protocols from feeder-free iPSCs based on the previous method with some modifications. Then, we set up extra- and intracellular assessments of iPSC-derived astrocytes by testing cytokine release, calcium influx, autophagy induction and migration. The results led us to analytic methods with conditions in which iPSC-derived astrocytes behave as in vivo. Finally, we applied these methods for modelling an astrocyte-related disease, Alexander disease. An analytic system using iPSC-derived astrocytes could be used to recapture complexities in human astrocyte diseases.
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Affiliation(s)
- Hideki Nonaka
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Mitsubishi Tanabe Pharma CorporationYokohamaJapan
| | - Takayuki Kondo
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Center for iPS Cell Research and Application (CiRA)Kyoto UniversityKyotoJapan
- Medical‐risk Avoidance based on iPS Cells Team, RIKEN Center for Advanced Intelligence Project (AIP)KyotoJapan
| | - Mika Suga
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Center for iPS Cell Research and Application (CiRA)Kyoto UniversityKyotoJapan
| | - Ryu Yamanaka
- Mitsubishi Tanabe Pharma CorporationYokohamaJapan
| | - Yukako Sagara
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Center for iPS Cell Research and Application (CiRA)Kyoto UniversityKyotoJapan
| | - Kayoko Tsukita
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Center for iPS Cell Research and Application (CiRA)Kyoto UniversityKyotoJapan
| | | | - Kengo Homma
- Mitsubishi Tanabe Pharma CorporationYokohamaJapan
| | - Ryuta Saito
- Mitsubishi Tanabe Pharma CorporationYokohamaJapan
| | | | | | | | - Haruhisa Inoue
- iPSC‐based Drug Discovery and Development Team, RIKEN BioResource Research Center (BRC)KyotoJapan
- Center for iPS Cell Research and Application (CiRA)Kyoto UniversityKyotoJapan
- Medical‐risk Avoidance based on iPS Cells Team, RIKEN Center for Advanced Intelligence Project (AIP)KyotoJapan
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Ito K. Older people living in the community with delusion. Geriatr Gerontol Int 2024; 24 Suppl 1:118-122. [PMID: 37846780 DOI: 10.1111/ggi.14699] [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: 08/20/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
AIM This study explores the intricate relationship between social interactions and the development of persecutory delusions among older women living alone in Japan. Focusing on the unique perspective of individuals experiencing delusions outside clinical settings, the aim was to understand the impact of interpersonal interactions on delusion formation. METHODS Cases of older women living alone with persecutory delusions were selected from records of municipal psychogeriatric services and medical consultations within a community space. This study employed a descriptive approach to propose a hypothesis regarding the possible connection between social interactions and the development of persecutory delusions within this demographic. RESULTS Two relevant cases were identified, from which a three-step hypothesis emerged regarding the potential link between social interactions and the development of persecutory delusions in this demographic. Insights from these cases suggest that anxiety can trigger hallucinations, which, when unaddressed, evolve into delusional interpretations. Addressing these unmet needs could mitigate the progression of persecutory delusions. CONCLUSIONS The findings of this study underline the critical relationship between social interactions and persecutory delusions among older women living alone. The unmet need for empathy influences the progression from anxiety-driven hallucinations to fully formed delusions. Early intervention can prevent the escalation of delusions and involuntary psychiatric hospitalization. This study underscores the importance of recognizing the link between social isolation and delusion emergence. It advocates for compassionate environments to meet the psychological needs of older individuals grappling with delusions. Geriatr Gerontol Int 2024; 24: 118-122.
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Affiliation(s)
- Kae Ito
- Tokyo Metropolitan Institute for Geriatrics and Gerontology Research Team for Human Care, Tokyo, Japan
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5
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Nakajima N, Jinnai M, Izumiyama S, Kuroki T. Evaluating Fourier-transform infrared spectroscopy with IR Biotyper as a faster and simpler method for investigating the sources of an outbreak of legionellosis. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04781-3. [PMID: 38379053 DOI: 10.1007/s10096-024-04781-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
Fourier-transform infrared (FTIR) spectroscopy using the IR Biotyper and core genome single nucleotide polymorphism (cgSNP) analysis were performed on 12 Legionella isolates associated with an outbreak at a spa house in Kanagawa Prefecture, Japan, and 3 non-outbreak isolates. The discriminative power of FTIR spectroscopy for 48-h incubation conditions of L. pneumophila in this outbreak was lower than cgSNP-based typing but higher than serogroup typing. FTIR spectroscopy could screen outbreak isolates from a group of genetically related isolates and may be useful as an initial typing method in Legionella outbreak investigations.
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Affiliation(s)
- Naoki Nakajima
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa, 253-0087, Japan.
| | - Michio Jinnai
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa, 253-0087, Japan
| | - Shinji Izumiyama
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshiro Kuroki
- Faculty of Veterinary Medicine, Okayama University of Science, Okayama, Japan
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Kawamura J, Tanaka T, Kanno S, Osawa K, Okabayashi K, Hirano H, Shirobe M, Nagatani M, Son BK, Lyu W, Iijima K. Relationship between a gum-chewing routine and oral, physical, and cognitive functions of community-dwelling older adults: A Kashiwa cohort study. Geriatr Gerontol Int 2024; 24:68-74. [PMID: 38054384 DOI: 10.1111/ggi.14757] [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: 03/27/2023] [Revised: 09/21/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023]
Abstract
AIM As associations between oral function and general health have been reported in community-dwelling older adults, easily implementable preventive measures are urgently required. We focused on the health benefits of gum chewing, as no studies have been carried out on the impact of gum-chewing routines on the health of older adults. This cross-sectional study aimed to determine whether the gum-chewing routine is associated with oral, physical and cognitive functions in community-dwelling older adults. METHODS This study included 1617 community-dwelling older participants in a health survey carried out in 2021. The gum-chewing routine and weekly chewing time were assessed using a self-administered questionnaire. The outcome measures, including actual measurements of oral function, physical function, cognitive function, dietary intake and lifestyle, were evaluated using self-administered questionnaires or health surveys. RESULTS We analyzed 1474 (mean age 76.1 ± 5.8 years, 45% women) participants for whom all data were not missing, and 14% of them had a gum-chewing routine for more than 30 min weekly. Oral functions were significantly higher in older adults with a gum-chewing routine, and there were substantially fewer participants with oral frailty (adjusted odds ratio 0.581, 95% confidence interval 0.340-0.993). Additionally, cognitive and physical functions, including grip strength, were significantly higher in the gum-chewing routine group. CONCLUSIONS Community-dwelling older adults with a gum-chewing routine have higher oral, physical and cognitive functions. These findings indicate that a gum-chewing routine might contribute to maintaining oral function and preventing frailty. Geriatr Gerontol Int 2024; 24: 68-74.
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Affiliation(s)
- Jun Kawamura
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Central Research Laboratory, LOTTE CO., LTD., Tokyo, Japan
| | - Tomoki Tanaka
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Susumu Kanno
- Central Research Laboratory, LOTTE CO., LTD., Tokyo, Japan
| | - Kenji Osawa
- Central Research Laboratory, LOTTE CO., LTD., Tokyo, Japan
| | | | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Miyuki Nagatani
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Bo-Kyung Son
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Weida Lyu
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Yamazaki S, Ura C, Inagaki H, Sugiyama M, Miyamae F, Edahiro A, Ito K, Iwasaki M, Sasai H, Okamura T, Hirano H, Awata S. Social isolation and well-being among families of middle-aged and older hikikomori people. Psychogeriatrics 2024; 24:145-147. [PMID: 37932240 DOI: 10.1111/psyg.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/26/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Affiliation(s)
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kae Ito
- Research Team for Human Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Okamura T, Ura C, Kugimiya Y, Okamura M, Yamamura M, Okado H, Kaneko M, Yamashita M, Wakui T. Inaccessibility, unresponsiveness, inconsistency, and invisibility of informal caregivers of older persons with cognitive impairment: community-based participatory research. BMC Geriatr 2023; 23:812. [PMID: 38057710 PMCID: PMC10702127 DOI: 10.1186/s12877-023-04542-5] [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: 05/26/2023] [Accepted: 11/30/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Studies on informal caregivers in Japan have been limited to family caregivers and largely conducted where family caregivers generally gather. Family caregivers who do not visit such places or non-family caregivers are generally overlooked, and data on these informal caregivers remains scant. Consequently, a framework is needed through which healthcare professionals can approach the informal caregivers of community-dwelling older persons. Therefore, this study approaches such informal caregivers and proposes a classification system for them from the starting point of older persons living in the community with cognitive impairment. METHODS In 2016, we conducted an epidemiological survey of 7000 + community-dwelling older persons and identified 198 residents with Mini-mental state examination scores less than 23. A team of healthcare professionals contacted them regularly. By 2022, 92 people were still living in the community, and we systematically asked them about their informal caregivers. After approaching the caregivers and obtaining informed consent, we mailed separate questionnaires to older persons and informal caregivers. RESULTS Among the caregivers, 59%, 34%, and 3% were the child, spouse, and sibling of the older person, while the remaining 4% were non-family caregivers. Except for two daughters-in-laws, all children were biological children of the older person. Male caregivers (46%) tended to have full-time jobs, whereas female caregivers (54%) tended to face financial difficulties. Only 3% of the caregivers had joined a family caregivers' association. Caregivers' reason for not joining such organizations was a lack of time and knowledge. A 3-tiered classification system was developed for these informal caregivers: (1) the household form, (2) accessibility, and (3) the reciprocal awareness of caregiving. Furthermore, family caregivers who lived with the older person or visited them more than once a week with reciprocal awareness of caring and being cared, or "traditional caregivers," accounted for 68% of the caregivers in this study. CONCLUSION Core family caregivers can be easily approached at places where such caregivers generally gather. However, there also exists a group of informal caregivers who are sometimes inaccessible, unresponsive, and invisible to healthcare professionals. Moreover, their awareness of caregiving is sometimes inconsistent.
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Affiliation(s)
- Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yukiko Kugimiya
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Mutsuko Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masako Yamamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hidemi Okado
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Mayumi Kaneko
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Mari Yamashita
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Tomoko Wakui
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Okamura T, Taga T, Inagaki H, Miyamae F, Ura C, Sugiyama M, Edahiro A, Shirobe M, Motokawa K, Kojima N, Osuka Y, Iwasaki M, Sasai H, Hirano H, Awata S. Barrier to sharing a dementia diagnosis with neighbors in Tokyo. Geriatr Gerontol Int 2023; 23:761-763. [PMID: 37691496 DOI: 10.1111/ggi.14662] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/18/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Affiliation(s)
- Tsuyoshi Okamura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Tsutomu Taga
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Fumiko Miyamae
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Chiaki Ura
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Mika Sugiyama
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Hokkaido University, Sapporo, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
| | - Shuichi Awata
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology and Geriatrics, Tokyo, Japan
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10
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Sakamoto A, Inokuchi R, Iwagami M, Hanari K, Tamiya N. Association between physicians' characteristics and their knowledge, attitudes, and practices regarding advance care planning: a cross-sectional study. BMC Palliat Care 2023; 22:134. [PMID: 37697265 PMCID: PMC10494406 DOI: 10.1186/s12904-023-01253-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Despite physicians' vital role in advance care planning, a limited number of physicians practice it. This study assessed factors associated with physicians' knowledge, attitudes, and practices regarding advance care planning. METHODS This cross-sectional study used data from an anonymous survey conducted by the Japanese Ministry of Health, Labour and Welfare. Questionnaires were mailed to 4500 physicians in November and December 2022. Data from 1260 respondents were analyzed. RESULTS Of the respondents, 46.4%, 77.0%, and 82.0% reported good knowledge of advance care planning, agreed with promoting it, and with its provision by medical/care staff, respectively. Male physicians were significantly less likely to support advance care planning (odds ratio: 0.54, 95% confidence interval: 0.35-0.84) or agree to its provision by medical/care staff (odds ratio: 0.47, 95% confidence interval: 0.29-0.78) but significantly more likely to practice it (odds ratio: 1.58, 95% confidence interval: 1.05-2.36). Physicians specialized in surgery or internal/general/palliative medicine were more knowledgeable about advance care planning and more likely to practice it. Physicians working in clinics were significantly less knowledgeable (odds ratio: 0.33, 95% confidence interval: 0.25-0.44) about advance care planning and less likely to support it (odds ratio: 0.37, 95% confidence interval: 0.27-0.50), agree with its provision by medical/care staff (odds ratio: 0.54, 95% confidence interval: 0.39-0.75), or to practice it (odds ratio: 0.16, 95% confidence interval: 0.12-0.22). CONCLUSIONS Physicians working in clinics had less knowledge of advance care planning, less supportive attitudes, and less likely to practice it. Knowledge, attitudes and practice also varied by gender and specialty. Interventions should target physicians working in clinics.
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Affiliation(s)
- Ayaka Sakamoto
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
- Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Ryota Inokuchi
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan.
| | - Masao Iwagami
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Kyoko Hanari
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Nanako Tamiya
- Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
- Department of Health Services Research, Institute of Medicine, University of Tsukuba, 1-1-1 Tenno-Dai, Tsukuba, Ibaraki, 305-8577, Japan
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11
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Obata S, Hisatsune J, Kawasaki H, Fukushima-Nomura A, Ebihara T, Arai C, Masuda K, Kutsuno S, Iwao Y, Sugai M, Amagai M, Tanese K. Comprehensive Genomic Characterization of Staphylococcus aureus Isolated from Atopic Dermatitis Patients in Japan: Correlations with Disease Severity, Eruption Type, and Anatomical Site. Microbiol Spectr 2023; 11:e0523922. [PMID: 37432109 PMCID: PMC10434064 DOI: 10.1128/spectrum.05239-22] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/12/2023] [Indexed: 07/12/2023] Open
Abstract
Atopic dermatitis (AD) shows frequent recurrence. Staphylococcus aureus is the primary microbial component in AD and is associated with disease activity. However, traditional typing methods have failed to characterize virulent AD isolates at the clone level. We conducted a comprehensive genomic characterization of S. aureus strains isolated from the skin of AD patients and healthy donors, comparing the whole-genome sequences of the 261 isolates with anatomical and lesional (AD-A)/nonlesional (AD-NL)/healthy sites, eruption types, clinical scores, virulence, and antimicrobial resistance gene repertoires in Japan. Sequence type (ST) diversity was lost with worsening disease activity; ST188 was the most frequently detected ST in AD-A and had the strongest correlation with AD according to the culture rate and proportion with worsening disease activity. ST188 and ST20 isolates inhabited all skin conditions, with significantly higher proportions in AD skin than in healthy skin. ST8, ST15, and ST5 proportions were equivalent for all skin conditions; ST30 was detected only in healthy skin; and ST12 was detected only in AD skin. ST97 detected in AD-A and healthy skin was clearly branched into two subclades, designated ST97A and ST97H. A comparison of two genomes led to the discovery that only ST97A possessed the complete trp operon, enabling bacterial survival without exogenous tryptophan (Trp) on AD skin, where the Trp level was significantly reduced. Primary STs showing an AD skin inhabitation trend (ST188, ST97A, ST20, and ST12) were all trp operon positive. The predominant clones (ST188 and ST97) possessed almost no enterotoxin genes, no mecA gene, and few other antimicrobial resistance genes, different from the trend observed in Europe/North America. IMPORTANCE While Staphylococcus aureus is a member of the normal human skin flora, its strong association with the onset of atopic dermatitis (AD) has been suggested. However, previous studies failed to assign specific clones relevant to disease activities. Enterotoxins produced by S. aureus have been suggested to aggravate and exacerbate the inflammation of AD skin, but their role remains ambiguous. We conducted a nuanced comprehensive characterization of isolates from AD patients and healthy donors, comparing the whole-genome sequences of the isolates with anatomical and lesional/nonlesional/healthy sites, eruption types, clinical scores, virulence, and antimicrobial resistance gene repertoires in Japan. We demonstrate that specific clones are associated with disease severity and clinical manifestations, and the dominant clones are devoid of enterotoxin genes and antimicrobial resistance genes. These findings undermine the established notion of the pathophysiological function of S. aureus associated with AD and introduce a new concept of S. aureus colonization in AD.
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Affiliation(s)
- Shoko Obata
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Antimicrobial Resistance, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Kawasaki
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
- Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Laboratory for Developmental Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - Tamotsu Ebihara
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Chika Arai
- Department of Antimicrobial Resistance, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Kanako Masuda
- Department of Antimicrobial Resistance, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Shoko Kutsuno
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Antimicrobial Resistance, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuhisa Iwao
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Antimicrobial Resistance, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
- Laboratory for Skin Homeostasis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Keiji Tanese
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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12
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Fujita K, Arai R, Shoji S, Saito R, Nomura M, Hotta T, Asahina H, Kawakami M, Nakachi I, Hasegawa Y, Okafuji K, Suzuki A, Miyanaga A, Sunaga N, Nagashima H, Ikeda N, Watanabe S, Nagai Y, Furuta M, Kage H, Arai D, Fukuhara T, Nakayama M, Morita S, Kobayashi K, Hagiwara K. Detection of multiple druggable mutations of lung cancer from cytology specimens by MINtS: An advanced medicine A trial. Cancer Sci 2023; 114:3342-3351. [PMID: 37139543 PMCID: PMC10394136 DOI: 10.1111/cas.15831] [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: 02/12/2023] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 05/05/2023] Open
Abstract
Most multigene mutation tests require tissue specimens. However, cytological specimens are easily obtained in the clinical practice and provide high-quality DNA and RNA. We aimed to establish a test that utilizes cytological specimens and performed a multi-institutional study to investigate the performance of MINtS, a test based on next-generation sequencing. A standard procedure for specimen isolation was defined. The specimens were considered suitable for the test if >100 ng DNA and >50 ng RNA could be extracted from them. In total, 500 specimens from 19 institutions were investigated. MINtS detected druggable mutations in 63% (136 of 222) of adenocarcinomas. Discordant results between MINtS and the companion diagnostics were observed in 14 of 310 specimens for the EGFR gene, and 6 of 339 specimens for the ALK fusion genes. Confirmation by other companion diagnostics for the EGFR mutations or the clinical response to an ALK inhibitor all supported the results obtained by MINtS. MINtS along with the isolation procedure presented in the current study will be a platform to establish multigene mutation tests that utilize cytological specimens. UMIN000040415.
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Affiliation(s)
- Kazutaka Fujita
- Division of Pulmonary Medicine, Department of Internal MedicineJichi Medical UniversityTochigiJapan
| | - Ryo Arai
- Department of Pulmonary and Clinical ImmunologyDokkyo Medical University School of Medicine, Shimotsuga‐gun Mibu‐machiTochigiJapan
| | - Satoshi Shoji
- Department of Respiratory Medicine and Infectious DiseasesNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Ryota Saito
- Department of Respiratory MedicineTohoku University Graduate School of MedicineSendaiJapan
| | - Motoko Nomura
- Division of Pulmonary Medicine, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Takamasa Hotta
- Department of Internal Medicine. Division of Medical Oncology and Respiratory MedicineShimane UniversityIzumoJapan
| | - Hajime Asahina
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
| | - Masanori Kawakami
- Department of Respiratory MedicineThe University of Tokyo HospitalTokyoJapan
| | - Ichiro Nakachi
- Pulmonary Division, Department of Internal MedicineSaiseikai Utsunomiya HospitalTochigiJapan
| | - Yukihiro Hasegawa
- Department of Respiratory MedicineAomori Prefectural Central HospitalAomoriJapan
| | - Kohei Okafuji
- Department of Pulmonary MedicineSt. Luke's International HospitalTokyoJapan
| | - Aya Suzuki
- Miyagi Cancer CenterDepartment of Respiratory MedicineNatoriJapan
| | - Akihiko Miyanaga
- Department of Pulmonary Medicine and OncologyGraduate School of Medicine, Nippon Medical SchoolTokyoJapan
| | - Noriaki Sunaga
- Department of Respiratory MedicineGunma University Graduate School of MedicineMaebashiJapan
| | - Hiromi Nagashima
- Division of Pulmonary Medicine, Department of Internal MedicineIwate Medical UniversityIwateJapan
| | - Naoya Ikeda
- Department of Pulmonary and Clinical ImmunologyDokkyo Medical University School of Medicine, Shimotsuga‐gun Mibu‐machiTochigiJapan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious DiseasesNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
| | - Yoshiaki Nagai
- Division of Pulmonary Medicine, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
| | - Megumi Furuta
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
| | - Hidenori Kage
- Department of Respiratory MedicineThe University of Tokyo HospitalTokyoJapan
| | - Daisuke Arai
- Pulmonary Division, Department of Internal MedicineSaiseikai Utsunomiya HospitalTochigiJapan
| | - Tatsuro Fukuhara
- Miyagi Cancer CenterDepartment of Respiratory MedicineNatoriJapan
| | - Masayuki Nakayama
- Division of Pulmonary Medicine, Department of Internal MedicineJichi Medical UniversityTochigiJapan
| | - Satoshi Morita
- Department of Biomedical Statistics and BioinformaticsKyoto University Graduate School of MedicineKyotoJapan
| | - Kunihiko Kobayashi
- Department of Respiratory MedicineSaitama Medical University, International Medical CenterSaitamaJapan
| | - Koichi Hagiwara
- Division of Pulmonary Medicine, Department of Internal MedicineJichi Medical UniversityTochigiJapan
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13
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Yu L, Hisatsune J, Kutsuno S, Sugai M. New Molecular Mechanism of Superbiofilm Elaboration in a Staphylococcus aureus Clinical Strain. Microbiol Spectr 2023; 11:e0442522. [PMID: 36719203 PMCID: PMC10100805 DOI: 10.1128/spectrum.04425-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023] Open
Abstract
Previously, we reported a novel regulator of biofilm (rob) with a nonsense mutation in the superbiofilm-elaborating strain JP080. Intriguingly, the complementation of JP080 with wild-type rob did not completely abolish its superbiofilm-elaborating phenotype. Therefore, we searched for other possible mutation(s) using complete genome sequence data and found a missense mutation in the gene icaR, which altered its 35th amino acid (Ala35Thr). To further study the mechanism of superbiofilm elaboration in JP080, we reconstructed the same mutations of rob and icaR in the strain FK300 and analyzed the phenotypes. The mutation of rob (A331T) increased biofilm elaboration, as previously demonstrated; similarly, an icaR mutation increased poly-N-acetylglucosamine and biofilm production in strain FK300. Furthermore, our analyses indicated that the double mutant of rob and icaR produced significantly more biofilms than the single mutants. Additionally, gel shift analysis revealed that the icaR from JP080 lost its ability to bind to the ica promoter region. These findings suggest that the icaR mutation in JP080 may result in a nonfunctional protein. We compared ica operon expression in an icaR single mutant, rob single mutant, and rob and icaR double mutant to the wild type. The rob and icaR mutants showed increased ica operon transcription by approximately 19- and 79-fold, respectively. However, the rob and icaR double mutant showed an approximately 350-fold increase, indicating the synergistic effects of icaR and rob on JP080 biofilm elaboration. Consequently, we concluded that the double mutations rob and icaR synergistically increased ica operon transcription, resulting in a superbiofilm phenotype in Staphylococcus aureus. IMPORTANCE Poly-N-acetylglucosamine (PNAG) is a major component of S. aureus biofilm. PNAG production is mediated by the products of four genes, icaADBC encoded in the ica operon, and the major negative regulator of this operon is IcaR encoded just upstream of icaADBC. Previously, we reported another negative regulator, Rob, through gene expression analysis of clinically isolated superbiofilm-elaborating strain JP080. The rob gene is encoded at different loci distant from the ica operon. Here, we report that JP080 also carried a mutation in icaR and demonstrated that IcaR and Rob synergistically regulate PNAG production. We successfully reconstructed these mutations in a wild type, and the double mutant resulted in superbiofilm-elaborating phenotype. We clearly show that loss of function of both IcaR and Rob is the very reason that JP080 is showing the superbiofilm-elaborating phenotype. This study clearly demonstrated there are at least two independent regulators synergistically fine-tuning PNAG production and suggested the complex regulatory mechanism of biofilm production.
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Affiliation(s)
- Liansheng Yu
- Antimicrobial Resistance Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shoko Kutsuno
- Antimicrobial Resistance Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Centre, National Institute of Infectious Diseases, Tokyo, Japan
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
- Department of Antimicrobial Resistance, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Osaki T, Souri M, Ichinose A. Important roles of the human leukocyte antigen class I and II molecules and their associated genes in the autoimmune coagulation factor XIII deficiency via whole-exome sequencing analysis. PLoS One 2021; 16:e0257322. [PMID: 34506591 PMCID: PMC8432773 DOI: 10.1371/journal.pone.0257322] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
Autoimmune coagulation factor XIII deficiency is a bleeding disorder caused by the formation of autoantibodies against the coagulation factor XIII (FXIII); however, the molecular mechanism underlying this process is unknown. Therefore, in the present study, we aimed to elucidate this mechanism by performing whole-exome sequencing analysis of 20 cases of autoimmune FXIII deficiency. We identified approximately 21,788–23,916 variants in each case. In addition to their ability to activate T cells, present antigens, and immune tolerance, the candidate alleles were further narrowed down according to their allelic frequencies and the magnitude of damage caused by the substitution of amino acids. After selecting 44 candidate alleles, we investigated whether they were associated with the FXIII inhibitory titers and/or the anti-FXIII autoantibodies. We found that two polymorphisms whose variant allele frequencies were significantly lower in the patients tended to decrease FXIII inhibitory titers as the number of variant alleles increased. We also found that five polymorphisms whose variant allele frequencies were significantly higher in the patients tended to increase the levels of the anti-FXIII autoantibodies as the number of variant alleles increased. All of these polymorphisms were found in the human leukocyte antigen (HLA) class I and II molecules and their associated genes. In particular, the HLA class II molecule and its associated genes were found to be involved in the presentation of foreign antigens as well as the negative regulation of the proliferation of T-cells and the release of cytokines. Polymorphisms in the HLA class II molecules and the cytotoxic T lymphocyte antigen 4 have been reported to be associated with the development of autoantibodies in acquired hemophilia A. Therefore, we hypothesized that these polymorphisms may be associated with the development of autoantibodies in autoimmune FXIII deficiency.
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Affiliation(s)
- Tsukasa Osaki
- Japanese Collaborative Research Group on Autoimmune Coagulation Factor Deficiencies (JCRG supported by the Japanese Ministry of Health, Labor and Welfare), Yamagata, Japan
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan
- Department of Public Health and Hygiene, Yamagata University Faculty of Medicine, Yamagata, Japan
- * E-mail:
| | - Masayoshi Souri
- Japanese Collaborative Research Group on Autoimmune Coagulation Factor Deficiencies (JCRG supported by the Japanese Ministry of Health, Labor and Welfare), Yamagata, Japan
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan
- Department of Public Health and Hygiene, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Akitada Ichinose
- Japanese Collaborative Research Group on Autoimmune Coagulation Factor Deficiencies (JCRG supported by the Japanese Ministry of Health, Labor and Welfare), Yamagata, Japan
- Department of Molecular Patho-Biochemistry and Patho-Biology, Yamagata University School of Medicine, Yamagata, Japan
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15
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Yamada G, Hayakawa K, Matsunaga N, Terada M, Suzuki S, Asai Y, Ohtsu H, Toyoda A, Kitajima K, Tsuzuki S, Saito S, Ohmagari N. Predicting respiratory failure for COVID-19 patients in Japan: a simple clinical score for evaluating the need for hospitalisation. Epidemiol Infect 2021; 149:e175. [PMID: 36043382 PMCID: PMC8365048 DOI: 10.1017/s0950268821001837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Indexed: 12/24/2022] Open
Abstract
Predicting the need for hospitalisation of patients with coronavirus disease 2019 (COVID-19) is important for preventing healthcare disruptions. This observational study aimed to use the COVID-19 Registry Japan (COVIREGI-JP) to develop a simple scoring system to predict respiratory failure due to COVID-19 using only underlying diseases and symptoms. A total of 6873 patients with COVID-19 admitted to Japanese medical institutions between 1 June 2020 and 2 December 2020 were included and divided into derivation and validation cohorts according to the date of admission. We used multivariable logistic regression analysis to create a simple risk score model, with respiratory failure as the outcome for young (18-39 years), middle-aged (40-64 years) and older (≥65 years) groups, using sex, age, body mass index, medical history and symptoms. The models selected for each age group were quite different. Areas under the receiver operating characteristic curves for the simple risk score model were 0.87, 0.79 and 0.80 for young, middle-aged and elderly derivation cohorts, and 0.81, 0.80 and 0.67 in the validation cohorts. Calibration of the model was good. The simple scoring system may be useful in the appropriate allocation of medical resources during the COVID-19 pandemic.
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Affiliation(s)
- Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Author for correspondence: Gen Yamada, E-mail:
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Setsuko Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ako Toyoda
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Kitajima
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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16
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Terada M, Ohtsu H, Saito S, Hayakawa K, Tsuzuki S, Asai Y, Matsunaga N, Kutsuna S, Sugiura W, Ohmagari N. Risk factors for severity on admission and the disease progression during hospitalisation in a large cohort of patients with COVID-19 in Japan. BMJ Open 2021; 11:e047007. [PMID: 34130961 PMCID: PMC8210659 DOI: 10.1136/bmjopen-2020-047007] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES To investigate the risk factors contributing to severity on admission. Additionally, risk factors of worst severity and fatality were studied. Moreover, factors were compared based on three points: early severity, worst severity and fatality. DESIGN An observational cohort study using data entered in a Japan nationwide COVID-19 inpatient registry, COVIREGI-JP. SETTING As of 28 September 2020, 10480 cases from 802 facilities have been registered. Participating facilities cover a wide range of hospitals where patients with COVID-19 are admitted in Japan. PARTICIPANTS Participants who had a positive test result on any applicable SARS-CoV-2 diagnostic tests were admitted to participating healthcare facilities. A total of 3829 cases were identified from 16 January to 31 May 2020, of which 3376 cases were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was severe or nonsevere on admission, determined by the requirement of mechanical ventilation or oxygen therapy, SpO2 or respiratory rate. Secondary outcome was the worst severity during hospitalisation, judged by the requirement of oxygen and/orinvasive mechanical ventilation/extracorporeal membrane oxygenation. RESULTS Risk factors for severity on admission were older age, men, cardiovascular disease, chronic respiratory disease, diabetes, obesity and hypertension. Cerebrovascular disease, liver disease, renal disease or dialysis, solid tumour and hyperlipidaemia did not influence severity on admission; however, it influenced worst severity. Fatality rates for obesity, hypertension and hyperlipidaemia were relatively lower. CONCLUSIONS This study segregated the comorbidities influencing severity and death. It is possible that risk factors for severity on admission, worst severity and fatality are not consistent and may be propelled by different factors. Specifically, while hypertension, hyperlipidaemia and obesity had major effect on worst severity, their impact was mild on fatality in the Japanese population. Some studies contradict our results; therefore, detailed analyses, considering in-hospital treatments, are needed for validation. TRIAL REGISTRATION NUMBER UMIN000039873. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045453.
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Affiliation(s)
- Mari Terada
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinya Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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Takayama T, Inoue Y, Yokota R, Hayakawa M, Yamaki C, Toh Y. New Approach for Collecting Cancer Patients' Views and Preferences Through Medical Staff. Patient Prefer Adherence 2021; 15:375-385. [PMID: 33633445 PMCID: PMC7901553 DOI: 10.2147/ppa.s292239] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE It is crucial for health professionals to understand patients' and families' views and preferences (PVPs) to enhance their adherence to treatments and subsequent satisfaction. Regularly and consistently collecting comprehensive information on the needs and concerns of patients/families and utilizing the information is vital for improving clinical practice and the healthcare environment. As an initial approach, this study aimed to develop a new system for appropriately collecting PVPs regarding cancer from nationwide medical staff and consider the potential utilization of PVPs in clinical practice. METHODS Web-based anonymous surveys were conducted with medical staff in nationwide cancer care hospitals in Japan. The surveys queried the questions, values, desires, and experiences expressed by cancer patients or their families on five topics, namely two cancer sites (colorectal and esophageal cancers) and three symptoms and signs (lymphedema, urinary symptoms, and tingling/numbness/pain) within the past year. The PVPs were compared to the five topics and staff medical specialties, and those on tingling/numbness/pain were analyzed qualitatively. RESULTS Among the 904 medical staff who responded to this survey, the PVPs encountered by the staff differed according to the topic and staff medical specialty. Tingling/numbness/pain was the most frequently encountered symptom, and urinary symptoms were the least encountered. Only half or fewer of the medical staff had information available regarding urinary symptoms and tingling/numbness/pain. Further, qualitative content analysis of the expressed PVPs regarding tingling/numbness/pain raised clinical questions on this topic that led to the construction of a "Questions & Answers" section on a public website in Japan. CONCLUSION This study suggests that collecting PVPs through nationwide cancer-related medical staff might be an efficient way to understand the specific requirements of patients/families. It would also be possible to document PVP trends according to changes in the environments of patients/families by nationwide, consistent, and continuous PVP collection.
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Affiliation(s)
- Tomoko Takayama
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
- Correspondence: Tomoko Takayama Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045, JapanTel +81-3-3542-2511 Ex. 1621Fax +81-3-3547-8577 Email
| | - Yoji Inoue
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayo Hayakawa
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Chikako Yamaki
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Yasushi Toh
- National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
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Mizuno H, Ekuni D, Maruyama T, Kataoka K, Yoneda T, Fukuhara D, Sugiura Y, Tomofuji T, Wada J, Morita M. The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: A randomized clinical trial. PLoS One 2017; 12:e0188171. [PMID: 29145468 PMCID: PMC5689834 DOI: 10.1371/journal.pone.0188171] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/31/2017] [Indexed: 12/17/2022] Open
Abstract
Aim The purpose of this study was to investigate the effects of non-surgical periodontal treatment on hemoglobinA1c (HbA1c) levels, oxidative stress balance and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM) compared to no periodontal treatment (simple oral hygiene instructions only). Methods The design was a 6-month, single-masked, single center, randomized clinical trial. Patients had both T2DM and chronic periodontitis. Forty participants were enrolled between April 2014 and March 2016 at the Nephrology, Diabetology and Endocrinology Department of Okayama University Hospital. The periodontal treatment group (n = 20) received non-surgical periodontal therapy, including scaling and root planing plus oral hygiene instructions, and consecutive supportive periodontal therapy at 3 and 6 months. The control group (n = 17) received only oral hygiene instructions without treatment during the experimental period. The primary study outcome was the change in HbA1c levels from baseline to 3 months. Secondary outcomes included changes in oxidative stress balance (Oxidative-INDEX), the Diabetes Therapy-Related QOL and clinical periodontal parameters from baseline to 3 months and baseline to 6 months. Results Changes in HbA1c in the periodontal treatment group were not significantly different with those in the control group at 3 and 6 months. Systemic oxidative stress balance and QOL significantly improved in the periodontal treatment group compared to the control group at 3 months. In the subgroup analysis (moderately poor control of diabetes), the decrease in HbA1c levels in the periodontal treatment group was greater than that in the control group at 3 months but not significant. Conclusions In T2DM patients, non-surgical periodontal treatment improved systemic oxidative stress balance and QOL, but did not decrease HbA1c levels at 3 months follow-up. Trial registration Current Controlled Trials UMIN-ICDR UMIN 000013278 (Registered April 1, 2014).
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Affiliation(s)
- Hirofumi Mizuno
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama, Japan
- * E-mail:
| | - Takayuki Maruyama
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Kota Kataoka
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiki Yoneda
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Daiki Fukuhara
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshio Sugiura
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takaaki Tomofuji
- Department of Community Oral Health, Asahi University School of Dentistry, Mizuho, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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