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Yagahara A.,Hokkaido University | Tsuji S.,Hokkaido University | Fukuda A.,National Hospital Organization Hokkaido Medical Center | Yokooka Y.,Japan National Institute of Radiological Sciences | And 2 more authors.
Studies in Health Technology and Informatics | Year: 2013

Mammography is complex and difficult for beginner radiologic technologists (RTs) because knowledge and technical skills rely on one's experience, and it is often difficult for experienced RTs to verbally explain the process to co-workers or beginners. The purpose of this study was to construct a mammography examination process ontology for knowledge sharing among RTs and propose a new ontology construction method using an affinity diagram (AD) and hierarchical task analysis (HTA). First, tasks collected by brainstorming were clustered and connected using the AD. Subsequently, a hierarchical structure was constructed based on the clusters and relations determined in the AD. Finally, a mammography process ontology was determined based on the relations noted in the AD and HTA. As a result, the ontology contained 203 classes and 669 relations. © 2013 IMIA and IOS Press. Source

Katayama K.,Chiba University | Misawa S.,Chiba University | Sato Y.,Chiba University | Sobue G.,Nagoya University | And 12 more authors.
BMJ Open | Year: 2015

Polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome is a fatal systemic disorder associated with plasma cell dyscrasia and the overproduction of the vascular endothelial growth factor (VEGF). Recently, the prognosis of POEMS was substantially improved by introduction of therapeutic intervention for myeloma. However, no randomised clinical trial has been performed because of the rarity and severity of the disease. Methods and analysis: The Japanese POEMS syndrome with Thalidomide ( J-POST) Trial is a phase II/ III multicentre, double-blinded, randomised, controlled trial that aims to evaluate the efficacy and safety of a 24-week treatment with thalidomide in POEMS syndrome, with an additional 48-week open-label safety study. Adults with POEMS syndrome who have no indication for transplantation are assessed for eligibility at 12 tertiary neurology centres in Japan. Patients who satisfy the eligibility criteria are randomised (1:1) to receive thalidomide (100-300 mg daily) plus dexamethasone (12 mg/m2 on days 1-4 of a 28-day cycle) or placebo plus dexamethasone. Both treatments were administered for 24 weeks (six cycles; randomised comparative study period). Patients who complete the randomised study period or show subacute deterioration during the randomised period participate in the subsequent 48-week open-label safety study (long-term safety period). The primary end point of the study is the reduction rate of serum VEGF levels at 24 weeks. Ethics and dissemination: The protocol was approved by the Institutional Review Board of each hospital. The trial was notified and registered at the Pharmaceutical and Medical Devices Agency, Japan (No. 22-1716). The J-POST Trial is currently ongoing and is due to finish in August 2015. The findings of this trial will be disseminated through peer-reviewed publications and conference presentations and will also be disseminated to participants. Trial registration number: UMIN000004179 and JMA-IIA00046. Source

Imasawa T.,National Hospital Organization Chiba East Hospital | Nakazato T.,National Hospital Organization Chiba Medical Center | Ikehira H.,National Hospital Organization Chiba East Hospital | Fujikawa H.,National Hospital Organization Chiba East Hospital | And 15 more authors.
BMC Nephrology | Year: 2012

Background: The nephron number is thought to be associated with the outcome of chronic kidney disease (CKD). If the nephron number can be estimated in the clinical setting, it could become a strong tool to predict renal outcome. This study was designed to estimate the nephron number in CKD patients and to establish a method to predict the outcome by using the estimated nephron number. Methods/Design. The hypothesis of this study is that the estimated nephron number can predict the outcome of a CKD patient. This will be a multicenter, prospective (minimum 3 and maximum 5 years follow-up) study. The subjects will comprise CKD patients aged over 14 years who have undergone a kidney biopsy. From January 2011 to March 2013, we will recruit 600 CKD patients from 10 hospitals belonging to the National Hospital Organization of Japan. The primary parameter for assessment is the composite of total mortality, renal death, cerebro-cardiovascular events, and a 50% reduction in the eGFR. The secondary parameter is the rate of eGFR decline per year. The nephron number will be estimated by the glomerular density in biopsy specimens and the renal cortex volume. This study includes one sub-cohort study to establish the equation to calculate the renal cortex volume. Enrollment will be performed at the time of the kidney biopsy, and the data will consist of a medical interview, ultrasound for measurement of the kidney size, blood or urine test, and the pathological findings of the kidney biopsy. Patients will continue to have medical consultations and receive examinations and/or treatment as usual. The data from the patients will be collected once a year after the kidney biopsy until March 2016. All data using this study are easily obtained in routine clinical practice. Discussion. This study includes the first trials to estimate the renal cortex volume and nephron number in the general clinical setting. Furthermore, this is the first prospective study to examine whether the nephron number predicts the outcome of CKD patients. The results from this study should provide powerful new tools for nephrologists in routine clinical practice. Trial registration. UMIN-Clinical Trial Registration, UMIN000004784. © 2012 Imasawa et al; licensee BioMed Central Ltd. Source

Miyake N.,Yokohama City University | Tsurusaki Y.,Yokohama City University | Koshimizu E.,Yokohama City University | Okamoto N.,Osaka Medical Center and Research Institute for Maternal and Child Health | And 13 more authors.
Clinical Genetics | Year: 2016

Wiedemann-Steiner syndrome (WSS) is an autosomal dominant congenital anomaly syndrome characterized by hairy elbows, dysmorphic facial appearances (hypertelorism, thick eyebrows, downslanted and vertically narrow palpebral fissures), pre- and post-natal growth deficiency, and psychomotor delay. WSS is caused by heterozygous mutations in KMT2A (also known as MLL), a gene encoding a histone methyltransferase. Here, we identify six novel KMT2A mutations in six WSS patients, with four mutations occurring de novo. Interestingly, some of the patients were initially diagnosed with atypical Kabuki syndrome, which is caused by mutations in KMT2D or KDM6A, genes also involved in histone methylation. KMT2A mutations and clinical features are summarized in our six patients together with eight previously reported patients. Furthermore, clinical comparison of the two syndromes is discussed in detail. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Source

Takeda H.,Hokkaido University | Nakagawa K.,Hokkaido University | Okubo N.,Hokkaido University | Nishimura M.,Hokkaido University | And 5 more authors.
Biological and Pharmaceutical Bulletin | Year: 2013

Anorexia is an important issue in the management of elderly patients with cancer because it contributes to the development of malnutrition, increases morbidity and mortality, and negatively affects patients' quality of life. This review summarizes the potential mechanisms of the development of anorexia in three animal models that mimic the situations commonly seen in elderly patients receiving chemotherapy. Cisplatin-induced anorexia is attributable to a decrease in peripheral and central ghrelin secretion caused by the stimulation of serotonin (5-hydroxytryptamine; 5-HT)2B and 5-HT2C receptors via 5-HT secretion. Age-associated anorexia is caused by an increase in plasma leptin, which results from disturbed reactivity of ghrelin in the hypothalamus and regulation of ghrelin secretion. Environmental change causes the activation of central 5-HT1B and 5-HT2C receptors and the melanocortin-4 receptor system, resulting in a decrease in circulating ghrelin levels which lowers food intake. New therapeutic approaches based on these pathophysiological mechanisms are warranted for the treatment of anorexia in cancer patients, especially elderly ones. © 2013 The Pharmaceutical Society of Japan. Source

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