167 results on '"K, Sakata"'
Search Results
2. Retrospective Study of the Analgesic Effect of Sacroiliac Joint Radiofrequency Denervation
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Ligia Ft, Kawamoto, Rioko K, Sakata, Jose L, Campos, Luis A, Borges, and Leonardo Hc, Ferraro
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Adult ,Male ,Adolescent ,Sacroiliac Joint ,Middle Aged ,Denervation ,Young Adult ,Treatment Outcome ,Humans ,Female ,Low Back Pain ,Aged ,Pain Measurement ,Retrospective Studies - Abstract
Interventional radiofrequency (RF) ablation techniques are indicated when an adequate effect is not obtained with conservative measures.The primary objective of this study was to evaluate pain relief after RF denervation of the sacroiliac joint. The secondary objective was to evaluate pain intensity and relief duration.The study was retrospective.The study was conducted at Vera Cruz Hospital, Campinas, Brazil.Data were collected from the medical records of patients undergoing RF denervation for low back pain originating in the sacroiliac joint, from January 2015 to December 2017. There were 78 patients studied, between 18 and 65 years old, of both genders, ASA I or II, who underwent knee arthroscopic meniscectomy. The patients were submitted to denervation of sacroiliac joint by 3 types of RF (conventional, pulsed, and cooled). The following parameters were evaluated, number of patients who obtained ? 50% pain relief; pain intensity, measured using the visual analog scale (before the procedure and 15, 30, 90 and 180 days after, performed by the same evaluator); and the use of complementary analgesic for 2 weeks.Of the 78 included patients, 56 (71.8%) underwent conventional RF, 9 (11.5%) underwent pulsed RF, and 13 (16.7%) underwent cooled RF. There were losses to follow-up including 40 patients who underwent conventional RF, 5 who underwent pulsed RF, and 12 who underwent cooled RF, who were retained for 6 months. There was significant pain relief with the three types of RF for up to 6 months of follow-up, with no difference among the types. After 6 months, 90.2% of patients who underwent conventional RF, 100% who underwent pulsed RF, and 91.7% who underwent cooled RF maintained ≥ 50% pain relief. Complementary analgesics were used by 95% of the patients who underwent conventional RF, 80% who underwent pulsed RF, and 91% who underwent cooled RF 2 weeks after the procedure. There were mild adverse effects, such as edema, hematoma, and local pain, without complications.As for limitations, the number of pulsed and cooled RF is low and in a retrospective study some data may be missing, especially from follow-up.RF denervation of the sacroiliac joint is effective and promotes a long-lasting analgesic effect.
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- 2021
3. Association of radiographic findings in hand X-ray with clinical features and autoantibodies in patients with systemic sclerosis
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Yuko Kaneko, Hidekata Yasuoka, Tsutomu Takeuchi, and K. Sakata
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Male ,medicine.medical_specialty ,Arthritis, Rheumatoid ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Calcinosis ,Internal medicine ,Osteoarthritis ,medicine ,Humans ,030212 general & internal medicine ,skin and connective tissue diseases ,Aged ,Autoantibodies ,030203 arthritis & rheumatology ,Subluxation ,Flexion contracture ,Gastrointestinal tract ,Scleroderma, Systemic ,Acro-Osteolysis ,integumentary system ,business.industry ,Autoantibody ,Interstitial lung disease ,General Medicine ,Middle Aged ,Hand ,medicine.disease ,Dermatology ,Radiography ,Female ,business - Abstract
Musculoskeletal involvement is one of the major causes of impairment in daily life of patients with systemic sclerosis (SSc). Several hand radiographic findings can be seen in SSc patients; however, their association with clinical features and autoantibodies remains unclear. Here, we analyzed 124 SSc patients with their hand X-rays and clinical and serological features. Abnormal findings in hand X-rays including acro-osteolysis, calcinosis, flexion contracture, erosive change, joint space narrowing, and subluxation were observed in 110 patients (68%). These X-ray findings were more prevalent in patients with longer disease duration and digital ischemic changes. The majority of erosions were typical for erosive hand osteoarthritis, which was seen in 19% of patients. Hand X-ray findings were associated with involved organs; acro-osteolysis with interstitial lung disease, calcinosis with pulmonary arterial hypertension and gastrointestinal tract involvement, and flexion contracture with gastrointestinal tract involvement. Those findings were also relevant to autoantibodies; acro-osteolysis was more common in SSc patients with anti-Scl70 antibody but less in patients with anticentromere antibody. Calcinosis was more prevalent in patient with anticentromere antibody. In our study, organ involvements and SSc-associated autoantibodies showed associations with hand radiographic abnormalities. Hand X-ray findings might reflect underlying pathogenesis and autoantibody profiles in SSc patients.Key Points• Hand X-ray abnormalities were observed in approximately two-thirds of patients with SSc.• Erosive osteoarthritis was more prevalent in SSc patients than general population.• Hand X-ray findings were associated with disease duration, organ involvements, and SSc-associated autoantibodies, reflecting underlying pathogenesis.
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- 2019
4. The Effect of Branched Chain Amino Acids-Enriched Nutritional Supplements on Activities of Daily Living and Muscle Mass in Inpatients with Gait Impairments: A Randomized Controlled Trial
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Kazuhisa Domen, K. Sakata, Misa Moriwaki, and Hidetaka Wakabayashi
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Male ,Sarcopenia ,medicine.medical_specialty ,030309 nutrition & dietetics ,medicine.medical_treatment ,Medicine (miscellaneous) ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Gait training ,law ,Internal medicine ,Acute care ,Activities of Daily Living ,medicine ,Vitamin D and neurology ,Humans ,030212 general & internal medicine ,Mobility Limitation ,Vitamin D ,Muscle, Skeletal ,Gait ,Aged ,Inpatients ,0303 health sciences ,Nutrition and Dietetics ,Rehabilitation ,business.industry ,Body Weight ,medicine.disease ,Functional Independence Measure ,Patient Discharge ,Dietary Supplements ,Female ,Geriatrics and Gerontology ,business ,Amino Acids, Branched-Chain - Abstract
To investigate the effects of continuous intervention with branched chain amino acids-enriched nutritional supplements from the acute phase to convalescent rehabilitation wards in inpatients with gait impairments. Open-label, randomized, parallel-group comparison study (UMIN Clinical Trials Registry ID: UMIN000018640). Acute care and convalescent rehabilitation wards We studied 80 patients undergoing stand/gait training. Participants in the intervention group (RJ group) received nutritional supplements (jelly foods comprising 2500 mg BCAA and 20 IU vitamin D) twice a day until hospital discharge. The primary outcome was the motor components of the Functional Independence Measure (FIM-m), and the secondary outcome was skeletal muscle mass index. Analyses were conducted on 55 patients who were able to perform stand/gait training continuously from the acute until the recovery phases. FIM-m was significantly elevated in the RJ group and the control group, but no difference was noted between the two groups. Only the RJ group showed a significant increase in skeletal muscle mass index, and the amount of variation was significantly different between the two groups (the control group decreased an average of 2.2% and the RJ group increased an average of 4.3%; P = 0.014). A significant decrease in body weight was found only in the control group (P = 0.084). Nutritional interventions using branched chain amino acids (BCAA)-enriched nutritional supplements demonstrated no significant difference in activities of daily living; however, an increase in skeletal muscle mass was noted. Skeletal muscle mass and body weight differed significantly between the two groups, and BCAA-enriched nutritional supplements intake in acute and convalescent rehabilitation wards may be effective for the prevention of malnutrition and sarcopenia.
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- 2019
5. Refractory IgG4-related Pleural Disease with Chylothorax: A Case Report and Literature Review
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Yuichiro Ota, Naoshi Nishina, Katsura Emoto, Jun Kikuchi, Tsutomu Takeuchi, Yuko Kaneko, Tomomi Kotaki, Hironari Hanaoka, Katsuya Suzuki, Kotaro Otomo, and K. Sakata
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Male ,medicine.medical_specialty ,Pleural effusion ,Case Report ,030204 cardiovascular system & hematology ,Chylothorax ,Thoracic duct ,03 medical and health sciences ,Pleural disease ,0302 clinical medicine ,rituximab ,Refractory ,Internal Medicine ,medicine ,Humans ,IgG4-related disease ,Pleurisy ,Aged ,business.industry ,pleuritis ,General Medicine ,medicine.disease ,Surgery ,Pleural Effusion ,medicine.anatomical_structure ,Immunoglobulin G ,Prednisolone ,Pleura ,030211 gastroenterology & hepatology ,Rituximab ,Immunoglobulin G4-Related Disease ,business ,medicine.drug - Abstract
We herein report a rare case of a 66-year-old man with refractory chylothorax. Although he had been treated with moderate doses of prednisolone (PSL) on suspicion of pleuritis with Sjogren syndrome, the pleural effusion expanded after the reduction of prednisolone. Further workup including histopathological examinations of pleura led to the diagnosis of IgG4-RD with bilateral chylothorax without any leakage from the thoracic duct. Combination therapy with high-dose PSL plus rituximab successfully decreased the pleural effusion. This is a very rare case of IgG4-related pleuritis with chylothorax and the first report of its successful treatment with rituximab.
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- 2021
6. Decreased activation of ataxia telangiectasia mutated (ATM) in monocytes from patients with systemic sclerosis
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Keiko Yoshimoto, Hidekata Yasuoka, Tsutomu Takeuchi, and K. Sakata
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0301 basic medicine ,Adult ,Male ,DNA repair ,Neutrophils ,Morpholines ,Gene Expression ,Ataxia Telangiectasia Mutated Proteins ,Systemic scleroderma ,medicine.disease_cause ,Monocytes ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,medicine ,Humans ,Pharmacology (medical) ,Whole blood ,030203 arthritis & rheumatology ,chemistry.chemical_classification ,Reactive oxygen species ,Scleroderma, Systemic ,business.industry ,Interstitial lung disease ,Middle Aged ,medicine.disease ,Flow Cytometry ,Oxidative Stress ,030104 developmental biology ,chemistry ,Pyrones ,Case-Control Studies ,Ataxia-telangiectasia ,Immunology ,business ,Reactive Oxygen Species ,Oxidative stress - Abstract
Objectives The regulation system for oxidative stress in systemic sclerosis (SSc) remains unclear. This study aimed to clarify the possible involvement of ataxia telangiectasia mutated (ATM), which plays a key role in DNA repair and redox balance, in the pathogenesis of SSc. Methods Thirty patients with SSc and 15 healthy controls were enrolled. Expression of ATM and phosphorylated ATM (pATM), an activated form of ATM, in phagocytes in whole blood samples was analysed by FACS. Correlations between expression levels of ATM/pATM and clinical parameters of SSc patients were statistically analysed. Peripheral monocytes were cultured with an ATM-specific inhibitor (KU55933), and reactive oxygen species production in the cells was measured. Results Expression level of pATM in peripheral monocytes and neutrophils from SSc patients was significantly lower than those in healthy controls (P = 0.04 and P Conclusion Our data revealed that decreased ATM activation in monocytes was associated with SSc-interstitial lung disease and that impaired ATM activation in monocytes may contribute to the disease process of SSc via uncontrolled reactive oxygen species production.
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- 2019
7. Methylene Blue for Bronchopleural Fistula Localization
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Darlene R. Nelson, Kenneth K. Sakata, John J. Mullon, Dante N. Schiavo, Ryan Kern, and Faria Nasim
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Fistula ,Bronchopleural fistula ,Coloring agents ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Bronchoscopy ,medicine ,Humans ,030212 general & internal medicine ,Coloring Agents ,Aged ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Pleural Diseases ,Pigtail catheter ,medicine.disease ,Surgery ,Methylene Blue ,chemistry ,Balloon occlusion ,Thoracic muscle ,Female ,Bronchial Fistula ,business ,Methylene blue - Abstract
A bronchopleural fistula (BPF) is a communication between the pleural space and the bronchial tree. BPFs are challenging to diagnose and are associated with a high morbidity and mortality. Sequential balloon occlusion is commonly used for localization of a BPF. We describe our experience with 4 cases of successful localization of the BPF by instillation of methylene blue into the pleural space through a pigtail catheter, with simultaneous bronchoscopic visualization of dye in the tracheobronchial tree. Two patients were treated with endobronchial valves and 3 had a surgical thoracic muscle flap placed.
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- 2018
8. Pulmonary Epithelioid Hemangioendothelioma Diagnosed With Endobronchial Biopsies
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Neera Agrwal, Karen L. Swanson, Maxwell L. Smith, Michael B. Gotway, Kenneth K. Sakata, Nina J. Karlin, and James M. Parish
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Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Biopsy ,Lung biopsy ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Bronchoscopy ,Humans ,Medicine ,Endobronchial biopsy ,Epithelioid hemangioendothelioma ,Aged ,medicine.diagnostic_test ,business.industry ,Nodule (medicine) ,Pulmonary Epithelioid Hemangioendothelioma ,Middle Aged ,medicine.disease ,030228 respiratory system ,030220 oncology & carcinogenesis ,Hemangioendothelioma, Epithelioid ,Vascular tumor ,Female ,Radiology ,medicine.symptom ,business - Abstract
Pulmonary epithelioid hemangioendothelioma (PEHE) is a rare vascular tumor of endothelial origin first described in 1975 as intravascular bronchioloalveolar tumor. Since then, >100 cases have been reported, and most cases require surgical lung biopsy for diagnosis. We report the case of a 46-year-old man with a diagnosis of PEHE from endobronchial biopsies of an intraluminal nodule, a rare presentation of this disease. We summarize a review of the literature and the bronchoscopic findings of PEHE.
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- 2016
9. Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake
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M. Tsubota-Utsugi, Y. Yonekura, K. Tanno, M. Nozue, H. Shimoda, N. Nishi, K. Sakata, S. Kobayashi, and for the RIAS study
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Male ,Gerontology ,Health Status ,lcsh:Geriatrics ,030204 cardiovascular system & hematology ,Standard of living ,Overweight ,Disasters ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Surveys and Questionnaires ,Earthquakes ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Survivors ,030212 general & internal medicine ,Prospective cohort study ,Exercise ,Life Style ,Aged ,Sedentary lifestyle ,Aged, 80 and over ,Frailty ,business.industry ,Multilevel model ,Odds ratio ,lcsh:RC952-954.6 ,Housing ,Female ,Observational study ,Geriatrics and Gerontology ,medicine.symptom ,business ,Psychosocial ,Research Article ,Follow-Up Studies - Abstract
Background Many survivors of the Great East Japan Earthquake that occurred in 2011 were at risk of deteriorating health, especially elderly people living in disaster-stricken areas. The objectives of this prospective study were: a) to clarify the different lifestyle and psychosocial factors associated with frailty by sex among the non-disabled elderly survivors, and b) to describe the differences in characteristics stratified by the degree of disaster-related housing damage. Methods We followed 2261 Japanese survivors aged ≥65 years (45.3% male; mean age, 71.7 years) without disability or frailty who completed a self-administered questionnaire at baseline. All participants completed a baseline questionnaire in 2011 and at least one identical follow-up questionnaire between 2012 and 2015 regarding lifestyle (smoking status, alcohol intake, physical activity, sedentary lifestyle, and dietary intake) and psychosocial factors (self-rated health, standard of living, psychological distress, and social networks). Frailty was defined as a score of ≥5 on the Kihon Checklist, which is used by the Japanese government to certify the need for long-term care insurance. Adjusted odds ratios and 95% confidence intervals with frailty as the dichotomous dependent variable and health factors as the independent variables were calculated using a multilevel model for repeated measures by sex, followed by stratification analyses by the degree of housing damage. Results Over the 4-year study period, 510 participants (22.6%) developed frailty. In the post-disaster setting, many of the psychosocial factors remained more prevalent 4 years later among survivors with extensive housing damage. The presence of risk factors regarding the development of frailty differed by the degree of housing damage. Among men, psychological distress, in parallel with a poor social network, was related to frailty among only the participants with extensive housing damage and those living in temporary housing, whereas among women, worsening psychological distress was associated only with no damage and no displaced survivors. Among women with extensive damage and displacement, health outcomes such as overweight and diabetes and poor social networks were strongly related to frailty. Conclusions Lifestyle and psychosocial factors associated with the risk of frailty differ by sex and the degree of housing damage. Electronic supplementary material The online version of this article (10.1186/s12877-018-0828-x) contains supplementary material, which is available to authorized users.
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- 2018
10. Comparison of Programmed Death Ligand-1 Immunohistochemical Staining Between Endobronchial Ultrasound Transbronchial Needle Aspiration and Resected Lung Cancer Specimens
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John J. Mullon, Dante N. Schiavo, James R. Jett, Marie Christine Aubry, Darlene R. Nelson, David E. Midthun, Kenneth K. Sakata, Eric S. Edell, and Ryan Kern
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Pulmonary and Respiratory Medicine ,Adult ,Male ,Lung Neoplasms ,Concordance ,Adenocarcinoma ,Critical Care and Intensive Care Medicine ,Stain ,B7-H1 Antigen ,Endosonography ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Biopsy ,Bronchoscopy ,medicine ,Carcinoma ,Biomarkers, Tumor ,Humans ,Lung cancer ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Immunohistochemistry ,030228 respiratory system ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Carcinoma, Large Cell ,Female ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business - Abstract
Background In advanced non-small cell lung cancer (NSCLC), small biopsy specimens from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are often the only available material from cancer tissue for the analysis of programmed death ligand-1 (PD-L1) expression. We aim to assess the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PD-L1 expression at ≥ 1% and ≥ 50% on EBUS-TBNA samples compared with their corresponding surgically resected tumor. Methods We retrospectively reviewed all patients who underwent EBUS-TBNA followed by surgical resection of NSCLC between July 2006 and September 2016. Demographic information and periprocedural/surgical data were collected. The archived specimens were retrieved and assessed for PD-L1. A positive PD-L1 stain was defined using two separate cutoff points: ≥ 1% and ≥ 50% of tumor cell positivity. EBUS-TBNA aspirates were compared with the surgically resected specimen to calculate the sensitivity, specificity, PPV, and NPV. Results Sixty-one patients were included. For PD-L1 ≥ 1%, the sensitivity, specificity, PPV, and NPV were 72%, 100%, 100%, and 80%, respectively. For PD-L1 ≥ 50%, the sensitivity, specificity, PPV, and NPV were 47%, 93%, 70%, and 84%, respectively. The concordance rates for PD-L1 ≥ 1% and ≥ 50% were 87% and 82%, respectively. Conclusions A PD-L1 cutoff of ≥ 1% on EBUS-TBNA has a strong correlation with resected tumor specimen. For PD-L1 ≥ 50%, there is a significant decrease in the sensitivity and PPV of EBUS-TBNA specimen when compared with resected tumor. When analyzing for PD-L1 expression using a cutoff of ≥ 50%, EBUS-TBNA specimens may misclassify the status of PD-L1.
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- 2018
11. Comparison of Respiratory Pathogen Detection in Upper versus Lower Respiratory Tract Samples Using the BioFire FilmArray Respiratory Panel in the Immunocompromised Host
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Natalya Azadeh, Kenneth K. Sakata, John J. Mullon, Andrew H. Limper, Thomas E. Grys, Ali Saeed, and Matthew J. Binnicker
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Adult ,Male ,0301 basic medicine ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Article Subject ,Concordance ,030106 microbiology ,Gastroenterology ,law.invention ,Diseases of the respiratory system ,Immunocompromised Host ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,Multiplex polymerase chain reaction ,Humans ,Medicine ,Multiplex ,Prospective Studies ,030212 general & internal medicine ,cardiovascular diseases ,Respiratory system ,Prospective cohort study ,Respiratory Tract Infections ,Pathogen ,Polymerase chain reaction ,Aged ,Aged, 80 and over ,RC705-779 ,business.industry ,Middle Aged ,nervous system diseases ,medicine.anatomical_structure ,Female ,business ,Multiplex Polymerase Chain Reaction ,Research Article ,Respiratory tract - Abstract
Background. The FilmArray Respiratory Panel (FARP) (BioFire Diagnostics, Inc.) is a multiplex, polymerase chain reaction (PCR) technique that can detect 17 respiratory viruses and 3 bacterial targets in a single reaction. Immunocompromised hosts (ICH) with respiratory illnesses often undergo bronchoscopy with bronchoalveolar lavage (BAL). This prospective study aimed to evaluate the yield and concordance of NP and BAL FARP testing when performed on the same patient concurrently. Methods. From February to December 2016, 125 patients (100 ICH and 25 non-ICH) were enrolled. NP swabs and BAL samples were sent for FARP testing. Results. The yield of the BAL FARP among ICH and non-ICH was 24% (24/100) and 8% (2/25), respectively. The yield of positive NP swabs in ICH was 27% (27/100) versus 4% (1/25) in non-ICH. The majority of patients (89%; 111/125) had concordant results between NP and BAL specimens. Of the 24 ICH patients who had a positive BAL FARP, the majority (79%) had the same pathogen detected from the NP swab. Conclusion. The FARP may be useful in the ICH. Given the high concordance, in patients whom a pathogen is identified on the NP FARP, a FARP performed on BAL will likely yield the same result. However, if the NP FARP is negative, performing the test on a BAL sample may have an incremental yield.
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- 2018
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12. Impact of Nasopharyngeal FilmArray Respiratory Panel Results on Antimicrobial Decisions in Hospitalized Patients
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Natalya Azadeh, Thomas E. Grys, Anjuli Brighton, Christine L. Klassen, M'hamed Temkit, Holenarasipur R. Vikram, and Kenneth K. Sakata
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Male ,Methicillin-Resistant Staphylococcus aureus ,medicine.medical_specialty ,Article Subject ,medicine.drug_class ,medicine.medical_treatment ,030106 microbiology ,Antibiotics ,Clinical Decision-Making ,medicine.disease_cause ,Group A ,Procalcitonin ,03 medical and health sciences ,Diseases of the respiratory system ,Immunocompromised Host ,0302 clinical medicine ,Internal medicine ,Nasopharynx ,medicine ,Humans ,030212 general & internal medicine ,Respiratory Tract Infections ,Aged ,Retrospective Studies ,RC705-779 ,business.industry ,Immunosuppression ,Retrospective cohort study ,Bacterial Infections ,Middle Aged ,Antimicrobial ,Methicillin-resistant Staphylococcus aureus ,Anti-Bacterial Agents ,Hospitalization ,Molecular Diagnostic Techniques ,Staphylococcus aureus ,Virus Diseases ,Female ,business ,Research Article - Abstract
Objective. To determine whether results of the nasopharyngeal FilmArray respiratory panel (NP-FARP) influenced antibiotic decisions. Methods. We reviewed the medical records of nonintensive care unit (ICU) inpatients that had an NP-FARP performed at our institution between June 2013 and June 2014. The inpatient records were reviewed 48 hours after the NP-FARP for the following data: demographic information; NP-FARP, serum procalcitonin, and methicillin-resistant Staphylococcus aureus nasal swab (MRSA NS) results; antibiotics prior and post-48 hours of the NP-FARP result; and the current immunosuppression status. Clinical outcome data were not obtained. Patients were categorized into those who had a positive (+) or a negative (−) NP-FARP. We further subdivided these two categories into groups A, B, and C based on the antibiotic modifications 48 hours after their NP-FARP result. Group A included patients who were never initiated on antimicrobial therapy. Patients whose antibiotics were discontinued or deescalated were placed in group B. Patients with antibiotic escalation or continuation without change constituted group C. We compared and analyzed groups A, B, and C in the (+) and (−) NP-FARP cohorts. Results. A total of 545 patients were included. There were 143 (26%) patients with positive and 402 (74%) patients with negative NP-FARPs. Comparison of groups A, B, and C between those with a (+) and (−) NP-FARP were as follows: (+) A and (−) A, 28/143 (20%) and 84/402 (21%); (+) B and (−) B, 59/143 (41%) and 147/402 (37%); and (+) C and (−) C, 56/143 (39%) and 171/402 (43%), respectively. We found no statistically significant differences between groups (+) A versus (−) A, (+) B versus (−) B, and (+) C versus (−) C with respect to age, gender, MRSA NS result, procalcitonin result, or concurrent immunosuppression. Conclusion. In non-ICU inpatients, NP-FARP alone or in combination with procalcitonin or MRSA NS did not influence antibiotic decisions during the study period.
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- 2017
13. Uncertainty in patient set-up margin analysis in radiation therapy
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Kunihiko Tateoka, T. Abe, Masato Hareyama, K. Sakata, Yuichi Saitoh, K. Fujimoto, A Nakata, Takuya Nakazawa, Yuji Yaegashi, K. Shima, and J. Suzuki
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Male ,Percentile ,medicine.medical_specialty ,Technology ,Health, Toxicology and Mutagenesis ,media_common.quotation_subject ,Normal Distribution ,Interval (mathematics) ,PTV ,Plot (graphics) ,Normal distribution ,Margin (machine learning) ,Histogram ,Statistics ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Normality ,media_common ,Radiation ,business.industry ,Small number ,Radiotherapy Planning, Computer-Assisted ,X-Rays ,SM ,Prostate ,Uncertainty ,Prostatic Neoplasms ,Reproducibility of Results ,Equipment Design ,Radiation Oncology ,Radiotherapy, Intensity-Modulated ,set-up error ,business ,Tomography, X-Ray Computed ,Algorithms - Abstract
We investigated the uncertainty in patient set-up margin analysis with a small dataset consisting of a limited number of clinical cases over a short time period, and propose a method for determining the optimum set-up margin. Patient set-up errors from 555 registration images of 15 patients with prostate cancer were tested for normality using a quantile-quantile (Q-Q) plot and a Kolmogorov-Smirnov test with the hypothesis that the data were not normally distributed. The ranges of set-up errors include the set-up errors within the 95% interval of the entire patient data histogram, and their equivalent normal distributions were compared. The patient set-up error was not normally distributed. When the patient set-up error distribution was assumed to have a normal distribution, an underestimate of the actual set-up error occurred in some patients but an overestimate occurred in others. When using a limited dataset for patient set-up errors, which consists of only a small number of the cases over a short period of time in a clinical practice, the 2.5% and 97.5% intervals of the actual patient data histogram from the percentile method should be used for estimating the set-up margin. Since set-up error data is usually not normally distributed, these intervals should provide a more accurate estimate of set-up margin. In this way, the uncertainty in patient set-up margin analysis in radiation therapy can be reduced.
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- 2012
14. FilmArray Respiratory Panel Assay: Comparison of Nasopharyngeal Swabs and Bronchoalveolar Lavage Samples
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Kenneth K. Sakata, Natalya Azadeh, Holenarasipur R. Vikram, Thomas E. Grys, and Anjuli Brighton
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Microbiology (medical) ,Male ,Polymerase Chain Reaction ,Sensitivity and Specificity ,law.invention ,Specimen Handling ,law ,Virology ,Nasopharynx ,Medicine ,Molecular diagnostic techniques ,Humans ,Respiratory system ,Pathogen ,Respiratory Tract Infections ,Polymerase chain reaction ,Retrospective Studies ,medicine.diagnostic_test ,Respiratory tract infections ,business.industry ,respiratory system ,Middle Aged ,respiratory tract diseases ,Bronchoalveolar lavage ,Molecular Diagnostic Techniques ,Immunology ,Female ,business ,Bronchoalveolar Lavage Fluid ,Multiplex Polymerase Chain Reaction - Abstract
The FilmArray respiratory panel (FARP) reliably and rapidly identifies 17 viruses and 3 bacterial pathogens. A nasopharyngeal swab FARP (NP FARP) is performed for many patients with respiratory symptoms. For patients who are acutely ill or immunocompromised or fail to improve, a bronchoalveolar lavage sample FARP (BAL FARP) is performed in addition to the NP FARP. To date, no studies have compared the yield of a BAL FARP with that of an NP FARP. We retrospectively studied all patients who had a BAL FARP within 7 days after an NP FARP between June 2013 and May 2014. Demographic information, comorbidities, FARP results, and all microbiologic data from BAL fluid were collected. Eighty-six patients had a BAL FARP performed within 7 days (mean, 1.6; median, 1) after an NP FARP. Of these, 66 (77%) had concordant BAL and NP FARP results: 15 (23%) had the same pathogen identified from the NP and BAL FARPs, and 51 (77%) had concordant negative FARP results. In 18 of the 86 patients (21%), a pathogen was detected from the NP FARP; of these, 15 (83%) had a concordant match on a subsequent BAL FARP, and the remaining 3 had negative BAL FARPs. In 17 of the 86 patients (20%), pathogens were identified from the BAL FARPs that were not detected by the NP FARPs; of these, 16 (94%) had initial negative NP FARPs. The data suggest that once a pathogen is identified by an NP FARP, a subsequent BAL FARP is unlikely to add new microbiologic information. However, a BAL FARP may provide new, useful microbiologic information when performed within 7 days after a negative NP FARP.
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- 2015
15. Identifying a breeding habitat of a critically endangered fish, Acheilognathus typus, in a natural river in Japan
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Masayuki K. Sakata, Nobutaka Maki, Hideki Sugiyama, and Toshifumi Minamoto
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0106 biological sciences ,0301 basic medicine ,Male ,Endangered species ,Biodiversity ,Acheilognathus typus ,Omono River ,Breeding ,010603 evolutionary biology ,01 natural sciences ,Polymerase Chain Reaction ,03 medical and health sciences ,Critically endangered ,Japan ,Rivers ,Animals ,Environmental DNA ,Ecology, Evolution, Behavior and Systematics ,Ecosystem ,biology ,Ecology ,Endangered Species ,Breeding site ,Fishes ,General Medicine ,Cytochromes b ,biology.organism_classification ,Bivalvia ,Fishery ,030104 developmental biology ,Habitat ,Environmental DNA (eDNA) ,Threatened species ,Freshwater fish ,Female ,Species-specific detection ,Real-time PCR - Abstract
Freshwater biodiversity has been severely threatened in recent years, and to conserve endangered species, their distribution and breeding habitats need to be clarified. However, identifying breeding sites in a large area is generally difficult. Here, by combining the emerging environmental DNA (eDNA) analysis with subsequent traditional collection surveys, we successfully identified a breeding habitat for the critically endangered freshwater fish Acheilognathus typus in the mainstream of Omono River in Akita Prefecture, Japan, which is one of the original habitats of this species. Based on DNA cytochrome B sequences of A. typus and closely related species, we developed species-specific primers and a probe that were used in real-time PCR for detecting A. typus eDNA. After verifying the specificity and applicability of the primers and probe on water samples from known artificial habitats, eDNA analysis was applied to water samples collected at 99 sites along Omono River. Two of the samples were positive for A. typus eDNA, and thus, small fixed nets and bottle traps were set out to capture adult fish and verify egg deposition in bivalves (the preferred breeding substrate for A. typus) in the corresponding regions. Mature female and male individuals and bivalves containing laid eggs were collected at one of the eDNA-positive sites. This was the first record of adult A. typus in Omono River in 11 years. This study highlights the value of eDNA analysis to guide conventional monitoring surveys and shows that combining both methods can provide important information on breeding sites that is essential for species’ conservation.
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- 2017
16. Serum Pepsinogen Values and Helicobacter pylori Status among Control Subjects of a Nested Case-Control Study in the JACC study
- Author
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Hiroshi Yatsuya, Takaaki Kondo, Kiyoko Yagyu, Takesumi Yoshimura, Lin Yingsong, Yuki Obata, Akiko Tamakoshi, Yoshihisa Fujino, Norihiko Hayakawa, K Sakata, Shogo Kikuchi, Yoshiharu Hoshiyama, Teruo Ishibashi, Noritaka Tokui, Tetsuya Mizoue, and Hideaki Toyoshima
- Subjects
Adult ,Male ,Rural Population ,medicine.medical_specialty ,Pepsinogen A ,Epidemiology ,Health Status ,Gastroenterology ,Helicobacter Infections ,Serology ,Atrophy ,Japan ,Risk Factors ,Stomach Neoplasms ,Pepsinogen B ,Seroepidemiologic Studies ,Internal medicine ,Prevalence ,medicine ,Humans ,Seroprevalence ,Stomach cancer ,Aged ,Helicobacter pylori ,biology ,business.industry ,Case-control study ,General Medicine ,Middle Aged ,medicine.disease ,biology.organism_classification ,Antibodies, Bacterial ,Cross-Sectional Studies ,Gastric Mucosa ,Case-Control Studies ,Nested case-control study ,Immunology ,Female ,Original Article ,business ,Biomarkers - Abstract
BACKGROUND: Helicobacter pylori infection and serum pepsinogen values are strongly related with stomach cancer. The aim of this study was to know what were these factors among general population.METHODS: Subjects were randomly selected 633 control subjects in a nested case-control study for risk of stomach cancer. Most of them were from rural areas of Japan. Using frozen sera, pepsinogen I (PG I) and II (PG II) values and H. pylori antibody were measured. Those with PG I less than 50 ng/mL and the ratio of PG I to PG II (PG I/II) was less than 2.0 were defined as severe, those with PG I less than 70 ng/ml and PG I/II less than 3.0 were defined as mild and the other subjects were defined as no serological atrophy.RESULTS: About 70% of the subjects were H. pylori seropositive and the seroprevalence did not depend on age or sex. Percentages of those with severe serological atrophy increased with age from 10% in those aged 40-49 years to 38% in 70 and more, and percentages of those with mild serological atrophy were about 30% independent of age.CONCLUSIONS: The subjects, who were expected to represent populations of rural area of Japan, had high prevalence of both H. pylori infection and serological atrophy of gastric mucosa. These facts should be considered in discussing results of the nested case-control study.J Epidemiol 2005; 15: S126-S133.
- Published
- 2005
17. A nested case–control study of stomach cancer in relation to green tea consumption in Japan
- Author
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Takaaki Kondo, Noritaka Tokui, T Mizoue, Shogo Kikuchi, Norihiko Hayakawa, Hiroshi Yatsuya, Takeshi Kawaguchi, K Sakata, Yoshiyuki Ohno, Akiko Tamakoshi, Takesumi Yoshimura, Y Miura, Y Hoshiyama, and Hideaki Toyoshima
- Subjects
JACC Study ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Epidemiology ,green tea ,Japan ,Stomach Neoplasms ,Humans ,Medicine ,Family history ,Stomach cancer ,Aged ,Consumption (economics) ,stomach cancer ,Tea ,business.industry ,Incidence ,Incidence (epidemiology) ,Case-control study ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Oncology ,Case-Control Studies ,Relative risk ,Nested case-control study ,Regression Analysis ,Female ,business ,Demography - Abstract
To evaluate whether green tea consumption provides protection against stomach cancer, the relative risks (RRs) were calculated in the Japan Collaborative Study for Evaluation of Cancer Risk, sponsored by the Ministry of Health and Welfare (JACC Study). The study was based on 157 incident cases and 285 controls aged 40-79 years. Cox proportional hazards regression analysis was used to estimate the RRs for stomach cancer. It was found that green tea consumption had no protective effect against stomach cancer. After adjustment for age, smoking status, H. pylori infection, history of peptic ulcer, and family history of stomach cancer along with certain dietary elements, the risks associated with drinking one or two, three or four, five to nine, and 10 or more cups of green tea per day, relative to those of drinking less than one cup per day, were 1.3 (95% confidence interval (CI): 0.6-2.8), 1.0 (95% CI: 0.5-1.9), 0.8 (95% CI: 0.4-1.6), and 1.2 (95% CI: 0.6-2.5), respectively (P for trend=0.899). We found no inverse association between green tea consumption and the risk of stomach cancer.
- Published
- 2004
18. Aggregation of stomach cancer history in parents and offspring in comparison with other sites
- Author
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Koji Tamakoshi, Hiroshi Yatsuya, Norihiko Hayakawa, Noritaki Tokui, Hideaki Toyoshima, Tetsuya Mizoue, Yoshiharu Hoshiyama, Yoko Hori, Shogo Kikuchi, Akiko Tamakoshi, K Sakata, Yoshie Tsuzuki, Takaaki Kondo, Yoshiyuki Ohno, and Takesumi Yoshimura
- Subjects
Adult ,Male ,Parents ,Risk ,medicine.medical_specialty ,Lung Neoplasms ,Epidemiology ,Offspring ,Physiology ,Gastroenterology ,Stomach Neoplasms ,Internal medicine ,Odds Ratio ,medicine ,Humans ,Genetic Predisposition to Disease ,Lung cancer ,Stomach cancer ,Aged ,Family Health ,business.industry ,Incidence ,Siblings ,Stomach ,Bronchial Neoplasms ,Liver Neoplasms ,Cancer ,Family aggregation ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Female ,Birth Order ,Colorectal Neoplasms ,Liver cancer ,business - Abstract
Background The aim of this study is to evaluate the magnitude of the aggregation of a stomach cancer history in parents and their offspring in comparison with that of a history at other sites. Methods We used the baseline data from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study), which was initiated during 1988-1990 in Japan. Association of the cancer history of the subjects' parents with that of the subjects themselves and any of the subjects' siblings was evaluated with odds ratios (OR) by the crude and generalized estimating equations (GEE) technique for four sites: stomach, colorectum, liver, and lung/bronchus. Results The aggregation of a history of stomach cancer between parents and their offspring was evident with significant OR >2.5. The magnitude of the parent-offspring association of a disease history of the colorectum and liver was found to be greater than that for stomach cancer. Conversely, lung and bronchus cancer failed to demonstrate a significant aggregation. Conclusions The hereditary and environmental influences shared by parents and offspring are likely to play a strong aetiological role in colorectal or liver cancer versus a weaker but still significant role in stomach cancer. In contrast, the aetiological role of familial predisposition to lung cancer was indeterminate, which suggests a predominant role of non-familial factors in the development of lung cancer.
- Published
- 2003
19. A prospective study of stomach cancer death in relation to green tea consumption in Japan
- Author
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Y Hoshiyama, Hiroshi Yatsuya, T Mizoue, Takaaki Kondo, Takeshi Kawaguchi, K Sakata, Shogo Kikuchi, Y Miura, Yoshiyuki Ohno, Noritaka Tokui, Takesumi Yoshimura, Akiko Tamakoshi, Norihiko Hayakawa, and Hideaki Toyoshima
- Subjects
Gerontology ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Epidemiology ,green tea ,Japan ,Stomach Neoplasms ,medicine ,Humans ,Prospective Studies ,Family history ,Prospective cohort study ,Stomach cancer ,Aged ,stomach cancer ,Tea ,business.industry ,Public health ,Stomach ,JACC study ,Middle Aged ,Green tea ,medicine.disease ,medicine.anatomical_structure ,Oncology ,Relative risk ,Female ,business ,Demography - Abstract
To evaluate whether green tea consumption provides protection against stomach cancer death, relative risks were calculated using Cox proportional hazards regression analysis in the Japan Collaborative Study for Evaluation of Cancer Risk, sponsored by the Ministry of Health and Welfare (JACC Study). The study was based on 30 370 men and 42 481 women aged 40–79. After adjustment for age, smoking status, history of peptic ulcer, family history of stomach cancer along with certain dietary items, the risks associated with drinking one or two, three or four, five to nine, and 10 or more cups of green tea per day, relative to those of drinking less than one cup per day, were 1.6 (95% CI: 0.9–2.9), 1.1 (95% CI: 0.6–1.9), 1.0 (95% CI: 0.5–2.0), and 1.0 (95% CI: 0.5–2.0), respectively, in men (P for trend=0.669), and 1.1 (95% CI: 0.5–2.5), 1.0 (95% CI: 0.5–2.5), 0.8 (95% CI: 0.4–1.6), and 0.8 (95% CI: 0.3–2.1), respectively, in women (P for trend=0.488). We found no inverse association between green tea consumption and the risk of stomach cancer death. British Journal of Cancer (2002) 87, 309–313. doi:10.1038/sj.bjc.6600487 www.bjcancer.com © 2002 Cancer Research UK
- Published
- 2002
20. Microbiologic yield of bronchoalveolar lavage specimens from stem cell transplant recipients
- Author
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Lewis J. Wesselius, James L. Slack, Kathryn Bollin, Christine L. Klassen, Kenneth K. Sakata, Holenarasipur R. Vikram, and Thomas E. Grys
- Subjects
Male ,Bronchoalveolar Lavage ,0302 clinical medicine ,Bronchoscopy ,Neoplasms ,stem cell transplant ,fiberoptic bronchoscopy ,030212 general & internal medicine ,Respiratory Tract Infections ,education.field_of_study ,medicine.diagnostic_test ,Respiratory tract infections ,Medical record ,bone marrow transplant ,Middle Aged ,respiratory system ,Fiberoptic bronchoscopy ,Anti-Bacterial Agents ,immunocompromised ,Infectious Diseases ,Original Article ,Female ,Stem cell ,Bronchoalveolar Lavage Fluid ,Adult ,medicine.medical_specialty ,Population ,Transplantation, Autologous ,Immunocompromised Host ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Transplantation, Homologous ,education ,immunosuppressed ,Aged ,Retrospective Studies ,Transplantation ,business.industry ,Retrospective cohort study ,Original Articles ,respiratory tract diseases ,Surgery ,Bronchoalveolar lavage ,030228 respiratory system ,Tomography, X-Ray Computed ,business ,Stem Cell Transplantation - Abstract
Purpose Stem cell transplant (SCT) recipients commonly undergo bronchoalveolar lavage (BAL) collection as an infectious pulmonary work-up. Previous studies report the utility and overall diagnostic yield of fiberoptic bronchoscopy with BAL in this vulnerable population, though none focused purely on microbiologic yield or made comparisons with less invasive means of pathogen detection. We sought to determine and elaborate on the microbiologic yield of BAL in SCT recipients, assess a correlation between BAL studies and less invasive means of pathogen detection, and assess the utility of repeating a BAL within 30 days. Methods Between January 1, 2009, and July 31, 2013, we reviewed medical records of 125 SCT recipients who underwent 179 BALs. In addition to demographic information and details pertaining to their SCT, a comprehensive review of their microbiologic data was performed and recorded. Results Our study showed an overall BAL microbiologic yield of 40%, despite 92% of patients receiving broad-spectrum antimicrobial therapy at the time of the BAL procedure. Conclusions Although an initial BAL sample in this population provides crucial microbiologic information, repeating the procedure within 30 days may have minimal additional microbiologic yield. BAL continues to be an essential diagnostic tool in SCT recipients undergoing an infectious pulmonary work-up. This article is protected by copyright. All rights reserved.
- Published
- 2017
21. Serum procalcitonin levels in patients with primary pulmonary coccidioidomycosis
- Author
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Holenarasipur R. Vikram, Yu Hui H. Chang, Janis E. Blair, Kenneth K. Sakata, and Thomas E. Grys
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,Calcitonin ,Male ,medicine.medical_specialty ,Calcitonin Gene-Related Peptide ,Pilot Projects ,Gastroenterology ,Procalcitonin ,Community-acquired pneumonia ,Interquartile range ,Internal medicine ,parasitic diseases ,medicine ,Primary pulmonary coccidioidomycosis ,Pneumonia, Bacterial ,Humans ,In patient ,Prospective Studies ,Protein Precursors ,Aged ,Glycoproteins ,Aged, 80 and over ,Coccidioidomycosis ,Respiratory tract infections ,business.industry ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,Immunology ,Biomarker (medicine) ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,Biomarkers - Abstract
The serum procalcitonin assay has emerged as a promising biomarker to distinguish between bacterial and viral respiratory tract infections but has not been used to differentiate coccidioidomycosis from bacterial infection. A correlation between procalcitonin serum levels and coccidioidomycosis has never been reported.To determine any association between serum procalcitonin levels and primary pulmonary coccidioidomycosis.We identified and enrolled 20 immunocompetent patients with symptomatic primary pulmonary coccidioidomycosis of8 weeks' duration and performed a one-time procalcitonin assay, with a cutoff of0.25 μg/L indicating a nonbacterial infection.Nineteen of 20 patients (95%) had serum procalcitonin of0.25 μg/L. The median procalcitonin level was 0.05 μg/L (range,0.05-0.87 μg/L; interquartile range, 0.05-0.05 μg/L). Sixteen of 20 patients (80%) had undetectable procalcitonin of0.05 μg/L. The four patients with detectable procalcitonin had a median value of 0.2 μg/L (range, 0.09-0.87 μg/L).In this pilot study, procalcitonin was not elevated in immunocompetent patients with primary pulmonary coccidioidomycosis at a median of 32 days after symptom onset. Larger prospective studies are needed to confirm this finding.
- Published
- 2014
22. Virtual CT Cholangioscopy: Comparison with Fiberoptic Cholangioscopy
- Author
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M. Mukaiya, Kazumitsu Koito, Naoki Hirokawa, Tsutomu Namieno, Naoya Yama, Takeshi Ichimura, Masato Hareyama, Takaharu Syonai, K. Sakata, and Koichi Hirata
- Subjects
Adult ,Male ,medicine.medical_specialty ,Common Bile Duct Diseases ,Computed tomography ,User-Computer Interface ,Image Processing, Computer-Assisted ,medicine ,Fiber Optic Technology ,Humans ,Endoscopy, Digestive System ,Aged ,Retrospective Studies ,Aged, 80 and over ,Common bile duct ,medicine.diagnostic_test ,business.industry ,Significant difference ,Gastroenterology ,Mean age ,Middle Aged ,medicine.disease ,Endoscopy ,Stenosis ,medicine.anatomical_structure ,Biliary tract ,Feasibility Studies ,Female ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
BACKGROUND AND STUDY AIMS No studies comparing virtual computed tomography (CT) cholangioscopy of the common bile duct compared with fiberoptic cholangioscopy are available. The aim of our study was to evaluate the feasibility of virtual CT cholangioscopy of the common bile duct. PATIENTS AND METHODS The study population comprised 52 patients (25 women, 27 men; mean age 56.5, range 32 - 81) with biliopancreatic disorders. Endoscopic images were produced by a volume-rendering method and a perspective projection. The ability to detect the endoluminal view and abnormalities of the common bile duct by virtual CT cholangioscopy and fiberoptic cholangioscopy was evaluated. RESULTS Except for two cases (4 %), virtual CT cholangioscopy revealed excellent and moderate endoluminal visualization. There was no significant difference between the techniques (virtual CT cholangioscopy vs. fiberoptic cholangioscopy: excellent, 73 % vs. 85 %, P = 0.149; moderate 23 % vs. 15 % (P = 0.319); poor, 4 % vs. 0 %, P = 0.153). Virtual CT cholangioscopy revealed no significantly different ability to detect stenosis and obstruction of the common bile duct, compared with fiberoptic cholangioscopy. However, the ability of virtual CT cholangioscopy to detect minute papillary tumors (virtual CT cholangioscopy 30 % vs. fiberoptic cholangioscopy 100 %, P = 0.001) and stones smaller than 5 mm (virtual CT cholangioscopy 25 % vs. fiberoptic cholangioscopy 100 %; P = 0.002 was significantly less than that of fiberoptic cholangioscopy. CONCLUSIONS Virtual CT cholangioscopy cannot replace fiberoptic cholangioscopy completely. However, the use of this technique, instead of fiberoptic cholangioscopy, may be feasible for following up patients after biliary intervention.
- Published
- 2001
23. Propensity of ectopic liver to hepatocarcinogenesis: Case reports and a review of the literature
- Author
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Yoshio Kimura, Yasuhiko Kubo, Kunio Okuda, Takashi Fukushima, Masahiro Arakawa, and K Sakata
- Subjects
Male ,Alcoholic liver disease ,medicine.medical_specialty ,Pathology ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Stomach Diseases ,Gallbladder Diseases ,Choristoma ,Gastroenterology ,Liver Function Tests ,Liver Cirrhosis, Alcoholic ,Internal medicine ,Carcinoma ,medicine ,Humans ,neoplasms ,Fibrous capsule of Glisson ,Hepatology ,business.industry ,Gallbladder ,Stomach ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Ectopic liver ,digestive system diseases ,medicine.anatomical_structure ,Liver ,Hepatocellular carcinoma ,Gastrectomy ,alpha-Fetoproteins ,business - Abstract
Two patients with ectopic liver are described. In one patient, a small ectopic liver attached to the gastric serosa developed hepatocellular carcinoma (HCC). The preoperative diagnosis was an alpha-fetoprotein (AFP)-producing carcinoma and a malignant ulcer of the stomach. Total gastrectomy and esophago-jejunostomy were performed. The tumor that measured 4 x 2 x 2 cm contained an AFP-producing HCC and normal liver tissue. In another patient who had alcoholic cirrhosis, ectopic liver on the serosa of the gallbladder was found to have the same histological changes as the mother liver. A survey of the literature disclosed more than 20 cases in which HCC developed outside the liver; the liver did not have HCC. By contrast, there was only one report on HCC occurring in the liver in the presence of a noncancerous, relatively large accessory liver lobe. Because ectopic liver does not have a complete vascular and ductal system as a normal liver, it is perhaps functionally handicapped and more prone to hepatocarcinogenesis.
- Published
- 1999
24. Right-sided pedunculated hepatocellular carcinoma: A form of adrenal metastasis
- Author
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Masahiro Arakawa, K Sakata, Shozo Iwamoto, Shigeaki Takeda, Koshi Sonoda, Masayoshi Kage, Yasuhiko Kubo, Hayato Sanefuji, and Kunio Okuda
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Adrenal Gland Neoplasms ,Metastasis ,Hepatic Artery ,Parenchyma ,medicine ,Carcinoma ,Humans ,Aged ,Hepatology ,medicine.diagnostic_test ,Adrenal gland ,business.industry ,Liver Neoplasms ,Angiography ,Middle Aged ,medicine.disease ,digestive system diseases ,Lobe ,medicine.anatomical_structure ,Hepatocellular carcinoma ,Tomography, X-Ray Computed ,business ,Artery - Abstract
Pedunculated hepatocellular carcinoma (HCC) or extrahepatic growth of HC C is an uncommon but not rare pathological form, but its genesis is unknown. Right-sided adrenal metastases of HCC that were abutting on or about to fuse with the right hepatic lobe were resected in three patients. The masses seemed to have originated in the para-adrenal tissue, leaving the adrenal gland intact. They were partially supplied by the hepatic artery as well as by the suprarenal artery. Four cases of autopsied pedunculated HCC of the right lobe were also studied. The mass was protruding caudad from the noncancerous parenchyma of the right lobe. Postmortem angiography carried out on one liver showed that only a small portion of the mass toward the liver was supplied from the hepatic artery. These observations suggest that some, perhaps most, of the right-sided pedunculated HCCs represent fusion of the right lobe and para-adrenal or adrenal metastatic HCC. This phenomenon may be explained by possible transport of cancer cells toward the right adrenal gland through the so-called adrenohepatic fusion, a relatively common anatomical change in advanced age.
- Published
- 1998
25. Epidemiology of osteoporosis in Japan
- Author
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K. Sakata, Tsutomu Hashimoto, and Noriko Yoshimura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Osteoporosis ,Poison control ,Suicide prevention ,Occupational safety and health ,Cohort Studies ,Age Distribution ,Japan ,Bone Density ,Risk Factors ,Internal medicine ,Injury prevention ,Epidemiology ,Prevalence ,Humans ,Medicine ,Sex Distribution ,Aged ,Aged, 80 and over ,Hip Fractures ,business.industry ,Human factors and ergonomics ,Middle Aged ,medicine.disease ,Rheumatology ,Fractures, Spontaneous ,Emergency medicine ,Spinal Fractures ,Female ,Medical emergency ,business - Published
- 1997
26. MRI in thorotrastosis
- Author
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Hiroyasu Ijyuin, Aoki Y, Kenji Hirai, Naofumi Ono, Satoshi Itano, K Sakata, Kyuichi Tanikawa, Hirohiko Abe, Hideya Noguchi, and Tomoki Aritaka
- Subjects
Male ,medicine.medical_specialty ,Contrast Media ,Early detection ,Spleen ,Computed tomography ,Diagnosis, Differential ,chemistry.chemical_compound ,Atrophy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lymphatic Diseases ,Thorotrast ,Aged ,Splenic Diseases ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Liver ,chemistry ,Abdominal lymph nodes ,Thorium Dioxide ,Lymph Nodes ,Radiology ,Chemical and Drug Induced Liver Injury ,Tomography, X-Ray Computed ,Complication ,Nuclear medicine ,business ,Follow-Up Studies - Abstract
Magnetic resonance imaging (MRI) and computed tomography (CT) were performed in four patients with thorotrastosis. On CT scan, Thorotrast (thorium oxide) deposition was shown as high-density areas in the liver and spleen and the abdominal lymph nodes. These deposits were not found on MRIs. Splenic volume was significantly small due to atrophy. The contrast-noise ratio in the spleen on T1-weighted images was significantly lower. Thorotrast deposition does not affect MRI appearance; therefore it may be useful for the early detection of malignant tumors as a complication of thorotrastosis.
- Published
- 1995
27. Efficacy, safety, and survival factors for sorafenib treatment in Japanese patients with advanced hepatocellular carcinoma
- Author
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Hiroaki Nagamatsu, Akio Takata, Terufumi Sakai, Norito Matsukuma, Yoichi Yano, Ryoko Kuromatsu, Hironori Koga, Shuji Sumie, Satoru Matsugaki, Masatoshi Tanaka, Masahiko Kajiwara, Junichi Kurogi, Takuji Torimura, Michio Sata, Nobuyoshi Tajiri, Manabu Satani, K Sakata, Hideki Iwamoto, Hajime Aino, Shingo Yamada, Kunitaka Fukuizumi, Noriyuki Ono, Masahito Nakano, and Takashi Niizeki
- Subjects
Oncology ,Sorafenib ,Adult ,Male ,Niacinamide ,Cancer Research ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Pyridines ,Sorafenib treatment ,urologic and male genital diseases ,Multikinase inhibitor ,Asian People ,Risk Factors ,Internal medicine ,medicine ,Carcinoma ,Humans ,heterocyclic compounds ,Prospective Studies ,Prospective cohort study ,neoplasms ,Survival rate ,Protein Kinase Inhibitors ,Aged ,Neoplasm Staging ,Aged, 80 and over ,business.industry ,Phenylurea Compounds ,Benzenesulfonates ,Liver Neoplasms ,Follow up studies ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,female genital diseases and pregnancy complications ,digestive system diseases ,Survival Rate ,Hepatocellular carcinoma ,Disease Progression ,Female ,raf Kinases ,Safety ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background: Sorafenib, an oral multikinase inhibitor, was approved for the treatment of advanced hepatocellular carcinoma (HCC), but has not been adequately evaluated for safety and effectiveness in Japanese patients with advanced HCC. Aims: The purpose of this study was to prospectively assess the efficacy, safety, and risk factors for survival in patients with advanced HCC treated with sorafenib. Methods: Between May 2009 and December 2010, 96 Japanese patients with advanced HCC (76 male, 20 female, mean age: 70.4 years) were treated with sorafenib. Eighty-eight patients had Child-Pugh class A, and 8 patients had Child-Pugh class B liver cirrhosis. Barcelona Clinic Liver Cancer stage B and C were found in 64 and 32 patients, respectively. Results: Twelve patients demonstrated partial response to sorafenib therapy, 43 patients had stable disease, and 33 patients had progressive disease at the first radiologic assessment. The most frequent adverse events leading to discontinuation of sorafenib treatment were liver dysfunction (n = 8), hand-foot skin reaction (n = 7), and diarrhea (n = 4). The median survival time and time to progression were 11.6 and 3.2 months, respectively. By multivariate analysis, des-γ-carboxy prothrombin serum levels and duration of treatment were identified as independent risk factors for survival. Conclusions: This study showed that sorafenib was safe and useful in Japanese patients with advanced HCC. In addition, this study demonstrated that sorafenib should be administered as a long-term treatment for advanced HCC regardless of therapeutic effect and dosage.
- Published
- 2012
28. Pharmacokinetic and biotransformation studies of ormaplatin in conjunction with a phase I clinical trial
- Author
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David C. Smith, James Fangmeier, Michael K. Sakata, Stephen G. Chaney, T. D. Brown, William P. Petros, and Donald L. Trump
- Subjects
Adult ,Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,Organoplatinum Compounds ,Phases of clinical research ,Antineoplastic Agents ,Urine ,Pharmacology ,Toxicology ,High-performance liquid chromatography ,Pharmacokinetics ,Neoplasms ,medicine ,Humans ,Distribution (pharmacology) ,Pharmacology (medical) ,Biotransformation ,Aged ,Volume of distribution ,Chemistry ,Middle Aged ,Ormaplatin ,Oncology ,Female ,Perfusion - Abstract
Ormaplatin is a second-generation platinum (Pt) analogue with in vitro activity against some cisplatin-resistant malignant cell lines. We have evaluated the pharmacokinetics and biotransformations of ormaplatin during a phase I trial in which ormaplatin was administered by daily 30-min infusions on 5 consecutive days every 28 days. Sixteen patients received 25 courses at doses ranging from 5.0 to 11.6 mg/m2 per day. Pharmacokinetic parameters determined for ultrafilterable Pt measured by atomic absorption spectrophotometry revealed a short half-life (t1/2 16 min), moderate volume of distribution (Vd 12 l/m2), and relatively fast systemic clearance (Cls 544 ml/min per m2). Cls and percentage of drug unbound decreased during the 5-day administration period. Average systemic exposure increased with dose; however, inter-individual variability in Cls produced overlap in systemic exposure between the dose levels. The major active biotransformation product [PtCl2(dach)] was evaluated at the highest dose level by HPLC. This product decayed monoexponentially with a mean t1/2 of 13 min and a higher degree of pharmacokinetic variability than that of ultrafilterable Pt at this dose. No uncreacted ormaplatin was detected; however, several inactive biotransformation products persisted for at least 120 min. Approximately 32% of the dose was excreted in the urine during the first day, one-third of this during the initial 1.5 h. The human pharmacokinetic characteristics of ormaplatin resemble those of cisplatin; however, additional study will be required to discern which analyte of ormaplatin correlates best with clinical effects.
- Published
- 1994
29. Comparison of acupuncture to injection for myofascial trigger point pain
- Author
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Miriam C B, Gazi, Adriana M, Issy, Ilíada P, Avila, and Rioko K, Sakata
- Subjects
Adult ,Male ,Young Adult ,Adolescent ,Humans ,Female ,Acupuncture Analgesia ,Anesthetics, Local ,Middle Aged ,Myofascial Pain Syndromes ,Aged - Abstract
Many treatments have been proposed for myofascial pain syndrome. The objective of this study was to compare the analgesic effect of acupuncture to trigger point injection combined with cyclobenzaprine chlorhydrate and sodium dipyrone.A randomized study was performed in 30 patients divided into 2 groups: G1 received trigger point injection with 0.25% bupivacaine twice weekly, and both cyclobenzaprine chlorhydrate 10 mg/day and sodium dipyrone 500 mg every 8 hours; G2 received classical and trigger point acupuncture twice weekly. All patients were instructed in physical exercise. The following parameters were evaluated: pain intensity rated on a numerical scale, number of trigger points, and quality of life before and 4 weeks after treatment.The pain scores and the number of trigger points reduced significantly in both groups, with no significant difference between groups. Significant improvement in the quality of life scores was observed for some of the functional domains in the 2 groups, whereas there was no improvement of the general health status domain in either group or of the emotional domain in G1.Acupuncture, when compared with trigger point injection, combined with cyclobenzaprine chlorhydrate and sodium dipyrone provided similar pain relief and improvement in quality of life measures at 4 weeks.
- Published
- 2010
30. Cigarette smoking, alcohol drinking, and oral and pharyngeal cancer mortality in Japan
- Author
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R, Ide, T, Mizoue, Y, Fujino, Y, Hoshiyama, K, Sakata, A, Tamakoshi, T, Yoshimura, and Kazuo, Tajima
- Subjects
Adult ,Male ,medicine.medical_specialty ,Alcohol Drinking ,Alcohol ,Cohort Studies ,chemistry.chemical_compound ,Japan ,Risk Factors ,Pharyngeal cancer ,Internal medicine ,Surveys and Questionnaires ,Vegetables ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,General Dentistry ,Aged ,Proportional Hazards Models ,Cocarcinogenesis ,Tea ,business.industry ,Proportional hazards model ,Pharynx ,Smoking ,Pharyngeal Neoplasms ,Sodium, Dietary ,Feeding Behavior ,Middle Aged ,Confidence interval ,Surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,chemistry ,Relative risk ,Female ,Mouth Neoplasms ,business ,Cohort study - Abstract
Objectives: To prospectively examine the association of cigarette smoking and alcohol drinking with oral and pharyngeal carcinogenesis, we analyzed data from a nation-wide large-scale cohort study in Japan. Methods: A total of 34 136 men and 43 711 women aged 40–79 years were included in the study. The Cox proportional hazard model was used to estimate the relative risk (RR) and 95% confidence interval (95% CI) of oral and pharyngeal cancer for smoking and drinking by sex, while adjusting for age, consumption of green tea, preference for salty foods, and consumption of green yellow vegetables. Results: Current smokers were found to have a higher risk of death caused by oral and pharyngeal cancer compared with non-smokers in both sexes: the RR was 2.6 (95% CI: 1.0–6.7) in men and 8.2 (95% CI: 2.1–32.1) in women. Men who drank more than 46 g ethanol per day had an approximately threefold increased risk of oral and pharyngeal cancer. Simultaneous exposure to both factors was significantly associated with an elevated risk of oral and pharyngeal cancer (RR: 3.3, 95% CI: 1.1–9.6). Conclusions: The result supports the carcinogenic effect of cigarette smoking and alcohol drinking on the oral cavity and pharynx.
- Published
- 2008
31. Radiotherapy of bone metastases of a spinal meningeal hemangiopericytoma
- Author
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K Sakata, Katsuyuki Karasawa, Yasuhito Sasaki, A. Terahara, Y. Onogi, Yoshiro Aoki, Keiichi Nakagawa, Kenji Hasezawa, Masato Hareyama, Masao Tago, and Nobuharu Muta
- Subjects
Adult ,Male ,Surgical resection ,medicine.medical_specialty ,Time Factors ,Malignant hemangiopericytoma ,medicine.medical_treatment ,Bone Neoplasms ,Metastasis ,Meningeal Neoplasms ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Hemangiopericytoma ,Meningeal hemangiopericytoma ,Spinal Neoplasms ,Vascular disease ,business.industry ,Radiotherapy Dosage ,Spinal cord ,medicine.disease ,Surgery ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,business - Abstract
Hemangiopericytoma is a rare tumor arising from pericapillary cells or pericytes of Zimmerman, and can occur anywhere capillaries are found. We describe a patient with a meningeal hemangiopericytoma who was treated with primary surgical resection and experienced multiple bone metastases 20 years after the first treatment. This patient with multiple bone metastases was treated with multiple courses of irradiation and good palliation was achieved.
- Published
- 1998
32. [Congenital bronchial atresia treated with video-assisted thoracoscopic surgery; report of a case]
- Author
-
Mitsuhiro, Kamiyoshihara, A, Otaki, T, Nameki, O, Kawashima, Y, Otani, K, Sakata, and Y, Morishita
- Subjects
Adult ,Male ,Pulmonary Emphysema ,Cysts ,Thoracic Surgery, Video-Assisted ,Humans ,Bronchi ,Pneumonectomy - Abstract
We report an adult case of congenital lobar emphysema due to bronchial atresia. A 24-year-old man was referred to our department because of cough and fever. A chest roentgenogram on admission showed multiple cystic shadows in the left lower lung field. Chest computed tomography (CT) demonstrated multiple cysts with neveau and scattered infiltration in the left lingual segment and lower lobe. Surgical treatment was scheduled because of no improvement of the chest lesions. The interlobar fissure was not found between the upper and the lower lobes, but between the upper and the lingual divisions. Additionally, the lingual bronchus was not bifurcated from the upper bronchus, but from the lower bronchus. As inflammatory changes were extended to the lingual division and the lower lobe, a left lingual segmentectomy and a lower lobectomy with video-assisted thoracoscopic surgery were performed. His postoperative course was uneventful and he was discharged at the seventh day after surgery.
- Published
- 2004
33. Individual and joint impact of family history and Helicobacter pylori infection on the risk of stomach cancer: a nested case-control study
- Author
-
Shogo Kikuchi, Takaaki Kondo, Noritaka Tokui, Akiko Tamakoshi, Koji Tamakoshi, Tetsuya Mizoue, Hiroshi Yatsuya, K Sakata, Norihiko Hayakawa, Takesumi Yoshimura, Y Hoshiyama, and Hideaki Toyoshima
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Epidemiology ,sex difference ,Gastroenterology ,Helicobacter Infections ,Sex Factors ,Risk Factors ,Stomach Neoplasms ,Internal medicine ,medicine ,Prevalence ,Animals ,Humans ,Genetic Predisposition to Disease ,Risk factor ,Family history ,Prospective cohort study ,Stomach cancer ,Aged ,family history ,stomach cancer ,biology ,Helicobacter pylori ,business.industry ,JACC study ,Family aggregation ,Middle Aged ,nested case–control study ,medicine.disease ,biology.organism_classification ,Logistic Models ,Oncology ,Case-Control Studies ,Immunology ,Nested case-control study ,Female ,business ,Cohort study - Abstract
Familial aggregation of stomach cancer has long been noted (Macklin, 1960; Toyoshima et al, 1997; Yatsuya et al, 2002; Kondo et al, 2003). Certain evidence, however, suggests that both genetic and environmental factors are responsible for familial clustering (Palli et al, 2001). One environmental risk factor is infection with Helicobacter pylori (H. pylori) (Talley et al, 1991), and previous studies have revealed that this also aggregates within families (Dominici et al, 1999). A case–control study found that a family history of stomach cancer significantly increased the risk of the disease independent of H. pylori infection (Brenner et al, 2000). In addition, positive family history in individuals with H. pylori infection appeared to be a stronger risk factor for the disease compared to those without such an infection. There are, however, no prospective studies of this subject. We, therefore, conducted a nested case–control investigation within a cohort study to examine the independent effect of family history on the risk of stomach cancer after controlling first for the H. pylori infection, and, second, to evaluate any joint contribution of these two factors to the disease risk.
- Published
- 2004
34. Structure-based design, synthesis, and biological evaluation of irreversible human rhinovirus 3C protease inhibitors. 8. Pharmacological optimization of orally bioavailable 2-pyridone-containing peptidomimetics
- Author
-
Hiep T. Luu, Zhen Ping Wu, Theodore O. Johnson, Jia Liu, Bennett Chaplin Borer, Tove Tuntland, Junhua Tao, Caroline A. Lee, Fausto Maldonado, Amy K. Patick, Sylvie K. Sakata, Thomas J. Prins, Naresh K. Nayyar, Rose Ann Ferre, Michael Mohajeri, Peter W. Rose, Maha B. Kosa, David A. Matthews, Kevin Scott Mcgee, Leora S. Zalman, Steven Lee, Peter S. Dragovich, Ellen Y. Wu, Bo Liu, Shella A. Fuhrman, Ye Hua, Elena Z. Dovalsantos, Paul A. Rejto, Ru Zhou, Mark Christopher Guzman, Ming Guo, Edward L. Brown, Minerva R. Batugo, James W. Meador, Lijian Chen, Andreas Liese, Moran Terence Jarold, and Jean-Paul R. Gleeson
- Subjects
Male ,Magnetic Resonance Spectroscopy ,Picornain 3C ,Rhinovirus ,Peptidomimetic ,Stereochemistry ,Pyridones ,Biological Availability ,In Vitro Techniques ,Chemical synthesis ,Antiviral Agents ,Structure-Activity Relationship ,Viral Proteins ,Dogs ,Oral administration ,Drug Discovery ,Animals ,Humans ,Protease Inhibitors ,chemistry.chemical_classification ,biology ,3C Viral Proteases ,Biological activity ,Blood Proteins ,Blood proteins ,Cysteine Endopeptidases ,Macaca fascicularis ,Enzyme ,chemistry ,Solubility ,Enzyme inhibitor ,Drug Design ,biology.protein ,Hepatocytes ,Microsomes, Liver ,Molecular Medicine ,Indicators and Reagents ,Caco-2 Cells ,Half-Life ,Protein Binding - Abstract
The optimization of the pharmacokinetic performance of various 2-pyridone-containing human rhinovirus (HRV) 3C protease (3CP) inhibitors following oral administration to either beagle dogs or CM-monkeys is described. The molecules described in this work are composed of a 2-pyridone-containing peptidomimetic binding determinant and an alpha,beta-unsaturated ester Michael acceptor moiety which forms an irreversible covalent adduct with the active site cysteine residue of the 3C enzyme. Modification of the ester contained within these compounds is detailed along with alteration of the P(2) substituent present in the peptidomimetic portion of the inhibitors. The pharmacokinetics of several inhibitors in both dogs and monkeys are described (7 h plasma concentrations after oral administration) along with their human plasma stabilities, stabilities in incubations with human, dog, and monkey microsomes and hepatocytes, Caco-2 permeabilities, and aqueous solubilities. Compounds containing an alpha,beta-unsaturated ethyl ester fragment and either an ethyl or propargyl P(2) moiety displayed the most promising combination of 3C enzyme inhibition (k(obs)/[I] 170 000-223 000 M(-1) s(-1)), antiviral activity (EC(50) = 0.047-0.058 microM, mean vs seven HRV serotypes), and pharmacokinetics following oral administration (7 h dog plasma levels = 0.248-0.682 microM; 7 h CM-monkey plasma levels = 0.057-0.896 microM).
- Published
- 2003
35. A COX-2 inhibitor, nimesulide, inhibits chemically-induced rat tongue carcinogenesis through suppression of cell proliferation activity and COX-2 and iNOS expression
- Author
-
K, Yoshida, T, Tanaka, H, Kohno, K, Sakata, T, Kawamori, H, Mori, and K, Wakabayashi
- Subjects
Male ,Sulfonamides ,Cyclooxygenase 2 Inhibitors ,Nitric Oxide Synthase Type II ,Apoptosis ,4-Nitroquinoline-1-oxide ,Rats, Inbred F344 ,Rats ,Tongue Neoplasms ,Isoenzymes ,Cyclooxygenase 2 ,Prostaglandin-Endoperoxide Synthases ,Carcinogens ,Polyamines ,Animals ,Anticarcinogenic Agents ,Cyclooxygenase Inhibitors ,Nitric Oxide Synthase ,Cell Division - Abstract
The modifying effects of a cyclooxygenase (cox)-2 selective inhibitor nimesulide on tongue carcinogenesis were investigated in male F344 rats initiated with 4-nitroquinoline-1-oxide (4-NQO). The cell proliferation activity measured by proliferating cell nuclear antigen (PCNA)-positive index and apoptotic index, and the immunohistochemical expression of COX-2, and inducible nitric oxide synthase (iNOS) in the tongue mucosa or neoplasms were also examined for mechanistic analysis of modifying effects of nimesulide on tongue carcinogenesis. All animals except those treated with nimesulide alone and untreated rats were given 20 ppm 4-NQO in drinking water for 8 weeks to induce tongue neoplasms. Starting 1 week after the cessation of 4-NQO exposure, rats given 4-NQO were fed the experimental diets containing nimesulide (100 and 400 ppm) for 22 weeks. At week 32, the incidence of tongue squamous cell carcinoma was significantly reduced by feeding of the diet containing 400 ppm nimesulide. Feeding of nimesulide significantly decreased polyamine content and PCNA-labeling index in tongue carcinoma. Apoptotic index in tongue carcinoma was increased by feeding of nimesulide. In addition, nimesulide feeding reduced COX-2 and iNOS expression in the tongue dysplasia and neoplasms. These results suggest that 400 ppm nimesulide in diet, when given during the promotion phase, exerts chemopreventive ability against 4-NQO-induced tongue tumorigenesis through inhibition of cell proliferation activity in conjunction with modification of COX-2 and iNOS expression of the target lesions.
- Published
- 2003
36. Absence of an association between serum uric acid and mortality from cardiovascular disease: NIPPON DATA 80, 1980-1994. National Integrated Projects for Prospective Observation of Non-communicable Diseases and its Trend in the Aged
- Author
-
K, Sakata, T, Hashimoto, H, Ueshima, and A, Okayama
- Subjects
Adult ,Male ,Middle Aged ,Uric Acid ,Japan ,Cardiovascular Diseases ,Risk Factors ,Cause of Death ,Linear Models ,Humans ,Female ,Prospective Studies ,Aged ,Proportional Hazards Models - Abstract
Although elevated serum uric acid has been associated with an increased risk of cardiovascular disease, its importance as a risk factor is still controversial. The authors examined the relationship between serum uric acid levels and death from all causes, including cardiovascular disease and stroke. The baseline data were collected in the National Cardiovascular Survey in 1980. The survey was carried out for all household members aged 30 years or older in 300 districts, which were randomly selected throughout Japan. The number who participated in the survey was 10,897. The vital status was ascertained in 1994. Finally, 8172 subjects were available for the analyses. There were 108,284 person-years of follow-up, and 960 deaths from all causes, 249 deaths from cardiovascular disease, and 174 deaths from stroke. After adjustment for age and other cardiovascular disease risk factors, uric acid levels were not associated with mortality from all causes, cardiovascular disease, or stroke. These findings indicate that serum uric acid levels are not related to increased risk for death from all causes, including cardiovascular disease and stroke in a Japanese population.
- Published
- 2002
37. Lung impairment following cardiac surgery in patients with pulmonary hypertension
- Author
-
S, Ishikawa, A, Ohtaki, T, Takahashi, S, Ohki, Y, Hasegawa, T, Yamagishi, K, Oshima, Y, Hamada, K, Sakata, and Y, Morishita
- Subjects
Lung Diseases ,Male ,Blood Volume ,Hypertension, Pulmonary ,Heart Valve Diseases ,Blood Pressure ,Middle Aged ,Pulmonary Artery ,Heart Septal Defects, Atrial ,Respiratory Function Tests ,Oxygen ,Postoperative Complications ,Humans ,Mitral Valve ,Female ,Blood Gas Analysis ,Cardiac Surgical Procedures ,Retrospective Studies - Abstract
Postoperative respiratory management following cardiac surgery is sometimes troublesome in patients with pulmonary hypertension. We retrospectively studied the relationship between the etiology of preoperative pulmonary hypertension and the postoperative decline of blood oxygenation capacity by focusing on the postoperative intravascular fluid volume.Sixteen adult patients with an atrial septal defect (preload group) and 17 patients with solitary mitral valve disease (afterload group) were studied. The mean age of the patients in the preload and afterload group was 51 and 52 years old, respectively.Preoperative pulmonary-systemic pressure ratio and pulmonary artery resistance index were significantly higher in the preload group than in the afterload group. The respiratory index (RI) and the pulmonary shunt ratio (Qs/Qt) measured immediately after the operation was larger in the afterload group than in the preload group. Postoperative RI and Qs/Qt remained high until postoperative day 3 in both groups. In the preload group RI on postoperative day 1 had a reverse correlation with the central venous pressure (CVP). Meanwhile, the RI in the afterload group on postoperative day 1 was slightly larger in patients with a high CVP and pulmonary capillary wedged pressure. Similar relationships were seen in the relations between pulmonary capillary wedged pressure and RI in the afterload group. CONCLUSIONS In conclusion, a preoperative pulmonary vascular change and a postoperative precipitous decrease of pulmonary blood flow may have caused postoperative lung oxygenation impairment in the preload group. An extended period of extracorporeal circulation associated with cardiac arrest and postoperative volume overload may have caused lung impairment in the afterload group. In aspect of postoperative management, low CVP is beneficial to the patients in the afterload group, however, hypovolemia should be avoided in patients of the preload group.
- Published
- 2002
38. [Pulmonary embolism following lung resection: a case report and review of the Japanese literature]
- Author
-
M, Kamiyoshihara, K, Sakata, S, Ishikawa, and Y, Morishita
- Subjects
Male ,Lung Neoplasms ,Postoperative Complications ,Heparin ,Acute Disease ,Humans ,Thrombolytic Therapy ,Adenocarcinoma ,Pneumonectomy ,Pulmonary Embolism ,Urokinase-Type Plasminogen Activator ,Aged - Abstract
A 73-year-old male was admitted to our hospital with an abnormal shadow on a chest X-ray film. Chest CT demonstrated that a tumor shadow measuring 23 x 22 mm in size with pleural retraction was located in the right lower lobe. Transbronchial lung biopsy yielded a diagnosis of primary pulmonary adenocarcinoma. We performed a right lower lobectomy with mediastinal lymph node dissection. The patient suddenly complained of a syncope attack, tachycardia, hypotension, and hypoxemia 2 days after surgery. A perfusion lung scintigram with Tc-99 m macroaggregated albumin demonstrated localized defects at both the left lower lobe and a part of the left upper lobe. Thrombolytic and anticoagulation therapy with urokinase and heparin were immediately started. A postoperative lung scintigram 14 days after the onset of pulmonary thromboembolism showed normal filling of the left lung. The patient was discharged on the 37th postoperative day, and he has been followed up with anticoagulation therapy.
- Published
- 2002
39. [Successful treatment of a patient with low pressure syndrome associated with gait disturbance]
- Author
-
S, Suzuki, K, Sakata, G, Gonndou, H, Kanno, K, Miyahara, C, Chong, and I, Yamamoto
- Subjects
Adult ,Male ,Movement Disorders ,Intracranial Hypotension ,Humans ,Equipment Design ,Gait ,Cerebrospinal Fluid Shunts - Abstract
The authors report an unusual case of low intracranial pressure (ICP) syndrome that was successfully treated by the placement of an anti-siphon device (ASD). This 36-year-old male had suffered suprasellar germinoma with hydrocephalus and had had a V-P shunt following radiotherapy. Sixteen years later he developed gait disturbance and somnolence and MRI demonstrated a small lateral ventricle as well as a diffuse dural enhancement. A lumbar tap revealed a low ICP of 12 mmH2O. Because of this, an ASD was placed in the patient. Postoperatively, his symptoms of gait and consciousness disturbance improved. Typical clinical findings of low ICP syndrome such as headache were not observed in this case. To our knowledge, no symptom of gait disturbance with low ICP has been reported previously. We present an interesting case of low ICP syndrome with gait disturbance and discuss the mechanism of the symptoms. Symptoms of this patient were due at first to brain ischemia. After convulsion and consciousness disturbance due to low intracranial pressure, the symptoms increased in strength until gait disturbance occurred. The possibility is suggested that gait disturbance in this patient was due both to brain ischemia and low intracranial pressure.
- Published
- 2001
40. Cerebral arterial air embolism following CT-guided lung needle marking. Report of a case
- Author
-
M, Kamiyoshihara, K, Sakata, S, Ishikawa, and Y, Morishita
- Subjects
Adult ,Male ,Lung Neoplasms ,Intracranial Embolism ,Biopsy, Needle ,Embolism, Air ,Humans ,Tomography, X-Ray Computed - Abstract
We report a case of survival following a temporary cerebral air embolism, which occurred immediately after CT guided lung needle marking. A 24-year-old man was referred to our hospital for resection of a pulmonary nodule. To localize the tumor, lung needle marking under CT guidance was performed. Almost immediately, the patient experienced symptoms of cerebral arterial air embolism. The following day, the symptoms diminished, and a brain CT showed no abnormal lesions. A video-assisted thoracoscopic wedge resection was performed as scheduled, the patient's postoperative course was uneventful, and he was discharged in relatively good condition.
- Published
- 2001
41. A new technique for two-trocar laparoscopic cholecystectomy
- Author
-
Kan Ideguchi, Y. Ikeda, K. Sakata, T. Mori, T. Yasumitsu, K. Nakagawa, and K. Okamoto
- Subjects
Laparoscopic surgery ,Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Cost-Benefit Analysis ,Endoscopic surgery ,Internal medicine ,medicine ,Humans ,Intraoperative Complications ,Laparoscopic cholecystectomy ,Aged ,Aged, 80 and over ,business.industry ,General surgery ,Hepatology ,Middle Aged ,Surgery ,Cholecystectomy, Laparoscopic ,Cholecystectomy ,Female ,business ,Abdominal surgery - Abstract
New techniques for laparoscopic cholecystectomy (LC) that reduce the number of trocars or use very thin instruments have been devised with the goal of further minimizing surgical invasiveness.We performed two-trocar LC using an original new technique in 70 consecutive patients. A 10-mm trocar and a 5-mm trocar were inserted in the subumbilical and epigastrium positions, respectively. A 2-mm grasper forceps was inserted directly without a trocar below the costal margin. The fundus of the gallbladder was ligated and lifted up with a folded 0 silk string and a 16-gauge vessel cannula.The mean operative time was 73.2 +/- 23.5 min. A third trocar was added in two cases. None of the patients required conversion of the procedure to an open cholecystectomy, and there were no intraoperative complications.Based on our experience, we think that this technique is as safe and effective as the classic four-trocar technique; moreover, it has a cost benefit.
- Published
- 2001
42. Clinical studies of immunohistochemical staining of DNA-dependent protein kinase in oropharyngeal and hypopharyngeal carcinomas
- Author
-
K, Sakata, Y, Matsumoto, M, Satoh, A, Oouchi, H, Nagakura, K, Koito, Y, Hosoi, M, Hareyama, and N, Suzuki
- Subjects
DNA-Binding Proteins ,Male ,Oropharyngeal Neoplasms ,Hypopharyngeal Neoplasms ,Biopsy ,Carcinoma, Squamous Cell ,Humans ,Nuclear Proteins ,DNA-Activated Protein Kinase ,Protein Serine-Threonine Kinases ,Immunohistochemistry ,Aged - Abstract
DNA-dependent protein kinase (DNA-PK), a serine/threonine kinase composed of p470 catalytic subunit (DNA-PKcs) and p85/p70 heterodimer (Ku antigen), is considered a critical enzyme in the repair of the DNA double-strand breaks (DSB) that are the major lethal lesions induced by ionizing radiation. We investigated the expression of DNA-PK subunits in human tumors.We examined immunohistochemically the biopsy specimens of 44 patients with oropharyngeal carcinoma and 32 patients with hypopharyngeal carcinoma who had been treated with radiotherapy.Immunopositivity to Ku85 and DNA-PKcs was found in all patients. The staining of Ku85 and DNA-PKcs was nuclear, with none of the normal epithelial cells or malignant cells exhibiting cytoplasmic or membrane immunoreactivity. Normal epithelial cells were all stained intensely. In tumors, intense nuclear staining of DNA-PKcs was seen in 75 of 76 tumors, while that of Ku85 was seen in all 76 patients. The radiation responses of a primary tumor that was stained weakly with DNA-PKcs were excellent.Our results suggest the possibility of predicting the intrinsic radiosensitivity of human tumors in clinics able to perform immunohistochemical analysis of DNA-PK.
- Published
- 2001
43. [Spontaneous dissection of the anterior cerebral artery presenting subarachnoid hemorrhage and cerebral infarction: a case report]
- Author
-
K, Miyahara, K, Sakata, G, Gondo, H, Kanno, and I, Yamamoto
- Subjects
Male ,Aortic Dissection ,Anterior Cerebral Artery ,Humans ,Intracranial Aneurysm ,Cerebral Infarction ,Middle Aged ,Subarachnoid Hemorrhage - Abstract
A case is reported of anterior cerebral artery dissecting aneurysm presenting with subarachnoid hemorrhage and cerebral infarction. A 50-year-old man presented with sudden onset of weakness of the left lower limb was admitted to our hospital. CT scan on admission showed a subarachnoid hemorrhage in the interhemispheric fissure and CT on the 6th day demonstrated a cerebral infarction on the right medial frontal lobe. A carotid angiogram 12 hours after the onset showed no aneurysmal lesion, but, the angiogram repeated 11 days after the onset revealed an aneurysmal dilatation with distal narrowing at the right A2-A3 segment. To prevent rebleeding, we performed a wrapping procedure through the interhemispheric route on the 18th day after onset. The postoperative course was uneventful. We reviewed 27 previously reported cases with symptomatic dissecting aneurysm confined to the anterior cerebral artery.
- Published
- 2001
44. The characteristics of screened patients with abdominal aortic aneurysm
- Author
-
S, Ishikawa, A, Ohtaki, T, Takahashi, K, Sakata, Y, Otani, Y, Hamada, T, Koyano, M, Kano, K, Oshima, and Y, Morishita
- Subjects
Aged, 80 and over ,Male ,Middle Aged ,Iliac Artery ,Diagnosis, Differential ,Cross-Sectional Studies ,Sex Factors ,Japan ,Risk Factors ,Humans ,Mass Screening ,Female ,Aged ,Aortic Aneurysm, Abdominal ,Ultrasonography - Abstract
Screening for abdominal aortic aneurysm (AAA) has not yet been established in Japan. We therefore report the characteristics of a screened population and discuss the implications of screening using ultrasound in Japan.The subjects in our screening group were composed of 4428 participants who were 60 years of age or older. Aneurysm was detected in 16 cases, 15 males and 1 female, the detection rate being 0.4% in total and 0.9% in the males. We compare the characteristics of screened patients (n = 16) with non-screened patients operated on for abdominal aortic aneurysm (n = 166).There were no significant differences in the mean age or in the female ratio between the screened and non-screened groups (71 vs 70 y/o, 6% vs 13%, respectively). Solitary iliac aneurysms were significantly (p0.05) more frequent in the screened than in the non-screened group (19% vs 3%). The size of aneurysm in the screened group was significantly (p0.05) smaller compared with the non-screened group. Sixty-three per cent of the screened group and only 8% of the non-screened group had an aneurysm less than 40 mm in size. Aneurysm was palpable in only 31% of those of the screened group. There were no significant differences between the groups in the frequency of arteriosclerotic risk factors such as hypertension, ischaemic heart disease, diabetes mellitus, peripheral vascular disease and smoking habits. Surgical treatment was selected in 7 out of 16 screened patients. The remaining 9 patients with small-sized abdominal aortic aneurysms have been carefully followed up.Screening for abdominal aortic aneurysm using ultrasound is advisable especially for male participants and for the detection of iliac aneurysms. This screening procedure is useful for early detection because the screened aneurysm is generally small-sized and impalpable.
- Published
- 2001
45. Effects of cilnidipine on lipids, lipoproteins and fibrinolytic system in hypertensive patients
- Author
-
J E, Ahaneku, K, Sakata, T, Uranol, Y, Takada, and A, Takada
- Subjects
Male ,Dihydropyridines ,Lipoproteins ,Blood Pressure ,Middle Aged ,Calcium Channel Blockers ,Lipids ,Tissue Plasminogen Activator ,Hypertension ,Plasminogen Activator Inhibitor 1 ,Humans ,Female ,Antihypertensive Agents ,Aged - Abstract
Sixteen Japanese patients of both sexes aged 46-78 years with essential hypertension were studied at the cardiac clinic of the Department of Cardiology, Shizuoka General Hospital, Shizuoka, Japan. Serum lipids, lipoproteins, plasma fibrinolytic parameters, renin and noradrenaline were determined before and after 3 months of cilnidipine treatment. Systolic and diastolic blood pressures and heart rate were reduced while renin and noradrenaline levels remained unchanged after cilnidipine treatment. Total cholesterol and tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and t-PA-PAI-1 complex were reduced. Changes in the other lipids, lipoproteins and fibrinolytic parameters were not significant after cilnidipine treatment. A negative correlation was found between low-density lipoprotein cholesterol and t-PA antigen levels after cilnidipine treatment. In conclusion, cilnidipine was effective for the treatment of hypertension and did not cause reflex tachycardia in Japanese patients. Cilnidipine treatment produced a beneficial lipid profile (decrease in total cholesterol), but did not show a consistent effect on fibrinolytic parameters in hypertensive patients. The metabolic interaction between beneficial lipid changes and fibrinolysis will be of value to better our understanding of the antiatherogenic effects of cilnidipine treatment in hypertensive patients.
- Published
- 2000
46. Cardiac sympathetic dysfunction contributes to left ventricular remodeling after acute myocardial infarction
- Author
-
K. Sakata, M. Mochizuki, K. Ohbayashi, H. Yoshida, J. Ishikawa, R. Nawada, and H. Tamekiyo
- Subjects
Adult ,Male ,Sympathetic nervous system ,medicine.medical_specialty ,Sympathetic Nervous System ,Heart disease ,Myocardial Infarction ,Scintigraphy ,Technetium (99mTc) sestamibi ,Ventricular Function, Left ,Organophosphorus Compounds ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Myocardial infarction ,Prospective Studies ,Aged ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Heart ,General Medicine ,Organotechnetium Compounds ,Middle Aged ,medicine.disease ,3-Iodobenzylguanidine ,medicine.anatomical_structure ,Heart failure ,Cardiology ,Female ,business ,medicine.drug ,Artery - Abstract
To investigate the role of the cardiac sympathetic nervous system in left ventricular remodelling, 50 patients with first-time acute myocardial infarction (AMI) and patency of the infarct-related artery after reperfusion underwent quantitative iodine-123 metaiodobenzylguanidine (MIBG) imaging at 4 days and 4 weeks (n=42), and quantitative technetium-99m tetrofosmin imaging at 2 days after AMI. They also underwent both ventriculography and coronary angiography on admission and about 4 weeks after AMI. On the basis of left ventricular end-systolic volume (LVESV), patients were divided into two groups. Patients with LVESV dilatation (n=20) had a significantly lower ejection fraction (P0.003) and a significantly higher severity score of 99mTc-tetrofosmin (P0.04), and total severity (P0.01), delta extent (P0.007) and delta severity (P0.0008) scores of MIBG than patients without LVESV dilatation (n=30). delta severity score of MIBG was directly correlated with change in LVESV at 4 weeks (r=0.63, P0.0001). Stepwise linear discriminant function analysis showed that delta severity score of MIBG (P0.0002) was the only discriminator of LVESV dilatation. Patients with LVESV dilatation had higher regional washout rates in both the infarct and the non-infarct zones than patients without such dilatation. Furthermore, no MIBG parameters changed significantly between 4 days and 4 weeks after AMI. In reperfused AMI, delta severity score of MIBG was related to the degree of ventricular dilatation and was the only powerful discriminator of ventricular dilatation. These results suggest that cardiac sympathetic nervous abnormality might contribute to left ventricular remodelling in reperfused AMI. MIBG imaging may allow identification of reperfused AMI patients at high risk for left ventricular remodelling.
- Published
- 2000
47. [Idiopathic pulmonary fibrosis of the upper lobe: a case report]
- Author
-
Y, Kobayashi, M, Sakurai, M, Kushiya, T, Mizukoshi, Y, Nishi, J H, Choo, M, Shibasaki, K, Tabe, K, Sakata, M, Nagata, K, Kuramitsu, Y, Sakamoto, K, Kaneko, H, Shimizu, and Y, Kawabata
- Subjects
Adult ,Male ,Treatment Outcome ,Prednisolone ,Pulmonary Fibrosis ,Anti-Inflammatory Agents ,Humans ,Lung - Abstract
A 26-year-old man was admitted to our hospital complaining of exertional dyspnea. Chest x-ray films disclosed reticulonodular shadows predominantly in the upper fields of both lungs, but no apical cap. Lung biopsy specimens obtained from the upper lobe by video-assisted thoracoscopy revealed subpleural elasto-fibrosis. Also, specimens obtained from the lower lobes disclosed micro-honeycombing due to peri-lobular fibrosis resembling usual interstitial pneumonia. Although pneumothorax occurred repeatedly, the lungs reinflated on each occasion without artificial intervention. Similar radiographic findings had been obtained on the patient's father, who died of idiopathic pulmonary fibrosis at the age of 56. Idiopathic pulmonary upper lobe fibrosis was conclusively diagnosed because the patient exhibited most of the features originally described by Amitani et al.
- Published
- 1999
48. Differential inhibition by ferrous ions of [3H]MK-801 binding to native N-methyl-D-aspartate channel in neonatal and adult rat brains
- Author
-
K, Ogita, M, Shuto, N, Kuramoto, T, Manabe, E, Hinoi, T, Kitayama, K, Sakata, and Y, Yoneda
- Subjects
Male ,Radioligand Assay ,Animals, Newborn ,Synaptic Membranes ,Animals ,Brain ,Ferrous Compounds ,Dizocilpine Maleate ,Rats, Wistar ,Tritium ,Receptors, N-Methyl-D-Aspartate ,Ion Channels ,Rats - Abstract
In vitro addition or pretreatment with/=1 microM ferrous chloride markedly inhibited in a concentration-dependent manner [3H]dizocilpine (MK-801) binding to an open ion channel associated with the N-methyl-D-aspartate (NMDA) receptor in rat brain synaptic membranes. The addition of NMDA agonists invariably attenuated the inhibition of [3H]MK-801 binding in hippocampal synaptic membranes previously treated with ferrous chloride, without significantly affecting that in cerebellar synaptic membranes. In the absence of spermidine, ferrous chloride was more potent in inhibiting binding in the cerebral cortex and hippocampus in adult rats than in those in rats at 3 days after birth, while in the striatum [3H]MK-801 binding was 10 times more sensitive to inhibition by added ferrous chloride in neonatal rats than in adult rats. Addition of spermidine significantly attenuated the potency of ferrous chloride to inhibit binding in the cerebral cortex of adult rats, with facilitation of the inhibition in newborn rats. Moreover, spermidine significantly reduced the inhibitory potency of ferrous chloride in neonatal rat striatum, without markedly affecting that in adult rat striatum. These results suggest that ferrous ions may interfere with opening processes of the native NMDA channel through molecular mechanisms peculiar to neuronal development in a manner associated with the polyamine recognition domain.
- Published
- 1999
49. Cardiac sympathetic nervous system in early essential hypertension assessed by 123I-MIBG
- Author
-
K, Sakata, M, Shirotani, H, Yoshida, and C, Kurata
- Subjects
Adult ,Iodine Radioisotopes ,Male ,3-Iodobenzylguanidine ,Sympathetic Nervous System ,Echocardiography ,Hypertension ,Humans ,Heart ,Middle Aged ,Radiopharmaceuticals ,Radionuclide Imaging ,Aged - Abstract
Sympathetic overactivity has been noted in various clinical stages of essential hypertension. The purpose of this study is to investigate 123I-metaiodobenzylguanidine (MIBG) uptake and washout in patients with borderline and mild hypertension.To assess cardiac sympathetic function in essential hypertension, we performed 123I-MIBG cardiac imaging and echocardiography in 25 normotensive, 25 borderline hypertensive and 24 mildly hypertensive men. Age and body mass index were similar in the three groups.Regarding the echocardiographic variables, the left ventricular mass index (LVMI) was significantly higher in the mildly hypertensive group (125.6+/-28.6 g/m2) than in the normotensive (99.9+/-20.7 g/m2) and the borderline hypertensive (110.0+/-24.4 g/m2) groups (P0.001 and P0.05, respectively). Regarding the scintigraphic variables, the heart-to-mediastinum (H/M) ratio was significantly lower in the mildly hypertensive group (1.8+/-0.3) than in the normotensive (2.1+/-0.3) and the borderline hypertensive (2.1+/-0.2) groups. In contrast, the washout rate was significantly higher in the mildly hypertensive group (17.6%+/-10.8%) than in the normotensive (7.0%+/-4.9%) and the borderline (11.9%+/-8.9%) hypertensive groups (P0.001 and P0.02, respectively). In addition, the borderline hypertensive group had a significantly higher washout rate than the normotensive group (P0.05). MIBG washout rate had a strong positive correlation with LVMI (r = 0.77, P0.0001). In contrast, the H/M ratio had a weak negative correlation with LVMI (r = -0.40, P0.0006).During the course of establishment of essential hypertension, the washout rate becomes higher with the advance of hypertension and with the development of left ventricular hypertrophy. Thus, we suggest a strong relationship between cardiac sympathetic activity and the advance of hypertension at its early stages.
- Published
- 1999
50. Analysis of treatment results of hypopharyngeal cancer
- Author
-
K, Sakata, Y, Aoki, K, Karasawa, K, Nakagawa, K, Hasezawa, N, Muta, A, Terahara, Y, Onogi, Y, Sasaki, K, Nibu, T, Sugasawa, K, Ichimura, and M, Hareyama
- Subjects
Male ,Hypopharyngeal Neoplasms ,Time Factors ,Laryngectomy ,Radiotherapy Dosage ,Middle Aged ,Prognosis ,Disease-Free Survival ,Treatment Outcome ,Pharyngectomy ,Multivariate Analysis ,Carcinoma, Squamous Cell ,Humans ,Female ,Radiotherapy, Adjuvant ,Follow-Up Studies - Abstract
Sixty-three patients with squamous cell carcinoma of the hypopharynx were treated at the University of Tokyo between 1985 and 1993. Twelve patients were treated with surgery alone, 16 with preoperative irradiation, 26 with postoperative irradiation, and nine with irradiation alone. A tumor dose of 50 Gy (25 fractions/5 weeks) was used in postoperative irradiation, 40-60 Gy in preoperative irradiation, and 70 Gy in irradiation alone. When "number of indications," including, for example, partial pharyngectomy, positive or close (or = 5 mm) margin, and extracapsular extension, was used for multivariate analysis in patients who underwent surgery, it proved to be the only significant prognostic factor for gross survival. Six of seven patients with a positive surgical margin or close margin who received postoperative irradiation had local recurrence. A tumor dose of 50 Gy (25 fractions/5 weeks) in postoperative irradiation is not enough. It is difficult to cure by irradiation metastases to the parapharyngeal lymph nodes large enough to be detected with CT. It is necessary to irradiate parapharyngeal lymph nodes prophylactically, but 50 Gy in postoperative irradiation may not be enough from our results. The same may be true for metastases to the paratracheal nodes, which lie close to the lower poles of the thyroid gland or within the superior mediastinum and are difficult to access through surgery. In the patients who were operated on, N stage and the number of lymph node metastases were significant for gross survival. When "number of indications" was used for analysis, "number of indications" proved to be the most significant prognostic factor for gross survival.
- Published
- 1998
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