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Kodama R.,University of Tokyo | Muraki S.,Tokyo Medical University | Iidaka T.,Tokyo Medical University | Oka H.,Tokyo Medical University | And 10 more authors.
Journal of Bone and Mineral Metabolism | Year: 2017

To purpose of this study was to reveal the mean levels and positive proportion of serological markers related to rheumatoid arthritis, and clarify their relationship with osteoporosis and hand osteoarthritis (OA). A total of 1546 participants from the third survey of the research on osteoarthritis/osteoporosis against disability study were enrolled in the current study. Using participant blood samples, the levels of anti-cyclic citrullinated protein (CCP) antibody, rheumatoid factor (RF), matrix metalloproteinase-3 (MMP-3), C-reactive protein (CRP), and high-sensitivity CRP (hsCRP) were measured. Subjects with higher than normal levels were defined as being positive. Osteoporosis was defined according to the recommendations set by World Health Organization criteria in 1994. Radiographic hand OA was evaluated using the modified Kellgren–Lawrence (KL) scale. The positive proportion of anti-CCP antibody, RF, MMP-3, CRP, and hsCRP was 1.8, 7.1, 15.0, 6.7, and 6.4%, respectively. MMP-3 was associated with age, and was significantly higher in men than in women. Positive MMP-3 was not significantly related to osteoporosis or severe hand OA (KL grade ≥3) after adjustment for other factors including age, sex, and body mass index. The results from this study clarified the values and positive proportion of RA-related markers and revealed their relationship with osteoporosis and hand OA. © 2017 The Japanese Society for Bone and Mineral Research and Springer Japan


PubMed | National Rehabilitation Center for Persons with Disabilities, University of Tokyo, University of Hong Kong, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center and 2 more.
Type: Journal Article | Journal: PloS one | Year: 2016

High intensity zones (HIZ) of the lumbar spine are a phenotype of the intervertebral disc noted on MRI whose clinical relevance has been debated. Traditionally, T2-weighted (T2W) magnetic resonance imaging (MRI) has been utilized to identify HIZ of lumbar discs. However, controversy exists with regards to HIZ morphology, topography, and association with other MRI spinal phenotypes. Moreover, classification of HIZ has not been thoroughly defined in the past and the use of additional imaging parameters (e.g. T1W MRI) to assist in defining this phenotype has not been addressed.A cross-sectional study of 814 (69.8% females) subjects with mean age of 63.6 years from a homogenous Japanese population was performed. T2W and T1W sagittal 1.5T MRI was obtained on all subjects to assess HIZ from L1-S1. We created a morphological and topographical HIZ classification based on disc level, shape type (round, fissure, vertical, rim, and enlarged), location within the disc (posterior, anterior), and signal type on T1W MRI (low, high and iso intensity) in comparison to the typical high intensity on T2W MRI.HIZ was noted in 38.0% of subjects. Of these, the prevalence of posterior, anterior, and both posterior/anterior HIZ in the overall lumbar spine were 47.3%, 42.4%, and 10.4%, respectively. Posterior HIZ was most common, occurring at L4/5 (32.5%) and L5/S1 (47.0%), whereas anterior HIZ was most common at L3/4 (41.8%). T1W iso-intensity type of HIZ was most prevalent (71.8%), followed by T1W high-intensity (21.4%) and T1W low-intensity (6.8%). Of all discs, round types were most prevalent (anterior: 3.6%, posterior: 3.7%) followed by vertical type (posterior: 1.6%). At all affected levels, there was a significant association between HIZ and disc degeneration, disc bulge/protrusion and Modic type II (p<0.01). Posterior HIZ and T1W high-intensity type of HIZ were significantly associated with disc bulge/protrusion and disc degeneration (p<0.01). In addition, posterior HIZ was significantly associated with Modic type II and III. T1W low-intensity type of HIZ was significantly associated with Modic type II.This is the first large-scale study reporting a novel classification scheme of HIZ of the lumbar spine. This study is the first that has utilized T2W and T1W MRIs in differentiating HIZ sub-phenotypes. Specific HIZ sub-phenotypes were found to be more associated with specific MRI degenerative changes. With a more detailed description of the HIZ phenotype, this scheme can be standardized for future clinical and research initiatives.


Iidaka T.,Tokyo Medical University | Muraki S.,Tokyo Medical University | Akune T.,National Rehabilitation Center for Persons with Disabilities | Oka H.,Tokyo Medical University | And 5 more authors.
Osteoarthritis and Cartilage | Year: 2016

Objective: Although hip osteoarthritis (OA) is a major cause of hip pain and disability in elderly people, few epidemiologic studies have been performed. We investigated the prevalence of radiographic hip OA and its association with hip pain in Japanese men and women using a large-scale population of a nationwide cohort study, Research on Osteoarthritis/osteoporosis Against Disability (ROAD). Methods: From the baseline survey of the ROAD study, 2975 participants (1043 men and 1932 women), aged 23-94 years (mean 70.2 years), living in urban, mountainous, and coastal communities were analyzed. The radiographic severity at both hips was determined by the Kellgren/Lawrence (K/L) grading system. Radiographic hip OA was defined as K/L ≥ 2, and severe radiographic hip OA as K/L ≥ 3. Results: The crude prevalence of radiographic hip OA was 18.2% and 14.3% in men and women, respectively, that of severe radiographic hip OA was 1.34% and 2.54%, and that of symptomatic K/L ≥ 2 OA was 0.29% and 0.99%, respectively. The crude prevalence of hip OA, including severe OA, was not age-dependent in men or women. Male sex was a risk factor for radiographic hip OA, whereas female sex was a risk factor for severe radiographic hip OA and hip pain. Compared with K/L = 0/1, hip pain was significantly associated with K/L ≥ 3, but not with K/L = 2. Conclusion: The present cross-sectional study revealed the prevalence of radiographic hip OA and severe hip OA in Japanese men and women. Hip pain was strongly associated with K/L ≥ 3. © 2015 Osteoarthritis Research Society International.


Nakahara H.,University of Tokyo | Kaburaki T.,University of Tokyo | Tanaka R.,University of Tokyo | Takamoto M.,University of Tokyo | And 6 more authors.
Ocular Immunology and Inflammation | Year: 2016

Purpose: To investigate the frequency of conditions of newly arrived patients with uveitis from 2010 to 2012 and compare this frequency with that since 2004. Methods: We retrospectively analyzed clinical records of patients who visited the outpatient clinic from January 2010 to December 2012, and compared them with those from 2004–2009. Results: From 2010 to 2012, 695 new patients with uveitis visited Tokyo University Hospital, with a definite diagnosis made in 431 (62.0%). The most common diagnosis was scleritis (8.3%), followed by sarcoidosis (8.1%); herpetic iridocyclitis (5.5%); Behçet disease (4.6%); Vogt–Koyanagi–Harada disease (4.0%); acute anterior uveitis (3.7%); Posner–Schlossman syndrome (3.6%); intraocular malignant lymphoma (3.0%); and bacterial endophthalmitis (1.9%). The most frequent unclassified type of uveitis was sarcoidosis-suspected (14.8%). Conclusions: When compared with years 2004–2009, the present series showed an increasing trend of intraocular malignant lymphoma, bacterial endophthalmitis, and chronic iridocyclitis, and a notable increase in chronic iridocyclitis in young girls, with decreasing trends of scleritis and Vogt–Koyanagi–Harada disease. © 2016, Informa Healthcare. All rights reserved.


PubMed | National Rehabilitation Center for Persons with Disabilities, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo Medical University and University of Tokyo
Type: Journal Article | Journal: Osteoarthritis and cartilage | Year: 2015

Although hip osteoarthritis (OA) is a major cause of hip pain and disability in elderly people, few epidemiologic studies have been performed. We investigated the prevalence of radiographic hip OA and its association with hip pain in Japanese men and women using a large-scale population of a nationwide cohort study, Research on Osteoarthritis/osteoporosis Against Disability (ROAD).From the baseline survey of the ROAD study, 2975 participants (1043 men and 1932 women), aged 23-94 years (mean 70.2 years), living in urban, mountainous, and coastal communities were analyzed. The radiographic severity at both hips was determined by the Kellgren/Lawrence (K/L) grading system. Radiographic hip OA was defined as K/L 2, and severe radiographic hip OA as K/L 3.The crude prevalence of radiographic hip OA was 18.2% and 14.3% in men and women, respectively, that of severe radiographic hip OA was 1.34% and 2.54%, and that of symptomatic K/L 2 OA was 0.29% and 0.99%, respectively. The crude prevalence of hip OA, including severe OA, was not age-dependent in men or women. Male sex was a risk factor for radiographic hip OA, whereas female sex was a risk factor for severe radiographic hip OA and hip pain. Compared with K/L = 0/1, hip pain was significantly associated with K/L 3, but not with K/L = 2.The present cross-sectional study revealed the prevalence of radiographic hip OA and severe hip OA in Japanese men and women. Hip pain was strongly associated with K/L 3.


PubMed | National Rehabilitation Center for Persons with Disabilities, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Wakayama Medical University, Tokyo Medical University and University of Tokyo
Type: | Journal: Osteoarthritis and cartilage | Year: 2017

The present study examined the progression, incidence, and risk factors for intervertebral disc degeneration (DD) throughout the lumbar spine using magnetic resonance imaging (MRI) in a large population-based cohort.We followed up 617 subjects for more than 4 years as part of the Wakayama Spine Study. 1) Progression of DD in each of the entire, upper (L1/2 to L3/4) and lower (L4/5 and L5/S1) lumbar spine was defined as Pfirrmann grade progression at follow-up in at least one disc in the affected region. 2) Incidence of DD in each of these regions was defined if all discs were grade 3 or lower (white disc) at baseline, and at least one disc had progressed to grade 4 or higher (black disc) at follow-up. Logistic regression analyses were used to determine the risk factors for progression and incidence of DD.DD progression and incidence in the entire lumbar spine were 52.0% and 31.6% in men, and 60.4% and 44.7% in women, respectively. Women was associated with DD progression in the upper lumbar spine (odds ratio [OR]=1.68, 95% confidence interval [CI]=1.18-2.42). Aging was associated with the incidence of DD in each region (entire: OR=1.14, CI=1.06-1.14; upper: OR=1.10, CI=1.05-1.15; lower: OR=1.11, CI=1.05-1.19). Diabetes mellitus (DM) was associated with the incidence of DD in the upper lumbar spine (OR=6.83, CI=1.07-133.7).This 4-year longitudinal study is the first to demonstrate DD progression and incidence in the lumbar spine and their risk factors in a large population-based cohort.


PubMed | National Rehabilitation Center for Persons with Disabilities, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Wakayama Medical University, Tokyo Medical University and University of Tokyo
Type: Journal Article | Journal: PloS one | Year: 2016

The objective of the present study was to examine the associations between metabolic syndrome (MS) components, such as overweight (OW), hypertension (HT), dyslipidemia (DL), and impaired glucose tolerance (IGT), and intervertebral disc degeneration (DD).The present study included 928 participants (308 men, 620 women) of the 1,011 participants in the Wakayama Spine Study. DD on magnetic resonance imaging was classified according to the Pfirrmann system. OW, HT, DL, and IGT were assessed using the criteria of the Examination Committee of Criteria for MS in Japan.Multivariable logistic regression analysis revealed that OW was significantly associated with cervical, thoracic, and lumbar DD (cervical: odds ratio [OR], 1.28; 95% confidence interval [CI], 0.92-1.78; thoracic: OR, 1.75; 95% CI, 1.24-2.51; lumbar: OR, 1.87; 95% CI, 1.06-3.48). HT and IGT were significantly associated with thoracic DD (HT: OR, 1.54; 95% CI, 1.09-2.18; IGT: OR, 1.65; 95% CI, 1.12-2.48). Furthermore, subjects with 1 or more MS components had a higher OR for thoracic DD compared with those without MS components (vs. no component; 1 component: OR, 1.58; 95% CI, 1.03-2.42; 2 components: OR, 2.60; 95% CI, 1.62-4.20; 3 components: OR, 2.62; 95% CI, 1.42-5.00).MS components were significantly associated with thoracic DD. Furthermore, accumulation of MS components significantly increased the OR for thoracic DD. These findings support the need for further studies of the effects of metabolic abnormality on DD.


Yamaji Y.,Japan Community Healthcare Organization Tokyo Shinjuku Medical Center | Itatani M.,Japan Community Healthcare Organization Tokyo Shinjuku Medical Center | Imai K.,Japan Community Healthcare Organization Tokyo Shinjuku Medical Center | Yamazaki A.,Japan Community Healthcare Organization Tokyo Shinjuku Medical Center | And 3 more authors.
Journal of the Japan Diabetes Society | Year: 2015

With the goal of assuring the standardized treatment of diabetic inpatients, we installed an institutional framework to support diabetes care in non-diabetic sections by means of providing regular rounds by an expert team composed of diabetologists, a nurse certified in diabetes nursing and a registered dietician. The team mostly took responsibility for ensuring adequate glucose monitoring, determining the insulin regimen and oral therapy and safeguarding patient safety, including the prevention of hypoglycemia. In order to evaluate the usefulness of these rounds, we conducted a questionnaire survey of nurses and doctors on the non-diabetic wards at one and five years after implementation. The results showed that 98% of the nurses appreciated the program after one year and gave significantly higher scores for all items of the questionnaire after five years versus the previous survey with respect to efficacy of the rounds in improving the patients' treatment in addition to addressing their own concerns and understanding about diabetes care. After five years, 97% of the doctors required a commitment for the diabetes team and 90% observed the program to be highly effective. Therefore, our cross-sectional approach is considered to be useful for improving the hospital-wide quality of diabetes care. © 2015, Japan Diabetes Society. All rights reserved.

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