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Kondo A.,Chubu University | Zierler B.K.,University of Washington | Isokawa Y.,Juzenkai Hospital | Hagino H.,Tottori University | And 2 more authors.
Disability and Rehabilitation

Purpose. To examine whether the length of stay (LOS) after hip fracture surgery was related to mortality after discharge by comparing between hospitals in Japan and the United States (US). Method. This is a retrospective observational study of three hospitals in Japan and two in the Pacific Northwest in the US. The median follow-up day was 276 days after surgery. The participants were 65 years or older who had experienced hip fracture and were admitted to one of the study hospitals for surgery. Results. The median LOS after surgery was 34 days in Japan and 5 days in the US. The survival rate was 89.5% in Japan and 77.2% in the US among patients who could be followed-up. In the Cox regression, every 10 day increase in the LOS after surgery was associated with a 26% reduction in the risk of mortality (Hazard ratio=0.744, p=0.014) after adjusting for LOS before surgery, patients' basic characteristics, number of complications and country. Conclusions. Shorter lengths of stay after surgery did not predict better survival across the two countries. Larger longitudinal or randomized studies that determine the effects of LOS after surgery on mortality are necessary. © 2010 Informa UK Ltd. Source

Okunaga T.,Nagasaki Rosai Hospital | Izumo T.,Nagasaki Rosai Hospital | Yoshioka T.,Nagasaki Rosai Hospital | Shimizu T.,Juzenkai Hospital | And 2 more authors.
Neurological Surgery

This report presents a case of a transorbital penetrating brain injury caused by a metal rod. A 47-year-old male injured his left lower eyelid with no witness during working hours. The two days later, he presented with a right hand tremor and abnormal behavior, and was admitted to the hospital. A CT showed a bone fracture of the left orbital roof and a low-density lesion of the left frontal lobe. The initial diagnosis was a cerebral contusion due to a blow-out fracture. However, sagittal MR images on the tenth day in the hospital demonstrated a penetrating tract that was running linearly from the left orbital roof to the left caudate head. Therefore, the final diagnosis was a transorbital penetrating brain injury. This case had no severe complications in spite of the delayed diagnosis. Careful examinations are thus required in order to make a correct diagnosis at the first examination, because a transorbital penetrating brain injury might initially present as a slight wound with no neurological signs. Source

Oku T.,Nagasaki University | Tanabe K.,Nagasaki University | Ogawa S.,Juzenkai Hospital | Sadamori N.,Nagasaki University | Nakamura S.,Nagasaki University
Clinical and Experimental Gastroenterology

Background: The purpose of this study was to clarify whether it is possible to extrapolate results from studies of the hydrolyzing activity of disaccharidases from rats to humans. Materials and methods: We measured disaccharidase activity in humans and rats using identical preparation and assay methods, and investigated the similarity in hydrolyzing activity. Small intestinal samples without malignancy were donated by five patients who had undergone bladder tumor surgery, and homogenates were prepared to measure disaccharidase activity. Adult rat homogenates were prepared using small intestine. Results: Maltase activity was the highest among the five disaccharidases, followed by sucrase and then palatinase in humans and rats. Trehalase activity was slightly lower than that of palatinase in humans and was similar to that of sucrase in rats. Lactase activity was the lowest in humans, but was similar to that of palatinase in rats. Thus, the hydrolyzing activity of five disaccharidases was generally similar in humans and rats. The relative activity of sucrose and palatinase versus maltase was generally similar between humans and rats. The ratio of rat to human hydrolyzing activity of maltase, sucrase, and palatinase was 1.9-3.1, but this was not a significant difference. Leaf extract from Morus alba strongly inhibited the activity of maltase, sucrase, and palatinase, but not trehalase and lactase, and the degree of inhibition was similar in humans and rats. L-arabinose mildly inhibited sucrase activity, but hardly inhibited the activity of maltase, palatinase, trehalase and lactase in humans and rats. The digestibility of 1-kestose, galactosylsucrose, and panose by small intestinal enzymes was very similar between humans and rats. Conclusion: These results demonstrate that the digestibility of newly developed saccharide materials evaluated by rat small intestinal enzymes can substitute for evaluation using human enzymes. © 2011 Oku et al. Source

Tazawa R.,Niigata University | Inoue Y.,Kinki chuo Chest Medical Center | Arai T.,Kinki chuo Chest Medical Center | Takada T.,Niigata University | And 19 more authors.

Background: Treatment of autoimmune pulmonary alveolar proteinosis (aPAP) by subcutaneous injection or inhaled therapy of granulocyte-macrophage colony-stimulating factor (GM-CSF) has been demonstrated to be safe and efficacious in several reports. However, some reports of subcutaneous injection described transient benefit in most instances. The durability of response to inhaled GM-CSF therapy is not well characterized. Methods: To elucidate the risk factors for recurrence of aPAP after GM-CSF inhalation, 35 patients were followed up, monitoring for the use of any additional PAP therapies and disease severity score every 6 months. Physiologic, serologic, and radiologic features of the patients were analyzed for the findings of 30-month observation after the end of inhalation therapy. Results: During the observation, 23 patients remained free from additional treatments, and twelve patients required additional treatments. There were no significant differences in age, sex, symptoms, oxygenation indexes, or anti-GM-CSF antibody levels at the beginning of treatment between the two groups. Baseline vital capacity (% predicted, %VC) were higher among those who required additional treatment ( P < .01). Those patients not requiring additional treatment maintained the improved disease severity score initially achieved. A significant difference in the time to additional treatment between the high %VC group (%VC ≥ 80.5) and the low %VC group was seen by a Kaplan-Meier analysis and a log-rank test ( P < .0005). Conclusions: These results demonstrate that inhaled GM-CSF therapy sustained remission of aPAP in more than one-half of cases, and baseline %VC might be a prognostic factor for disease recurrence. © 2014 American College of Chest Physicians. Source

Zaraket H.,American University of Beirut | Kondo H.,Niigata University | Hibino A.,Niigata University | Yagami R.,Niigata University | And 30 more authors.
Frontiers in Microbiology

Influenza A viruses evolve at a high rate requiring continuous monitoring to maintain the efficacy of vaccines and antiviral drugs. We performed next generation sequencing analysis of 100 influenza A/H3N2 isolates collected in four Asian countries (Japan, Lebanon, Myanmar, and Vietnam) during 2012-2015. Phylogenetic analysis revealed several reassortment events leading to the circulation of multiple clades within the same season. This was particularly evident during the 2013 and 2013/2014 seasons. Importantly, our data showed that certain lineages appeared to be fitter and were able to persist into the following season. The majority of A/H3N2 viruses continued to harbor the M2-S31N mutation conferring amantadine-resistance. In addition, an S31D mutation in the M2-protein, conferring a similar level of resistance as the S31N mutation, was detected in three isolates obtained in Japan during the 2014/2015 season. None of the isolates possessed the NA-H274Y mutation conferring oseltamivir-resistance, though a few isolates were found to contain mutations at the catalytic residue 151 (D151A/G/N or V) of the NA protein. These variations did not alter the susceptibility to neuraminidase inhibitors and were not detected in the original clinical specimens, suggesting that they had been acquired during their passage in MDCK cells. Novel polymorphisms were detected in the PB1-F2 open-reading frame resulting in truncations in the protein of 24-34 aminoacids in length. Thus, this study has demonstrated the utility of monitoring the full genome of influenza viruses to allow the detection of the potentially fittest lineages. This enhances our ability to predict the strain(s) most likely to persist into the following seasons and predict the potential degree of vaccine match or mismatch with the seasonal influenza season for that year. This will enable the public health and clinical teams to prepare for any related healthcare burden, depending on whether the vaccine match is predicted to be good or poor for that season. © 2016 Zaraket, Kondo, Hibino, Yagami, Odagiri, Takemae, Tsunekuni, Saito, Japanese Influenza Collaborative Study Group, Myint, Kyaw, Oo, Tin, Lin, Anh, Hang, Mai, Hassan, Shobugawa, Tang, Dbaibo and Saito. Source

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