Kojima T.,Nagoya University |
Kaneko A.,Nagoya Medical Center |
Hirano Y.,Toyohashi Municipal Hospital |
Ishikawa H.,Red Cross |
And 17 more authors.
Modern Rheumatology | Year: 2012
Biologic agents have proven to be effective against rheumatoid arthritis (RA) in clinical trials and postmarketing surveillance (PMS) studies. However, limited follow-up periods and strict criteria for recruitment might lead to an underestimation of adverse events. To document the long-term course of patients with RA treated with biologics in clinical settings, we established the Tsurumai Biologics Communication Registry (TBCR). First, we retrospectively collected data of patients registered for any biologic PMS study or clinical trial at participatinginstitutes. Thus far, thirteen institutes have joined the registry and 860 patients have been identified. Comparing baseline characteristics by age and initiation year of biologics, young patients had significantly less joint damage and dysfunction and a higher dose of concomitant methotrexate (MTX) compared to older patients. Older age and functional class were significantly related to the incidence of adverse events that resulted in discontinuation of the 1st biologic treatment. The TBCR is in its initial stages, and information on all patients newly starting biologic therapy at participating institutes is being collected prospectively. Differences in baseline characteristics by age and initiation year of biologics need to be carefully evaluated in order to report on drug-related survival and long-term prognosis, using follow-up data in the near future. © Japan College of Rheumatology 2011.
Minamikawa Y.,Tokyo KoseiNenkin Hospital |
Sugisaki K.,Tokyo KoseiNenkin Hospital |
Tanabe T.,Tokyo KoseiNenkin Hospital |
Fujino Y.,Tokyo KoseiNenkin Hospital
Japanese Journal of Clinical Ophthalmology | Year: 2014
Purpose: To report a case who showed ocular pain and elevated intraocular pressure (IOP) during hemodialysis that responded after switching to hemofiltration. Case: A 57-year-old male presented with pain in the right eye during each session of hemodialysis. He had been diagnosed with diabetes mellitus at the age of 32 years, and started receiving hemodialysis for kidney cyst with renal failure since the age of 39 years. His mother, brother and sister had died due to kidney cyst with renal failure. Findings: He was doing well before hemodialysis with corrected visual acuity of 1.2 in either eye and IOP of 20 mmHg in the right eye and 15 mmHg in the left. Both eyes were free of diabetic retinopathy. IOP rose to 30 mmHg in the right eye and 21 mmHg in the left immediately after hemodialysis. Peroral intake of 200 ml glycerine failed to prevent IOP elevation during and after hemodialysis. Hemodialysis was switched to hemofiltration 3 months after his initial visit. IOP remained between 14 and 20 mmHg with no ocular pain after switching. Conclusion: Switching to hemofiltration was effective for ocular hypertension during hemodialysis.
Goto O.,University of Tokyo |
Fujishiro M.,University of Tokyo |
Oda I.,National Cancer Center Hospital |
Kakushima N.,Shizuoka Cancer Center |
And 12 more authors.
Digestive Diseases and Sciences | Year: 2012
Background and Aims: Bleeding is a major complication after gastric endoscopic submucosal dissection (ESD). An evidence-based strategy for postoperative care related to delayed bleeding is required. We conducted a multicenter survey to assess the current status of management after gastric ESD. Methods: A total of 1,814 gastric epithelial neoplasms in 2009 at ten tertiary referral centers were enrolled. The current status of the management after gastric ESD (use of an antisecretory drug, food intake, and second-look endoscopy) at participating hospitals was assessed. Furthermore, the rate of post-ESD bleeding and the differences in each parameter were retrospectively analyzed. Results: Postoperative bleeding occurred in 100 cases (5.5%), which included 62 cases of bleeding within 24 h after ESD. In all of the hospitals, proton pump inhibitors (PPIs) were used. The median administration period was 56 days (range 14-60 days). Food intake was resumed from postoperative day (POD) 1 in 4 hospitals and from POD 2 in 6 hospitals. Second-look endoscopy was performed for almost all cases, fewer cases, and rarely or none in 6, 2, and 2 hospitals, respectively. The day of second-look endoscopy varied among hospitals. There was no statistical relationship between the postoperative bleeding rate and the differences in these three parameters. Conclusions: Post-ESD management (duration of PPI use, resumption of food intake, and performance of second-look endoscopy) varied among the medical centers; thus, randomized controlled trials are required for an optimal strategy after gastric ESD. © 2011 Springer Science+Business Media, LLC.
PubMed | Red Cross, Kashiwa City Hospital, Tokyo Metropolitan Tama Medical Center, Kagawa Nutrition University and 12 more.
Type: Journal Article | Journal: PloS one | Year: 2015
There exists a subpopulation of T2DM in whom first-line doses of statin are insufficient for optimally reducing LDL-C, representing a major risk of CVD. The RESEARCH study focuses on LDL-C reduction in this population along with modifications of the lipid profiles leading to residual risks.Lipid changes were assessed in a randomized, multicenter, 12-week, open-label study comparing a high-potency statin (10mg of atorvastatin or 1mg of pitavastatin) plus ezetimibe (EAT: n = 53) with a double dose of statin (20mg of atorvastatin or 2mg of pitavastatin) (DST: n = 56) in DM subjects who had failed to achieve the optimal LDL-C targets. Lipid variables were compared with a primary focus on LDL-C and with secondary focuses on the percentage of patients who reached the LDL-C targets and changes in the levels of RLP-C (remnant like particle cholesterol) and sd-LDL-C, two characteristic atherogenic risks of DM.The reduction of LDL-C (%), the primary endpoint, differed significantly between the two groups (-24.6 in EAT vs. -10.9 in DST). In the analyses of the secondary endpoints, EAT treatment brought about significantly larger reductions in sd-LDL-C (-20.5 vs. -3.7) and RLP-C (-19.7 vs. +5.5). In total, 89.4% of the patients receiving EAT reached the optimized treatment goal compared to 51.0% of the patients receiving DST. The changes in TC (-16.3 vs. -6.3) and non-HDL-C (-20.7 vs. -8.3) differed significantly between the two groups.Ezetimibe added to high-potency statin (10 mg of atorvastatin or 1 mg of pitavastatin) was more effective than the intensified-dose statin (20 mg of atorvastatin or 2 mg of pitavastatin) treatment not only in helping T2DM patients attain more LDL-C reduction, but also in improving their atherogenic lipid profiles, including their levels of sd-LDL-C and RLP-C. We thus recommend the addition of ezetimibe to high-potency statin as a first line strategy for T2DM patients with insufficient statin response.The UMIN Clinical Trials Registry UMIN000002593.
Nomiya T.,Japan National Institute of Radiological Sciences |
Tsuji H.,Japan National Institute of Radiological Sciences |
Maruyama K.,Japan National Institute of Radiological Sciences |
Toyama S.,Japan National Institute of Radiological Sciences |
And 6 more authors.
British Journal of Cancer | Year: 2014
Background:The purpose of this study was to evaluate the feasibility of a new shortened 3-week treatment schedule of carbon ion radiotherapy (CIRT) for prostate cancer.Methods:Beginning in May 2010, patients with T1b-T3bN0M0, histologically proven prostate adenocarcinoma were enrolled in the phase II trial of CIRT. Patients received 51.6 GyE in 12 fractions over 3 weeks (protocol 1002). The primary end point was defined as the incidence of late adverse events that were evaluated based on the Common Terminology Criteria for Adverse Events version 4.0. Biochemical failure was determined using the Phoenix definition (nadir +2.0 ng ml -1).Results:Forty-six patients were enrolled, and all patients were included in the analysis. The number of low-, intermediate-, and high-risk patients was 12 (26%), 9 (20%), and 25 (54%), respectively. The median follow-up period of surviving patients was 32.3 months. Two patients had intercurrent death without recurrence, and the remaining 44 patients were alive at the time of this analysis. In the analysis of late toxicities, grade 1 (G1) rectal haemorrhage was observed in 3 (7%) patients. The incidence of G1 haematuria was observed in 6 (13%) patients, and G1 urinary frequency was observed in 17 (37%) patients. No ≥G2 late toxicities were observed. In the analysis of acute toxicities, 2 (4%) patients showed G2 urinary frequency, and no other G2 acute toxicities were observed.Conclusions:The new shortened CIRT schedule over 3 weeks was considered as feasible. The analysis of long-term outcome is warranted. © 2014 Cancer Research UK.
Clinical comparison of human and canine atopic dermatitis using human diagnostic criteria (Japanese Dermatological Association, 2009): Proposal of provisional diagnostic criteria for canine atopic dermatitis
Terada Y.,ASC Dermatology Service |
Nagata M.,ASC Dermatology Service |
Murayama N.,ASC Dermatology Service |
Nanko H.,Tokyo Koseinenkin Hospital |
Furue M.,Kyushu University
Journal of Dermatology | Year: 2011
Atopic dermatitis (AD) is a common skin disease encountered in both humans and dogs. Canine AD can be used in the analysis of naturally occurring AD; however, details of clinical comparison have been lacking. The purpose of this study is to compare those clinical features using the human diagnostic criteria (Japanese Dermatological Association, 2009). Fifty-one dogs with canine AD were evaluated by the human criteria. Prior to this study, canine AD was basically diagnosed by the fulfillment of two authentic canine AD criteria and a positive reaction against Dermatophagoides farinae in serum immunoglobulin E levels and/or in intradermal tests. Among the human AD criteria items, behavior corresponding to pruritus was observed in all 51 dogs. Skin lesions corresponding to eczematous dermatitis were seen in 50 dogs, and symmetrical distribution of skin lesions was noted in all 51 dogs. A chronic or chronically relapsing course was observed in 50 dogs. Based on these results, the concordance rate for the criteria was 96% (49/51). Differential diagnoses of AD were also investigated in the same manner. The concordance rate for the criteria was 0% (0/69) in scabies, 2% (1/50) in pyoderma, 0% (0/50) in demodicosis, 0% (0/9) in cutaneous lymphoma, 0% (0/2) in ichthyosis, 25% (2/7) in flea allergy, 48% (24/50) in seborrheic dermatitis and 75% (3/4) in food allergy. Canine AD is thus indicated as a valuable counterpart to human AD in clinical aspects. In addition, the human AD criteria could be applicable, with some modification, as provisional diagnostic criteria for canine AD. © 2011 Japanese Dermatological Association.
Nishimura T.,Chiyoda Corporation |
Furihata M.,Chiyoda Corporation |
Kubo H.,Chiyoda Corporation |
Tani M.,Chiyoda Corporation |
And 3 more authors.
World Journal of Gastroenterology | Year: 2011
Treatment with bevacizumab, an antiangiogenic agent, in patients with metastatic or unresectable colorectal cancer was approved less than 4 years ago in Japan. Bevacizumab improves the survival of patients with metastatic colorectal cancer; however, it may lead to complications such as bleeding, which are sometimes fatal. Bevacizumab should be administered only after careful consideration because the potential risks of therapy outweigh its benefits. Therefore, pharmaceutical companies do not recommend bevacizumab therapy for patients with brain metastases. While some reports support the cautious use of bevacizumab, others report that it is not always necessary to prohibit its use in patients with metastases to the central nervous system (CNS), including the brain. Thus, bevacizumab therapy in colorectal cancer patients with brain metas-tases is controversial, and it is unclear whether brain metastases are a risk factor for intracranial hemorrhage during anti-vascular endothelial growth factor (VEGF) therapy. We report a 64-year-old man and a 65-year-old man with recurrent colorectal cancer without brain metastases; these patients developed multi-focal and solitary intracranial hemorrhage, respectively, after the administration of bevacizumab. Our fndings suggest that intracranial hemorrhage can occur even if the patient does not have brain metastases prior to bevacizumab treatment and also suggest that brain metastases are not a risk factor for intracranial hemorrhage with bevacizumab treatment. These fndings also question the necessity of excluding patients with brain metastases from clinical trials on anti-VEGF therapy. © 2011 Baishideng. All rights reserved.
Okamoto M.,University of Tokyo |
Sugisaki K.,University of Tokyo |
Sugisaki K.,Tokyo Koseinenkin Hospital |
Murata H.,University of Tokyo |
And 3 more authors.
Scientific Reports | Year: 2014
The purpose of the study was to investigate the influence of VF and the VA on vision related quality of life (VRQoL) in advanced glaucoma. Subjects consist of 50 glaucoma patients with mean deviation (MD) less than -20 dB in at least one eye. Patients' VRQoL was assessed using the 'Sumi questionnaire'. The impact of seven visual measures on VRQoL were compared using principal component regression: MDs of better and worse eyes with 10-2 and 24-2 Humphrey VFs, LogMAR VAs of better and worse eyes and the Esterman score. The root mean of the squared prediction error (RMSE) was calculated using leave-one-out cross validation. Better eye summary measurements were much more influential on VRQoL than corresponding worse eye measurements and Esterman score in every VRQoL task. In conclusion, in advanced glaucoma, VF parameters of the better eye are important for the VRQoL of the patient.
Murata H.,University of Tokyo |
Hirasawa H.,University of Tokyo |
Aoyama Y.,University of Tokyo |
Sugisaki K.,University of Tokyo |
And 6 more authors.
PLoS ONE | Year: 2013
Purpose: The purpose of this study was to create a vision-related quality of life (VRQoL) prediction system to identify visual field (VF) test points associated with decreased VRQoL in patients with glaucoma. Method: VRQoL score was surveyed in 164 patients with glaucoma using the 'Sumi questionnaire'. A binocular VF was created from monocular VFs by using the integrated VF (IVF) method. VRQoL score was predicted using the 'Random Forest' method, based on visual acuity (VA) of better and worse eyes (better-eye and worse-eye VA) and total deviation (TD) values from the IVF. For comparison, VRQoL scores were regressed (linear regression) against: (i) mean of TD (IVF MD); (ii) better-eye VA; (iii) worse-eye VA; and (iv) IVF MD and better- and worse-eye VAs. The rank of importance of IVF test points was identified using the Random Forest method. Results: The root mean of squared prediction error associated with the Random Forest method (0.30 to 1.97) was significantly smaller than those with linear regression models (0.34 to 3.38, p<0.05, ten-fold cross validation test). Worse-eye VA was the most important variable in all VRQoL tasks. In general, important VF test points were concentrated along the horizontal meridian. Particular areas of the IVF were important for different tasks: peripheral superior and inferior areas in the left hemifield for the 'letters and sentences' task, peripheral, mid-peripheral and para-central inferior regions for the 'walking' task, the peripheral superior region for the 'going out' task, and a broad scattered area across the IVF for the 'dining' task. Conclusion: The VRQoL prediction model with the Random Forest method enables clinicians to better understand patients' VRQoL based on standard clinical measurements of VA and VF. © 2013 Murata et al.
PubMed | Tokyo Koseinenkin Hospital
Type: Journal Article | Journal: Anatomia, histologia, embryologia | Year: 2012
The anatomy of the brachial plexus in the common hippopotamus (Hippopotamus amphibius), which has not been previously reported, was first examined bilaterally in a newborn hippopotamus. Our observations clarified the following: (1) the brachial plexus comprises the fifth cervical (C5) to first thoracic (T1) nerves. These formed two trunks, C5-C6 and C7-T1; in addition, the axillary artery passed in between C6 and C7, (2) unique branches to the brachialis muscle and those of the lateral cutaneous antebrachii nerves ramified from the median nerve, (3) nerve fibre analysis revealed that these unique nerve branches from the median nerve were closely related and structurally similar to the musculocutaneous (MC) nerve; however, they had changed course from the MC to the median nerve, and (4) this unique branching pattern is likely to be a common morphological feature of the brachial plexus in amphibians, reptiles and certain mammals.