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PubMed | Fukushima Medical University, Fukuoka Childrens Hospital and Medical Center for Infectious Diseases, National Hospital Organization Kagoshima Medical Center, University of Tsukuba and 5 more.
Type: Journal Article | Journal: European journal of pediatrics | Year: 2016

While the prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, this decline has plateaued recently. Strategies are needed to resume the constant decrease of SIDS in Japan. A prospective electrocardiographic screening program for infants was performed between July 2010 and March 2011. Parents of 4319 infants were asked about environmental factors related to SIDS through questionnaires at a one-month medical checkup and one year. Parental awareness of prone position, smoke exposure, and breast feeding as environmental factors were 81.4%, 69.0%, and 47.8%, respectively. The prevalence of laying infants exclusively in a supine position was 96.7%. At the one-month medical checkup, smoking prevalence was 41.7% in fathers and 2.1% in mothers. Maternal smoking prevalence was significantly increased at one year after (p<0.001). Multivariate regression analysis showed that risk factors for new or continued maternal smoking habits were maternal smoking habits at one month (p<0.001), paternal smoking habits one year later (p<0.001), and younger maternal age (p=0.02).Most parents already avoid laying infants in the prone position, and parental smoking is still a SIDS risk concern in Japan. Smoking cessation programs should be further implemented for parents to decrease risks of SIDS in Japan. What is Known: The prevalence of sudden infant death syndrome (SIDS) has decreased worldwide, however, this decline has plateaued recently. What is New: Most infants were laid sleeping in the supine position (96.7%) and were fed breast milk or a mix of expressed milk and formula (92.7%), and 2.1% of mothers smoked at the one-month medical checkup. Maternal smoking prevalence significantly increased from the one-month medical checkup to one year later, and smoking mothers were more likely to feed infants by formula rather than breast milk. Independent risk factors for new or continued maternal smoking habits included younger maternal age, maternal smoking habits at one month, and paternal smoking habits one year later.


Watanabe S.,Niigata University | Minegishi Y.,Infections Disease and Oncology | Yoshizawa H.,Niigata University | Maemondo M.,Miyagi Cancer Center | And 8 more authors.
Journal of Thoracic Oncology | Year: 2014

INTRODUCTION:: In non-small-cell lung cancer, an exon 19 deletion and an L858R point mutation in the epidermal growth factor receptor (EGFR) are predictors of a response to EGFR-tyrosine kinase inhibitors. However, it is uncertain whether other uncommon EGFR mutations are associated with sensitivity to EGFR-tyrosine kinase inhibitors. METHODS:: A post-hoc analysis to assess prognostic factors was performed with the use of patients with EGFR mutations (exon 19 deletion, L858R, G719X, and L861Q) who were treated with gefitinib in the NEJ002 study, which compared gefitinib with carboplatin-paclitaxel as the first-line therapy. RESULTS:: In the NEJ002 study, 225 patients with EGFR mutations received gefitinib at any treatment line. The Cox proportional hazards model indicated that performance status, response to chemotherapy, response to gefitinib, and mutation types were significant prognostic factors. Overall survival (OS) was significantly shorter among patients with uncommon EGFR mutations (G719X or L861Q) compared with OS of those with common EGFR mutations (12 versus 28.4 months; p = 0.002). In the gefitinib group (n = 114), patients with uncommon EGFR mutations had a significantly shorter OS (11.9 versus 29.3 months; p < 0.001). By contrast, OS was similar between patients with uncommon mutations and those with common mutations in the carboplatin-paclitaxel group (n = 111; 22.8 versus 28 months; p = 0.358). CONCLUSIONS:: The post-hoc analyses clearly demonstrated shorter survival for gefitinib-treated patients with uncommon EGFR mutations compared with the survival of those with common mutations and suggest that the first-line chemotherapy may be relatively effective for non-small-cell lung cancer with uncommon EGFR mutations. © 2013 by the International Association for the Study of Lung Cancer.


Vivat B.,Brunel University | Young T.,Mount Vernon Cancer Center | Efficace F.,Health Outcomes Research Unit | Siguradottir V.,University of Iceland | And 6 more authors.
Palliative Medicine | Year: 2013

Background: No existing stand-alone measures of spiritual wellbeing have been developed in cross-cultural and multiple linguistic contexts. Aim: Cross-cultural development of a stand-alone European Organisation for Research and Treatment of Cancer (EORTC) measure of spiritual wellbeing for palliative care patients with cancer. Design: Broadly following EORTC Quality of Life Group (QLG) guidelines for developing questionnaires, the study comprised three phases. Phase I identified relevant issues and obtained the views of palliative care patients and professionals about those issues. Phase II operationalised issues into items. Phase III pilot-tested those items with palliative care patients. Amendments to the guidelines included an intermediate Phase IIIa, and debriefing questions specific to the measure. Setting/participants: Phase III pilot-testing recruited 113 people with incurable cancer from hospitals and hospices in six European countries and Japan. Results: A provisional 36-item measure ready for Phase IV field-testing, the EORTC QLQ-SWB36, has been developed. Careful attention to translation and simultaneous development in multiple languages means items are acceptable and consistent between different countries and languages. Phase III data from 113 patients in seven countries show that the items are comprehensible across languages and cultures. Phase III patient participants in several countries used the measure as a starting point for discussing the issues it addresses. Conclusion: The EORTC QLG's rigorous cross-cultural development process ensures that the EORTC QLQ-SWB36 identifies key issues for spiritual wellbeing in multiple cultural contexts, and that items are comprehensible and consistent across languages. Some cross-cultural differences were observed, but data were insufficient to enable generalisation. Phase IV field-testing will investigate these differences further. © 2012 The Author(s).


PubMed | Tokyo Metropolitan Geriatric Hospital, Shizuoka Institute of Epilepsy and Neurological Disorders and Saitama International Medical Center
Type: Case Reports | Journal: Neuropathology : official journal of the Japanese Society of Neuropathology | Year: 2016

We describe a woman with a 13-year history of postural instability, vertical gaze palsy and dopa-responsive parkinsonism - a clinical profile that corresponds to progressive supranuclear palsy (PSP) and Parkinsons disease (PD). The patient died at the age of 82years. Neuropathological features included neuronal loss and gliosis in the substantia nigra, locus ceruleus, dorsal motor nucleus of the vagus, thoracic intermediolateral nucleus and nucleus basalis of Meynert, in addition to the typical pathology of PSP. Immunohistochemical studies demonstrated that PSP-tau pathology was localized in the central nervous system, but Lewy body-related -synucleinopathy was extensive in the central and peripheral nervous systems. Although PSP and PD may represent independent processes, this case could provide insight into a common defect in either protein phosphorylation or the proteinase surveillance system that contributes to human aging.


Van Der Kloot W.A.,Leiden University | Kobayashi K.,Saitama International Medical Center | Yamaoka K.,University of Tokyo | Inoue K.,Saitama Cancer Center | And 2 more authors.
Journal of Psychosocial Oncology | Year: 2014

The intercorrelations among the 15 scales of the 30-item Core version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire suggest that one may combine (1) the physical functioning and role functioning scales, (2) the emotional functioning and cognitive functioning scales, and (3) the nine symptom scales. Together with the global health/quality of life scale and the social functioning scale, five measures remain. Principal component analysis of those five measures, using data from Japanese and Dutch breast and lung cancer patients, yielded two dimensions: (1) generalized health related quality of life and (2) health-independent psychological well-being. The correlations of these dimensions with the Brief Illness Perception Questionnaire and Karnofsky performance substantiated this interpretation. Copyright © 2014 Taylor & Francis Group, LLC.


Nishibe S.,Saitama International Medical Center | Tsujita M.,Saitama International Medical Center
Interactive Cardiovascular and Thoracic Surgery | Year: 2012

Objectives: Although recent advances have led to a better understanding of the beneficial effects of vasopressin on haemodynamics in paediatric cardiac surgery, not much information is available on the adverse effects. The objective of this study was to assess the impact of intraoperative vasopressin infusion on postoperative liver, renal and haemostatic function and lactate levels in neonates undergoing cardiac surgery. Method: We reviewed data from 34 consecutive neonates who had undergone complex cardiac surgery. The cohort was divided into two groups according to the use of vasopressin. Seventeen patients received vasopressin [vasopressin (+) group], and 17 patients did not [vasopressin (-) group]. Results: No differences between the groups in terms of age, weight, cardiopulmonary bypass time, Risk Adjustment for Congenital Heart Surgery-1 score or the comprehensive Aristotle score were seen. No differences in the systolic or diastolic arterial blood pressures, heart rate or inotropic score upon admission to the intensive care unit were observed between the groups. No adverse effects on the aminotransferase levels were seen. The vasopressin (+) group had higher urea and creatinine levels. All the patients except one received peritoneal dialysis on the day of surgery. Thirteen patients in the vasopressin (+) group and 7 patients in the vasopressin (-) group continued to require peritoneal dialysis on postoperative day 5 (POD 5) (P = 0.04). The platelet count had decreased to a significantly lower level in the vasopressin (+) group on POD 5 [97 × 103/mm3 (range: 40-132 × 103/mm3)]. A tendency toward a high lactate concentration was seen in the vasopressin (+) group. In comparison with the vasopressin (-) group, the number of patients whose lactate level remained above 2.0 mmol/l was higher in the vasopressin (+) group on PODs 2 and 3 (17 patients vs 8 patients, P < 0.01 and 15 patients vs 7 patients, P = 0.01, respectively). Conclusion: These findings suggest that the intraoperative use of vasopressin extends the period of peritoneal dialysis, reduces platelet counts and delays the recovery of the lactate concentration. Intraoperative vasopressin infusion should not be used routinely, but only in catecholamine-refractory shock. © 2012 The Author. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


So E.Y.,University of Chicago | Ausman M.,University of Chicago | Saeki T.,Saitama International Medical Center | Ouchi T.,University of Chicago
Cell Death and Disease | Year: 2011

DNA damage signaling pathways are initiated in response to chemical reagents and radiation damage, as well as in response to hypoxia. It is implicated that structural maintenance of chromosomes 1 (SMC1) is not only a component of the cohesion complex but also facilitates the activation of DNA damage checkpoint proteins. Here, we studied the mechanism of DNA damage checkpoint activated by ATR-SMC1 pathway when cells are treated with desferrioxamine (DFO), a hypoxia-mimetic reagent. We show that DFO treatment induces phosphorylation of SMC1 at Ser966, NBS1 at Ser343, Chk1 at Ser317, Chk2 at Thr68, and p53 at Ser15. Among these sites, phosphorylation of SMC1, NBS1, and Chk1 by DFO are mediated by ATR as it is greatly reduced in both ATR-deficient human fibroblasts and HCT116 human colon cancer cells in which ATR is heterozygously mutated, whereas these proteins are phosphorylated in cells deficient for ATM and DNA-PKcs. DFO-induced apoptosis is decreased in ATR-mutant HCT116 cells, although p53 is normally activated in those cells. Expression of SMC1 S966A in which Ser966 is substituted to Ala attenuates apoptosis and phosphorylation of Chk1 at Ser317 after DFO treatment, although levels of HIF1a are not significantly changed. These results suggest that DFO induces apoptosis through the ATR-SMC1 arm of the pathway. © 2011 Macmillan Publishers Limited All rights reserved.


Hagiwara K.,Saitama University | Kobayashi K.,Saitama International Medical Center
Cancer Science | Year: 2013

Mutations in the epidermal growth factor receptor (EGFR) gene confer it with cancer driver gene functions in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor -tyrosine kinase inhibitors are effective agents against NSCLC with a mutated EGFR gene. Accordingly, many guidelines recommend the use of an EGFR mutation test in NSCLC. However, not all patients are tested in most countries where tissue samples are mainly used for the test. As of 2011, most of the patients with advanced NSCLC are tested in Japan, and the use of cytological samples has significantly contributed to this success. A portion of samples used to determine a definite diagnosis of NSCLC, either tissue samples or cytological samples, is ensured to contain cancer cells, and is then investigated by an EGFR mutation test that is applicable to both tissue samples and cytological samples. Cytological samples now account for one-third of all the samples investigated. EGFR mutation is detected in cytological samples at a similar rate with tissue samples. The criterion ensuring an EGFR mutation test to have satisfactory sensitivity and specificity for use in both tissue and cytological samples is presented. Cytological samples are valuable clinical sources being collected less invasively than tissue samples, and should therefore be extensively used in EGFR mutation testing. © 2012 Japanese Cancer Association.


PubMed | Saitama Cancer Center, Leiden University, Nippon Medical School, Alrijne Hospital and 2 more.
Type: Journal Article | Journal: Lung cancer (Amsterdam, Netherlands) | Year: 2016

This study reviews empirical studies in the area of illness perceptions in patients with non-small-cell lung cancer (NSCLC). Beliefs about the illness and its consequences, including its medical management, are part of the review. Also, the relatively small research area of perceptions and views about patients with NSCLC of caregivers and health care providers is reviewed. Given our earlier review of the topic in this Journal [5], we now report on papers published after that 2011 publication. 38 papers were identified, a quite major increase in published research compared to the 15 papers in our previous publication (2011 and earlier). Most papers report on psychosocial concepts that determine responses to the illness and its treatment. Increasingly, reactions of caregivers and health care providers are studied. These last two categories of respondents perceive the psychosocial consequences of NSCLC as more severe than the patients themselves. Psychosocial variables appear to be stronger predictors of psychological distress and reduced quality of life than sociodemographic or clinical variables. These results are instrumental in the developing field of psychosocial interventions for patients with non-small-cell lung cancer and their caregivers, which may also be helpful for health care providers. Suggestions for research and clinical implications are presented.


PubMed | Leiden University, Teikyo University, Saitama Cancer Center and Saitama International Medical Center
Type: Journal Article | Journal: Chinese clinical oncology | Year: 2016

Responses to diagnosis and treatment of cancer are mediated by a patients illness perceptions. Such perceptions, though different among individuals, may be culturally dependent, and act upon health related quality of life (HRQOL). Over time, individual patients show different types of response trajectories. Four issues were investigated: (I) country and disease differences in illness beliefs between Japanese and Dutch patients with lung or breast cancer; (II) country and disease differences in HRQOL in early chemotherapy; (III) individual, country, and disease differences among HRQOL trajectories; (IV) the impact of illness beliefs on HRQOL trajectories.A total of 89 Japanese and Dutch patients with lung or breast cancer cooperated immediately before, one week after, and eight weeks after the start of chemotherapy. Data included the EORTC QLQ-C30 quality of life (QL) questionnaire and the Brief Illness Perception Questionnaire (B-IPQ). EORTC QLQ-C30 scales were summarized by two dimensions: generalized quality of life (GENQOL) and psychological well-being (PSYQOL).(I) Japanese patients had higher means on B-IPQs concern and time line than Dutch patients. Japanese lung cancer patients had a higher mean on treatment control than all other patients; (II) no differences between country and cancer type occurred on the two HRQOL dimensions. First assessment HRQOL differed significantly from the second and third assessments without differences between the latter two. Between the first two assessments, a decrease in GENQOL occurred, together with an improvement in PSYQOL; (III) individual differences dominated the trajectories; (IV) negative beliefs usually coincided with lower scores on GENQOL and PSYQOL. Patients initially lower on PSYQOL generally showed larger improvement.Individual differences in HRQOL dominate differences between culture and cancer type, and illness beliefs influence HRQOL changes in individual patients. Clinical application is possible through influencing the patients illness beliefs to create an optimal starting position for chemotherapy.

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