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Your search keyword '"Iwashita A"' showing total 179 results
Start Over Author "Iwashita A" Publisher biomed central
179 results on '"Iwashita A"'

2. WONDER-02: plastic stent vs. lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic pseudocysts—study protocol for a multicentre randomised non-inferiority trial

Author

Saito, Tomotaka, Takenaka, Mamoru, Kuwatani, Masaki, Doi, Shinpei, Ohyama, Hiroshi, Fujisawa, Toshio, Masuda, Atsuhiro, Iwashita, Takuji, Shiomi, Hideyuki, Hayashi, Nobuhiko, Iwata, Keisuke, Maruta, Akinori, Mukai, Tsuyoshi, Matsubara, Saburo, Hamada, Tsuyoshi, Inoue, Tadahisa, Matsumoto, Kazuyuki, Hirose, Sumio, Fujimori, Nao, Kashiwabara, Kosuke, Kamada, Hideki, Hashimoto, Shinichi, Shiratori, Toshiyasu, Yamada, Reiko, Kogure, Hirofumi, Nakahara, Kazunari, Ogura, Takeshi, Kitano, Masayuki, Yasuda, Ichiro, Isayama, Hiroyuki, and Nakai, Yousuke

Published
2024
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5. Correction: The spectrum of TP53 mutations in Rwandan patients with gastric cancer

Author

Nzitakera, Augustin, Surwumwe, Jean Bosco, Ndoricyimpaye, Ella Larissa, Uwamungu, Schifra, Uwamariya, Delphine, Manirakiza, Felix, Ndayisaba, Marie Claire, Ntakirutimana, Gervais, Seminega, Benoit, Dusabejambo, Vincent, Rutaganda, Eric, Kamali, Placide, Ngabonziza, François, Ishikawa, Rei, Rugwizangoga, Belson, Iwashita, Yuji, Yamada, Hidetaka, Yoshimura, Kimio, Sugimura, Haruhiko, and Shinmura, Kazuya

Published
2024
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6. The spectrum of TP53 mutations in Rwandan patients with gastric cancer

Author

Nzitakera, Augustin, Surwumwe, Jean Bosco, Ndoricyimpaye, Ella Larissa, Uwamungu, Schifra, Uwamariya, Delphine, Manirakiza, Felix, Ndayisaba, Marie Claire, Ntakirutimana, Gervais, Seminega, Benoit, Dusabejambo, Vincent, Rutaganda, Eric, Kamali, Placide, Ngabonziza, François, Ishikawa, Rei, Rugwizangoga, Belson, Iwashita, Yuji, Yamada, Hidetaka, Yoshimura, Kimio, Sugimura, Haruhiko, and Shinmura, Kazuya

Published
2024
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10. Community-based lifestyle intervention for diabetes (Co-LID study) management in rural Nepal: study protocol for a clustered randomized controlled trial

Author

Rawal, Lal, Dahal, Padam, Paudel, Grish, Biswas, Tuhin, Shrestha, Rabina, Makaju, Deepa, Shrestha, Abha, Yadav, Uday, Sahle, Berhe W, Iwashita, Hanako, Masuda, Gaku, Renzaho, Andre, Shakya, Prabin, Shrestha, Archana, Karmacharya, Biraj, Sakamoto, Haruka, Koju, Rajendra, and Sugishita, Tomohiko

Published
2023
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12. Non-CpG sites preference in G:C > A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan)

Author

Natsume, Hiroko, Szczepaniak, Kinga, Yamada, Hidetaka, Iwashita, Yuji, Gędek, Marta, Šuto, Jelena, Ishino, Keiko, Kasajima, Rika, Matsuda, Tomonari, Manirakiza, Felix, Nzitakera, Augustin, Wu, Yijia, Xiao, Nong, He, Qiong, Guo, Wenwen, Cai, Zhenming, Ohta, Tsutomu, Szekely, Tıberiu, Kadar, Zoltan, Sekiyama, Akiko, Oshima, Takashi, Yoshikawa, Takaki, Tsuburaya, Akira, Kurono, Nobuhito, Wang, Yaping, Miyagi, Yohei, Gurzu, Simona, and Sugimura, Haruhiko

Published
2023
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13. WONDER-01: immediate necrosectomy vs. drainage-oriented step-up approach after endoscopic ultrasound-guided drainage of walled-off necrosis—study protocol for a multicentre randomised controlled trial

Author

Sato, Tatsuya, Saito, Tomotaka, Takenaka, Mamoru, Iwashita, Takuji, Shiomi, Hideyuki, Fujisawa, Toshio, Hayashi, Nobuhiko, Iwata, Keisuke, Maruta, Akinori, Mukai, Tsuyoshi, Masuda, Atsuhiro, Matsubara, Saburo, Hamada, Tsuyoshi, Inoue, Tadahisa, Ohyama, Hiroshi, Kuwatani, Masaki, Kamada, Hideki, Hashimoto, Shinichi, Shiratori, Toshiyasu, Yamada, Reiko, Kogure, Hirofumi, Ogura, Takeshi, Nakahara, Kazunari, Doi, Shinpei, Chinen, Kenji, Isayama, Hiroyuki, Yasuda, Ichiro, and Nakai, Yousuke

Published
2023
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17. Adverse effects of cell-free and concentrated ascites reinfusion therapy for malignant ascites: a single-institute experience

Author

Tsubokura, Misato, Adegawa, Yuko, Kojima, Minoru, Tanosaki, Ryuji, Ohtake, Ryuzaburo, Kase, Yuki, Iwashita, Nao, Kasane, Moemi, Nakabayashi, Saori, Takeuchi, Sayaka, Kato, Ken, Boku, Narikazu, Kanemitsu, Yukihide, Okusaka, Takuji, Fujimoto, Hiroyuki, Yonemori, Kan, Ishiki, Hiroto, Kawamura, Kimihiko, Satomi, Eriko, and Matsushita, Hiromichi

Published
2022
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32. Anorexia, pain and peripheral neuropathy are associated with a decrease in quality of life in patients with advanced pancreatic cancer receiving outpatient chemotherapy — a retrospective observational study

Author

Fujii, Hironori, Koda, Maaya, Sadaka, Shiori, Ohata, Koichi, Kato-Hayashi, Hiroko, Iihara, Hirotoshi, Kobayashi, Ryo, Ishihara, Takuma, Uemura, Shinya, Iwashita, Takuji, Hayashi, Hideki, Sugiyama, Tadashi, Shimizu, Masahito, and Suzuki, Akio

Published
2021
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34. Genotyping of a gene cluster for production of colibactin and in vitro genotoxicity analysis of Escherichia coli strains obtained from the Japan Collection of Microorganisms

Author

Kawanishi, Masanobu, Shimohara, Chiaki, Oda, Yoshimitsu, Hisatomi, Yuuta, Tsunematsu, Yuta, Sato, Michio, Hirayama, Yuichiro, Miyoshi, Noriyuki, Iwashita, Yuji, Yoshikawa, Yuko, Sugimura, Haruhiko, Mutoh, Michihiro, Ishikawa, Hideki, Wakabayashi, Keiji, Yagi, Takashi, and Watanabe, Kenji

Published
2020
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37. Possible involvement of normalized Pin1 expression level and AMPK activation in the molecular mechanisms underlying renal protective effects of SGLT2 inhibitors in mice

Author

Inoue, Masa-Ki, Matsunaga, Yasuka, Nakatsu, Yusuke, Yamamotoya, Takeshi, Ueda, Koji, Kushiyama, Akifumi, Sakoda, Hideyuki, Fujishiro, Midori, Ono, Hiraku, Iwashita, Misaki, Sano, Tomomi, Nishimura, Fusanori, Morii, Kenichi, Sasaki, Kensuke, Masaki, Takao, and Asano, Tomoichiro

Published
2019
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41. Community-based lifestyle intervention for diabetes (Co-LID study) management rural Nepal: study protocol for a clustered randomized controlled trial.

Author

Rawal, Lal, Dahal, Padam, Paudel, Grish, Biswas, Tuhin, Shrestha, Rabina, Makaju, Deepa, Shrestha, Abha, Yadav, Uday, Sahle, Berhe W, Iwashita, Hanako, Masuda, Gaku, Renzaho, Andre, Shakya, Prabin, Shrestha, Archana, Karmacharya, Biraj, Sakamoto, Haruka, Koju, Rajendra, and Sugishita, Tomohiko

Subjects
RANDOMIZED controlled trials, TYPE 2 diabetes, CLUSTER randomized controlled trials, COMMUNITY health workers, HEALTH facilities
Abstract

Background: Type 2 diabetes mellitus (T2DM) has increased globally; with a disproportionate burden in South and Southeast Asian countries, including Nepal. There is an urgent need for clinically and cost-effective culturally adapted T2DM management programs. In this study, we aim to assess the effectiveness of community based culturally appropriate lifestyle intervention in improving the management and care of people with T2DM. Methods: We will conduct a cluster randomized control trial to evaluate the effectiveness of community based culturally appropriate lifestyle intervention in improving T2DM outcomes. The trial will be conducted in 30 randomly selected healthcare facilities from two purposively selected districts (Kavrepalanchowk and Nuwakot districts) of Bagmati province, Nepal. The selected healthcare facilities are being randomized into 15 interventions (n = 15) and usual care (n = 15) groups. Those in the intervention will receive group-based 12 an hour-long fortnightly session delivered over 6 months period. The intervention package includes 12 planned modules related to diabetes care, ongoing support, supervision and monitoring, follow-up from the trained community health workers, and educational materials on diabetes self-management. The participants in the usual care groups will receive pictorial brochure on diabetes management and they will continue receiving the usual care available from the local health facilities. The primary outcome is HbA1c level, and the secondary outcomes include quality of life, health care utilization, and practice of self-care behaviour, depression, oral health quality of life, and economic assessment of the intervention. Two points measurements will be collected by the trained research assistants at baseline and at the end of the intervention. Discussion: This study will provide tested approaches for culturally adapting T2DM interventions in the Nepalese context. The findings will also have practice and policy implications for T2DM prevention and management in Nepal. Trial registration: Australia and New Zealand Clinical Trial Registry (ACTRN12621000531819). Registered on May 6, 2021. [ABSTRACT FROM AUTHOR]

Published
2023
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42. Long- and short-term outcomes of balloon dilation for benign choledochojejunal anastomotic stricture using balloon endoscopy-assisted ERCP: a multi-center retrospective cohort study.

Author

Iwasa, Yuhei, Iwashita, Takuji, Iwata, Keisuke, Uemura, Shinya, Okuno, Mitsuru, Tezuka, Ryuichi, Senju, Akihiko, Mukai, Tsuyoshi, and Shimizu, Masahito

Subjects
*PANCREATICODUODENECTOMY, *RECEIVER operating characteristic curves, *URETHROPLASTY, *ENDOSCOPIC retrograde cholangiopancreatography, *COHORT analysis, *WAIST circumference
Abstract

Background: Benign choledochojejunal anastomotic stricture (CJS) is a common complication of pancreaticoduodenectomy and choledochojejunostomy. CJS is generally treated with balloon dilation, using balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP); however, its long- and short-term outcomes have not been fully evaluated. Therefore, we evaluated the treatment outcomes of balloon dilation with BE-ERCP for CJS. Methods: We retrospectively analyzed 40 patients who had undergone balloon dilation with BE-ERCP for CJS between January 2009 and December 2022. The primary outcomes were technical and clinical success, and adverse event rates of balloon dilation using BE-ERCP for CJS. The secondary outcomes were long-term treatment outcomes for CJS recurrence, and evaluation of risk factors for recurrence. Result: Technical and clinical success rates were 93% (37/40) and 100% (37/37), respectively. CJS recurrence occurred in 32% (20/37). No procedure-related adverse events were observed. The significant risk factors of CJS after balloon dilation were its early occurrence after surgery (unit hazard ratio [HR] for month, 0.87; 95% confidence interval [CI], 0.76–0.99; p-value = 0.04) and residual waist during balloon dilation (HR, 5.46; 95% CI, 1.18–25.1; p-value = 0.03). Receiver operating characteristic curve analysis of time from surgery to balloon dilation revealed an area under the curve of 0.80 (95% CI, 0.65–0.94) and the cut-off value was 13.2 months. Conclusion: Treatment of CJS with balloon dilation was effective, although CJS recurrence occurred in one-third of the patients. The risk factors for recurrence were early occurrence of CJS after surgery and remaining waist circumference during balloon dilation. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Early short course of neuromuscular blocking agents in patients with COVID-19 ARDS: a propensity score analysis

Author

Li Bassi, G., Gibbons, K., Suen, J. Y., Dalton, H. J., White, N., Corley, A., Shrapnel, S., Hinton, S., Forsyth, S., Laffey, J. G., Fan, E., Fanning, J. P., Panigada, M., Bartlett, R., Brodie, D., Burrell, A., Chiumello, D., Elhazmi, A., Esperatti, M., Grasselli, G., Hodgson, C., Ichiba, S., Luna, C., Marwali, E., Merson, L., Murthy, S., Nichol, A., Ogino, M., Pelosi, P., Torres, A., P. Y., Ng, Fraser, J. F., Al-Dabbous, T., Alfoudri, H., Shamsah, M., Elapavaluru, S., Berg, A., Horn, C., Mayasi, Y., Schroll, S., Meyer, D., Velazco, J., Ploskanych, L., Fikes, W., Bagewadi, R., Dao, M., White, H., Ehlers, A., Shalabi-McGuire, M., Witt, T., Grazioli, L., Lorini, L., Grandin, E. W., Nunez, J., Reyes, T., Obriain, D., Hunter, S., Ramanan, M., Affleck, J., Veerendra, H. H., Rai, S., Russell-Brown, J., Nourse, M., Joseph, M., Mitchell, B., Tenzer, M., Abe, R., Cho, H. J., Jeong, I. S., Rahman, N., Kakar, V., Brozzi, N., Mehkri, O., Krishnan, S., Duggal, A., Houltham, S., Graf, J., Diaz, R., Orrego, R., Delgado, C., Gonzalez, J., Sanchez, M. S., Piagnerelli, M., Sarrazin, J. V., Zabert, A. /P. G., Espinosa, L., Delgado, P., Delgado, V., Rincon, D. F. B., Yanten, A. M. M., Duque, M. B., Al-Hudaib, A., Callahan, M., Taufik, M. A., Wardoyo, E. Y., Gunawan, M., Trisnaningrum, N. S., Irawany, V., Rayhan, M., Pesenti, A., Zanella, A., Leone, M., Coppola, S., Colombo, S., Antonelli, M., Carelli, S., Grieco, D. L., Asaki, M., Hoshino, K., Salazar, L., Duarte, L., Laffey, J., Mcnicholas, B., Cosgrave, D., Mccaffrey, J., Bone, A., Hakeem, Y., Winearls, J., Tallott, M., Thomson, D., Arnold-Day, C., Cupido, J., Fanie, Z., Miller, M., Seymore, L., van Straaten, D., Hssain, A. A., Aliudin, J., Alqahtani, A. -R., Mohamed, K., Mohamed, A., Tan, D., Villanueva, J., Zaqout, A., Kurtzman, E., Ademi, A., Dobrita, A., El Aoudi, K., Segura, J., Giwangkancana, G., Ohshimo, S., Hitoshi, S., Osatnik, J., Joosten, A., Yang, M., Motos, A., Arancibia, F., Williams, V., Noel, A., Luque, N., Trung, T. H., Yacoub, S., Fantini, M., Garcia, R. N. J., Alvarez, E. C., Greti, A., Ceccato, A., Sanchez, A., Vazquez, A. L., Roche-Campo, F., Franch-Llasat, D., Tuazon, D., Amato, M., Cassimiro, L., Pola, F., Ribeiro, F., Fonseca, G., Dalton, H., Desai, M., Osborn, E., Deeb, H., Arcadipane, A., Martucci, G., Panarello, G., Vitiello, C., Bianco, C., Occhipinti, G., Rossetti, M., Cuffaro, R., Cho, S. -M., Shimizu, H., Moriyama, N., Kim, J. -B., Kitamura, N., Gebauer, J., Yokoyama, T., Al-Fares, A., Buabbas, S., Alamad, E., Alawadhi, F., Alawadi, K., Tanaka, H., Hashimoto, S., Yamazaki, M., T. -H., Oh, Epler, M., Forney, C., Kruse, L., Feister, J., Williamson, J., Grobengieser, K., Gnall, E., Golden, S., Caroline, M., Shapiro, T., Karaj, C., Thome, L., Sher, L., Vanderland, M., Welch, M., Mcdermott, S., Brain, M., Mineall, S., Kimura, D., Brazzi, L., Sales, G., Ogston, T., Nagpal, D., Fischer, K., Lorusso, R., Rangappa, R., Appu, A., Carton, E. G., Sen, A., Palacios, A., Rainey, D., Samoukoviv, G., Campisi, J., Durham, L., Neumann, E., Seefeldt, C., Falcucci, O., Emmrich, A., Guy, J., Johns, C., Potzner, K., Zimmermann, C., Espinal, A., Buchtele, N., Schwameis, M., Stecher, S. -S., Singh, D., Barnikel, M., Arenz, L., Zaaqoq, A., Galloway, L. A., Merley, C., Csete, M., Quesada, L., Saba, I., Kasugai, D., Hiraiwa, H., Tanaka, T., Purnama, Y., Dewayanti, S. R., Ardiyan, Juzar, D. A., Siagian, D., Chen, Y. -S., Ratsep, I., Oigus, G., Erikson, K., Post, A. -M., Enneveer, L., Sillaots, P., Manetta, F., Mihelis, E., Sarmiento, I. C., Narasimhan, M., Varrone, M., Komats, M., Garcia-Diaz, J., Harmon, C., Satyapriya, S. V., Bhatt, A., Mokadam, N. A., Uribe, A., Gonzalez, A., Shi, H., Mckeown, J., Pasek, J., Fiorda, J., Echeverria, M., Moreno, R., Zakhary, B., Cavana, M., Cucino, A., Foti, G., Giani, M., Russotto, V., Castagna, V., Dellamore, A., Navalesi, P., Shum, H. -P., Vuysteke, A., Usman, A., Acker, A., Smood, B., Mergler, B., Sertic, F., Subramanian, M., Sperry, A., Rizer, N., Burhan, E., Rasmin, M., Akmal, E., Sitompul, F., Lolong, N., Naivedh, B., Erickson, S., Barrett, P., Dean, D., Daugherty, J., Loforte, A., Khan, I., Abraar Quraishi, M., Desantis, O., So, D., Kandamby, D., Mandei, J. M., Natanael, H., Yudhalantang, E., Lantang, A., Wijaya, S. O., Jung, A., Ng, G., W. Y., Ng, Fang, S., Tabah, A., Ratcliffe, M., Duroux, M., Adachi, S., Nakao, S., Blanco, P., Prieto, A., Sanchez, J., Nicholson, M., Butt, W., Serratore, A., Delzoppo, C., Janin, P., Yarad, E., Totaro, R., Coles, J., Pujo, B., Balk, R., Vissing, A., Kapania, E., Hays, J., Fox, S., Yantosh, G., Mishin, P., Yuliarto, S., Hari Santoso, K., Djajalaksana, S., Fatoni, A. Z., Fukuda, M., Liu, K., Battaglini, D., Jimenez, J. F. M., Bastos, D., Gaiao, S., Rusmawatiningtyas, D., Buchner, J., Cho, Y. -J., Lee, S. H., Kawasaki, T., Munshi, L., Sakiyalak, P., Nitayavardhana, P., Seitz, T., Arora, R., Kent, D., Marino, D., Parwar, S., Cheng, A., Miller, J., Fujitani, S., Shimizu, N., Madhok, J., Owyang, C., Buscher, H., Reynolds, C., Maasikas, O., Beljantsev, A., Mihnovits, V., Akimoto, T., Aizawa, M., Horibe, K., Onodera, R., Young, M., George, T., Shekar, K., Mcguinness, N., Irvine, L., Flynn, B., Endo, T., Sugiyama, K., Shimizu, K., Exconde, K., Lussier, L., Lotz, G., Malfertheiner, M., Maier, L., Dreier, E., Kusumastuti, N. P., Mccloskey, C., Dabaliz, A. -A., Elshazly, T. B., Smith, J., Szuldrzynski, K. S., Bielanski, P., Wille, K., Parhar, K. K. S., Fiest, K. M., Codan, C., Shahid, A., Fayed, M., Evans, T., Garcia, R., Gutierrez, A., Song, T., Rose, R., Bennett, S., Richardson, D., Peek, G., Arora, L., Rappapport, K., Rudolph, K., Sibenaller, Z., Stout, L., Walter, A., Herr, D., Vedadi, N., Thompson, S., Sindt, L., Rajnic, S., Ewald, C., Hoffman, J., Ying, X., Kennedy, R., Griffee, M., Ciullo, A., Kida, Y., Roca, R. F., Riera, J. I., Contreras, S., Alegre, C., Kay, C., Fischer, I., Renner, E., Taniguci, H., Fraser, J., Bassi, G. L., Suen, J., Barnett, A., Pearse, I., Abbate, G., Hassan, H., Heinsar, S., Karnik, V. A., Ki, K., Oneill, H. F., Obonyo, N., Pimenta, L. P., Reid, J. D., Sato, K., Vuorinen, A., Wildi, K. S., Wood, E. S., Yerkovich, S., Lee, J., Plotkin, D., Citarella, B. W., Hartley, E., Lubis, B., Ikeyama, T., Bhaskar, B., Jung, J. -S., Mcguinness, S., Eastwood, G., Marta, S. R., Guarracino, F., Gerle, S., Coxon, E., Claro, B., Loverde, D., Patil, N., Parrini, V., Mcbride, A., Negaard, K., Ratsch, A., Abdelaziz, A., Uribe, J. D., Peris, A., Sanders, M., Emerson, D., Kamal, M., Povoa, P., Francis, R., Cherif, A., Joseph, S., Di Nardo, M., Heard, M., Kyle, K., Blackwell, R. A., Biston, P., Jeong, H. W., Smith, R., Prawira, Y., Montrucchio, G., Garcia, A. H., Salterain, N., Meyns, B., Moreno, M., Walia, R., Mehta, A., Schweda, A., Supriatna, M., Kirakli, C., Williams, M., Kim, K. H., Assad, A., Giraldo, E., Karolak, W., Balik, M., Pocock, E., Gajkowski, E., Masafumi, K., Barrett, N., Takeyama, Y., Park, S., Amin, F., Andriyani, F. M., Sudakevych, S., Vera, M., Cornejo, R., Schwarz, P., Mardini, A. C., de Paula, T., Neto, A. S., Villoldo, A., Colafranceschi, A. S., Iglesias, A. U., Granjean, J., Melro, L. M. G., Romualdo, G. F., Gaia, D., Souza, H., Galas, F., Mendiluce, R. M., Sosa, A., Martinez, I., Kurosawa, H., Salgado, J., Hugi-MayrCharbonneau, B. E., Barzilai, V. S., Monteiro, V., de Souza, R. R., Harper, M., Suzuki, H., Adams, C., Brieva, J., Nyale, G., Eltatar, F. S., Fatani, J., Baeissa, H., Masri, A. A., Rabie, A., Hui, M. Y., Yamane, M., Jung, H., Margaret, A. M., Nacpil, N., Ruck, K., Bakken, R., Jara, C., Felton, T., Berra, L., Shah, B., Chakraborty, A., Cardona, M., Capatos, G., Akkanti, B., Orija, A., Jain, H., Ito, A., Housni, B., Low, S., Iihara, K., Chavez, J., Ramanathan, K., Zabert, G., Naidoo, K., Seppelt, I., Vandyk, M., Macdonald, S., Mcgregor, R., Siebenaler, T., Flynn, H., Lofton, K., Aokage, T., Shigemitsu, K., Moscatelli, A., Fiorentino, G., Baumgaertel, M., Mba, S. E., Assy, J., Hutahaean, A., Roush, H., Sichting, K. A., Alessandri, F., Burns, D., Salt, G., Garabedian, C. P., Millar, J., Sim, M., Mattke, A., Mcauley, D., Tadili, J., Frenzel, T., Bar-Lavie, Y., Ortiz, A. B., Stone, J., Attokaran, A., Farquharson, M., Patel, B., Gunning, D., Baillie, K., Watson, P., Tamai, K., Sajinadiyasa, G. K., Kanyawati, D., Salgado, M., Sassine, A., Yudo, B., Mccaul, S., Lee, B., Lee, S. M., Afek, A., Iwashita, Y., Semedi, B. P., Metiva, J., Van Belle, N., Martin-Loeches, I., Ivatt, L., Woon, C. Y., Kang, H. M., Smith, T., James, E., Al-Rawas, N., Iwasaki, Y., King-Chung, K. C., Gudzenko, V., Hugi-Mayr, B., Taccone, F., Perdhana, F., Lamarche, Y., Ribeiro, J. M., Bradic, N., Van den Bossche, K., Lansink, O., Singh, G., Debeuckelaere, G., Stelfox, H. T., Yi, C., Elia, J., Tribble, T., Shankar, S., Padmanabhan, R., Hallinan, B., Paoletti, L., Leyva, Y., Fykuda, T., Badulak, J., Koch, J., Hackman, A., Janowaik, L., Hernandez, D., Osofsky, J., Donadello, K., Lawang, A., Fine, J., Davidson, B., Vazquez, A. O. R., COVID-19 Critical Care Consortium, and Consortium, COVID-19 Critical Care

Subjects
Male, Respiratory Distress Syndrome, COVID-19, Intensive care unit, Mechanical ventilation, Neuromuscular blocking agent, SARS-CoV-2, Aged, Female, Humans, Intensive Care Units, Middle Aged, Propensity Score, Respiration, Artificial, Neuromuscular Blocking Agents, Respiration, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Settore MED/41 - Anestesiologia, Critical Care and Intensive Care Medicine, COVID-19 Drug Treatment, Artificial, Human medicine
Abstract

Background The role of neuromuscular blocking agents (NMBAs) in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is not fully elucidated. Therefore, we aimed to investigate in COVID-19 patients with moderate-to-severe ARDS the impact of early use of NMBAs on 90-day mortality, through propensity score (PS) matching analysis. Methods We analyzed a convenience sample of patients with COVID-19 and moderate-to-severe ARDS, admitted to 244 intensive care units within the COVID-19 Critical Care Consortium, from February 1, 2020, through October 31, 2021. Patients undergoing at least 2 days and up to 3 consecutive days of NMBAs (NMBA treatment), within 48 h from commencement of IMV were compared with subjects who did not receive NMBAs or only upon commencement of IMV (control). The primary objective in the PS-matched cohort was comparison between groups in 90-day in-hospital mortality, assessed through Cox proportional hazard modeling. Secondary objectives were comparisons in the numbers of ventilator-free days (VFD) between day 1 and day 28 and between day 1 and 90 through competing risk regression. Results Data from 1953 patients were included. After propensity score matching, 210 cases from each group were well matched. In the PS-matched cohort, mean (± SD) age was 60.3 ± 13.2 years and 296 (70.5%) were male and the most common comorbidities were hypertension (56.9%), obesity (41.1%), and diabetes (30.0%). The unadjusted hazard ratio (HR) for death at 90 days in the NMBA treatment vs control group was 1.12 (95% CI 0.79, 1.59, p = 0.534). After adjustment for smoking habit and critical therapeutic covariates, the HR was 1.07 (95% CI 0.72, 1.61, p = 0.729). At 28 days, VFD were 16 (IQR 0–25) and 25 (IQR 7–26) in the NMBA treatment and control groups, respectively (sub-hazard ratio 0.82, 95% CI 0.67, 1.00, p = 0.055). At 90 days, VFD were 77 (IQR 0–87) and 87 (IQR 0–88) (sub-hazard ratio 0.86 (95% CI 0.69, 1.07; p = 0.177). Conclusions In patients with COVID-19 and moderate-to-severe ARDS, short course of NMBA treatment, applied early, did not significantly improve 90-day mortality and VFD. In the absence of definitive data from clinical trials, NMBAs should be indicated cautiously in this setting.

Published
2022
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45. Prolonged activation of cytomegalovirus early gene e1-promoter exclusively in neurons during infection of the developing cerebrum

Author

Yoshifumi Arai, Hideya Kawasaki, Satoshi Baba, Toshihide Iwashita, Yoshihiro Tsutsui, and Isao Kosugi

Subjects
Genetically modified mouse, Muromegalovirus, Time Factors, Cerebral neuron, Hippocampus, Cytomegalovirus, Mice, Transgenic, Biology, Persistent infection, lcsh:RC346-429, Pathology and Forensic Medicine, Cellular and Molecular Neuroscience, Mice, Neurodevelopmental disorder, Congenital infection, medicine, Animals, Tissue Distribution, Promoter Regions, Genetic, Antigens, Viral, Cerebrum, lcsh:Neurology. Diseases of the nervous system, Cells, Cultured, Neurons, Research, e1-promoter, Wild type, Molecular biology, Disease Models, Animal, medicine.anatomical_structure, Lytic cycle, Viral replication, nervous system, Cerebral cortex, Cytomegalovirus Infections, Central Nervous System Viral Diseases, Neurology (clinical), Neuron, Neuroglia
Abstract

The brain is the major target of congenital cytomegalovirus (CMV) infection. It is possible that neuron disorder in the developing brain is a critical factor in the development of neuropsychiatric diseases in later life. Previous studies using mouse model of murine CMV (MCMV) infection demonstrated that the viral early antigen (E1 as a product ofe1gene) persists in the postnatal neurons of the hippocampus (HP) and cerebral cortex (CX) after the disappearance of lytic infection from non-neuronal cells in the periventricular (PV) region. Furthermore, neuron-specific activation of the MCMV-e1-promoter (e1-pro) was found in the cerebrum of transgenic mice carrying thee1-pro-lacZreporter construct. In this study, in order to elucidate the mechanisms ofe1-proactivation in cerebral neurons during actual MCMV infection, we have generated the recombinant MCMV (rMCMV) carrying longe1-pro1373- or shorte1-pro448-EGFP reporter constructs. The length of the former, 1373 nucleotides (nt), is similar to that of transgenic mice. rMCMVs and wild type MCMV did not significantly differed in terms of viral replication or E1 expression. rMCMV-infected mouse embryonic fibroblasts showed lytic infection and activation of both promoters, while virus-infected cerebral neurons in primary neuronal cultures demonstrated the non-lytic and persistent infection as well as the activation ofe1-pro-1373, but not -448. In the rMCMV-infected postnatal cerebrum, lytic infection and the activation of both promoters were found in non-neuronal cells of the PV region until postnatal 8 days (P8), but these disappeared at P12, while the activation ofe1-pro-1373, but not -448 appeared in HP and CX neurons at P8 and were prolonged exclusively in these neurons at P12, with preservation of the neuronal morphology. Therefore,e1-pro-448 is sufficient to activate E1 expression in non-neuronal cells, however, the upstream sequence from nt -449 to -1373 ine1-pro-1373 is supposed to work as an enhancer necessary for the neuron-specific activation ofe1-pro, particularly around the second postnatal week. This unique activation ofe1-proin developing cerebral neurons may be an important factor in the neurodevelopmental disorders induced by congenital CMV infection.

Published
2021

47. Ccr7 null mice are protected against diet-induced obesity via Ucp1 upregulation and enhanced energy expenditure

Author

Yusuke Sotomaru, Fusanori Nishimura, Akiko Yamashita, Tomoichiro Asano, Takao Fukuda, Takanori Shinjo, Taiki Sanada, Terukazu Sanui, Tomomi Sano, Takashi Kanematsu, and Misaki Iwashita

Subjects
medicine.medical_specialty, 030309 nutrition & dietetics, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Adipose tissue, C-C chemokine receptor type 7, Inflammation, lcsh:TX341-641, Biology, Brown adipose tissue, 03 medical and health sciences, Insulin resistance, Downregulation and upregulation, Internal medicine, medicine, Obesity, lcsh:RC620-627, PRDM16, 0303 health sciences, Nutrition and Dietetics, Adiponectin, Research, medicine.disease, lcsh:Nutritional diseases. Deficiency diseases, medicine.anatomical_structure, Endocrinology, Energy expenditure, medicine.symptom, lcsh:Nutrition. Foods and food supply
Abstract

Background The chemokine receptor CCR7, expressed on various immune cells, is associated with cell migration and lympho-node homing. Mice lacking Ccr7 are protected from diet-induced obesity and subsequent insulin resistance. We evaluated the mechanism underlying these protective effects from the standpoint of energy expenditure. Methods Wild-type and Ccr7 null mice were fed a high-fat diet, and the regulation of energy metabolism and energy metabolism-related molecules, e.g., Ucp1, Cidea, and Pgc1α, were evaluated. Results Food intake did not differ between groups. O2 consumption and CO2 production were higher in Ccr7 null mice than in wild-type mice, despite a similar respiratory quotient and glucose and lipid utilization, suggesting that energy expenditure increased in Ccr7 null mice via enhanced metabolism. In white adipose tissues of Ccr7 null mice, Prdm16, Cd137, Tmem26, Th, and Tbx1 expression increased. Similarly, in brown adipose tissues of Ccr7 null mice, Dio2, Pgc1α, Cidea, Sirt1, and Adiponectin expression increased. In both white and brown adipose tissues, Ucp1 gene and protein expression levels were higher in null mice than in wild-type mice. Conclusions In Ccr7 null mice, browning of white adipocytes as well as the activation of brown adipocytes cause enhanced energy metabolism, resulting in protection against diet-induced obesity. Electronic supplementary material The online version of this article (10.1186/s12986-019-0372-5) contains supplementary material, which is available to authorized users.

Published
2019

49. Use of a fixed, body weight-unadjusted loading dose of unfractionated heparin for extracorporeal cardiopulmonary resuscitation

Author

Akitaka Yamamoto, Hiroshi Imai, Mashiro Yukimitsu, Yoshiaki Iwashita, Ken Ishikura, and Masaki Matsuduki

Subjects
medicine.medical_specialty, business.industry, Heparin, Incidence (epidemiology), medicine.medical_treatment, Research, Extracorporeal membrane oxygenator, Critical Care and Intensive Care Medicine, Body weight, Loading dose, Surgery, Extracorporeal cardiopulmonary resuscitation, Activated coagulation time, Medicine, Cardiopulmonary resuscitation, Bolus (digestion), business, medicine.drug
Abstract

Background Extracorporeal cardiopulmonary resuscitation (ECPR) is being used increasingly in the emergency and critical care field in Japan. A major complication of ECPR is bleeding; however, the optimal initial heparin dose and activated coagulation time (ACT) remain unknown. The aim of this study was to assess the appropriateness of our initial anticoagulation protocol. Methods We retrospectively evaluated the initial heparin dose, ACT value, and incidence of bleeding and thrombotic complications in post-cardiopulmonary arrest patients who received a fixed, body weight-unadjusted loading dose of unfractionated heparin (3000 U) prior to veno-arterial extracorporeal membrane oxygenator (ECMO) between February 2011 and November 2013 at Mie University Hospital, Japan. Results ACT was evaluated within 3 h of initiation of 32 consecutive ECPR patients. The mean heparin dose per body weight was 53.6 U/kg and the mean ACT was 231.3 s. In 17 patients, ACT exceeded 200 s. Three patients experienced fatal bleeding in the chest wall within 24 h of receiving ECMO. The mean heparin dose per kilogram body weight, mean initial ACT, and mean duration of cardiopulmonary resuscitation (CPR) did not statistically differ between the patients who experienced fatal bleeding and those who did not. Conclusions Fixed-dose heparin of 3000-U bolus resulted in a mean heparin dose per kilogram body weight of 53.6 U/kg and an ACT of 231.3 s and experienced 3 out of 32 fatal bleedings. Further researches are warranted to optimize anticoagulation protocol for ECPR patients.

Published
2015

50. High-fat diet feeding significantly attenuates anagliptin-induced regeneration of islets of Langerhans in streptozotocin-induced diabetic mice

Author

Misaki Iwashita, Akifumi Kushiyama, Midori Fujishiro, Takanori Shinjo, Fusanori Nishimura, Hideyuki Sakoda, Yusuke Nakatsu, Tomoichiro Asano, Hisamitsu Ishihara, and Tomomi Sano

Subjects
medicine.medical_specialty, endocrine system, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Short Report, Alpha (ethology), Glucagon, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, DPP-4 inhibitor, Islet of Langerhans, geography, geography.geographical_feature_category, business.industry, Streptozotocin, Anagliptin, nutritional and metabolic diseases, medicine.disease, Islet, Endocrinology, medicine.anatomical_structure, High-fat diet, Blood sugar regulation, business, Pancreas, medicine.drug
Abstract

Background DPP-4 inhibitors reportedly exert effects on both alpha and beta cells, and promote the proliferation and survival of beta cells. We investigated the effects of anagliptin on structurally-impaired islets of Langerhans in streptozotocin (STZ)-treated mice, fed either a normal or a high-fat diet. Pdx-1 expression in the pancreas and serum insulin/glucagon concentrations were also examined. Findings Anagliptin treatment significantly up-regulated pancreatic Pdx-1 expression, with elevated serum glucagon-like peptide-1 concentrations, regardless of whether the diet was normal or high-fat. However, interestingly, the beta cell regeneration, structural normalization of islets of Langerhans including alpha cell: beta cell area ratios, and serum insulin elevation, all observed with anagliptin administration in the animals fed a normal diet, were markedly suppressed in the high-fat fed group. Conclusions High-fat diet feeding clearly weakened the regenerative effects of anagliptin on the islets of Langerhans in STZ-treated mice. Our findings suggest the importance of normalizing lipid metabolism for full manifestation of DPP-4 inhibitor effects on the islets of Langerhans. Electronic supplementary material The online version of this article (doi:10.1186/s13098-015-0047-y) contains supplementary material, which is available to authorized users.

Published
2015

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