50 results on '"K. Yamaji"'
Search Results
2. Nationwide epidemiological survey of juvenile idiopathic arthritis during transition to young adulthood in Japan using the National Database of Designated Incurable Diseases of Japan.
- Author
-
Inoue Y, Sakai R, Inoue E, Mitsunaga K, Shimizu M, Sugihara T, Matsushita M, Yamaji K, Mori M, Shimojo N, and Miyamae T
- Abstract
Objectives We aimed to assess the unmet medical needs of young adult patients with juvenile idiopathic arthritis by evaluating real-world treatment data. Methods We analyzed data on juvenile idiopathic arthritis in the 20-29 age group from the National Database of Designated Incurable Diseases of Japan, which records severe cases or those requiring high-cost medical care registered between April 2018 and March 2020. Results Overall, 322 patients with juvenile idiopathic arthritis transitioning to adulthood were included. A high frequency of methotrexate use was observed among all juvenile idiopathic arthritis subtypes. The frequency of methotrexate use at registration was significantly higher in patients with rheumatoid factor-positive polyarthritis and those with oligoarthritis or polyarthritis than in those with systemic arthritis. The historical use percentage of any biological disease-modifying antirheumatic drug was ≥85% for all juvenile idiopathic arthritis subtypes. The proportion of patients with ≥2 biological disease-modifying antirheumatic drug prescriptions was significantly higher in patients with rheumatoid factor-positive polyarthritis than in those with systemic arthritis. Conclusions High-cost drugs were necessary for many patients with juvenile idiopathic arthritis transitioning to young adulthood and registered in the database. Further studies on the medical interventions and support for these patients are needed., (© Japan College of Rheumatology 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF
3. Delayed global standardization and prefectural disparities in systematic lupus erythematosus treatment in Japan: a nationwide study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan.
- Author
-
Yokogawa N, Sakai R, Matsushita M, Shimizu M, Inoue Y, Inoue E, Yamaji K, Mori M, and Miyamae T
- Abstract
Objectives: To evaluate the status of the global standardization of, and prefectural differences in, systematic lupus erythematosus (SLE) treatments in Japan., Methods: The Japanese National Database of Health Insurance Claims and Specific Health Checkups (NDB Japan) was used. A patient with SLE was defined as having a disease with ICD10 code M321 or M329 between April 2019 and March 2020, for which oral corticosteroids (OCS), immunosuppressive agents or biologic agents were prescribed at least once during a given month. SLE treatments were evaluated by treatment center type and prefecture., Results: In total, 74,277 patients met the definition of SLE. The SLE prevalence was 60 per 100,000 (range: 47 - 102 per 100,000 by prefecture). Nationwide, 79.4% of the patients (range: 52.1% - 93.3% by prefecture) visited a specialized treatment center (STC); 37.4% (range: 26.4% - 51.3% by prefecture) received only OCS, with fewer of these patients visiting a STC than a non-STC (34.8% and 49.7%, p<0.001); and 21.4% (range: 10.7% - 35.0%) received HCQ, with more of these patients visiting a STC than a non-STC (23.0% and 13.5%; p<0.001)., Conclusions: NDB Japan demonstrated delayed global standardization of, and prefectural disparity in, SLE treatments in Japan., (© Japan College of Rheumatology 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF
4. A case of cryopyrin-associated periodic syndrome due to somatic mosaic mutation complicated with recurrent circinate erythematous psoriasis.
- Author
-
Ando T, Abe Y, Yamaji K, Nishikomori R, and Tamura N
- Subjects
- Humans, Mutation, Male, Female, Mosaicism, Recurrence, Cryopyrin-Associated Periodic Syndromes genetics, Cryopyrin-Associated Periodic Syndromes diagnosis, Cryopyrin-Associated Periodic Syndromes complications, NLR Family, Pyrin Domain-Containing 3 Protein genetics, Psoriasis genetics, Psoriasis diagnosis, Psoriasis complications
- Abstract
Cryopyrin-associated periotic syndrome (CAPS) is a rare autoinflammatory disease caused by genetic variants in innate immunity genes. Autoinflammatory diseases, including CAPS, mediate proinflammatory cytokines such as interleukin (IL)-1 and IL-18 and result in severe systemic inflammation. A gain-of-function mutation in the NLR family pyrin domain-containing 3 (NLRP3) gene, which encodes the protein cryopyrin, was identified to be responsible for CAPS in 2001, and since then several additional pathogenic mutations have been found. Moreover, other phenotypes have been identified based on severity and symptomatology, including familial cold autoinflammatory syndrome, Muckle-Wells syndrome, and neonatal-onset multisystem inflammatory disease/chronic neurologic cutaneous articular syndrome. Prompt diagnosis of CAPS remains challenging, however, due to unspecific, extensive clinical signs, and delayed diagnosis and treatment targeting IL-1 lead to multiorgan damage. Another factor complicating diagnosis is the existence of somatic mosaic mutations in the NLRP3 gene in some cases, resulting in symptoms and clinical courses that are atypical. The frequency of somatic mosaic mutations in CAPS was estimated to be 19% in a systematic review. Psoriasis is a chronic inflammatory skin disease that affects ∼3% of the global population. Although no reports have shown complication between CAPS and psoriasis, these diseases have several similarities and potential relationships, for instance activation of T helper 17 cells in the dermis and increased NLRP3 gene expression in psoriatic skin compared with normal skin. Here, we report a case of CAPS due to a somatic mosaic mutation with recurrent circinate erythematous psoriasis., (© Japan College of Rheumatology 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2024
- Full Text
- View/download PDF
5. Polyarteritis nodosa diagnosed in a young male after COVID-19 vaccine: A case report.
- Author
-
Makiyama A, Abe Y, Furusawa H, Kogami M, Ando T, Tada K, Onimaru M, Ishizu A, Yamaji K, and Tamura N
- Subjects
- Adult, Humans, Male, Adrenal Cortex Hormones, Skin pathology, COVID-19 diagnosis, COVID-19 prevention & control, COVID-19 complications, COVID-19 Vaccines adverse effects, Polyarteritis Nodosa diagnosis, Polyarteritis Nodosa etiology
- Abstract
In response to the coronavirus disease 2019 pandemic, the coronavirus disease 2019 vaccine was rapidly developed and the effectiveness of the vaccine has been established. However, various adverse effects have been reported, including the development of autoimmune diseases. We report a case of new-onset polyarteritis nodosa in a 32-year-old male following the coronavirus disease 2019 vaccination. The patient developed limb pain, fever, pulmonary embolism, multiple subcutaneous nodules, and haematomas. Skin biopsy revealed necrotising inflammation accompanied by fibrinoid necrosis and high inflammatory cell infiltration in the walls of medium to small arteries. The symptoms resolved following corticosteroid treatment. Although it is difficult to prove a relationship between the vaccine and polyarteritis nodosa, similar cases have been reported and further reports and analyses are therefore necessary., (© Japan College of Rheumatology 2023. Published by Oxford University Press.)
- Published
- 2023
- Full Text
- View/download PDF
6. Transitions in vascular ultrasonography findings of temporal arteritis in a GCA case with progressive temporal headache and visual impairment.
- Author
-
Kawamoto T, Ogasawara M, Murayama G, Matsuki-Muramoto Y, Hayashi E, Harada M, Kusaoi M, Matsushita M, Yamaji K, and Tamura N
- Subjects
- Humans, Temporal Arteries diagnostic imaging, Temporal Arteries pathology, Headache etiology, Ultrasonography, Vision Disorders diagnosis, Vision Disorders etiology, Vision Disorders pathology, Giant Cell Arteritis complications, Giant Cell Arteritis diagnosis, Giant Cell Arteritis drug therapy
- Abstract
The European League Against Rheumatism and the American College of Rheumatology have stated that the halo sign on vascular ultrasonography (v-US) is relevant in diagnosing giant cell arteritis (GCA) and is equivalent to temporal artery biopsy. However, there are only a few reports about transitions in v-US findings after glucocorticoid (GC) therapy. We report the transitions in the v-US findings in a case of GCA after GC therapy. The patient had rapidly progressive symptoms, and there were concerns about blindness. After GC therapy, we first observed improvement in headache and visual impairment symptoms within 1 week, followed by rapid improvement in laboratory findings within 2 weeks. Subsequently, there were improvements in v-US findings after more than 2 months. In conclusion, these findings showed a dissociation between improvements in clinical symptoms and v-US findings of the temporal artery. Additionally, this case suggests that regular examination of v-US findings is useful in evaluating GCA with evident vascular wall thickness before GC therapy., (© Japan College of Rheumatology 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
- Full Text
- View/download PDF
7. Avacopan is possibly associated with the improvement of ANCA-associated vasculitis activity without decreasing ANCA titres: a four-case series.
- Author
-
Abe Y, Minowa K, Kogami M, Ando T, Makiyama A, Yamaji K, and Tamura N
- Subjects
- Humans, Aniline Compounds, Nipecotic Acids, Antibodies, Antineutrophil Cytoplasmic, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis drug therapy
- Published
- 2023
- Full Text
- View/download PDF
8. Autoantibodies in lupus nephritis useful in distinguishing proliferative nephritis from membranous nephritis.
- Author
-
Asanuma Y, Nozawa K, Matsushita M, Kusaoi M, Abe Y, Yamaji K, and Tamura N
- Subjects
- Humans, Autoantibodies, Nucleosomes, Lupus Nephritis diagnosis, Lupus Erythematosus, Systemic, Glomerulonephritis, Membranous
- Abstract
Objectives: This study was conducted to determine autoantibodies associated with lupus nephritis (LN), especially those useful in diagnosing proliferative and membranous nephritis., Methods: A total of 106 patients with LN and 63 patients with systemic lupus erythematosus but no nephritis were enrolled; then, 55 patients were selected from the LN group and were divided into two groups: proliferative nephritis patients (n = 36) and membranous nephritis patients (n = 19). The autoantibody profiles of patients' sera were evaluated using the EUROLINE ANA Profile 3 (IgG) kit., Results: A higher positivity rate of anti-double-stranded DNA antibody and anti-histone antibody was seen in LN patients compared to nonrenal systemic lupus erythematosus patients. In comparing between proliferative and membranous nephritis, the positivity of anti-nucleosome antibody was higher in proliferative nephritis, although it was not statistically significant. However, anti-nucleosome antibody-positive patients with LN had a higher prevalence of haematuria and pyuria, which are strong indications of proliferative nephritis. Also, a significantly higher positivity rate of anti-RNP70 antibody was seen in membranous nephritis compared to proliferative nephritis., Conclusions: Our results showed that anti-nucleosome and anti-RNP70 antibodies may be predictive nonhistological factors for discriminating between proliferative and membranous LN., (© Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2023
- Full Text
- View/download PDF
9. Changes in anti-MDA5 antibody titres and serum cytokine levels before and after diagnosis of anti-MDA5 antibody-positive dermatomyositis.
- Author
-
Kogami M, Abe Y, Ando T, Makiyama A, Yamaji K, and Tamura N
- Subjects
- Humans, Prognosis, Interleukin-6, Retrospective Studies, Interferon-Induced Helicase, IFIH1, Chronic Disease, Autoantibodies, Disease Progression, Cytokines, Dermatomyositis
- Abstract
Objectives: Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM is characterized by rapidly progressive interstitial lung disease and has a poor prognosis. We aimed to investigate whether anti-MDA5 antibody titres and cytokine levels predict clinical course, and evaluate changes in both parameters before and after diagnosis., Methods: This was a retrospective, single-centre study in 38 patients with anti-MDA5 antibody-positive DM. We compared clinical characteristics and laboratory data at diagnosis between patients in the treatment response (n = 23) and non-response (n = 15) groups, and between those in the relapse (n = 5) and non-relapse (n = 24) groups. We also measured serum anti-MDA5 antibody titres and cytokine levels before and after diagnosis., Results: The non-response group was older, had a higher ground-glass opacity score, lower PaO2/FiO2, higher CRP level, and higher anti-MDA5 antibody titre than the response group. No cytokines significantly differed between groups at diagnosis. The relapse group had a significantly higher anti-MDA5 antibody titre than the non-relapse group. In the survivor group, the anti-MDA5 antibody titre and levels of IFN-α, IFN-γ, monocyte chemotactic protein-1 (MCP-1), IL-6, IL-33, CRP, and ferritin were significantly lower 6 months post-treatment than at diagnosis. Macrophage-associated cytokines such as IL-6, IL-8, IL-18 and MCP-1 increased after anti-MDA5 antibody positivity in three patients who were anti-MDA5 antibody-positive before diagnosis., Conclusion: The anti-MDA5 antibody titre at diagnosis may predict the clinical course. Levels of macrophage-associated cytokines significantly declined at 6 months post-treatment, and they may have increased after anti-MDA5 antibody titre positivity., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2023
- Full Text
- View/download PDF
10. Ontogenetic changes in root and shoot respiration, fresh mass and surface area of Fagus crenata.
- Author
-
Kurosawa Y, Mori S, Wang M, Pedro Ferrio J, Nishizono T, Yamaji K, Koyama K, Haruma T, and Doyama K
- Subjects
- Plant Shoots, Ecosystem, Seedlings physiology, Trees physiology, Respiration, Plant Roots, Fagus
- Abstract
Background and Aims: To date, studies on terrestrial plant ecology and evolution have focused primarily on the trade-off patterns in the allocation of metabolic production to roots and shoots in individual plants and the scaling of whole-plant respiration. However, few empirical studies have investigated the root : shoot ratio by considering scaling whole-plant respiration at various sizes throughout ontogeny., Methods: Here, using a whole-plant chamber system, we measured the respiration rates, fresh mass and surface area of entire roots and shoots from 377 Fagus crenata individuals, from germinating seeds to mature trees, collected from five different Japanese provenances. Non-linear regression analysis was performed for scaling of root and shoot respiration, fresh mass and surface area with body size., Key Results: Whole-plant respiration increased rapidly in germinating seeds. In the seedling to mature tree size range, the scaling of whole-plant respiration to whole-plant fresh mass was expressed as a linear trend on the log-log coordinates (exponent slightly greater than 0.75). In the same body size range, root and shoot respiration vs. whole-plant fresh mass were modelled by upward-convex (exponent decreased from 2.35 to 0.638) and downward-convex trends (exponent increased from -0.918 to 0.864), respectively. The root fraction in whole-plant respiration, fresh mass and surface area shifted continuously throughout ontogeny, increasing in smaller seedlings during early growth stages and decreasing in larger trees., Conclusions: Our results suggest a gradual shift in allocation priorities of metabolic energy from roots in seedlings to shoots in mature trees, providing insights into how roots contribute to shoot and whole-plant growth during ontogeny. The models of root : shoot ratio in relation to whole-plant physiology could be applied in tree growth modelling, and in linking the different levels of ecological phenomena, from individuals to ecosystems., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Annals of Botany Company.)
- Published
- 2023
- Full Text
- View/download PDF
11. Potential high-risk sign of cough-induced transient left bundle branch block in severe aortic valve stenosis.
- Author
-
Yamaji K, Tahara N, Honda A, Bekki M, Maeda-Ogata S, Yoshimura H, Sugiyama Y, Igata S, and Fukumoto Y
- Published
- 2022
- Full Text
- View/download PDF
12. Phialocephala fortinii increases aluminum tolerance in Miscanthus sinensis growing in acidic mine soil.
- Author
-
Haruma T, Yamaji K, and Masuya H
- Subjects
- Ascomycota, Plant Roots, Poaceae, Aluminum toxicity, Soil
- Abstract
Miscanthus sinensis growing in our study mine site contained a high concentration of Al in the adventitious roots. It has a root endophyte, Phialocephala fortinii, in its adventitious roots at a high frequency. The purpose of this study was to elucidate the effects of P. fortinii on Al tolerance mechanisms of M. sinensis and reveal potential underlying mechanisms. In the absence of P. fortinii, M. sinensis produced chlorogenic, citric, and malic acids that could act to alleviate Al toxicity in acidic mine soil. Up on fungal inoculation, the levels of these compounds were reduced, although the growth of seedlings and Mg concentration in the roots were increased. IAA production by the fungus may contribute to enhanced plant growth whereas an increase of Mg uptake could reduce toxicity of reactive oxygen species under Al stress. These actions of P. fortinii could promote growth and survival of M. sinensis in mine sites., (© 2021 The Society for Applied Microbiology.)
- Published
- 2021
- Full Text
- View/download PDF
13. Relationship between arterial remodelling and serial changes in coronary atherosclerosis by intravascular ultrasound: an analysis of the IBIS-4 study.
- Author
-
Koskinas KC, Maldonado R, Garcia-Garcia HM, Yamaji K, Taniwaki M, Ueki Y, Otsuka T, Zanchin C, Karagiannis A, Radu Juul Jensen MD, Losdat S, Zaugg S, Windecker S, and Räber L
- Subjects
- Coronary Vessels diagnostic imaging, Disease Progression, Humans, Ultrasonography, Ultrasonography, Interventional, Coronary Artery Disease diagnostic imaging, Plaque, Atherosclerotic diagnostic imaging, Plaque, Atherosclerotic drug therapy
- Abstract
Aims: Arterial remodelling is an important determinant of coronary atherosclerosis. Assessment of the remodelling index, comparing a lesion to a local reference site, is a suboptimal correlate of serial vascular changes. We assessed a novel approach which, unlike the local-reference approach, uses the entire artery's global remodelling as reference., Methods and Results: Serial (baseline and 13 months) intravascular ultrasound was performed in 146 non-infarct-related arteries of 82 patients treated with high-intensity statin. Arteries were divided into 3-mm segments (n = 1479), and focal remodelling was characterized in individual segments at both timepoints applying the global arterial reference approach. First, we compared preceding vascular changes in relation to follow-up remodelling. Second, we examined whether baseline remodelling predicts subsequent plaque progression/regression. At follow-up, segments with constrictive vs. compensatory or expansive remodelling had greater preceding reduction of vessel area (-0.67 vs. -0.38 vs. -0.002 mm2; P < 0.001) and lumen area (-0.82 vs. -0.09 vs. 0.40 mm2; P < 0.001). Overall, we found significant regression in percent atheroma volume (PAV) [-0.80% (-1.41 to -0.19)]. Segments with constrictive remodelling at baseline had greater subsequent PAV regression vs. modest regression in the compensatory, and PAV progression in the expansive remodelling group (-6.14% vs. -0.71% vs. 2.26%; P < 0.001). Lesion-level analyses (n = 118) showed no differences when remodelling was defined by the local reference approach at baseline or follow-up., Conclusion: Remodelling assessment using a global arterial reference approach, but not the commonly used, local reference site approach, correlated reasonably well with serial changes in arterial dimensions and identified arterial segments with subsequent PAV progression despite intensive statin treatment and overall atheroma regression., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
- Full Text
- View/download PDF
14. Recurrence in long-term survivor of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis: case series and literature review.
- Author
-
Suzuki S, Ikeda K, Yamaji K, Tamura N, and Morimoto S
- Subjects
- Autoantibodies isolation & purification, Humans, Interferon-Induced Helicase, IFIH1 immunology, Recurrence, Survivors, Dermatomyositis diagnosis
- Abstract
Anti-MDA5 antibody-positive clinically amyopathic dermatomyositis (CADM) is often complicated by rapidly progressive interstitial lung disease and is associated with poor prognosis. However, even though recurrence is reported to be infrequent if successful medical treatment is administered, the long-term prognosis remains unclear. In this case report, we examined the clinical features and treatment details of three patients with anti-MDA5 antibody-positive CADM with multiple recurrences during long-term survival at Juntendo University Urayasu Hospital. Of the three patients, two failed to convert to an anti-MDA5 antibody-negative status, and one patient died. One of the remaining patients experienced two relapses but eventually tested negative for anti-MDA5 antibodies and showed a relatively stable clinical course. Although cases of recurring anti-MDA5 antibody-positive CADM rarely occur, they may occasionally be fatal. The prognosis for anti-MDA5 antibody-positive CADM has improved over time owing to its establishment as a disease. However, further information and research is necessary to ascertain its long-term prognosis.
- Published
- 2021
- Full Text
- View/download PDF
15. Amelioration of rheumatoid arthritis in a breast cancer patient treated with palbociclib: a case report.
- Author
-
Murakami F, Horimoto Y, Shimizu H, Tada K, Yamaji K, Tamura N, and Saito M
- Subjects
- Cyclin-Dependent Kinase 4 antagonists & inhibitors, Cyclin-Dependent Kinase 6 antagonists & inhibitors, Female, Humans, Middle Aged, Protein Kinase Inhibitors therapeutic use, Treatment Outcome, Arthritis, Rheumatoid drug therapy, Breast Neoplasms drug therapy, Piperazines therapeutic use, Pyridines therapeutic use
- Abstract
Rheumatoid arthritis is a common autoimmune disease that requires new therapeutic agents. Cyclin-dependent kinase 4/6 inhibitors have recently been approved for metastatic breast cancer patients and have also been reported to improve the arthritis score in collagen-induced arthritis mouse models. We report a 56-year-old woman who had previously been diagnosed with rheumatoid arthritis and treated with methotrexate. At age 40, she underwent surgery with curative intent for breast cancer but subsequently developed lung metastases. Palbociclib, a cyclin-dependent kinase 4/6 inhibitor, was administered in combination with fulvestrant (anti-oestrogen drug) for metastatic breast cancer. One month later, serum matrix metalloproteinase-3 and C-reactive protein levels were markedly decreased, and her rheumatoid arthritis symptoms, which had worsened just prior to the detection of metastatic lung disease, showed amelioration. Methotrexate, which had been used to treat her rheumatoid arthritis, could subsequently be administered in a reduced dose. The cyclin-dependent kinase 4/6 inhibitor was also effective for the metastatic breast cancer, and, to date, the patient's disease has remained stable for more than one year. Based on the results of basic research, cyclin-dependent kinase 4/6 inhibitors are promising new therapeutic agents for rheumatoid arthritis patients, although these drugs have not, as yet, been used in a clinical setting. To the best of our knowledge, this is the first report to describe a patient whose rheumatoid arthritis responded to a cyclin-dependent kinase 4/6 inhibitor administered for metastatic breast cancer.
- Published
- 2021
- Full Text
- View/download PDF
16. Follow-up magnetic resonance imaging of Löffler endocarditis: a case report.
- Author
-
Ito S, Isotani A, Yamaji K, and Ando K
- Abstract
Background: Löffler endocarditis is a condition characterized by cardiac infiltration of eosinophils. Cardiac magnetic resonance imaging (MRI) is a modality for the diagnosis of myocardial damage., Case Summary: This is the case of a 77-year-old man with acute decompensated heart failure who was admitted. Transthoracic echocardiography showed preserved left ventricular (LV) systolic function along with LV thrombi attached to the septo-apical wall and the posterior wall, consistent with Löffler endocarditis. Cardiac MRI revealed obliteration of the LV apex and partial filling of the LV cavity, as well as near circumferential subendocardial late gadolinium enhancement (LGE) in the mid- and apical segments. T2-weighted images showed a near circumferential high-intensity area of the LV subendocardial muscle in the mid- and apical segments. High-dose corticosteroids and intravenous heparin were initiated, followed by maintenance warfarin therapy. At 18 months, follow-up cardiac MRI revealed the disappearance of the LV thrombi, and a reduction of LGE, as well as high-intensity areas in the T2-weighted images., Discussion: The high-intensity area of T2-weighted images indicate the presence of subendocardial oedema. Eosinophil-mediated heart damage evolves through three stages: (i) acute necrotic, (ii) thrombotic, and (iii) fibrotic stages. Since the deposition of toxic eosinophil granule proteins and eosinophil infiltration injured the endocardium, the first-line treatment for Löffler endocarditis is corticosteroid therapy. In this case, LGE in the subendocardium and the high-intensity area in the T2-weighted images were reduced at 18 months. High-intensity areas of T2-weighted images in the acute phase might indicate the possibility of therapeutic response to corticosteroid therapy., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2020
- Full Text
- View/download PDF
17. Elevated cerebrospinal fluid levels of total protein in patients with secondary central nervous system vasculitis and giant cell arteritis.
- Author
-
Abe Y, Harada M, Tada K, Yamaji K, and Tamura N
- Subjects
- Aged, Albumins cerebrospinal fluid, Biomarkers cerebrospinal fluid, Female, Giant Cell Arteritis complications, Humans, Male, Middle Aged, Vasculitis, Central Nervous System complications, Giant Cell Arteritis cerebrospinal fluid, Vasculitis, Central Nervous System cerebrospinal fluid
- Abstract
Objectives: Secondary central nervous system vasculitis (SCNSV) is an extremely rare, refractory, and fatal disease in patients with giant cell arteritis (GCA). We compared the characteristics of GCA patients with and without SCNSV. Methods: This retrospective, single-center, observational cohort study included 35 patients with GCA admitted to Juntendo University Hospital from April 2009 to March 2019. The primary outcome was all-cause mortality. Results: We diagnosed four patients with GCA and SCNSV (SCNSV group) and 31 patients with GCA but no SCNSV (non-SCNSV group). The mortality rate of the SCNSV and non-SCNSV groups was 100% and 10%, respectively ( p = .001). The SCNSV group had lower serum levels of C-reactive protein at the time of GCA diagnosis and higher cerebrospinal fluid (CSF) levels of total protein (102 mg/dL vs. 38 mg/dL, p = .008) and albumin (66 mg/dL vs. 21 mg/dL, p = .008) at the time of SCNSV diagnosis. Conclusion: At the time of SCNSV diagnosis, GCA patients had elevated CSF total protein and albumin levels. CSF examination in GCA patients suspected of having SCNSV may be useful for early diagnosis of SCNSV.
- Published
- 2020
- Full Text
- View/download PDF
18. Association of mucosal-associated invariant T cells with different disease phases of polymyalgia rheumatica.
- Author
-
Nakajima S, Chiba A, Makiyama A, Hayashi E, Murayama G, Yamaji K, Kobayashi S, Tamura N, Takasaki Y, and Miyake S
- Subjects
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Chemokines blood, Female, Flow Cytometry, Humans, Immunity, Cellular, Lymphocyte Activation, Male, Polymyalgia Rheumatica blood, Polymyalgia Rheumatica pathology, CD4-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes immunology, Cytokines blood, Mucosal-Associated Invariant T Cells immunology, Polymyalgia Rheumatica immunology
- Abstract
Objectives: Although T cells are thought to be involved in the pathogenesis of PMR, whether innate-like T cells are involved in the process remains unknown., Methods: The serum levels of 27 cytokines/chemokines in patients with PMR were measured by a multiplex immunoassay (Bio-Plex Assay). The cytokine-producing capacity of T and innate-like T cells was assessed by intracellular cytokine staining and flow cytometry. The frequency and activated status of T and innate-like T cells were investigated by flow cytometry and their associations with clinical parameters were assessed., Results: The levels of inflammatory cytokines were associated with disease activity in PMR. The cytokine-producing capacity by CD8+ T and innate-like T cells was associated with disease activity. The frequency of HLA-DR+ CD38+ cells among CD8+ T cells was increased in patients with active disease. The frequencies of HLA-DR+ CD38+ cells among CD4+ T, mucosal-associated invariant T (MAIT) and γδ T cells were higher in patients with inactive disease. The frequency of HLA-DR+ CD38+ MAIT cells was associated with the PMR activity score and CRP levels in patients in remission., Conclusion: The inflammatory cytokine-producing capacity and expression of activation markers of CD8+ T and innate-like T cells were associated with the disease activity of PMR. MAIT cell activation in patients in remission may contribute to the subclinical activity of the disease., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
19. Inhibition of mTOR suppresses IFNα production and the STING pathway in monocytes from systemic lupus erythematosus patients.
- Author
-
Murayama G, Chiba A, Kuga T, Makiyama A, Yamaji K, Tamura N, and Miyake S
- Subjects
- Adult, Case-Control Studies, Dendritic Cells metabolism, Down-Regulation, Female, Flow Cytometry, Humans, Immunosuppressive Agents pharmacology, Interferon-alpha pharmacology, Male, Microscopy, Confocal, Middle Aged, Monocytes drug effects, Nucleotides, Cyclic pharmacology, Sirolimus pharmacology, Young Adult, Interferon-alpha biosynthesis, Lupus Erythematosus, Systemic metabolism, Membrane Proteins biosynthesis, Monocytes metabolism, Protein Serine-Threonine Kinases metabolism, TOR Serine-Threonine Kinases antagonists & inhibitors
- Abstract
Objective: Increased IFNα is important in the pathogenesis of SLE. Plasmacytoid dendritic cells are considered the main producer of IFNα upon Toll-like receptor pathway activation. However, which cells produce IFNα following stimulation with cyclic GMP-AMP synthase (cGAS) and stimulator of IFN genes (STING) in SLE remains unknown. We investigated the IFNα producing capacity of myeloid cells under cGAS-STING pathway stimulation., Methods: IFNα levels in peripheral blood mononuclear cells from SLE patients and healthy controls stimulated with 2'3'c-GAMP, a stimulator of cGAS-STING, were measured by intracellular cytokine staining and flow cytometry. STING expression and its co-localization with TBK1 were examined by flow cytometry or confocal microscopy. The effects of in vitro exposure to IFNα on IFNα production and STING expression, and in vitro rapamycin treatment on IFNα production and STING, pTBK1 and IRF3 expression were examined., Results: IFNα was produced by monocytes, conventional dendritic cells and plasmacytoid dendritic cells upon cGAS-STING pathway activation. The frequency of IFNα-producing monocytes positively correlated with SLE disease activity. STING expression and its co-localization with TBK1 were increased in lupus monocytes. Prior exposure to IFNα enhanced the IFNα-producing capacity of monocytes. Inhibition of the mechanistic target of the rapamycin (mTOR) pathway suppressed IFNα production from monocytes and downregulated enhanced STING expression and its downstream molecules., Conclusion: Enhanced IFNα from lupus monocytes induced by augmented STING pathway activation is associated with SLE pathogenesis. Suppression of the mTOR pathway downregulated the enhanced STING expression and the subsequent IFNα production by monocytes., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
20. Percutaneous coronary intervention for delayed coronary obstruction due to endothelialization of self-expandable transcatheter heart valve: a case report.
- Author
-
Takiguchi H, Yamaji K, Shirai S, and Ando K
- Abstract
Background: Coronary obstruction is one of the serious complications associated with transcatheter aortic valve implantation (TAVI). Delayed coronary obstruction (DCO) is a rare manifestation of coronary obstruction., Case Summary: A 91-year-old woman was diagnosed with severe aortic stenosis. She underwent TAVI with a self-expandable valve, without any complications. After 8 months, she was readmitted to our hospital for effort angina. Transthoracic echocardiogram and myocardial scintigraphy suggested left coronary artery ischaemia. Computed tomography revealed that the transcatheter heart valve (THV) frame was covered with a low-density mass that occluded the left coronary sinus (LCS). Transoesophageal echocardiogram showed a Doppler signal flowing from the non-coronary sinus to the LCS through the roundabout route between the aortic wall and the THV. Percutaneous coronary intervention was performed for the roundabout route. Although intravascular ultrasound after the implantation of one drug-eluting stent showed the underexpansion of the stent, another stent deployment improved the expansion. After the procedure, her symptom improved., Discussion: Reportedly, the mechanism of DCO occurring months or years after TAVI is thought to be thrombus formation or THV endothelialization. In our case, the low-density mass was considered to be endothelium which developed along the THV frame. Low sinotubular junction height and higher THV position could be the underlying mechanisms of DCO. Percutaneous coronary intervention is a possible treatment option for DCO caused by THV endothelialization., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2020
- Full Text
- View/download PDF
21. Impact of reduced-dose prasugrel vs. standard-dose clopidogrel on in-hospital outcomes of percutaneous coronary intervention in 62 737 patients with acute coronary syndromes: a nationwide registry study in Japan.
- Author
-
Akita K, Inohara T, Yamaji K, Kohsaka S, Numasawa Y, Ishii H, Amano T, Kadota K, Nakamura M, and Maekawa Y
- Subjects
- Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Aged, Aged, 80 and over, Clopidogrel adverse effects, Coronary Thrombosis mortality, Coronary Thrombosis prevention & control, Databases, Factual, Female, Hemorrhage chemically induced, Hospital Mortality, Humans, Incidence, Japan epidemiology, Male, Middle Aged, Platelet Aggregation Inhibitors adverse effects, Prasugrel Hydrochloride adverse effects, Propensity Score, Prospective Studies, Registries, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction mortality, Time Factors, Treatment Outcome, Acute Coronary Syndrome therapy, Clopidogrel administration & dosage, Hospitalization, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Platelet Aggregation Inhibitors administration & dosage, Prasugrel Hydrochloride administration & dosage, ST Elevation Myocardial Infarction therapy
- Abstract
Aims: In Japan, reduced-dose prasugrel (loading/maintenance dose, 20/3.75 mg) has been approved for use in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), because of the higher bleeding risk among East Asians. However, its safety in the real-world population has not been investigated. We aimed to evaluate the effectiveness and safety of reduced-dose prasugrel vs. standard-dose clopidogrel in ACS patients undergoing PCI., Methods and Results: Acute coronary syndrome patients who underwent PCI in 2016, who were treated with either reduced-dose prasugrel or standard-dose clopidogrel in addition to aspirin, were identified from the nationwide Japanese PCI registry. The primary outcome was in-hospital mortality following PCI. Secondary outcomes included stent thrombosis and bleeding complication after PCI. Among 62 737 ACS patients who underwent PCI at any of 986 participating centres across Japan (clopidogrel 31.9%; prasugrel 68.1%), we identified 12 016 propensity score-matched pairs (24 032 patients; age 69.4 ± 12.2 years; female 24.9%; ST-elevation myocardial infarction 42.3%). Compared with standard-dose clopidogrel, reduced-dose prasugrel was associated with increased risk of bleeding [odds ratio (OR) 1.65, 95% confidence interval (CI) 1.10-2.51; P = 0.016], but both had similar rates of mortality (OR 1.11, 95% CI 0.89-1.38; P = 0.371) and stent thrombosis (OR 1.29, 95% CI 0.73-2.30; P = 0.387) as well as similar falsification endpoints of cardiac tamponade and emergent operation., Conclusion: In Japanese ACS patients undergoing PCI, the risk of bleeding is higher when using reduced-dose prasugrel than when using standard-dose clopidogrel, but there is no significant difference in in-hospital mortality and incidence of stent thrombosis between the two antiplatelet regimens., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
22. Picture superiority effect as one of the potential advantages of musculoskeletal ultrasound complementation for verbal explanation.
- Author
-
Matsuki-Muramoto Y, Ogasawara M, Kawamoto T, Yamaji K, and Tamura N
- Subjects
- Aged, Female, Humans, Male, Ultrasonography standards, Arthralgia diagnostic imaging, Arthritis, Rheumatoid diagnostic imaging, Ultrasonography methods
- Abstract
Objective: We conducted a questionnaire survey within a standard clinical setting to clarify that picture superiority effect (PSE) could be obtained by musculoskeletal ultrasound (MSKUS) examination. Methods: One hundred patients with rheumatoid arthritis or arthralgia, who visited the Rheumatology Unit, Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine, and received first-time MSKUS from June 2017 to August 2017, were sequentially requested to complete an anonymous questionnaire based on their experiences of the explanation with or without MSKUS. MSKUS was implemented as point-of-care ultrasonography (POCUS) or on the other reserved examination day. Results: We obtained answers from all patients ( n = 100); 80% or more subjects strongly agreed that the explanation complemented with MSKUS contributed to 'easier understanding,' 'better communication,' and 'preference for MSKUS-available hospital' ( p < .001). This agreement was also observed in elderly patients and when MSKUS was implemented as POCUS. There was no correlation between the number of examined joints ( r = 0.18, p = .15), time required for MSKUS ( r = -0.17, p = .09), the severity of the MSKUS results ( r = -0.06, p = .52), and degree of agreement. Conclusion: MSKUS addition has shown to offer PSE, which contributes to patients' understanding and experience of improved communication. We should acknowledge the effects of PSE by MSKUS and utilize it for informed consent and shared decision-making in musculoskeletal symptomatic patients.
- Published
- 2020
- Full Text
- View/download PDF
23. Successful treatment of anti-MDA5 antibody-positive refractory interstitial lung disease with plasma exchange therapy.
- Author
-
Abe Y, Kusaoi M, Tada K, Yamaji K, and Tamura N
- Subjects
- Adult, Aged, Anaphylaxis epidemiology, Anaphylaxis etiology, Dermatomyositis complications, Drug Resistance, Female, Humans, Lung Diseases, Interstitial complications, Lung Diseases, Interstitial immunology, Male, Middle Aged, Plasma, Plasma Exchange adverse effects, Plasmapheresis, Survival Rate, Transfusion Reaction epidemiology, Transfusion Reaction etiology, Treatment Outcome, Autoantibodies immunology, Dermatomyositis immunology, Immunosuppressive Agents therapeutic use, Interferon-Induced Helicase, IFIH1 immunology, Lung Diseases, Interstitial therapy, Plasma Exchange methods
- Abstract
Objectives: We examined the effectiveness of plasma exchange (PE) therapy to reduce the mortality of rapidly progressive interstitial lung disease (RP-ILD) in patients positive for anti-melanoma differentiation-associated gene 5 (MDA5) antibodies., Methods: Among 142 patients newly diagnosed with PM/DM or clinically amyopathic DM from 2008 to 2019 at our hospital, 10 were diagnosed with refractory RP-ILD and were positive for anti-MDA5 antibodies. PE was used as an adjunct to standard therapy and consisted of fresh frozen plasma as replacement solution. The primary outcome was non-disease-specific mortality., Results: Anti-MDA5 antibodies were detected in 28 patients, of whom 21 were diagnosed with RP-ILD and 10 were refractory to intensive immunosuppressive therapy. Six patients received PE (PE group) and four did not (non-PE group). The 1-year survival rate of the PE group was higher than that of the non-PE group (100% and 25%, respectively, P = 0.033). Regarding adverse events associated with PE, two patients had anaphylactic shock, one had high fever due to fresh frozen plasma allergy and one had a catheter infection. All adverse events resolved with appropriate treatment., Conclusion: We evaluated the association between 1-year survival rate and PE for refractory RP-ILD in patients positive for anti-MDA5 antibodies. Intensive immunosuppressive therapy improved the survival rate in RP-ILD patients with anti-MDA5 antibodies, but 20-30% of cases were still fatal. PE could be administered to patients with active infectious disease who were immunocompromised by intensive immunosuppressive therapy. PE may be considered in refractory RP-ILD patients positive for anti-MDA5 antibodies., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
24. Regulatory role of pyruvate-sensing BtsSR in biofilm formation by Escherichia coli K-12.
- Author
-
Ogasawara H, Ishizuka T, Yamaji K, Kato Y, Shimada T, and Ishihama A
- Subjects
- Escherichia coli K12 genetics, Escherichia coli Proteins genetics, Gene Expression Regulation, Bacterial genetics, Gene Expression Regulation, Bacterial physiology, Promoter Regions, Genetic genetics, Transcription Factors genetics, Transcription Factors metabolism, Biofilms growth & development, Escherichia coli K12 growth & development, Escherichia coli K12 metabolism, Escherichia coli Proteins metabolism, Pyruvic Acid metabolism
- Abstract
Pyruvate, the key regulator in connection of a variety of metabolic pathways, influences transcription of the Escherichia coli genome through controlling the activity of two pyruvate-sensing two-component systems (TCSs), BtsSR and PyrSR. Previously, we identified the whole set of regulatory targets of PyrSR with low-affinity to pyruvate. Using gSELEX screening system, we found here that BtsSR with high-affinity to pyruvate regulates more than 100 genes including as many as 13 transcription factors genes including the csgD gene encoding the master regulator of biofilm formation. CsgD regulates more than 20 target genes including the csg operons encoding the Curli fimbriae. In addition, we identified the csgBAC as one of the regulatory targets of BtsR, thus indicating the involvement of two pyruvate-dependent regulatory pathways of the curli formation: indirect regulation by CsgD; and direct regulation by BtsR. Based on the findings of the whole set of regulatory targets by two pyruvate-sensing BtsR and PyrR, we further propose an innovative concept that the pyruvate level-dependent regulation of different gene sets takes place through two pyruvate-sensing TCS systems, high-affinity BtsSR and low-affinity PyrSR to pyruvate., (© FEMS 2019.)
- Published
- 2019
- Full Text
- View/download PDF
25. Expanded circulating peripheral helper T cells in systemic lupus erythematosus: association with disease activity and B cell differentiation.
- Author
-
Makiyama A, Chiba A, Noto D, Murayama G, Yamaji K, Tamura N, and Miyake S
- Subjects
- Adult, Antibody Formation immunology, Female, Humans, Interleukins metabolism, Leukocytes, Mononuclear, Lymphocyte Activation immunology, Male, Middle Aged, Programmed Cell Death 1 Receptor metabolism, Th1 Cells immunology, B-Lymphocytes immunology, Cell Differentiation immunology, Lupus Erythematosus, Systemic immunology, T-Lymphocytes, Helper-Inducer immunology
- Abstract
Objective: Peripheral helper T (TPH) cells are a recently identified Th cell subset that promotes B cell differentiation and antibody production in inflamed tissues. This study investigated circulating TPH cells to determine their involvement in systemic lupus erythematosus (SLE)., Methods: Peripheral blood mononuclear cells collected from SLE patients and healthy individuals were analysed. TPH cells were identified as CD3+CD4+CD45RA-CXCR5- cells with a high expression of PD-1. The frequency, activation status and subsets of TPH cells were evaluated by flow cytometry. The production of IL-21 was assessed by intracellular staining and the association of TPH cells with disease activity and B cell populations was determined., Results: Circulating TPH cells, identified as CD3+CD4+CD45RA-PD-1highCXCR5- cells were increased in the peripheral blood of SLE patients compared with controls. Circulating TPH cells produced similar amounts of IL-21 compared with follicular Th cells. The expansion and activation of TPH cells were correlated with SLE disease activity. Activated TPH cells, particularly Th1-type TPH cells, were associated with the promotion of B cell differentiation in SLE patients., Conclusion: The association of TPH cells with disease activity suggests the involvement of extrafollicular T-B cell interactions in the pathogenesis of SLE. TPH cells promote autoantibody production in aberrant lymphoid organs and therefore might be a novel therapeutic target in autoantibody-producing disorders., (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
- Full Text
- View/download PDF
26. EFFECT ON MICROBIAL PRODUCTS ON CAESIUM ELUTION BEHAVIOUR FROM CLAY MINERALS.
- Author
-
Kimura T, Fukutani S, Yamaji K, Ikegami M, and Yoneda M
- Subjects
- Aluminum Silicates chemistry, Clay microbiology, Ferrous Compounds chemistry, Medicago microbiology, Plant Roots microbiology, Siderophores metabolism, Bacteria metabolism, Cesium Radioisotopes analysis, Clay chemistry, Minerals analysis, Soil Microbiology, Soil Pollutants, Radioactive analysis
- Abstract
Some microorganisms in the environment make siderophores, which are low molecular chelators, to take up minerals from soil. Eleven bacteria were separated from the root of white clover by chlome azrol S (CAS) assay. Each bacterium was incubated in casamino acid (CAA) culture, and siderophores in CAA culture were purified. These extractions were applied to biotite or vermiculite spiked with Cs. From each clay mineral, 57.1-72.8% (5100 ppm), 55.6-63.8% (920 ppm) and 48.6-54.3% (2300 ppm), 31.6-34.4% (520 ppm) was eluted, respectively. To understand elution behaviour, Cs desorption ratio of each clay was measured every 30 min. The results indicate Cs elution was occurred quickly., (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
- Full Text
- View/download PDF
27. Immunosuppressive therapy to reduce mitral regurgitation in Libman-Sacks endocarditis: a case report.
- Author
-
Ishizu K, Isotani A, Yamaji K, and Ando K
- Abstract
Background: Libman-Sacks endocarditis is a cardiac manifestation of systemic lupus erythematosus (SLE) and is characterized by non-bacterial verrucous vegetations, causing valvular stenosis and/or regurgitation. The effectiveness of immunosuppressive therapy for valve dysfunction due to Libman-Sacks endocarditis has not been reported., Case Summary: A 67-year-old woman with a history of chronic atrial fibrillation was emergently admitted with acute decompensated heart failure. Transoesophageal echocardiogram revealed severe mitral regurgitation (MR) due to oedematous thickening and poor coaptation of the medial edge of A2/P2 segments and the lateral edge of A3/P3 segments. Serial blood culture results were negative, suggesting bacterial infective endocarditis to be a less likely cause of valvular damage. Because the patient developed photosensitivity, livedo reticularis, and pancytopenia, Libman-Sacks endocarditis with rapidly progressive SLE was diagnosed on the basis of positive test results of anti-double-stranded DNA-IgG and its complement titer. Two months after, immunosuppressive therapy including corticosteroids, a transoesophageal echocardiogram revealed thinning of the degenerative mitral valve leaflets and a reduction of MR from severe to mild., Discussion: Corticosteroid therapy for Libman-Sacks endocarditis reportedly increases the extent of fibrosis and scarring of the valve leaflets, resulting in worse valve function. In our patient, MR decreased from severe to mild after corticosteroid therapy. Because low-echoic thickening of the mitral valve leaflets suggested acute oedematous changes without scarring and fibrosis and other clinical symptoms of SLE rapidly progressed, early initiation of immunosuppressive therapy for Libman-Sacks endocarditis lead to a benign clinical course in our patient., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2019
- Full Text
- View/download PDF
28. Recurrent cerebral infarctions due to a sewing needle penetrating the left ventricle.
- Author
-
Hirose K, Yamaji K, Sakaguchi G, Okamoto K, and Ando K
- Subjects
- Cardiac-Gated Imaging Techniques, Echocardiography, Female, Foreign Bodies surgery, Humans, Magnetic Resonance Imaging, Middle Aged, Recurrence, Suicide, Attempted, Tomography, X-Ray Computed, Cerebral Infarction etiology, Foreign Bodies complications, Foreign Bodies diagnostic imaging, Heart Ventricles injuries, Needles
- Published
- 2019
- Full Text
- View/download PDF
29. Rapid glucocorticoid tapering therapy to reduce mortality from pneumocystis pneumonia in patients with rheumatic disease.
- Author
-
Ando T, Abe Y, Endo Y, Tada K, Yamaji K, and Tamura N
- Subjects
- Adult, Aged, Female, Glucocorticoids administration & dosage, Humans, Male, Middle Aged, Pneumonia, Pneumocystis etiology, Treatment Outcome, Glucocorticoids therapeutic use, Pneumonia, Pneumocystis drug therapy, Rheumatic Diseases complications
- Abstract
Objective: Pneumocystis pneumonia (PCP) is a serious complication in patients with rheumatic diseases who are receiving immunosuppressive therapy. These patients have a higher mortality from PCP than those with human immunodeficiency virus. We examined factors associated with poor prognosis in patients with rheumatic diseases and evaluated PCP treatment in this population. Methods: This retrospective, single-center, observational cohort study included 31 patients with rheumatic diseases who were admitted to Juntendo University Hospital for PCP treatment from June 2006 to December 2017. The primary outcome was non-disease-specific mortality at discharge. Results: The median age at PCP diagnosis was 64 years. The survival rate was 61.3% (19/31). Twelve patients died, in all cases due to respiratory failure due to PCP. Among variables at PCP diagnosis and those related to PCP treatment, the presence of coexisting pulmonary diseases and greater glucocorticoid dose at PCP diagnosis were associated with higher mortality. The mortality related to biological agents for PCP was low. Rapid tapering of glucocorticoids improved survivability. Conclusion: In the treatment of PCP in patients with rheumatic diseases, rapid tapering of glucocorticoids was associated with a higher survival rate than the use of conventional therapy.
- Published
- 2019
- Full Text
- View/download PDF
30. Five-year clinical outcomes and intracoronary imaging findings of the COMFORTABLE AMI trial: randomized comparison of biodegradable polymer-based biolimus-eluting stents with bare-metal stents in patients with acute ST-segment elevation myocardial infarction.
- Author
-
Räber L, Yamaji K, Kelbæk H, Engstrøm T, Baumbach A, Roffi M, von Birgelen C, Taniwaki M, Moschovitis A, Zaugg S, Ostojic M, Pedrazzini G, Karagiannis-Voules DA, Lüscher TF, Kornowski R, Tüller D, Vukcevic V, Heg D, and Windecker S
- Subjects
- Absorbable Implants, Acute Disease, Coronary Restenosis epidemiology, Coronary Restenosis etiology, Female, Follow-Up Studies, Humans, Male, Metals, Percutaneous Coronary Intervention methods, Polymers, Prosthesis Design, ST Elevation Myocardial Infarction physiopathology, Sirolimus analogs & derivatives, Stents trends, Thrombosis epidemiology, Thrombosis etiology, Tomography, Optical Coherence methods, Treatment Outcome, Ultrasonography, Interventional methods, Drug-Eluting Stents adverse effects, ST Elevation Myocardial Infarction surgery, Stents adverse effects
- Abstract
Aims: The long-term outcomes of biolimus-eluting stents (BESs) with biodegradable polymer as compared with bare-metal stent (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remain unknown., Methods and Results: We performed a 5-year clinical follow-up of 1157 patients (BES: N = 575 and BMS: N = 582) included in the randomized COMFORTABLE AMI trial. Serial intracoronary imaging of stented segments using both intravascular ultrasound (IVUS) and optical coherence tomography performed at baseline and 13 months follow-up were analysed in 103 patients. At 5 years, BES reduced the risk of major adverse cardiac events [MACE; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.39-0.79, P = 0.001], driven by lower risks for target vessel-related reinfarction (HR 0.44, 95% CI: 0.22-0.87, P = 0.02) and ischaemia-driven target lesion revascularization (HR 0.41, 95% CI: 0.25-0.66, P < 0.001). Definite stent thrombosis (ST) was recorded in 2.2% and 3.9% (HR 0.57, 95% CI: 0.28-1.16, P = 0.12) with no differences in rates of very late definite ST (1.3% vs. 1.6%, P = 0.77). Optical coherence tomography showed no difference in the frequency of malapposed stent struts at follow-up (BES 0.08% vs. BMS 0.02%, P = 0.10). Uncovered stent struts were rarely observed but more frequent in BES (2.1% vs. 0.15%, P < 0.001). In the IVUS analysis, there was no positive remodelling in either group (external elastic membrane area change BES: -0.63 mm2, 95% CI: -1.44 to 0.39 vs. BMS -1.11 mm2, 95% CI: -2.27 to 0.04, P = 0.07)., Conclusion: Compared with BMS, the implantation of biodegradable polymer-coated BES resulted in a lower 5-year rate of MACE in patients with STEMI undergoing primary percutaneous coronary intervention. At 13 months, vascular healing in treated culprit lesions was almost complete irrespective of stent type., Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00962416., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
- Full Text
- View/download PDF
31. Angiographic derived endothelial shear stress: a new predictor of atherosclerotic disease progression.
- Author
-
Bourantas CV, Ramasamy A, Karagiannis A, Sakellarios A, Zanchin T, Yamaji K, Ueki Y, Shen X, Fotiadis DI, Michalis LK, Mathur A, Serruys PW, Garcia-Garcia HM, Koskinas K, Torii R, Windecker S, and Räber L
- Subjects
- Aged, Cohort Studies, Coronary Angiography methods, Coronary Artery Disease physiopathology, Coronary Circulation physiology, Disease Progression, Endothelium, Vascular diagnostic imaging, Female, Humans, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, ROC Curve, Retrospective Studies, Risk Assessment, Coronary Artery Disease diagnostic imaging, Endothelium, Vascular pathology, Imaging, Three-Dimensional, ST Elevation Myocardial Infarction diagnostic imaging, Ultrasonography, Interventional methods
- Abstract
Aims: To examine the efficacy of angiography derived endothelial shear stress (ESS) in predicting atherosclerotic disease progression., Methods and Results: Thirty-five patients admitted with ST-elevation myocardial infarction that had three-vessel intravascular ultrasound (IVUS) immediately after revascularization and at 13 months follow-up were included. Three dimensional (3D) reconstruction of the non-culprit vessels were performed using (i) quantitative coronary angiography (QCA) and (ii) methodology involving fusion of IVUS and biplane angiography. In both models, blood flow simulation was performed and the minimum predominant ESS was estimated in 3 mm segments. Baseline plaque characteristics and ESS were used to identify predictors of atherosclerotic disease progression defied as plaque area increase and lumen reduction at follow-up. Fifty-four vessels were included in the final analysis. A moderate correlation was noted between ESS estimated in the 3D QCA and the IVUS-derived models (r = 0.588, P < 0.001); 3D QCA accurately identified segments exposed to low (<1 Pa) ESS in the IVUS-based reconstructions (AUC: 0.793, P < 0.001). Low 3D QCA-derived ESS (<1.75 Pa) was associated with an increase in plaque area, burden, and necrotic core at follow-up. In multivariate analysis, low ESS estimated either in 3D QCA [odds ratio (OR): 2.07, 95% confidence interval (CI): 1.17-3.67; P = 0.012) or in IVUS (<1 Pa; OR: 2.23, 95% CI: 1.23-4.03; P = 0.008) models, and plaque burden were independent predictors of atherosclerotic disease progression; 3D QCA and IVUS-derived models had a similar accuracy in predicting disease progression (AUC: 0.826 vs. 0.827, P = 0.907)., Conclusions: 3D QCA-derived ESS can predict disease progression. Further research is required to examine its value in detecting vulnerable plaques., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
- Full Text
- View/download PDF
32. Changes in antibody titres in patients with anti-transcription intermediary factor 1-gamma antibody-positive idiopathic inflammatory myositis.
- Author
-
Abe Y, Ando T, Matsushita M, Tada K, Yamaji K, and Tamura N
- Subjects
- Autoantibodies immunology, Humans, Myositis complications, Myositis immunology, Retrospective Studies, Autoantibodies blood, Myositis blood, Neoplasms immunology, Transcription Factors immunology
- Published
- 2019
- Full Text
- View/download PDF
33. COMBO dual-therapy stent: non-inferior to drug-eluting stents or stepping back to bare metal stents?
- Author
-
Yamaji K and Kimura T
- Subjects
- Humans, Japan, Metals, Stents, United States, Acute Coronary Syndrome, Drug-Eluting Stents, Endothelial Progenitor Cells
- Published
- 2018
- Full Text
- View/download PDF
34. Association of five-factor score with the mortality in Japanese patients with polyarteritis nodosa.
- Author
-
Abe Y, Tada K, Yamaji K, Takasaki Y, and Tamura N
- Subjects
- Adult, Aged, Biomarkers blood, Female, Humans, Japan, Male, Middle Aged, Polyarteritis Nodosa epidemiology, Polyarteritis Nodosa mortality, Survival Rate, Factor V metabolism, Polyarteritis Nodosa blood
- Abstract
Aim: To determine mortality and its predictive factors in Japanese patients with polyarteritis nodosa (PAN)., Methods: This retrospective single-center study determined the mortality of 18 patients with PAN who were admitted to Juntendo University Hospital from 1994 to 2016. The variables at baseline, including patient demographics, clinical characteristics, and treatment, were analyzed for their association with mortality., Results: The median age of onset was 57.0 years. The 1-year survival rate was 100% (16/16) and the 5-year survival rate was 80.0% (8/10). The relationship between mortality, as defined by the survival rate and each variable was evaluated by Cox univariate analysis. A higher 2009 five-factor score (FFS) was associated with increased mortality, with a hazard ratio of 2.34 (p = .04). Analysis of the secondary outcome of relapse-free survival time revealed an association with rapid progressive renal failure, Birmingham Vasculitis Activity Score (BVAS), the 1996 FFS, and the 2009 FFS, with hazard ratios of 7.28 (p = .048), 1.26 (p = .02), 2.32 (p = .03), and 1.82 (p = .04), respectively., Conclusion: We investigated mortality, relapse-free survival, and their predictive factors in Japanese patients with PAN. The BVAS and the 1996 FFS at diagnosis may be prognostic factors for relapse-free survival, and the 2009 FFS at diagnosis may be a prognostic factor for both mortality and relapse-free survival.
- Published
- 2018
- Full Text
- View/download PDF
35. Clinical characteristics and change in the antibody titres of patients with anti-MDA5 antibody-positive inflammatory myositis.
- Author
-
Abe Y, Matsushita M, Tada K, Yamaji K, Takasaki Y, and Tamura N
- Subjects
- Adult, Biomarkers blood, Enzyme-Linked Immunosorbent Assay methods, Female, Glucocorticoids therapeutic use, Humans, Immunosuppressive Agents therapeutic use, Kaplan-Meier Estimate, Male, Middle Aged, Polymyositis diagnosis, Polymyositis drug therapy, Prognosis, Retrospective Studies, Autoantibodies blood, Interferon-Induced Helicase, IFIH1 immunology, Polymyositis immunology
- Abstract
Objective: The aim of this study was to evaluate the clinical characteristics of patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive inflammatory myositis, and the change in anti-MDA5 antibody titres before and after onset., Method: For 105 PM/DM patients, newly diagnosed in our hospital within the period 2008-2016, serum anti-MDA5 antibody levels were measured at diagnosis and after treatment by ELISA using the MESACUP anti-MDA5 test. The relationships between anti-MDA5 antibody levels and clinical manifestations, laboratory data, and mortality were examined., Result: Compared with patients who were anti-MDA5 antibody negative, those who were antibody positive demonstrated more frequent dermatitis, clinically amyopathic DM, interstitial lung disease and rapid-progressive interstitial lung disease, as well as significantly higher serum ferritin, significantly lower creatine kinase and aldolase, and significantly less frequent ANA (⩾1:160) and anti-cytoplasmic pattern of ANA staining positivity. Anti-MDA5 antibody titres were examined before disease onset in two patients; one showed antibody positivity with low titres 2 years earlier, while both exhibited increased titres at onset. Anti-MDA5 antibody titres declined significantly less in survivors than in non-survivors after treatment; however, there was no significant difference between the two groups when the rate was compared at 2 months after treatment., Conclusion: An initial decrease in anti-MDA5 antibody titre after commencement of treatment was observed in most of the patients, including in fatal cases, suggesting that this may not necessarily be a useful marker for treatment of patients with DM., (© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com)
- Published
- 2017
- Full Text
- View/download PDF
36. Predictive factors for mortality in elderly Japanese patients with severe microscopic polyangiitis: A retrospective single-center study.
- Author
-
Abe Y, Tamura N, Yang KS, Matsuoka J, Kon T, Yamaji K, Hashimoto H, Tsuda H, and Takasaki Y
- Subjects
- Aged, Female, Humans, Japan, Male, Middle Aged, Recurrence, Retrospective Studies, Survival Rate, Microscopic Polyangiitis epidemiology
- Abstract
Purpose: To determine mortality and its predictive factors in elderly Japanese patients with severe microscopic polyangiitis (MPA)., Method: This retrospective single-center study determined the mortality of 52 patients with MPA who were admitted to our geriatric medical center from 2002 to 2014. The variables at baseline, including patient demographics, clinical characteristics, and treatment, were analyzed for their association with mortality., Result: Mean age at onset of MPA was 73.2 years, and the one-year survival rate was 65.9%. Relapse was observed in 32.7%. Among variables at diagnosis, age, cardiomyopathy, central nervous system (CNS) involvement, alveolar hemorrhage, disease severity, the 1996 Five-Factor Score (FFS), and the 2009 FFS were associated with mortality in univariate analysis. Cardiomyopathy, CNS involvement, age >65 years, disease severity, Birmingham Vasculitis Activity Score, the 1996 FFS, and the 2009 FFS were associated with relapse-free survival in univariate analysis., Conclusion: We investigated mortality and relapse-free survival and their predictive factors in elderly Japanese patients with severe MPA. Age, disease severity, the 1996 FFS, and the 2009 FFS at diagnosis were prognostic factors for both mortality and relapse-free survival.
- Published
- 2017
- Full Text
- View/download PDF
37. Disease flare patterns and predictors of systemic lupus erythematosus in a monocentric cohort of 423 Japanese patients during a long-term follow-up: The JUDE study.
- Author
-
Minowa K, Amano H, Ando S, Watanabe T, Ogasawara M, Kawano S, Kaneko T, Morimoto S, Yamaji K, Tamura N, Tokano Y, Hashimoto H, and Takasaki Y
- Subjects
- Adolescent, Adult, Age of Onset, Aged, Child, Female, Follow-Up Studies, Humans, Lupus Erythematosus, Systemic drug therapy, Male, Middle Aged, Recurrence, Severity of Illness Index, Symptom Assessment, Thrombocytopenia drug therapy, Young Adult, Immunosuppressive Agents therapeutic use, Lupus Erythematosus, Systemic diagnosis, Thrombocytopenia diagnosis
- Abstract
Objective: To clarify the clinical features of systemic lupus erythematosus (SLE) patients, factors associated with flares, and changes over time., Methods: Patients having SLE with a visiting history were entered into the Juntendo University Database of Erythematosus. We included 423 cases in the long-term follow-up analysis, and 383 cases were followed for 10 years after the initiation of any therapeutic intervention (comparative analysis: 1973-1982, 82 cases; 1983-1992, 141, and 1993-2002, 160). We assessed changes in the patients' background characteristics, disease symptoms, flare rates, etc., Results: Among the 423 cases, the mean follow-up period was 25.9 years, and mean number of flares was 0.51. Of those, 31.9% had ≥1 flares. Thrombocytopenia at onset contributed to the flares. For disease symptoms at onset, a recent trend in increasing thrombocytopenia was observed. The combination rate of immunosuppressive agents for diseases other than lupus nephritis was slightly increased, and there was no improvement until the first flare or in the flare rate., Conclusions: Thrombocytopenia at onset is predictive factor for flares. Since SLE is a diverse disease with varying symptoms at recurrence, the treatment guidelines should be improved for thrombocytopenia from a long-term perspective.
- Published
- 2017
- Full Text
- View/download PDF
38. Ten-year clinical outcomes of first-generation drug-eluting stents: the Sirolimus-Eluting vs. Paclitaxel-Eluting Stents for Coronary Revascularization (SIRTAX) VERY LATE trial.
- Author
-
Yamaji K, Räber L, Zanchin T, Spitzer E, Zanchin C, Pilgrim T, Stortecky S, Moschovitis A, Billinger M, Schönenberger C, Eberli F, Jüni P, Lüscher TF, Heg D, and Windecker S
- Subjects
- Coronary Restenosis, Follow-Up Studies, Humans, Myocardial Infarction, Paclitaxel, Sirolimus, Stents, Treatment Outcome, Drug-Eluting Stents
- Abstract
Aims: Compared with bare metal stents, first-generation drug-eluting stents (DES) are associated with an increased risk of late restenosis and stent thrombosis (ST). Whether this risk continues or attenuates during long-term follow-up remains unknown., Methods and Results: We extended the follow-up of 1012 patients [sirolimus-eluting stent (SES): N = 503 and paclitaxel-eluting stent (PES): N = 509] included in the all-comers, randomized Sirolimus-Eluting vs. Paclitaxel-Eluting Stents for Coronary Revascularization (SIRTAX) trial to 10 years. Follow-up was complete in 895 patients (88.4%) at 10 years. At 1, 5, and 10 years of follow-up, rates of ischaemia-driven target lesion revascularization (ID-TLR) were 8.1%, 14.6% and 17.7%, respectively, and rates of ST were 1.9%, 4.5% and 5.6%, respectively. The annual risks of ID-TLR and definite ST were significantly higher between 1 and 5 years as compared with the 5- to 10-year period [ID-TLR: 1.8% vs. 0.7%/year, hazard ratio (HR) 0.36, 95% confidence intervals (95% CI) 0.21-0.62, P < 0.001; definite ST: 0.67% vs. 0.23%/year, HR 0.31, 95% CI 0.13-0.75, P = 0.01]. The attenuation of the risk of ID-TLR and ST beyond 5 years was independent of age. Major adverse events (cardiac death, myocardial infarction, and ID-TLR) occurred in 33.7% of SES- and 33.8% of PES-treated patients (P = 0.72)., Conclusions: During long-term follow-up through 10 years, the annual risks of ID-TLR and definite ST significantly decreased beyond 5 years after first-generation DES implantation. These findings may have important implications for secondary prevention after percutaneous coronary intervention with first-generation DES including long-term antiplatelet therapy., Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT00297661., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.)
- Published
- 2016
- Full Text
- View/download PDF
39. The synovial grade corresponding to clinically involved joints and a feasible ultrasound-adjusted simple disease activity index for monitoring rheumatoid arthritis.
- Author
-
Yamada Y, Ogasawara M, Gorai M, Matsuki Y, Murayama G, Sugisaki N, Nemoto T, Ando S, Minowa K, Nakano S, Kon T, Tada K, Matsushita M, Yamaji K, Tamura N, and Takasaki Y
- Subjects
- Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid blood, Blood Sedimentation, Disease Progression, Female, Humans, Male, Middle Aged, Physical Examination, Severity of Illness Index, Synovitis blood, Young Adult, Arthritis, Rheumatoid diagnostic imaging, Arthrography methods, Synovitis diagnostic imaging, Ultrasonography, Doppler
- Abstract
Objectives: To determine which grade of ultrasound (US) synovitis corresponds to clinically involved joints in rheumatoid arthritis (RA) and develops a new US-adjusted composite measure., Methods: Clinical and US examinations were performed on 137 patients with RA (28 joints). Synovial effusion, hypertrophy, and blood flow were semiquantitatively graded from 0 to 3 using gray scale (GS) and power Doppler (PD) modes. We calculated US-adjusted simple disease activity index (SDAI) and assessed feasibility, and external validity by comparing with erythrocyte sedimentation rate (ESR), and modified health assessment questionnaires (MHAQ)., Results: GS ≥2 and PD ≥0 corresponds to clinically swollen joints, and GS ≥2 and PD ≥1 corresponds to tender joints. The US-adjusted SDAI showed the highest correlation when US-determined swollen joints were defined as PD ≥2 with ESR, and GS ≥3 and PD ≥2 with MHAQ. A feasible US-adjusted SDAI examining only clinically involved joints still showed a higher correlation with ESR and MHAQ than SDAI., Conclusion: Our composite measure complemented by US only for clinically involved joints is feasible and reliable for monitoring disease activity.
- Published
- 2016
- Full Text
- View/download PDF
40. Predictive grade of ultrasound synovitis for diagnosing rheumatoid arthritis in clinical practice and the possible difference between patients with and without seropositivity.
- Author
-
Minowa K, Ogasawara M, Murayama G, Gorai M, Yamada Y, Nemoto T, Matsuki Y, Sugisaki N, Ando S, Kon T, Tada K, Matsushita M, Yamaji K, Tamura N, and Takasaki Y
- Subjects
- Adult, Aged, Arthritis, Rheumatoid blood, Arthritis, Rheumatoid drug therapy, C-Reactive Protein analysis, Female, Humans, Male, Middle Aged, Rheumatoid Factor blood, Rheumatology, Ultrasonography, Arthritis, Rheumatoid diagnostic imaging, Metacarpophalangeal Joint diagnostic imaging, Synovitis diagnostic imaging, Wrist Joint diagnostic imaging
- Abstract
Objective: To determine the degree of contribution and the contributing factors of ultrasound in the diagnosis of rheumatoid arthritis (RA) in daily clinical practice and the predictive differences depending on seropositivity., Methods: We included 122 patients who presented with the main complaint of finger and/or wrist joint pain but for whom no definite diagnosis was reached or treatment strategy was provided. Ultrasound was performed on at least 22 joints (both wrist joints, proximal interphalangeal joint, and metacarpophalangeal joints), and patients were followed for ≥6 months. Factors contributing to RA diagnosis were determined and compared between seropositive and seronegative RA patients., Results: RA was diagnosed in 52 of 122 patients, in whom the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria (odds ratio [OR] = 4.74, P = 0.01) and gray scale (GS) grade of 3 (OR = 3.64, P = 0.04) for ≥ 1 joint were the contributing factors. In seropositive RA, the ACR/EULAR criteria (OR = 15.53, P < 0.001) and power Doppler (PD) ≥ 2 for ≥ 1 joint (OR = 10.48, P = 0.0048) were the contributing factors. In seronegative RA, PD ≥ 1 for ≥ 1 joint contributed the most (OR = 20.00, P = 0.0044), but the ACR/EULAR criteria did not contribute to RA diagnosis (P = 0.57)., Conclusion: Ultrasound findings contributed to RA diagnosis in clinical practice. The contributing factors are different in the presence or absence of seropositivity, and ultrasound complementation was particularly useful in seronegative RA patients.
- Published
- 2016
- Full Text
- View/download PDF
41. Vascular response to bioresorbable polymer sirolimus-eluting stent vs. permanent polymer everolimus-eluting stent at 9-month follow-up: an optical coherence tomography sub-study from the CENTURY II trial.
- Author
-
Kuramitsu S, Kazuno Y, Sonoda S, Domei T, Jinnouchi H, Yamaji K, Soga Y, Shirai S, Ando K, and Saito S
- Subjects
- Absorbable Implants, Aged, Aged, 80 and over, Coronary Angiography methods, Female, Follow-Up Studies, Humans, Japan, Male, Neointima, Percutaneous Coronary Intervention, Polymers, Prosthesis Design, Single-Blind Method, Treatment Outcome, Coronary Artery Disease surgery, Drug-Eluting Stents, Everolimus administration & dosage, Immunosuppressive Agents administration & dosage, Sirolimus administration & dosage, Tomography, Optical Coherence methods
- Abstract
Aims: The Ultimaster bioresorbable polymer sirolimus-eluting stent (BP-SES) is a newly developed drug-eluting stent (DES) that consists of a thin-strut, cobalt chromium with bioresorbable polymer coated only albuminally. We sought to compare tissue coverage in coronary lesions treated with BP-SES with the XIENCE permanent polymer everolimus-eluting stent (PP-EES) using optical coherence tomography (OCT)., Methods and Results: A total of 36 patients participated in the CENTURY II trial in our institution and were randomly assigned to BP-SES (n = 15) and PP-EES (n = 21). Of these, 27 patients (13 BP-SES and 14 PP-EES) underwent OCT at 9-month follow-up. Tissue coverage and apposition were assessed on each strut, and the results in both groups were compared using multilevel logistic or linear regression models with random effects at three levels: patient, lesion, and struts. A total of 6450 struts (BP-SES, n = 2951; PP-EES, n = 3499) were analysed. Thirty and 79 uncovered struts (1.02 and 2.26%, P = 0.35), and 3 and 4 malapposed struts (0.10 and 0.11%, P = 0.94) were found in BP-SES and PP-EES groups, respectively. Mean neointimal thickness did not significantly differ between both groups (110 ± 10 vs. 93 ± 10 µm, P = 0.22). No significant differences in per cent neointimal volume obstruction (13.2 ± 4.6 vs. 10.5 ± 4.9%, P = 0.14) or other areas-volumetric parameters were detected between both groups., Conclusion: BP-SES shows an excellent vascular healing response at 9-month follow-up, which is similar to PP-EES., (© The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2016
- Full Text
- View/download PDF
42. Predictive value of bone destruction and duration of clinical remission for subclinical synovitis in rheumatoid arthritis patients.
- Author
-
Tokai N, Ogasawara M, Gorai M, Matsuki Y, Yamada Y, Murayama G, Sugisaki N, Nemoto T, Ando S, Minowa K, Kon T, Tada K, Matsushita M, Yamaji K, Tamura N, Makino S, and Takasaki Y
- Subjects
- Adult, Aged, Arthritis, Rheumatoid drug therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Remission Induction methods, Synovitis etiology, Ultrasonography, Doppler, Young Adult, Arthritis, Rheumatoid diagnostic imaging, Metacarpophalangeal Joint diagnostic imaging, Synovitis diagnostic imaging
- Abstract
Objectives: Treatment for rheumatoid arthritis (RA) should aim to achieve full remission. The aim of this study was to investigate predictors of persistent subclinical synovitis and whether longer clinical remission is effective in reducing subclinical synovitis., Methods: Forty-four RA patients who achieved DAS28ESR clinical remission for at least 3 months were enrolled in this study and underwent ultrasound examination of 22 joints (bilateral proximal interphalangeal joints, metacarpophalangeal joints, and wrists); bilateral hand X-ray; and blood examination. The severity of synovial effusion, synovial hypertrophy, and blood flow were semi-quantitatively graded from 0 to 3 using gray-scale (GS) and power Doppler (PD) modes., Results: Among patients with DAS28ESR-defined clinical remission, 59.1% (26/44) demonstrated residual synovitis (≥ PD1) in at least one joint. Genant-modified total Sharp score (TSS) demonstrated the highest statistical difference between patients with and without residual subclinical synovitis (p = 0.0057), and full remission was only observed in patients with low TSS. A nonsignificant trend for decreased residual synovitis with longer sustained clinical remission was also observed (p = 0.724)., Conclusion: Residual synovitis can persist during clinical remission, particularly in patients with progressive bone destruction. Early treatment and longer sustained clinical remission prior to bone destruction are critical for full remission.
- Published
- 2015
- Full Text
- View/download PDF
43. Weighting with the Lansbury articular index improves the correlation of ultrasound score with serum matrix metalloproteinase-3 level in rheumatoid arthritis patients.
- Author
-
Gorai M, Ogasawara M, Matsuki Y, Yamada Y, Murayama G, Sugisaki N, Nemoto T, Ando S, Minowa K, Kon T, Tada K, Matsushita M, Yamaji K, Tamura N, and Takasaki Y
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers blood, Female, Humans, Male, Middle Aged, Severity of Illness Index, Ultrasonography, Young Adult, Arthritis, Rheumatoid blood, Arthritis, Rheumatoid diagnostic imaging, Joints diagnostic imaging, Matrix Metalloproteinase 3 blood, Synovial Membrane diagnostic imaging
- Abstract
Objective: To determine whether weighting improves the correlation of ultrasound (US) score with serum matrix metalloproteinase-3 (MMP-3) level in rheumatoid arthritis (RA)., Methods: As ultrasound examination was performed on 100 RA patients, and the severity of synovial effusion and synovial hypertrophy and the blood flow were semi-quantitatively graded from 0 to 3 by using the gray-scale (GS) and power Doppler (PD) modes. We then calculated the sums of the scores of the 28 joints of each patient in the 2 modes, that is, the GS28 and PD28 scores, as well as the respective scores weighted using the Lansbury articular index (LAI, shoulder and elbow, × 12; wrist, × 8; and knee, × 24)-Lans GS28 and Lans PD28 scores., Result: The Lans PD28 score showed a higher correlation with MMP-3 (r = 0.591; 95% confidence interval, 0.446-0.705, p < 0.0001) than the existing measures. The scores of the large joints-the knee, shoulder, and elbow-correlated well with the serum MMP-3 level., Conclusion: Weighting with the LAI can improve the correlation of US findings with serum MMP-3 level. Bidirectional approach based on both serum MMP-3 level and US scores can further improve the assessment of disease activity in RA patients.
- Published
- 2014
- Full Text
- View/download PDF
44. Recent trends in use of nonbiologic DMARDs and evaluation of their continuation rates in single and dual combination therapies in rheumatoid arthritis patients in Japan.
- Author
-
Ogasawara M, Kageyama M, Kusaoi M, Onuma S, Kon T, Sekiya F, Sugimoto K, Matsudaira R, Matsushita M, Tada K, Kempe K, Yamaji K, Tamura N, and Takasaki Y
- Subjects
- Adult, Cysteine analogs & derivatives, Cysteine therapeutic use, Drug Therapy, Combination, Female, Humans, Japan, Male, Methotrexate therapeutic use, Severity of Illness Index, Sulfasalazine therapeutic use, Treatment Outcome, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Practice Patterns, Physicians' trends
- Abstract
Objective: We aim to examine changes in usage of nonbiologic, disease-modifying antirheumatic drugs (DMARDs) and evaluate their continuation rates in Japan., Methods: We analyzed DMARD treatment data for 3,734 patients with rheumatoid arthritis (RA) from 1998 to 2009 at Juntendo Hospital in Tokyo, Japan. The DMARD usage rate per month was determined to evaluate RA treatment history in the last decade. We also evaluated continuation rates of nonbiologic DMARDs in single and combination therapies and number of nonbiologic DMARD combination therapies used in each patient., Results: We found that nonbiologic DMARD usage has dramatically changed in the last decade, with the most commonly used DMARD shifting from bucillamine to methotrexate (MTX). MTX showed the highest continuation rate; however, much lower continuation rate was observed when used alone rather than in combination treatments. Further, MTX was also used in the highest number of different combination therapies for a particular patient., Conclusions: These findings indicate that single MTX treatment may be unable to keep patients in clinical remission or lower disease activity compared with several combination therapies. Recent change in permitted maximum dosage of MTX from 8 to 16 mg/week may improve its efficacy and continuation rate in treating Japanese RA patients.
- Published
- 2012
- Full Text
- View/download PDF
45. Investigation of pathological and clinical features of lupus nephritis in 73 autopsied cases with systemic lupus erythematosus.
- Author
-
Kon T, Yamaji K, Sugimoto K, Ogasawara M, Kenpe K, Ogasawara H, Yang KS, Tsuda H, Matsumoto T, Hashimoto H, and Takasaki Y
- Subjects
- Adolescent, Adult, Aged, Autopsy, Disease Progression, Female, Humans, Lupus Nephritis physiopathology, Male, Middle Aged, Prognosis, Young Adult, Lupus Nephritis pathology
- Abstract
The aims of this study were to analyze the clinical and pathological features of lupus nephritis (LN) and examine the association between these features and pathological condition, treatment, and prognosis. Of the 177 systemic lupus erythematosus patients who died while receiving inpatient care at Juntendo University Hospital between 1960 and 2001, we investigated the clinical features, treatment, and pathological features of 73 of these who underwent pathological autopsy and had a clear medical history. We divided these cases into two groups, i.e., those up to 1979 (Group A) and those during and after 1980 (Group B) in order to investigate changes in tendencies by age. We also divided the cases into three groups by time interval between diagnosis and death to investigate long-term prognosis. Uremia was the direct cause of death in 38.9% of cases in Group A and only 10.8% of cases in Group B. Pathological features showed a tendency to change to a sclerotic lesion as the duration of the disorder became longer. Uremia attributable to LN was the direct cause of death in relatively fewer cases, although it is still found in the majority of LN cases and remains a problem requiring stringent management. The treatment of sclerotic lesions may be an issue that needs further attention.
- Published
- 2010
- Full Text
- View/download PDF
46. Efficacy and safety of rebamipide for the treatment of dry mouth symptoms in patients with Sjögren's syndrome: a double-blind placebo-controlled multicenter trial.
- Author
-
Sugai S, Takahashi H, Ohta S, Nishinarita M, Takei M, Sawada S, Yamaji K, Oka H, Umehara H, Koni I, Sugiyama E, Nishiyama S, and Kawakami A
- Subjects
- Aged, Alanine adverse effects, Alanine therapeutic use, Anti-Inflammatory Agents adverse effects, Double-Blind Method, Eating drug effects, Female, Humans, Male, Middle Aged, Mouth drug effects, Prostaglandins biosynthesis, Quinolones adverse effects, Saliva drug effects, Saliva metabolism, Sleep drug effects, Treatment Outcome, Alanine analogs & derivatives, Anti-Inflammatory Agents therapeutic use, Quinolones therapeutic use, Sjogren's Syndrome drug therapy, Xerostomia drug therapy
- Abstract
The effects of rebamipide on dry mouth and salivary secretion in Sjögren's syndrome patients were investigated in a double-blind placebo-controlled study. Rebamipide (100 mg TID) or placebo was administered for eight weeks and patient-assessed improvement of dry mouth and increase in salivary secretion measured by the Saxon test were evaluated. At two, four, and eight weeks, dry mouth improvement rates were, respectively, 26.0, 44.0, and 46.9% for rebamipide and 20.0, 27.1, and 39.1% for placebo, and mean increases in salivary secretion were, respectively, 0.14, 0.24, and 0.35 g for rebamipide and 0.03, 0.09, and 0.17 g for placebo, indicating higher values in the rebamipide group for both parameters at all timepoints but no significant differences between the two groups. Analysis by baseline characteristics suggested a statistically significant salivary secretion increasing effect of rebamipide in cases of primary Sjögren's syndrome. No difference in the incidence of adverse events was seen between the two groups, confirming the safety of rebamipide. As a salivary secretion increasing effect was strongly suggested in cases of primary Sjögren's syndrome, further study on the administration of rebamipide for the treatment of dry mouth in patients with Sjögren's syndrome is required.
- Published
- 2009
- Full Text
- View/download PDF
47. A case of very-late-onset systemic lupus erythematosus.
- Author
-
Yamaji K, Yasuda M, Yang KS, Kanai Y, Yamaji C, Kawanishi T, Toumyo M, Funabiki K, Tsuda H, and Takasaki Y
- Subjects
- Age of Onset, Aged, 80 and over, Female, Humans, Lupus Erythematosus, Systemic drug therapy, Pleurisy diagnosis, Pleurisy etiology, Prednisolone pharmacology, Prednisolone therapeutic use, Radiography, Thoracic methods, Tomography, X-Ray Computed methods, Treatment Outcome, Lupus Erythematosus, Systemic diagnosis, Lupus Erythematosus, Systemic pathology
- Abstract
A 93-year-old woman was admitted to our hospital because of fever. Radiographic findings revealed accumulation of pleural fluid. Moreover, blood tests revealed inflammation, lymphopenia, hypocomplementemia, positive for anti-nuclear antibody, and elevated anti-DNA antibody level. Therefore, the patient was diagnosed with pleuritis associated with systemic lupus erythematosus (SLE). Administration of prednisolone 20 mg/day resulted in a marked improvement in fever, pleuritis, and laboratory findings. We report a case of very-late-onset SLE that occurred at the age of 93.
- Published
- 2007
- Full Text
- View/download PDF
48. Age-related accumulation of Ig V(H) gene somatic mutations in peripheral B cells from aged humans.
- Author
-
Chong Y, Ikematsu H, Yamaji K, Nishimura M, Kashiwagi S, and Hayashi J
- Subjects
- Adult, Aged, Aged, 80 and over, Antibody Formation genetics, Chi-Square Distribution, DNA Mutational Analysis, Female, Humans, Immunoglobulin Joining Region, Immunoglobulin M, Immunologic Memory, Male, Aging immunology, B-Lymphocytes immunology, Immunoglobulin Variable Region genetics
- Abstract
To investigate age-related alterations in human humoral immunity, we analysed Ig heavy chain variable region genes expressed by peripheral B cells from young and aged individuals. Three hundred and twenty-seven cDNA sequences, 163 micro and 164 gamma transcripts with VH5 family genes, were analysed for somatic hypermutation and VHDJH recombinational features. Unmutated and mutated micro transcripts were interpreted as being from naive and memory IgM B cells, respectively. In young and aged individuals, the percentages of naive IgM among total micro transcripts were 39% and 42%, respectively. D and JH segment usage in naive IgM from aged individuals was similar to that from young individuals. The mutational frequencies of memory IgM were similar in young and aged individuals. gamma transcripts, which are regarded as being from memory IgG B cells, showed a significantly higher mutational frequency (7.6%) in aged than in young individuals (5.8%) (P < 0.01). These findings suggest that VHDJH recombinational diversity was preserved, but that the accumulation of somatic mutations in the IgG VH region was increased in aged humans. The accumulation of somatic mutations in IgG B cells during ageing may imply that an age-related alteration exists in the selection and/or maintenance of peripheral memory B cells.
- Published
- 2003
- Full Text
- View/download PDF
49. Practical Total Synthesis of (2S,3S,4R)-1-O-(α-D-Galactopyranosyl)-N-hexacosanoyl-2-amino-1,3,4-octadecanetriol, the Antitumorial and Immunostimulatory α-Galactosylcer-amide, KRN7000.
- Author
-
Morita M, Sawa E, Yamaji K, Sakai T, Natori T, Koezuka Y, Fukushima H, and Akimoto K
- Abstract
A practical total synthesis of (2S,3S,4R)-l-O-(α-d-galactopyranosyl)-N-hexacosanoyl-2-amino-l,3,4-octadecanetriol (KRN7000), an antitumorial and immunostimulatory glycosphingolipid derived from agelasphins, was achieved in 14 steps starting from d-lyxose in a 16% overall yield.
- Published
- 1996
- Full Text
- View/download PDF
50. An immunochemical study of D-amino-acid oxidase.
- Author
-
Miyake Y, Yamaji K, and Yamano T
- Subjects
- Agar, Alanine, Animals, Antigen-Antibody Reactions, Centrifugation, Chromatography, Flavin-Adenine Dinucleotide metabolism, Immunochemistry, Immunodiffusion, Immunoglobulin G, Kidney enzymology, Kinetics, Male, Papain pharmacology, Precipitin Tests, Rabbits, Spectrophotometry, Swine, Time Factors, Antibodies analysis, D-Amino-Acid Oxidase metabolism
- Published
- 1969
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.