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Fukuoka-shi, Japan

Nakashima Y.,Kyushu University | Kondo M.,Kondo Clinic of Rheumatology and Orthopaedic Surgery | Fukuda T.,Kurume University | Harada H.,Morooka Orthopedic Clinic | And 18 more authors.
Modern Rheumatology | Year: 2014

Objectives. This study aimed to evaluate the remission in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ), based on prospectively registered data in clinical practice. Methods. We studied 114 consecutive RA patients treated with TCZ for an average of 3.5 years. Remission was evaluated by using the EULAR criteria and the new ACR/EULAR Boolean-based criteria. Results. Among 114 patients (average age 52.2 years; average disease duration 10.6 years), 76 (67 %) had previously received anti-TNF biologics. Mean baseline DAS28-ESR of 5.4 and improved to 2.4 at 36 months. Overall, DAS28-ESR <2.6 was attained by 66.7 %, while ACR/EULAR remission was attained by 35.1 %. ACR/EULAR remission rate was significantly higher in the patients who were biologics-naïve and had good response at the first month. Among 23 patients who completed the treatment for 3 years and had ACR/EULAR remission at 1 year, 15 (65 %) remained in the remission and 16 (70 %) had a DAS28-ESR <2.6 at the final follow-up. The retention rate at 36 months was 68.2 %. Conclusions. In patients with RA, TCZ is highly effective for both biologics-naïve patients and patients previously exposed to biologics, achieving a high remission rate and drug continuation rate (68.2 %) in clinical practice. © 2014 Japan College of Rheumatology. Source


Kawasaki T.,University of Occupational and Environmental Health Japan | Kawasaki C.,Sugioka Memorial Hospital | Ueki M.,University of Occupational and Environmental Health Japan | Hamada K.,University of Occupational and Environmental Health Japan | And 2 more authors.
Journal of Trauma and Acute Care Surgery | Year: 2013

Background: It has been demonstrated that proinflammatory mediators increase in patients with sepsis, trauma, and burns. These mediators are associated with the development of septic shock and organ dysfunction. Dexmedetomidine (DEX), a selective agonist of the α2-adrenergic receptors, is used in intensive care units for sedation. However, it still remains unclear whether DEX administration has any effects on the production of proinflammatory mediators. In this study, we investigated the effects of DEX on lipopolysaccharide (LPS)-induced production of tumor necrosis factor α, interleukin 6 (IL-6), IL-8, and high-mobility group box 1 protein in human whole blood. Methods: Human whole blood was cultured with LPS for up to 24 hours, and LPS-induced proinflammatory mediator production was measured. Next, we tested the effect of DEX on whole blood proinflammatory mediator production. Human whole blood was cultured with LPS and various concentrations of DEX for 12 hours. Then, we investigated the influence of yohimbine, an antagonist of the α2-adrenergic receptors, on the effects of DEX. The effect of DEX on necrosis factor κB (NFκB) activation was also investigated. Results: DEX suppressed tumor necrosis factor α, IL-6, IL-8, and high-mobility group box 1 protein production in human whole blood. The suppressing effects of DEX on proinflammatory mediator production were reversed by yohimbine. The Results suggested that the mechanism for the suppressive effects of DEX on proinflammatory mediator production is meditated via α2-adrenergic receptors. These effects of DEX also include an inhibitory effect on NFκB activation. Conclusion: We demonstrate the suppressing effect of DEX on inflammatory mediator production in human whole blood after LPS stimulation. The mechanism for the suppressive effect of DEX on proinflammatory mediator production may be through the α2-adrenergic receptors and NFκB inhibition. © 2013 Lippincott Williams and Wilkins. Source


Mohd Afzan M.A.,Kyushu University | Mohd Afzan M.A.,University Technology of MARA | Todo M.,Kyushu University | Nagamine R.,Sugioka Memorial Hospital | Hirokawa S.,Saga University
Applied Mechanics and Materials | Year: 2013

Characterizing the relative performance between mobile bearing and fixed bearing knee prosthesis remains seen as a difficult task as the previous short-term and mid-term clinical studies disable to observe any evidence of superiority of one design over another. The aim of the present study is to characterize the mechanics comparison between both designs of prosthesis during deep flexional motion with tibial rotation. Three dimensional (3D) FE model of clinically used mobile bearing posterior stabilized (PS) prosthesis was developed from its CAD data. Explicit finite element model was used to simulate the dynamic loaded deep flexional motion from 0 to 135° with neutral and 10° tibial rotation. Fixed bearing prosthesis was represented by fixing the tibial insert to the tibial component. The fixed bearing design was found relatively sensitive to flexion motion and tibial rotation in terms of contact area and maximum shear stress as compared to the mobile bearing design. Tibial rotation increased the peak value of maximum shear stress up to 58 MPa for the fixed bearing, on the contrary, the mobile bearing maintained the peak value of maximum shear stress at 31 MPa even with tibial axial rotation. The influence of post-cam design was also discussed in this study. The mobile bearing has an ability to maintain conformity and relatively low shear stress during very deep flexion with tibial axial rotation in comparison to the fixed bearing. © (2013) Trans Tech Publications, Switzerland. Source


Mohd Anuar M.A.,Kyushu University | Mohd Anuar M.A.,University Technology of MARA | Todo M.,Kyushu University | Nagamine R.,Sugioka Memorial Hospital | Hirokawa S.,Kyushu University
Scientific World Journal | Year: 2014

The primary objective of this study is to distinguish between mobile bearing and fixed bearing posterior stabilized knee prostheses in the mechanics performance using the finite element simulation. Quantifying the relative mechanics attributes and survivorship between the mobile bearing and the fixed bearing prosthesis remains in investigation among researchers. In the present study, 3-dimensional computational model of a clinically used mobile bearing PS type knee prosthesis was utilized to develop a finite element and dynamic simulation model. Combination of displacement and force driven knee motion was adapted to simulate a flexion motion from 0° to 135° with neutral, 10°, and 20° internal tibial rotation to represent deep knee bending. Introduction of the secondary moving articulation in the mobile bearing knee prosthesis has been found to maintain relatively low shear stress during deep knee motion with tibial rotation. © 2014 Mohd Afzan Mohd Anuar et al. Source


Nakashima Y.,Kyushu University | Kondo M.,Kondo Clinic of Rheumatology and Orthopaedic Surgery | Fukuda T.,Kurume University | Harada H.,Morooka Orthopedic Clinic | And 18 more authors.
Modern Rheumatology | Year: 2013

Objectives: This study aimed to evaluate the remission in rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ), based on prospectively registered data in clinical practice. Methods: We studied 114 consecutive RA patients treated with TCZ for an average of 3.5 years. Remission was evaluated by using the EULAR criteria and the new ACR/EULAR Boolean-based criteria. Results: Among 114 patients (average age 52.2 years; average disease duration 10.6 years), 76 (67 %) had previously received anti-TNF biologics. Mean baseline DAS28-ESR of 5.4 and improved to 2.4 at 36 months. Overall, DAS28-ESR <2.6 was attained by 66.7 %, while ACR/EULAR remission was attained by 35.1 %. ACR/EULAR remission rate was significantly higher in the patients who were biologics-naïve and had good response at the first month. Among 23 patients who completed the treatment for 3 years and had ACR/EULAR remission at 1 year, 15 (65 %) remained in the remission and 16 (70 %) had a DAS28-ESR <2.6 at the final follow-up. The retention rate at 36 months was 68.2 %. Conclusions: In patients with RA, TCZ is highly effective for both biologics-naïve patients and patients previously exposed to biologics, achieving a high remission rate and drug continuation rate (68.2 %) in clinical practice. © 2013 Japan College of Rheumatology. Source

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