Okinawa, Japan
Okinawa, Japan

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PubMed | Red Cross, University of Ryukyus, Okinawa Prefectural Nambu Medical Center and Childrens Medical Center, Heartlife Hospital and 4 more.
Type: Journal Article | Journal: International journal of hematology | Year: 2016

Okinawa Prefecture, located in the subtropics, is an area of endemic adult T-cell leukemia-lymphoma (ATL) in Japan. We retrospectively analyzed 659 patients with aggressive ATL in seven institutions in Okinawa between 2002 and 2011. The median patient age was 68years. More patients were aged 90years (2.6%), in this study, than in a nationwide survey (<1%). The median survival time (MST) of the entire cohort was 6.5months. Of the 217 patients who had a clinical status similar to that stated in the eligibility criteria of JCOG9801 (a randomized phase III study comparing VCAP-AMP-VECP with CHOP-14), 147 who received the CHOP regimen had a poorer MST than those in the CHOP-14 arm of JCOG9801 (8 vs 11months). The prevalence of strongyloidiasis in the ATL patients was much higher (12.4%) than in the historical cohort who visited the University of the Ryukyus Hospital (3.4%). Furthermore, strongyloidiasis may be associated with ATL-related deaths. These findings suggest that, compared with other areas in Japan, in Okinawa, the proportion of patients aged 90years with clinical features of aggressive ATL is higher, outcomes are poorer, and the disease is associated with a higher prevalence of strongyloidiasis.


PubMed | Shizuoka Cancer Center, University of Ryukyus, Chubu Tokushukai Hospital, National Cancer Center Hospital and 7 more.
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2017

57 Background: Although cancer is the leading cause of death in Japan, systematic quality monitoring of cancer care has not been established. In an attempt to explore such systems, we measured the quality of cancer care in several facilities through chart reviews by tumor registrars. The subsequent step is the provision of effective feedback of these results to the practicing physicians and other health professionals for further improvement. However, the receptiveness of lead practicing physicians may be debatable.We measured 23 quality indicators (QIs) (10 indicators for stomach cancer and 13 for colorectal cancer) in 10 designated cancer hospitals between 2010 and 2011. The staff who worked in these hospitals could see results of the measured QIs on web pages. All three designated cancer hospitals and one large general hospital in Okinawa Prefecture participated in feedback meetings. A feedback meeting was held in each of the four hospitals for one hour each. The feedback meeting consisted of three parts: general explanation of the measured QIs by the researcher, feedback regarding results of each indicator by the panels, and discussions. At the end of the meeting, participants answered a questionnaire regarding the meeting.Of the 190 hospital staff who participated in the meeting (52 were medical doctors, 21 were nurse, 15 were other medical staff, and 102 were medical clerks), 142 (75%) answered the questionnaire. Majority of the responses were supportive of the quality measurement and feedback activities: 85% of the participants understood results of the measured QIs and 94% replied that the feedback methods were good. In addition, 86% answered that they would recommend other hospitals to participate if there was an opportunity. Among the physicians who participated, 89% answered that results of the measured QIs would influence their practices and 95% answered that data abstraction by tumor registrars was appropriate.Feedback by the panels who established QIs was favorably perceived by the hospital staff and could influence the attitude of physicians regarding current practices.


Takeda K.,University of Ryukyus | Takeda K.,Kanehide Bio Co. | Tomimori K.,University of Ryukyus | Tomimori K.,Naha City Hospital | And 6 more authors.
International Journal of Oncology | Year: 2012

Fucoidan, a sulfated polysaccharide, has significant cytotoxic activity against tumor cells; however, the mechanism(s) of this action remains poorly understood. The present study was designed to determine the in vitro and in vivo effects of fucoidan and their molecular mechanisms. Fucoidan from Cladosiphon okamuranus Tokida cultivated in Okinawa, Japan, delayed tumor growth in Sarcoma 180 (S-180)-bearing mice. However, it failed to inhibit S-180 cell growth in vitro. Activated macrophages are known to have anti-tumor effects. Murine RAW264.7 macrophages stimulated with fucoidan exerted cytotoxicity towards S-180 cells in vitro. This cytotoxicity was associated with nitric oxide (NO) production. Both cytocidal effect and NO production were significantly inhibited by L-NAME, an inhibitor of NO synthase (NOS). Furthermore, activation of nuclear factor-κB was a key step in the transcriptional activation of the inducible NOS gene. Taken together, our results indicate that the anti-tumor activity of fucoidan on S-180 cells is mediated through increased NO production by fucoidan-stimulated macrophages via nuclear factor-κB-dependent signaling pathway.


Akamine I.,University of Ryukyus | Akamine I.,Okinawa Prefectural College of Nursing | Uza M.,University of Ryukyus | Shinjo M.,Okinawa Prefectural College of Nursing | Nakamori E.,Naha City Hospital
Japan Journal of Nursing Science | Year: 2013

Aim: The aim of this study was to develop a new scale, the Competence Scale for Senior Clinical Nurses (CS-SCN), to assess and evaluate senior clinical nurses in hospitals, and to confirm the validity and reliability of the scale. Method: A cross-sectional questionnaire survey was undertaken at a hospital in Japan, using an anonymous self-administered questionnaire administered to clinical nurses (n=374). A useable sample of 218 was achieved, which was used in the analysis. Statistical analysis examined exploratory/confirmatory factor analysis, internal consistency, and construct validity. Results: A five factor solution with 22 items was extracted for nursing competence in senior clinical nurses, which was the interpretable questionnaire. In the confirmatory factor analysis, the indices of fitness supported these results. Cronbach's alpha coefficient was 0.93 for the total score and varied between 0.63 and 0.90 in the five factors. Five factors emerged from an oblique factor analysis, with a cumulative variance of 66.7%: "role accomplishment"; "self-management"; "research"; "practice and coordination"; and "work implementation". The five factors had only a moderate correlation (0.30-0.77, P<0.001) with each other, which indicated construct validity. Conclusion: The CS-SCN, a concise scale to measure and evaluate the competence of senior clinical nurses, was developed. Results suggest initial support for the new instrument as a measure of competence of senior clinical nurses, but it must be further refined, tested, and evaluated. Both the validity and reliability of the scale were verified. Future studies using the CS-SCN might lead to improvement in the competence of senior clinical nurses. © 2012 The Authors Japan Journal of Nursing Science © 2012 Japan Academy of Nursing Science.


Ishikawa C.,University of Ryukyus | Kawakami H.,University of Ryukyus | Uchihara J.-N.,Naha City Hospital | Senba M.,Nagasaki University | Mori N.,University of Ryukyus
Biochimica et Biophysica Acta - Molecular Cell Research | Year: 2013

Human T-cell leukemia virus type 1 (HTLV-1) infection is associated with the development of adult T-cell leukemia (ATL) and various inflammatory diseases. CD69 is a marker of early activation of lymphocytes. We investigated the effects of HTLV-1 infection on the expression of CD69. The CD69 gene was upregulated in all viral protein Tax-expressing HTLV-1-transformed T-cell lines, except MT-2 and peripheral blood mononuclear cells from patients with ATL compared with uninfected T-cell line, Tax-negative ATL-derived T-cell lines and normal peripheral blood mononuclear cells. Flow cytometric analysis and immunohistochemical analysis confirmed the enhanced expression of CD69 in HTLV-1-transformed T-cell lines and in ATL cells in lymph nodes and skin lesions, and its absence in MT-2 and peripheral blood mononuclear cells. CD69 expression was induced following infection of human T-cell line with HTLV-1, and specifically by Tax. Tax transcriptionally activated CD69 gene through both nuclear factor-κB and cyclic adenosine 3',5'-monophosphate response element-binding protein signaling pathways. Detailed analysis of the CD69 promoter indicated that the Tax-induced expression of CD69 was regulated by multiple cis-acting elements and by the interplay of transcription factors of the nuclear factor-κB, early growth response and cyclic adenosine 3',5'-monophosphate response element-binding protein families. The lack of CD69 expression in MT-2 is due to epigenetic mechanism involving deacetylation, but not methylation. We conclude that CD69 is a Tax-regulated gene, and its regulation by Tax may play a role in cellular activation and HTLV-1-induced disease pathogenesis. © 2013 Elsevier B.V.


Imaizumi A.,Naha City Hospital | Imaizumi A.,University of Ryukyus | Kusaka S.,Kinki University | Noguchi H.,Naha City Hospital | And 2 more authors.
American Journal of Ophthalmology | Year: 2014

Purpose To evaluate the efficacy of perfluoro-n-octane as a postoperative short-term tamponade after vitrectomy in pediatric cases with complex retinal detachment (RD) and proliferative vitreoretinopathy (PVR). Design Prospective, noncomparative, interventional case series. Methods The medical records of 10 eyes of 9 children (6 boys and 3 girls), whose age ranged from 3 months to 11 years, with a median of 7.5 months, were reviewed. The cause of the PVR was retinopathy of prematurity (7 eyes of 6 patients); familial exudative vitreoretinopathy; or tractional RD associated with congenital optic nerve anomalies,1 and persistent fetal vasculature. Perfluoro-n-octane was injected into the eyes at the primary surgery in 2 eyes and at the repeat surgeries in 8 eyes. The perfluoro-n-octane was removed after 1 to 4 postoperative weeks. The patients were followed for 5 to 43 months. Results At the last examination, the retinas were reattached in 8 eyes (80%). In the other two eyes, a retinal attachment was not obtained. Postoperatively, the best-corrected visual acuity improved from hand motion to 0.1 in 1 eye and could not be measured in the other 9 patients because of their ages. No apparent adverse events related to the use of perfluoro-n-octane were noted. Conclusions Although cautions should be exercised regarding potential mechanical retinal injuries by heavy liquids in the eye, short-term perfluoro-n-octane tamponade was effective in pediatric cases with severe PVR in which retinal reattachment is considered to be difficult with conventional gas or silicone oil tamponade. © 2014 BY ELSEVIER INC. ALL RIGHTS RESERVED.


PubMed | Naha City Hospital, University of Ryukyus and Tokushima University
Type: | Journal: Cardiovascular diabetology | Year: 2016

Impaired vasoreactivity is often observed in subjects with metabolic syndrome, a condition that includes the presence of a specific cluster of risk factors for obesity and cardiovascular disease. However, hierarchical causes in the impaired vasoreactivity have not been clarified. We evaluated the impact of individual metabolic risk components or its clustering under the condition of insulin resistance on endothelial and smooth muscle cell function.Vascular reactivity to acetylcholine (Ach), with or without nitric oxide synthase (NOS) inhibitor N (G)-monomethyl-L-arginine (L-NMMA), or sodium nitroprusside (SNP) by forearm venous occlusion plethysmography and insulin sensitivity index (M mg/kg/min) in euglycemic clamp were measured in men without (n = 18, control group) or with (n = 19, metabolic syndrome group) metabolic syndrome.(1) Ach-induced maximal forearm blood flow (maxFBF) was impaired in subjects with metabolic syndrome. In particular, the NOS-dependent component of Ach-induced maxFBF was selectively decreased, while the NOS-independent component remained relatively unchanged. (2) Ach-induced maxFBF and Ach-induced maxFBF with L-NMMA were correlated with waist circumference, glucose, and triglycerides, and most strongly correlated with visceral fat area, adiponectin, and M. (3) Multivariate regression analysis indicated that individual metabolic risk components explained Ach-induced maxFBF by 4-21 %. Clustering of all metabolic risk components increased this to 35 %, and the presence of metabolic syndrome explained 30 %, indicating that defining metabolic syndrome can effectively predict impairment of endothelial dysfunction.Endothelial dysfunction was correlated with individual metabolic risk components, but more strongly with clustering of the components under a condition with low insulin sensitivity. We suggest that in subjects with metabolic syndrome, endothelial function is impaired by multiple cardiovascular risk factors exclusively when under the condition of insulin insensitivity and also that defining metabolic syndrome can effectively predict impairment of endothelial dysfunction.


PubMed | Gifu University and Naha City Hospital
Type: Journal Article | Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy | Year: 2016

Blood culturing and the rapid reporting of results are essential for infectious disease clinics to obtain bacterial information that can affect patient prognosis. When gram-positive coccoid cells are observed in blood culture bottles, it is important to determine whether the strain is Staphylococcus aureus and whether the strain has resistance genes, such as mecA and blaZ, for proper antibiotic selection. Previous work led to the development of a PCR method that is useful for rapid identification of bacterial species and antimicrobial susceptibility. However, that method has not yet been adopted in community hospitals due to the high cost and methodological complexity. We report here the development of a quick PCR and DNA-chromatography test, based on single-tag hybridization chromatography, that permits detection of S.aureus and the mecA and blaZ genes; results can be obtained within 1h for positive blood culture bottles. We evaluated this method using 42 clinical isolates. Detection of S.aureus and the resistance genes by the PCR-DNA-chromatography method was compared with that obtained via the conventional identification method and actual antimicrobial susceptibility testing. Our method had a sensitivity of 97.0% and a specificity of 100% for the identification of the bacterial species. For the detection of the mecA gene of S.aureus, the sensitivity was 100% and the specificity was 95.2%. For the detection of the blaZ gene of S.aureus, the sensitivity was 100% and the specificity was 88.9%. The speed and simplicity of this PCR-DNA-chromatography method suggest that our method will facilitate rapid diagnoses.

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